bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin D and Physical Function in Sedentary Older Men
Authors: Levis Silvina , Gómez‐Marín Orlando 
Published: November 2016

ObjectivesTo determine the effectiveness of vitamin D supplementation in preventing decline in physical function in older men.DesignRandomized, double‐blind, placebo‐controlled clinical trial.SettingSingle‐center study conducted at a Veterans Affairs Healthcare System.ParticipantsSedentary men aged 65 to 90 (mean 72.4 ± 6.8) with baseline 25‐hydroxyvitamin D (25(OH)D levels of less than 30 ng/mL and Short Physical Performance Battery (SPPB) test scores of 9 or less (N = 130).InterventionDaily capsule containing cholecalciferol 4,000 IU daily or placebo for 9 months.MeasurementsMain outcomes were SPPB score and gait speed.ResultsAfter the intervention, serum 25(OH)D increased from 23.1 ± 5.0 ng/mL to 46.2 ± 12.7 ng/mL in the cholecalciferol group and from 22.5 ± 5.3 ng/mL to 24.0 ± 7.2 ng/mL in the placebo group. At study end, improvements in SPPB score and gait speed were not significantly greater in men receiving cholecalciferol than in those receiving placebo. No differences were found in adverse events or numbers of falls.ConclusionDaily cholecalciferol 4,000 IU for 9 months resulted in significant increases in 25(OH)D concentrations, but achieving these higher levels did not result in improvements in SPPB score or gait speed. These data do not support prescribing vitamin D supplements to older sedentary men to prevent physical function decline.
Effect of Cognitively Stimulating Activities on Symptom Management of Delirium Superimposed on Dementia: A Randomized Controlled Trial
Authors: Kolanowski Ann , Fick Donna , Litaker Mark , Mulhall Paula , Clare Linda , Hill Nikki , Mogle Jacqueline , Boustani Malaz , Gill David , Yevchak‐Sillner Andrea 
Published: November 2016

ObjectiveTo determine whether cognitively stimulating activities would reduce duration and severity of delirium and improve cognitive and physical function to a greater extent than usual care.DesignSingle‐blind randomized clinical trial.SettingEight post‐acute care (PAC) facilities.ParticipantsCommunity‐dwelling older adults with dementia and delirium (N = 283).InterventionResearch staff provided cognitively stimulating activities daily for up to 30 days.MeasurementsPrimary outcomes were delirium duration (Confusion Assessment Method) and delirium severity (Delirium Rating Scale). Secondary outcomes were cognitive function (Digits Forward, Montreal Cognitive Assessment, CLOX) and physical function (Barthel Index).ResultsMean percentage of delirium‐free days (intervention: 64.8%, 95% confidence interval (CI) = 59.6–70.1; control: 68.7%, 95% CI = 63.9–73.6; P = .37, Wilcoxon rank sum test) and delirium severity (range 0–39: intervention: 10.77, 95% CI = 10.10–11.45; control: 11.15, 95% CI = 10.50–11.80; difference 0.37, 95% CI = 0.56–1.31, P = .43) were similar in both groups. Significant differences for secondary outcomes favoring intervention were found (executive function (range 0–15): intervention: 6.58, 95% CI = 6.12–7.04; control: 5.89, 95% CI = 5.45–6.33; difference −0.69, 95% CI = 1.33 to −0.06, P = .03; constructional praxis (range 0–15): intervention: 8.84, 95% CI = 8.83–9.34; control: 7.53, 95% CI = 7.04–8.01; difference −1.31, 95% CI = 2.01 to −0.61, P < .001). After adjusting for baseline constructional praxis, the group comparison was no longer significant. Average length of stay was shorter in the intervention (36.09 days) than the control (53.13 days) group (standard error = 0.15, P = .01, negative binomial regression).ConclusionCognitively stimulating activities did not improve delirium but improved executive function and reduced length of stay. Resolution of delirium may require more‐intense nonpharmacological management when the individual has dementia.
A matter of life and death: knowledge about the body and concept of death in adults with intellectual disabilities
Authors: McEvoy J. , Treacy B. , Quigley J. 
Published: November 2016

