bluuebunny/crossref_metadata_2025 huggingface dataset:
Schützen langkettige Omega‐3‐Fettsäuren vor atopischer Dermatitis?
Authors: Reese Imke , Werfel Thomas
Published: August 2015

Langkettige mehrfach ungesättigte Fettsäuren sind essentiell für die menschliche Ernährung. Die Anzahl der vorhandenen Doppelbindungen bestimmt, ob die Fettsäure als 2‐, 3‐ oder x‐fach ungesättigt bezeichnet wird. Abhängig davon, wie weit die erste Doppelbindung von der Methylgruppe der Fettsäure entfernt ist, unterscheidet man zwischen Omega‐3‐ und Omega‐6‐Fettsäuren.

Während sich die Gabe von γ‐Linolensäure, einer langkettigen Fettsäure der Omega‐6‐Familie, sowohl in der Prävention als auch in der Therapie der atopischen Dermatitis als erfolglos herausgestellt hat, kann die Supplementation mit langkettigen Omega‐3‐Fettsäuren einen erfolgsversprechenden Ansatz bei der Prävention allergischer Erkrankungen, vor allem der atopischen Dermatitis, darstellen. Ob sich das Konzept einer Gabe von langkettigen Fettsäuren der Omega‐3‐Familie auch therapeutisch durchsetzen kann, ist abhängig davon, ob sich die bisher beobachteten günstigen Wirkungen in randomisiert kontrollierten Interventionsstudien nachweisen lassen.
Hochauflösende optische Kohärenztomografie – ein Hilfsmittel in klinischer Praxis und dermatologischer Forschung
Authors: Cao Taige , Tey Hong Liang
Published: August 2015

Die Diagnose von Hautkrankheiten beruht derzeit, über die klinische Beurteilung hinaus, hauptsächlich auf der Histologie. Hautbiopsien haben jedoch zahlreiche Nachteile, beispielsweise Schmerzen, Narbenbildung, Infektionsrisiko und Fehler bei der Probennahme. Mit den Fortschritten bezüglich dermatologischer Bildgebungstechnologien in jüngerer Zeit eröffneten sich klinische Anwendungsmöglichkeiten von Bildgebungsmethoden bei der Behandlung von Hautkrankheiten. Vor Kurzem wurde die hochauflösende optische Kohärenztomografie (HD‐OCT) für die In‐vivo‐Anwendung entwickelt und kommerzialisiert (Skintell®; Agfa, Belgien). Diese Technologie verfügt über höhere Auflösung als die konventionelle OCT, ermöglicht eine schnellere Bilderfassung als die Reflektanz‐konfokale Mikroskopie und bietet größere Eindringtiefe und Sichtfeld. Die HD‐OCT ist zukunftsträchtig, erfordert aber umfangreiche weitere Untersuchungen, um sie von einem Forschungsinstrument zu einem wertvollen Hilfsmittel für die nichtinvasive Diagnose von Hautläsionen weiterzuentwickeln. Zur Identifizierung von HD‐OCT‐Charakteristika bei verschiedenen Krankheiten sind bereits detaillierte Arbeiten durchgeführt worden, deren Auswertung aber zeitaufwändig und mühsam sein kann. Derzeit laufen Projekte zur Automatisierung dieser Abläufe und zur Verbesserung der Bildqualität.
Enzymes in the in‐situ pellicle of children with different caries activity
Authors: Grychtol Susann , Viergutz Gabriele , Pötschke Sandra , Bowen William H. , Hoth‐Hannig Wiebke , Leis Birgit , Umanskaya Natalia , Hannig Matthias , Hannig Christian
Published: August 2015

The present study investigated, for the first time, enzymes in the in‐situ pellicle of children. Furthermore, it was purposed to detect glucosyltransferase (GTF) isoforms in each child's pellicle. Twenty‐four children (5–9 yr of age) participated in the study. Twelve were caries free with no decayed, missing, and filled teeth (dmft), whereas 12 had active caries (dmft ≥ 2, indicating at least two untreated carious lesions). Bovine enamel slabs, fixed on individual upper jaw splints, were utilized for pellicle formation in situ. After 3 and 30 min, samples were tested for amylase, lysozyme, and peroxidase activities; total GTF activity was examined only in the 30‐min pellicle. Gold‐immunolabelling was used to quantify the GTF B, C, and D isoforms in the pellicle by transmission electron microscopy (TEM). All enzymes tested were detected in the children's in‐situ pellicle in an active conformation, and there were no significant differences in their levels of activity between caries‐free and caries‐active children. All GTF isoforms were found to be randomly distributed within all pellicle layers, althoug GTF B was only detected very sporadically. A significantly higher amount of GTF D was detected in the pellicle of caries‐active children. Pellicle formation in children is characterized by uniformity and selectivity. Glucosyltransferase D might represent a possible biomarker for high caries risk in children.
Homocysteine excess: delineating the possible mechanism of neurotoxicity and depression
Authors: Bhatia Pankaj , Singh Nirmal
Published: August 2015

