bluuebunny/crossref_metadata_2025 huggingface dataset:
An evaluation of group reminiscence arts sessions for people with dementia living in care homes
Authors: Keating Frank , Cole Laura , Grant Robert
Published: July 2018

Dementia has been identified as one of the major challenges in the 21st Century. The detrimental effects of dementia can jeopardise personhood, thus person-centred interventions including reminiscence and arts practice have been recommended as tools to promote social inclusion and improve the quality of life. This study aimed to evaluate the effectiveness of group reminiscence arts sessions for people living with dementia in care homes (residential and nursing homes) using a comparative and time series design to collect data on quality of life. The intervention was conducted in six care homes in London over a period of 24 weeks and compared with six care homes not receiving the intervention (control). Dementia Care Mapping was used as the primary data collection instrument to measure positive behaviours and rate quality of life before, during and after group reminiscence arts sessions. The evaluation team observed the sessions at three-weekly intervals. Statistical modelling found that positive behaviours and quality of life of care home residents participating in group reminiscence arts sessions increased over the 24-week period. Well-being increased sharply during each session and plateaued at 50 minutes with a sustained positive effect after the sessions. On a longer timescale, well-being and quality of life increased slowly and steadily from one session to the next. The findings were statistically significant ( p < 0.001). The study concludes that group reminiscence arts sessions can have a positive and sustained impact on the quality of life of people with dementia. However, the evidence on the sustainability of the effect over time remains unknown. More research is needed to assess in much greater depth the association between quality of life and group reminiscence arts sessions.
Attendance in Recreational Groups for Persons With Dementia: The Impact of Stimulus and Environmental Factors
Authors: Cohen-Mansfield Jiska , Jensen Barbara
Published: July 2018

Objectives:

Participation in group activities can benefit persons with dementia, alleviating boredom, improving affect, maintaining function, and decreasing problematic behaviors.

Methods:

We describe patterns of attendance of residents with dementia at nursing home activity groups and investigate stimulus and environmental factors that may affect attendance.

Results:

Residents participated in 60.8% of the activities, with reasons for nonattendance including refusal (9.7%), not being on the unit (7.8%), being asleep (6.8%), and being involved in activities of daily living and other activities (8.3%). On average, 3.5 other residents not recruited for the study chose to participate in each group session. Group attendance was significantly related to group topic.

Implication:

The need for activities was evident by the attendance of both invited and other residents. Understanding the factors that affect attendance is the first step toward developing procedures to maximize participation in activities in order to decrease loneliness and boredom in this population.
Robust composite neural dynamic surface control for the path following of unmanned marine surface vessels with unknown disturbances
Authors: Zeng Jiangfeng , Wan Lei , Li Yueming , Zhang Ziyang , Xu Yufei , Li Gongrong
Published: July 2018

This article presents a robust composite neural-based dynamic surface control design for the path following of unmanned marine surface vessels in the presence of nonlinearly parameterized uncertainties and unknown time-varying disturbances. Compared with the existing neural network-based dynamic surface control methods where only the tracking errors are commonly used for the neural network weight updating, the proposed scheme employs both the tracking errors and the prediction errors to construct the adaption law. Therefore, faster identification of the system dynamics and improved tracking accuracy are achieved. In particular, an outstanding advantage of the proposed neural network structure is simplicity. No matter how many neural network nodes are utilized, only one adaptive parameter that needs to be tuned online, which effectively reduces the computational burden and facilitates to implement the proposed controller in practice. The uniformly ultimate boundedness stability of the closed-loop system is established via Lyapunov analysis. Comparison studies are presented to demonstrate the effectiveness of the proposed composite neural-based dynamic surface control architecture.
Working memory in older adults declines with age, but is modulated by sex and education
Authors: Pliatsikas Christos , Veríssimo João , Babcock Laura , Pullman Mariel Y , Glei Dana A , Weinstein Maxine , Goldman Noreen , Ullman Michael T
Published: July 2018

Working memory (WM), which underlies the temporary storage and manipulation of information, is critical for multiple aspects of cognition and everyday life. Nevertheless, research examining WM specifically in older adults remains limited, despite the global rapid increase in human life expectancy. We examined WM in a large sample ( N = 754) of healthy older adults (aged 58-89) in a non-Western population (Chinese speakers) in Taiwan, on a digit n-back task. We tested not only the influence of age itself and of load (1-back vs. 2-back) but also the effects of both sex and education, which have been shown to modulate WM abilities. Mixed-effects regression revealed that, within older adulthood, age negatively impacted WM abilities (with linear, not nonlinear, effects), as did load (worse performance at 2-back). In contrast, education level was positively associated with WM. Moreover, both age and education interacted with sex. With increasing age, males showed a steeper WM decline than females; with increasing education, females showed greater WM gains than males. Together with other findings, the evidence suggests that age, sex, and education all impact WM in older adults, but interact in particular ways. The results have both basic research and translational implications and are consistent with particular benefits from increased education for women.
Prehospital idarucizumab prior to intravenous thrombolysis in a mobile stroke unit
Authors: Zhao Henry , Coote Skye , Pesavento Lauren , Jones Brett , Rodrigues Edrich , Ng Jo Lyn , Ng Felix , Yan Bernard , Parsons Mark , Campbell Bruce CV , Easton Damien , Donnan Geoffrey A , Davis Stephen M
Published: July 2018

Background

Administration of intravenous idarucizumab to reverse dabigatran anticoagulation prior to thrombolysis for patients with acute ischemic stroke has been previously described, but not in the prehospital setting. The speed and predictability of idarucizumab reversal is well suited to prehospital treatment in a mobile stroke unit and allows patients with recent dabigatran intake to access reperfusion therapy.