AbstractBackgroundAn increased awareness of how people with intellectual disabilities (ID) understand death and dying is necessary in supporting life‐long learning, post‐bereavement support and planning end‐of‐life care. Previous research suggests that adults with ID have a limited or ‘patchy’ understanding of the basic biological components of death. However, the relationship between biological understanding of how the body works and conceptualisation of death remains unexplored in this population.MethodThirty adults with ID were interviewed to assess their knowledge of human body function and their understanding of the concept of death. Using pictures, participants were asked if they recognised certain organs, asked to explain the function of various body parts and what would happen if certain body parts were missing or did not work. Participants who referred to ‘life’ or ‘not dying’ as the goal of body function were categorised as ‘Life Theorisers’. In addition, participants were asked about the causes of death, whether all things die and the status of the body after death.ResultsThe results support previous studies suggesting that understanding of death in adults with ID varies from partial to full comprehension and is associated with level of ID. Also, death comprehension was positively correlated with total body interview scores and ‘Life Theorisers’ who understood that body parts maintain life and who spontaneously appealed to ‘vitalistic’ concepts when reasoning about the human body were also more sophisticated in their understanding of death.ConclusionThe study highlights the relationship between knowledge about the goal of human body functioning and death comprehension in adults with ID. The potential that learning to adopt a ‘vitalistic’ approach to human functioning may have on the acquisition of a greater understanding of death and dying, understanding illness and supporting end‐of‐life planning is discussed.
Motivations for Entering the Doula Profession: Perspectives From Women of Color
Authors: Hardeman Rachel R. , Kozhimannil Katy B. 
Published: November 2016

IntroductionThe imperative to diversify the health care workforce is evident: increased diversity contributes to the overall health of the nation. Given persistent racial and ethnic disparities in birth outcomes, workforce diversity is particularly urgent in the context of clinical and supportive care during pregnancy and childbirth. The goal of this analysis was to characterize the intentions and motivations of racially and ethnically diverse women who chose to become doulas (maternal support professionals) and to describe their early doula careers, including the experiences that sustain their work.MethodsIn 2014, 12 women of color in the Minneapolis, Minnesota, metropolitan area (eg, African American, Somali, Hmong, Latina, American Indian) applied and were selected (from a pool of 58) to receive doula training and certification. In January and February 2015, we conducted semistructured interviews (30 to 90 minutes) with the newly trained doulas. We used an inductive qualitative approach to analyze key themes related to motivation and satisfaction with doula work.ResultsFor many of the women of color we interviewed, the underlying motivation for becoming a doula was related directly to a desire to support women from the doula's own racial, ethnic, and cultural community. Other key themes related to both motivation and satisfaction included perceiving birth work as a calling, easing women's transitions to motherhood by “holding space,” honoring the ritual and ceremony of childbirth, and providing culturally competent support, often as the sole source of cultural knowledge during labor and birth.DiscussionDoulas of color have a strong commitment to supporting women from their communities. Given the evidence linking doula support to improved birth outcomes, successful recruitment and retention of women of color as doulas may support broader efforts to reduce long‐standing disparities in birth outcomes.
The neuroprotective effect of latanoprost acts via klotho‐mediated suppression of calpain activation after optic nerve transection
Authors: Yamamoto Kotaro , Sato Kota , Yukita Masayoshi , Yasuda Masayuki , Omodaka Kazuko , Ryu Morin , Fujita Kosuke , Nishiguchi Koji M. , Machida Shigeki , Nakazawa Toru 
Published: November 2016