Homocysteine (Hcy) is a nonproteogenic sulfur containing amino acid derived from dietary methionine through demethylation. Homocysteine can be re‐methylated to methionine [precursor of S‐adenosylmethionine (SAM)] via the re‐methylation or 5‐methyltetrahydrofolate pathway or undergoes transsulfuration to form cysteine by the action of metabolic enzymes and cofactors. Impaired metabolism due to genetic alteration in metabolic enzymes (methionine synthase, methyltetrahydrofolate reductase (MTHFR), cystathionine β‐synthase (CβS), and cystathionine‐γ‐lyase (CγL) or deficiency in cofactors (vitamin B6, B12, folate) may lead to acquired metabolic anomaly known as hyperhomocysteinemia. Hcy excess decreases the S‐adenosylmethionine (SAM)‐dependent synthesis of catecholamines, viz. dopamine, norepinephrine, epinephrine, and noncatecholamine, viz. serotonin (5‐HT), due to genetic alteration in key enzyme MTHFR in the homocysteine metabolism pathway that leads to depression. Thus, hyperhomocysteinemia (HHcy)‐induced SAM level is influenced by the single nucleotide polymorphism (SNP) MTHFR C677T. Furthermore, HHcy leads to production of precarious neurotoxic product homocysteic acid (HCA) and cysteine sulfinic acid (CSA) which acts as an N‐methyl‐D‐aspartate (NMDA) receptor agonist and has neurotoxic effects on dopaminergic neurons. In the current review, an attempt has been made to discuss the neurotoxic effects of HHcy in the pathogenesis of depression.
Once daily ledipasvir/sofosbuvir fixed‐dose combination with ribavirin in patients with inherited bleeding disorders and hepatitis C genotype 1 infection
Authors: Stedman C. A. M. , Hyland R. H. , Ding X. , Pang P. S. , McHutchison J. G. , Gane E. J.
Published: August 2015

Aim

People with inherited bleeding disorders have been disproportionally affected by HCV. We assessed the fixed‐dose combination of the NS5A inhibitor ledipasvir (LDV) with the NS5B polymerase inhibitor sofosbuvir (SOF) with ribavirin (RBV) in patients with genotype 1 HCV and inherited bleeding disorders.

Methods

To be eligible, patients had to be over 18 years of age and have an inherited bleeding disorder. HCV treatment‐naïve and ‐experienced patients could enrol. All patients received LDV 90 mg per SOF 400 mg once daily and weight‐based RBV in a divided dose for 12 weeks. The primary efficacy endpoint was sustained virologic response (SVR), defined as HCV RNA below the limit of detection (15 IU mL−1) 12 weeks after the end of treatment (SVR12).

Results

Of the 14 patients enrolled, 8 (57%) had haemophilia A, 3 (21%) had haemophilia B and 2 (14%) had von Willebrand disease, and 1 (7%) had factor XIII deficiency. All 14 patients (100%, 95% CI: 77–100%) achieved SVR12. Treatment was well tolerated: all patients completed therapy, with mostly mild adverse events. No specific safety concerns associated with the patient's underlying bleeding disorders were noted.

Conclusion

These results appear to suggest that people with HCV and inherited bleeding disorders can be safely and effectively treated with 12 weeks of LDV/SOF plus RBV.
Live attenuated herpes zoster vaccine for HIV‐infected adults
Authors: Shafran SD
Published: August 2015

Objectives

Multiple guidelines exist for the use of live viral vaccines for measles‐mumps‐rubella (MMR), varicella and yellow fever in people with HIV infections, but these guidelines do not make recommendations regarding live attenuated herpes zoster vaccine (LAHZV), which is approved for people over 50 years in the general population. LAHZV is made with the same virus used in varicella vaccine. The incidence of herpes zoster remains increased in people with HIV infection, even when on suppressive antiretroviral therapy, and a growing proportion of HIV‐infected patients are over 50 years of age. The purpose of this article is to review the use of varicella vaccine and LAHZV in people with HIV infection and to make recommendations about the use of LAHZV in adults with HIV infection.

Methods

A PubMed search was undertaken using the terms ‘herpes zoster AND HIV’ and ‘varicella AND HIV’. Reference lists were also reviewed for pertinent citations.

Results

Varicella vaccine is recommended in varicella‐susceptible adults, as long as they have a CD4 count > 200 cells/μL, the same CD4 threshold used for MMR and yellow fever vaccines. No transmission of vaccine strain Varicella zoster virus has been documented in people with HIV infections with a CD4 count above this threshold. LAHZV was administered to 295 HIV‐infected adults with a CD4 count > 200 cells/μL, and was safe and immunogenic with no cases of vaccine strain infection.

Conclusions

It is recommended that LAHZV be administered to HIV‐infected adults with a CD4 count above 200 cells/μL, the same CD4 threshold used for other live attenuated viral vaccines.
‘I Hate Talking About It’: Identifying and Supporting Traumatised Young People in Custody
Authors: GRAY PAUL
Published: August 2015

Research has shown that a significant proportion of young people in custody have experienced some form of abuse and/or loss in their lives. This article uses the biographies of three young men (all serving custodial sentences) to elucidate the feelings that experiences of this nature can engender. Crucially, none of the three was effectively helped to resolve their experiences. The article goes on to argue that more needs to be done to identify and support traumatised young people in custody. The article concludes that, while the CHAT: Secure tool may go some way to better identifying those needing support, an individual's reluctance to disclose their traumatic experiences in the first place may limit the tool's efficacy.
Physical changes in the home environment to reduce television viewing and sugar‐sweetened beverage consumption among 5‐ to 12‐year‐old children: a randomized pilot study
Authors: French S. A. , Sherwood N. E. , JaKa M. M. , Haapala J. L. , Ebbeling C. B. , Ludwig D. S.
Published: August 2015

