bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of quantitative assessment‐based nursing intervention on the bowel function and life quality of patients with neurogenic bowel dysfunction after spinal cord injury
Authors: Zhang Yanyan , Xia Xiyan , Zhuang Xuewei 
Published: November 2017

Aims and objectivesTo study the effect of quantitative assessment‐based nursing intervention on the bowel function and life quality of patients with neurogenic bowel dysfunction after spinal cord injury.BackgroundNeurogenic bowel dysfunction after spinal cord injury was clinically manifested by abdominal distension, intractable constipation, prolonged defecation and faecal incontinence, which seriously affected the normal life of patients. Traditional ways of nursing for these patients focused on basic care, but lacked sufficient recognition of disease severity and individual needs.DesignOne hundred and eighty‐four patients with neurogenic bowel dysfunction after spinal cord injury were randomly allocated into observation group (n = 92) and control group (n = 92).MethodsThe patients in the control group were given regular nursing, and the patients in the observation group were given quantitative assessment‐based nursing intervention. Recovery of bowel function, quality of life and satisfaction were compared between the two groups.ResultsScores for bowel function including bloating, constipation, prolonged defecation, defecation drug dependence and faecal incontinence in the observation group were significantly lower than those in the control group (p < .05). The scores for the quality of life including physical function, general health, social functioning, role‐motional, mental health in the observation group were significantly higher than those in the control group (p < .001). Finally, the satisfaction rate in the observation group was 95.56%, which was significantly higher than that in the control group (83.7%) (p < .01).ConclusionWe concluded that quantitative assessment‐based nursing intervention contributed to recovery of bowel function and improvement of life quality and satisfaction.Relevance to clinical practiceOur finding can increase the rational allocation of nurse–patient ratio and provide personalised nursing for severe patients to reduce complications and promote the rehabilitation of the disease. Our findings can also serve as a reference for other countries to develop the nurse practitioner role.
Patient perceptions of deterioration and patient and family activated escalation systems—A qualitative study
Authors: Guinane Jessica , Hutchinson Alison M , Bucknall Tracey K 
Published: November 2017

Aims and objectivesTo investigate the experiences of patients who received a medical emergency team review following a period of clinical deterioration and their views about the potential use of a patient and family activated escalation system.BackgroundDelay or failure by health professionals to respond to clinical deterioration remains a patient safety concern. Patients may sometimes identify subtle cues of early deterioration prior to changes in vital signs. In response to health professional and system failures, patient and family activated escalation systems have been mandated and implemented in Australia. However, little research has evaluated their effectiveness nor taken patients’ perspectives into account.DesignQualitative exploratory descriptive design was used.MethodsPurposive sampling was used. Semistructured interviews were undertaken in 2014 with 33 patients who required medical emergency team intervention. Data were collected from one private and one public hospital in Melbourne, Victoria, Australia. The framework method was used to analyse the data.ResultsAll patients stated that it was the clinician who detected and responded to deterioration. Private patient participants were unaware of the medical emergency team system, and felt escalating care was not their responsibility. These patients reported being too sick to communicate prior to and during medical emergency team review and did not favour a patient and family activated escalation system. Public patients were well informed about the medical emergency team system yet expressed concerns around overriding clinicians if activating a patient and family activated escalation system.ConclusionPatient participation during a period of deterioration is restricted by their clinical condition and limited medical knowledge. Patients felt comfortable to communicate concerns to clinicians but felt they would not activate the patient and family activated escalation system. This behoves clinicians to actively listen and respond to patient concerns.Relevance to clinical practiceClinicians must promote a collaborative relationship and encourage patients to communicate their concerns. Given the perceived barriers to patient and family activated escalation systems use, resources being employed for their implementation could be redistributed to other areas of patient safety.
Older Brazilian caregivers and their lived experiences of caring—A hermeneutic phenomenological study
Authors: Pedreira Larissa Chaves , Maria Cabral Ferreira Acylene , Tadeu Reis Silva Gilberto , Maria de Oliveira Silva Rosana , Marques Freitas Carolina 
Published: November 2017

