bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of frailty and residual subsyndromal delirium on 1‐year functional recovery: A prospective cohort study
Authors: Chew Justin , Lim Wee Shiong , Chong Mei Sian , Ding Yew Yoong , Tay Laura 
Published: June 2017

AimTo investigate the association between frailty and incomplete delirium recovery at discharge (residual subsyndromal delirium [RSSD]), and to examine the mediating role of RSSD in the relationship between frailty and functional recovery at 12 months post‐delirium.MethodsThis was a prospective observational study of 234 individuals aged ≥65 years admitted to a specialized delirium unit. A 20‐item frailty index was derived using items from a comprehensive geriatric assessment. Individuals with frailty index ≥0.25 were defined as being frail. Diagnosis of delirium was in accordance with the Confusion Assessment Method. RSSD was defined by the Delirium Rating Scale‐Revised‐98 severity score of ≥13. We measured functional status (modified Barthel Index) on admission and 12 months post‐delirium. We carried out mediation analysis to elucidate the role of baseline frailty and RSSD on 12‐month functional recovery.ResultsA total of 167 (71%) older adults were available for analysis of 12‐month functional status. Frailty was an independent predictor for RSSD (OR 4.1, 95% CI 2.1–8.2,P < 0.001) and functional recovery at 12 months post‐delirium (β = −13.4, 95% CI –24.9 to –1.8,P = 0.02). RSSD significantly mediated the effect of baseline frailty status on functional recovery at 12 months (coefficient = −0.1, 95% CI –0.2 to –0.02,P = 0.02), with 45% of the total effect mediated by RSSD.ConclusionsFrailty as a risk factor for poor functional recovery in the year post‐delirium might be attributable in part to its impact on incomplete delirium recovery at discharge (RSSD). Our findings support screening and interventions for frailty at admission, and extended rehabilitation for frail individuals with RSSD.Geriatr Gerontol Int 2017; 17: 2472–2478.
A qualitative study exploring the difficulties influencing decision making at the end of life for people with dementia
Authors: Lamahewa Kethakie , Mathew Rammya , Iliffe Steve , Wilcock Jane , Manthorpe Jill , Sampson Elizabeth L , Davies Nathan 
Published: June 2017

AbstractBackgroundDementia is a progressive neurodegenerative condition characterized by declining functional and cognitive abilities. The quality of end of life care for people with dementia in the UK can be poor. Several difficult decisions may arise at the end of life, relating to the care of the person with dementia, for example management of comorbidities.ObjectiveTo explore difficulties in decision making for practitioners and family carers at the end of life for people with dementia.DesignQualitative methodology using focus groups and semi‐structured interviews and thematic analysis methods.Settings and participantsFormer (n=4) and current (n=6) family carers of people with experience of end of life care for a person with dementia were recruited from an English dementia voluntary group in 2015. A further 24 health and care professionals were purposively sampled to include a broad range of expertise and experience in dementia end of life care.ResultsFour key themes were identified as follows: challenges of delivering coherent care in dynamic systems; uncertainty amongst decision makers; internal and external conflict amongst decision makers; and a lack of preparedness for the end of life. Overarching difficulties such as poor communication, uncertainty and conflict about the needs of the person with dementia as well as the decision maker's own role can characterize decision making at the end of life.ConclusionsThis study suggests that decision making at the end of life for people with dementia has the potential to be improved. More planning earlier in the course of dementia with an on‐going approach to conversation may increase preparedness and family carers’ expectations of end of life.
Phylogeography and population dynamics of Antbirds (Thamnophilidae) from Amazonian fluvial islands
Authors: Choueri Érik L. , Gubili Chrysoula , Borges Sérgio H. , Thom Gregory , Sawakuchi André O. , Soares Emílio A. A. , Ribas Camila C. 
Published: June 2017

