bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health‐Related Quality of Life at Admission Is Associated with Postdischarge Mortality, Functional Decline, and Institutionalization in Acutely Hospitalized Older Medical Patients
Authors: Parlevliet Juliette L. , MacNeil‐Vroomen Janet , Buurman Bianca M. , de Rooij Sophia E. , Bosmans Judith E. 
Published: April 2016

ObjectivesTo assess the independent association between health‐related quality of life (HRQOL) at admission and mortality, functional decline, and institutionalization 3 and 12 months after admission in acutely hospitalized older adults.DesignPost hoc analysis of data from prospective cohort study, 2006 to 2009, 12‐month follow‐up.SettingEleven medical wards in three hospitals in the Netherlands.ParticipantsMedical patients aged 65 and older acutely hospitalized for 48 hours or longer (N = 473).MeasurementsOutcomes: mortality, functional decline, and institutionalization, 3 and 12 months after admission. Main determinant was HRQOL (utility based on the EuroQol‐5D at admission, reflecting the relative desirability of a particular health state and is measured on a scale from 0 (death) to 1 (full health). Some health states are regarded as being worse than death, resulting in negative utilities, with a minimum of −0.330). Participants were split into two groups based on median utility at admission. Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using Cox and logistic regression analyses, adjusted for sociodemographic and health variables.ResultsMedian utility was 0.775 (interquartile range 0.399–0.861). Utility greater than 0.775, indicating high HRQOL, was associated with lower risk of mortality (hazard ratio = 0.38, 95% CI = 0.18–0.83) and functional decline (OR = 0.47, 95% CI = 0.28–0.79) at 3 months in the adjusted models. At 12 months, these associations were statistically significant in the crude models but not in the adjusted models. Utility was not associated with risk of institutionalization at 3 or 12 months.ConclusionHigher HRQOL at admission was associated with lower risk of mortality and functional decline 3 months after admission. In older, acutely hospitalized individuals, the EQ‐5D may provide a means of risk stratification and may ultimately guide individuals, their families, and professionals in treatment decisions during hospitalization.
Frailty Screening in Low‐ and Middle‐Income Countries: A Systematic Review
Authors: Gray William K. , Richardson Jenny , McGuire Jackie , Dewhurst Felicity , Elder Vasanthi , Weeks Julie , Walker Richard W. , Dotchin Catherine L. 
Published: April 2016

ObjectivesTo conduct a systematic review of frailty screening tools used in low‐ and middle‐income countries (LMICs).DesignSystematic review.SettingLMICs, as defined by the World Bank on June 30, 2014.ParticipantsElderly adults (as defined by the authors) living in LMICs.MeasurementsStudies were included if the population under consideration lived in a LMIC, the study involved an assessment of frailty, the study population was elderly adults, and the full text of the study was available in English. The Medline, Embase, CINAHL and PsychINFO databases were searched up to June 30, 2014.ResultsSeventy studies with data from 22 LMICs were included in the review. Brazil, Mexico, and China provided data for 60 of the 70 studies (85.7%), and 15 countries contributed data to only one study. Thirty‐six studies used the Fried criteria to assess frailty, 20 used a Frailty Index, and eight used the Edmonton Frailty Scale; none of the assessment tools used had been fully validated for use in a LMIC.ConclusionThere has been a rapid increase in the number of published studies of frailty in LMICs over the last 5 years. Further validation of the assessment tools used to identify frail elderly people in LMICs is needed if they are to be efficient in identifying those most in need of health care in such settings.
Using ‘candidacy’ as a framework for understanding access to mainstream psychological treatment for people with intellectual disabilities and common mental health problems within the English Improving Access to Psychological Therapies service
Authors: Chinn D. , Abraham E. 
Published: April 2016

