bluuebunny/crossref_metadata_2025 huggingface dataset:
Exogenous cesarean scar pregnancies managed by suction curettage alone or in combination with other therapeutic procedures: A series of 33 cases and analysis of complication profile
Authors: Özdamar Özkan , Doğer Emek , Arlıer Sefa , Çakıroğlu Yiğit , Ergin Rahime Nida , Köpük Şule Yıldırım , Çalışkan Eray
Published: April 2016

Aim

The aim of this study was to review our exogenous cesarean scar pregnancy (CSP) cases that were managed through transabdominal ultrasound (TAUS)‐guided suction curettage either alone or with a concomitant additional therapeutic modality. The study was carried out over a 6‐year period and we compared clinical outcomes, success rates and complication profiles between the two therapeutic approaches.

Methods

A total of 33 exogenous CSP patients who were managed by suction curettage were extracted from the medical records. The patients were analyzed according to the intervention applied in the two groups as: TAUS‐guided suction curettage alone (Group 1); and additional therapeutic tools, such as systemic or intracavitary administration of methotrexate and intracavitary ethanol instillation, in combination with suction curettage (Group 2). Basic demographic and clinical characteristics of women experiencing hemorrhagic complications and those who did not after the treatment were also compared.

Results

There were no cases of uterine perforation, hysterectomy or unresponsiveness to treatment in our analyzed CSP cases. Four patients, two in each group, required blood transfusion. Our success rate in the overall patient population was 87.8% (29/33). Fourteen out of 16 patients who were treated with TAUS‐guided suction curettage alone, and 15 out of 17 patients who received other interventional treatment modalities preceding suction curettage revealed successful resolution of the CSP without any complication (P= 0.948). Clinical and demographic characteristics of women who experienced any hemorrhagic complication did not significantly differ from those who did not.

Conclusion

In appropriate CSP cases, TAUS‐guided suction curettage appears to be a reliable treatment option with acceptable success rates and similar complication profile to other therapeutic options.
Fulminant liver failure in a neonate
Authors: Clarke Naomi E , Gilby Damien , Savoia Helen , Oliver Mark R , Rogerson Sheryle
Published: April 2016

Neonatal acute liver disease is relatively rare, with multiple different aetiologies including congenital infections, metabolic disorders, gestational alloimmune liver disease, haemophagocytic lymphohistiocytosis, and ischaemic injury. We report a case of neonatal liver failure in a preterm, growth‐restricted infant, who underwent extensive investigation and was clinically diagnosed with gestational alloimmune liver disease, which was confirmed on post‐mortem examination. We then discuss management of neonatal liver failure and gestational alloimmune liver disease, including maternal management in future pregnancies.
Somatic Hybrids Between Potato and S. berthaultii Show Partial Resistance to Soil‐Borne Fungi and Potato Virus Y
Authors: Nouri‐Ellouz Oumèma , Triki Mohamed Ali , Jbir‐Koubaa Rania , Louhichi Assawer , Charfeddine Safa , Drira Noureddine , Gargouri‐Bouzid Radhia
Published: April 2016

Three tetraploid somatic hybrid lines produced by protoplast fusion between a dihaploid potato, Solanum tuberosum, cultivar BF15 and the wild potato species Solanum berthaultii were evaluated here for their response to different soil‐borne pathogens, that is Fusarium solani, Pythium aphanidermatum and Rhizoctonia solani as well as to infection by potato virus Y (PVY). Both hybrid and BF15 plants grown in vitro were inoculated with the tested pathogen strains, that is R. solani, P. aphanidermatum, or F. solani. The growth level and disease severity index of these plants were compared to the susceptible commercial cultivar Spunta. A better growth of inoculated hybrid plants and restricted disease symptoms were observed in comparison with the commercial plants. Under glasshouse conditions and after inoculation with R. solani and P. aphanidermatum, improved resistance of the hybrid plants to these pathogens was confirmed. Indeed, these plants showed no significant damage following inoculation and a better development in R. solani‐infected plants. The susceptibility of the hybrid tubers to R. solani, P. aphanidermatum, and to F. solani infection was also determined. A significant reduction of tissue colonisation was observed in all the hybrid lines compared to the cultivated cultivars. The STBc and STBd hybrids also showed improved resistance to the PVY ordinary strain (PVYo) under glasshouse conditions.
Food Sensory Properties and the Older Adult
Authors: Field Katherine , Duizer Lisa M.
Published: April 2016

Older adults represent a large and growing portion of the global population. Given the high risk of malnutrition in this population, it is important to understand factors influencing food intake; sensory perception is one of these factors. Aging is associated with a number of physiological changes that alter the way food sensory properties are perceived. Because of these changes, it is often assumed that older adults experience a decrease in food liking. Although there is little evidence to support this assumption, many studies have evaluated flavor enhancement strategies aiming to increase food liking in older adults. As older adults exhibit a high degree of heterogeneity in their liking response, more tailored approaches may be required to increase food liking in older adult populations. Current attempts to classify subgroups of older adults have had little success. Furthermore, consideration should be given to food texture in future studies, as it plays a dominant and increasingly vital role in food perception by older adults.

