bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of life of older persons in nursing homes after the implementation of a knowledge‐based palliative care intervention
Authors: Bökberg Christina , Behm Lina , Ahlström Gerd 
Published: July 2019

AbstractBackgroundThe goals of palliative care are to relieve suffering and promote quality of life. Palliative care for older persons has been less prioritised than palliative care for younger people with cancer, which may lead to unnecessary suffering and decreased quality of life at the final stage of life.AimTo evaluate whether a palliative care intervention had any influence on the perceived quality of life of older persons (≥65 years).MethodsThis study was conducted as a complex intervention performed with an experimental crossover design. The intervention was implemented in 20 nursing homes, with a six‐month intervention period in each nursing home. Twenty‐three older persons (≥65 years) in the intervention group and 29 in the control group were interviewed using the WHOQOL‐BREF and WHOQOL‐OLD questionnaires at both baseline and follow‐up. The collected data were analysed using the Wilcoxon signed‐rank test to compare paired data between baseline and follow‐up.ResultsIn the intervention group, no statistically significant increases in quality of life were found. This result contrasted with the control group, which revealed statistically significant declines in quality of life at both the dimension and item levels. Accordingly, this study showed a trend of decreased health after nine months in both the intervention and control groups.ConclusionIt is reasonable to believe that quality of life decreases with age as part of the natural course of the ageing process. However, it seems that the palliative care approach of the intervention prevented unnecessary quality of life decline by supporting sensory abilities, autonomy and social participation among older persons in nursing homes. From the ageing perspective, it may not be realistic to strive for an increased quality of life in older people living in nursing homes; maybe the goal should be to delay or prevent reduced quality of life. Based on this perspective, the intervention prevented decline in quality of life in nursing home residents.Implications for practiceThe high number of deaths shows the importance to identify palliative care needs in older persons at an early stage to prevent or delay deterioration of quality of life.
Single and multiple time‐point allergic sensitization during childhood and risk of asthma by age 13
Authors: Schoos Ann‐Marie Malby , Jelding‐Dannemand Ea , Stokholm Jakob , Bønnelykke Klaus , Bisgaard Hans , Chawes Bo Lund 
Published: July 2019

AbstractBackgroundThe relationship between allergic sensitization during childhood and risk of developing asthma remains unclear.ObjectiveTo analyze single time‐point and temporal patterns of sensitization in childhood in relation to asthma at age 13.MethodsSpecific IgE (sIgE) level and skin prick test (SPT) toward 22 food allergens and aeroallergens were assessed at 6, 18 months, 4, 6, and 13 years in children from the high‐risk Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000) mother‐child cohort. We analyzed the association between single time‐point monosensitization, polysensitization, and quantitative assessment of sensitization, that is, sum of all sIgE levels and SPT wheal sizes, against asthma at age 13. In addition, we analyzed the association between three temporal patterns of sensitization: (a) early‐transient, (b) late‐onset, and (c) persistent sensitization and asthma.ResultsPolysensitization status measured by SPT or sIgE was at all single time‐points associated with increased risk of asthma at age 13: OR range, SPT = 3.0‐15.7, and sIgE = 2.6‐15.7, respectively, whereas monosensitization status was inconsistently associated with asthma. Quantitative assessment of both sIgE and SPT results was associated with asthma at all single time‐points: OR range, SPT = 1.3‐3.6, and sIgE = 1.1‐1.7. Persistent sensitization, but not early‐transient or late‐onset sensitization was associated with asthma by age 13: OR [95% CI], SPT = 8.9 [2.8‐28.23], and sIgE = 2.9 [1.1‐7.6], respectively.ConclusionSensitization to multiple allergens at single time‐points, increasing sIgE levels and SPT wheal sizes, and persistent sensitization during childhood were associated with increased risk of asthma at age 13, suggesting the use of quantitative and repetitive sensitization measurements when assessing risk of developing asthma.
Changes in DNA methylation patterns affect ripening time in Satsuma mandarin fruit
Authors: Chen Zhiyou , Zhao Ying , Jiang Dong , Xiang Suqiong , Li Jiana 
Published: July 2019

