bluuebunny/crossref_metadata_2025_split huggingface dataset:
The roles of bone‐derived exosomes and exosomal microRNAs in regulating bone remodelling
Authors: Xie Yong , Chen Yanyu , Zhang Licheng , Ge Wei , Tang Peifu 
Published: November 2016

AbstractPathological destructive bone diseases are primarily caused by the failure of a lifelong self‐renewal process of the skeletal system called bone remodelling. The mechanisms underlying this process include enhanced osteoclast activity and decreased generation of the osteoblast lineage. Intercellular interaction and crosstalk among these cell types are crucial for the maintenance of bone remodelling, either through the secretion of growth factors or direct cell–cell physical engagement. Recent studies have revealed that exosomes derived from bone cells, including osteoclasts, osteoblasts and their precursors, play pivotal roles on bone remodelling by transferring biologically active molecules to target cells, especially in the processes of osteoclast and osteoblast differentiation. Here, we review the contents of bone‐derived exosomes and their functions in the regulatory processes of differentiation and communication of osteoclasts and osteoblasts. In addition, we highlight the characteristics of microRNAs of bone‐derived exosomes involved in the regulation of bone remodelling, as well as the potential clinical applications of bone‐derived exosomes in bone remodelling disorders.
No End in Sight: Benzodiazepine Use in Older Adults in the United States
Authors: Maust Donovan T. , Kales Helen C. , Wiechers Ilse R. , Blow Frederic C. , Olfson Mark 
Published: November 2016

ObjectivesTo establish the rate of new and continuation of benzodiazepine use in older adults seen by nonpsychiatrist physicians and to identify subpopulations at risk of new and continuation benzodiazepine use.DesignCross‐sectional analysis.SettingNational Ambulatory Medical Care Survey (2007–10).ParticipantsAdults visiting office‐based nonpsychiatrist physicians (n = 98,818) who were prescribed a benzodiazepine (new or continuation).MeasurementsPercentage of benzodiazepine visits of all outpatient encounters according to patient age and corresponding annual visit rate per 1,000 population. Analysis was then limited to adults aged 65 and older, demographic, clinical, and visits characteristics were used to compare visits of benzodiazepine users with those of nonusers and visits of continuation users with those of new users.ResultsThe overall proportion of benzodiazepine visits ranged from 3.2% (95% confidence interval (CI) = 2.7–3.7) of those aged 18 to 34 to 6.6% (95% CI = 5.8–7.6) of those aged 80 and older, and the proportion of continuation visits increased with age, rising to 90.2% (95% CI = 86.2–93.1) of those aged 80 and older. The population‐based visit rate ranged from 61.7 (95% CI = 50.7–72.7) per 1,000 persons in the youngest adults to 463.7 (95% CI = 385.4–542.0) in those aged 80 and older. Only 16.0% (95% CI = 13.5–18.8) of continuation users had any mental health diagnosis. Of all benzodiazepine users, fewer than 1% (95% CI = .4–1.8) were provided or referred to psychotherapy, and 10.0% (95% CI = 7. 2–13.3) were also prescribed an opioid.ConclusionIn the United States, few older adult benzodiazepine users receive a clinical mental health diagnosis, and almost none are provided or referred to psychotherapy. Prescribing to older adults continues despite decades of evidence documenting safety concerns, effective alternative treatments, and effective methods for tapering even chronic users.
Relationship Between Age and Trajectories of Rehospitalization Risk in Older Adults
Authors: Dharmarajan Kumar , Hsieh Angela , Dreyer Rachel P. , Welsh Jack , Qin Li , Krumholz Harlan M. 
Published: November 2016