AbstractBackgroundThe Improving Access to Psychological Therapies (IAPT) service was established to address common mental health problems among the English population in a timely manner in order to counter the social and economic disadvantage accompanying such difficulties. Using the concept of candidacy, we examined how the legitimacy of claims by people with intellectual disabilities to use this service is facilitated or impeded.MethodWe used a sequential mixed methods design. We completed 21 interviews with a range of stakeholders, including people with intellectual disabilities and their carers. Themes from the interviews were used to design an online survey questionnaire that was returned by 452 staff from IAPT and specialist intellectual disability services.ResultsUsing the candidacy framework, we noted that eligibility and access to IAPT were achieved through dynamic and iterative processes of negotiation involving people with intellectual disabilities and their supporters on one side and IAPT staff and service structures on the other. Barriers and facilitators were apparent throughout the seven dimensions of candidacy (identification, navigation, permeability of services, appearances, adjudications, offers and resistance and operating conditions) and were linked to discourses relating to the character and purpose of IAPT and specialist intellectual disability services.ConclusionsOpportunities exist for some people with intellectual disabilities to assert their candidacy for IAPT input, although there are barriers at individual, professional, organisational and structural levels. More attention needs to be paid to how principles of inclusiveness are operationalised within IAPT teams and to the mental health facilitation role of specialist intellectual disability staff.
Impact of reassurance on pain perception in patients with primary burning mouth syndrome
Authors: Brailo V , Firić M , Vučićević Boras V , Andabak Rogulj A , Krstevski I , Alajbeg I 
Published: April 2016

ObjectivesIn spite of extensive research, no effective treatment of primary burning mouth syndrome (BMS) still exists. The aim of this study was to determine the impact of informative intervention/reassurance on pain perception and quality of life in patients with primary BMS.Materials and MethodsInformative intervention/reassurance was undertaken in 28 patients diagnosed with primary BMS. Patients received information about all aspects of BMS verbally and in an informative leaflet. Numerical scale (0–10), Pain Catastrophizing Scale and Oral Health Impact Profile‐14 (OHIP‐14) were used to assess pain intensity, pain perception, and quality of life before the intervention and 6 months after. No other treatment was given to the patients.ResultsSignificant reduction in symptom intensity, pain catastrophizing along with positive increase in the quality of life compared with baseline, was observed on a follow‐up examination 6 months after the informative intervention (P < 0.001).ConclusionsThe results of this study confirm that objective informing/reassurance of patients with primary BMS can result in decreased catastrophizing and improvement in the quality of life. By eliminating/changing negative patterns of behavior, a reduction in symptoms comparable with pharmacological treatment can be achieved.
Local allergic rhinitis: A critical reappraisal from a paediatric perspective
Authors: Arasi Stefania , Pajno Giovanni Battista , Lau Susanne , Matricardi Paolo Maria 
Published: April 2016

AbstractThe so‐called local allergic rhinitis (LAR) has been proposed as a phenotype of rhinitis with Th2‐driven prominent local allergic inflammation, nasal synthesis of specific IgE and a positive response to a nasal allergen provocation test, in the absence of ‘systemic’ atopy (negative skin prick test and serum allergen‐specific IgE antibodies). To date, available data on LAR are mostly focused on adults. The purpose of this ‘Rostrum’ was to critically discuss data and implications of the ‘LAR concept’ in paediatrics. In the natural history of rhinitis due to IgE‐mediated reactions triggered by exposure to allergens, a ‘LAR’ can be either the initial, transient stage of classical allergic rhinitis or a stable phenotype never evolving to ‘systemic’ IgE sensitization. Given the present difficulties in performing routinely nasal allergen provocation test in children, the development of sensitive and specific tests to detect IgE in the child's nasal secretions is a research priority. We suggest also the hypothetical role of allergen immunoprophylaxis or immunotherapy in LAR. Last, the term ‘local allergic rhinitis’ may be inappropriate, as rhinitis is always ‘local’, while IgE sensitization can be either ‘local’ or ‘systemic’.
Serology and longevity of immunity against Echinococcus granulosus in sheep and llama induced by an oil‐based EG95 vaccine
Authors: Poggio T. V. , Jensen O. , Mossello M. , Iriarte J. , Avila H. G. , Gertiser M. L. , Serafino J. J. , Romero S. , Echenique M. A. , Dominguez D. E. , Barrios J. R. , Heath D. 
Published: April 2016