Aims

To describe feasibility of prehospital idarucizumab administration prior to thrombolysis on the Melbourne mobile stroke unit.

Methods

The Melbourne mobile stroke unit is a specialized stroke ambulance servicing central metropolitan Melbourne, Australia and provides prehospital assessment, scanning and treatment with an integrated CT scanner and multidisciplinary stroke team. All cases were identified through the mobile stroke unit treatment registry since launch in November 2017.

Results

Of a total of n = 20 thrombolysis cases in the first 4 months of operation, three patients (15%) received intravenous idarucizumab 5 g for dabigatran reversal prior to thrombolysis. Mean time between idarucizumab administration and thrombolysis was approximately 10 minutes. Two of the three patients were shown to have large vessel occlusion on CTA in the mobile stroke unit and proceeded to endovascular thrombectomy. At 24 hours, only one patient had a small amount of asymptomatic petechial hemorrhage on follow-up imaging. All patients demonstrated substantial neurological recovery and were discharged to inpatient rehabilitation.

Conclusions

Rapid treatment with prehospital administration of idarucizumab prior to thrombolysis using a mobile stroke unit is feasible and facilitates hyperacute treatment.
Itineraries of the Great War and the rise of the local on the Western Front: Memory, commemoration and the shifting regimes of remembrance tourism
Authors: Ahmad Rafiq , Hertzog Anne
Published: July 2018

The mainstream grand narratives of the Great War have tended to disregard local perspectives from territories on the Western Front. Using on-the-field visits of battlefields, interviews with stakeholders and analysis of battlefield guidebooks and itineraries, this article addresses these gaps by examining local assertions in the re-invention of battlefield itineraries and remembrance trails of the Great War, the new socio-spatial order they establish and discordance of perspectives it triggers between the nation and the territory. The itinerary, thus, devised by memory entrepreneurs and performed by visitors on the ground becomes an ‘effort of remembrance’ and a dynamic scheme mediating between participants and place.
Advances in proton therapy in lung cancer
Authors: Vyfhuis Melissa A.L. , Onyeuku Nasarachi , Diwanji Tejan , Mossahebi Sina , Amin Neha P. , Badiyan Shahed N. , Mohindra Pranshu , Simone Charles B.
Published: July 2018

Lung cancer remains the leading cause of cancer deaths in the United States (US) and worldwide. Radiation therapy is a mainstay in the treatment of locally advanced non-small cell lung cancer (NSCLC) and serves as an excellent alternative for early stage patients who are medically inoperable or who decline surgery. Proton therapy has been shown to offer a significant dosimetric advantage in NSCLC patients over photon therapy, with a decrease in dose to vital organs at risk (OARs) including the heart, lungs and esophagus. This in turn, can lead to a decrease in acute and late toxicities in a population already predisposed to lung and cardiac injury. Here, we present a review on proton treatment techniques, studies, clinical outcomes and toxicities associated with treating both early stage and locally advanced NSCLC.
MOG-IgG-associated disease has a stereotypical clinical course, asymptomatic visual impairment and good treatment response
Authors: Pandit Lekha , Mustafa Sharik , Nakashima Ichiro , Takahashi Toshyuki , Kaneko Kimhiko
Published: July 2018

Objectives

We investigated the clinical characteristics and treatment response in myelin oligodendrocyte glycoprotein antibody (MOG-IgG)-associated disease and looked for evidence of subclinical disease.

Methods

We prospectively evaluated the frequency and pattern of relapse, tested afferent visual function and monitored treatment response in 42 south Asian patients from a single centre.

Results

Eighteen patients (42.9%) had monophasic and 24 (57.1%) a relapsing course. Disease duration was longer ( P<0.02) in those with a relapsing course. Median time to the second attack was prolonged ( P<0.04) in patients with recurrent transverse myelitis when compared with neuromyelitis optica spectrum disorder and recurrent optic neuritis. Thirteen out of 17 patients (76.5%) initially presenting with optic neuritis developed recurrent optic neuritis later. After the first attack of transverse myelitis, 17 out of 22 (77.3%) had disease confined to the spinal cord. Optical coherence tomography detected peripapillary retinal nerve fibre layer thickness ( P<0.05) and macular ganglion cell complex volume ( P<0.005) abnormalities in seven out of 10 (70.0%) patients without clinical optic neuritis. Immunosuppressants induced remission in 17 out of 22 (77.3%) patients during a median follow-up of 48 months and the median Expanded Disability Status Score was 1 (range 1–10).