This study evaluated the feasibility of a home‐based intervention to reduce sugar‐sweetened beverage intake and television viewing among children. Lower income parents of overweight children aged 5–12 years (n = 40) were randomized to a home environment intervention to reduce television viewing with locking devices and displace availability of sugar‐sweetened beverages with home delivery of non‐caloric beverages (n = 25), or to a no‐intervention control group (n = 15) for 6 months. Data were collected at baseline and 6 months. After 6 months, television viewing hours per day was significantly lower in the intervention group compared with the control group (1.7 [SE = .02] vs. 2.6 [SE = .25] hours/day, respectively, P < .01). Sugar‐sweetened beverage intake was marginally significantly lower among intervention group compared to control group children (0.21 [SE = .09] vs. 0.45 [SE = .10], respectively, P < .09). Body mass index (BMI) z‐score was not significantly lower among intervention compared to control children. Among a lower income sample of children, a home‐based intervention reduced television viewing, but not sugar‐sweetened beverage intake or BMI z‐score.
Acute Stroke or Transient Ischemic Attack Treated with Aspirin or Ticagrelor and Patient Outcomes (Socrates) Trial: Rationale and Design
Authors: Johnston S. Claiborne , Amarenco Pierre , Albers Gregory W. , Denison Hans , Easton J. Donald , Held Peter , Jonasson Jenny , Minematsu Kazuo , Molina Carlos A. , Wong Lawrence K. S.
Published: August 2015

Rationale

The risk of recurrent ischemia is high in the acute period after ischemic stroke and transient ischemic attack. Aspirin is recommended by guidelines for this indication, but more intensive antiplatelet therapy may be justified.

Aims

We aim to evaluate whether ticagrelor, a potent antiplatelet agent that blocks the P2Y12 receptor without requiring metabolic activation, reduces the risk of major vascular events compared with aspirin when randomization occurs within 24 h after symptom onset of a nonsevere ischemic stroke or high-risk transient ischemic attack.

Design

Acute Stroke or Transient Ischemic Attack Treated with Aspirin or Ticagrelor and Patient Outcomes (SOCRATES) is a randomized, double-blind, event-driven trial and will include an estimated 13 600 participants randomized in 33 countries worldwide to collect 844 primary events.

Study outcomes

The primary endpoint is the composite of stroke (ischemic or hemorrhagic), myocardial infarction, and death. Time to the first primary endpoint will be compared in the treatment groups during 90-day follow-up, with major hemorrhage serving as the primary safety endpoint. Participants will be followed for an additional 30 days after the randomized treatment period.

Discussion

The SOCRATES trial fulfills an important clinical need by evaluating a potent antiplatelet agent as a superior alternative to current standard of care in patients presenting acutely with ischemic stroke or transient ischemic attack.
The psychosocial dimensions of fatigue in men treated for prostate cancer
Authors: McConkey Robert W.
Published: August 2015

Prostate cancer is one of the most prevalent forms of cancer in men worldwide. Cancer‐related fatigue (CRF) is the most frequently reported side effect of all cancer treatments and occurs in up to 74% of men treated for prostate cancer, particularly those receiving combined hormone and radiation therapies. Patients report the devastating impact of CRF on their quality of life and psychosocial functioning, affecting work, social, emotional and cognitive performance. It can manifest during treatment and persist long after its completion. A diagnosis of CRF is achieved once all other treatable factors such as anaemia or anxiety and depression have been managed, but does not alleviate the fatigue. The Functional Assessment of Cancer Therapy‐Fatigue (FACT‐F) is a brief and easily administered valid and reliable tool recommended for the assessment of CRF. Non‐pharmacological interventions such as activity‐based programs and psychosocial interventions including prostate cancer specific education and cognitive behavioural therapy have shown benefits in reducing levels of CRF. A multidisciplinary approach to the management of CRF in prostate cancer patients is advocated. The NICE four‐tier model of psychological support can be used as a framework to assist nurses and other health care professionals to alleviate the psychosocial burden of CRF. More research studies using a solid methodological foundation are required in men with prostate cancer to provide robust evidence which can be applied in practice.
Venues and Filters in Managed Migration Policy: The Case of the United Kingdom
Authors: Scott Sam
Published: August 2015

The United Kingdom, like many developed world economies, has witnessed unprecedented immigration since the early 1990s. Also in line with other developed world economies, the United Kingdom has adopted a “managed migration” policy paradigm. The paper argues that the operation of this paradigm is best understood with reference to two key concepts: migration policy “venues” and migration policy “filters.” In terms of the former, the paper argues that managed migration policy is associated with outward, upward, and downward rescaling and commensurate venue growth and diversification. In terms of the latter, the paper argues that six policy filters (legal, geographical, credential, transfer-based, monetary, and humanitarian) are commonly used to determine legitimate forms of migration but that one (the geographical filter) has been particularly prominent within the United Kingdom's managed migration policy paradigm.
Tracking Banks’ Systemic Importance Before and After the Crisis
Authors: Alessandri Piergiorgio , Masciantonio Sergio , Zaghini Andrea
Published: August 2015

We develop a methodology to identify and rank ‘systemically important financial institutions’ (SIFIs). Our approach is free of discretion and based entirely on publicly available data, thus filling the gap between the judgment of the regulator and the views that market participants may form with their own information. We apply the methodology to three samples of banks (global, EU and euro area) for the years 2007–2012 and find that both the nature of systemic importance and its geographical distribution have changed significantly over time, with a shift from advanced western economies towards emerging markets, particularly China. Moreover, a distinctive consequence of the crisis is the proliferation of SIFIs that are at the same time complex and poorly substitutable, a combination that seemed relatively rare at the onset of the crisis and might not be entirely consistent with regulatory aspirations for a less risky financial framework.
Lognormal Distributions and Geometric Averages of Symmetric Positive Definite Matrices
Authors: Schwartzman Armin
Published: August 2015

