bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of the Eurozone Crisis on National Foreign Policy: Enhancing Europeanization in the Case of Cyprus*
Authors: Christou George , Kyris George 
Published: April 2017

AbstractThis article investigates the impact of the eurozone crisis on the foreign policy of an EU Member State, Cyprus. Drawing on the literature on Europeanization of national foreign policies, it is argued that Cypriot foreign policy, despite the general frustration caused by the financial crisis within broader society, has actually undergone further Europeanization. We show that leadership is a critical intervening variable in this enhanced Europeanization, as well as pointing to the salience of the explanatory mechanisms of social and instrumental learning. The contribution of the article is twofold. It offers an empirical account of contemporary Cypriot foreign policy and contributes to the discussion of the impact of the Eurozone crisis on national foreign policy. Both, we contend, remain relatively neglected topics in the literature.
Adapting the Vulnerable Elders Survey‐13 to Predict Mortality Using Responses to the Medicare Health Outcomes Survey
Authors: Beckett Megan K. , Elliott Marc N. , Ritenour Douglas , Giordano Laura A. , Grace Susan C. , Malinoff Rochelle , Saliba Debra 
Published: April 2017

ObjectivesTo use items from the Medicare Health Outcomes Survey (HOS) to adapt or validate a simple method for identifying community‐dwelling older adults at greater risk of death and to extend the method to identify a very high‐risk group.DesignAnalysis of longitudinal data.SettingNational sample of beneficiaries from Medicare Advantage plans with 500 or more enrollees.ParticipantsMedicare beneficiaries aged 65 and older responding to 2009 baseline and 2011 follow‐up HOS (N = 238,687).MeasurementsBivariate and multivariate analyses of the HOS; adaptation and validation of a previously validated Vulnerable Elders Survey‐13 (VES‐13) scoring system that uses age and self‐reported function to predict mortality.ResultsA modified predictive model, that uses substitutes for several items in the previously validated VES‐13, predicted 2‐year mortality; 10.6% of those scoring 3 or more, and 2.4% of those scoring less than 3 died within 2 years (relative risk of death 4.4, similar to 4.2 for the original VES‐13 sample), and 15.5% of those scoring 7 or more died within 2 years (relative risk of death (relative to scores <3) of 6.5). Sixteen percent of HOS beneficiaries were missing some data; 2‐year mortality for those with missing items was 9.5%, versus 7.1% for those with no missing items (P < .001). Imputation of median values for missing VES‐13 items results in valid predictions of mortality for those with partially missing data.ConclusionThe VES‐13 algorithm is robust to substitution of functional items and can be used to identify very high‐risk older adults. Multiple imputation of missing items reduces loss‐to‐follow‐up bias and increases sample size.
Home‐ and Community‐Based Occupational Therapy Improves Functioning in Frail Older People: A Systematic Review
Authors: De Coninck Leen , Bekkering Geertruida E. , Bouckaert Leen , Declercq Anja , Graff Maud J. L. , Aertgeerts Bert 
Published: April 2017

ObjectivesThe objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community‐dwelling physically frail older people.DesignWe conducted a systematic review and meta‐analysis. We included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions.MeasurementsMeta‐analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons.ResultsNine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of −0.30 (95% CI −0.50 to −0.11; P = .002), for social participation −0.44 (95% CI −0.69, −0.19; P = .0007) and for mobility −0.45 (95% CI −0.78 to −0.12; P = .007). All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found.ConclusionThere is strong evidence that occupational therapy improves functioning in community‐dwelling physically frail older people.
End‐of‐Life Care Transition Patterns of Medicare Beneficiaries
Authors: Wang Shi‐Yi , Aldridge Melissa D. , Gross Cary P. , Canavan Maureen , Cherlin Emily , Bradley Elizabeth 
Published: April 2017