Practical Applications

Sensory perception plays an important role in food choice and intake, thus it is important to understand how foods are perceived by older adults. This is essential to the health and well‐being of older adults, as the reduction in food intake often observed with ageing is a key contributor to malnutrition in this population. The success of studies aiming to improve food liking in older adults have had very limited success to date, with some strategies actually leadings to a reduction in food consumption. To improve the success of future strategies, food perception by older adults, and the increasingly vital role of food texture must be understood.
Polyploid unisexual salamanders have higher tissue regeneration rates than diploid sexual relatives
Authors: Saccucci M. J. , Denton R. D. , Holding M. L. , Gibbs H. L.
Published: April 2016

Differences in genome composition are known to influence cell division and tissue growth, yet few studies have compared tissue growth between closely related taxa that vary in ploidy and genome composition. Whether cellular mechanisms scale to a functional trait such as tissue regeneration is important for understanding the ecological interactions between polyploids and closely related diploid taxa. We studied regeneration in unisexual Ambystoma salamanders, an ancient unisexual (all‐female) lineage in which most individuals are triploids consisting of combinations of two or more distinct genomes from their sexual relatives. We discuss the aspects of haploid genome size and polyploidy that may contribute to variation in tissue regeneration and hypothesize that higher ploidy or variations in genome composition in unisexual Ambystoma would result in increased tissue regeneration compared to diploid sexual relatives, as polyploidy is generally associated with faster limb regeneration. We tested this hypothesis by comparing tail regeneration rates over 4 months between polyploid unisexual salamanders and sympatric diploid sexual salamanders under standardized laboratory conditions. Consistent with our prediction, unisexual Ambystoma regenerated tail tissue at approximately twice the rate of the sexual species. This result provides a physiological difference between unisexual and sexual salamanders that could influence their coexistence.
Prediction of HCV vertical transmission: what factors should be optimized using data mining computational analysis
Authors: Elrazek Abd , Amer Mohamed , El‐Hawary Bahaa , Salah Altaher , Bhagavathula Akshaya S. , Alboraie M. , Saab Samy
Published: April 2016

Background & Aims

Neonates born to hepatitis C virus (HCV)‐positive mothers are usually not screened for HCV. Unscreened children may act as active sources for social HCV transmission, and factors contributing for vertical HCV transmitting still remained controversial and needed optimization. We aimed to investigate the factors contributing for vertical HCV transmission in Egypt; the highest HCV prevalence worldwide.

Methods

We prospectively followed the neonates born to HCV‐positive mother in the child‐bearing period, to identify mother‐to‐child transmission (MTCT) factors from January 2015 to March 2016. Data mining computational analysis was used to quantify the findings.

Results

Among 3000 randomized pregnant women, prevalence of HCV was 46/3000 (1.53%). HCV vertical transmission was identified in eight neonates (17.39%). Only high viral load identified at 975.000 IU was the predictor risk for MTCT.

Conclusions

Hepatitis C virus in pregnancy has substantial risk for vertical HCV transmission: High viral load in HCV‐positive women increases the risk of HCV transmission to neonates. Screening pregnant women during early stage of pregnancy and optimizing the HCV viral load in HCV‐positive women might prevent vertical HCV transmission to neonates.
The detection of oesophageal varices using a novel, disposable, probe‐based transnasal endoscope: a prospective diagnostic pilot study
Authors: Sami Sarmed S. , Ragunath Krish , Wilkes Emilie A. , James Martin , Mansilla‐Vivar Rodrigo , Ortiz‐Fernández‐Sordo Jacobo , White Jonathan , Khanna Amardeep , Coletta Marina , Samuel Sunil , Aithal Guruprasad P. , Guha Indra Neil
Published: April 2016

Background & Aims

Screening for oesophageal varices (OV) using conventional oesophagogastroduodenoscopy (C‐OGD) is invasive and requires costly monitoring, recovery, and decontamination facilities. We aimed to evaluate the technical feasibility, acceptability and accuracy of a novel, portable and disposable office‐based transnasal endoscope (EG Scan™) compared to C‐OGD as the reference standard.

Methods

This was a prospective cohort study. Consecutive adult patients with cirrhosis were invited to participate. All subjects underwent the two procedures on the same day performed by two endoscopists in a blinded design. Patients completed preference and validated tolerability (10‐point visual analogue scale (VAS)) questionnaires on day 0 and day 14 post procedures.

Results

Forty‐five of 50 patients (90%) completed both interventions. Mean age was 59 years and OV prevalence was 49%.

Patients reported higher preference (percentage) and better experience (mean VAS) with EG Scan compared to C‐OGD on day 0 (76.5% vs. 23.5%, P < 0.001; 7.8 vs. 6.8, P = 0.058, respectively) and day 14 (77.8% vs. 22.2%, P < 0.001; 7.0 vs. 5.5, P = 0.0013 respectively). Sensitivity and specificity of the EG Scan for the diagnosis of any size OV were 0.82 (95% confidence interval (CI) 0.60–0.95), and 0.78 (95% CI 0.56–0.93) respectively. Corresponding values for the diagnosis of clinically significant (medium/large) OV were 0.92 (95% CI 0.62–1.0), 0.97 (95% CI 0.84–1.0) respectively. No serious adverse events occurred.

