bluuebunny/crossref_metadata_2025 huggingface dataset:
Statin Discontinuation in Nursing Home Residents with Advanced Dementia
Authors: Tjia Jennifer , Cutrona Sarah L. , Peterson Daniel , Reed George , Andrade Susan E. , Mitchell Susan L.
Published: November 2014

Objectives

To describe patterns of, and factors associated with, statin use and discontinuation in nursing home (NH) residents progressing to advanced dementia and followed for at least 90 days.

Design

Retrospective inception cohort using a dataset linking 2007 to 2008 Minimum Data Set (MDS) to Medicare denominator and Part D files.

Setting

All NHs in five states (Minnesota, Massachusetts, Pennsylvania, California, Florida).

Participants

NH residents with dementia.

Measurements

Residents who developed advanced dementia were observed from baseline (date of progression to very severe cognitive impairment with eating problems) and followed for at least 90 days to statin discontinuation or death. Logistic regression was used to identify baseline factors associated with statin use. Cox proportional hazard regression was used to identify factors associated with time to statin discontinuation.

Results

Of 10,212 residents, 16.6% (n = 1,699) used statins. Greater odds of statin use were associated with having diabetes mellitus (adjusted odds ratio (AOR) = 1.24, 95% confidence interval (CI) = 1.09–1.40), stroke (AOR = 1.31, 95% CI = 1.16–1.48), and hypertension (AOR = 1.35, 95% CI = 1.18–1.54); hospice enrollment was associated with lower odds (AOR = 0.75, 95% CI = 0.64–0.89). In follow‐up, 37.2% (n = 632) discontinued statins. Median time to discontinuation was 36 days (interquartile range 12–110 days). Shorter time to discontinuation was associated with hospitalization in past 30 days (adjusted hazard ratio (AHR) = 1.67, 95% CI = 1.40–1.99) and more daily medications (AHR = 1.02, 95% CI = 1.01–1.04). When statins were discontinued, 15.0% (n = 95) of residents stopped only statins, and 47.5% (n = 300) stopped at least one other medication.

Conclusion

Most NH residents who use statins at the time of progression to advanced dementia continue use in follow‐up.
Frailty Status Can Predict Further Lean Body Mass Decline in Older Adults
Authors: Jung Hee‐Won , Kim Sun‐Wook , Lim Jae‐Young , Kim Ki‐Woong , Jang Hak Chul , Kim Cheol‐Ho , Kim Kwang‐il
Published: November 2014

Objectives

To assess whether frailty is a risk factor for skeletal muscle mass decline in community‐dwelling elderly people.

Design

Prospective observational cohort study.

Setting

Seongnam, Gyeongi Province, Korea.

Participants

Community‐dwelling Koreans aged 65 and older (n = 341).

Measurements

Bioimpedance analysis (BIA) was used to measure body composition at baseline and 5 years later. Laboratory examination and comprehensive geriatric assessment were performed at both times. Lean mass index (LMI) was defined as total body lean mass/height2. A decrease of more than 5% in the LMI was considered to be significant. Frailty status was defined using the Cardiovascular Health Study criteria.

Results

LMI decline occurred in 196 (54.1%) subjects during the follow‐up period (5.0 ± 0.7 years). Baseline LMI was highest in robust (17.6 ± 1.8 kg/m2, n = 126), lower prefrail (17.0 ± 1.7 kg/m2, n = 185), and lowest in frail (16.7 ± 1.3 kg/m2, n = 30) subjects (P < .001). Frailty status was associated with LMI decline at 5‐year follow‐up (robust 0.81 ± 0.78 kg/m2, prefrail 1.00 ± 0.92 kg/m2, frail 1.35 ± 0.85 kg/m2, P < .001). This effect of frailty on LMI decline persisted after adjusting for covariables (P = .02). The risk of significant LMI decline was 2.9 times as great in frail elderly adults as in those who were robust even after adjusting for covariates (95% confidence interval = 1.01–8.55).

Conclusion

Frailty status was found to be independently associated with subsequent LMI decline in community‐dwelling older adults.
Community‐Acquired Meningitis in Older Adults: Clinical Features, Etiology, and Prognostic Factors
Authors: Wang Amy Y. , Machicado Jorge D. , Khoury Nabil T. , Wootton Susan H. , Salazar Lucrecia , Hasbun Rodrigo
Published: November 2014

Objectives

To investigate the epidemiology and outcomes of community‐acquired meningitis in older adults.

Design

Retrospective study.

Setting

Participants adults in Houston, Texas, with community‐acquired meningitis hospitalized between January 1, 2005, and January 1, 2010 (N = 619; n = 54, 8.7%, aged ≥65; n = 565 aged <65).

Methods

An adverse clinical outcome was defined as a Glasgow Outcome Scale score of 4 or less.

Results

Older adults had higher rates of comorbidities, abnormal neurological and laboratory (serum white blood cell count >12,000/μL, and cerebrospinal fluid protein >100 mg/dL) findings (P < .001), abnormalities on computed tomography and magnetic resonance imaging of the head (P = .002), and adverse clinical outcomes (ACOs) (P < .001). The majority of participants (65.8%) had meningitis of unknown etiology. Bacterial meningitis was an infrequent cause of community‐acquired meningitis (7.4%). Of the known causes, bacterial meningitis and West Nile virus were more common in older than younger adults; younger participants more frequently had cryptococcal and viral meningitis. On logistic regression, female sex was predictive of a poor outcome in the older participants (P = .002), whereas abnormal neurological examination (P < .001), fever (P = .01), and a cerebrospinal fluid glucose level less than 45 mg/dL (P = .002) were significant poor prognostic factors in younger participants.