Conclusion

Our study highlighted the tendency for stereotypical attacks in MOG-IgG-associated disease, heterogeneity in clinical course among subtypes, subclinical visual impairment and the need for early and sustained immunosuppressive therapy.
IAPP/amylin deposition, which is correlated with expressions of ASC and IL-1β in β-cells of Langerhans’ islets, directly initiates NLRP3 inflammasome activation
Authors: Morikawa Shinnosuke , Kaneko Naoe , Okumura Chikara , Taguchi Haruka , Kurata Mie , Yamamoto Toshihiro , Osawa Haruhiko , Nakanishi Ayaka , Zako Tamotsu , Masumoto Junya
Published: July 2018

Recent findings revealed that type 2 diabetes mellitus (T2D) is a chronic inflammatory disease and an islet amyloid polypeptide (IAPP)/amylin, is deposited within pancreatic islets. IAPP/amylin has been reported to activate NACHT, LRR, and PYD domains-containing protein 3 (NLRP3) inflammasome in infiltrated macrophages. NLRP3, an intracellular pattern recognition receptor, has been shown to recognize pathogens and/or metabolites and complexes with the adopter protein apoptosis-associated speck-like protein containing a caspase-recruitment domain ASC to form a huge complex, called an inflammasome, an interleukin (IL)-1β-processing platform. Although reactive oxygen species (ROS) were reported to be involved in activation of NLRP3 inflammasome, we were hypothesized that IAPP could directly activate NLRP3 inflammasome, leading to islets β-cell death. We analyzed expression of the inflammasome components ASC, NLRP3, caspase-1, IL-1β, IAPP/amylin, and insulin immunohistochemically in Langerhans’ islets of autopsy cases. The initial event of NLRP3 inflammasome activation was assessed using a cell-free system consisting of NLRP3 and ASC with the amplified luminescent proximity homogeneous assay. IAPP/amylin deposition in Langerhans’ islets was detected and significantly correlated with expressions of IL-1β and ASC. IAPP/amylin directly interacted with NLRP3 and initiated an interaction between NLRP3 and ASC in a cell-free system. The deposition of IAPP/amylin in β-cells of Langerhans’ islets may act together with the expression level of an inflammasome component, ASC, to regulate IL-1β processing, and directly lead to the dysfunction of β-cells. The interaction between IAPP/amylin and NLRP3 could be an attractive drug target to avoid both inflammation and β-cell death for T2D therapy.
College Status and Trajectories of Perceived Leadership Ability Among Emerging Adults
Authors: Moore Stephanie S. , Schmidt Carissa J. , Heinze Justin E. , Diemer Matthew A. , Zimmerman Marc A.
Published: July 2018

This study explores changes in perceived leadership ability during emerging adulthood among a predominantly African American sample, with special consideration of the differences between the experiences of individuals who attended 4-year universities and those who did not. We used data from a longitudinal study that followed participants from high school into adulthood. Findings demonstrated that perceived leadership ability declined between the ages of 18 and 22, with the largest declines occurring among emerging adults who did not attend 4-year colleges. These findings suggest that perceived leadership ability is malleable and responds to contextual factors, such as limited access to leadership roles during emerging adulthood. We conclude with implications for practice to support leadership development among emerging adults.
The Association Between Musculoskeletal Symptoms and Traditional Chinese Medicine Use Among Chinese Older Adults in the Greater Chicago Area
Authors: Dong XinQi , Li Ke
Published: July 2018

Older adults disproportionately experience musculoskeletal symptoms, which are associated with morbidity and mortality. Traditional Chinese medicine (TCM) is an important part of Chinese culture and for millennia have been used to maintain health. This article aims to examine the association between musculoskeletal symptoms and different subtypes of TCM usage. Data were collected through the Population Study of Chinese Elderly in Chicago (PINE) study, a community-engaged, epidemiological study of a U.S. Chinese population. Review of systems was used to measure musculoskeletal symptoms. TCM use was measured by using a 5-point scale. Logistic regression analyses were conducted to control for potential confounding factors. Of 3,157 Chinese, older adults aged 60 and older, the mean age was 72.8 ( SD = 8.3) and 58.9% were female. Older adults with any musculoskeletal symptoms had greater utilization of overall TCM use (odds ratio [OR] = 2.10, 95% confidence interval [CI] = [1.76, 2.52]), especially massage therapy (OR = 3.41, 95% CI = [2.51, 4.63]), herbal (OR = 2.68, 95% CI = [2.28, 3.14]), and acupuncture (OR = 2.49, 95% CI = [1.87, 3.32]). However, there was no statistically significant association between the presence of musculoskeletal symptoms and Tai-Chi (OR = 1.18, 95% CI = [0.93, 1.50]). This study demonstrated that musculoskeletal symptoms among Chinese older adults were strongly associated with the use of TCM. Future research is needed to examine the effectiveness of TCM in treating musculoskeletal symptoms.
Exploring Relationships of Psychological Sense of Community With Self-Rated Health and Depressive Symptoms Among Older Chinese Americans
Authors: Tang Fengyan , Chi Iris , Xu Ling , Dong XinQi
Published: July 2018

This study examined the relationships of psychological sense of community (PSOC) with self-rated health and depressive symptoms among older Chinese Americans. The sample was taken from the Population Study of Chinese Elderly in Chicago (PINE), a population-based survey of 3,159 community-dwelling seniors. PSOC was measured through the Sense of Community Index (SCI). Factor analysis indicated a four-dimensional structure within the SCI; however, the SCI lacked dimensional consistency and items that composed four underlying factors were different than the proposed ones. After controlling for sociodemographics, binary and multinomial logistic regression analyses showed that a higher level of PSOC was related to a lower likelihood of self-reporting poor or fair health and of developing more depressive symptoms. The identified factors of influence and emotional connection were also significantly related to self-rated health and depressive symptoms. Future research need aim at improving the conceptualization process of the PSOC and cultural relevance in minority populations.
Acculturation and Activity Engagement Among Older Chinese Americans
Authors: Tang Fengyan , Zhang Wei , Chi Iris , Dong XinQi
Published: July 2018