Conclusions

EG Scan accuracy was higher for the diagnosis of medium/large OV compared to any size OV. Patients' preference and overall experience of the EG Scan was favourable compared to C‐OGD 14 days after procedures.
Transcriptomic plasticity in brown adipose tissue contributes to an enhanced capacity for nonshivering thermogenesis in deer mice
Authors: Velotta Jonathan P. , Jones Jennifer , Wolf Cole J. , Cheviron Zachary A.
Published: April 2016

For small mammals living at high altitude, aerobic heat generation (thermogenesis) is essential for survival during prolonged periods of cold, but is severely impaired under conditions of hypobaric hypoxia. Recent studies in deer mice (Peromyscus maniculatus) reveal adaptive enhancement of thermogenesis in high‐ compared to low‐altitude populations under hypoxic cold stress, an enhancement that is attributable to modifications in the aerobic metabolism of muscles used in shivering. However, because small mammals rely heavily on nonshivering mechanisms for cold acclimatization, we tested for evidence of adaptive divergence in nonshivering thermogenesis (NST) under hypoxia. To do so, we measured NST and characterized transcriptional profiles of brown adipose tissue (BAT) in high‐ and low‐altitude deer mice that were (i) wild‐caught and acclimatized to their native altitude, and (ii) born and reared under common garden conditions at low elevation. We found that NST performance under hypoxia is enhanced in wild‐caught, high‐altitude deer mice, a difference that is associated with increased expression of coregulated genes that influence several physiological traits. These traits include vascularization and O2 supply to BAT, brown adipocyte proliferation and the uncoupling of oxidative phosphorylation from ATP synthesis in the generation of heat. Our results suggest that acclimatization to hypoxic cold stress is facilitated by enhancement of nonshivering heat production, which is driven by regulatory plasticity in a suite of genes that influence intersecting physiological pathways.
Base J represses genes at the end of polycistronic gene clusters in Leishmania major by promoting RNAP II termination
Authors: Reynolds David L. , Hofmeister Brigitte T. , Cliffe Laura , Siegel T. Nicolai , Anderson Britta A. , Beverley Stephen M. , Schmitz Robert J. , Sabatini Robert
Published: April 2016

The genomes of kinetoplastids are organized into polycistronic gene clusters that are flanked by the modified DNA base J. Previous work has established a role of base J in promoting RNA polymerase II termination in Leishmania spp. where the loss of J leads to termination defects and transcription into adjacent gene clusters. It remains unclear whether these termination defects affect gene expression and whether read through transcription is detrimental to cell growth, thus explaining the essential nature of J. We now demonstrate that reduction of base J at specific sites within polycistronic gene clusters in L. major leads to read through transcription and increased expression of downstream genes in the cluster. Interestingly, subsequent transcription into the opposing polycistronic gene cluster does not lead to downregulation of sense mRNAs. These findings indicate a conserved role for J regulating transcription termination and expression of genes within polycistronic gene clusters in trypanosomatids. In contrast to the expectations often attributed to opposing transcription, the essential nature of J in Leishmania spp. is related to its role in gene repression rather than preventing transcriptional interference resulting from read through and dual strand transcription.
Arabidopsis thalianaG2‐LIKE FLAVONOID REGULATOR and BRASSINOSTEROID ENHANCED EXPRESSION1 are low‐temperature regulators of flavonoid accumulation
Authors: Petridis Antonios , Döll Stefanie , Nichelmann Lars , Bilger Wolfgang , Mock Hans‐Peter
Published: April 2016

Flavonoid synthesis is predominantly regulated at the transcriptional level through the MYB−basic helix‐loop‐helix (bHLH)−WD40 (MBW) (MYB: transcription factor of the myeloblastosis protein family, WD40: tanscription factor with a short structural motif of 40 amino acids which terminates in an aspartic acid–tryptophan dipeptide) complex, and responds to both environmental and developmental stimuli. Although the developmental regulation of flavonoid accumulation inArabidopsis thalianahas been examined in great detail, the response of the flavonoid synthesis pathway to abiotic stress (particularly low temperature) remains unclear.

A screen of a Dissociation element (Ds) transposon‐induced mutation collection identified two lines which exhibited an altered profile of phenylpropanoid accumulation following exposure to low‐temperature stress. One of the mutated genes (BRASSINOSTEROID ENHANCED EXPRESSION1(BEE1)) encoded a brassinosteroid enhanced expression transcription factor, while the other (G2‐LIKE FLAVONOID REGULATOR(GFR)) encoded a G2‐like flavonoid regulator. Phenylpropanoid‐targeted analysis was performed using high‐performance LC‐MS, and gene expression analysis using quantitative reverse transcription−PCR.

In both mutants, the accumulation of quercetins and scopolin was reduced under low‐temperature growing conditions, whereas that of anthocyanin was increased.BEE1andGFRwere both shown to negatively regulate anthocyanin accumulation by inhibiting anthocyanin synthesis genes via the suppression of the bHLH (TRANSPARENT TESTA8(TT8) andGLABROUS3(GL3)) and/or the MYB (PRODUCTION OF ANTHOCYANIN PIGMENTS2(PAP2)) components of the MBW complex.