This article gives a formal definition of a lognormal family of probability distributions on the set of symmetric positive definite (SPD) matrices, seen as a matrix‐variate extension of the univariate lognormal family of distributions. Two forms of this distribution are obtained as the large sample limiting distribution via the central limit theorem of two types of geometric averages of i.i.d. SPD matrices: the log‐Euclidean average and the canonical geometric average. These averages correspond to two different geometries imposed on the set of SPD matrices. The limiting distributions of these averages are used to provide large‐sample confidence regions and two‐sample tests for the corresponding population means. The methods are illustrated on a voxelwise analysis of diffusion tensor imaging data, permitting a comparison between the various average types from the point of view of their sampling variability.
Pollen limitation and its influence on natural selection through seed set
Authors: Bartkowska M. P. , Johnston M. O.
Published: August 2015

Stronger pollen limitation should increase competition among plants, leading to stronger selection on traits important for pollen receipt. The few explicit tests of this hypothesis, however, have provided conflicting support. Using the arithmetic relationship between these two quantities, we show that increased pollen limitation will automatically result in stronger selection (all else equal) although other factors can alter selection independently of pollen limitation. We then tested the hypothesis using two approaches. First, we analysed the published studies containing information on both pollen limitation and selection. Second, we explored how natural selection measured in one Ontario population of Lobelia cardinalis over 3 years and two Michigan populations in 1 year relates to pollen limitation. For the Ontario population, we also explored whether pollinator‐mediated selection is related to pollen limitation. Consistent with the hypothesis, we found an overall positive relationship between selection strength and pollen limitation both among species and within L. cardinalis. Unexpectedly, this relationship was found even for vegetative traits among species, and was not found in L. cardinalis for pollinator‐mediated selection on nearly all trait types.
Visceral adiposity is associated with an increased risk of functional dyspepsia
Authors: Jung Jae Gu , Yang Jae Nam , Lee Chang Geun , Choi Sung Hun , Kwack Won Gun , Lee Jin Ho , Kang Hyoun Woo
Published: August 2015

Background

The relationship between visceral adiposity and the incidence of functional dyspepsia (FD) has not yet been studied. The purpose of the present study is to evaluate the association between visceral adiposity and the risk of FD.

Methods

This is a case–control study that compares the abdominal adipose tissue area between subjects with FD and control subjects without FD, who underwent abdomen computerized tomography (CT) for health examinations in a tertiary center. Retrospectively, a telephone survey was conducted to diagnose FD using the Rome III criteria. We measured various indices of obesity including body mass index (BMI), waist circumference (WC), visceral adipose tissue (VAT) area, subcutaneous adipose tissue (SAT) area and the VAT/SAT ratio in order to evaluate the association between FD and abdominal adiposity.

Key Results

A total of 363 subjects were included in the present study. FD was diagnosed in 90 subjects (24.8%). In the univariate analysis, WC, VAT area, TAT area, VAT/SAT ratio, and the presence of erosive esophagitis were significantly higher in the FD group than in the non‐FD group. In the multivariate analysis, a higher VAT area (odds ratio (OR), 3.76; 95% confidence interval (CI), 1.24–11.40; highest quartile vs lowest quartile, p = 0.019) and VAT/SAT ratio (OR, 2.35; 95% CI, 1.27–4.32; highest quartile vs lowest quartile, p = 0.006) were independently associated with a risk of FD.

Conclusion and Inferences

Visceral adiposity as measured by the VAT area and VAT/SAT ratio is associated with an increased risk of FD.
Subgroup analysis of East Asians in RAINBOW: A phase 3 trial of ramucirumab plus paclitaxel for advanced gastric cancer
Authors: Muro Kei , Oh Sang Cheul , Shimada Yasuhiro , Lee Keun‐Wook , Yen Chia‐Jui , Chao Yee , Cho Jae Yong , Cheng Rebecca , Carlesi Roberto , Chandrawansa Kumari , Orlando Mauro , Ohtsu Atsushi
Published: August 2015

Background and Aim

East Asia has higher gastric cancer incidence and mortality rates than other regions. We present a subgroup analysis of East Asians in the positive study RAINBOW.

Methods

Patients with advanced gastric or gastroesophageal junction adenocarcinoma previously treated with platinum and fluoropyrimidine received ramucirumab 8 mg/kg or placebo on days 1 and 15 plus paclitaxel 80 mg/m2 on days 1, 8, and 15 of a 28‐day cycle.

Results

Of 665 intention‐to‐treat patients, 223 were East Asian. Median overall survival was 12.1 months for ramucirumab plus paclitaxel and 10.5 months for placebo plus paclitaxel (hazard ratio: 0.986, 95% confidence interval: 0.727–1.337, P = 0.929). Median progression‐free survival was 5.5 months for ramucirumab plus paclitaxel and 2.8 months for placebo plus paclitaxel (hazard ratio: 0.628, 95% confidence interval: 0.473–0.834, P = 0.001). Objective response rates were 34% for ramucirumab plus paclitaxel and 20% for placebo plus paclitaxel. Grade ≥ 3 neutropenia (60% vs 28%) and leukopenia (34% vs 13%) were higher for ramucirumab plus paclitaxel. The rate of febrile neutropenia was low (4% vs 4%). Special interest adverse events included any grade bleeding/hemorrhage (55% vs 25%), proteinuria (27% vs 7%), and hypertension (22% vs 2%).