Conclusion

Most cases of community‐acquired meningitis are of unknown origin. Older adults are more likely than younger adults to have bacterial meningitis and West Nile virus infection when a cause can be identified. They also have more neurological abnormalities, laboratory and imaging abnormalities, and adverse clinical outcomes.
The Process of Translating Family Nursing Knowledge Into Clinical Practice
Authors: Svavarsdottir Erla Kolbrun , Sigurdardottir Anna Olafia , Konradsdottir Elisabet , Stefansdottir Anna , Sveinbjarnardottir Eydís Kristin , Ketilsdottir Audur , Blondal Katrin , Jónsdóttir Arndís , Bergs Dorothea , Guðmundsdottir Hlíf
Published: November 2014

Purpose

To report on approaches that were used to assist with implementation of family systems nursing (FSN) at a university hospital level in Northern Europe.

Design and Methods

A quasi‐experimental research design was used for the first phase of the study. For the second phase, a cross‐sectional research design was used. Data were collected in the first phase of the study from 457 nurses in all except one of the divisions of the hospital regarding their attitudes towards involving families into their care before and after having participated in the education and training intervention (ETI) program in FSN. Furthermore, in the second phase, data were collected from 812 nurses, after FSN had been implemented in all divisions at Landspitali University Hospital, regarding the nurses’ knowledge of FSN and their evaluation of the quality of the ETI program (i.e., theoretical lectures on FSN as well as the benefit of the skill lab training regarding applying FSN into their clinical practices). Graham and colleagues’ Knowledge to Action framework was used as the conceptual framework for the research.

Results

Nurses who had taken a course in FSN reported a significantly more positive attitude towards involving families in their care after the ETI program compared to those who had not taken such a course. Furthermore, a majority of the nurses who participated in the ETI program reported that the program was a favorable experience and indicated readiness for applying FSN in clinical practice.

Conclusions

Further research is needed regarding the benefits of offering FSN at an institutional level, but focusing international attention on effective strategies to implement FSN into nursing practice may result in better health care for individuals and families around the globe.

Clinical Relevance

Providing clinically meaningful education and training in family nursing through programs such as the ETI program for practicing nurses at a university hospital is essential in supporting nurses applying new knowledge, when providing evidence‐based health care services, to individuals and their family members. Such training can facilitate integration of new and needed information in clinical practice.
Nuclear fractal dimension in oral squamous cell carcinoma: a novel method for the evaluation of grading, staging, and survival
Authors: Mincione Gabriella , Di Nicola Marta , Di Marcantonio Maria Carmela , Muraro Raffaella , Piattelli Adriano , Rubini Corrado , Penitente Enrico , Piccirilli Marcello , Aprile Giuseppe , Perrotti Vittoria , Artese Luciano
Published: November 2014

Fractal dimension (FD) in tissue specimens from patients with oral squamous cell carcinoma (OSCC) was evaluated. FD values in different stages of OSCC, and the correlations with clinicopathological variables and patient survival were investigated. Histological sections from OSCC and control non‐neoplastic mucosa specimens were stained with hematoxylin–eosin for pathological analysis and with Feulgen for nuclear evaluation. FD in OSCC groups vs. controls revealed statistically significant differences (P < 0.001). In addition, a progressive increase of FD from stage I and II lesions and stage III and IV lesions was observed, with statistically significant differences (P = 0.003). Moreover, different degrees of tumor differentiation showed a significant difference in the average nuclear FD values (P = 0.001). A relationship between FD and patients' survival was also detected with lower FD values associated to longer survival time and higher FD values with shorter survival time (P = 0.034). These data showed that FD significantly increased during OSCC progression. Thus, FD could represent a novel prognostic tool for OSCC, as FD values significantly correlated with patient survival. Fractal geometry could give insights into tumor morphology and could become an useful tool for analyzing irregular tumor growth patterns.
Cryogun cryotherapy for oral leukoplakia and adjacent melanosis lesions
Authors: Chen Hsin‐Ming , Cheng Shih‐Jung , Lin Hung‐Pin , Yu Chuan‐Hang , Wu Yang‐Che , Chiang Chun‐Pin
Published: November 2014

Background

Our previous study has shown that cryogun cryotherapy is a good and effective treatment modality for oral leukoplakia.

Methods

In this study, we used cryogun cryotherapy to treat 72 oral leukoplakia and adjacent smoking‐induced melanosis (OLM) lesions on the buccal mucosae.

Results

Of 72 OLM lesions, 14 had epithelial hyperplasia with parakeratosis, 24 had epithelial hyperplasia with hyperkeratosis, 26 had mild dysplasia, seven had moderate dysplasia, and one had severe dysplasia. Complete regression was achieved in all 72 OLM lesions after a mean of 3.3 ± 1.3 cryogun cryotherapy treatments. We found that OLM lesions in patients without smoking habit, with the greatest diameter < 2.8 cm, with epithelial dysplasia, or with a surface keratin thickness ≤ 50 μm needed significantly fewer mean number of cryogun cryotherapy treatment to achieve complete regression than those OLM lesions in patients with smoking habit, with the greatest diameter ≥ 2.8 cm, without epithelial dysplasia, or with a surface keratin thickness > 50 μm (all P‐values < 0.001), respectively. Univariate logistic regression analyses showed that the greatest diameter, epithelial dysplasia, smoking habit, and surface keratin thickness were the factors influencing the cryogun cryotherapy treatment number (all P‐values < 0.001). However, only the greatest diameter < 2.8 cm (P < 0.001) was an independent factor influencing the number of cryogun cryotherapy treatment required to achieve complete regression of the OLM lesion by multivariate logistic regression analyses.

