bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disconnected lives: Women with intellectual disabilities in conflict with the law
Authors: Levine Kathryn Ann , Proulx Jocelyn , Schwartz Karen 
Published: July 2017

BackgroundWomen with intellectual/developmental disabilities in conflict with the law experience childhood trauma, substance abuse and intimate partner violence but continue to have difficulty accessing appropriate therapeutic services, both within correctional settings and upon discharge. The aim of this study is to explore women's service needs and to critically assess whether the available services are meeting their identified needs.MethodSemi‐structured interviews were conducted with 16 women with intellectual/developmental disabilities who were in the Special Needs Unit of a women's correctional centre from December 2014 to March 2015.ResultsWomen with intellectual/developmental disabilities struggle to manage the impact of intergenerational trauma, exacerbated by issues of substance abuse and addiction, poor coping skills and minimal education, all of which impact their sense of well‐being.ConclusionsThis study highlights the need for increasing trauma treatment for women with intellectual/developmental disabilities, and emphasizes the need for accessible intervention to facilitate coping, trauma processing and community integration.
Development and implementation of a clinical pathway for cardiac surgery in the intensive care unit: Effects on protocol adherence
Authors: van der Kolk Marion , van den Boogaard Mark , ter Brugge‐Speelman Corine , Hol Jeroen , Noyez Luc , van Laarhoven Kees , van der Hoeven Hans , Pickkers Peter 
Published: July 2017

AbstractRationale, aims and objectivesCardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients.MethodsThis is a pre‐post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU‐nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report. A tailored implementation strategy was used. Primary outcome measure was protocol adherence above 80% on the domains of blood pressure control, action on chest tube blood loss and electrolyte control within the CP.ResultsIn a 4‐month period, 84 consecutive CP patients were included and compared with 162 matched control patients admitted in the year before implementation; 3 patients were excluded. Propensity score was used as matching parameter. CP patients were more likely to receive early adequate treatment for derangements in electrolytes (96% vs 47%, P < .001), blood pressure (90% vs 49%, P < .001) and adequate treatment for chest tube blood loss (90% vs 10%, P < .001). We found no differences in hospital and ICU LOS, ICU readmission or mortality.ConclusionUse of the CP improved postoperative ICU treatment for cardiac surgical patients. Implementation of a CP and the use of a special variance report could be a blueprint for the implementation and use of a CP in low‐volume high complex surgery.
Commitment, Forgiveness, and Relationship Self‐Regulation: An Actor Partner Interdependence Model of Relationship Virtues and Relationship Effort in Couple Relationships
Authors: Novak Joshua R. , Smith Heather M. , Larson Jeffry H. , Crane D. Russell 
Published: July 2017

Dyadic data from 679 committed couples were used to examine associations between commitment, forgiveness, and perceptions of partner's relationship self‐regulation (RSR) behaviors—that is effort and strategies that partners exert to maintain the relationship. We found that for both partners, higher self‐reports of commitment and forgiveness were associated with higher perceptions of their partner's RSR. For females, higher commitment and forgiveness were associated with higher male perceptions of her RSR, and higher male forgiveness was associated with higher female perceptions of his RSR. These findings demonstrate the importance of marital virtues and relationship work and give credence to the marital competence model of “other‐centeredness” by Carroll et al. (2006, Journal of Family Issues, 27(7), 1001). Clinical implications are discussed.
Melatonin impedes Tet1‐dependent mGluR5 promoter demethylation to relieve pain
Authors: Hsieh Ming‐Chun , Ho Yu‐Cheng , Lai Cheng‐Yuan , Chou Dylan , Wang Hsueh‐Hsiao , Chen Gin‐Den , Lin Tzer‐Bin , Peng Hsien‐Yu 
Published: July 2017

