bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical Restraints: Consensus of a Research Definition Using a Modified Delphi Technique
Authors: Bleijlevens Michel H. C. , Wagner Laura M. , Capezuti Elizabeth , Hamers Jan P. H. ,   the International Physical Restraint Workgroup
Published: September 2016

Objectives

To develop an internationally accepted research definition of physical restraint.

Design

Comprehensive literature search followed by a web‐based, three‐round, modified Delphi technique comprising reviews and feedback.

Setting

Clinical care settings.

Participants

An international group of 48 experts consisting of researchers and clinicians from 14 countries who have made sustained contribution to research and clinical application in the field of physical restraint in clinical care.

Measurements

Data were collected using an online survey program and one in‐person meeting. Results of the online survey and the in‐person meeting were used for distribution in subsequent rounds until consensus on a definition was reached. Consensus was defined as 90% of the participating experts agreeing with the proposed definition of physical restraint.

Results

Thirty‐four different definitions were identified during the literature search and served as a starting point for the modified Delphi technique. After three rounds, 45 (95.7%) of 47 remaining experts agreed with the newly proposed definition: “Physical restraint is defined as any action or procedure that prevents a person's free body movement to a position of choice and/or normal access to his/her body by the use of any method, attached or adjacent to a person's body that he/she cannot control or remove easily.”

Conclusion

A multidisciplinary, internationally representative panel of experts reached consensus on a research definition for physical restraints in older persons. This is a necessary step toward improved comparisons of the prevalence of physical restraint use across studies and countries. This definition can further guide research interventions aimed at reducing use of physical restraints.
Concomitant Opioid and Laxative Use in Older Adults in Hospice Care in the United States: 2007
Authors: Lau Denys T. , Dwyer Lisa L. , Shega Joseph W.
Published: September 2016

Objectives

To examine laxative use by individuals in hospice who were taking opioids during the last week of life.

Design

Retrospective cross‐sectional.

Setting

2007 National Home and Hospice Care Survey.

Participants

Individuals in hospice aged 65 and older who were taking opioids during the last week of life (N = 2,825).

Measurements

Hospice staff were asked the names of all medications and drugs that participants were taking 7 days before and on the day of death while in hospice, including any standing, routine, or as‐needed medications.” Medications “used” included medications taken and as‐needed medications provided in case a symptom developed. Opioids included all opioid‐combination drugs. Laxatives included fibers, lubricants, stimulants, and suppositories.

Results

Forty‐one percent of participants had cancer as the primary hospice diagnosis, 13% heart disease, 12% debility, 11% dementia, 8% lung disease, and 15% other. Overall, 52% of opioid users used a laxative in the last week of life; the proportions of opioid and laxative users did not differ according to diagnosis. Racial minorities taking opioids had lower odds than white participants (odds ratio (OR) = 0.57, 95% confidence interval (CI) = 0.33–0.99) of using laxatives. Participants taking opioids enrolled in hospice for 7 days or less had lower odds of using laxatives than those enrolled for more than 7 days (OR = 0.65, 95% CI = 0.37–0.95), as did those in hospice inpatient, hospital, or other settings (OR = 0.45, 95% CI = 0.43–0.93) than those in long‐term care settings. Participants using five or fewer medications had lower odds of using laxatives than those using six to 10 (OR = 6.01, 95% CI = 3.88–9.32) or 11 to 25 medications (OR = 13.80, 95% CI = 8.74–21.80).

Conclusion

In 2007, slightly more than half of older adults in hospice who were taking opioids used laxatives during the last week of life. Recent quality indicators from the Centers for Medicare and Medicaid Services recommend laxative treatment when opioid therapy is initiated to prevent opioid‐induced constipation and are intended to improve laxative use in individuals in hospice treated with opioids.
Predictors of Place of Death of Individuals in a Home‐Based Primary and Palliative Care Program
Authors: Prioleau Phoebe G. , Soones Tacara N. , Ornstein Katherine , Zhang Meng , Smith Cardinale B. , Wajnberg Ania
Published: September 2016

Objectives

To investigate factors associated with place of death of individuals in the Mount Sinai Visiting Doctors Program (MSVD).

Design

A retrospective chart review was performed of all MSVD participants who died in 2012 to assess predictors of place of death in the last month of life.

Setting

MSVD, a home‐based primary and palliative care program in New York.

Participants

MSVD participants who were discharged from the program because of death between January 2012 and December 2012 and died at home, in inpatient hospice, or in the hospital (N = 183).

Measurements

Electronic medical records were reviewed to collect information on demographic characteristics, physician visits, and end‐of‐life conversations.

Results

Of 183 participants, 103 (56%) died at home, approximately twice the national average; 28 (15%) died in inpatient hospice; and 52 (28%) died in the hospital. Bivariate analyses showed that participants who were white, aged 90 and older, non‐Medicaid, or had a recorded preference for place of death were more likely to die outside the hospital. Diagnoses and living situation were not significantly associated with place of death. Multivariate logistic regression analysis showed no statistical association between place of death and home visits in the last month of life (odds ratio = 1.21, 95% confidence interval = 0.52–2.77).