Conclusion

Cryogun cryotherapy is an effective treatment modality for OLM lesions.
Plant–soil feedback effects on plant quality and performance of an aboveground herbivore interact with fertilisation
Authors: Kos Martine , Tuijl Maarten A. B. , de Roo Joris , Mulder Patrick P. J. , Bezemer T. Martijn
Published: November 2014

Plant–soil feedback (PSF) effects on plant performance can be influenced by the availability of nutrients in the soil. Recent studies have shown that PSF effects can also change aboveground plant–insect interactions via soil‐mediated changes in plant quality, but whether this is influenced by soil nutrient availability is unknown. We examined how fertilisation influences PSF effects on aboveground plant‐aphid interactions in ragwort Jacobaea vulgaris. We grew J. vulgaris in soil conditioned by conspecific plants and in unconditioned soil at two levels of fertilisation and measured soil fungal communities, plant biomass, concentrations of primary (amino acids) and secondary (pyrrolizidine alkaloids; PAs) metabolites in phloem exudates, performance of the specialist aphid Aphis jacobaeae and sequestration of PAs by the aphid. We observed a strong interaction between soil conditioning and fertilisation on amino acid and PA concentrations in phloem exudates of J. vulgaris and on aphid performance, with opposite effects of soil conditioning at the two fertilisation levels. Plant biomass was reduced by soil conditioning and increased by fertilisation. Aphids contained high PA concentrations, converted N‐oxides into tertiary amines and preferentially sequestered certain PA compounds, but PA sequestration was not affected by any of the treatments. We conclude that effects of PSF and fertilisation on plant chemistry and aphid performance are interdependent. Our study highlights the need to consider the importance of abiotic soil conditions on the outcome of PSF effects on aboveground plant–insect interactions.
The calcium‐dependent protein kinase CPK7 acts on root hydraulic conductivity
Authors: LI GUOWEI , BOUDSOCQ MARIE , HEM SONIA , VIALARET JÉRÔME , ROSSIGNOL MICHEL , MAUREL CHRISTOPHE , SANTONI VÉRONIQUE
Published: November 2014

The hydraulic conductivity of plant roots (Lpr) is determined in large part by the activity of aquaporins. Mechanisms occurring at the post‐translational level, in particular phosphorylation of aquaporins of the plasma membrane intrinsic protein 2 (PIP2) subfamily, are thought to be of critical importance for regulating root water transport. However, knowledge of protein kinases and phosphatases acting on aquaporin function is still scarce. In the present work, we investigated the Lpr of knockout Arabidopsis plants for four Ca2+‐dependent protein kinases. cpk7 plants showed a 30% increase in Lpr because of a higher aquaporin activity. A quantitative proteomic analysis of wild‐type and cpk7 plants revealed that PIP gene expression and PIP protein quantity were not correlated and that CPK7 has no effect on PIP2 phosphorylation. In contrast, CPK7 exerts a negative control on the cellular abundance of PIP1s, which likely accounts for the higher Lpr of cpk7. In addition, this study revealed that the cellular amount of a few additional proteins including membrane transporters is controlled by CPK7. The overall work provides evidence for CPK7‐dependent stability of specific membrane proteins.
Hospital Admissions and Gestational Age at Birth: 18 Years of Follow Up in Western Australia
Authors: Slimings Claudia , Einarsdóttir Kristjana , Srinivasjois Ravisha , Leonard Helen
Published: November 2014

Background

Infants born moderate to late preterm are twice as likely to be rehospitalised within the first few weeks following discharge from the birth admission. It is not understood how rehospitalisation risk changes with age or how risks have changed over time.

Methods

A retrospective birth cohort study of all live, singleton births in Western Australia 1 January 1980–31 December 2010, without congenital anomalies, followed to 18 years of age. Rehospitalisation rates for gestational age categories (<28, 28–31, 32–33, 34–36, 37–38 and ≥42 weeks) were compared with term births (39–41 weeks) using negative binomial regression. To assess whether rehospitalisation risk changed with age or over time, analyses were conducted for different age intervals and for 5‐year birth cohorts.

Results

Rehospitalisation rates were higher up to 18 years for all preterm and early term categories including early term (37–38 weeks) [130.2/1000 person‐years at risk (pyr); 95% confidence interval 129.1, 131.4]; late preterm (34–36 weeks) (164.2/1000 pyr; 161.1, 167.4), and post‐term (≥42 weeks) (115.3/1000 pyr; 111.7, 119.0) compared with term births (109.1/1000 pyr; 108.5, 109.7). The effect of gestational age on rehospitalisation was highest during the first year of life and declined by adolescence [e.g. 34–36 weeks: rate ratio = 2.10 (2.04, 2.15) for 29 days–1 year; 1.14 (1.11, 1.18) for 12–18 years]. The risk of rehospitalisation up to 1 year of age has declined since 1980, except for those born <32 weeks.