SummaryAn oil‐based formulation of the EG95 vaccine to protect grazing animals against infection with Echinococcus granulosus was formulated in Argentina. The efficacy of the vaccine was monitored by serology in sheep and llama (Lama glama) and was compared to the serology in sheep previously published using a QuilA‐adjuvanted vaccine. Long‐term efficacy was also tested in sheep by challenging with E. granulosus eggs of the G1 strain 4 years after the beginning of the trial. The serological results for both sheep and llama were similar to those described previously, except that there was a more rapid response after the first vaccination. A third vaccination given after 1 year resulted in a transient boost in serology that lasted for about 12 months, which was similar to results previously described. Sheep challenged after 4 years with three vaccinations presented 84·2% reduction of live cysts counts compared with control group, and after a fourth vaccination prior to challenge, this reduction was 94·7%. The oil‐based vaccine appeared to be bio‐equivalent to the QuilA vaccine.
Effects of Interferon‐Tau and Steroids on Cytochrome P450 Activity in Bovine Endometrial Epithelial Cells
Authors: Gilfeather CL , Lemley CO 
Published: April 2016

ContentsThe objective of the current study was to examine cyclooxygenase (COX), cytochrome P450 1A (CYP1A) and 2C (CYP2C) activity in bovine endometrial cell cultures following exposure to oxytocin (OT), interferon‐τ (IFN), estradiol (E2) and/or progesterone (P4). Bovine endometrial epithelial cells were treated with OT, IFN, a combination of OT+IFN or control (CON) media for 24 h. For the second experiment, cells were treated with E2, P4, a combination of E2 + P4 or CON media for 24 h. Treatments were performed in triplicate, and the experiment was repeated four times (n = 12 per treatment). Treatment with OT alone increased (p < 0.01) activity of COX compared with CON; however, OT alone did not alter activity of CYP1A (p = 0.55) or CYP2C (p = 0.46) compared with CON. Activity of CYP1A and CYP2C was decreased in cells exposed to IFN (p < 0.01) or OT+IFN (p < 0.01) compared with CON. Treatment with E2 alone did not alter activity of CYP1A (p = 0.64) or CYP2C (p = 0.06) compared with CON. Activity of CYP1A and CYP2C was decreased (p < 0.01) in P4 vs CON. In summary, IFN exposure, irrespective of OT treatment, decreased the activity of CYP1A and CYP2C. Activity of CYP1A was decreased following P4 treatment alone, while that of CYP2C was decreased following both P4 and E2 + P4 treatment. The mixed function monooxygenase enzymes, CYP1A and CYP2C, have been implicated in synthesizing embryotoxic compounds; therefore, downregulation in the endometrium may be necessary during maternal recognition of pregnancy.
Oligomerization of Mannan‐binding Lectin Dictates Binding Properties and Complement Activation
Authors: Kjaer T. R. , Jensen L. , Hansen A. , Dani R. , Jensenius J. C. , Dobó J. , Gál P. , Thiel S. 
Published: April 2016

AbstractThe complement system is a part of the innate immune system and is involved in recognition and clearance of pathogens and altered‐self structures. The lectin pathway of the complement system is initiated when soluble pattern recognition molecules (PRMs) with collagen‐like regions bind to foreign or altered self‐surfaces. Associated with the collagen‐like stems of these PRMs are three mannan‐binding lectin (MBL)‐associated serine proteases (MASPs) and two MBL‐associated proteins (MAps). The most studied of the PRMs, MBL, is present in serum mainly as trimeric and tetrameric oligomers of the structural subunit. We hypothesized that oligomerization of MBL may influence both the potential to bind to micro organisms and the interaction with the MASPs and MAps, thus influencing the ability to initiate complement activation. When testing binding at 37 °C, we found higher binding of tetrameric MBL to Staphylococcus aureus (S. aureus) than trimeric and dimeric MBL. In serum, we found that tetrameric MBL was the main oligomeric form present in complexes with the MASPs and MAp44. Such preference was confirmed using purified forms of recombinant MBL (rMBL) oligomers, where tetrameric rMBL interacted stronger with all of the MASPs and MAp44, compared to trimeric MBL. As a direct consequence of the weaker interaction with the MASPs, we found that trimeric rMBL was inferior to tetrameric rMBL in activating the complement system. Our data suggest that the oligomeric state of MBL is crucial both for the binding properties and the effector function of MBL.
VH and VL Domains of Polyspecific IgM and Monospecific IgG Antibodies Contribute Differentially to Antigen Recognition and Virus Neutralization Functions
Authors: Pasman Y. , Kaushik A. K. 
Published: April 2016