Aims and objectivesTo understand the lived experiences of older Brazilian carers.BackgroundFor many caregivers, the practice of caregiving becomes their daily lives, embedding in their care and the experiences, beliefs, learning and techniques that contribute to the meanings these caregivers attach to their world. Studies have reported on the experiences of caregivers in general; however, few studies have addressed the unique characteristics of older caregivers.MethodPhenomenological research was conducted in the homes of these persons who were registered in a public programme of home care. This study utilised recorded interviews with a guiding question and roadmap for characterisation. The transcribed interviews were analysed based on philosophical hermeneutics and on the understanding of the hermeneutic circle. The units of meaning were discussed from the perspective of Heidegger's phenomenology.ResultsSix older primary caregivers participated, aged between 62–84 years. The following units of meaning were developed: the daily life of being in the world as an older person caring for another older person, the historicity and their disclosedness to the world of care.ConclusionsThe worldliness of these people is influenced by a taxing routine and being overloaded and lonely, which renders these caregivers vulnerable because of this routine and because of the inherent weaknesses induced by the ageing process.Relevance to clinical practiceThis research can help health professionals better understand the worldliness of older caregivers. Such understanding will enhance the assistance available to caregivers, which must extend beyond the care of the sick person: interventions can reduce their overburden and risk of illness, improving their experiences as caregivers and their quality of life.
Advanced glycation end‐products increase IL‐6 and ICAM‐1 expression via RAGE, MAPK and NF‐κB pathways in human gingival fibroblasts
Authors: Nonaka K. , Kajiura Y. , Bando M. , Sakamoto E. , Inagaki Y. , Lew J. H. , Naruishi K. , Ikuta T. , Yoshida K. , Kobayashi T. , Yoshie H. , Nagata T. , Kido J. 
Published: November 2017

Background and ObjectivesDiabetes mellitus (DM) is a risk factor for periodontal diseases and may exacerbate the progression of the pathogenesis of periodontitis. Advanced glycation end‐products (AGEs) cause DM complications relative to levels of glycemic control and larger amounts accumulate in the periodontal tissues of patients with periodontitis and DM. In the present study, we investigated the effects of AGEs on the expression of inflammation‐related factors in human gingival fibroblasts (HGFs) to elucidate the impact of AGEs on DM‐associated periodontitis.Material and MethodsHGFs were cultured with or without AGEs. Cell viability was examined, and RNA and protein fractions were isolated from AGE‐treated cells. The expression of interleukin (IL)‐6, intercellular adhesion molecule‐1 (ICAM‐1), and the receptor for AGE (RAGE) was investigated using reverse transcription‐polymerase chain reaction, quantitative real‐time polymerase chain reaction and enzyme‐linked immunosorbent assay, and reactive oxygen species activity was measured using a kit with 2′,7′‐dichlorofluorescin diacetate. Human monocytic cells (THP‐1) labeled with a fluorescent reagent were co‐cultured with HGFs treated with AGEs and IL‐6 siRNA, and the adhesive activity of THP‐1 cells to HGFs was assessed. The expression of IL‐6 and ICAM‐1 was examined when HGFs were pretreated with recombinant human IL‐6, the siRNAs of RAGE and IL‐6, and inhibitors of MAPK and NF‐κB, and then cultured with and without AGEs. The phosphorylation of MAPK and NF‐κB was assessed using western blotting.ResultsAGEs increased the mRNA and protein expressions of RAGE, IL‐6, ICAM‐1 and reactive oxygen species activity in HGFs, and promoted the adhesion of THP‐1 cells to HGFs, but had no effect on cell viability until 72 hours. Recombinant human IL‐6 increased ICAM‐1 expression in HGFs, while the siRNAs of RAGE and IL‐6 inhibited AGE‐induced IL6 and ICAM1 mRNA expression, and IL‐6 siRNA depressed AGE‐induced THP‐1 cell adhesion. AGEs increased the phosphorylation of p38 and ERK MAPKs, p65 NF‐κB and IκBα, while inhibitors of p38, ERK MAPKs and NF‐κB significantly decreased AGE‐induced IL‐6 and ICAM‐1 expression.ConclusionAGEs increase IL‐6 and ICAM‐1 expression via the RAGE, MAPK and NF‐κB pathways in HGFs and may exacerbate the progression of the pathogenesis of periodontal diseases.
Trends in hepatocellular carcinoma incidence and survival among people with hepatitis C: An international study
Authors: Alavi M. , Janjua N. Z. , Chong M. , Grebely J. , Aspinall E. J. , Innes H. , Valerio H. , Hajarizadeh B. , Hayes P. C. , Krajden M. , Amin J. , Law M. G. , George J. , Goldberg D. J. , Hutchinson S. J. , Dore G. J. 
Published: November 2017