Conclusions

Rehospitalisation risk is greater for singleton children born at all gestational ages compared with those born full term. This effect of gestational age on rehospitalisation is highest in the first year post‐discharge, but has almost disappeared by adolescence.
Maternal HLA‐C2 and 14 bp insertion in HLA‐G is associated with recurrent implantation failure after in vitro fertilization treatment
Authors: Lashley L. E. E. L. O. , van der Westerlaken L. A. J. , Haasnoot G. W. , Drabbels J. J. M. , Spruyt‐Gerritse M. J. , Scherjon S. A. , Claas F. H. J.
Published: November 2014

The major rate‐limiting step in in vitro fertilization (IVF) success appears to be the implantation of the semi‐allogeneic embryo into the maternal endometrium. To determine possible risk factors of recurrent failure of embryos to implant, we investigated immunogenetic determinants as level of human leukocyte antigen (HLA) histocompatibility, frequency of killer‐cell immunoglobulin‐like receptors (KIR) and HLA‐C alleles and HLA‐G polymorphism. We DNA typed women with recurrent implantation failure (RIF) and their partners for classical HLA Class I, HLA Class II, HLA‐G and KIR alleles and compared these results with couples with successful embryo implantation after their first IVF and normal fertile couples. No association was found between RIF and the degree of histocompatibility between partners or sharing of a specific antigen. Also, no significant difference in KIR haplotype or combination of HLA‐C group and KIR was observed. We did find a higher frequency of HLA‐C2 and a higher frequency of 14 base pair (bp) insertion in HLA‐G in women with RIF. Therefore we conclude that the degree of histocompatibility between partners is not a determining factor for the occurrence of RIF. However, presence of the HLA‐C2 allotype and the HLA‐G allele with a 14 bp insertion is a significant risk factor.
Hepatitis C transmission from viremic donors in hematopoietic stem cell transplant
Authors: Hsiao H.‐H. , Liu Y.‐C. , Wang H.‐C. , Wu C.‐H. , Cho S.‐F. , Hsu J.‐F. , Tsai H.‐J. , Hsiao S.Y. , Chang C.‐S. , Lin S.‐F. , Liu T.‐C. , Chuang W.‐L. , Yu M.‐L.
Published: November 2014

Transmission of hepatitis C virus (HCV) to recipients of hematopoietic stem cell transplant (HSCT) occurs frequently from HCV viremic donors and causes complications. Here, we report the outcomes of 3 cases from our 265 allogeneic HSCTs, whose donors had HCV infections. Successful prevention of HCV transmission was noted in 1 recipient by pretreatment of the donor with peginterferon/ribavirin to undetectable levels of HCV viremia before stem cell harvest. This case stressed the important role of effective antiviral therapy and HCV RNA seronegativity before cell harvest for prevention of HCV transmission in HSCT.
Prospective cohort study of a new vacuum delivery device to assist with complicated labour in low‐resource settings
Authors: Khan Mishal , Hashmani Farah Naz , Ahmed Sajjad , Ahmed Owais , Asim Shabnam S. , Wajahat Yasmin , Sobani Shoaib , Syed Shershah , Qazi Fahad
Published: November 2014

Objectives

Currently available vacuum devices used to assist women undergoing complicated labour are unsuitable for use in low‐resource settings. The objective of this study was to evaluate the safety and feasibility of a new low‐cost vacuum device, named Koohi Goth Vacuum Delivery System (KGVDS), designed for use in low‐resource settings.

Methods

A hospital‐based, multicentre, prospective cohort study with no control group was conducted in Karachi, Pakistan. After training, KGVDS devices were made available for use by labour room staff at their discretion when instrumental delivery was indicated. Women to whom KGVDS was applied were followed from the start of labour until discharge. Feasibility was assessed in terms of successful expulsion of the foetal head following application of KGVDS and ease of use ratings. Safety was assessed by observing maternal and newborn post‐delivery outcomes prior to discharge.

Results

Koohi Goth Vacuum Delivery System was applied to 137 women requiring instrumental delivery, of whom 111 (81%; 95% CI = 74–88%) successfully expelled the foetal head assisted by KGVDS and 103 (75%) stated that they would agree to use KGVDS again. There were no serious maternal or neonatal injuries or infections related to KGVDS use. The mean score for ‘ease of use’ given by doctors and midwives using the device was 8 of 10.

Conclusions

Koohi Goth Vacuum Delivery System was feasible and safe to use for assisting complicated deliveries in low‐resource hospitals in this initial evaluation. Our results indicate that this new device may have the potential to improve birth outcomes in settings where most mortality occurs and that further evaluations should be conducted.
Health policy for sickle cell disease in Africa: experience from Tanzania on interventions to reduce under‐five mortality
Authors: Makani Julie , Soka Deogratias , Rwezaula Stella , Krag Marlene , Mghamba Janneth , Ramaiya Kaushik , Cox Sharon E. , Grosse Scott D.
Published: November 2014

Tanzania has made considerable progress towards reducing childhood mortality, achieving a 57% decrease between 1980 and 2011. This epidemiological transition will cause a reduction in the contribution of infectious diseases to childhood mortality and increase in contribution from non‐communicable diseases (NCDs). Haemoglobinopathies are amongst the most common childhood NCDs, with sickle cell disease (SCD) being the commonest haemoglobinopathy in Africa. In Tanzania, 10 313 children with SCD under 5 years of age (U5) are estimated to die every year, contributing an estimated 7% of overall deaths in U5 children. Key policies that governments in Africa are able to implement would reduce mortality in SCD, focusing on newborn screening and comprehensive SCD care programmes. Such programmes would ensure that interventions such as prevention of infections using penicillin plus prompt diagnosis and treatment of complications are provided to all individuals with SCD.
Biaxial Contractile Mechanics of Common Carotid Arteries of Rabbit
Authors: Takamizawa Keiichi
Published: November 2014