Conclusion

Home‐based primary and palliative care results in a high likelihood of nonhospital death, although certain demographic characteristics are strong predictors of death in the hospital. For MSVD participants, home visits in the last month of life were not associated with death outside the hospital.
Two‐Year Mortality in Homebound Older Adults: An Analysis of the National Health and Aging Trends Study
Authors: Soones Tacara , Federman Alex , Leff Bruce , Siu Albert L. , Ornstein Katherine
Published: September 2016

Objectives

To determine the association between homebound status and mortality.

Design

Cross‐sectional.

Setting

Annual, in‐person interviews.

Participants

A nationally representative sample of community‐dwelling, Medicare beneficiaries aged 65 and older enrolled in the National Health and Aging Trends Study between 2011 and 2013 (N = 6,400).

Measurements

Two‐year mortality and prevalence of homebound status in the year before death are described using three categories of homebound status: homebound (never or rarely left home in the last month), semihomebound (left home with assistance, needed help or had difficulty), and nonhomebound (left home without help or difficulty).

Results

In unadjusted analyses, 2‐year mortality was 40.3% in homebound participants, 21.3% in those who were semihomebound and 5.8% in those who were nonhomebound. Homebound status was associated with greater 2‐year mortality, adjusted for sociodemographic characteristics, comorbidities, and functional status (hazard ratio = 2.08; 95% confidence interval = 1.63–2.65, P < .001). Half of older community‐dwelling Medicare beneficiaries were homebound in the year before death.

Conclusion

Homebound status is associated with greater risk of death independent of functional impairment and comorbidities. To improve outcomes for homebound older adults and the many older adults who will become homebound in the last year of life, providers and policymakers need to extend healthcare services from hospitals and clinics to the homes of vulnerable individuals.
Palliative Care Consultations in Nursing Homes and Reductions in Acute Care Use and Potentially Burdensome End‐of‐Life Transitions
Authors: Miller Susan C. , Lima Julie C. , Intrator Orna , Martin Edward , Bull Janet , Hanson Laura C.
Published: September 2016

Objectives

To evaluate how receipt and timing of nursing home (NH) palliative care consultations (primarily by nurse practitioners with palliative care expertise) are associated with end‐of‐life care transitions and acute care use

Design

Propensity score–matched retrospective cohort study.

Setting

Forty‐six NHs in two states.

Participants

Nursing home residents who died from 2006 to 2010 stratified according to days between initial consultation and death (≤7, 8–30, 31–60, 61–180). Propensity score matching identified three controls (n = 1,174) according to strata for each consultation recipient (n = 477).

Measurements

Outcomes were hospitalizations in the last 7, 30, and 60 days of life; emergency department (ED) visits in the last 30 and 60 days; and any potentially burdensome care transition, defined as hospitalization or hospice admission within 3 days of death or two or more hospitalizations or ED visits within 30 days. Weighted multivariate logistic regression analyses were used to evaluate outcomes.

Results

Residents with consultations had lower rates of hospitalization than controls, with rates lowest when initial consultations were furthest from death. For instance, in residents with initial consultations 8 to 30 days before death, the adjusted hospitalization rate in the last 7 days of life was 11.1% (95% confidence interval (CI) = 9.8–12.4%), vs 22.0% (95% CI = 20.6–23.4%) in controls, although in those with initial consultations 61 to 180 days before death, rates were 6.9% (95% CI = 5.5–8.4%), vs 22.9% (95% CI = 20.5–25.4%). Potentially burdensome transition rates were lower when consultations were 61 to 180 days before death (16.2%, 95% CI = 13.7–18.6%), vs 28.2% (95% CI = 25.8–30.6%) for controls.

Conclusion

Palliative care consultations improve end‐of‐life NH care by reducing acute care use and potentially burdensome care transitions.
Unraveling the Relationship Between Delirium, Brain Damage, and Subsequent Cognitive Decline in a Cohort of Individuals Undergoing Surgery for Hip Fracture
Authors: Beishuizen Sara J. E. , Scholtens Rikie M. , van Munster Barbara C. , de Rooij Sophia E.
Published: September 2016

Objectives

To assess the association between serum S100B levels (a marker of brain damage), delirium, and subsequent cognitive decline.

Design

Substudy of a multicenter randomized controlled trial.

Setting

Surgical, orthopedic, and trauma surgery wards of two teaching hospitals.

Participants

Individuals aged 65 and older (range 65–102) admitted for hip fracture surgery (N = 385).

Measurements

During hospitalization, presence of delirium was assessed daily. S100B was assayed in repeated serum samples. Twelve months after discharge, cognitive decline and mortality were evaluated. Cognitive decline was defined as an increase in Informant Questionnaire on Cognitive Decline Short Form score of 1 standard deviation or more or a decrease in Mini Mental State Examination score of 3 points or more between admission and 12 months after discharge.

Results

Premorbid cognitive impairment was present in 226 (58.7%) participants, and 127 (33.0%) experienced perioperative delirium. Multivariable analysis showed that older age and presence of infection, but not of delirium, were associated with higher S100B levels. Levels were also higher after surgery than before. Of participants with perioperative delirium, 58.6% experienced cognitive decline or death, and only age was a risk factor; 36.5% of participants without perioperative delirium experienced cognitive decline or death in the following year, and higher S100B, premorbid cognitive impairment, and older age were risk factors.