SummaryThis study evaluates trends in hepatitis C virus (HCV)‐related hepatocellular carcinoma (HCC) incidence and survival in three settings, prior to introduction of direct‐acting antiviral (DAA) therapies. HCV notifications from British Columbia (BC), Canada; New South Wales (NSW), Australia; and Scotland (1995‐2011/2012/2013, respectively) were linked to HCC diagnosis data via hospital admissions (2001‐2012/2013/2014, respectively) and mortality (1995‐2013/2014/2015, respectively). Age‐standardized HCC incidence rates were evaluated, associated factors were assessed using Cox regression, and median survival time after HCC diagnosis was calculated. Among 58 487, 84 529 and 31 924 people with HCV in BC, NSW and Scotland, 734 (1.3%), 1045 (1.2%) and 345 (1.1%) had an HCC diagnosis. Since mid‐2000s, HCC diagnosis numbers increased in all jurisdictions. Age‐standardized HCC incidence rates remained stable in BC and Scotland and increased in NSW. The strongest predictor of HCC diagnosis was older age [birth <1945, aHR in BC 5.74, 95% CI 4.84, 6.82; NSW 9.26, 95% CI 7.93, 10.82; Scotland 12.55, 95% CI 9.19, 17.15]. Median survival after HCC diagnosis remained stable in BC (0.8 years in 2001‐2006 and 2007‐2011) and NSW (0.9 years in 2001‐2006 and 2007‐2013) and improved in Scotland (0.7 years in 2001‐2006 to 1.5 years in 2007‐2014). Across the settings, HCC burden increased, individual‐level risk of HCC remained stable or increased, and HCC survival remained extremely low. These findings highlight the minimal impact of HCC prevention and management strategies during the interferon‐based HCV treatment era and form the basis for evaluating the impact of DAA therapy in the coming years.
The Influence of Chronic Kidney Disease on the Structural and Mechanical Properties of Canine Bone
Authors: Shipov A. , Shahar R. , Sugar N. , Segev G. 
Published: November 2017

BackgroundChronic kidney disease (CKD) is common in companion animals. Secondary hyperparathyroidism is an inevitable consequence of the disease and may have deleterious effect on the bone; however, the information regarding CKD‐associated bone abnormalities in companion animals is scarce.Hypothesis/ObjectivesDogs with CKD have decreased bone quality compared to dogs without CKD.AnimalsNine dogs diagnosed with naturally occurring CKD for at least 6 months and 9 age‐matched controls.MethodsDogs with CKD were enrolled and compared to 9 age‐, weight‐, and sex‐matched control dogs with no evidence of CKD. Samples were assessed using light microscopy, mechanical testing, and microcomputed tomography. Variables evaluated included microstructural features such as number, size, and density of Haversian canals, resorption cavities and osteocytic lacunae, bone mineral density, porosity and Young's modulus.ResultsMedian lacunae size was significantly smaller in the CKD group compared to the control group (P = 0.001). Resorption cavity density was higher in the CKD compared to the control group (10 [8–14] vs. 7 [4–9]/mm2, respectively, P = 0.001). Overall porosity was significantly (2.3‐fold) higher in the CKD compared to the control group. There was no difference in Young's moduli between groups.Conclusions and Clinical ImportanceNaturally occurring CKD affects bone quality in dogs, but these changes are relatively mild and likely not to be manifested clinically. The duration of the disease in dogs evaluated here is short compared to cats and human patients, likely accounting for the more subtle changes in dogs compared to other species.
c‐Kit Mutation and Localization Status as Response Predictors in Mast Cell Tumors in Dogs Treated with Prednisone and Toceranib or Vinblastine
Authors: Weishaar K.M. , Ehrhart E.J. , Avery A.C. , Charles J.B. , Elmslie R.E. , Vail D.M. , London C.A. , Clifford C.A. , Eickhoff J.C. , Thamm D.H. 
Published: November 2017