AbstractMelatonin (N‐acetyl‐5‐methoxytryptamine)/MT2 receptor‐dependent epigenetic modification represents a novel pathway in the treatment of neuropathic pain. Because spinal ten‐eleven translocation methylcytosine dioxygenase 1 (Tet1)‐dependent epigenetic demethylation has recently been linked to pain hypersensitivity, we hypothesized that melatonin/MT2‐dependent analgesia involves spinal Tet1‐dependent demethylation. Here, we showed that spinal Tet1 gene transfer by intrathecal delivery of Tet1‐encoding vectors to naïve rats produced profound and long‐lasting nociceptive hypersensitivity. In addition, enhanced Tet1 expression, Tet1‐metabotropic glutamate receptor subtype 5 (mGluR5) promoter coupling, demethylation at the mGluR5 promoter, and mGluR5 expression in dorsal horn neurons were observed. Rats subjected to spinal nerve ligation and intraplantar complete Freund's adjuvant injection displayed tactile allodynia and behavioral hyperalgesia associated with similar changes in the dorsal horn. Notably, intrathecal melatonin injection reversed the protein expression, protein‐promoter coupling, promoter demethylation, and pain hypersensitivity induced by Tet1 gene transfer, spinal nerve ligation, and intraplantar complete Freund's adjuvant injection. All the effects caused by melatonin were blocked by pretreatment with a MT2 receptor‐selective antagonist. In conclusion, melatonin relieves pain by impeding Tet1‐dependent demethylation of mGluR5 in dorsal horn neurons through the MT2 receptor. Our findings link melatonin/MT2 signaling to Tet1‐dependent epigenetic demethylation of nociceptive genes for the first time and suggest melatonin as a promising therapy for the treatment of pain.
Brainstem auditory evoked responses in 37 dogs with otitis media before and after topical therapy
Authors: Paterson S. 
Published: July 2017

ObjectivesThe objective of this study was to determine whether intra‐aural administration of aqueous solutions of marbofloxacin, gentamicin, tobramycin and ticarcillin (used off‐licence) was associated with changes in hearing as measured by brainstem auditory evoked responses.Materials and MethodsDogs diagnosed with otitis media (n=37) underwent brainstem auditory evoked response testing and then were treated for their ear disease. First, the external ear canal and middle ear were flushed with sterile saline followed by EDTA tris with 0·15% chlorhexidine. Then, a combination of aqueous antibiotic mixed with an aqueous solution of EDTA tris was instilled into the middle ear. Follow‐up examinations were undertaken for each dog, and treatment was continued until there were no detected infectious organisms or inflammatory infiltrate. Brainstem auditory evoked response testing was repeated after resolution of the infection and discontinuation of therapy.ResultsBrainstem auditory evoked responses in dogs treated with aqueous solutions of marbofloxacin or gentamicin remained unchanged or improved after therapy of otitis media but were impaired in dogs treated with ticarcillin or tobramycin.Clinical SignificanceIf off‐licence use of topical antibiotics is deemed necessary in cases of otitis media, aqueous solutions of marbofloxacin and gentamicin appear to be less ototoxic than aqueous solutions of ticarcillin or tobramycin.
Creativity in local government: Definition and determinants
Authors: Kruyen Peter M. , van Genugten Marieke 
Published: July 2017

AbstractIn current thinking about public service improvement, civil servant creativity plays an important role. Using the results of 43 semi‐structured interviews, we assessed the degree to which our theoretical knowledge about creativity—based primarily on business research—matches the insights of managers in local government. Respondents considered employee creativity to be important, but—in contrast to the literature—understood creativity as the act of trying out new things to better deal with specific problems at hand instead of developing new ideas potentially applicable to a wider context. As such, respondents did not see creativity as the main precondition for innovation. In line with the literature, there is little consistency across respondents about individual‐ and context‐level determinants of creativity. Lastly, respondents put forward several factors that have received little attention in the literature but are particularly relevant in understanding differences in work‐related creativity in the context of local government.
Multidimensional assessment of quality of life of children and problems of parents in Indian society after pediatric renal transplant: Beyond the conventional thoughts
Authors: Yadav Priyank , Nunia Sandeep , Bansal Ankur , Sureka Sanjoy K. , Jena Rahul , Ansari Mohd. Sualeh , Srivastava Aneesh 
Published: July 2017