ObjectivesTo characterize the magnitude and duration of risk of rehospitalization according to age after hospitalization for heart failure (HF), acute myocardial infarction (AMI), or pneumonia.DesignRetrospective cohort study.SettingU.S. hospitals (n = 4,767).ParticipantsAll Medicare fee‐for‐service beneficiaries aged 65 and older surviving hospitalization for HF, AMI, or pneumonia between October 2012 and December 2013.MeasurementsDaily risk of first rehospitalization for 1 year after hospital discharge was calculated according to age category (65–74, 75–84, ≥85) after adjustment for sex, race, comorbidities, and median ZIP code income. Time required for adjusted rehospitalization risk to decline 50% from maximum value after discharge, time required for adjusted risk to approach a plateau period of minimal day‐to‐day change, and degree to which adjusted risk was higher in recently hospitalized individuals than in the general elderly population were identified.ResultsThere were 414,720 hospitalizations for HF, 177,752 for AMI, and 568,304 for pneumonia. The adjusted risk of rehospitalization declined with increasing age after HF hospitalization (P < .001), rose with increasing age after AMI hospitalization (P < .001), and was slightly lower with increasing age after pneumonia hospitalization (P = .002). Adjusted risks of rehospitalization were high beyond 30 days after hospitalization for all ages.ConclusionAlthough older age has heterogeneous relationships with rehospitalization risk, risk of readmission remains high for an extended time after discharge regardless of age or admitting condition. Condition‐specific data on risk can be used to guide discussions on advanced care planning and strategies for longitudinal follow‐up after hospitalization.
Structural and functional brain alterations in a murine model of Angiotensin II‐induced hypertension
Authors: Meissner Anja , Minnerup Jens , Soria Guadalupe , Planas Anna M 
Published: November 2016

AbstractHypertension is a main risk factor for the development of cerebral small vessel disease (cSVD) – a major contributor to stroke and the most common cause of vascular dementia. Despite the increasing socioeconomic importance arising from cSVD, currently only a few specific treatment strategies with proven efficacy are known. Fundamental to the lack of specific treatments is poor understanding of the disease pathogenesis and a lack of appropriate animal models resembling all symptoms of the human disease. However, chronic hypertensive rat models have been shown to bear similarities to most key features of cSVD. Despite a significantly larger toolbox available for genotypic and phenotypic modifications compared to rats, mouse models of hypertension are unusual when modeling cSVD and associated cognitive impairment experimentally. In the present study, we therefore characterized hypertension‐mediated cerebrovascular alterations and accompanying structural and functional consequences by simultaneously treating adult wild‐type mice (C57BL/6N) with Angiotensin II (AngII) and the nitric oxide synthases inhibitor L‐NAME for 4 weeks. Hypertension associated to cerebral alterations reminiscent of early‐onset cSVD and vascular cognitive impairment when combined with additional AngII bolus injections. Most importantly, preventing the elevation of blood pressure (BP) protected from the development of cSVD symptoms and associated cognitive decline. Our data strongly support the suitability of this particular mouse model of AngII‐induced hypertension as an appropriate animal model for early‐onset cSVD and hence, vascular cognitive impairment, pathologies commonly preceding vascular dementia.image
Maternity groups in the postpartum period at well child clinics – mothers’ experiences
Authors: Glavin Kari , Tveiten Sidsel , Økland Toril , Hjälmhult Esther 
Published: November 2016

Aims and objectivesTo explore mothers’ experiences as participants in maternity groups at well child clinics (WCCs).BackgroundThe level of psychological distress that new mothers have may be related to the quantity of social support they receive. Maternity groups to support new parents have a long tradition at WCCs in Norway, and most of the clinics have offered these groups. However, there is little knowledge about mothers’ experiences of participating in these groups.DesignQualitative design.MethodFocus group interviews with mothers who had participated in maternity groups facilitated by public health nurses (PHNs) at WCCs. Interpretive description was used to analyse the transcripts from the interviews.ResultsEight focus group interviews were conducted with a total of 30 mothers who had participated in maternity groups at WCCs in two counties in eastern Norway. The analysis resulted in one main category, ‘The maternity group's salutogenic importance’ and three subcategories, ‘Networks that can last for many years’, ‘Fellowship with others in the same situation’ and ‘Become confident in mothering’.ConclusionMothers wanted fellowship and found it important to share experiences with other mothers. Maternity groups offered to parents are essential to meet parents’ need to discuss experiences and challenges related to parenting. Maternity groups can also create a basis for establishing a social network for those who want it.Relevance to clinical practiceWell child clinics should offer all mothers the opportunity to participate in groups to strengthen their social relations and their confidence in parenting. PHNs play an important role in facilitating groups for first‐time parents. Group leadership can influence how mothers in a group connect and whether the parental role is affected.
Development of the Chinese version of Meaning in Life Scale for cancer patients and psychometric evaluation
Authors: Xia Hao‐Zhi , Gao Lei , Wang Yang , Song Hui , Shi Bao‐Xin 
Published: November 2016