BackgroundKIT inhibitors, such as toceranib (TOC), and vinblastine (VBL) have not been prospectively compared in the treatment of macroscopic mast cell tumors (MCTs). Also, it is unknown whether VBL or TOC is superior for treating MCT without c‐kit mutations.Hypothesis/ObjectivesTo determine the value of KIT genotyping and localization in treatment decisions for dogs with macroscopic MCT. We hypothesized that c‐kit mutated MCT would have a better response to TOC than VBL.AnimalsEighty‐eight client‐owned dogs with macroscopic MCT.MethodsProspective, randomized trial. Dogs were randomized to TOC (2.75 mg/kg EOD) or VBL (2.5 mg/m2 weekly × 4 then EOW) by KIT localization and c‐kit mutation status using an adaptive randomization scheme.ResultsSixty dogs were allocated to TOC and 28 to VBL. Of the dogs receiving TOC, 20% had c‐kit mutations, compared to 30% receiving VBL (P = 0.74). Overall response rates were 46% (TOC) and 30% (VBL) (odds ratio = 1.56 [0.62–3.92]; P = 0.28). Median progression‐free survival (PFS) for dogs receiving VBL was 78 days (7–1,521) and for TOC 95.5 (14–990); hazard ratio (HR) = 1.34 [0.72–2.50]; P = 0.36. Median overall survival (OS) was 241.5 days (10–1,521) for the VBL group and 159 (20–990) for the TOC group; HR = 0.80 ([0.45–1.41]; P = 0.44).Conclusions and Clinical ImportanceNeither PFS nor OS was significantly different between treatment groups. As the proportion of dogs with c‐kit mutations was not different between treatment groups in this population of dogs, c‐kit mutation status did not predict treatment response.
SolarUV‐Bradiation and ethylene play a key role in modulating effective defenses againstAnticarsia gemmatalislarvae in field‐grown soybean
Authors: Dillon Francisco M. , Tejedor M. Daniela , Ilina Natalia , Chludil Hugo D. , Mithöfer Axel , Pagano Eduardo A. , Zavala Jorge A. 
Published: November 2017

AbstractSolar UV‐B radiation has been reported to enhance plant defenses against herbivore insects in many species. However, the mechanism and traits involved in the UV‐B mediated increment of plant resistance are unknown in crops species, such as soybean. Here, we studied defense‐related responses in undamaged andAnticarsia gemmatalislarvae‐damaged leaves of two soybean cultivars grown under attenuated or full solar UV‐B radiation. We determined changes in jasmonates, ethylene (ET), salicylic acid, trypsin protease inhibitor activity, flavonoids, and mRNA expression of genes related with defenses. ET emission induced byAnticarsia gemmatalisdamage was synergistically increased in plants grown under solar UV‐B radiation and was positively correlated with malonyl genistin concentration, trypsin proteinase inhibitor activity and expression ofIFS2, and the pathogenesis proteinPR2, while was negatively correlated with leaf consumption. The precursor of ET, aminocyclopropane‐carboxylic acid, applied exogenously to soybean was sufficient to strongly induce leaf isoflavonoids. Our results showed that in field‐grown soybean isoflavonoids were regulated by both herbivory and solar UV‐B inducible ET, whereas flavonols were regulated by solar UV‐B radiation only and not by herbivory or ET. Our study suggests that, although ET can modulate UV‐B‐mediated priming of inducible plant defenses, some plant defenses, such as isoflavonoids, are regulated by ET alone.
Elevated ozone concentration decreases whole‐plant hydraulic conductance and disturbs water use regulation in soybean plants
Authors: Zhang Wei‐Wei , Wang Miao , Wang Ai‐Ying , Yin Xiao‐Han , Feng Zhao‐Zhong , Hao Guang‐You 
Published: November 2017

Elevated tropospheric ozone (O3) concentration has been shown to affect many aspects of plant performance including detrimental effects on leaf photosynthesis and plant growth. However, it is not known whether such changes are accompanied by concomitant responses in plant hydraulic architecture and water relations, which would have great implications for plant growth and survival in face of unfavorable water conditions. A soybean (Glycine max (L.) Merr.) cultivar commonly used in Northeast China was exposed to non‐filtered air (NF, averaged 24.0 nl l−1) and elevated O3 concentrations (eO3, 40 nl l−1 supplied with NF air) in six open‐top chambers for 50 days. The eO3 treatment resulted in a significant decrease in whole‐plant hydraulic conductance that is mainly attributable to the reduced hydraulic conductance of the root system and the leaflets, while stem and leaf petiole hydraulic conductance showed no significant response to eO3. Stomatal conductance of plants grown under eO3 was lower during mid‐morning but significantly higher at midday, which resulted in substantially more negative daily minimum water potentials. Moreover, excised leaves from the eO3 treated plants showed significantly higher rates of water loss, suggesting a lower ability to withhold water when water supply is impeded. Our results indicate that, besides the direct detrimental effects of eO3 on photosynthetic carbon assimilation, its influences on hydraulic architecture and water relations may also negatively affect O3‐sensitive crops by deteriorating the detrimental effects of unfavorable water conditions.
Microbial colonization of the periodontal pocket and its significance for periodontal therapy
Authors: Mombelli Andrea 
Published: November 2017