Few multiaxial constitutive laws under the vasoactive condition have been proposed as compared with those under the passive condition. The biaxial isometric properties of vasoactive rabbit arteries were studied, although the constitutive law was not proposed. The purpose of the present study is also to describe the multiaxial active mechanical properties of arteries. A novel strain energy function for the active stress has been proposed. This function is simple and may describe the multiaxial characteristics of constricted vessels. Although this study used mean stress and mean stretch ratio to determine the mechanical properties of vessels, a triaxial constitutive law of constricted vessels may be developed. There remains the subject of residual strains under active condition. If this problem will be solved, the accurate stress analysis under vasoactive conditions is possible.
An Approach to Study Associations Between Design Concepts and Design Outcomes
Authors: Takai Shun , Esterman Marcos , Midha Ashok
Published: November 2014

This paper proposes an approach to investigate associations between design concepts and design outcomes. In the proposed approach, three deliverables (concept sketches, proof-of-concept (POC) prototypes, and final products) are evaluated using metrics called creative product semantic scale (CPSS). CPSS scores are analyzed using two methods: correlation analysis and classification tree analysis. Correlation analysis is used to investigate associations between the concept sketches or the POC prototypes and the final products. Classification tree analysis (together with leave-one-out cross-validation (LOOCV) and permutation test) is used to investigate relationships between CPSS scores and the retention of design concepts (i.e., concepts that are embodied in the final products). The proposed approach is illustrated using deliverables in a project-based design class.
Determination of spot size and acid diffusion length in positive chemically amplified resist for e-beam lithography at 100 and 5 kV
Authors: Delachat Florian , Constancias Christophe , Reche Jérôme , Dal'Zotto Bernard , Pain Laurent , Le Drogoff Boris , Chaker Mohamed , Margot Joëlle
Published: November 2014

An experimental method to determine the beam spot size and the acid diffusion length of a positive chemically amplified electron-beam resist (p-CAR) is proposed. This method is applied to a reference p-CAR with a Vistec VB6 electron beam at 100 kV and with a MAPPER tool at 5 kV. Beam spot size characterization is based on the width measurement of a single line exposure. This procedure is applied to two specific dose ranges. In the first one, the chemical mechanism occurring in the exposed resist is dominated by acid catalytic deprotection of a partially protected polymer (standard process). In the second dose range, the chemistry is governed by the cross-linking mechanism due to the intentional overdose of the p-CAR, leading to a polarity inversion. The authors assume that comparing the results obtained with the standard and the cross-linked p-CAR enables the determination of the acid diffusion length of the p-CAR process. This hypothesis was verified with measurements performed with a nonchemically amplified process. A relationship between the best exposure latitudes achieved at 5 and 100 kV and the minimum spot sizes determined with the present method is observed with very high resolution grating exposures. In this work, a suitable method is proposed for fine resist process characterization.
Evolution of titanium residue on the walls of a plasma-etching reactor and its effect on the polysilicon etching rate
Authors: Hirota Kosa , Itabashi Naoshi , Tanaka Junichi
Published: November 2014

The variation in polysilicon plasma etching rates caused by Ti residue on the reactor walls was investigated. The amount of Ti residue was measured using attenuated total reflection Fourier transform infrared spectroscopy with the HgCdTe (MCT) detector installed on the side of the reactor. As the amount of Ti residue increased, the number of fluorine radicals and the polysilicon etching rate increased. However, a maximum limit in the etching rate was observed. A mechanism of rate variation was proposed, whereby F radical consumption on the quartz reactor wall is suppressed by the Ti residue. The authors also investigated a plasma-cleaning method for the removal of Ti residue without using a BCl3 gas, because the reaction products (e.g., boron oxide) on the reactor walls frequently cause contamination of the product wafers during etching. CH-assisted chlorine cleaning, which is a combination of CHF3 and Cl2 plasma treatment, was found to effectively remove Ti residue from the reactor walls. This result shows that CH radicals play an important role in deoxidizing and/or defluorinating Ti residue on the reactor walls.
Patterns of Objectively Measured Moderate-to-Vigorous Physical Activity in Preschool Children
Authors: O’Dwyer Mareesa , Fairclough Stuart J. , Ridgers Nicola Diane , Knowles Zoe Rebecca , Foweather Lawrence , Stratton Gareth
Published: November 2014

Background:

Identifying periods of the day which are susceptible to varying levels of physical activity (PA) may help identify key times to intervene and potentially change preschool children’s PA behaviors. This study assessed variability of objectively measured moderate-to-vigorous physical activity (MVPA) during weekdays and weekend days among preschool children.

Methods:

One hundred and eighty-eight children (aged 3 to 5 years; 53.2% boys) from a northwest English city wore uni-axial accelerometers for 7 consecutive days.

Results:

Higher levels of MVPA were recorded in boys, particularly those who attended preschool for a half day. Children who attended preschool for a full day engaged in 11.1 minutes less MVPA than children who attended for a half day. After-school hours were characterized by a decrease in activity for all groups. Patterns of activity during the weekend were smoother with less variability.

Conclusion:

This study identified discrete segments of the week, specifically afterschool and during the weekend, when preschoolers engage in low levels of PA. Higher levels of MVPA among children who attended preschool for less time each day suggests that the structured preschool environment is related to decreased activity. Consequently, there is a need for interventions in young children to focus on school and home environments.
Daily Physical Activity Behavior Patterns of Hispanic Adolescents in Puerto Rico
Authors: Vigo-Valentín Alexander , Bush Kimberly A. , Hodge Samuel R.
Published: November 2014

Background:

There is limited evidence on physical activity patterns among Hispanic adolescents in Puerto Rico. This restricts opportunities to implement effective interventions and policies to increase physical activity in schools. The purpose of this study was to examine the physical activity behaviors of adolescents attending middle and high schools in Puerto Rico based on a compendium of moderate to vigorous physical activities including walking, jogging or running, bicycling, sports and more. A secondary purpose was to examine group differences as a function of gender and school level.