Aims and ObjectivesTo develop a Meaning in Life Scale for cancer patients in Chinese version and to test the validity and reliability.BackgroundMeaning in life is a protective factor of psychological well‐being and is negatively related to depression and demoralisation among cancer patients. The existing scales measuring meaning in life are mostly designed in English and there is no scale designed for Chinese cancer patients based on Chinese cultural background.DesignProcess of instrument development and psychometric evaluation were used.MethodsItems were generated from literature review and a focus group interview. Delphi technique was used to test the content validity. Item analysis and exploratory factor analysis were performed with data from 251 cancer patients. The internal consistency of the scale was tested by Cronbach's alpha.ResultsA 25‐item Meaning in Life Scale in Chinese version with five domains was developed. The five factors explained 62·686% of the variance. The Cronbach's alpha for the total scale was 0·897.ConclusionsThe Meaning in Life Scale in Chinese version has acceptable internal consistency reliability and good content validity and acceptable construct validity. The content of the scale reflected the attitudes of cancer patients towards meaning in life based on Chinese cultural background.Relevance to clinical practiceThe Chinese version of Meaning in Life Scale for Cancer Patients appears to be a new scale to assess meaning in life among Chinese cancer patients exactly and the concept of meaning in life presented in this scale provides new ideas of meaning intervention in routine clinical practice.
Fibroblast growth factor 21 night watch: advances and uncertainties in the field
Authors: Kharitonenkov A. , DiMarchi R. 
Published: November 2016

AbstractFibroblast growth factor (FGF) 21 belongs to a hormone‐like subgroup within the FGF superfamily. The members of this subfamily, FGF19, FGF21 and FGF23, are characterized by their reduced binding affinity for heparin that enables them to be transported in the circulation and function in an endocrine manner. It is likely that FGF21 also acts in an autocrine and paracrine fashion, as multiple organs can produce this protein and its plasma concentration seems to be below the level necessary to induce a pharmacological effect. FGF21 signals via FGF receptors, but for efficient receptor engagement it requires a cofactor, membrane‐spanning βKlotho (KLB). The regulation of glucose uptake in adipocytes was the initial biological activity ascribed to FGF21, but this hormone is now recognized to stimulate many other pathways in vitro and display multiple pharmacological effects in metabolically compromised animals and humans. Understanding of the precise physiology of FGF21 and its potential medicinal role has evolved exponentially over the last decade, yet numerous aspects remain to be defined and others are a source of debate. Here we provide a historical overview of the advances in FGF21 biology focusing on the uncertainties in the mechanism of action as well as the differing viewpoints relating to this intriguing protein.
Climate and seed availability initiate alternate post‐fire trajectories in a lower subalpine forest
Authors: Urza Alexandra K. , Sibold Jason S. 
Published: November 2016

AbstractQuestionsDo functional traits explain individual tree species’ responses to environmental filters and dispersal limitations following stand‐replacing fire? Can post‐fire conditions initiate alternate trajectories of community assembly?LocationGlacier National Park, Montana,USA.MethodsWe characterized the species composition of tree re‐establishment following nine recent fires in the lower subalpine zone of Glacier National Park, a region with multiple co‐dominant tree species that has experienced extensive fire in recent decades. We usedGLMMsto describe individual species’ responses to spatial and temporal heterogeneity of post‐fire conditions and seed availability, and used multivariate approaches to examine whether post‐fire conditions can initiate alternate trajectories of forest community assembly.ResultsPost‐fire regeneration responses were strongly species‐dependent and consistent with functional trait differences. We found that there was a brief opportunity for establishment during the first several years after fire, during which tree recruitment for all species was contingent upon the availability of nearby seeds and the occurrence of favourable weather conditions. There was a remarkable amount of compositional change following fire, and the majority of our study sites transitioned from a mixed forest to a tree assemblage dominated by a single species.ConclusionsDifferential species‐specific responses to climate and disturbance can initiate alternate trajectories of community assembly, triggering substantial changes in forest composition. The composition of post‐fire tree assemblages reflects the differential responses of individual species to climate and disturbance, providing support for the interacting role of dispersal and environmental filtering in shaping post‐disturbance communities and highlighting the importance of incorporating functional traits into predictive models of ecosystem dynamics.
Introgression and selection shaped the evolutionary history of sympatric sister‐species of coral reef fishes (genus: Haemulon)
Authors: Bernal Moisés A. , Gaither Michelle R. , Simison W. Brian , Rocha Luiz A. 
Published: November 2016