Conclusions

Ramucirumab plus paclitaxel significantly improves progression‐free survival and response rate, with prolonged median overall survival and an acceptable safety profile in East Asians with advanced gastric cancer.
Patients' beliefs and attitudes about their treatment for inflammatory bowel disease in Korea
Authors: Kim Sung Bum , Kim Kyeong Ok , Jang Byung Ik , Kim Eun Soo , Cho Kwang Bum , Park Kyung Sik , Chung Min Kyu , Jeon Seong Woo ,   Daegu‐Gyeongbuk Gastrointestinal Study Group (DGSG)
Published: August 2015

Background and Aims

Adherence to medication during the treatment of inflammatory bowel disease (IBD) is important in terms of maintaining remission. According to studies on adherence to medication in other chronic diseases, non‐adherence is associated with negative attitudes to treatment. The aims of this study were to assess adherence rates and IBD patients' beliefs and attitudes regarding medication using a questionnaire based approach.

Methods

Two hundred and eighty seven patients from three tertiary hospitals were enrolled and completed a questionnaire that addressed adherence (Medication Adherence Report Scale, MARS), beliefs, and attitudes to medication (Beliefs about Medications Questionnaire, BMQ).

Results

Using a cutoff score of 16/20 for MARS, 64 (22.3%) patients did not adhere to medication. According to attitude analysis conducted using the BMQ, 41.8% of the 287 study subjects felt high necessity but low concern for the medication (“accepting”) and 34.8% felt high necessity and concern (“ambivalent”). Multivariate analysis showed significantly lower adherence to medication among younger patients, patients with experience of adverse effects to medication, patients with demanding jobs, and for those with an “indifferent” or “skeptical” attitude regarding the benefits of medication. On the other hand, IBD patients with “accepting” attitude adhered to medication.

Conclusion

Twenty‐two percent of IBD patients were non‐adherent to medical treatment, and belief of the need for medication was found to significantly enhance adherence. Interventions, such as education about the efficacy and safety of medications, should be considered to facilitate adherence to medical treatment among IBD patients.
Orthostatic Blood Pressure Behavior in People with Mild Cognitive Impairment Predicts Conversion to Dementia
Authors: Hayakawa Tomoaki , McGarrigle Christine A. , Coen Robert F. , Soraghan Christopher J. , Foran Tim , Lawlor Brian A. , Kenny Rose Anne
Published: August 2015

Objectives

To compare the patterns of blood pressure (BP) behavior during orthostasis in individuals with mild cognitive impairment (MCI) with those of controls and to investigate whether orthostatic BP behavior differs between individuals with MCI who convert to dementia and those who do not.

Design

Longitudinal study with 3 years of follow‐up.

Setting

Memory clinic in Dublin, Ireland, between 2007 and 2012.

Participants

Community‐dwelling individuals with MCI (n = 150) and controls (n = 75).

Measurements

Orthostatic BP was examined using the active standing test with a beat‐to‐beat continuous BP monitoring device in addition to neuropsychological testing. Hazard ratios (HRs) from parametric survival models were used to determine whether conversion to dementia was independently associated with baseline orthostatic BP variables.

Results

Individuals with MCI were more likely than controls to have a systolic BP (SBP) deficit of greater than 30% 30 seconds after standing (P = .01). Thirty percent of participants with MCI (n = 43) converted to dementia within the 3‐year follow‐up period. Individuals with MCI with a SBP deficit greater than 30% 30 seconds after standing were twice as likely to convert to dementia as those without the deficit (HR = 2.77, 95% confidence interval = 1.02–7.50).

Conclusion

Human beings have evolved an elaborate neurological control system to maintain cerebral perfusion during orthostatic challenge. In people with MCI, this response is impaired and renders them twice as likely to convert to dementia.
Pressure ulcer risk assessment: retrospective analysis of Braden Scale scores in Portuguese hospitalised adult patients
Authors: Sardo Pedro , Simões Cláudia , Alvarelhão José , Costa César , Simões Carlos J , Figueira Jorge , Simões João L , Amado Francisco , Amaro António , Melo Elsa
Published: August 2015

Aims and objectives

To analyse the Braden Scale scores and sub‐scores assessed in Portuguese hospitalised adult patients in association with their characteristics, diagnoses and length of stay.

Background

The Braden Scale is used worldwide for pressure ulcer risk assessment and supports nurses in the implementation of preventive interventions.

Design

Retrospective cohort analysis of electronic health record database from adult patients admitted to medical and surgical areas during 2012.

Methods

Braden Scale scores and sub‐scores of 8147 patients were associated with age, gender, type of admission (emergency service or programmed), specialty units (medical or surgical), length of stay, patient discharge (discharge, decease or transference to other hospital) and ICD‐9 diagnosis.

Results

The participants with significantly lower Braden Scale scores were women, older people, hospitalised in medical units, with emergency service admission, longer hospitalisation stays and/or with vascular, traumatisms, respiratory, infection or cardiac diseases. Mobility, friction/shear forces and activity had higher contributions to the Braden Scale score, while nutrition had the lowest contribution.

Conclusions

Approximately one‐third of all participants had high risk of pressure ulcer development at admission, which led to the application of nursing preventive care. Our study demonstrated that nurses should pay special attention to patients over 50 years of age, who had significantly lower Braden Scale scores. The Braden Scale scores significantly increased in the last assessments showing that Braden Scale is sensitive to the clinical improvement of the patient. Braden Scale correlations with length of stay reveal its importance as predictor of length of stay.

Relevance to clinical practice

Nurses should use Braden Scale assessment and consider patients' characteristics and diagnoses to plan more focused preventive interventions and improve nursing care. This study could be the first step to create a preventive protocol based on institutional reality, patients' characteristics, level of risk and affected sub‐scales.
Nursing teams caring for hospitalised older adults
Authors: Dahlke Sherry , Baumbusch Jennifer
Published: August 2015

Aims and objectives

To offer an explanation of how registered nurses’ are providing care to hospitalised older adults in nursing teams comprised of a variety of roles and educational levels.