Conclusion

In a cohort of older adults with hip fracture, no association was found between serum S100B levels and occurrence of delirium. S100B was associated with cognitive decline or death in the first year after hip fracture only in participants without perioperative delirium. S100B seems to be of limited value as a biomarker of brain damage associated with delirium.
Alkaline phosphatase and OCT‐3/4 as useful markers for predicting susceptibility of human deciduous teeth‐derived dental pulp cells to reprogramming factor‐induced iPS cells
Authors: Inada Emi , Saitoh Issei , Kubota Naoko , Soda Miki , Matsueda Kazunari , Murakami Tomoya , Sawami Tadashi , Kagoshima Akiko , Yamasaki Youichi , Sato Masahiro
Published: September 2016

Aim

The aim of the present study was to prove that primary cells enriched with stem cells are more easily reprogrammed to generate induced pluripotent stem (iPS) cells than those with scarce numbers of stem cells.

Methods

We surveyed the alkaline phosphatase (ALP) activity in five primarily‐isolated human deciduous teeth‐derived dental pulp cells (HDDPC) with cytochemical staining to examine the possible presence of stem cells. Next, the expression of stemness‐specific factors, such as OCT(Octumer‐binding transcription factor)3/4, NANOG, SOX2(SRY (sex determining region Y)‐box 2), CD90, muscle segment homeodomain homeobox (MSX) 1, and MSX2, was assessed with a reverse transcription polymerase chain reaction method. Finally, these isolated HDDPC were transfected with plasmids carrying genes coding Yamanaka factors to determine whether these cells could be reprogrammed to generate iPS cells.

Results

Of the five primarily‐isolated HDDPC, two (HDDPC‐1 and ‐5) exhibited higher degrees of ALP activity. OCT‐3/4 expression was also prominent in those two lines. Furthermore, these two lines proliferated faster than the other three lines. The transfection of HDDPC with Yamanaka factors resulted in the generation of iPS cells from HDDPC‐1 and ‐5.

Conclusion

The number of cells with the stemness property of HDDPC differs among individuals, which suggests that HDDPC showing an increased expression of both ALP and OCT‐3/4 can be more easily reprogrammed to generate iPS cells after the forced expression of reprogramming factors.
Software‐based measurement of thin filament lengths: an open‐source GUI for Distributed Deconvolution analysis of fluorescence images
Authors: GOKHIN DAVID S. , FOWLER VELIA M.
Published: September 2016

The periodically arranged thin filaments within the striated myofibrils of skeletal and cardiac muscle have precisely regulated lengths, which can change in response to developmental adaptations, pathophysiological states, and genetic perturbations. We have developed a user‐friendly, open‐source ImageJ plugin that provides a graphical user interface (GUI) for super‐resolution measurement of thin filament lengths by applying Distributed Deconvolution (DDecon) analysis to periodic line scans collected from fluorescence images. In the workflow presented here, we demonstrate thin filament length measurement using a phalloidin‐stained cryosection of mouse skeletal muscle. The DDecon plugin is also capable of measuring distances of any periodically localized fluorescent signal from the Z‐ or M‐line, as well as distances between successive Z‐ or M‐lines, providing a broadly applicable tool for quantitative analysis of muscle cytoarchitecture. These functionalities can also be used to analyse periodic fluorescence signals in nonmuscle cells.
Influence of walking speed on gait parameters of bipedal locomotion in rhesus monkeys
Authors: Wei Rui‐Han , Song Wei , Zhao Can , Zhao Wen , Li Li‐Feng , Ji Run , Rao Jia‐Sheng , Yang Zhao‐Yang , Li Xiao‐Guang
Published: September 2016

Background

The primate model of bipedal locomotion has been extensively used to study human evolution and played a critical role in exploring the pathological mechanisms of human neurologic disease and spinal cord injury. Speed has great influence on both walking posture and gait parameters in human walking; however, how speed changes the gait pattern of bipedal locomotion in primates remains unclear.

Methods

We chose six adult female rhesus monkeys (Macaca mulatta) and collected the gait parameters of these animals during their treadmill locomotion over a wide range of speed. Using a 3D motion analysis system, we studied the spatiotemporal characteristics of the gait pattern.

Results and Conclusions

We have built an efficient and time‐saving primate model and shown that speed significantly impacts kinematic parameters. This may present a thorough description of speed‐related changes in the gait pattern of rhesus and shed light on the control of bipedal locomotion in primates.
Cervical cytological abnormalities and human papilloma virus infection in women infected with HIV in Southern India
Authors: Thunga Suchitra , Andrews Anusmitha , Ramapuram John , Satyamoorthy Kapaettu , Kini Hema , Unnikrishnan B. , Adhikari Prabha , Singh Prakhar , Kabekkodu Shama Prasada , Bhat Samatha , Kadam Anagha , Shetty Avinash K
Published: September 2016

Aim

The aim of this study was to examine the association between CD4 count, human papilloma virus (HPV) infection, and the risk of cervical intraepithelial neoplasia among HIV‐infected women.

Methods

A cross‐sectional study was conducted among 104 HIV‐infected women attending an antiretroviral therapy clinic. They underwent Pap smear and cervical HPV DNA testing.

Results

The overall prevalence of HPV infection was 57.7%. HPV 16 was the commonest genotype found (38.5%); HPV 16 and 18 put together contributed to 73.3% of HPV infection; 27.5% of HIV‐infected women had squamous cell abnormalities. Cervical intraepithelial neoplasia was less likely among women with CD4 count > 500/mm3 (12%) and in those without opportunistic infections (17.8%). The prevalence of high‐risk HPV infection was higher in women with high‐grade squamous intraepithelial lesions or greater lesions (85.7%) as compared to women with normal cytology (52.1%).