Method:

A cross-sectional survey research design was used. Students (N = 637) attending public middle and high schools completed a Visual 7-Day Physical Activity Recall survey. Both descriptive and inferential analyses were conducted to describe the sample and to determine group differences.

Results:

Puerto Rican adolescents’ levels of physical activity decreased throughout the week. Only a small proportion of them reached at least 60 minutes everyday of the week. Differences were found between middle and high school students’ daily and weekly participation in physical activities.

Conclusions:

Most adolescents do not engage in sufficient physical activity.

Implications:

Implications of the results are discussed and recommendations are articulated for policy makers, educators, and other professionals.
Individual, Psychosocial, and Environmental Correlates of 4-Year Declines in Walking Among Middle-to-Older Aged Adults
Authors: Shimura Hiroko , Winkler Elisabeth , Owen Neville
Published: November 2014

Background:

We examined associations of individual, psychosocial and environmental characteristics with 4-year changes in walking among middle-to-older aged adults; few such studies have employed prospective designs.

Methods:

Walking for transport and walking for recreation were assessed during 2003–2004 (baseline) and 2007–2008 (follow-up) among 445 adults aged 50–65 years residing in Adelaide, Australia. Logistic regression analyses examined predictors of being in the highest quintile of decline in walking (21.4 minutes/day or more reduction in walking for transport; 18.6 minutes/day or more reduction in walking for recreation).

Results:

Declines in walking for transport were related to higher level of walking at baseline, low perceived benefits of activity, low family social support, a medium level of social interaction, low sense of community, and higher neighborhood walkability. Declines in walking for recreation were related to higher level of walking at baseline, low self-efficacy for activity, low family social support, and a medium level of available walking facilities.

Conclusions:

Declines in middle-to-older aged adults’ walking for transport and walking for recreation have differing personal, psychosocial and built-environment correlates, for which particular preventive strategies may be developed. Targeted campaigns, community-based programs, and environmental and policy initiatives can be informed by these findings.
A Physical Activity Program for Swedish Physically Inactive Female High School Students: A Controlled Intervention Study
Authors: Kahlin Yvonne , Werner Suzanne , Alricsson Marie
Published: November 2014

Background:

Physical activity and sport participation often decline during adolescence.

Aim:

To investigate if physical exercise during 6 months could lead to a positive behavior of physical activity, improve physical fitness and self-related health in physically inactive female high school students.

Methods:

A prospective cluster-randomized controlled intervention study included 104 physically inactive female high school students, 60 in an intervention group and 44 controls. At baseline there were no group differences regarding self-related health. The intervention group exercised at least once per week. A questionnaire and physical fitness tests were used for evaluation, at baseline and 6 months later.

Results:

The intervention group improved their self-related health compared with the controls (P = .012). When divided into a regular (n = 27) and an irregular training group (n = 33) the regular training group improved their self-related health compared with the controls, while the irregular training group did not differ from the other groups. Maximal oxygen consumption was improved in the intervention group compared with the controls (P < .001). No group differences were found in muscle strength and endurance.

Conclusion:

Physical exercise at least once per week during 6 months improved physical fitness (maximal oxygen consumption) and self-related health in physically inactive female high school students.
Resistance Training During Pregnancy and Perinatal Outcomes
Authors: White Erin , Pivarnik Jim , Pfeiffer Karin
Published: November 2014

Background:

Approximately 10% of women engage in resistance training during pregnancy; however there is limited research on this activity. The purpose of this study was to examine associations between resistance training and adverse outcomes.

Methods:

Women completed an online survey and recalled their exercise habits during each trimester of their most recent pregnancy within the previous 5 years. Women also reported pregnancy and birth outcomes. Participants were then categorized into 3 groups based on leisure-time exercise: 1) Resistance + aerobic training (RTAE), 2) Aerobic exercise only (AE), and 3) no exercise (NE).

Results:

284 women completed the survey. Women in the RTAE group resistance trained on average 2.9 days/week for 27.3 minutes/session. The prevalences of hypertensive disorders (HD) and gestational diabetes mellitus (GDM) were significantly lower in the RTAE group when compared with the grouping of AE + NE women. Prepregnancy body mass index (BMI) was the strongest factor related to both GDM and HD. There was no difference in the risk of preterm labor, mode of delivery, or gestational age at delivery by exercise status.

Conclusions:

Our results suggest that women can safely engage in aerobic exercise and resistance training for muscular endurance 3 days/week for 30 minutes throughout gestation.
Accelerometer-Assessed Sedentary and Physical Activity Behavior and Its Association With Vision Among U.S. Adults With Diabetes
Authors: Loprinzi Paul D. , Pariser Gina , Ramulu Pradeep Y.
Published: November 2014

Background:

To examine the association between accelerometer-assessed physical activity and visual acuity among a nationally representative sample of adults with evidence of diabetes.

Methods:

Six hundred seventy adult participants with diabetes (age 20 to 85) from the 2003–2006 NHANES cycles constituted the analyzed sample. Participants wore an accelerometer for 7 days to quantify time spent in sedentary behavior, light-intensity physical activity and moderate-to-vigorous physical activity. Visual acuity was objectively assessed for each eye.

