bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast cancer and screening in persons with an intellectual disability living in institutions in France
Authors: Trétarre B. , Bourgarel S. , Stoebner‐Delbarre A. , Jacot W. , Bessaoud F. , Satge D. 
Published: September 2016

AbstractBackgroundWe aimed to describe, among a population of women with intellectual disabilities (ID) living in institutions in France, the characteristics in whom breast cancer (BC) was diagnosed and of those who participated in BC screening.MethodsStudy was performed in 2009 among a random, representative sample of women with ID living in institutions in France. Participants answered a questionnaire either directly by themselves, or with the help of an intermediary.ResultsIn total, 978 women with ID aged over 18 years were included, and 14 were diagnosed with BC. The incidence observed in this sample of women with ID is similar to that of the general population (standardised incidence ratio, SIR 0.857, 95% confidence interval (CI) 0.42–1.53). Average age at diagnosis was 47.8 years, and the risk of developing BC before the age of 50 was 2.03% (0.4–3.66). This risk was not significantly different from that of the general population (2.4%, 1.0–3.78). Obesity was almost twice as frequent in women who had BC as compared to those without BC (43% vs. 22.5%, P = 0.0196). Among the 310 women aged >50 years and eligible for the national BC screening programme, 238 (77%) had already had at least one mammogram, and 199 had had it within the previous 2 years. Adherence to the screening programme was 64.2% (199/310) in the participating institutions. This rate was slightly higher than the national average of 62% for the same period.ConclusionsThe results of this study show that BC is equally as frequent among women with ID living in institutions as in the general population, and occurs at around the same age. Obesity was significantly more frequent among women in whom BC was diagnosed in our study. Participation in BC screening is slightly higher among women with ID living in institutions than among the general population.
Continence care for people with dementia living at home in Europe: a review of literature with a focus on problems and challenges
Authors: Gove Dianne , Scerri Anthony , Georges Jean , van Houten Paul , Huige Nicole , Hayder‐Beichel Daniela , Leichsenring Kai , Morris Vikky Christina 
Published: September 2016

Aims and objectivesTo report the findings of a review of literature relating to the continence care of community‐dwelling people with dementia in Europe.BackgroundMore than two‐thirds of people with dementia live at home, and many experience continence problems. Incontinence is a significant contributor towards institutionalisation. Care and support is often inadequate or inappropriate, and guidelines are lacking. This represents a failure to respect the human rights and dignity of this group.DesignA structured review of the literature relating to the continence care of community‐dwelling people with dementia in Europe with a focus on problems and challenges.MethodsSearch terms reflecting dementia, continence, care/management and guidelines for community‐dwelling people with dementia were applied to four databases. Hand‐searching was also carried out. A total of 208 articles were searched for content relating to problems and challenges linked to continence care for this group.ResultsSix relevant articles were fully reviewed. The main difficulties and challenges included the following: (1) perceptions, (2) availability/provision of support and care, (3) financial cost, (4) mobility and the environment, (5) relationships and social inclusion and (6) emotional issues.ConclusionDementia and incontinence have profound effects on quality of life. The dearth of good quality data within this area and the findings of the review confirm the need for expert, consensus‐based guidelines and appropriate research to ensure that the rights and dignity of people with dementia are respected.Relevance to clinical practiceThe findings of the review will hopefully raise awareness amongst healthcare professionals in community practice of unmet needs of people with dementia and continence problems, and their caregivers, especially those related to social, financial, emotional and relational issues. The review does not provide solutions or guidance but is helpful in highlighting some of the key areas where special attention is needed.
Validation of the optimal site in the neck region for detecting swallowing sounds
Authors: Pan Q. , Maeda N. , Manda Y. , Kodama N. , Minagi S. 
Published: September 2016