Background

Around the globe economic pressures, nursing shortages and increased patient acuity have resulted in tasks being shifted to healthcare workers with less education and fewer qualifications than registered nurses. In acute care hospitals, this often means reducing the number of registered nurses and adding licensed practical nurses and care aides (also referred to as unregulated healthcare workers) to the nursing care team. The implications of these changes are not well understood especially in the context of hospitalised older adults, who are complex and the most common care recipients.

Design

Thematic analysis of data that were collected in a previous grounded theory study to provide an opportunity in‐depth analysis of how nurses provided care to hospitalised older adults within nursing teams.

Methods

Data collected in western Canada on two hospital units in two different health authorities were analysed in relation to how nursing teams provide care. Hand coding and thematic analysis were employed.

Results

The themes of scrutinised skill mix and working together highlighted how the established nursing value of reciprocity is challenging to enact in teams with a variety of scopes of practice. The value of reciprocity both aided and hindered the nursing team in engaging in team behaviours to effectively manage patient care.

Conclusion

Educators and leaders could assist the nursing care team in re‐thinking how they engage in teamwork by providing education about roles and communication techniques to support teams and ultimately improve nursing care.

Relevance to clinical practice

The value of reciprocity within nursing teams needs to be re‐examined within the context of team members with varying abilities to reciprocate in kind.
Willingness of reproductive‐aged women in a Nigerian community to accept human papillomavirus vaccination for their children
Authors: Morhason‐Bello Imran O. , Wallis Selina , Adedokun Babatunde O. , Adewole Isaac F.
Published: August 2015

Aim

The aim of this study was to determine the willingness of reproductive‐aged women in a Nigerian community to allow human papillomavirus (HPV) vaccination in their children and the associated factors with this decision.

Material and Methods

A multistage household survey of 1002 women who participated in the HPV Vaccine and Cervical Cancer Prevention Survey from 26 August to 29 September 2012 at Ibadan North Local Government Area, Mokola Ibadan, Nigeria. Descriptive, bivariate and multivariable analyses were performed, and statistical significance was set at 95% confidence level (CI).

Results

There was high willingness (88.6%) to vaccinate, and this attitude was associated with previous history of genital discharge or sores (adjusted odds ratio, 1.91; 95%CI, 1.05–3.45), and knowledge that cervical cancer is preventable (adjusted odds ratio, 1.67; 95%CI, 1.07–2.59). On the likely acceptability of Nigerian HPV vaccine policy, about two‐thirds strongly agreed to its incorporation into the routine immunization program (66.9%), it being free (66.7%) and mandatory (64.3%), amongst other factors. The commonest concerns raised were cost/expenses (10.2%), that it might encourage promiscuity (9.9%), or stimulate early sexual debut (6.7%), and fear of infertility (6.3%).

Conclusion

This study found that the majority of Nigerian women are willing to vaccinate their children against HPV infection and would prefer free universal HPV vaccination with regulation to ensure better uptake. The concerns expressed would need to be addressed by policy‐makers to increase its acceptability.
Lumbar paraspinal muscle transverse area and symmetry in dogs with and without degenerative lumbosacral stenosis
Authors: Henderson A. L. , Hecht S. , Millis D. L.
Published: August 2015

OBJECTIVES

To investigate whether dogs with degenerative lumbosacral stenosis have decreased lumbar paraspinal muscle transverse area and symmetry compared with control dogs.

MATERIALS AND METHODS

Retrospective cross‐sectional study comparing muscles in transverse T2‐weighted magnetic resonance images for nine dogs with and nine dogs without degenerative ‐lumbosacral stenosis. Mean transverse area was measured for the lumbar multifidus and sacrocaudalis dorsalis lateralis muscles bilaterally and the L7 vertebral body at the level of the caudal endplate. Transverse areas of both muscle groups relative to L7 and asymmetry indices were compared between study populations using independent t tests.

RESULTS

Mean muscle‐to‐L7 transverse area ratios were significantly smaller in the degenerative lumbosacral stenosis group compared with those in the control group in both lumbar multifidus (0·84 ±0·26 versus 1·09 ±0·25; P=0·027) and sacrocaudalis dorsalis lateralis (0·5 ±0·15 versus 0·68 ±0·12; P=0·005) muscles. Mean asymmetry indices were higher for both muscles in the group with degenerative lumbosacral stenosis than in the control group, but highly variable and the difference was not statistically significant.

CLINICAL SIGNIFICANCE

These findings suggest that dogs with degenerative lumbosacral stenosis have decreased lumbar paraspinal muscle mass that may be a cause or consequence of the ‐syndrome. Understanding altered paraspinal muscle characteristics may improve understanding of the ‐pathophysiology and management options for degenerative lumbosacral stenosis.
Phylogenomics of polyploid Fothergilla (Hamamelidaceae) by RAD‐tag based GBS—insights into species origin and effects of software pipelines
Authors: Qi Zhe‐Chen , Yu Yi , Liu Xiang , Pais Andrew , Ranney Thomas , Whetten Ross , Xiang Qiu‐Yun (Jenny)
Published: August 2015