AbstractDifferences in DNA methylation patterns might lead to differences in fruit maturation time in the citrus Satsuma, but the underlying mechanism is unclear. Here, we explored the differences in methylation patterns during fruit ripening in Satsuma among 20 early‐ and late‐maturing Satsuma varieties and compared DNA methylation patterns in two Satsuma cultivars (Ooita wase and Aoshima unshiu) at different developmental stages using methylation‐sensitive fragment length polymorphism (MSAP) analysis. We cloned and sequenced DNA from different bands to identify differentially methylated genes involved in fruit ripening. The internal methylation of CCGG sequences occurred more frequently in the early‐maturing Satsuma cultivars (8.47%) than the late‐maturing cultivars (6.74%), whereas the external methylation of CCGG sequences occurred less frequently in the early‐maturing cultivars (24.98%) compared to the late‐maturing types (27.27%). Genes encoding the G protein α subunit and zinc‐binding protein of the histidine triad (HIT) family and two unknown genes homologous to expressed sequence tag (EST) sequences (CX052976.1 and CX071135.1) were found to be modified by methylation during the fruit ripening process. These findings suggest that DNA methylation might play important roles in regulating fruit ripening in Satsuma. Our results lay the foundation for analysing the molecular mechanism underlying fruit ripening in this important citrus crop.
Seizures in children with epilepsy and attention‐deficit/hyperactivity disorder
Authors: Goker Zeynep , Yilmaz Arzu , Eraslan Ayse Nihal , Sivri Rukiye Colak , Aydin Rezzan 
Published: July 2019

AbstractBackgroundEpilepsy is an important disorder that is sometimes accompanied by inattention problems. This study explored the features of seizures in children with epilepsy, with or without attention‐deficit/hyperactivity disorder (ADHD).MethodsBetween January 2017 and January 2018, data records of children with epilepsy aged 5–18 years admitted to hospital were retrospectively collected. SPSS 17.0 was used for analyses and P < 0.05 was accepted as significant.ResultsOf 301 patients with epilepsy, 32 of them had ADHD. Median age at diagnosis of epilepsy in the epilepsy + ADHD group was lower than in the epilepsy alone group (6 vs 8 years; z = −2.989, P = 0.003). The two groups were similar in terms of duration of epilepsy, seizure types and features of complicated versus non‐complicated epilepsy, number of anti‐epileptic drugs (AED) used (for all, P > 0.05). The epilepsy + ADHD group had a significantly higher prevalence of intellectual disability (31.3% vs 12.6%; χ2(1) = 7.9, P = 0.014) and specific learning disorder (12.5% vs 1.9%; χ2(1) = 11.1, P = 0.009) than the epilepsy alone group (χ2(1) = 11.1, P = 0.009). ADHD medication use was identified in 68.8% of children in the epilepsy + ADHD group.ConclusionAttention‐deficit–hyperactivity disorder was identified in 11.8% of 5–18‐year‐old children (32/301) with epilepsy in a 1 year period. ADHD is more frequent in children with epilepsy in childhood (5–11 years of age). Epilepsy diagnosis is more frequent in younger children with ADHD. Children with epilepsy and ADHD, also have a significantly higher prevalence of intellectual disability and specific learning disorder. Younger children diagnosed with epilepsy should be carefully monitored for ADHD.
Severe heart failure and the need for mechanical circulatory support and heart transplantation in pediatric patients with myocarditis: Results from the prospective multicenter registry “MYKKE”
Authors: Schubert Stephan , Opgen‐Rhein Bernd , Boehne Martin , Weigelt Annika , Wagner Robert , Müller Götz , Rentzsch Axel , zu Knyphausen Edzard , Fischer Marcus , Papakostas Konstantin , Wiegand Gesa , Ruf Bettina , Hannes Tobias , Reineker Katja , Kiski Daniela , Khalil Markus , Steinmetz Michael , Fischer Gunther , Pickardt Thomas , Klingel Karin , Messroghli Daniel R. , Degener Franziska ,   the MYKKE consortium
Published: July 2019