Our results provide new insight into the regulatory control of phenylpropanoid metabolism at low temperatures, and reveal thatBEE1andGFRact as important components of the signal transduction chain.
Assessment and treatment of pain in thalassemia
Authors: Lal Ashutosh
Published: April 2016

Pain is a subjective symptom whose prevalence can be grossly underestimated. The high proportion of adults with thalassemia who experience chronic pain is evident from recent surveys. However, pain has not received enough attention in the overall management of thalassemia. The association of pain with the type and treatment of thalassemia or with its comorbidities is unclear. Abnormal spine imaging is seen in patients reporting pain, although the role of osteopenia has not been established. Pain becomes more frequent with age. The lower back is the most common site and can be particularly disabling and difficult to treat. Treatable causes, such as extramedullary masses or disc herniation or fractures, must be ruled out. Some adults experience increasing pain when the hemoglobin drops at the end of transfusion cycles. Interdisciplinary management of pain is necessary, while overreliance on medications can be counterproductive. The impact of chronic pain on the quality of life must be acknowledged. Physical therapy, psychological counseling, and vocational rehabilitation are vital to management. I recommend a proactive approach for prevention of pain by maintaining optimal bone density and an active lifestyle. I further propose that a universal tool be adopted to document and characterize pain at routine clinic visits.
Quasi‐Experimental Evidence on the Effects of Health Information on Preventive Behaviour in Europe
Authors: Carrieri Vincenzo , Wuebker Ansgar
Published: April 2016

We investigate the effect of information on preventive decisions in a quasi‐experimental setting arising from the implementation of local breast cancer screening programmes in Europe. To identify the causal effect of invitation on preventive uptake, we link administrative public data on regional screening policies to individual data from the Survey of Health Ageing and Retirement in Europe (SHARE) and exploit regional variation in the availability of screening policies and in age eligibility criteria. We find home invitation increases mammography uptakes by around 24%. Significant effects are found when at least 50% of the population is reached by the invitation letter. The stock of health information and the ability to process the information received seem to play a significant role, as the effects of invitation are higher among low educated and lower among cognitively impaired women.
Is there a relationship between obesity and tooth loss and edentulism? A systematic review and meta‐analysis
Authors: Nascimento G. G. , Leite F. R. M. , Conceição D. A. , Ferrúa C. P. , Singh A. , Demarco F. F.
Published: April 2016

This study conducted a systematic review to assess the bi‐directional association between tooth loss/edentulism and obesity. Electronic searches were performed in four different databases. Observational studies that tested associations between tooth loss/edentulism and obesity as either exposures or outcomes were included. Additionally, meta‐analyses, funnel plots and sensitivity analyses were conducted to synthesize the evidence. A total of 549 articles were identified in the electronic database search. Out of which, 16 studies were included within the meta‐analyses: 75% considered tooth loss/edentulism as exposure and obesity as outcome, whereas 25% alternatively considered obesity as exposure and tooth loss/edentulism as outcome. Pooled estimates showed that obese individuals had 1.49 (95%CI 1.20–1.86) and 1.25 (95%CI 1.10–1.42) times higher odds of having any tooth loss and edentulism, respectively. Alternatively, when tooth loss or edentulism were considered as exposures, individuals with any tooth loss had 1.41 (95%CI 1.11–1.79) times higher odds for obesity, while edentates had even higher odds (OR 1.60; 95%CI 1.29–2.00). The results indicate a bi‐directional association between tooth loss and obesity. Considering that all selected studies were of cross‐sectional study design limiting inferences on temporality, longitudinal prospective studies are required to test the causal relationship between tooth loss/edentulism and obesity or vice a versa. © 2016 World Obesity
The incretin system ABCs in obesity and diabetes – novel therapeutic strategies for weight loss and beyond
Authors: João A. L. , Reis F. , Fernandes R.
Published: April 2016

Incretins are gastrointestinal‐derived hormones released in response to a meal playing a key role in the regulation of postprandial secretion of insulin (incretin effect) and glucagon by the pancreas. Both incretins, glucose‐dependent insulinotropic polypeptide and glucagon‐like peptide‐1 (GLP‐1), have several other actions by peripheral and central mechanisms. GLP‐1 regulates body weight by inhibiting appetite and delaying gastric, emptying actions that are dependent on central nervous system GLP‐1 receptor activation. Several other hormones and gut peptides, including leptin and ghrelin, interact with GLP‐1 to modulate appetite. GLP‐1 is rapidly degraded by the multifunctional enzyme dipeptidyl peptidase‐4 (DPP‐4). DPP‐4 is involved in adipose tissue inflammation, which is associated with insulin resistance and diabetes progression, being a common pathophysiological mechanism in obesity‐related complications. Furthermore, the incretin system appears to provide the basis for understanding the high weight loss efficacy of bariatric surgery, a widely used treatment for obesity, often in association with diabetes. The present review brings together new insights into obesity pathogenesis, integrating GLP‐1 and DPP‐4 in the complex interplay between obesity and inflammation, namely, in diabetic patients. This in turn will provide the basis for novel incretin‐based therapeutic strategies for obesity and diabetes with promising benefits in addition to weight loss. © 2016 World Obesity
Resistance to anthracnose and turcicum leaf blight in sorghum under dual infection
Authors: Beshir Mayada M. , Okori Patrick , Ahmed Nafisa E. , Rubaihayo Patrick , Ali Abdelbagi Mukhtar , Karim Serunkuuma
Published: April 2016