Fothergilla (Hamamelidaceae) consists of Fothergilla gardenii (4x) from the coastal plains of the southeastern USA, F. major (6x) from the piedmont and mountains of the same region, and a few allopatric diploid populations of unknown taxonomic status. The objective of this study was to explore the relationships of the polyploid species with the diploid plants. Genotyping by sequencing (GBS) was applied to generate genome‐wide molecular markers for phylogenetic and genetic structure analyses of 36 accessions of Fothergilla. Sanger sequencing of three plastid and one nuclear regions provided data for comparison with GBS‐based results. Phylogenetic outcomes were compared using data from different sequencing runs and different software workflows. The different data sets showed substantial differences in inferred phylogenies, but all supported a genetically distinct 6x F. major and two lineages of the diploid populations closely associated with the 4x F. gardenii. We hypothesize that the 4x F. gardenii originated through hybridization between the Gulf coastal 2x and an extinct (or undiscovered) 2x lineage, followed by backcrosses to the Atlantic coastal 2x before chromosome doubling, and the 6x F. major also originated from the “extinct” 2x lineage. Alternative scenarios are possible but are not as well supported. The origins and divergence of the polyploid species likely occurred during the Pleistocene cycles of glaciation, although fossil evidence indicates the genus might have existed for a much longer time with a wider past distribution. Our study demonstrates the power of combining GBS data with Sanger sequencing in reconstructing the evolutionary network of polyploid lineages.
Traces of Memory for a Lost Childhood Language: The Savings Paradigm Expanded
Authors: Isurin Ludmila , Seidel Christy
Published: August 2015

The loss of a childhood language, especially in adoptees, has attracted scholars’ attention in the past, but a search for any memory traces has yielded conflicting results. In a psycholinguistic tradition known as the savings paradigm, a learn‐and‐relearn technique is employed to examine whether the relearning of lexical items once known, often in a second or foreign language, can lead to a rate of learning advantage for old (previously known) over new (previously unknown) words. The present study adopted this technique to examine remnants of a lost childhood language in TJ, an adoptee who did not know her linguistic background prior to her adoption at the age of 3 years. Delayed posttests provided evidence for the savings effect for old words: TJ showed better savings for words that were likely known in her childhood language at the age of 3. In contrast, the comparison group revealed no effect for old words over new ones.
Detection of selective sweeps in structured populations: a comparison of recent methods
Authors: Vatsiou Alexandra I. , Bazin Eric , Gaggiotti Oscar E.
Published: August 2015

Identifying genomic regions targeted by positive selection has been a long‐standing interest of evolutionary biologists. This objective was difficult to achieve until the recent emergence of next‐generation sequencing, which is fostering the development of large‐scale catalogues of genetic variation for increasing number of species. Several statistical methods have been recently developed to analyse these rich data sets, but there is still a poor understanding of the conditions under which these methods produce reliable results. This study aims at filling this gap by assessing the performance of genome‐scan methods that consider explicitly the physical linkage among SNPs surrounding a selected variant. Our study compares the performance of seven recent methods for the detection of selective sweeps (iHS, nSL, EHHST, xp‐EHH, XP‐EHHST, XPCLR and hapFLK). We use an individual‐based simulation approach to investigate the power and accuracy of these methods under a wide range of population models under both hard and soft sweeps. Our results indicate that XPCLR and hapFLK perform best and can detect soft sweeps under simple population structure scenarios if migration rate is low. All methods perform poorly with moderate‐to‐high migration rates, or with weak selection and very poorly under a hierarchical population structure. Finally, no single method is able to detect both starting and nearly completed selective sweeps. However, combining several methods (XPCLR or hapFLK with iHS or nSL) can greatly increase the power to pinpoint the selected region.
Role of ToxS in the proteolytic cascade of virulence regulator ToxR in Vibrio cholerae
Authors: Almagro‐Moreno Salvador , Root Michael Z. , Taylor Ronald K.
Published: August 2015

Two of the primary virulence regulators of Vibrio cholerae, ToxR and TcpP, function together with cognate effector proteins. ToxR undergoes regulated intramembrane proteolysis (RIP) during late stationary phase in response to nutrient limitation at alkaline pH; however, the specific function of its cognate ToxS remains unresolved. In this work, we found that ToxR rapidly becomes undetectable in a ΔtoxS mutant when cultures are exposed to either starvation conditions or after alkaline pH shock individually. A ΔtoxS mutant enters into a dormant state associated with the proteolysis of ToxR at a faster rate than wild‐type, closely resembling a ΔtoxR mutant. Using a mutant with a periplasmic substitution in ToxS, we found that the proteases DegS and DegP function additively with VesC and a novel protease, TapA, to degrade ToxR in the mutant. Overall, the results shown here reveal a role for ToxS in the stabilization of ToxR by protecting the virulence regulator from premature proteolysis.
Osmoporin OmpC forms a complex with MlaA to maintain outer membrane lipid asymmetry in Escherichia coli
Authors: Chong Zhi‐Soon , Woo Wei‐Fen , Chng Shu‐Sin
Published: August 2015

Gram‐negative bacteria can survive in harsh environments in part because the asymmetric outer membrane (OM) hinders the entry of toxic compounds. Lipid asymmetry is established by having phospholipids (PLs) confined to the inner leaflet of the membrane and lipopolysaccharides (LPS) to the outer leaflet. Perturbation of OM lipid asymmetry, characterized by PL accumulation in the outer leaflet, disrupts proper LPS packing and increases membrane permeability. The multi‐component Mla system prevents PL accumulation in the outer leaflet of the OM via an unknown mechanism. Here, we demonstrate that in Escherichia coli, the Mla system maintains OM lipid asymmetry with the help of osmoporin OmpC. We show that the OM lipoprotein MlaA interacts specifically with OmpC and OmpF. This interaction is sufficient to localize MlaA lacking its lipid anchor to the OM. Removing OmpC, but not OmpF, causes accumulation of PLs in the outer leaflet of the OM in stationary phase, as was previously observed for MlaA. We establish that OmpC is an additional component of the Mla system; the OmpC‐MlaA complex may function to remove PLs directly from the outer leaflet to maintain OM lipid asymmetry. Our work reveals a novel function for the general diffusion channel OmpC in lipid transport.
A mutational analysis of the cytosolic domain of the tomato Cf‐9 disease‐resistance protein shows that membrane‐proximal residues are important for Avr9‐dependent necrosis
Authors: Chakrabarti Apratim , Velusamy Thilaga , Tee Choon Yang , Jones David A.
Published: August 2015