AbstractMyocarditis represents an important cause for acute heart failure. MYKKE, a prospective multicenter registry of pediatric patients with myocarditis, aims to gain knowledge on courses, diagnostics, and therapy of pediatric myocarditis. The role of mechanical circulatory support (MCS) in children with severe heart failure and myocarditis is unclear. The aim of this study was to determine characteristics and outcome of patients with severe heart failure requiring MCS and/or heart transplantation. The MYKKE cohort between September 2013 and 2016 was analyzed. A total of 195 patients were prospectively enrolled by 17 German hospitals. Twenty‐eight patients (14%) received MCS (median 1.5 years), more frequently in the youngest age group (0‐2 years) than in the older groups (P < 0.001; 2‐12 and 13‐18 years). In the MCS group, 50% received a VAD, 36% ECMO, and 14% both, with a survival rate of 79%. The weaning rate was 43% (12/28). Nine (32%) patients were transplanted, one had ongoing support, and six (21%) died. Histology was positive for myocarditis in 63% of the MCS group. Patients within the whole cohort with age <2 years and/or ejection fraction <30% had a significantly worse survival with high risk for MCS, transplantation, and death (P < 0.001). Myocarditis represents a life‐threatening disease with an overall mortality of 4.6% in this cohort. The fulminant form more often affected the youngest, leading to significantly higher rate of MCS, transplantation, and mortality. MCS represents an important and life‐saving therapeutic option in children with myocarditis with a weaning rate of 43%.
Telomere length regulators are activated in young men after pediatric kidney transplantation compared to healthy controls and survivors of childhood cancer—A cross‐sectional study
Authors: Endén Kira , Tainio Juuso , Hou Mi , Suominen Anu , Pakarinen Mikko , Huang Tao , Söder Olle , Jalanko Hannu , Jahnukainen Kirsi , Jahnukainen Timo 
Published: July 2019

AbstractChronic diseases are known to cause premature aging and frailty. Data about telomere length and telomere length‐regulating proteins after pediatric KTx are scarce. Leukocyte telomere length and gene expression level of eight telomere‐binding proteins were analyzed in 20 KTx recipients, eight childhood NBL survivors, and nine healthy controls. The influence of key clinical parameters on telomere length and on regulators of telomere length was evaluated. The telomere length in the KTx recipients tended to be shorter (0.53 AU) than in the healthy controls (0.64 AU) but longer than in the NBL survivors (0.38 AU). There was no significant difference in telomere length between the NBL survivors and the KTx recipients (P = .110). The gene expression level of telomere length‐preserving protein RPA1 was significantly higher in the KTx recipients than among the NBL survivors or healthy controls, while the expression of TRF2 and the tumor suppressor gene p16 was significantly higher in the KTX recipients when compared to the controls. TRF2 and TIN2 correlated significantly with hsCRP; additionally, TRF2 showed significant correlation with plasma creatinine and eGFR. KTx recipients have near to normal telomere length, but they have significantly higher gene expression levels of telomere regulatory proteins compared with healthy controls, suggesting activation of mechanisms preserving telomere length among KTx recipients. Our results suggest that declined graft function and consequent inflammatory response may have influence on telomerase activity.
The role of the social innovation and entrepreneurship development fund in fostering social entrepreneurship in Hong Kong: A study on public policy innovation
Authors: Chan Chee Hon , Chui Cheryl Hiu‐Kwan , Chan Kristy Shuk Ting , Yip Paul Siu Fai 
Published: July 2019

AbstractCreating an enabling environment for social entrepreneurship in tackling complex socio‐economic challenges is at the forefront of government policy agendas globally. Although several policy mechanisms have been proposed to this end, whether and to what extent those policy mechanisms may (re)shape the social entrepreneurship environments have rarely been explored. By examining the Social Innovation and Entrepreneurship Development Fund (SIE Fund), a recent policy project aimed at fostering social innovation in Hong Kong, this article presents a rare empirical exploration to illustrate how public policies can potentially drive social innovation. We explore first the impact of the SIE Fund in fostering innovation among its funded social enterprises, and second, how the SIE Fund may have influenced Hong Kong's social entrepreneurship environment. Results show that the projects under the SIE Fund exhibit characteristics distinct from the social enterprises prior to the inception of the SIE Fund. In addition, evidence of innovations in terms of product, process, marketing, and innovation in developing new or improved social practices were also identified. This study illustrates how specific public policy mechanisms may potentially facilitate the diversification, inclusion, innovation, and expansion of the social entrepreneurship environment. Findings carry substantial policy implications, in particular to neighbouring East Asian societies typically characterized by a strong government, and face similar structural, demographic and socio‐economic challenges that necessitate innovative solutions.
Well‐being for trainees caring for homeless veterans
Authors: Moore Elizabeth , Soh Michael , Stuber Margaret , Warde Carole 
Published: July 2019