Conclusion

The high prevalence of HPV infection and cervical intraepithelial neoplasia in HIV‐infected women warrants the need for regular Pap smear screening in these women and routine HPV vaccination for adolescents to reduce the burden of cervical cancer in India.
Paraaortic node recurrence 25 years after removal of epithelial ovarian carcinoma
Authors: Otsuka Isao , Shoji Kazufusa
Published: September 2016

In epithelial ovarian carcinoma, very late (more than 20 years) recurrence is an unusual event. In patients experiencing such a recurrence, the effectiveness of platinum/taxane chemotherapy has been questioned. A 54‐year old woman presented with paraaortic node swelling that appeared 25 years after treatment of stage I epithelial ovarian carcinoma. She underwent a partial resection of the nodes and histologic examination showed high‐grade serous carcinoma. She received paclitaxel and carboplatin chemotherapy and a partial response was initially observed on imaging studies; however, serum cancer antigen125 levels increased thereafter. She received radiation therapy to the paraaortic nodal disease with doses of 45 Gy and achieved a complete response. She was disease‐free more than eight years after the detection of recurrence. In conclusion, radiation therapy may be an effective treatment option in patients with very late recurrence of epithelial ovarian carcinoma refractory to platinum/taxane chemotherapy.
Addition of adjuvant progesterone to physical‐exam‐indicated cervical cerclage to prevent preterm birth
Authors: Jung Eun Young , Oh Kyung Joon , Hong Joon‐Seok , Han Bo Ryoung , Joo Jung Kyung
Published: September 2016

Aim

The aim of this study was to assess the effect of vaginal progesterone as an adjuvant therapy to physical‐exam‐indicated cervical cerclage (PEICC).

Methods

This retrospective cohort study included 53 consecutive singleton women who underwent PEICC because of acute cervical insufficiency at 17–24 gestational weeks. The study population was divided into two groups: the adjuvant progesterone group (n = 18) and the non‐adjuvant group (n = 35). A 200‐mg dose of vaginal micronized natural progesterone was administered after cerclage in the adjuvant progesterone group. Primary outcome measure was spontaneous preterm birth (SPTB) at <36 weeks.

Results

The SPTB rate at <36 weeks in the adjuvant group was significantly lower than in the non‐adjuvant group (17% vs 51%, P < 0.05). Adjuvant progesterone therapy was significantly associated with a reduction in SPTB at <36 weeks (adjusted odds ratio, 0.12; 95% confidence interval, 0.02–0.69, P < 0.05) even after adjusting for known covariates, including a visible membrane size of ≥4 cm, gestational age, prior SPTB, and use of amnioreduction. The frequency of SPTB at <32 weeks, birthweight < 2500 g, and neonatal intensive care unit admission was significantly lower in the adjuvant progesterone group than in the non‐adjuvant group (P < 0.05 for all).

Conclusion

Adjuvant vaginal progesterone therapy with PEICC was associated with reductions in SPTB, low birthweight, and neonatal intensive care unit admission.
Spontaneous parasitic leiomyoma in a post‐partum woman
Authors: Iida Mana , Ishikawa Hiroshi , Shozu Makio
Published: September 2016

We report a case of spontaneous parasitic leiomyoma in a 30‐year‐old post‐partum woman. A subserosal leiomyoma had been noted at the first trimester screening, and she had experienced persistent abdominal pain during her previous pregnancy. She was referred to hospital with severe abdominal pain at 7 months after delivery. We detected a homogenous solid tumor that resembled the subserosal leiomyoma but was completely detached from the uterus. On laparoscopy the vascularization of the tumor was supplied from the omentum, which was tightly adherent to the tumor. Histopathologically, the tumor was surrounded by a fibrous vascular capsule, and broadly hyalinized and partially calcified, consistent with a degenerated uterine leiomyoma. Detachment of a pedunculated subserosal leiomyoma from the uterus following adhesion to other pelvic structures throughout pregnancy may result in a parasitic leiomyoma, a rare subtype of uterine leiomyoma.
C‐peptide and diabetic kidney disease
Authors: Brunskill N. J.
Published: September 2016

Kidney disease is a serious development in diabetes mellitus and poses an increasing clinical problem. Despite increasing incidence and prevalence of diabetic kidney disease, there have been no new therapies for this condition in the last 20 years. Mounting evidence supports a biological role for C‐peptide, and findings from multiple studies now suggest that C‐peptide may beneficially affect the disturbed metabolic and pathophysiological pathways leading to the development of diabetic nephropathy. Studies of C‐peptide in animal models and in humans with type 1 diabetes all suggest a renoprotective effect for this peptide. In diabetic rodents, C‐peptide reduces glomerular hyperfiltration and albuminuria. Cohort studies of diabetic patients with combined islet and kidney transplants suggest that maintained C‐peptide secretion is protective of renal graft function. Further, in short‐term studies of patients with type 1 diabetes, administration of C‐peptide is also associated with a lowered hyperfiltration rate and reduced microalbuminuria. Thus, the available information suggests that type 1 diabetes should be regarded as a dual hormone deficiency disease and that clinical trials of C‐peptide in diabetic nephropathy are both justified and urgently required.
Letting Oneself Go Isn't Enough: Cognitively Oriented Expressive Writing Reduces Preadolescent Peer Problems
Authors: Travagin Gabriele , Margola Davide , Dennis John L. , Revenson Tracey A.
Published: September 2016