Results:

In multivariable models, every 1-hour increment in daily sedentary behavior was associated with 23% greater likelihood (OR = 1.23; 95% CI: 1.01–1.52) of having uncorrected refractive error as opposed to normal sight. Performing more than 5 minutes of daily moderate-to-vigorous physical activity was associated with a 82% lower likelihood of having vision impairment as opposed to normal sight (OR = 0.18; 95% CI: 0.06–0.50) while every 1-hour increment in daily light-intensity physical activity was, after adjustments, independently associated with a 38% lower likelihood of vision impairment (OR = 0.62; 95% CI: 0.42–0.92).

Conclusion:

People with diabetes spending more time in sedentary behavior and less time performing light or moderate-to-vigorous physical activity are more likely to have poorer vision.
Associations of Leisure-Time Sitting in Cars With Neighborhood Walkability
Authors: Koohsari Mohammad Javad , Sugiyama Takemi , Kaczynski Andrew T. , Owen Neville
Published: November 2014

Background:

Too much sitting, including time spent sitting in cars, is associated with poor health outcomes. Identifying the built-environment attributes that may reduce vehicular sitting time can inform future initiatives linking the public health, urban design, and transportation sectors.

Methods:

Data collected in 2003–2004 from adult residents (n = 2521) of Adelaide, Australia were used. Logistic regression analyses examined associations of prolonged time spent sitting in cars during leisure time (30 min/day or more) with neighborhood walkability and its components (dwelling density; intersection density; land use mix; net retail area ratio).

Results:

Lower overall walkability was significantly associated with a higher odds (OR = 1.43, 95% CI: 1.21–1.70) of spending prolonged time in cars. For analyses with walkability components, lower net retail area ratio, lower residential density, and lower intersection density were significantly associated with prolonged sitting in cars.

Conclusion:

This study found that residents of high walkable neighborhoods tended to spend less time sitting in cars. In particular, higher net retail area ratio, an indicator of tightly spaced commercial areas, was strongly associated with less time in cars. Policy and planning initiatives to reduce car use require further evidence, particularly on the influence of neighborhood retail areas.
Costs Associated With Women’s Physical Activity Musculoskeletal Injuries: The Women’s Injury Study
Authors: Kaplan Robert M. , Herrmann Alison K. , Morrison James T. , DeFina Laura F. , Morrow James R.
Published: November 2014

Background:

Despite benefits of physical activity (PA), exercise is also associated with risks. Musculoskeletal injury (MSI) risk increases with exercise frequency/intensity. MSI is associated with costs including medical care and time lost from work.

Purpose:

To evaluate the economic costs associated with PA-related MSIs in community-dwelling women.

Method:

Participants included 909 women in the Women’s Injury Study reporting PA behaviors and MSI incidence weekly via the Internet for up to 3 years (mean follow-up 1.89 years). Participants provided consent to obtain health records. Costs were estimated by medical records and self-reports of medical care. Components included physician visits, medical facility contacts, medication costs, and missed work.

Results:

Of 909 participants, 243 reported 323 episodes of expenditure or contact with the health care system associated with PA. Total costs of episodes ranged from $0–$18,934. Modal cost was $0 (mean = $433 ± $1670). Costs were positively skewed with nearly all participants reporting no or very low costs.

Conclusions:

About 1 in 4 community-dwelling women who are physically active experienced a PA-related MSI. The majority of injuries were minor, and large expenses associated with MSI were rare. The long-term health benefits and costs savings resulting from PA likely outweigh the minor costs associated with MSI from a physically-active lifestyle.
Cationic Liposomal Sodium Stibogluconate (SSG), a Potent Therapeutic Tool for Treatment of Infection by SSG-Sensitive and -Resistant Leishmania donovani
Authors: Sinha Roma , Roychoudhury Jayeeta , Palit Partha , Ali Nahid
Published: November 2014

Pentavalent antimonials have been the first-line treatment for leishmaniasis for decades. However, the development of resistance to sodium stibogluconate (SSG) has limited its use, especially for treating visceral leishmaniasis (VL). The present work aims to optimize a cationic liposomal formulation of SSG for the treatment of both SSG-sensitive (AG83) and SSG-resistant (GE1F8R and CK1R)
Leishmania donovani
infections. Parasite killing was determined by the 3-(4,5-dimethylthiazol-2)-2,5-diphenyltetrazolium bromide (MTT) assay and microscopic counting of Giemsa-stained macrophages. Macrophage uptake studies were carried out by confocal microscopic imaging. Parasite-liposome interactions were visualized through transmission electron microscopy. Toxicity tests were performed using assay kits. Organ parasite burdens were determined by microscopic counting and limiting dilution assays. Cytokines were measured by enzyme-linked immunosorbent assays (ELISAs) and flow cytometry. Although all cationic liposomes studied demonstrated leishmanicidal activity, phosphatidylcholine (PC)-dimethyldioctadecylammonium bromide (DDAB) vesicles were most effective, followed by PC-stearylamine (SA) liposomes. Since entrapment of SSG in PC-DDAB liposomes demonstrated enhanced ultrastructural alterations in promastigotes, PC-DDAB-SSG vesicles were further investigated
in vitro
and
in vivo
. PC-DDAB-SSG could effectively alleviate SSG-sensitive and SSG-resistant
L. donovani
infections in the liver, spleen, and bone marrow of BALB/c mice at a dose of SSG (3 mg/kg body weight) not reported previously. The parasiticidal activity of these vesicles was attributed to better interactions with the parasite membranes, resulting in direct killing, and generation of a strong host-protective environment, necessitating a very low dose of SSG for effective cures.
A Chemical Rescue Screen Identifies a Plasmodium falciparum Apicoplast Inhibitor Targeting MEP Isoprenoid Precursor Biosynthesis
Authors: Wu Wesley , Herrera Zachary , Ebert Danny , Baska Katie , Cho Seok H. , DeRisi Joseph L. , Yeh Ellen
Published: November 2014