AbstractWe analysed contributions of variable heavy (FdVH) and variable light (FdVL) domains in comparison to scFv (FdVH+FdVL) of naturally occurring polyspecific bovine IgM with an exceptionally long CDR3H and an induced monospecific bovine herpes virus‐1 (BoHV‐1) neutralizing IgG1 antibody in the context of to antigen‐binding site and antibody function. Various recombinant FdVH, FdVL and scFv were constructed and expressed in Pichia pastoris from the bovine IgM and IgG1 antibody encoding cDNA. The scFv1H12 showed polyspecific antigen binding similar to parent IgM antibody, though subtle differences, for example, higher thyroglobulin recognition. Such differences reflect influence of the constant region on the antigen‐binding site configuration. Unlike, variable light domain FdVL1H12, the variable heavy domain FdVH1H12 alone recognized multiple antigens that differed from the recognition pattern of scFv1H12 (FdVH+FdVL) and the parent IgM antibody. Nonetheless, role of FdVL1H12 in providing structural support to FdVH in antigen recognition is noted, apart from its intrinsic antigen recognition ability. Surface plasmon resonance analysis revealed low to moderate affinity of scFv1H12 to IgG antigen. By contrast, the individual FdVH073 and FdVL074, originating from induced BoHV‐1 neutralizing IgG1 antibody, recognized target epitope on BoHV‐1 weakly when compared to FdVH+FdVL (scFv3‐18L). Interestingly, both the FdVH and FdVL domains of induced IgG antibody are required to achieve BoHV‐1 neutralization. To conclude, there exist subtle functional differences in the contribution of FdVH and FdVL to antigen‐binding site generation of polyspecific IgM and monospecific IgG antibodies relevant to antigen recognition and virus neutralization functions.
Income Poverty and Multiple Deprivations in a High‐Income Country: The Case of the United States*
Authors: Mitra Sophie , Brucker Debra L. 
Published: April 2016

ObjectivesThe objective of this study is to develop a measure of multiple deprivations for the United States that is similar to those used on the international stage as multidimensional poverty. The latter is understood broadly as a deprivation of well‐being across multiple dimensions rather than purely as a lack of income or other financial resources.MethodsUsing Current Population Survey and American Community Survey data, this study develops a measure of the joint distribution of multiple deprivations in the United States, in other words, a measure of the extent to which different deprivations are experienced by the same individuals.ResultsThe experience of multiple deprivations affects 15 percent of Americans. An estimated 17.1 million Americans, 5.5 percent of the population, experience multiple deprivations while they are not income poor. The odds of experiencing multiple deprivations are significantly higher for Hispanics, immigrants, and persons with disabilities.ConclusionsIncome poverty is not a reliable proxy to measure multiple deprivations. Further measurement efforts are needed on overlapping multiple deprivations in the United States as such measures can be used in policy evaluation and monitoring.
Population Ethics and Different‐Number‐Based Imprecision
Authors: Arrhenius Gustaf 
Published: April 2016

AbstractRecently, in his Rolf Schock Prize Lecture, Derek Parfit has suggested a novel way of avoiding the Repugnant Conclusion by introducing what he calls “imprecision” in value comparisons. He suggests that in a range of important cases, populations of different sizes are only imprecisely comparable. Parfit suggests that this feature of value comparisons opens up a way of avoiding the Repugnant Conclusion without implying other counterintuitive conclusions, and thus solves one of the major challenges in ethics. In this article, I try to clarify Parfit's proposal and evaluate whether it will help us with the paradoxes in population ethics.
Blood donation in Guangdong Province, China, from 2006–2014
Authors: Ou‐Yang J. , Bei C‐H. 
Published: April 2016