AbstractThis study evaluated multidimensional QoL after renal transplant to find the physical, psychosocial, and economic issues after pediatric transplant. Sixty‐two patients under the age of 18 at the time of assessment were asked to complete WHOQOL questionnaires. Assessment of behavioral, emotional status of child, problems of parents, and SEC of family were also performed. The beneficial effect of transplantation was observed across all domains of QoL (physical, psychological, social, environmental, and overall QoL). The greatest change was observed in QoL domains that dealt with overall satisfaction (81.28±15.76 vs 45.32±10.98; P<.0001). The domain dealing with environmental factors showed the least variation after transplantation (65.58±17.45 vs 51.34±17.81; P<.0001). Feelings of happiness and peer group socialization were reported in 81% and 69% of patients, respectively. There was no marital disharmony in 52% of families. However, SEC deteriorated in 16% of families and 59% of the families availed financial assistance. Sixty‐nine percent of children had not attended school after one year of transplantation, but return to school after transplant was reduced to 8% at 5 years. Pre‐ and post‐transplant social and psychological support may help these patients and their families adjust in society and have a positive outlook for their future.
A systematic review of the prevalence and impact of urinary incontinence in cystic fibrosis
Authors: Frayman Katherine B. , Kazmerski Traci M. , Sawyer Susan M. 
Published: July 2017

ABSTRACTThis systematic review synthesizes published articles investigating the prevalence, severity and impact of urinary incontinence (UI), a condition associated with cystic fibrosis (CF). References were identified through searching Medline, Embase and PubMed using the medical subject headings ‘cystic fibrosis’ AND ‘urinary incontinence’. Articles were included if UI prevalence was investigated as an outcome. Twelve studies met selection criteria. The prevalence of UI ranged from 5% to 76%. Age and gender contributed to this variability. When assessed, UI commonly limited airway clearance, exercise and/or spirometry, and had a variable impact on patients’ lives. Worry and embarrassment were features for many; others were less affected. In CF, UI is common and can interfere with respiratory care and social well‐being. The prevalence, characteristics and impact are poorly understood, which is made worse by inconsistent definitions across studies. Future research is needed to improve approaches to prevention, identification, management and education.
Scope to map soil management units at the district level from remotely sensed γ‐ray spectrometry and proximal sensed EM induction data
Authors: Jing Y. Z. , Huang J. , Banks R. , Triantafilis J. 
Published: July 2017

AbstractThe traditional method of soil mapping involves classifying soil into pre‐existing classes using morphological observations and then air‐photograph interpretation to extrapolate the information. To accelerate the process, less costly ancillary data can be used to assist mapping. However, digital soil mapping (DSM) is still affected by the classifications used to identify soil types. One reason is because the morphological characteristics are not mutually exclusive, which causes misclassification. In this study, we used a DSM approach, where ancillary data were surrogate for morphological data, with soil types identified by numerical clustering of remotely and proximally sensed data collected across a farming district near Gunnedah, Australia. Remotely sensed data were obtained from an air‐borne gamma‐ray (γ‐ray) spectrometer survey, including potassium (K), thorium (Th), uranium (U) and total counts. Proximally sensed data were measured using EM38 (i.e. EM38h and EM38v). Using fuzzy k‐means and a linear mixed model with measured physical (e.g. clay) and chemical (e.g. CEC) properties from the topsoil (0–0.30 m) and subsoil (0.9–1.2 m), we found that k = 5 was also optimal given that mean‐squared prediction error (i.e. ) was minimised. The approach highlighted subtle differences in physical and chemical properties in productive areas. The DSM was unsuccessful in identifying small units; however, inclusion of elevation data might overcome this limitation. This research has implications for providing fast, accurate and meaningful DSM at a district scale, where traditional methods are too expensive.
Can virtue be learned? An exploration of student learning experiences in ethics courses and their implications for influencing moral character
Authors: Agnew Cochran Elizabeth , Fozard Weaver Darlene 
Published: July 2017