SummaryBackgroundHealth care trainees caring for homeless patients may experience stress and burnout. Reasons for this include high rates of medical and psychiatric illness and complex social needs within this patient population. This can lead to feelings of inadequacy and exhaustion among health care trainees. To address this, we developed a toolkit for trainees from multiple professions caring for homeless veterans and examined its impact on trainee well‐being.MethodsFifteen trainees and six faculty members participated in a half‐day workshop given by a national expert that demonstrated a variety of well‐being practices. Trainees and faculty members then identified 14 evidence‐based practices relevant to the clinic for inclusion in the well‐being toolkit. Half of the tools were for personal use and half were intended for teams. We developed simple graphics demonstrating each tool, and these were displayed as posters throughout the clinic. Tools were reviewed through workshops and handouts. To assess the trainee response to the toolkit, we used validated measures of burnout, stress, resilience and mindfulness at the beginning and at the end of the academic year. Trainees also rated the value of each tool.ResultsTrainees did not experience burnout during the year, and nor did the stress levels change. Both resilience and mindfulness trended towards improvement. Trainees rated the team‐based tools as more important than the personal tools; they were also more confident in using the team‐based tools.Burnout among physicians caring for marginalised patients can originate from a sense of futility and from witnessing needless sufferingDiscussionTeam‐based well‐being tools may represent a better avenue for residency programmes and training sites to pursue well‐being programmes, especially for trainees caring for marginalised populations.
An integrative longitudinal resilience curriculum
Authors: Kulman‐Lipsey Shayna , Yang Samantha , Pedram Javidan Arshia , Fung Benjamin , Levinson Andrea , Vernon Jordyn , Nickell Leslie , Leo Joanne 
Published: July 2019

SummaryBackgroundIt is well documented that student well‐being is challenged at medical school and that levels of distress increase as students navigate their training. The Doctor of Medicine (MD) programme at the University of Toronto developed a 4‐year resilience curriculum (RC) to encourage students to reach out for help and equip them with resilience‐building strategies to manage adversities in a demanding academic and clinical programme.… resilience curriculum (RC) to encourage students to reach out for help and equip them with resilience‐building strategiesMethodsSatisfaction surveys, consisting of statements rated by a five‐point Likert scale and short‐answer questions, were distributed to 518 students; in total, data from four workshops were collected. Two focus groups comprising 12 participants in total were facilitated (n = 6 per group). A thematic content analysis was conducted for the focus group data; open coding was used for transcriptions via an iterative process and inductive analysis.FindingsPreliminary quantitative and qualitative data suggest that students valued the curriculum. The main themes generated from the thematic content analysis were the value of the RC, the delivery of the RC, and developing a resilient community.DiscussionMore research must be conducted to assess whether the RC has affected student well‐being and resilience. The sustainability of the curriculum depends on the faculty members that support it; faculty development within the areas of wellness and resilience is imperative.Innovation and implicationsThe RC, embedded in the core curriculum and integrated within a medical community, is gaining momentum and is valued by students. Further research will assist in the creation of an innovative tool to assess the impact of the RC on medical students.
The structural biology of the dynamin‐related proteins: New insights into a diverse, multitalented family
Authors: Ford Marijn G. J. , Chappie Joshua S. 
Published: July 2019