AbstractAimTo investigate the evolution of the avifauna associated to Amazonian fluvial islands, focusing on the Negro River archipelagos.LocationsFluvial islands in the Amazon Basin.MethodsOne generalist floodplain species (Hypocnemoides melanopogon) and three river island specialists (Myrmotherula assimilis, Myrmoborus lugubris and Thamnophilus nigrocinereus) were studied (Thamnophilidae). We sequenced two mitochondrial genes and genotyped eight microsatellite loci. Phylogenetic relationships among intraspecific lineages and divergence times were estimated using Bayesian Inference. Haplotype networks, AMOVA (analysis of molecular variance) and Mantel tests were used to verify the spatial organization of genetic diversity. Gene flow and population structure were evaluated using a dissimilarity index, Bayesian inference and allele frequencies. Historical demography was inferred through neutrality tests and Extended Bayesian skyline plots (EBSP).ResultsRiver island specialists have evolved distinct lineages in different Amazonian tributaries, but exhibit very weak population structure within the Negro river basin. The generalist floodplain species had no population structure along the Amazon basin or within the Negro river basin. Signals of weak and recent (Pleistocene) population expansion were recovered for all species.Main conclusionsRiver islands specialists show stronger population structure within Amazonia than floodplain generalists. They show a common spatial and temporal pattern of divergence between populations from the Negro islands and western Amazonia (upper and middle Solimões), which may be related to Amazonian drainage evolution. Island specialists had low genetic diversity within the Negro basin, while the higher and unstructured diversity pattern found in the floodplain generalist species may be a consequence of higher dispersal caused by the seasonal flooding pulse. River islands populations have a recent and dynamic history of contact and isolation, with small historical fluctuations of population sizes, which is in sharp contrast with the patterns found in upland forest birds.
SNP‐based genetic characterization of the Tulane National Primate Research Center's conventional and specific pathogen‐free rhesus macaque (Macaca mulatta) populations
Authors: Kanthaswamy Sree , Ng Jillian , Oldt Robert F. , Phillippi‐Falkenstein Kathrine , Kubisch H. Michael 
Published: June 2017

AbstractBackgroundThe rhesus macaque is an important biomedical model organism, and the Tulane National Primate Research Center (TNPRC) has one of the largest rhesus macaque breeding colonies in the United States.MethodsSNP profiles from 3266 rhesus macaques were used to examine the TNPRC colony genetic composition over time and across conventional or SPF animals of Chinese and Indian ancestry.ResultsChinese origin animals were the least genetically diverse and the most inbred; however, since their derivation from their conventional forebearers, neither the Chinese nor the Indian SPF animals exhibit any significant loss of genetic diversity or differentiation.ConclusionsThe TNPRC colony managers have successfully minimized loss in genetic variation across generations. Although founder effects and bottlenecks among the Indian animals have been successfully curtailed, the Chinese subpopulation still show some influences from these events.
A systematic review on identifying risk factors associated with early sexual debut and coerced sex among adolescents and young people in communities
Authors: Lee Regina Lai Tong , Yuen Loke Alice , Hung Tommy Tsz Man , Sobel Howard 
Published: June 2017

Aims and objectivesTo review literature on identifying the risk factors associated with early sexual coerced debut with the aim to facilitate the healthcare workers' planning of relevant health services to improve intervention strategies for delaying of early coerced sexual debut or forced sexual debut (CSD/FSD) in the communities.BackgroundIdentifying the risk factors associated with coercion at first sex is crucial for developing appropriate sexual and reproductive health information and health promotion in response. However, current knowledge about the risk factors associated with coercion, sexual debut (SD) and delayed SD among young people is limited. Health information programmes are important during adolescence, when young people are developing their values and beliefs about sexual activity and sexual norms. However, little is known about those risk factors on initiation of early sexual debut to plan relevant interventions that can delay SD and prevent CSD/FSD in this population.DesignA systematic review.MethodsAn extensive literature search using MEDLINE (PubMed), Nursing Journals (PubMed), Web of Science, PsychINFO and CINAHL.ResultsThe search generated 39 published studies that met our inclusion and exclusion criteria. Thirty‐two articles passed the quality appraisal and were selected. This review identified six domains of risk factors, categorised as: (1) the individual domain, (2) the family domain, (3) the partner/peer domain, (4) the school domain, (5) the community domain and (6) the cultural domain. These factors highlight the influences on sexual decision‐making among adolescents and young people and the timing of their first sexual intercourse.ConclusionIt is important to use the outcome of this review's categorisation of identified risk factors to facilitate the healthcare workers and plan relevant sexual and reproductive health programmes more accessible to adolescents, especially young females and their parents. There is a need to evaluate the impact of these programmes that can delay SD and prevent CSD/FSD in this population.Relevance to clinical practiceThe results of this study could provide guidance on the planning of effective interventions for delaying of early CSD/FSD in the communities.
Listening for commissioning: A participatory study exploring young people's experiences, views and preferences of school‐based sexual health and school nursing
Authors: Aranda Kay , Coleman Lester , Sherriff Nigel S , Cocking Chris , Zeeman Laetitia , Cunningham Liz 
Published: June 2017