AbstractWhat does it mean to teach virtue, or to learn it? We consider this question through an institutional review board (IRB) supported research study attending to student learning experiences in undergraduate ethics courses at a Catholic university with an explicit commitment to social justice. This essay draws on and interprets qualitative data concerning the outcomes of select pedagogical approaches that involve exposing students to the experiences of others: the use of narratives; participation in structured experiential learning activities; and community engagement through deep listening and facilitated dialogue. We focus our interpretation around the implications of these pedagogies in relation to student understanding of and attitudes regarding three character traits identified as “other‐regarding” virtues in theological and philosophical scholarship – altruism, compassion, and solidarity. This paper considers the implications of these pedagogies and the practical effects of different sorts of teaching strategies on students' self‐understanding as moral agents.
Aldehyde dehydrogenase 1 a1 regulates energy metabolism in adipocytes from different species
Authors: Yang Kefeng , Adin Christopher , Shen Qiwen , Lee Ly James , Yu Lianbo , Fadda Paolo , Samogyi Arpad , Ham Kathleen , Xu Lu , Gilor Chen , Ziouzenkova Ouliana 
Published: July 2017

AbstractBackgroundSurvival and longevity of xenotransplants depend on immune function and ability to integrate energy metabolism between cells from different species. However, mechanisms for interspecies cross talk in energy metabolism are not well understood. White adipose tissue stores energy and is capable of mobilization and dissipation of energy as heat (thermogenesis) by adipocytes expressing uncoupling protein 1 (Ucp1). Both pathways are under the control of vitamin A metabolizing enzymes. Deficient retinoic acid production in aldehyde dehydrogenase 1 A1 (Aldh1a1) knockout adipocytes (KO) inhibits adipogenesis and increases thermogenesis. Here we test the role Aldh1a1 in regulation of lipid metabolism in xenocultures.MethodsMurine wide‐type (WT) and KO pre‐adipocytes were encapsulated into a poly‐L‐lysine polymer that allows exchange of humoral factors <32kD via nanopores. Encapsulated murine adipocytes were co‐incubated with primary differentiated canine adipocytes. Then, expression of adipogenic and thermogenic genes in differentiated canine adipocytes was detected by real‐time polymerase chain reaction (PCR). The regulatory factors in WT and KO cells were identified by comparison of secretome using proteomics and in transcriptome by gene microarray.ResultsCo‐culture of encapsulated mouse KO vs WT adipocytes increased expression of peroxisome proliferator‐activated receptor gamma (Pparg), but reduced expression of its target genes fatty acid binding protein 4 (Fabp4), and adipose triglyceride lipase (Atgl) in canine adipocytes, suggesting inhibition of PPARγ activation. Co‐culture with KO adipocytes also induced expression of Ucp1 in canine adipocytes compared to expression in WT adipocytes. Cumulatively, murine KO compared to WT adipocytes decreased lipid accumulation in canine adipocytes. Comparative proteomics revealed significantly higher levels of vitamin A carriers, retinol binding protein 4 (RBP4), and lipokalin 2 (LCN2) in KO vs WT adipocytes.ConclusionsOur data demonstrate the functional exchange of regulatory factors between adipocytes from different species for regulation of energy balance. RBP4 and LCN2 appear to be involved in the transport of retinoids for regulation of lipid accumulation and thermogenesis in xenocultures. While the rarity of thermogenic adipocytes in humans and dogs precludes their use for autologous transplantation, our study demonstrates that xenotransplantation of engineered cells could be a potential solution for the reduction in obesity in dogs and a strategy for translation to patients.
Gene expression analyses reveal metabolic specifications in acute O2‐sensing chemoreceptor cells
Authors: Gao Lin , Bonilla‐Henao Victoria , García‐Flores Paula , Arias‐Mayenco Ignacio , Ortega‐Sáenz Patricia , López‐Barneo José 
Published: July 2017