ObjectivesTo characterize the patterns of transitions in care and factors associated with multiple transitions in the last 6 months of life of U.S. decedents (N = 660,132).DesignRetrospective study.SettingUnited States.ParticipantsMedicare beneficiaries aged 66 and older who died from July to December 2011.MeasurementsTransitions between healthcare settings (e.g., hospital, skilled nursing facility, inpatient hospice, home hospice, home without hospice) in the last 6 months of life. A count variable for number of transitions was summarized, and Sankey diagrams were produced to illustrate the sequences of healthcare transitions. Multivariable analyses were used to identify factors associated with likelihood of having four or more transitions.ResultsMore than 80% decedents (n = 556,437) had at least one transition within the last 6 months of life; 218,731 had four or more transitions within the last 6 months of life. The most‐frequent transition pattern (19.3% of all decedents; n = 127,435) was home to hospital, back to home or skilled nursing facility, to hospital again, and then to settings other than hospital, ending with four or more transitions. The average number of transitions in the last 6 months of life varied substantially across states, ranging from 1.8 in Alaska to 3.1 in New Jersey. Transitions became more intensive for decedents approaching death. In multivariable analyses, women, blacks, individuals younger than 85, and individuals without dementia were more likely to have four or more transitions (all P < .05).ConclusionApproximately one‐third of the Medicare beneficiaries who died in 2011 had four or more transitions within their last 6 months of life. Identifying interventions that can facilitate care transitions consistent with beneficiaries’ preferences is warranted.
Patient Satisfaction With Maternity Waiting Homes in Liberia: A Case Study During the Ebola Outbreak
Authors: Lori Jody R. , Munro‐Kramer Michelle L. , Shifman Jordan , Amarah Patricia N. M. , Williams Garfee 
Published: April 2017

IntroductionLiberia in West Africa has one of the highest maternal mortality ratios in the world (990/100,000 live births). Many women in Liberia live in rural, remote villages with little access to safe maternity services. The World Health Organization has identified maternity waiting homes (MWHs) as one strategy to minimize the barrier of distance in accessing a skilled birth attendant. However, limited data exist on satisfaction with MWHs or maternal health care in Liberia.MethodsThis mixed‐methods case study examines women's satisfaction with their stay at a MWH and compares utilization rates before and during the Ebola outbreak. From 2012 to 2014, 650 women who stayed at one of 6 MWHs in rural Liberia during the perinatal or postnatal period were surveyed. Additionally, 60 semi‐structured interviews were conducted with traditional providers, skilled birth attendants, and women utilizing the MWHs. Quantitative analyses assessed satisfaction rates before and during the Ebola outbreak. Content analysis of semi‐structured interviews supplemented the quantitative data and provided a lens into the elements of satisfaction with the MWHs.ResultsThe majority of women who utilized the MWHs stated they would suggest the MWH to a friend or relative who was pregnant (99.5%), and nearly all would utilize the home again (98.8%). Although satisfaction with the MWHs significantly decreased during the Ebola outbreak (P < .001), participants were satisfied overall with the MWHs. Content analysis identified areas of satisfaction that encompassed the themes of restful and supportive environment as well as areas for improvement such as lacking necessary resources and loneliness.DiscussionThis case study demonstrated that women using MWHs in Bong County, Liberia are generally satisfied with their experience and plan to use an MWH again during future pregnancies to access a skilled birth attendant for birth. Women are also willing to encourage family and friends to use MWHs.
Molecular mechanisms underlying protective effects of quercetin against mitochondrial dysfunction and progressive dopaminergic neurodegeneration in cell culture and MitoPark transgenic mouse models of Parkinson's Disease
Authors: Ay Muhammet , Luo Jie , Langley Monica , Jin Huajun , Anantharam Vellareddy , Kanthasamy Arthi , Kanthasamy Anumantha G. 
Published: April 2017

AbstractQuercetin, one of the major flavonoids in plants, has been recently reported to have neuroprotective effects against neurodegenerative processes. However, since the molecular signaling mechanisms governing these effects are not well clarified, we evaluated quercetin's effect on the neuroprotective signaling events in dopaminergic neuronal models and further tested its efficacy in the MitoPark transgenic mouse model of Parkinson's disease (PD). Western blot analysis revealed that quercetin significantly induced the activation of two major cell survival kinases, protein kinase D1 (PKD1) and Akt inMN9D dopaminergic neuronal cells. Furthermore, pharmacological inhibition or siRNAknockdown ofPKD1 blocked the activation of Akt, suggesting thatPKD1 acts as an upstream regulator of Akt in quercetin‐mediated neuroprotective signaling. Quercetin also enhanced cAMP response‐element binding protein phosphorylation and expression of the cAMP response‐element binding protein target gene brain‐derived neurotrophic factor. Results fromqRT‐PCR, Western blot analysis, mtDNAcontent analysis, and MitoTracker assay experiments revealed that quercetin augmented mitochondrial biogenesis. Quercetin also increased mitochondrial bioenergetics capacity and protectedMN9D cells against 6‐hydroxydopamine‐induced neurotoxicity. To further evaluate the neuroprotective efficacy of quercetin against the mitochondrial dysfunction underlyingPD, we used the progressive dopaminergic neurodegenerative MitoPark transgenic mouse model ofPD. Oral administration of quercetin significantly reversed behavioral deficits, striatal dopamine depletion, andTHneuronal cell loss in MitoPark mice. Together, our findings demonstrate that quercetin activates thePKD1‐Akt cell survival signaling axis and suggest that further exploration of quercetin as a promising neuroprotective agent for treatingPDmay offer clinical benefits.image
Contrast‐induced nephropathy in patients undergoing endovascular peripheral vascular intervention: Incidence, risk factors, and outcomes as observed in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium
Authors: Grossman P. Michael , Ali Syed S. , Aronow Herbert D. , Boros Michael , Nypaver Timothy J. , Schreiber Theodore L. , Park Yeo Jung , Henke Peter K. , Gurm Hitinder S. 
Published: April 2017