Peer problems are a stressor for many early adolescents, and simple cost‐effective tools for managing peer stress are needed. Expressive writing (EW) may be one such tool. With a sample of middle school children aged 12–14 years (n = 119; 53% males), this research evaluates whether cognitively oriented expressive writing (CEW), which focuses more on psychological self‐distancing, improves personal well‐being better than traditional EW, which focuses more on emotional disclosure. CEW—compared with EW—slightly enhanced long‐term social adjustment for the entire sample, and increased positive affect for those early adolescents that reported more peer problems at baseline. These findings suggest that structured writing instructions with early adolescents may be key to improvements.
The Effectiveness of a Parent Legislative Advocacy Program
Authors: Burke Meghan M. , Sandman Linda
Published: September 2016

Although parents of students with disabilities have several rights accorded by the Individuals with Disabilities Education Act (IDEA), they infrequently participate in legislative advocacy. Given that Individuals with Disabilities Education Act is expected to be reauthorized within the next few years, it is necessary to educate parents of students with disabilities to engage in broader systemic change. Using a culturally and linguistically diverse sample, this study evaluated the effectiveness of a parent advocacy program. We examined whether the program increased the empowerment, knowledge, and motivation of the participants. We also examined the long‐term effects of the advocacy program. Using pre‐ and postsurveys, we measured change in knowledge of special education and the legislative process, empowerment, and public service motivation of 41 participants in the program. We also conducted 6‐month, follow‐up surveys with 29 (70.7%) of the participants to measure their legislative advocacy activities. Results indicated that participants demonstrated significant gains in empowerment, knowledge (of special education and the legislative process) and public service motivation. Also, after attending the program, participants engaged in legislative advocacy. This study has important implications about parent legislative advocacy for researchers, practitioners, and policymakers.
Acute sleep restriction increases dietary intake in preschool‐age children
Authors: Mullins Elsa N. , Miller Alison L. , Cherian Sherin S. , Lumeng Julie C. , Wright Kenneth P. , Kurth Salome , Lebourgeois Monique K.
Published: September 2016

Epidemiological findings suggest short sleep duration is associated with overweight and obesity across the lifespan. In adults, experimental sleep loss increases caloric intake more than total daily energy needs, thus leading to weight gain. To date, little is known about the relationship between sleep restriction and dietary intake in preschool children. Healthy children (n = 10; 41.2 ± 5.4 months; 5 females) followed a strict sleep schedule for 5 days before each experimental condition: 1 day of baseline sleep (nap and scheduled bedtime/wake time) and 1 day of sleep restriction (no‐nap and ~2.3 h bedtime delay). Standardized parent‐report dietary intake measures were obtained on baseline, sleep restriction and sleep recovery (ad libitum sleep opportunity in the 24‐h following sleep restriction) days. As designed, children slept ~3 h less on the sleep restriction than the baseline day (P < 0.001), with no significant differences in sleep between baseline and recovery days (verified with actigraphy). Repeated‐measures anovas indicated differences across conditions in total kilocalories, sugar, carbohydrate and fat intake (all P < 0.05; no differences in protein). Post hoc tests revealed that compared with baseline, children consumed 21% more kilocalories, 25% more sugar and 26% more carbohydrates on the day of sleep restriction, as well as 14% more kilocalories and 23% more fat on the day of sleep recovery (all P < 0.05). Findings suggest that acute sleep loss increases dietary intake in preschoolers both on the day of and the day after sleep restriction. Increased kilocalorie intake may promote weight gain over time and be a mechanism through which short sleep contributes to childhood obesity risk.
Feline Exocrine Pancreatic Insufficiency: A Retrospective Study of 150 Cases
Authors: Xenoulis P.G. , Zoran D.L. , Fosgate G.T. , Suchodolski J.S. , Steiner J.M.
Published: September 2016

Background

Little information is available about the clinical presentation and response to treatment of cats with exocrine pancreatic insufficiency (EPI).

Objectives

To describe the signalment, clinical signs, concurrent diseases, and response to treatment of cats withEPI.

Animals

One hundred and fifty cats withEPI.

Methods

Retrospective case series.

Results

Questionnaires were sent to 261 veterinarians, and 150 (57%) were returned with data suitable for statistical analysis. The median age of the cats withEPIwas 7.7 years. The median body condition score was 3 of 9. Ninety‐two of 119 cats (77%) had hypocobalaminemia, and 56 of 119 cats (47%) had increased and 6 of 119 cats (5%) had decreased serum folate concentrations. Clinical signs included weight loss (91%), unformed feces (62%), poor hair coat (50%), anorexia (45%), increased appetite (42%), lethargy (40%), watery diarrhea (28%), and vomiting (19%). Eighty‐seven cats (58%) had concurrent diseases. Treatment response was reported to be good in 60%, partial in 27%, and poor in 13% of 121 cats. Trypsin‐like immunoreactivity <4 μg/L was associated with a positive response to treatment (OR, 3.2; 95%CI, 1.5–7.0;P= .004). Also, cobalamin supplementation improved the response to treatment (OR, 3.0; 95%CI, 1.4–6.6;P= .006).