Using data from the Population Study of Chinese Elderly in Chicago (PINE) conducted from 2011 to 2013, this study aims to examine the role of acculturation in engagement in cognitive, social, and religious activities among older Chinese Americans. Activity engagement and acculturation levels were relatively low in the study sample. Multivariate regression analyses showed that high levels of acculturation in general, and particularly media use (e.g., TV and radio) and ethnic social relations (i.e., preferred ethnicity of those with whom one interacts) were associated with more engagement in cognitive and social activities, respectively. High levels of acculturation in general and ethnic social relation in particular increased the likelihood of engaging in religious activities. Language use was not related to engagement in any activity, probably because only 2% of the PINE participants preferred to speak English. Findings indicate that acculturation can promote activity engagement probably through media use and social relations, whereby older adults may acquire information about opportunities for various activities. Active participation with life may improve older adults’ well-being and help address the widening health disparities among minority older populations in American society.
Employment and Life Satisfaction Among Middle- and Old-Aged Adults in China
Authors: Tang Fengyan , Chen Huajuan , Zhang Yalu , Mui Ada C.
Published: July 2018

The population in China has been aging rapidly over the past two decades, raising concerns about how to meet the health and long-term care needs of the growing older adult population. The productive aging framework has been applied to promote the active roles that older adults can play in society and to improve physical and psychological well-being. Employment, as an essential form of productive aging, is central to personal control, self-identify, economic resources, and social connectedness. However, there is no clear role or accommodation for older workers in China due to the mandatory retirement policy and traditional culture of gender roles. Using the World Health Organization (WHO) Study on Global Aging and Adult Health (SAGE) Wave 1 data, we examined the relationship between employment and life satisfaction in middle- and old-aged Chinese. Multiple regression analyses indicated that employment and certain work characteristics were positively related to life satisfaction in both the total and male samples. Overall, rural residents had higher levels of satisfaction than urban residents after equalizing socioeconomic resources and health. Policy and practice implications are discussed on how to improve life satisfaction through employment and how to address gender and residency gaps.
Two metropolisation gradients in the European system of cities revealed by scaling laws
Authors: Pumain Denise , Rozenblat Céline
Published: July 2018

Urban systems share with other complex systems constraints on their dynamics that are revealed by pervasive structural features, among which scaling laws. Scaling laws are relationships between cities’ attributes and their size (here measured by their population). When the relationship is non proportional with exponents larger than 1, scaling laws indicate the relative concentration of some urban functions at the higher levels of urban hierarchies. Superlinear scaling thus reveals the metropolisation trends that are produced in the urban system, according to our evolutionary theory perspective, by the hierarchical diffusion of innovation waves. Considering the current urban changes linked with the globalisation processes as an ‘innovation’ that is likely to diffuse hierarchically in urban systems, we analyse the relationships between 25 indicators expressive of their position in globalisation processes and the size of European cities (356 largest functional urban areas of the 28 European Union member states plus Switzerland and Norway). When summarised in a single metropolisation factor, we expected to find a unique superlinear scaling relationship that would reveal the hierarchical structure of the unifying European system of cities. We instead identify two distinct metropolisation gradients for each of the Western and Eastern subsystem that we interpret according to the delayed globalisation process in the latter. This provides a demonstration of the usefulness of scaling laws for summarising stages in the process of hierarchical diffusion of innovation in systems of cities.
AMPK-ACC signaling modulates platelet phospholipids and potentiates thrombus formation
Authors: Lepropre Sophie , Kautbally Shakeel , Octave Marie , Ginion Audrey , Onselaer Marie-Blanche , Steinberg Gregory R. , Kemp Bruce E. , Hego Alexandre , Wéra Odile , Brouns Sanne , Swieringa Frauke , Giera Martin , Darley-Usmar Victor M. , Ambroise Jérôme , Guigas Bruno , Heemskerk Johan , Bertrand Luc , Oury Cécile , Beauloye Christophe , Horman Sandrine
Published: July 2018

Key Points

AMPK-ACC signaling in platelets is a key mechanism regulating primary hemostasis and arterial thrombosis. AMPK-ACC signaling controls collagen-induced TXA2 generation and dense granule release by modulating platelet phospholipid content.
‘The axial rethink’ – making sense of language: an interview with Christian M.I.M. Matthiessen
Authors: Matthiessen Christian M. I. M. , Wang Bo , Mwinlaaru Isaac N. , Ma Yuanyi
Published: July 2018

Christian M.I.M. Matthiessen is a leading scholar in Systemic Functional Linguistics (SFL). Together with William C. Mann and Sandra A. Thompson, he developed Rhetorical Structure Theory, a discourse analytical framework which he has continued to expand and extend using insights from the architecture of SFL. Some of his other contributions are in the area of functional language typology, theoretical modelling of the dimensions of language and comprehensive paradigmatic description of English lexicogrammatical systems. In this interview, he discusses his early experience in linguistics and his motivations for working with Systemic Functional Linguistics. The interview also sheds light on the interaction between SFL and other linguistic schools in the European and American linguistic traditions, and indicates the distinctive contributions of SFL to linguistic science. The discussion contributes to the history of linguistics and the debates on the meta-theory of language.
Guided chemotherapy based on patient‐derived mini‐xenograft models improves survival of gallbladder carcinoma patients
Authors: Zhan Ming , Yang Rui‐meng , Wang Hui , He Min , Chen Wei , Xu Sun‐wang , Yang Lin‐hua , Liu Qiang , Long Man‐mei , Wang Jian
Published: July 2018

Background

Gallbladder carcinoma is highly aggressive and resistant to chemotherapy, with no consistent strategy to guide first line chemotherapy. However, patient‐derived xenograft (PDX) model has been increasingly used as an effective model for in preclinical study of chemosensitivity.