BackgroundThe incidence, risk factors, and outcomes associated with Contrast‐induced nephropathy (CIN) after Percutaneous Vascular Intervention (PVI) in contemporary medical practice are largely unknown.MethodsA total of 13 126 patients undergoing PVI were included in the analysis. CIN was defined as an increase in serum creatinine from pre‐PVI baseline to post‐PVI peak Cr of ≥0.5 mg/dL.ResultsCIN occurred in 3% (400 patients) of the cohort, and 26 patients (6.5%) required dialysis. Independent predictors of CIN were high and low body weight, diabetes, heart failure, anemia, baseline renal dysfunction, critical limb ischemia, and a higher acuity of the PVI procedure and a contrast dose that was greater than three times the calculated creatinine clearance (CCC) (adjusted OR 1.4, 95% CI: 1.1‐1.8, P = 0.003). CIN was strongly associated with adverse outcome including in‐hospital death (adjusted OR 18.1, CI 10.7‐30.6, P < 0.001), myocardial infarction (adjusted OR 16.2, CI 8.9‐29.5, P < 0.001), transient ischemic attack/stroke (adjusted OR 5.5, CI 3.2‐14.9, P = 0.001), vascular access complications (adjusted OR 3.4, CI 2.3‐5, P < 0.001), and transfusion (adjusted OR 7, CI 5.4‐9, P < 0.001). Hospital stay was longer in patients who developed CIN versus those who did not.ConclusionsCIN is not an uncommon complication associated with PVI, can be reliably predicted from pre‐procedural variables, including a contrast dose of greater than three times the CCC and is strongly associated with the risk of in‐hospital death, MI, stroke, transfusion, and increased hospital length of stay.
Why do people stay in or leave Fukushima?
Authors: Horie Shinya , Managi Shunsuke 
Published: April 2017

AbstractFrom the originally constructed survey data from 2011 Fukushima incident, this paper empirically assessed the sources of failures in disaster risk mitigation in short run. Although residential relocation from the cites at risk is one of the effective risk reduction measures, the relocation incurs mobility costs of developing social capital such as communities or searching public services such as education and medical institutions. The estimation results showed that the residents in the disaster cites of 2011 Fukushima incident can tolerate higher risks of radiation exposure when they have attachment to the original residence or higher demands for the public services, and can stay in the cites at risks consequently. Because the tolerance level can depend on the information associated with the risks, the results imply that the authorities’ providing the correct information is one of the keys for the disaster risk reduction in short run.
Glucose‐6‐phosphate dehydrogenase (G6PD)‐deficient infants: Enzyme activity and gene variants as risk factors for phototherapy in the first week of life
Authors: Wong Fei‐Liang , Ithnin Azlin , Othman Ainoon , Cheah Fook‐Choe 
Published: April 2017