Conclusions and Clinical Importance

Exocrine pancreatic insufficiency in cats often has a different clinical presentation than in dogs. The age range forEPIin cats is wide, and many cats can be ≤5 years of age. Most cats respond well to appropriate treatment forEPI, and cobalamin supplementation appears to be necessary for a good response.
Nitrogen uptake in light versus darkness of the seagrass Zostera noltei: integration with carbon metabolism
Authors: Alexandre Ana , Silva João , Santos Rui
Published: September 2016

We conducted a study that shows that light and dark conditions do not affect the uptake rates of ammonium and nitrate by the seagrass Zostera noltei. This is an important advantage over some seaweed species in which these rates are severely reduced at night. In the light, the ammonium uptake rates were initially higher (15 and 20 μmol·g−1·h−1) and stabilized at a rate of 5 μmol·g−1·h−1 after 1 h, whereas in the dark the rates remained constant at a rate of 10 μmol·g−1·h−1 over the first 180 min of incubation. The rates of nitrate uptake in the light were high within the first 120 min of incubation (7.2–11.1 μmol·g−1·h−1) and decreased afterwards to lower values (0.8–3.9 μmol·g−1·h−1), whereas in the dark the rates fluctuated around 0.0–11.1 μmol·g−1·h−1 throughout the whole incubation time (7 h). The soluble sugar content of Z. noltei leaves increased significantly with both ammonium and nitrate incubations in the light, indicating the metabolic outcome of photosynthesis. In the dark, there was no significant variation in either the soluble sugar or in the starch content of leaves, rhizomes or roots in either the ammonium or nitrate incubations. However, the total starch content of plants decreased at night whereas the total soluble sugars increased, suggesting a process of starch catabolism to generate energy with the consequent production of smaller monosaccharide products. The starch content of rhizomes decreased significantly during the light incubations with nitrate but not with ammonium. These results suggest that carbohydrate mobilization is necessary for Z. noltei to account for extra energetic costs needed for the uptake and assimilation of nitrate. Furthermore, our results suggest that nitrate uptake, at least during the day, requires the mobilization of starch whereas the uptake of ammonium does not.
Influence of anthropogenic pressure and seasonal upwelling on coral reefs in Nha Trang Bay (Central Vietnam)
Authors: Tkachenko Konstantin S. , Britayev Temir A. , Huan Nguyen H. , Pereladov Mikhail V. , Latypov Yuri Y.
Published: September 2016

The growing coastal development, dredging and dumping activities, overfishing and expansion of marine cage culture in Nha Trang Bay (NTB) of Central Vietnam since the beginning of the 2000s have resulted in a dramatic decrease of live coral cover. Surveys conducted in April–May 2013 and the same period in 2014 revealed that with an increase in distance from the outer part of the bay towards the mainland, the rivers’ influxes and dredged areas, coral cover decreased from 75% to 0.6% and species richness from 63 to 5, while the abundance of macroalgae increased from 0% to 56%. These changes correlate with differences in the concentration of suspended sediments on the same gradient. The abundance of the crown‐of‐thorns starfish Acanthaster planci and of the echinoid Diadema setosum significantly increased between the first estimation in 1998 and the survey in 2014, from 0 to 1.7 individuals (ind.) per 100 m−2 and from 50.8 to 94.5 ind. per 100 m−2, respectively, contributing to coral loss and intensive bioerosion of the reef framework in the bay. The large sizes of adult colonies of tabulate Acropora on the remote stations with negligible sedimentation and eutrophication loads were inconsistent with the assumptions that temperature‐induced coral bleaching or cyclones could be the major impacts in Nha Trang Bay. Analysis of the 16‐year thermal history of the bay did not reveal any instances in which the coral thermal bleaching threshold had been exceeded up to the present study. Seasonal upwelling, which occurs annually in the vicinity of Central Vietnam, may contribute to mitigation of thermal anomalies within NTB and to the maintenance of healthy coral communities on the remote reefs with relatively low anthropogenic impact.
The edges of the nation: a research agenda for uncovering the taken‐for‐granted foundations of everyday nationhood
Authors: Fox Jon E.
Published: September 2016

In many parts of the world, nationalism has gone underground. It's there, just beneath the surface, underpinning the social order without requiring, or even permitting, much tinkering. This is the realm of the unselfconscious: nationhood not as an object of purposeful manipulation, but as an unspoken set of assumptions about the national order of things. But if the nation is unseen, unheard, unnoticed, how do we know this? Indeed, how can we know this? In this paper, I elaborate a breaching approach for uncovering the ways the nation is taken for granted. I look to the edges of the nation: the places, times and situations where the nation is on the periphery – the edges – of consciousness, lurking just beneath the surface where it might be teased out with a carefully concocted breach. My aim is to explore and exploit these edges to turn unselfconscious suppositions about the nation into explicit articulations of the nation.
Defining roles of tandemly arrayed CBF genes in freezing tolerance with new genome editing tools
Authors: Hua Jian
Published: September 2016

This article is a commentary on Jia et al., 212: 345–353.
Altered Neural Correlates of Emotion Associated Pain Processing in Persistent Somatoform Pain Disorder: An fMRI Study
Authors: Luo Yanli , Yan Chao , Huang Tianming , Fan Mingxia , Liu Liang , Zhao Zhiyong , Ni Kaiji , Jiang Hong , Huang Xiao , Lu Zheng , Wu Wenyuan , Zhang Mingyuan , Fan Xiaoduo
Published: September 2016