A half diallel mating design was used to study the inheritance of anthracnose and turcicum leaf blight (TLB) in six sorghum cultivars. Applying pathogens inoculum separately and applying both pathogens simultaneously differently affected the reaction of each genotype. GA06/18 was resistant to both pathogens. GA06/106 x Epuripuri and MUC007/009 x Epuripuri showed high heterosis for resistance to both diseases indicating that they were good materials for sorghum breeding. Additive and non‐additive (dominance) variance components were almost equally reflected by equal contribution of both variances towards the anthracnose resistance suggesting that both additive and dominance gene effects were involved in anthracnose resistance. Contribution of additive gene effects towards TLB resistance was greater than non‐additive gene effects suggesting that additive gene effects were more important in controlling TLB resistance. This study highlighted that deployment of resistant varieties is the most cost effective way to manage both diseases especially when integrated with appropriate agronomy practices.
Melatonin Mediates Monochromatic Light‐induced Insulin‐like Growth Factor 1 Secretion of Chick Liver: Involvement of Membrane Receptors
Authors: Li Suqi , Cao Jing , Wang Zixu , Dong Yulan , Wang Wenli , Chen Yaoxing
Published: April 2016

Monochromatic lights influenced the proliferation and differentiation of skeletal satellite cells in broilers by the enhancement of insulin‐like growth factor 1 (IGF‐1) secretion. However, whether melatonin (MEL)‐mediated monochromatic lights influenced the IGF‐1 secretion remains unclear. Newly hatched broilers, including intact, sham operation and pinealectomy groups, were exposed to blue (BL), green (GL), red (RL) and white light (WL) from a light‐emitting diode system for 14 days. The results showed that GL effectively promoted the secretion of MEL and IGF‐1, the expression of proliferating cell nuclear antigen and MEL receptor subtypes Mel1a, Mel1b and Mel1c in the liver compared to BL and RL in vivo. Moreover, those was a positive correlation between MEL and IGF‐1 (r = 0.834). After pinealectomy, however, these parameters declined, and there were no differences between GL and other monochromatic light treatments. In vitro, exogenous MEL increased hepatocyte proliferation and IGF‐1 secretion. Meanwhile, the MEL enhancements were suppressed by prazosin (selective Mel1c antagonist), followed by luzindole (nonselective Mel1a/Mel1b antagonist), but not suppressed by 4‐phenyl‐2‐propionamideotetralin (selective Mel1b antagonist). These findings demonstrated that MEL mediated the monochromatic light‐induced secretion of IGF‐1 in chicks’ livers by Mel1c and that Mel1a may be involved in this process.
Public Problem Characterization, Policy Solution Generation, and Intra‐Agenda Connectivity
Authors: Liu Xinsheng , Robinson Scott , Vedlitz Arnold
Published: April 2016

While policy agenda studies have extensively examined the interplays of various venues, one under‐explored area is the internal dynamics within an agenda venue. In this study, we focus on one of the important venues—news media—and investigate the inherent connections between how a public problem is characterized and how problem solutions are generated in media agenda setting. Drawing on agenda‐setting theories, we develop a typology to theorize the relationships between problem characterization and solution advocacy, and use a news dataset on climate change to empirically assess how issue characterization affects issue solution generation. Our logistic regressions demonstrate that the likelihoods of climate change policy solutions being proposed in the news are significantly influenced by how the media stories characterize the issue along four key attribute dimensions: issue image, scope, linkage, and narrative style. Key implications are discussed in the conclusion.
Sex differences in concordance rates between auditory event‐related potentials and subjective sexual arousal
Authors: Oliver Taylor L. , Meana Marta , Snyder Joel S.
Published: April 2016

Much research indicates men show a greater concordance between subjective and genital sexual arousal than do women. We investigated the relationship between subjective sexual arousal and brain activation in men and women. Subjective sexual arousal and auditory N1 and P3b ERP amplitudes were measured while 38 participants viewed erotic and non‐erotic films. Most notably, there was a significant correlation between N1 amplitude and sexual arousal in men; for women, there was a significant correlation between the P3b amplitude and sexual arousal. ERP amplitudes were inversely associated with reported arousal, suggesting that sexual arousal interferes with early tone processing for men, and with later tone processing for women. Lastly, for women, pornography/erotica consumption was negatively correlated with P3b amplitudes, suggesting that women who consume more pornography/erotica may also show greater attention to erotic films.
The vulnerability of family caregivers in relation to vulnerability as understood by nurses
Authors: Sarvimäki Anneli , Stenbock‐Hult Bettina , Sundell Eija , Oesch‐Börman Christine
Published: April 2016

In Finland, the care of older persons is shifting from institutional care to family care. Research shows that family caregivers experience their situation much in the same way as professional nurses. The nurses' experiences have been studied in terms of vulnerability, and the same perspective could deepen our understanding of family caregivers' experiences. The aim of this study was to gain knowledge of the vulnerability of older caregivers taking care of an ageing family member. The research questions were as follows: How do family caregivers experience vulnerability? How do their experiences relate to vulnerability as understood by nurses? The study was done as a secondary analysis of focus group interviews on the experiences and daily life of older family caregivers. Four caregivers had taken part in monthly interviews during a period of 10 months. The interviews were analysed by deductive and inductive content analysis. The results showed that the caregivers saw caregiving as part of being human. They experienced a variety of feelings and moral agony and were harmed physically, mentally and socially. They showed courage, protected themselves and recognised that being a caregiver also was a source of maturing and developing. These results corresponded with the nurses' understanding of vulnerability. Shame, the experience of duty as a burden, worry and loneliness were themes that were found only among the family caregivers. The use of a matrix may have restricted the analysis, but using it in an unconstrained way allowed for new themes to be created. The results indicate a common humanness and vulnerability in professional and family caregiving. They also show that family caregivers need more support both from society and professionals.
Personal care assistants' experiences of caring for people on home mechanical ventilation
Authors: Israelsson‐Skogsberg Åsa , Lindahl Berit
Published: April 2016

Aim

The aim of this study was to describe personal care assistants' (PCA) experiences of working with a ventilator‐assisted person at home.