Aims and objectivesTo explore the experiences, views and preferences of young people aged 11–19 years regarding school‐based sexual health and school nursing to inform commissioning and delivery for one local authority area in England during 2015.BackgroundPromoting sexual health for young people remains a challenging, even controversial, but important public health issue. Concerns regarding accessibility, acceptability and efficacy in school‐based sexual health and school nursing are evident in the literature. Additionally, a complex public health policy context now governs the funding, provision and delivery of sexual health and school nursing, which potentially presents further challenges.DesignA qualitative, participatory design was used to explore sexual health and school nursing. Data were generated from 15 focus groups (n = 74), with young people aged 11–19 years, in educational‐based settings in one local authority area in England.ResultsThe resultant themes of visibility in relation to sexual health education and school nursing revealed both the complex tensions in designing and delivering acceptable and appropriate sexual health services for young people and the significance of participatory approaches.ConclusionOur study shows the importance of participatory approaches in working with young people to clearly identify what they want and need in relation to sexual health. The findings also confirm the ways in which school‐based sexual health remains challenging but requires a theoretical and conceptual shift. This we argue must be underpinned by participatory approaches.Relevance to clinical practiceSchool nurses have always had a significant role to play in promoting positive sexual health for young people and they are exceptionally well placed to challenge the risk‐based cultures that frequently dominate school‐based sexual health. A shift of debates and practices towards the promotion of positive sexual health cultures though previously argued for now requires the active engagement and involvement of young people.
Prying Eyes: A Dramaturgical Approach to Professional Surveillance
Authors: Visser Laura M. , Bleijenbergh Inge L. , Benschop Yvonne W. M. , van Riel Allard C. R. 
Published: June 2017

AbstractThis study examines how professionals engage with the increased surveillance of their daily work. We develop an understanding of professional surveillance at the micro‐level of interaction by drawing on dramaturgical literature. Based on qualitative interviews and observational data of healthcare professionals using a new technology to communicate simultaneously with each other and individual patients, we analyse how professionals use different elements of the theatre (e.g., stages and scripts) to enact surveillance. The significance of our contribution lies especially in the dramaturgical reconceptualization of surveillance as enacted, making it an integral part of displaying one's professionalism.
Understanding adaptogenic activity: specificity of the pharmacological action of adaptogens and other phytochemicals
Authors: Panossian Alexander 
Published: June 2017

AbstractAdaptogens are stress‐response modifiers that increase an organism's nonspecific resistance to stress by increasing its ability to adapt and survive. The classical reductionist model is insufficiently complex to explain the mechanistic aspects of the physiological notion of “adaptability” and the adaptogenic activity of adaptogens. Here, I demonstrate that (1) the mechanisms of action of adaptogens are impossible to rationally describe using the reductionist concept of pharmacology, whereas the network pharmacology approach is the most suitable method; and (2) the principles of systems biology and pharmacological networks appear to be more suitable for conceptualizing adaptogen function and are applicable to any phytochemical. Molecular targets, signaling pathways, and networks common to adaptogens have been identified. They are associated with stress hormones and key mediators of the regulation of homeostasis. In this context, the mechanisms of action of adaptogens are specifically related to stress‐protective activity and increased adaptability of the organism. Consequently, adaptogens exhibit polyvalent beneficial effects against chronic inflammation, atherosclerosis, neurodegenerative cognitive impairment, metabolic disorders, cancer, and other aging‐related diseases. Current and potential uses of adaptogens are mainly related to stress‐induced fatigue and cognitive function, mental illness, and behavioral disorders. Their prophylactic use by healthy subjects to ameliorate stress and prevent age‐related diseases appears to be justified. It is very unlikely that the pharmacological activity of any phytochemical is specific and associated only with one type of receptor, particularly adaptogenic compounds, which affect key mediators of the adaptive stress response at intracellular and extracellular levels of communication.
Production of human vitronectin in Nicotiana benthamiana using the INPACT hyperexpression platform
Authors: Dugdale Benjamin , Kato Maiko , Deo Pradeep , Plan Manuel , Harrison Mark , Lloyd Robyn , Walsh Terry , Harding Robert , Dale James 
Published: June 2017

SummaryHuman vitronectin (hVN) is a glycoprotein that functions as a cell adhesion molecule and a regulator of coagulation in blood plasma and the extracellular matrix. In vitro, hVN is added to serum‐free media in order to promote the adhesion of animal cells to tissue culture surfaces and the proliferation of undifferentiated stem cells. Here, we report the production of hVN in Nicotiana benthamiana using the inducible In Plant ACTivation (INPACT) hyperexpression platform. N. benthamiana plants were transformed with an INPACT expression cassette encoding hVN, and both the Tobacco yellow dwarf virus Rep/RepA activator and Tomato bushy stunt virus p19 gene under the transcriptional control of the ethanol‐inducible AlcR:alcA gene switch. hVN expression was maximal 4–5 days postactivation of the INPACT platform with a dilute ethanol solution, and crude yields of the recombinant protein reached a maximum of 643 ± 78 mg/kg fresh weight. A three‐stage purification protocol was developed using heparin and polyhistidine tag affinity binding and size exclusion filtration, resulting in a plant‐made hVN product of >90% purity. Storage conditions for plant‐made hVN were identified that maximized the capacity of the recombinant protein to promote cell adhesion. Critically, plant‐made hVN was shown to be functionally equivalent to commercial, plasma‐derived hVN at promoting one‐half maximal attachment of murine fibroblast cells (BALB‐C/3T3) in serum‐free medium at <0.1 μg/cm2 to tissue culture plasticware. The INPACT platform represents an attractive means of producing large quantities of functional, animal‐free hVN for in vitro applications.
Distinct controls of leaf widening and elongation by light and evaporative demand in maize
Authors: Lacube Sebastien , Fournier Christian , Palaffre Carine , Millet Emilie J. , Tardieu François , Parent Boris 
Published: June 2017