The tomato Cf‐9 gene encodes a membrane‐anchored glycoprotein that imparts race‐specific resistance against the tomato leaf mould fungus Cladosporium fulvum in response to the avirulence protein Avr9. Although the N‐terminal half of the extracellular leucine‐rich repeat (eLRR) domain of the Cf‐9 protein determines its specificity for Avr9, the C‐terminal half, including its small cytosolic domain, is postulated to be involved in signalling. The cytosolic domain of Cf‐9 carries several residues that are potential sites for ubiquitinylation or phosphorylation, or signals for endocytic uptake. A targeted mutagenesis approach was employed to investigate the roles of these residues and cellular processes in Avr9‐dependent necrosis triggered by Cf‐9. Our results indicate that the membrane‐proximal region of the cytosolic domain of Cf‐9 plays an important role in Cf‐9‐mediated necrosis, and two amino acids within this region, a threonine (T835) and a proline (P838), are particularly important for Cf‐9 function. An alanine mutation of T835 had no effect on Cf‐9 function, but an aspartic acid mutation, which mimics phosphorylation, reduced Cf‐9 function. We therefore postulate that phosphorylation/de‐phosphorylation of T835 could act as a molecular switch to determine whether Cf‐9 is in a primed or inactive state. Yeast two‐hybrid analysis was used to show that the cytosolic domain of Cf‐9 interacts with the cytosolic domain of tomato VAP27. This interaction could be disrupted by an alanine mutation of P838, whereas interaction with CITRX remained unaffected. We therefore postulate that a proline‐induced kink in the membrane‐proximal region of the cytosolic domain of Cf‐9 may be important for interaction with VAP27, which may, in turn, be important for Cf‐9 function.
ABC transporter PEN3/PDR8/ABCG36 interacts with calmodulin that, like PEN3, is required for Arabidopsis nonhost resistance
Authors: Campe Ruth , Langenbach Caspar , Leissing Franz , Popescu George V. , Popescu Sorina C. , Goellner Katharina , Beckers Gerold J. M. , Conrath Uwe
Published: August 2015

Nonhost resistance (NHR) is the most prevalent form of plant immunity. In Arabidopsis, NHR requires membrane‐localized ATP‐binding cassette (ABC) transporter PENETRATION (PEN) 3. Upon perception of pathogen‐associated molecular patterns, PEN3 becomes phosphorylated, suggestive of PEN3 regulation by post‐translational modification. Here, we investigated the PEN3 protein interaction network.

We probed the Arabidopsis protein microarray AtPMA‐5000 with the N‐terminal cytoplasmic domain of PEN3. Several of the proteins identified to interact with PEN3 in vitro represent cellular Ca2+ sensors, including calmodulin (CaM) 3, CaM7 and several CaM‐like proteins, pointing to the importance of Ca2+ sensing to PEN3‐mediated NHR.

We demonstrated co‐localization of PEN3 and CaM7, and we confirmed PEN3–CaM interaction in vitro and in vivo by PEN3 pull‐down with CaM Sepharose, CaM overlay assay and bimolecular fluorescence complementation. We also show that just like in pen3, NHR to the nonadapted fungal pathogens Phakopsora pachyrhizi and Blumeria graminis f.sp. hordei is compromised in the Arabidopsis cam7 and pen3 cam7 mutants.

Our study discloses CaM7 as a PEN3‐interacting protein crucial to Arabidopsis NHR and emphasizes the importance of Ca2+ sensing to plant immunity.
CML10, a variant of calmodulin, modulates ascorbic acid synthesis
Authors: Cho Kwang‐Moon , Nguyen Ha Thi Kim , Kim Soo Youn , Shin Jin Seok , Cho Dong Hwa , Hong Seung Beom , Shin Jeong Sheop , Ok Sung Han
Published: August 2015

Calmodulins (CaMs) regulate numerous Ca2+‐mediated cellular processes in plants by interacting with their respective downstream effectors. Due to the limited number of CaMs, other calcium sensors modulate the regulation of Ca2+‐mediated cellular processes that are not managed by CaMs. Of 50 CaM‐like (CML) proteins identified in Arabidopsis thaliana, we characterized the function of CML10.

Yeast two‐hybrid screening revealed phosphomannomutase (PMM) as a putative interaction partner of CML10. In vitro and in vivo interaction assays were performed to analyze the interaction mechanisms of CML10 and PMM. PMM activity and the phenotypes of cml10 knock‐down mutants were studied to elucidate the role(s) of the CML10–PMM interaction.

PMM interacted specifically with CML10 in the presence of Ca2+ through its multiple interaction motifs. This interaction promoted the activity of PMM. The phenotypes of cml10 knock‐down mutants were more sensitive to stress conditions than wild‐type plants, corresponding with the fact that PMM is an enzyme which modulates the biosynthesis of ascorbic acid, an antioxidant.

The results of this research demonstrate that a calcium sensor, CML10, which is an evolutionary variant of CaM, modulates the stress responses in Arabidopsis by regulating ascorbic acid production.