Methods

Data were collected from fifteen audiotaped semistructured interviews with PCAs supporting a child or adult using home mechanical ventilation (HMV). Thirteen women and two men participated; their working experience with HMV users ranged from one to 17 years (median 6 years). Data were subjected to qualitative content analysis in an inductive and interpretive manner.

Findings

Five categories emerged from the data: Being part of a complex work situation; Taking on a multidimensional responsibility; Caring carried out in someone's home; Creating boundaries in an environment with indistinct limits; and Being close to another's body and soul.

Conclusions

The participants felt very close to the person they worked with, both physically and emotionally. They had a great responsibility and therefore a commensurate need for support, guidance and a well‐functioning organisation around the HMV user. There is international consensus that advanced home care will continue to expand and personal care assistance is key in this development. We suggest that one way to move forward for PCAs working with HMV users is to create multiprofessional teams led by a key‐person who coordinates the individual needs. More research is needed within this area from a broad perspective including the HMV‐assisted persons, relatives, personal care assistants and management organisations.
The Eyberg Child Behavior Inventory: Factorial invariance in problem behaviors across gender and age
Authors: Hukkelberg Silje
Published: April 2016

The Eyberg Child Behavior Inventory (ECBI) assesses problem behaviors in children, and is a widely used instrument in both clinical work and research. Evidence suggests that the short ECBI version, comprising 22 items, can be reduced into the three oblique factors: Oppositional defiant behavior; Conduct problem behavior; and Inattentive behavior. The present study aimed to evaluate this three‐factor model in a Norwegian sample of 554 children, and examine multi‐group invariance across gender and age. Consistent with previous research, results confirmed a tripartite model, with the same residual covariances and cross‐loading appearing across groups. Multi‐group confirmatory factor analysis demonstrated partial measurement invariance across gender and age. Overall, findings support a meaningful comparison of the short ECBI across gender and age. The study makes a contribution to the generalizability issue of the ECBI.
Nitrogen release from differently aged Raphanus sativus L. nitrate catch crops during mineralization at autumn temperatures
Authors: Thomsen I. K. , Elsgaard L. , Olesen J. E. , Christensen B. T.
Published: April 2016

In temperate climates with surplus precipitation and low temperatures during autumn and winter, nitrate catch crops have become crucial in reducing nitrate leaching losses. Preferably, the N retained by the catch crop should remain in the soil and become available to the next main crop. Fodder radish (Raphanus sativus, L.) has emerged as a promising nitrate catch crop in cereal cropping, although the course of remineralization of residue N following termination of this frost‐sensitive crucifer remains obscured. We incubated radish residues of different age (different planting and harvest dates) with a loamy sand soil; mineralization of residue N was determined after 1, 2, 4 and 7 months of incubation at 2 °C and 10 °C. Incubations with soil only and with residues of white mustard (Sinapis alba, L) and perennial ryegrass (Lolium perenne, L.) were included as references. Using linear regression, net N release was fitted to plant chemical characteristics (initial concentrations of N, fibre fractions, lignin and C/N ratio). Residue C/N ratio (ranging from 10 to 25) and N concentration (ranging from 17 to 40 mg N/g dry matter) showed superior fits to net N release at both temperatures (r2, 0.64–0.94) while fibre analyses provided inferior fits (r2, 0.12–0.64). This was true across planting date and plant age. Net N release after 7 months of incubation at 2 °C and 10 °C accounted for up to 40% and 50% of residue N, respectively. During most of the incubation period, nitrate dominated the mineral N pool at both temperatures. The N mineralization and nitrification potential at these low soil temperatures suggest that a considerable fraction of the N captured by nitrate catch crops may be remineralized, nitrified and thus available for plant uptake but also for loss by leaching and denitrification.
Clinical outcomes of HIV‐exposed, HIV‐uninfected children in sub‐Saharan Africa
Authors: le Roux Stanzi M. , Abrams Elaine J. , Nguyen Kelly , Myer Landon
Published: April 2016

Objective

HIV‐exposed but HIV‐uninfected (HEU) children are widely considered at increased risk of mortality and morbidity. Recent advances in prevention of mother‐to‐child HIV transmission (PMTCT) strategies, incorporating life‐long universal maternal antiretroviral therapy (ART, “Option B+”) with extended breastfeeding, may improve HEU child health substantially. We critically reviewed reports of mortality/morbidity among HEU and HIV‐unexposed (HU) children in sub‐Saharan Africa.

Methods

We searched Medline, EMBASE, CINAHL, PsycINFO, Academic Search Premier, Global Health & Psychosocial Instruments databases, conference abstracts, and reference lists for longitudinal studies from sub‐Saharan Africa reporting mortality and clinical morbidity among HIV‐uninfected children aged ≤10 years, by maternal HIV status. Studies were appraised by Newcastle‐Ottawa Scale and ACROBAT‐NRSI. Due to substantial heterogeneity of study designs, populations and results (I2 = 75%), data were not synthesised.

Results

We included 37 reports (28 studies, 11 164 HEU children); methodological and reporting quality were variable. Most reports came from settings without universal access to maternal ART (n = 35). Results were conflicting, with some studies indicating increased risk of mortality, hospitalisation and/or under‐nutrition among HEU children, while others found no evidence of increased risk. In subanalyses, improved maternal health, ART use and breastfeeding were strongly protective for all outcomes. Only 39% (11/28) of studies adjusted for major confounders. Reports from settings using universal maternal ART with breastfeeding (n = 2) found no differences in growth or development but did not report mortality or infectious morbidity.