Methods

Mini‐PDX model was established using freshly resected primary lesions from 12 patients with gallbladder to examine the sensitivity with five of the most commonly used chemotherapeutic agents, namely gemcitabine, oxaliplatin, 5‐fluorouracil, nanoparticle albumin‐bound (nab)‐paclitaxel, and irinotecan. The results were used to guide the selection of chemotherapeutic agents for adjunctive treatment after the surgery. Kaplan–Meier method was used to compare overall survival (OS) and disease free survival (DFS) with 45 patients who received conventional chemotherapy with gemcitabine and oxaliplatin.

Results

Cell viability assays based on mini‐PDX model revealed significant heterogeneities in drug responsiveness. Kaplan–Meier analysis showed that patients in the PDX‐guided chemotherapy group had significantly longer median OS (18.6 months; 95% CI 15.9–21.3 months) than patients in the conventional chemotherapy group (13.9 months; 95% CI 11.7–16.2 months) (P = 0.030; HR 3.18; 95% CI 1.47–6.91). Patients in the PDX‐guided chemotherapy group also had significantly longer median DFS (17.6 months; 95% CI 14.5–20.6 months) than patients in the conventional chemotherapy group (12.0 months; 95% CI 9.7–14.4 months) (P = 0.014; HR 3.37; 95% CI 1.67–6.79).

Conclusion

The use of mini‐PDX model to guide selection of chemotherapeutic regimens could improve the outcome in patients with gallbladder carcinoma.
Time for a change of practice: the real-world value of testing for neuronal autoantibodies in acute first-episode psychosis
Authors: Pollak Thomas A. , Lennox Belinda R.
Published: July 2018

It is time that all patients with acute-onset psychosis are screened for autoimmune encephalitis, that lumbar puncture becomes a routine psychiatric investigation and that immunotherapy is available in indicated cases. We call for a culture change in the management of psychosis by psychiatry.

Declaration of interest

None.
Paradigm Shifts in Nocturnal Glucose Control in Type 2 Diabetes
Authors: Basu Ananda , Joshi Nisha , Miles John , Carter Rickey E , Rizza Robert A , Basu Rita
Published: July 2018

Context

A better understanding of nocturnal regulation of glucose homeostasis will provide the framework for designing rational therapeutic strategies to improve the management of overnight glucose in patients with type 2 diabetes (T2D).

Objective

To establish the nocturnal pattern and regulation of glucose production (EGP) in humans and to determine whether the pattern is dysregulated in people with T2D.

Design

Subjects were infused with [3-3H] glucose overnight. Arterial blood samples were drawn for hormones and analytes to estimate EGP throughout the night. Deuterium-labeled water was provided to measure gluconeogenesis (GNG) using the hexamethylenetetramine method of Landau.

Setting

Mayo Clinic Clinical Research Trials Unit, Rochester, MN, USA.

Participants and Interventions

A total of 43 subjects [23 subjects with T2D and 20 nondiabetic (ND) subjects comparable for age and body mass index] were included in this study.

Main Outcome(s) Measure(s)

Glucose and EGP.

Results

Plasma glucose, C-peptide, and glucagon concentrations were higher throughout the night, whereas insulin concentrations were higher in subjects with T2D vs ND subjects at 1:00 and 4:00 am but similar at 7:00 am. EGP was higher in the subjects with T2D than in the ND subjects throughout the night (P < 0.001). Glycogenolysis (GGL) fell and GNG rose, resulting in significantly higher (P < 0.001) rates of GNG at 4:00 and 7:00 am and significantly (P < 0.001) higher rates of GGL at 1:00, 4:00, and 7:00 am in T2D as compared with ND.

Conclusions

These data imply that optimal therapies for T2D for nocturnal/fasting glucose control should target not only the absolute rates of EGP but also the contributing pathways of GGL and GNG sequentially.
Effects of hypoxia on swimming and sensing in a weakly electric fish
Authors: Ackerly Kerri Lynn , Krahe Rüdiger , Sanford Christopher P. , Chapman Lauren J.
Published: July 2018