AbstractLatanoprost was first developed for use in glaucoma therapy as an ocular hypotensive agent targeting the prostaglandin F2α (FP) receptor. Subsequently, latanoprost showed a neuroprotective effect, an additional pharmacological action. However, although it is well‐known that latanoprost exerts an ocular hypotensive effect via the FP receptor, it is not known whether this is also true of its neuroprotective effect. Klotho was firstly identified as the gene linked to the suppression of aging phenotype: the defect of klotho gene in mice results aging phenotype such as hypokinesis, arteriosclerosis, and short lifespan. After that, the function of klotho was also reported to maintain calcium homeostasis and to exert a neuroprotective effect in various models of neurodegenerative disease. However, the function of klotho in eyes including retina is still poorly understood. Here, we show that klotho is a key factor underlying the neuroprotective effect of latanoprost during post‐axotomy retinal ganglion cell (RGC) degeneration. Importantly, a quantitative RT‐PCR gene expression analysis of klotho in sorted rat retinal cells revealed that the highest expression level of klotho in the retina was in the RGCs. Latanoprost acid, the biologically active form of latanoprost, inhibits post‐traumatic calpain activation and concomitantly facilitates the expression and shedding of klotho in axotomized RGCs. This expression profile is a good match with the localization, not of the FP receptor, but of organic anion transporting polypeptide 2B1, known as a prostaglandin transporter, in the ocular tissue. Furthermore, an organic anion transporting polypeptide 2B1 inhibitor suppressed latanoprost acid‐mediated klotho shedding ex vivo, whereas an FP receptor antagonist did not. The klotho fragments shed from the RGCs reduced the intracellular level of reactive oxygen species, and a specific klotho inhibitor accelerated and increased RGC death after axotomy. We conclude that the shed klotho fragments might contribute to the attenuation of axonal injury‐induced calpain activation and oxidative stress, thereby protecting RGCs from post‐traumatic neuronal degeneration.
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Dancing around families: neonatal nurses and their role in child protection
Authors: Saltmarsh Tina , Wilson Denise 
Published: November 2016

Aims and objectivesTo explore the processes neonatal intensive care nurses used in their child protection role with preterm infants.BackgroundNeonatal nurses’ screening for family violence is important in identifying at‐risk preterm infants requiring protection upon discharge from neonatal intensive care settings. We know little about neonatal nurses and their role in child protection.DesignA qualitative research design using Glaserian grounded theory.MethodsTen in‐depth semi‐structured interviews were conducted with New Zealand neonatal intensive care nurses. Data were simultaneously analysed using constant comparative analysis and theoretical sampling to develop a substantive grounded theory.ResultsDancing around families is the substantive grounded theory explaining how neonatal intensive care nurses respond to and manage an infant needing child protection. Knowing at‐risk families is the process these nurses used, which draws on their personal and professional knowledge to identify an infant's child welfare requirements. A tension exists for neonatal nurses in shaping and framing the baby's safety and protection needs between their role of nurturing and protecting an at‐risk infant and it belonging to the family.ConclusionsChild protection is a source of conflict for neonatal intensive care nurses. A lack of education, dodgy families and lack of confidence in child welfare services all compromise effective child protection. Their reality is tension between wanting the best possible outcomes for the baby, but having little or no control over what happens following its discharge.Relevance to clinical practiceNeonatal intensive care nurses are ideally positioned to identify and respond to those preterm infants at risk of child maltreatment. They need education in child maltreatment, and protection focused on preterm infants, collegial support and clinical supervision.
Vital signs as predictors for aggression in hospital patients (VAPA)
Authors: Considine Julie , Berry Debra , Johnson Rebecca , Sands Natisha 
Published: November 2016

Aims and objectivesTo examine and describe the relationship between physiological status and violent and aggressive behaviours in hospital patients.BackgroundThe majority of adverse events are preceded by physiological abnormalities; whether physiological deterioration is a predictor of violent or aggressive behaviours remains unknown.DesignProspective case–control study.MethodsProspective audit of 999 patients from two major health services in Melbourne, Australia. There were 333 cases who required an emergency response for aggressive or violent behaviour (Code Grey) in the emergency department, medical or surgical units, or inpatient mental health unit between January–June 2015. Two control patients who did not have a Code Grey were randomly selected from the same unit and same day that the Code Grey occurred for the case patient.ResultsPatient locations were 54·4% medical or surgical units, 23·7% emergency department and 21·9% mental health units. Code Grey patients had less documentation of physiological assessment and were more likely to have respiratory rate, heart rate and conscious state abnormalities in the 12 hours preceding Code Grey. After adjusting for confounders, the risk of Code Grey was highest for patients with confusion.ConclusionPatients experiencing behavioural disturbance had lower standards of patient assessment, greater incidence of physiological abnormalities and more inpatient deaths. Early recognition of, and response to, patient and physiological predictors of Code Grey should be a strategy to prevent behavioural escalation to the point of Code Grey.Relevance to clinical practiceStrategies are needed to improve physiological assessment of patients with behavioural disturbance while ensuring staff safety. There are patient and physiological factors associated with increased risk of Code Grey that may be used to prevent behavioural escalation to the point of an emergency response.
Effect of number of retrieved lymph nodes on prognosis in FIGO stage IB–IIA cervical cancer patients treated with primary radical surgery
Authors: Lim Soyi , Cho Kyungjoo , Lee Seungho , Lee Kwangbeom , Shin Jinwoo , Chung Donghae , Park Chanyong 
Published: November 2016