Conclusions

The existing literature provides little insight into HEU child health under recently adopted PMTCT strategies. There is a need for robust comparative data on HEU and HIV‐unexposed child health outcomes under Option B+; optimising breastfeeding practices and increasing maternal use of ART should be urgent public health priorities.
Drug resistance mutations after the first 12 months on antiretroviral therapy and determinants of virological failure in Rwanda
Authors: Ndahimana Jean d'Amour , Riedel David J. , Mwumvaneza Mutagoma , Sebuhoro Dieudone , Uwimbabazi Jean Claude , Kubwimana Marthe , Mugabo Jules , Mulindabigwi Augustin , Kirk Catherine , Kanters Steve , Forrest Jamie I. , Jagodzinski Linda L. , Peel Sheila A. , Ribakare Muhayimpundu , Redfield Robert R. , Nsanzimana Sabin
Published: April 2016

Objective

To evaluate HIV drug resistance (HIVDR) and determinants of virological failure in a large cohort of patients receiving first‐line tenofovir‐based antiretroviral therapy (ART) regimens.

Methods

A nationwide retrospective cohort from 42 health facilities was assessed for virological failure and development of HIVDR mutations. Data were collected at ART initiation and at 12 months of ART on patients with available HIV‐1 viral load (VL) and ART adherence measurements. HIV resistance genotyping was performed on patients with VL ≥1000 copies/ml. Multiple logistic regression was used to determine factors associated with treatment failure.

Results

Of 828 patients, 66% were women, and the median age was 37 years. Of the 597 patients from whom blood samples were collected, 86.9% were virologically suppressed, while 11.9% were not. Virological failure was strongly associated with age <25 years (adjusted odds ratio [aOR]: 6.4; 95% confidence interval [CI]: 3.2–12.9), low adherence (aOR: 2.87; 95% CI: 1.5–5.0) and baseline CD4 counts <200 cells/μl (aOR 3.4; 95% CI: 1.9–6.2). Overall, 9.1% of all patients on ART had drug resistance mutations after 1 year of ART; 27% of the patients who failed treatment had no evidence of HIVDR mutations. HIVDR mutations were not observed in patients on the recommended second‐line ART regimen in Rwanda.

Conclusions

The last step of the UNAIDS 90‐90‐90 target appears within grasp, with some viral failures still due to non‐adherence. Nonetheless, youth and late initiators are at higher risk of virological failure. Youth‐focused programmes could help prevent further drug HIVDR development.
Identification of a small protein domain present in all plant lineages that confers high prephenate dehydratase activity
Authors: El‐Azaz Jorge , de la Torre Fernando , Ávila Concepción , Cánovas Francisco M.
Published: April 2016

l‐Phenylalanine serves as a building block for the biosynthesis of proteins, but also as a precursor for a wide range of plant‐derived compounds essential for plants and animals. Plants can synthesize Phe within the plastids using arogenate as a precursor; however, an alternative pathway using phenylpyruvate as an intermediate, described for most microorganisms, has recently been proposed. The functionality of this pathway requires the existence of enzymes with prephenate dehydratase (PDT) activity (EC 4.2.1.51) in plants. Using phylogenetic studies, functional complementation assays in yeast and biochemical analysis, we have identified the enzymes displaying PDT activity in Pinus pinaster. Through sequence alignment comparisons and site‐directed mutagenesis we have identified a 22‐amino acid region conferring PDT activity (PAC domain) and a single Ala314 residue critical to trigger this activity. Our results demonstrate that all plant clades include PAC domain‐containing ADTs, suggesting that the PDT activity, and thus the ability to synthesize Phe using phenylpyruvate as an intermediate, has been preserved throughout the evolution of plants. Moreover, this pathway together with the arogenate pathway gives plants a broad and versatile capacity to synthesize Phe and its derived compounds. PAC domain‐containing enzymes are also present in green and red algae, and glaucophytes, the three emerging clades following the primary endosymbiont event resulting in the acquisition of plastids in eukaryotes. The evolutionary prokaryotic origin of this domain is discussed.
Molecular Mechanisms of Disease Pathogenesis Differ in Krabbe Disease Variants
Authors: Spratley Samantha J. , Hill Chris H. , Viuff Agnete H. , Edgar James R. , Skjødt Karsten , Deane Janet E.
Published: April 2016

Krabbe disease is a severe, fatal neurodegenerative disorder caused by defects in the lysosomal enzyme galactocerebrosidase (GALC). The correct targeting of GALC to the lysosome is essential for the degradation of glycosphingolipids including the primary lipid component of myelin. Over 100 different mutations have been identified in GALC that cause Krabbe disease but the mechanisms by which they cause disease remain unclear. We have generated monoclonal antibodies against full‐length human GALC and used these to monitor the trafficking and processing of GALC variants in cell‐based assays and by immunofluorescence microscopy. Striking differences in the secretion, processing and endosomal targeting of GALC variants allows the classification of these into distinct categories. A subset of GALC variants are not secreted by cells, not proteolytically processed, and remain trapped in the ER; these are likely to cause disease due to protein misfolding and should be targeted for pharmacological chaperone therapies. Other GALC variants can be correctly secreted by cells and cause disease due to catalytic defects in the enzyme active site, inappropriate post‐translational modification or a potential inability to bind essential cofactors. The classification of disease pathogenesis presented here provides a molecular framework for appropriate targeting of future Krabbe disease therapies.
Single‐use technology for solvent/detergent virus inactivation of industrial plasma products
Authors: Hsieh Yao‐Ting , Mullin Lori , Greenhalgh Patricia , Cunningham Michael , Goodrich Elizabeth , Shea Jessica , Youssef Eric , Burnouf Thierry
Published: April 2016