Low dissolved oxygen (hypoxia) can severely limit fish performance, especially aerobically expensive behaviours including swimming and acquisition of sensory information. Fishes can reduce oxygen requirements by altering these behaviours under hypoxia, but the underlying mechanisms can be difficult to quantify. We used a weakly electric fish as a model system to explore potential effects of hypoxia on swim performance and sensory information acquisition, which enabled us to non-invasively record electric signalling activity used for active acquisition of sensory information during swimming. To quantify potential effects of hypoxia, we measured critical swim speed (Ucrit) and concurrent electric signalling activity under high- and low-dissolved oxygen concentrations in a hypoxia-tolerant African mormyrid fish, Marcusenius victoriae. Fish were maintained under normoxia for 6 months prior to experimental treatments, and then acclimated for 8 weeks to normoxia or hypoxia and tested under both conditions (acute: 4 h exposure). Acute hypoxia exposure resulted in a significant reduction in both Ucrit and electric signalling activity in fish not acclimated to hypoxia. However, individuals acclimated to chronic hypoxia were characterized by a higher Ucrit under both hypoxia and normoxia than fish acclimated to normoxia. Following a 6 month re-introduction to normoxia, hypoxia-acclimated individuals still showed increased performance under acute hypoxic test conditions, but not under normoxia. Our results highlight the detrimental effects of hypoxia on aerobic swim performance and sensory information acquisition, and the ability of fish to heighten aerobic performance through acclimation processes that can still influence performance even months after initial exposure.
Recent advances in understanding and managing epidermolysis bullosa
Authors: Kiritsi Dimitra , Nyström Alexander
Published: July 2018

Epidermolysis bullosa (EB) is a clinically and genetically heterogeneous skin fragility disorder characterized by trauma-induced skin dissociation and the development of painful wounds. So far, mutations in 20 genes have been described as being associated with more than 30 clinical EB subtypes. The era of whole-exome sequencing has revolutionized EB diagnostics with gene panels being developed in several EB centers and allowing quicker diagnosis and prognostication. With the advances of gene editing, more focus has been placed on gene editing-based therapies for targeted treatment. However, their implementation in daily care will still take time. Thus, a significant focus is currently being placed on achieving a better understanding of the pathogenetic mechanisms of each subtype and using this knowledge for the design of symptom-relief therapies, i.e. treatment options aimed at ameliorating and not curing the disease.
Phenotype profiling of white-nose syndrome pathogen Pseudogymnoascus destructans and closely-related Pseudogymnoascus pannorum reveals metabolic differences underlying fungal lifestyles
Authors: Chaturvedi Vishnu , DeFiglio Holland , Chaturvedi Sudha
Published: July 2018

Background: Pseudogymnoascus destructans, a psychrophile, causes bat white-nose syndrome (WNS). Pseudogymnoascus pannorum, a closely related fungus, causes human and canine diseases rarely. Both pathogens were reported from the same mines and caves in the United States, but only P. destructans caused WNS. Earlier genome comparisons revealed that P. pannorum contained more deduced proteins with ascribed enzymatic functions than P. destructans.

Methods: We performed metabolic profiling with Biolog PM microarray plates to confirm in silico gene predictions.

Results: P. pannorum utilized 78 of 190 carbon sources (41%), and 41 of 91 nitrogen compounds (43%) tested. P. destructans used 23 carbon compounds (12%) and 23 nitrogen compounds (24%). P. destructans exhibited more robust growth on the phosphorous compounds and nutrient supplements (83% and 15%, respectively) compared to P. pannorum (27% and 1%, respectively.). P. pannorum exhibited higher tolerance to osmolytes, pH extremes, and a variety of chemical compounds than P. destructans.

Conclusions: An abundance of carbohydrate degradation pathways combined with robust stress tolerance provided clues for the soil distribution of P. pannorum. The limited metabolic profile of P. destructans was compatible with in silico predictions of far fewer proteins and enzymes. P. destructans ability to catabolize diverse phosphorous and nutrient supplements might be critical in the colonization and invasion of bat tissues. The present study of 1,047 different metabolic activities provides a framework for future gene-function investigations of the unique biology of the psychrophilic fungi.
Epiviz Web Components: reusable and extensible component library to visualize functional genomic datasets
Authors: Kancherla Jayaram , Zhang Alexander , Gottfried Brian , Bravo Hector Corrada
Published: July 2018

Interactive and integrative data visualization tools and libraries are integral to exploration and analysis of genomic data. Web based genome browsers allow integrative data exploration of a large number of data sets for a specific region in the genome. Currently available web-based genome browsers are developed for specific use cases and datasets, therefore integration and extensibility of the visualizations and the underlying libraries from these tools is a challenging task. Genomic data visualization and software libraries that enable bioinformatic researchers and developers to implement customized genomic data viewers and data analyses for their application are much needed.

Using recent advances in core web platform APIs and technologies including Web Components, we developed the Epiviz Component Library, a reusable and extensible data visualization library and application framework for genomic data. Epiviz Components can be integrated with most JavaScript libraries and frameworks designed for HTML. To demonstrate the ease of integration with other frameworks, we developed an R/Bioconductor epivizrChart package, that provides interactive, shareable and reproducible visualizations of genomic data objects in R, Shiny and also create standalone HTML documents. The component library is modular by design, reusable and natively extensible and therefore simplifies the process of managing and developing bioinformatic applications.
Dendritic cell-expressed common gamma-chain recruits IL-15 for trans-presentation at the murine immunological synapse
Authors: Beilin Chiara , Choudhuri Kaushik , Bouma Gerben , Malinova Dessislava , Llodra Jaime , Stokes David L. , Shimaoka Motumu , Springer Timothy A. , Dustin Michael L. , Thrasher Adrian J. , Burns Siobhan O.
Published: July 2018

Background:Mutations of the common cytokine receptor gamma chain (γc) cause Severe Combined Immunodeficiency characterized by absent T and NK cell development. Although stem cell therapy restores these lineages, residual immune defects are observed that may result from selective persistence of γc-deficiency in myeloid lineages. However, little is known about the contribution of myeloid-expressed γc to protective immune responses.  Here we examine the importance of γc for myeloid dendritic cell (DC) function.