AimGlucose‐6‐phosphate dehydrogenase (G6PD) deficiency is a recognised cause of severe neonatal hyperbilirubinaemia, and identifying which infants are at risk could optimise care and resources. In this study, we determined if G6PD enzyme activity (EA) and certain gene variants were associated with neonatal hyperbilirubinaemia requiring phototherapy during the first week after birth.MethodsNewborn infants with G6PD deficiency and a group with normal results obtained by the fluorescent spot test were selected for analyses of G6PD EA and the 10 commonly encountered G6PD mutations in this region, relating these with whether the infants required phototherapy before discharge from the hospital in the first week.ResultsA total of 222 infants with mean gestation and birth weight of 38.3 ± 1.8 weeks and 3.02 ± 0.48 kg, respectively, were enrolled. Of these, n = 121 were deficient with EA ≤6.76 U/g Hb, and approximately half (43%) received phototherapy in the first week after birth. The mean EA level was 3.7 U/g Hb. The EA had good accuracy in predicting phototherapy use, with area under the receiver‐operating‐characteristic curve of 0.81 ± 0.05. Infants on phototherapy more commonly displayed World Health Organization Class II mutations (<10% residual EA). Logistic regression analysis showed that deficiency in EA and mutation at c.1388G>A (adjusted odds ratio, 1.5 and 5.7; 95% confidence interval: 1.31–1.76 and 1.30–25.0, respectively) were independent risk factors for phototherapy.ConclusionLow G6PD EA (<6.76 U/g Hb) and the G6PD gene variant, c.1388G>A, are risk factors for the need of phototherapy in newborn infants during the first week after birth.
Chloroplast overexpression of rice caffeic acid O‐methyltransferase increases melatonin production in chloroplasts via the 5‐methoxytryptamine pathway in transgenic rice plants
Authors: Choi Geun‐Hee , Lee Hyoung Yool , Back Kyoungwhan 
Published: April 2017

AbstractRecent analyses of the enzymatic features of various melatonin biosynthetic genes from bacteria, animals, and plants have led to the hypothesis that melatonin could be synthesized via the 5‐methoxytryptamine (5‐MT) pathway. 5‐MT is known to be synthesized in vitro from serotonin by the enzymatic action of O‐methyltransferases, including N‐acetylserotonin methyltransferase (ASMT) and caffeic acid O‐methyltransferase (COMT), leading to melatonin synthesis by the subsequent enzymatic reaction with serotonin N‐acetyltransferase (SNAT). Here, we show that 5‐MT was produced and served as a precursor for melatonin synthesis in plants. When rice seedlings were challenged with senescence treatment, 5‐MT levels and melatonin production were increased in transgenic rice seedlings overexpressing the rice COMT in chloroplasts, while no such increases were observed in wild‐type or transgenic seedlings overexpressing the rice COMT in the cytosol, suggesting a 5‐MT transport limitation from the cytosol to chloroplasts. In contrast, cadmium treatment led to results different from those in senescence. The enhanced melatonin production was not observed in the chloroplast COMT lines relative over the cytosol COMT lines although 5‐MT levels were equally induced in all genotypes upon cadmium treatment. The transgenic seedlings with enhanced melatonin in their chloroplasts exhibited improved seedling growth vs the wild type under continuous light conditions. This is the first report describing enhanced melatonin production in chloroplasts via the 5‐MT pathway with the ectopic overexpression of COMT in chloroplasts in plants.
Clinical Characteristics of Adult Dogs More Than 5 Years of Age at Presentation for Patent Ductus Arteriosus
Authors: Boutet B.G. , Saunders A.B. , Gordon S.G. 
Published: April 2017

BackgroundThe median age at presentation for dogs with patent ductus arteriosus (PDA) is <6 months of age, and closure is associated with a decrease in heart size and increased survival time, which are not well described in older dogs.ObjectivesTo describe the clinical characteristics of dogs withPDA≥5 years of age at the time of presentation to a veterinary referral hospital.Animals35 client‐owned dogs.MethodsRetrospective case series.ResultsPDAwas diagnosed at a median age of 7.4 years (range, 5.1–12.3 years). Females represented 23/35 (65.7%) of the patients. Concurrent heart disease included degenerative mitral valve disease (DMVD; 13), arrhythmias (11), pulmonary hypertension (7), and other congenital defects (2). Cardiomegaly was documented in the majority of dogs consisting of left ventricular enlargement (91%) and left atrial enlargement (86%). Median vertebral heart size in 24 dogs was 12.9 (range, 10.7–18.2). ThePDAshunt direction was left‐to‐right in 33 and bidirectional in 2 dogs. Closure was performed in 26 dogs, including 4 with pulmonary hypertension. In 10 dogs receiving furosemide pre‐operatively for management of heart failure, furosemide was discontinued (8) or the dosage decreased (2) at the time of discharge.Conclusions and Clinical ImportanceAdult dogs can present with a left‐to‐right shuntingPDAthat results in cardiomegaly and clinical signs that can improve or resolve withPDAclosure. This improvement is also apparent in dogs withPDAcomplicated byDMVD. Pulmonary hypertension that does not result in complete right‐to‐left shunting should not be considered a contraindication to closure.
Prognostic Factors Associated with Recovery of Ambulation and Urinary Continence in Dogs with Acute Lumbosacral Spinal Cord Injury
Authors: Shaw T.A. , De Risio L. , Laws E.J. , Rose J.H. , Harcourt‐Brown T.R. , Granger N. 
Published: April 2017