AbstractLeaf expansion depends on both carbon and water availabilities. In cereals, most of experimental effort has focused on leaf elongation, with essentially hydraulic effects. We have tested if evaporative demand and light could have distinct effects on leaf elongation and widening, and if short‐term effects could translate into final leaf dimensions. For that, we have monitored leaf widening and elongation in a field experiment with temporary shading, and in a platform experiment with 15 min temporal resolution and contrasting evaporative demands. Leaf widening showed a strong (positive) sensitivity to whole‐plant intercepted light and no response to evaporative demand. Leaf elongation was (negatively) sensitive to evaporative demand, without effect of intercepted light per se. We have successfully tested resulting equations to predict leaf length and width in an external dataset of 15 field and six platform experiments. These effects also applied to a panel of 251 maize hybrids. Leaf length and width presented quantitative trait loci (QTLs) whose allelic effects largely differed between both dimensions but were consistent in the field and the platform, with high QTL × Environment interaction. It is therefore worthwhile to identify the genetic and environmental controls of leaf width and leaf length for prediction of plant leaf area.
Clinico‐molecular analysis of eleven patients with Hermansky–Pudlak type 5 syndrome, a mild form of HPS
Authors: Michaud Vincent , Lasseaux Eulalie , Plaisant Claudio , Verloes Alain , Perdomo‐Trujillo Yaumara , Hamel Christian , Elcioglu Nursel H. , Leroy Bart , Kaplan Josseline , Jouk Pierre‐Simon , Lacombe Didier , Fergelot Patricia , Morice‐Picard Fanny , Arveiler Benoit 
Published: June 2017

SummaryHermansky–Pudlak syndrome (HPS), first described in 1959, is a rare form of syndromic oculocutaneous albinism associated with bleeding diathesis and in some cases pulmonary fibrosis and granulomatous colitis. All 10 HPS types are caused by defects in vesicle trafficking of lysosome‐related organelles (LRO) proteins. The HPS5 protein associates with HPS3 and HPS6 to form the biogenesis of lysosome‐related organelles complex‐2 (BLOC‐2). Here, we report the clinical and genetic data of 11 patients with HPS‐5 analyzed in our laboratory. We report 11 new pathogenic variants. The 11 patients present with ocular features that are typical for albinism, with mild hypopigmentation, and with no other major complication, apart from a tendency to bleed. HPS‐5 therefore appears as a mild form of HPS, which is often clinically undistinguishable from mild oculocutaneous or ocular forms of albinism. Molecular analysis is therefore required to establish the diagnosis of this mild HPS form, which has consequences in terms of prognosis and of clinical management of the patients.
An assessment of differences in costs and health benefits of serology and NAT screening of donations for blood transfusion in different Western countries
Authors: Janssen M. P. , van Hulst M. , Custer B. ,   ABO RBDM Health Economics and Outcomes Working Group & Collaborators
Published: June 2017

Background and ObjectivesThe cost‐utility of safety interventions is becoming increasingly important as a driver of implementation decisions. The aim of this study was to compare the cost‐utility of different blood screening strategies in various settings, and to analyse the extent and cause of differences in health economic results.Materials and MethodsFor eight Western countries (Australia, Canada, Denmark, Finland, France, The Netherlands, UK and the United States of America), data were collected on donor and recipient populations, blood products, screening tests, and on patient treatment practices and costs. An existing ISBT web‐tool model was used to assess the cost‐utility of various strategies for HIV, HCV and HBV screening.ResultsThe cost‐utility ratio of serology screening for these eight countries ranges between −11 000 and 92 000 US$ per QALY, and for NAT between −12 000 and 113 000 US$ per QALY when compared to no screening. Combined serology and NAT ranges between 600 and 217 000 US$ per QALY. The incremental cost‐utility of NAT after implementation of serology screening ranges from 2 231 000 to 15 778 000 US$ per QALY.ConclusionThere are substantial differences in costs per QALY between countries for various HIV, HBV and HCV screening strategies. These differences are primarily caused by costs of screening tests and infection rates in the donor population. Within each country, similar cost per QALY results for serology and NAT compared to no screening, coupled with evidence of limited value of serology and NAT together prompts the need for further discussion on the acceptability of parallel testing by serology and NAT.