Key points
Glomus cells in the carotid body (CB) and chromaffin cells in the adrenal medulla (AM) are essential for reflex cardiorespiratory adaptation to hypoxia. However, the mechanisms whereby these cells detect changes in O2 tension are poorly understood.
The metabolic properties of acute O2‐sensing cells have been investigated by comparing the transcriptomes of CB and AM cells, which are O2‐sensitive, with superior cervical ganglion neurons, which are practically O2‐insensitive.
In O2‐sensitive cells, we found a characteristic prolyl hydroxylase 3 down‐regulation and hypoxia inducible factor 2α up‐regulation, as well as overexpression of genes coding for three atypical mitochondrial electron transport subunits and pyruvate carboxylase, an enzyme that replenishes tricarboxylic acid cycle intermediates.
In agreement with this observation, the inhibition of succinate dehydrogenase impairs CB acute O2 sensing. The responsiveness of peripheral chemoreceptor cells to acute hypoxia depends on a ‘signature metabolic profile’.
AbstractAcute O2 sensing is a fundamental property of cells in the peripheral chemoreceptors, e.g. glomus cells in the carotid body (CB) and chromaffin cells in the adrenal medulla (AM), and is necessary for adaptation to hypoxia. These cells contain O2‐sensitive ion channels, which mediate membrane depolarization and transmitter release upon exposure to hypoxia. However, the mechanisms underlying the detection of changes in O2 tension by cells are still poorly understood. Recently, we suggested that CB glomus cells have specific metabolic features that favour the accumulation of reduced quinone and the production of mitochondrial NADH and reactive oxygen species during hypoxia. These signals alter membrane ion channel activity. To investigate the metabolic profile characteristic of acute O2‐sensing cells, we used adult mice to compare the transcriptomes of three cell types derived from common sympathoadrenal progenitors, but exhibiting variable responsiveness to acute hypoxia: CB and AM cells, which are O2‐sensitive (glomus cells > chromaffin cells), and superior cervical ganglion neurons, which are practically O2‐insensitive. In the O2‐sensitive cells, we found a characteristic mRNA expression pattern of prolyl hydroxylase 3/hypoxia inducible factor 2α and up‐regulation of several genes, in particular three atypical mitochondrial electron transport subunits and some ion channels. In addition, we found that pyruvate carboxylase, an enzyme fundamental to tricarboxylic acid cycle anaplerosis, is overexpressed in CB glomus cells. We also observed that the inhibition of succinate dehydrogenase impairs CB acute O2 sensing. Our data suggest that responsiveness to acute hypoxia depends on a ‘signature metabolic profile’ in chemoreceptor cells.
Impact of a Carbapenem Antimicrobial Stewardship Program on Patient Outcomes
Authors: Seah Valerie Xue Fen , Ong Rina Yue Ling , Lim Ashley Shi Yuan , Chong Chia Yin , Tan Natalie Woon Hui , Thoon Koh Cheng 
Published: July 2017

ABSTRACTAntimicrobial stewardship programs (ASPs) aim to improve appropriate antimicrobial use. However, concerns of the negative consequences from accepting ASP interventions exist, particularly when deescalation or discontinuation of broad-spectrum antibiotics is recommended. Hence, we sought to evaluate the impact on clinical outcomes when ASP interventions for inappropriate carbapenem use were accepted or rejected by primary providers. We retrospectively reviewed all carbapenem prescriptions deemed inappropriate according to institutional guidelines with ASP interventions between July 2011 and December 2014. Intervention acceptance and outcomes, including carbapenem utilization, length of stay, hospitalization charges, 30-day readmission, and mortality rates were reviewed. Data were analyzed in two groups, one in which physicians accepted all interventions (“accepted”) and one in which interventions were rejected (“rejected”). A total of 158 ASP interventions were made. These included carbapenem discontinuation (35%), change to narrower-spectrum antibiotic (32%), dose optimization (17%), further investigations (including imaging and procalcitonin) (11%), infectious diseases referral (3%), antibiotic discontinuation (other than carbapenem) (1%), and source control (1%). Of 220 unique patients, carbapenem use was inappropriate in 101 (45.9%) patients. A significant reduction in carbapenem utilization was observed in the accepted group versus rejected group (median defined daily doses, 0.224 versus 0.668 per 1,000 patient-days, respectively;P< 0.001). There was a significant reduction in 30-day mortality in the accepted (none) versus rejected group (10 deaths,P= 0.015), but there were no differences in length of stay, hospitalization charge, or 30-day readmission rates. Hypotension was independently associated with mortality in multivariate analysis (odds ratio, 5.25; 95% confidence interval, 1.34 to 20.6). In our institution, acceptance of carbapenem ASP interventions did not compromise patient safety in terms of clinical outcomes while reducing consumption.