AbstractDynamin‐related proteins are multidomain, mechanochemical GTPases that self‐assemble and orchestrate a wide array of cellular processes. Over the past decade, structural insights from X‐ray crystallography and cryo‐electron microscopy have reshaped our mechanistic understanding of these proteins. Here, we provide a historical perspective on these advances that highlights the structural attributes of different dynamin family members and explores how these characteristics affect GTP hydrolysis, conformational coupling and oligomerization. We also discuss a number of lingering challenges remaining in the field that suggest future directions of study.
Canine ischaemic dermatopathy: a retrospective study of 177 cases (2005–2016)
Authors: Backel Katherine A. , Bradley Charles W. , Cain Christine L. , Morris Daniel O. , Goldschmidt Kyle H. , Mauldin Elizabeth A. 
Published: July 2019

BackgroundIschaemic dermatopathy encompasses a poorly understood subset of canine diseases that share similar clinical and histological features. Very little information is currently available regarding population characteristics, progression and outcome.Hypothesis/objectivesThis study aimed to describe the clinical features and therapeutic outcomes of ischaemia dermatopathy, excluding familial dermatomyositis, using cases diagnosed by histopathological analysis.AnimalsOne hundred and seventy‐seven cases submitted for histopathological analysis between 2005 and 2016 met inclusion criteria, of which 93 had complete medical records available.Methods and materialsBoth records and pointed surveys were used to retrieve information. Scoring systems were created to subjectively evaluate clinical outcomes and likelihood of a vaccine association.ResultsOf 177 cases, toy and miniature poodles, Chihuahuas, Maltese, Yorkshire terriers and Jack Russell terriers were significantly over‐represented (P < 0.001). Of the 93 cases for which historical data were obtained, median age at skin biopsy was five years (0.42–13 years) and median body weight was 7.3 kg (range 1.32–50.3 kg). The condition in 45 dogs (48.3%) was found likely to be associated with vaccination. Younger ages (P = 0.011) and higher body weights (P = 0.003) were positively correlated with greater likelihood of vaccination. Body weight <10 kg (P = 0.0045) and older ages (P = 0.0048) were significantly associated with worse outcomes.Conclusions and clinical importanceThis study provides support for breed predispositions and identifies potential prognostic factors. Importantly, over half of the cases were considered unlikely to be vaccine‐associated, demonstrating the need to investigate other underlying causes of this condition.
Optical coherence tomography of the retina, nerve fiber layer, and optic nerve head in dogs with glaucoma
Authors: Graham Kathleen L. , McCowan Christina I. , Caruso Kelly , Billson F. Mark , Whittaker Cameron J. G. , White Andrew 
Published: July 2019

AbstractObjectiveTo evaluate the retina and optic nerve head (ONH) in canine eyes predisposed to glaucoma using optical coherence tomography (OCT).AnimalsTwenty‐five eyes (24 dogs).MethodsMeasures of peripapillary retinal, retinal nerve fiber layer (RNFL), and ganglion cell complex (GCC) thickness and ONH parameters were obtained in vivo by OCT of the unaffected eye in dogs diagnosed with unilateral primary glaucoma (predisposed; n = 12) and compared with measures of healthy control eyes (normal; n = 13). Repeatability and intrarater reliability were explored using intraclass correlation coefficients (ICC).ResultsCompared to normal eyes, predisposed eyes had a thinner retina in the temporal (P = 0.005), inferior quadrants (P = 0.003), and decreased inner retinal thickness (superior: P = 0.003, temporal: P = 0.001, inferior: P < 0.001, nasal: P = 0.001). Predisposed eyes had a thinner RNFL compared to normal eyes (P = 0.005), and when analyzed in quadrants, it was thinner in the superior (P < 0.001), temporal (P = 0.034), and nasal quadrants (P = 0.001). Repeatability (ICC 0.763‐0.835) and intrarater reliability (ICC 0.824‐0.942) were good to excellent for measures of retinal thickness and adequate for RNFL measurements (ICC 0.701‐0.798). Reliable measurements of optic disk area were obtained and were similar between groups (P = 0.597). Measurements of parameters relying on automated software detection (GCC, optic cup, optic rim) had inadequate repeatability and reliability.ConclusionStatistically significant differences in retinal and RNFL thicknesses were identified in normal and predisposed eyes. Reliable and consistent measurements of variables with manual adjustment of software detected parameters were obtained. Validation of OCT as a diagnostic tool for clinical assessment in canine glaucoma is warranted.