Methods:We utilize a combination ofin vitroDC/T-cell co-culture assays and a novel lipid bilayer system mimicking the T cell surface to delineate the role of DC-expressed γc during DC/T-cell interaction.

Results:We observed that γc in DC was recruited to the contact interface following MHCII ligation, and promoted IL-15Rα colocalization with engaged MHCII. Unexpectedly, trans-presentation of IL-15 was required for optimal CD4+T cell activation by DC and depended on DC γc expression. Neither recruitment of IL-15Rα nor IL-15 trans-signaling at the DC immune synapse (IS), required γc signaling in DC, suggesting that γc facilitates IL-15 transpresentation through induced intermolecularcisassociations or cytoskeletal reorganization following MHCII ligation.

Conclusions:These findings show that DC-expressed γc is required for effective antigen-induced CD4+ T cell activation. We reveal a novel mechanism for recruitment of DC IL-15/IL-15Rα complexes to the IS, leading to CD4+ T cell costimulation through localized IL-15 transpresentation that is coordinated with antigen-recognition.
Frailty syndrome and functional disability among older adults with and without diabetes and foot ulcers
Authors: Bôas Nayana Cristina Reis Vilas , Salomé Geraldo Magela , Ferreira Lydia Masako
Published: July 2018

Objective:

To assess frailty and disability among older adults with and without diabetes or foot ulcers.

Method:

A descriptive, comparative, controlled, multicentre study. Equal numbers of participants were allocated to three groups: (I) no diabetes/no foot ulcers (control), (II) diabetes but no foot ulcers or (III) diabetes and foot ulcers. Individuals with arterial, venous, pressure or mixed ulcers were not included. We collected data using three methods: a sociodemographic questionnaire and the validated Brazilian versions of the Edmonton Frail Scale and Stanford Health Assessment Questionnaire 20-item Disability Scale (HAQ-20).

Results:

A total of 150 older people took part in the study. The majority of participants were female (n=84, 56%), married (n=86, 57%) and did not exercise (n=94, 63%). Their age ranged from 67.7–71.5 years. In group I, 32 (64%) patients showed no evidence of frailty. In group II, 18 (36%) patients and 12 (24%) patients were ‘apparently vulnerable’ and ‘mildly frail’, respectively and in group III 21 (42%) patients and 15 (22%) patients had ‘moderate’ and ‘severe frailty’, respectively. The mean total HAQ-20 scores were 0.24, 0.52, and 2.44 for groups I, II, and III, respectively. Patients in group III reported significantly higher scores on all HAQ-20 categories compared with patients in groups I and II.

Conclusion:

Older patients with DFUs showed frailty and physical disability in activities of daily living.
A simple and fast dressing for skin grafts: comparison with traditional techniques
Authors: Kim Sang Wha , Kim Ji Hun , Kim Jeong Tae , Kim Youn Hwan
Published: July 2018

Objective:

The split-thickness skin graft (STSG) is commonly used for reconstruction of skin and soft tissue defects. For a successful graft, the thin skin must be in close contact with the recipient bed until the graft stabilises. This study introduces a simple and fast dressing technique, and compares it with the traditional tie-over dressing.

Method:

All patients who received STSGs between January 2013 and March 2015 were identified. From these patients, those who were treated with skin graft only were included in the study. For comparison of the dressing techniques, operation times from skin incision to the end of procedure were analysed, together with the outcomes of the grafts. For the simple and fast method, the dressing was fixed with a skin stapler, and for tie-over dressings, the graft was fixed with sutures.

Results:

A total of 67 patients (38 females, 29 males), mean age 58.4 years (range: 24–86 years) were included in the study. Average operation times were 22.9 minutes (range: 10-40 minutes) using the simple and fast dressings and 45.3 minutes (range: 20–120 minutes) using the tie-over dressings, demonstrating a significant difference in operation times. Partial graft loss was reported in three cases with the tie-over dressings and in four cases with the simple and fast dressings, without significant difference.

Conclusion:

The simple and fast dressing is easy to apply, is able to be shaped according to the wound surface, and provides a secure dressing over the skin graft.
Topical oxygen therapy stimulates healing in difficult, chronic wounds: a tertiary centre experience
Authors: Kaufman Hanna , Gurevich Maxim , Tamir Eran , Keren Elad , Alexander Lipkin , Hayes Paul
Published: July 2018

Objective:

Oxygen plays a central role in wound healing. Recent technological advances have miniaturised oxygen delivery systems, with novel topical oxygen therapy allowing patients to receive oxygen therapy 24 hours a day while remaining completely mobile. Here we aim to examine the efficacy and safety of continuous topical oxygen diffusion in a ‘real-world’ setting.

Methods:

Topical oxygen therapy (TOT) was evaluated in patients with chronic, non-healing wounds in a tertiary referral specialist clinic.

Results:

The mean wound duration before TOT was 15 months. Regardless of treatment duration, in this previously non-healing group complete wound closure was observed in 32% of the total patients treated with the TOT device. However, optimal wound healing occurred when the device was used for >25 days, with an 83% wound area reduction and 47% wound closure rate seen in venous leg ulcers (VLUs) and a 74% reduction and a 57% wound closure rate in arterial foot ulcers.