AbstractAimIn the treatment of cervical cancer, the extent of lymphadenectomy is a matter of debate. The goal of the current study was to examine the question of whether the number of retrieved lymph nodes (RLN) can influence survival of patients with early stage cervical cancer.MethodsThe medical records of 180 FIGO stage IB–IIA cervical cancer patients treated with primary radical surgery were reviewed. Patients were divided into two groups: those with ≤ 40 RLN and those with > 40 RLN. Patients were also assigned to either the bulky (tumor size > 4 cm) cervical cancer group or the non‐bulky (tumor size ≤ 4 cm) cervical cancer group.ResultsThe number of RLN had a statistically significant effect on both disease‐free survival (P = 0.04) and overall survival (P = 0.02) of all patients. Patients with > 40 RLN had better prognoses than those with ≤ 40 RLN. In the bulky cervical cancer group, the number of RLN was an independent prognostic factor. In multivariate analysis for the bulky cervical cancer group, > 40 RLN had a significant positive effect on disease‐free survival (adjusted hazard ratio, 0.36; 95% confidence interval, 0.13–0.97) and overall survival (adjusted hazard ratio, 0.23; 95% confidence interval, 0.06–0.90). However, number of RLN was not an independent prognostic factor in the non‐bulky cervical cancer group.ConclusionsA more extensive lymphadenectomy increased the survival of bulky cervical cancer patients. This finding may be helpful in determining surgical extent before surgery for cervical cancer.
Association between nephrinuria, podocyturia, and proteinuria in women with pre‐eclampsia
Authors: Furuta Itsuko , Zhai Tianyue , Ishikawa Satoshi , Umazume Takeshi , Nakagawa Kinuko , Yamada Takahiro , Morikawa Mamoru , Minakami Hisanori 
Published: November 2016

AbstractAimPodocyte depletion in the kidney is associated with end‐stage kidney disease (ESKD). Pre‐eclampsia (PE) increases the risk of ESKD in later life. This study was performed to determine whether nephrinuria (soluble nephrin in the urine) is correlated with proteinuria and/or podocyturia (podocytes in the urine) in PE women.MethodsEighty‐three urine samples, consisting of 45 and 38 samples from 27 normotensive and nine PE women, respectively, underwent simultaneous determination of nephrin, protein, and creatinine concentrations in the urine supernatant and quantitative analysis of podocyte‐specific protein mRNA expression. This included podocin (Pod‐mRNA) and nephrin (Nep‐mRNA), using real‐time polymerase chain reaction in the pelleted urine. Nephrinuria and proteinuria were corrected by creatinine concentration. Pod‐ and Nep‐mRNA expression levels were corrected by GAPDH.ResultsNephrinuria, proteinuria, Pod‐mRNA expression, and Nep‐mRNA expression all increased with advancing gestation in PE women, while not in normotensive women. The nephrinuria was strongly correlated with proteinuria (R = 0.901, P <  0.001), Pod‐mRNA expression level (R = 0.824, P < 0.001), and Nep‐mRNA expression level (R  =  0.724, P <  0.001) in urine samples from PE women, while the nephrinuria was significantly correlated with proteinuria alone (R  =  0.419, P <  0.005) in urine samples from normotensive women.ConclusionNephrinuria reflected well the degrees of proteinuria and podocyturia in PE women. This suggested that increased nephrinuria/proteinuria was associated with podocyte loss in the kidneys of PE women.
Alarmins and central nervous system inflammation in HIV‐associated neurological disorders
Authors: Gougeon M.‐L. 
Published: November 2016