Patients with persistent somatoform pain disorder (PSPD) suffer from long‐term pain and emotional conflicts. Recently, accumulating evidence indicated that emotion has a significant role in pain perception of somatoform pain disorder. To further understand the association between emotion and pain‐related brain activities, functional activities of patients with PSPD fulfilling ICD‐10 criteria and healthy controls were assessed using functional magnetic resonance imaging technology, while participants viewed a series of positive, neutral, or negative pictures with or without pinprick pain stimulation. Results showed that patients with PSPD had altered brain activities in the parietal gyrus, temporal gyrus, posterior cingulate cortex, prefrontal cortex, and parahippocampus in response to pinprick pain stimuli during different emotions compared with the healthy control group. Moreover, patients with PSPD consistently showed hyperactivities in the prefrontal, the fusiform gyrus and the insula in response to negative stimuli under pinprick pain vs. non‐pain condition. The current findings provide some insights into the underlying relationship between emotion and pain‐related brain activity in patients with PSPD, which is of both theoretical and clinical importance.
Emergent Themes in the Interface Between Economics of Information Systems and Management of Technology
Authors: Ba Sulin , Nault Barrie R.
Published: September 2016

In this article, we look at research published over a five‐year time span in the economics of information systems (IS) area in four premier journals, including Management Science, Information Systems Research, MIS Quarterly, and Production and Operations Management, to identify research themes that have implications for future research in the area of Management of Technology (MOT). Through our examination of the literature, we identify three emergent themes that can be used to form foundations for future MOT research from an economics of IS perspective: productivity, vertical relations, and platforms. Within each of these themes, we classify previous research into subthemes, summarize the major findings, and explore future research opportunities within the MOT domain that are relevant to these subthemes. Specifically, we examine how information technology has impacted firm productivity, their product design and development process, innovation capabilities, knowledge management capabilities, and supply chain integration.
Does the implementation of environmental flows improve wetland ecosystem services and biodiversity? A literature review
Authors: Yang Wei , Sun Tao , Yang Zhifeng
Published: September 2016

Environmental flow releases are a tool for wetland restoration, but there has been no systematic evaluation of their success. We systematically assessed 102 published studies from a wide range of wetland ecosystems across the globe to determine whether releasing environmental flows could maintain or promote biodiversity and increase ecosystem services, and which strategies were most effective. We found that environmental flow releases remarkably increased regulating services (sediment regulation and water purification) and supporting services (primary production and habitat maintenance), and maintained biodiversity and provisioning services. Biodiversity responses were positive only in river wetlands, and were negative in coastal, lake, and marsh wetlands; the overall delivery of ecosystem services responded positively in all ecosystem types except artificial wetlands. The effects were positive for ecosystem services under all environmental flow regimes, and seasonal minimum flow releases could maintain biodiversity and improve ecosystem services. We also found that long‐term environmental flow releases (years to decades) maintained biodiversity. Values of a change‐in‐flow parameter (D) ranging from 0 to 10% improved both biodiversity and ecosystem services. In summary, long‐term implementation, a high‐flow regime, and D ranging from 0 to 10% for the environmental flows promoted biodiversity and improved ecosystem services around the world, particularly in river wetlands. Regional‐level conclusions might be applicable to guide the implementation of environmental flow releases, but small sample sizes reduce their reliability. We also found that the effect sizes of environmental flow release projects for biodiversity and ecosystem services were significantly and positively correlated in rivers, but not in other wetlands.
Addressing location uncertainties in GPS‐based activity monitoring: A methodological framework
Authors: Wan Neng , Lin Kan Ge , Wilson Gaines
Published: September 2016

Location uncertainty has been a major barrier in information mining from location data. Although the development of electronic and telecommunication equipment has led to an increased amount and refined resolution of data about individuals’ spatio‐temporal trajectories, the potential of such data, especially in the context of environmental health studies, has not been fully realized due to the lack of methodology that addresses location uncertainties. This article describes a methodological framework for deriving information about people's continuous activities from individual‐collected Global Positioning System (GPS) data, which is vital for a variety of environmental health studies. This framework is composed of two major methods that address critical issues at different stages of GPS data processing: (1) a fuzzy classification method for distinguishing activity patterns; and (2) a scale‐adaptive method for refining activity locations and outdoor/indoor environments. Evaluation of this framework based on smartphone‐collected GPS data indicates that it is robust to location errors and is able to generate useful information about individuals’ life trajectories.
Vancomycin‐resistant Enterococcus colonization and bloodstream infection: prevalence, risk factors, and the impact on early outcomes after allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia
Authors: Hefazi Mehrdad , Damlaj Moussab , Alkhateeb Hassan B. , Partain Daniel K. , Patel Robin , Razonable Raymund R. , Gastineau Dennis A. , Al‐Kali Aref , Hashmi Shahrukh K. , Hogan William J. , Litzow Mark R. , Patnaik Mrinal M.
Published: September 2016

Background

Screening for vancomycin‐resistant Enterococcus (VRE) is performed at many transplant centers, but data on the impact of VRE colonization and bloodstream infection (BSI) on hematopoietic cell transplantation (HCT) outcomes remain conflicting.

Methods

Consecutive adults with acute myeloid leukemia who underwent allogeneic HCT between 2004 and 2014 were retrospectively reviewed. Patients were screened by perirectal PCR swabs targeting vanA and vanB twice weekly while inpatient.