Conclusion:

Use of TOT in chronic wounds stimulates a healing state. In our study, almost half of the previously non-healing wounds closed.
Using AutoCAD software to measure venous leg ulcers: a reproducibility assessment study
Authors: Eberhardt Thaís D. , Lima Suzinara B.S. , Lopes Luis F.D. , Kessler Marciane , Fonseca Graziele G.P. , Soares Rhea S.A.
Published: July 2018

Objective:

To assess the reproducibility of using AutoCAD software to measure the area of venous leg ulcers (VLUs).

Method:

Data from patients with VLUs were collected between March and July 2015, using data collection forms and photographing the different ulcers. A researcher and five nurses collected the data. The wounds were measured using AutoCAD software. Data were analysed using intraclass correlation coefficient (ICC), concordance correlation coefficient (CCC) and Bland-Altman analysis.

Results:

A total of 21 patients with 36 VLUs were included in the study. A statistically significant difference (p<0.05) was observed between the areas of VLUs measured by the researcher and the evaluators. There was an excellent agreement when analysing the ICC [p=0.98; 95% CI (0.97–0.99); p <0.05] and the CCC [CCC=CI 0.97; 95% (0.95–0.98)]. There was no difference between the measurements of VLUs ≤10 cm2(p=0.49) and those with an area >10cm2(p=0.22).

Conclusion:

The use of AutoCAD software is appropriate for measuring VLUs and appears to be more accurate when used to measure VLUs with an area >10cm2.
Acetabular morphology in slipped capital femoral epiphysis: Comparison at treatment onset and skeletal maturity
Authors: Maranho D. A. , Davila-Parrilla A. , Miller P. E. , Kim Y.-J. , Novais E. N. , Millis M. B.
Published: July 2018

Purpose

To investigate changes in acetabular morphology during the follow-up of slipped capital femoral epiphysis (SCFE) and search for factors associated with acetabular dysplasia at skeletal maturity.

Methods

We evaluated 108 patients with unilateral SCFE (mean age at slip, 12.3 years sd 1.7) to skeletal maturity, with a minimum follow-up of two years (median 4.5 years; interquartile range 3.2 to 6.2). Acetabular parameters obtained from initial and most recent radiographs included the lateral centre-edge angle (LCEA), Tönnis angle (TA) and acetabular depth-width ratio (ADR). Acetabular dysplasia was considered for LCEA < 20° or TA > 10°. Femoral parameters consisted of the most recent head diameter, neck-shaft angle, neck length, articulotrochanteric distance and alpha angle.

Results

At SCFE onset, the affected hip showed a slightly lower LCEA (26.4° sd 6.1° versus 27.3° sd 5.7°; p = 0.01) and ADR (330 sd 30 versus 340 sd 30; p < 0.001) compared with the uninvolved hip. At final follow-up, the affected hip showed lower LCEA (24.5° sd 7.6° versus 28.8°sd 6.6°; p < 0.001) and ADR (330 sd 40 versus 350 sd 40; p < 0.001), and TA was larger (5.5° sd 5.4° versus 2.3° sd 4.2°; p < 0.001) compared with the uninvolved hip. Acetabular dysplasia was observed in 27 (25%) of 108 hips with SCFE. Femoral head overgrowth, age at slip and SCFE severity were independent factors associated with acetabular dysplasia (p < 0.05).

Conclusion

Acetabular coverage and depth are not increased in SCFE, and the acetabular coverage tends to decrease up to skeletal maturity. A potential disturbance in the acetabular growth and remodelling exists mainly for young children with severe SCFE, and a potential for acetabular insufficiency may be observed at the diagnosis and follow-up of SCFE.

Level of Evidence

Prognostic Level IV
El estrés oxidativo en la práctica de enfermería
Authors: Castillo Andrade Rocío , Salazar-Lugo Raquel Del valle
Published: July 2018

El personal de enfermería está expuesto a una gran carga de trabajo físico y psicosocial; éstos son factores estresantes que inciden directamente en la salud de este personal. Estudios demuestran que el estrés ocupacional en este personal incrementa el estrés oxidativo y así, la generación de especies reactivas de oxígeno lo cual puede conducir al envejecimiento prematuro, a las enfermedades neurodegenerativas y al cáncer. El manejo del estrés laboral en el trabajo de enfermería es un factor importante para disminuir la sobrecarga de estrés oxidativo que involucra esta profesión. La capacidad de resiliencia debe ser manejado como un aspecto robusto para poder sobrellevar el estrés oxidativo, con mínimos costos en la salud. Igualmente, cambios en el estilo de vida, como una alimentación saludable que involucre vegetales y frutas y la práctica deportiva también son necesarios para disminuir la carga oxidativa y mejorar la calidad de vida del personal de enfermería.
A NEW COMBINATION IN PSEUDERANTHEMUM (ACANTHACEAE)
Authors: Turner Ian
Published: July 2018

TURNER, I. M. 2018. A new combination in Pseuderanthemum (Acanthaceae). Reinwardtia 17(1): 55–57. — A new combination is provided in Pseuderanthemum for Eranthemum diantherum Roxb., an Acanthaceae species from the Moluccas. Pseuderanthemum depauperatum Merr. is a synonym of Pseuderanthemum diantherum. Lectotypes for Eranthemum diantherum and Pseuderanthemum depauperatum are designated.