The apicoplast is an essential plastid organelle found in
Plasmodium
parasites which contains several clinically validated antimalarial-drug targets. A chemical rescue screen identified MMV-08138 from the “Malaria Box” library of growth-inhibitory antimalarial compounds as having specific activity against the apicoplast. MMV-08138 inhibition of blood-stage
Plasmodium falciparum
growth is stereospecific and potent, with the most active diastereomer demonstrating a 50% effective concentration (EC
50
) of 110 nM. Whole-genome sequencing of 3 drug-resistant parasite populations from two independent selections revealed E688Q and L244I mutations in
P. falciparum
IspD, an enzyme in the MEP (methyl-
d
-erythritol-4-phosphate) isoprenoid precursor biosynthesis pathway in the apicoplast. The active diastereomer of MMV-08138 directly inhibited PfIspD activity
in vitro
with a 50% inhibitory concentration (IC
50
) of 7.0 nM. MMV-08138 is the first PfIspD inhibitor to be identified and, together with heterologously expressed PfIspD, provides the foundation for further development of this promising antimalarial drug candidate lead. Furthermore, this report validates the use of the apicoplast chemical rescue screen coupled with target elucidation as a discovery tool to identify specific apicoplast-targeting compounds with new mechanisms of action.
Systematic Review of Biomarkers To Monitor Therapeutic Response in Leishmaniasis
Authors: Kip Anke E. , Balasegaram Manica , Beijnen Jos H. , Schellens Jan H. M. , de Vries Peter J. , Dorlo Thomas P. C.
Published: November 2014

Recently, there has been a renewed interest in the development of new drugs for the treatment of leishmaniasis. This has spurred the need for pharmacodynamic markers to monitor and compare therapies specifically for visceral leishmaniasis, in which the primary recrudescence of parasites is a particularly long-term event that remains difficult to predict. We performed a systematic review of studies evaluating biomarkers in human patients with visceral, cutaneous, and post-kala-azar dermal leishmaniasis, which yielded a total of 170 studies in which 53 potential pharmacodynamic biomarkers were identified. In conclusion, the large majority of these biomarkers constituted universal indirect markers of activation and subsequent waning of cellular immunity and therefore lacked specificity. Macrophage-related markers demonstrate favorable sensitivity and times to normalcy, but more evidence is required to establish a link between these markers and clinical outcome. Most promising are the markers directly related to the parasite burden, but future effort should be focused on optimization of molecular or antigenic targets to increase the sensitivity of these markers. In general, future research should focus on the longitudinal evaluation of the pharmacodynamic biomarkers during treatment, with an emphasis on the correlation of studied biomarkers and clinical parameters.
Immune Characterization of Plasmodium falciparum Parasites with a Shared Genetic Signature in a Region of Decreasing Transmission
Authors: Bei Amy K. , Diouf Ababacar , Miura Kazutoyo , Larremore Daniel B. , Ribacke Ulf , Tullo Gregory , Moss Eli L. , Neafsey Daniel E. , Daniels Rachel F. , Zeituni Amir E. , Nosamiefan Iguosadolo , Volkman Sarah K. , Ahouidi Ambroise D. , Ndiaye Daouda , Dieye Tandakha , Mboup Souleymane , Buckee Caroline O. , Long Carole A. , Wirth Dyann F.
Published: November 2014

As the intensity of malaria transmission has declined,
Plasmodium falciparum
parasite populations have displayed decreased clonal diversity resulting from the emergence of many parasites with common genetic signatures (CGS). We have monitored such CGS parasite clusters from 2006 to 2013 in Thiès, Senegal, using the molecular barcode. The first, and one of the largest observed clusters of CGS parasites, was present in 24% of clinical isolates in 2008, declined to 3.4% of clinical isolates in 2009, and then disappeared. To begin to explore the relationship between the immune responses of the population and the emergence and decline of specific parasite genotypes, we have determined whether antibodies to CGS parasites correlate with their prevalence. We measured (i) antibodies capable of inhibiting parasite growth in culture and (ii) antibodies recognizing the surfaces of infected erythrocytes (RBCs). IgG obtained from volunteers in 2009 showed increased reactivity to the surfaces of CGS-parasitized erythrocytes over IgG from 2008. Since
P. falciparum
EMP-1 (PfEMP-1) is a major variant surface antigen, we used
var
Ups quantitative reverse transcription-PCR (qRT-PCR) and sequencing with degenerate DBL1α domain primers to characterize the
var
genes expressed by CGS parasites after short-term
in vitro
culture. CGS parasites show upregulation of UpsA
var
genes and 2-cysteine-containing PfEMP-1 molecules and express the same dominant
var
transcript. Our work indicates that the CGS parasites in this cluster express similar
var
genes, more than would be expected by chance in the population, and that there is year-to-year variation in immune recognition of surface antigens on CGS parasite-infected erythrocytes. This study lays the groundwork for detailed investigations of the mechanisms driving the expansion or contraction of specific parasite clones in the population.