BACKGROUND

Virus inactivation of plasma products is conducted using stainless‐steel vessels. Single‐use technology can offer significant benefits over stainless such as operational flexibility, reduced capital infrastructure costs, and increased efficiency by minimizing the time and validation requirements associated with hardware cleaning. This study qualifies a single‐use bag system for solvent/detergent (S/D) virus inactivation.

STUDY DESIGN AND METHODS

Human plasma and immunoglobulin test materials were S/D‐treated in Mobius single‐use bags using 1% tri‐n‐butyl phosphate (TnBP) with 1% Triton X‐100 or 1% Tween 80 at 31°C for 4 to 6 hours to evaluate the impact on protein quality. Volatile and nonvolatile organic leachables from low‐density polyethylene film (Pureflex film) used in 1‐L‐scale studies after exposure to S/D in phosphate‐buffered saline were identified compared to controls in glass containers. Virus inactivation studies were performed with xenotropic murine leukemia virus (XMuLV) and bovine viral diarrhea virus (BVDV) to determine the kinetics of virus inactivation, measured using infectivity assays.

RESULTS

S/D treatment in Mobius bags did not impact the protein content and profile of plasma and immunoglobulin, including proteolytic enzymes and thrombin generation. Cumulative leachable levels after exposure to S/D were 1.5 and 1.85 ppm when using 0.3% TnBP combined with 1% Tween 80 or 1% Triton X‐100, respectively. Efficient inactivation of both XMuLV and BVDV was observed, with differences in the rate of inactivation dependent on both virus and S/D mixture.

CONCLUSION

Effective S/D virus inactivation in single‐use container technology is achievable. It does not alter plasma proteins and induces minimal release of leachables.
Ventromedial hypothalamic melanocortin receptor activation: regulation of activity energy expenditure and skeletal muscle thermogenesis
Authors: Gavini Chaitanya K. , Jones William C. , Novak Colleen M.
Published: April 2016

Key points

The ventromedial hypothalamus (VMH) and the central melanocortin system both play vital roles in regulating energy balance by modulating energy intake and utilization.

Recent evidence suggests that activation of the VMH alters skeletal muscle metabolism.

We show that intra‐VMH melanocortin receptor activation increases energy expenditure and physical activity, switches fuel utilization to fats, and lowers work efficiency such that excess calories are dissipated by skeletal muscle as heat.

We also show that intra‐VMH melanocortin receptor activation increases sympathetic nervous system outflow to skeletal muscle.

Intra‐VMH melanocortin receptor activation also induced significant changes in the expression of mediators of energy expenditure in muscle.

These results support the role of melanocortin receptors in the VMH in the modulation of skeletal muscle metabolism.

The ventromedial hypothalamus (VMH) and the brain melanocortin system both play vital roles in increasing energy expenditure (EE) and physical activity, decreasing appetite and modulating sympathetic nervous system (SNS) outflow. Because of recent evidence showing that VMH activation modulates skeletal muscle metabolism, we propose the existence of an axis between the VMH and skeletal muscle, modulated by brain melanocortins, modelled on the brain control of brown adipose tissue. Activation of melanocortin receptors in the VMH of rats using a non‐specific agonist melanotan II (MTII), compared to vehicle, increased oxygen consumption and EE and decreased the respiratory exchange ratio. Intra‐VMH MTII enhanced activity‐related EE even when activity levels were held constant. MTII treatment increased gastrocnemius muscle heat dissipation during controlled activity, as well as in the home cage. Compared to vehicle‐treated rats, rats with intra‐VMH melanocortin receptor activation had higher skeletal muscle norepinephrine turnover, indicating an increased SNS drive to muscle. Lastly, intra‐VMH MTII induced mRNA expression of muscle energetic mediators, whereas short‐term changes at the protein level were primarily limited to phosphorylation events. These results support the hypothesis that melanocortin peptides act in the VMH to increase EE by lowering the economy of activity via the enhanced expression of mediators of EE in the periphery including skeletal muscle. The data are consistent with the role of melanocortins in the VMH in the modulation of skeletal muscle metabolism.
Macroecological drivers of archaea and bacteria in benthic deep-sea ecosystems
Authors: Danovaro Roberto , Molari Massimiliano , Corinaldesi Cinzia , Dell’Anno Antonio
Published: April 2016

Benthic deep-sea archaea are mainly controlled by temperature, whereas bacteria are controlled by food availability.
Saturation of recognition elements blocks evolution of new tRNA identities
Authors: Saint-Léger Adélaïde , Bello Carla , Dans Pablo D. , Torres Adrian Gabriel , Novoa Eva Maria , Camacho Noelia , Orozco Modesto , Kondrashov Fyodor A. , Ribas de Pouplana Lluís
Published: April 2016

The size of the genetic code is limited by the ability of transfer RNAs to acquire new identities.