AbstractClosely related marine species with large overlapping ranges provide opportunities to study mechanisms of speciation, particularly when there is evidence of gene flow between such lineages. Here, we focus on a case of hybridization between the sympatric sister‐species Haemulon maculicauda and H. flaviguttatum, using Sanger sequencing of mitochondrial and nuclear loci, as well as 2422 single nucleotide polymorphisms (SNPs) obtained via restriction site‐associated DNA sequencing (RADSeq). Mitochondrial markers revealed a shared haplotype for COI and low divergence for CytB and CR between the sister‐species. On the other hand, complete lineage sorting was observed at the nuclear loci and most of the SNPs. Under neutral expectations, the smaller effective population size of mtDNA should lead to fixation of mutations faster than nDNA. Thus, these results suggest that hybridization in the recent past (0.174–0.263 Ma) led to introgression of the mtDNA, with little effect on the nuclear genome. Analyses of the SNP data revealed 28 loci potentially under divergent selection between the two species. The combination of mtDNA introgression and limited nuclear DNA introgression provides a mechanism for the evolution of independent lineages despite recurrent hybridization events. This study adds to the growing body of research that exemplifies how genetic divergence can be maintained in the presence of gene flow between closely related species.
The power of the pen: how to make physicians more friendly and patients more attractive
Authors: Epstein Nurith , Brendel Thomas , Hege Inga , Ouellette Diana L , Schmidmaier Ralf , Kiesewetter Jan 
Published: November 2016

ContextStudies have shown that patients’ subjective perceptions of physicians’ competence and friendliness are relevant aspects of a successful treatment, influencing patients’ well‐being and trust in the physician. Psychological research has repeatedly shown that unconsciously contracting muscles that are usually used to smile can intensify and even elicit positive feelings (known as facial feedback). Empirical evidence also suggests that a smiling person is favourably judged by others with respect to attractiveness and trustworthiness.AimThis study's purpose was to investigate how an induced muscle contraction, similar to that of a smile, affects physicians’ interactions with a standardised patient. It was expected that the ‘smile intervention’ would affect physicians’ and patients’ perceptions, resulting in higher ratings of the friendliness and attractiveness of physicians in the intervention group.MethodsTwenty physicians participated in the randomised controlled study (10 male, 10 female). Physicians were randomly assigned to one of two conditions: an intervention group (performing an easy cognitive task while smiling; n = 11) or a control group (performing an easy cognitive task without smiling; n = 9). Afterwards, physicians had a 5‐minute consultation with a standardised patient. This consultation was subsequently rated by physicians, the patient and an external rater using 10‐point Likert scales.ResultsPhysicians in the intervention group were rated as significantly friendlier by the external rater (mean 7.81 versus 7.11; p = 0.097, η2 = 0.15). In addition, physicians in the intervention group rated the patient as significantly more attractive (mean 6.91 versus 4.78; p = 0.017; η2 = 0.28).ConclusionsOur results suggest that physicians can influence their friendliness and their perception of patients' attractiveness. Thereby the ‘power of pen’ can be an efficient method for making the hospital a friendlier place.
I want you to pretend to be sincere
Authors: Hynes Julia 
Published: November 2016