Results

Of a total of 203 patients (median age 54 years), 73 (36%) were VRE colonized prior to HCT, 23 (11%) became colonized within the first 100 days, and 107 (53%) remained non‐colonized through day 100 post HCT. A landmark analysis on HCT day 0 revealed no significant difference in overall survival according to pre‐transplant colonization status (P=.20). However, patients with subsequent VRE colonization within the first 100 days of HCT had a significantly worse survival on both univariable (P=.04) and multivariable (P=.03) analyses. During the first 30 days post HCT, 11 (5% of total and 11% of the VRE colonized) patients developed VRE BSI. Ten (91%) of these had screened positive for VRE colonization before the bacteremia. Age ≥60 years, HCT‐comorbidity index ≥3, and VRE colonization were independent risk factors for VRE BSI on multivariable analysis (P=.04, .03, .003, respectively). Only 1 (9%) patient with VRE BSI died within the first 100 days post HCT.

Conclusion

VRE colonization is a surrogate marker and not an independent predictor of worse outcomes post HCT. VRE BSI is associated with increased morbidity, but does not impact post‐HCT survival.
IMAGING DIAGNOSIS—THE COMPUTED TOMOGRAPHY FEATURES OF A PLEUROPERITONEAL HERNIA IN A CAT
Authors: Rose Anne Marie , Ryan Stewart D. , Johnstone Thurid , Beck Cathy
Published: September 2016

An 8‐year‐old female neutered domestic short hair cat presented for investigation of poorly controlled diabetes mellitus. Thoracic radiographs identified a soft tissue opacity in the caudoventral thorax adjacent to the diaphragm. Computed tomography (CT) then characterized a pleuroperitoneal hernia with cranial displacement of a portion of the liver within the hernia. A pleuroperitoneal hernia was confirmed and repaired via exploratory laparotomy. This is the first description of the CT features of a pleuroperitoneal hernia in a cat.
Practical alternatives to chronic caloric restriction for optimizing vascular function with ageing
Authors: Martens Christopher R. , Seals Douglas R.
Published: September 2016

Calorie restriction (CR) in the absence of malnutrition exerts a multitude of physiological benefits with ageing in model organisms and in humans including improvements in vascular function. Despite the well‐known benefits of chronic CR, long‐term energy restriction is not likely to be a feasible healthy lifestyle strategy in humans due to poor sustained adherence, and presents additional concerns if applied to normal weight older adults. This review summarizes what is known about the effects of CR on vascular function with ageing including the underlying molecular ‘energy‐ and nutrient‐sensing’ mechanisms, and discusses the limited but encouraging evidence for alternative pharmacological and lifestyle interventions that may improve vascular function with ageing by mimicking the beneficial effects of long‐term CR.

image
Relating interaural difference sensitivities for several parameters measured in normal-hearing and hearing-impaired listeners
Authors: Spencer Nathaniel J. , Hawley Monica L. , Colburn H. Steven
Published: September 2016

Just-noticeable differences (JNDs) in interaural time delay (ITD), interaural level difference (ILD), and interaural cross-correlation (ICC) were measured with low- and high-frequency noise bands over multiple sessions for 10 normal-hearing (NH) and 11 hearing-impaired (HI) listeners. Individual subject thresholds tended to improve with training then stabilize. Measured JNDs varied over these experienced listeners, for both subject groups and all tasks. Group JNDs were seldom predictable from hearing level. Individual listeners' JNDs were highly correlated across frequency for each task and group, except for ICC in the HI listeners. Further, ITD JNDs almost always significantly correlated with ILD JNDs within a group. Finally, although the ICC JNDs always significantly correlated with the ITD or ILD JNDs for the NH listeners, they often did not for the HI listeners. These findings suggest that little information about binaural sensitivity is added for NH listeners with multiple ITD, ILD, and ICC measures. For HI listeners, however, while ITD and ILD measures are well correlated, information is added with ICC measures. In general, the results suggest that less information is added with JND measures for NH listeners (15 significant correlations) than for HI listeners (six significant correlations).
Hijacking and Use of Host Lipids by Intracellular Pathogens
Authors: Toledo Alvaro , Benach Jorge L.
Published: September 2016

Intracellular bacteria use a number of strategies to survive, grow, multiply, and disseminate within the host. One of the most striking adaptations that intracellular pathogens have developed is the ability to utilize host lipids and their metabolism. Bacteria such as
Anaplasma
,
Chlamydia
, or
Mycobacterium
can use host lipids for different purposes, such as a means of entry through lipid rafts, building blocks for bacteria membrane formation, energy sources, camouflage to avoid the fusion of phagosomes and lysosomes, and dissemination. One of the most extreme examples of lipid exploitation is
Mycobacterium
, which not only utilizes the host lipid as a carbon and energy source but is also able to reprogram the host lipid metabolism. Likewise,
Chlamydia
spp. have also developed numerous mechanisms to reprogram lipids onto their intracellular inclusions. Finally, while the ability to exploit host lipids is important in intracellular bacteria, it is not an exclusive trait. Extracellular pathogens, including
Helicobacter
,
Mycoplasma
, and
Borrelia
, can recruit and metabolize host lipids that are important for their growth and survival.

Throughout this chapter we will review how intracellular and extracellular bacterial pathogens utilize host lipids to enter, survive, multiply, and disseminate in the host.