BackgroundLimited information is available about prognostic factors for recovery after spinal cord injury (SCI) to the L4‐S3 segments. Previous research suggests that L4‐S3 SCI does not have a worse prognosis than T3‐L3 SCI.Hypothesis/ObjectivesTo elucidate prognostic factors for regaining urinary continence and ambulation in dogs with L4‐S3 SCI and compare prognosis to T3‐L3 SCI.Animals/MethodsA retrospective study on 61 nonambulatory dogs with L4‐S3 SCI, matched to dogs with T3‐L3 SCI, compared 3 weeks after onset. Prognostic factors explored using logistic regression and used for matching: nonchondrodystrophic dogs >15 kg versus dogs that were chondrodystrophic or <15 kg; compressive versus noncompressive lesions; presence versus absence of conscious pain perception (CPP); and lower vs upper motor neuron (LMN/UMN) incontinence.ResultsFewer L4‐S3 dogs regained continence compared to T3‐L3 dogs (64 vs 85%, P = .0033), but no difference existed for regaining ambulation (66 vs 75%, P = .1306). In L4‐S3 SCI dogs, fewer dogs regained continence with loss of CPP (P < .001), LMN incontinence (P = .004), and noncompressive lesions (P = .006). Negative prognostic factors for regaining ambulation included absent CPP (P < .001) and large nonchondrodystrophic breed (P = .022).Conclusions and Clinical ImportanceDogs with L4‐S3 SCI have a poorer short‐term prognosis than do dogs with T3‐L3 SCI. Dogs with L4‐S3 SCI had a poor prognosis with loss of CPP, or noncompressive lesions combined with LMN incontinence. Small‐breed or chondrodystrophic dogs with retained CPP, compressive lesions, and UMN incontinence had an excellent prognosis. These findings may help guide decision‐making in L4‐S3 SCI.
Prognostic implication of left atrial sphericity in atrial fibrillation patients undergoing radiofrequency catheter ablation
Authors: Moon Jeonggeun , Lee Hye‐Jeong , Yu Jongwook , Pak Hui‐Nam , Ha Jong‐Won , Lee Moon‐Hyoung , Kim Young Jin , Joung Boyoung 
Published: April 2017

AbstractBackgroundLeft atrial (LA) sphericity can predict recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA). We sought to reconfirm the prognostic role of atrial sphericity after RFCA of atrial fibrillation (AF), assess any relationship between the atrial pressure and sphericity, and determine the characteristics of the patients for whom atrial sphericity was most highly predictive.MethodsAll 148 nonvalvular AF patients (57 ± 11 years, 121 men, 95 paroxysmal AF [PaAF]) who underwent RFCA were enrolled. The LA volume (LAV) was determined and LA sphericity assessed from three‐dimensional computed tomographic images. The preprocedural mean LA pressure (mLAP) was measured.ResultsAfter a 3‐month blanking period, AF/atrial tachycardia (AT) recurrences within 1 year were documented in 38 patients (26%). Patients with recurrence had a greater LAV (124 ± 35 mL vs 151 ± 45 mL, P < 0.001) and LA sphericity (0.669 ± 0.040 vs 0.684 ± 0.038, P = 0.041). In patients with smaller LAs (LAV < 125 mL), LA sphericity predicted AF/AT recurrences (odds ratio [OR]: 1.030 [for each 0.001 increase], 95% confidence interval [CI]: 1.008–1.053, P = 0.007), whereas the LAV did not. In patients with larger LAs (LAV ≥ 125 mL), the LAV could predict recurrence (OR: 1.021, 95% CI: 1.001–1.041, P = 0.036), while the LA sphericity could not. The LA sphericity and mLAP are linearly correlated (r = 0.345, P < 0.022) in persistent AF, but not PaAF.ConclusionsLA spherical change precedes severe LA enlargement in AF. It predicts 1‐year AF/AT recurrence after RFCA and is more important than the LA size in patients with less severe LA enlargement.