AbstractMedical education has changed dramatically since the inception of this journal 50 years ago and is indeed a work in progress: there is now heavy emphasis on the character of the physician, in particular, and professionalism, in general. The subjects of communications skills and the teaching of sincerity, empathy and compassion are relative newcomers to the stage: they are not even as old as this journal itself. Nevertheless, these topics arose in an ancient debate dating from classical antiquity. ‘Can we teach virtue?’ Plato wondered in the Meno. Not exactly, he concluded. Aristotle believed that acquirement of the virtues enables one to attain the human good, which, in turn, spills over to any profession in which the human being decides to engage. Aristotle, along with his successor, Thomas Aquinas, the 13th century philosopher, argued that the virtues cannot be taught but only acquired, with practice and time, in the real situation.
Discussing discursive discussions
Authors: Walsh Kieran 
Published: November 2016

AbstractDiscussions are an important part of medical education research papers, but there is little guidance on how to write up the discussion section. A good discussion section should relate closely to the results; it should include a balanced review of the strengths and weaknesses of the study; it should be realistic in evaluating the applicability of the results; and it should mention the feasibility of widespread adoption of the intervention. This paper describes a review of the discussion sections of research papers published in Medical Education. The review led to further discussion. Common errors in writing discussion sections include: minimising the weaknesses of a study or exaggerating its strengths; closing down debate too early or opening up new arguments at too late a stage; and getting carried away by the potential of technology or getting very carried away by the potential of technology. Some discussions can be too long, but restricted word counts keep abstracts mercifully short.
A study of Culicoides in Rondônia, in the Brazilian Amazon: species composition, relative abundance and potential vectors
Authors: CARVALHO L. P. C. , PEREIRA JÚNIOR A. M. , FARIAS E. S. , ALMEIDA J. F. , RODRIGUES M. S. , RESADORE F. , PESSOA F. A. C. , MEDEIROS J. F. 
Published: November 2016

AbstractThere is very little information available about Culicoides species (Diptera: Ceratopogonidae) in the western Brazilian Amazon. However, studies of the fauna of this region are essential to knowledge of the species and potential vectors within it. Thus, the present study aims to evaluate the abundance, richness and composition of Culicoides species in rural areas in the state of Rondônia, Brazil. Culicoides specimens were collected in forest and pasture environments in the municipality of Porto Velho, using light traps. A total of 1708 individuals (1136 females and 572 males) belonging to 33 species were collected; 28 of these samples represent new records for the state of Rondônia and include the first record of Culicoides contubernalis in Brazil. Culicoides insignis was the most abundant species (86.1%). Species richness was greater in forest areas (32 species, 96.96%), whereas pastures presented the greatest number of Culicoides captured (n = 1540, 90.1%). This study shows that Culicoides populations differ between forest and pasture environments and indicates that the abundance of C. insignis is an important factor in epidemiological vigilance studies in the region.
S‐nitrosoglutathione promotes cell wall remodelling, alters the transcriptional profile and induces root hair formation in the hairless root hair defective 6 (rhd6) mutant of Arabidopsis thaliana
Authors: Moro Camila Fernandes , Gaspar Marilia , da Silva Felipe Rodrigues , Pattathil Sivakumar , Hahn Michael G. , Salgado Ione , Braga Marcia Regina 
Published: November 2016

Summary

Nitric oxide (NO) exerts pleiotropic effects on plant development; however, its involvement in cell wall modification during root hair formation (RHF) has not yet been addressed.

Here, mutants of Arabidopsis thaliana with altered root hair phenotypes were used to assess the involvement of S‐nitrosoglutathione (GSNO), the primary NO source, in cell wall dynamics and gene expression in roots induced to form hairs.

GSNO and auxin restored the root hair phenotype of the hairless root hair defective 6 (rhd6) mutant. A positive correlation was observed between increased NO production and RHF induced by auxin in rhd6 and transparent testa glabra (ttg) mutants. Deposition of an epitope within rhamnogalacturonan‐I recognized by the CCRC‐M2 antibody was delayed in root hair cells (trichoblasts) compared with nonhair cells (atrichoblasts). GSNO, but not auxin, restored the wild‐type root glycome and transcriptome profiles in rhd6, modulating the expression of a large number of genes related to cell wall composition and metabolism, as well as those encoding ribosomal proteins, DNA and histone‐modifying enzymes and proteins involved in post‐translational modification.

Our results demonstrate that NO plays a key role in cell wall remodelling in trichoblasts and suggest that it also participates in chromatin modification in root cells of A. thaliana.