AbstractIn the era of highly active antiretroviral therapy (HAART), HIV‐1‐associated neurocognitive disorders (HAND) persist in infected individuals with adequate immunological and virological status. Risk factors for cognitive impairment include hepatitis C virus co‐infection, host genetic factors predisposing to HAND, the early establishment of the virus in the CNS and its persistence under HAART; thus, the CNS is an important reservoir for HIV. Microglial cells are permissive to HIV‐1, and NLRP3 inflammasome‐associated genes were found expressed in brains of HIV‐1‐infected persons, contributing to brain disease. Inflammasomes can be triggered by alarmins or danger‐associated molecular patterns (DAMPs), which directly stimulate the production of proinflammatory mediators by glial cells, contribute to blood–brain barrier injury through induction of release of various proteases and allow the passage of infected macrophages, and trigger IL‐1β release from primed cells. Amongst alarmins involved in HIV‐1‐induced neuropathogenesis, IL‐33 and high‐mobility group box 1 (HMGB1) are of particular interest. Neurocognitive alterations were recently associated with dysregulation of the IL‐33/ST2 axis in the CNS, leading to the induction of neuronal apoptosis, decrease in synaptic function and neuroinflammation. Specific biomarkers, including HMGB1 and anti‐HMGB1 antibodies, have been identified in cerebrospinal fluid from patients with HAND, correlated with immune activation and identifying a very early stage of neurocognitive impairment that precedes changes in metabolites detected by magnetic resonance spectroscopy. Moreover, HMGB1 plays a crucial role in HIV‐1 persistence in dendritic cells and in the constitution of viral reservoirs. In this review, the mechanisms whereby alarmins contribute to HIV‐1‐induced CNS inflammation and neuropathogenesis will be discussed.
Application of a barometer for assessment of oral functions: Donders space
Authors: Hiraki K. , Yamada Y. , Kurose M. , Ofusa W. , Sugiyama T. , Ishida R. 
Published: November 2016

SummaryWe developed a barometer applicable to a small space, to assess oral and pharyngeal functions. Negative oral pressure during rest and pressure changes during swallowing were measured in a space between the palate and tongue (STP). Twenty volunteers were asked to sit in a chair in a relaxed upright position. A sensor was placed on the posterior midline of hard palate. Recording commenced just before subjects closed their lips and continued. Subjects were asked to swallow saliva and keep the apposition. Finally, subjects were asked to open their mouth. Recordings were performed five times, and 5 s of continuous data in each phase was averaged. To verify the reliability of the system, the same procedure was accomplished with twin sensors. When the jaw and lips were closed, the pressure slightly decreased from atmospheric pressure (−0·17 ± 0·24‐kPa). After swallowing, the pressure in STP showed more negative value (−0·50 ± 0·59‐kPa). There is a significant difference between the values in open condition and after swallowing (P < 0·001) and between values after swallowing and final open condition (P < 0·05). Twin sensor showed almost the same trajectories of pressure changes for all the recordings. Obtained negative pressure might generate about 0·71‐N of force and would be enough to keep the tongue in the palatal fossa at rest. The system detected large negative/positive pressure changes during swallowing. We conclude this system may be a tool to evaluate oral functions.
Handling missing data in consumer hedonic tests arising from direct scaling
Authors: Franczak Brian C. , Castura John C. , Browne Ryan P. , Findlay Christopher J. , McNicholas Paul D. 
Published: November 2016

AbstractIn sensory evaluation, it may be necessary to design experiments that yield incomplete data sets. As such, sensory scientists will need to utilize statistical methods capable of handling data sets with missing values. This article demonstrates the advantages of a model‐based imputation procedure that simultaneously accounts for heterogeneity while imputing. We compare this model‐based approach to the current state‐of‐the‐art imputation procedures using two real data sets that arose from central location tests. These data sets contain missing values by design. In addition, these data sets have two data sets nested within each of them. We use these nested data sets to validate the results. Compared to the considered state‐of‐the‐art imputation procedures, we find evidence that the model‐based approach is able to recover the group structure and key characteristics of the data sets when a high percentage of the data are missing.Practical applicationsThe model‐based imputation procedure presented in this manuscript is used to analyse incomplete multivariate data sets arising from central location tests. It can be used to analyse incomplete mulitvariate data sets where there is correlation among the variables. Examples include data arising from high fatigue studies, just‐about‐right scale, free choice profiling, or from the ideal profile method.