SUMMARYObjectiveTo explore the trends in blood collection from 2006 to 2014 in Guangdong, China.BackgroundAlthough the Blood Donation Law of the People's Republic of China was implemented in 1998, voluntary non‐remunerated blood donation (VNRBD) has been promoted fully for only a decade. The provincial and local governments of Guangdong, one of the most well‐developed provinces in China, have promoted blood donation by various means.Material and methodsOfficial data on blood donation from 2006 to 2014, including the number of blood donations and the family replacement/mutual blood donation (FRMBD) rate, were collected from all blood collection and supply institutions in Guangdong. These data were analysed to explore trends in blood donation in Guangdong Province, and to detect differences among the province's four regions.ResultsThe number of blood donations in Guangdong increased by 38·23% from 2006 to 2014; overall, the rate increased annually, although it fluctuated in the eastern region. Family replacement/mutual whole blood and platelet donation rates decreased dramatically from 2006 to 2014 (from 39·99% to 20·16% and from 64·15% to 26·51%, respectively), but remained high. Marked disparities in blood donation development were detected among the four regions.DiscussionsWith nearly a decade of efforts, blood donation in Guangdong has developed rapidly and sustainably. All blood collection and supply institutions must strengthen efforts to improve awareness of blood donation among the population, retain repeat and regular donors and reduce the rate of FRMBD in favor of the development of VNRBD.
“Blood failure” time to view blood as an organ: how oxygen debt contributes to blood failure and its implications for remote damage control resuscitation
Authors: Bjerkvig Christopher K. , Strandenes Geir , Eliassen Håkon S. , Spinella Philip C. , Fosse Theodor K. , Cap Andrew P. , Ward Kevin R. 
Published: April 2016

Hemorrhagic shock is both a local and systemic disorder. In the context of systemic effects, blood loss may lead to levels of reduced oxygen delivery (DO2) sufficient to cause tissue ischemia. Similar to other physiologic debts such as sleep, it is not possible to incur a significant oxygen debt and suffer no consequences for lack of timely repayment.While the linkage between oxygen debt and traditional organ failure (renal, hepatic, lung, and circulation) has been long recognized, we should consider failure in two additional linked and very dynamic organ systems, the endothelium and blood. These systems are very sensitive to oxygen debt and at risk for failing, having further implications on all other organ systems. The degree of damage to the endothelium is largely modulated by the degree of oxygen debt. Thus hypoperfusion is believed to begin a cascade of events leading to acute traumatic coagulopathy (ATC). This combination of oxygen debt driven endothelial damage and ATC might be considered collectively as “blood failure” due to the highly connected networks between these drivers.This article presents the implications of oxygen debt for remote damage control resuscitation strategies, such as permissive hypotension and hemostatic resuscitation. We review the impact of whole blood resuscitation and red blood cell efficacy in mitigation of oxygen debt.At last, this article recognizes the need for simple and durable, lightweight equipment that can detect the adequacy of tissue DO2 and thus patient needs for resuscitative care.Point‐of‐care lactate measuring may be a predictive tool for identifying high‐risk trauma patients and occult shock because it provides information beyond that of vital signs and mechanism of injury as it may help predict the level of oxygen debt accumulation and need for resuscitation. Serial measurements may also be valuable as a tool in guiding resuscitative efforts.
Labour Demand, Offshoring and Inshoring: Evidence from Swedish Firm‐level Data
Authors: Andersson Linda , Karpaty Patrik , Savsin Selen 
Published: April 2016

AbstractThe objective of this paper was to analyse effects on firm–level relative demand for skilled labour due to imports of intermediates (offshoring) and exports of intermediates (inshoring). The study is based on a data set of Swedish manufacturing firms, 1997–2002, using trade flows in intermediate goods and services, respectively. Descriptive data show that goods inshoring is much larger than goods offshoring, while the reverse is true for services. There is, however, a strong increase in services inshoring over the study period. Controlling for potential endogeneity in offshoring and inshoring, our results indicate that there is a positive effect of services offshoring on the skill composition of workers in Swedish firms, while no such causality can be established from inshoring.