AbstractThe aim of this paper was to evaluate strategies for periodontal therapy from the perspective of periodontal disease being a consequence of microbial colonization of the periodontal pocket environment. In classic bacterial infections the diversity of the microbiota decreases as the disease develops. In most cases of periodontitis, however, the diversity of the flora increases. Most incriminating bacteria are thought to harm tissues significantly only if present in high numbers over prolonged periods of time. Clinical trials have repeatedly demonstrated that scaling and root planing, a procedure that aims to remove subgingival bacterial deposits by scraping on the tooth surface within the periodontal pocket, is effective. At present, for the therapy of any form of periodontal disease, there exists no protocol with proven superiority, in terms of efficiency or effectiveness, over scaling and root planing plus systemic amoxicillin and metronidazole. Some exponents advocate rationing these drugs for patients with a specific microbial profile. However, the evidence for any benefit of bacteriology‐assisted clinical protocols is unsatisfactory. Treated sites are subject to recolonization with a microbiota similar to that present before therapy. The degree and speed of recolonization depends on the treatment protocol, the distribution patterns of periodontal microorganisms elsewhere in the oral cavity and the quality of the patient's oral hygiene. To limit the use of antibiotics and to avoid accumulation of harmful effects by repeated therapy, further efforts must be made to optimize procedures addressing the microbial colonization and recolonization of the periodontal pocket.
Premature birth affects the degree of airway dysanapsis and mechanical ventilatory constraints
Authors: Duke Joseph W. , Gladstone Igor M. , Sheel A. William , Lovering Andrew T. 
Published: November 2017

New Findings
What is the central question of this study?
Adult survivors of preterm birth without (PRE) and with bronchopulmonary dysplasia (BPD) have airflow obstruction at rest and significant mechanical ventilatory constraints during exercise compared with those born at full term (CON). Do PRE/BPD have smaller airways, indexed via the dysanapsis ratio, than CON?

What is the main finding and its importance?
The dysanapsis ratio was significantly smaller in BPD and PRE compared with CON, with BPD having the smallest dysanapsis ratio. These data suggest that airflow obstruction in PRE and BPD might be because of smaller airways than CON.

Adult survivors of very preterm birth (≤32 weeks gestational age) without (PRE) and with bronchopulmonary dysplasia (BPD) have obstructive lung disease as evidenced by reduced expiratory airflow at rest and have significant mechanical ventilatory constraints during exercise. Airflow obstruction, in any conditions, could be attributable to several factors, including small airways. PRE and/or BPD could have smaller airways than their counterparts born at full term (CON) owing to a greater degree of dysanaptic airway development during the pre‐ and/or postnatal period. Thus, the purpose of the present study was to compare the dysanapsis ratio (DR), as an index of airway size, between PRE, BPD and CON. To do so, we calculated DR in PRE (n = 21), BPD (n = 14) and CON (n = 34) individuals and examined flow–volume loops at rest and during submaximal exercise. The DR, using multiple estimates of static recoil pressure, was significantly smaller in PRE and BPD (0.16 ± 0.05 and 0.10 ± 0.03 a.u.) compared with CON (0.22 ± 0.04 a.u.; both P < 0.001) and smallest in BPD (P < 0.001). The DR was significantly correlated with peak expiratory airflow at rest (r = 0.42; P < 0.001) and the extent of expiratory flow limitation during exercise (r = 0.60; P < 0.001). Our findings suggest that PRE/BPD might have anatomically smaller airways than CON, which might help to explain their lower expiratory airflow rate at rest and during exercise and further our understanding of the consequences of preterm birth and neonatal O2 therapy.