SummaryRecently, the swallowing sound has been used to detect swallowing events non‐invasively. A previous study, using an accelerometer, showed that the site over the lateral border of the trachea immediately inferior to the cricoid cartilage was the optimal site for detecting swallowing sounds. However, the optimal site for detection of the swallowing sound using a microphone remains undetermined. To validate the optimal site in the neck region for detecting swallowing sounds. Fourteen healthy subjects (mean age, 27·6 ± 2·2 years; seven male and seven female) participated in this study. Twenty condenser microphones were attached to 20 sites on the left neck surface to detect swallowing sounds. Participants were instructed to swallow five different stimuli three times as follows: Resting saliva, 1 and 5 mL of Japanese tea, and 1 and 5 mL of yoghurt. Mean relative peak intensity was used to indicate the magnitude of the swallowing sound. Sound spectrograms were used to illustrate differences in the properties of swallowing sounds. Mean relative peak intensity number was highest in sites at the inferior border of the mandible just above the sternocleidomastoid muscle (site 11) and sites over the lateral border of the trachea immediately inferior to the cricoid cartilage (site 8). Comparison of spectrograms showed a greater density distribution of higher frequency components at site 11 compared with site 8. These results indicate that the inferior border of the mandible just above the sternocleidomastoid muscle is the optimal site for the detection of swallowing sounds.
FACTOR ACCUMULATION, EXTERNALITIES, AND ABSORPTIVE CAPACITY IN REGIONAL GROWTH: EVIDENCE FROM EUROPE
Authors: Jung Juan , López‐Bazo Enrique 
Published: September 2016

ABSTRACTThis paper proposes a model that incorporates capital accumulation and spatial spillovers across economies, while allowing for regional differences in absorptive capacity. This model is estimated using a sample of EU regions, over a period including the enlargement of the single‐market area in the middle of the first decade of the 21st century. Results confirm the relevance of local absorptive capacity that is directly linked with the process of making the most of externalities. Capital deepening reduced the role of capital in explaining the regional productivity gap, but was not enough to help lagging regions to equal the return to human capital investments reached by most advanced regions.
Attachment and perceived stress in patients with ulcerative colitis, a case–control study
Authors: Agostini Alessandro , Spuri Fornarini Giulia , Ercolani Mauro , Campieri Massimo 
Published: September 2016

Accessible summaryWhat is known on the subject?

Ulcerative colitis (UC) is a chronic inflammatory disorder associated with high perceived psychological stress.

The attachment theory provides a psychodynamic perspective to investigate the relationship between close interpersonal relationships and stress in UC.

Researchers have hypothesized that the chronic illness might affect personality trait as the attachment style of patients.

What this paper adds to existing knowledge?

UC patients exhibit a more pronounced attachment insecurity that, in turn, resulted as a determinant of psychological stress.

This study suggests that UC could determine a shift towards insecurity in the attachment style that, in turn, promotes psychological stress and increases the risk of psychopathologies.

What are the implications for practice?

The more accurate knowledge of attachment insecurity in patients with chronic disorders such as UC may help the nurses to face with often dysfunctional patients’ styles of manifesting distress, patterns of help seeking and expectations of health professionals.

The knowledge of psychopathological mechanisms in patients with UC could improve the prevention and treatment of psychological disorders in affected patients.

AbstractIntroductionUlcerative colitis (UC) is a chronic disorder characterized by recurrent intestinal symptoms. The attachment theory provides a psychodynamic perspective to investigate the relationship between interpersonal relationships and stress in UC.AimThe aim of this study was to compare the attachment dimensions between UC patients and controls and to evaluate the impact of these dimensions on perceived stress in patients.MethodIn all, 101 patients with UC completed the attachment style questionnaire and the perceived stress questionnaire (PSQ). Clinical and psychometric parameters were added as predictor variables in a regression with the PSQ score as dependent variable. One hundred and five healthy subjects took part in the study as controls.ResultsCompared to controls, UC patients exhibited greater scores in relationships as secondary, need for approval and preoccupation with relationships. In UC, disease activity, confidence and preoccupation with relationships resulted predictors of perceived stress.DiscussionCompared to healthy controls, UC patients exhibited more pronounced attachment insecurity that, in turn, was a significant predictor of the perceived stress.Implications for practiceThe knowledge of attachment insecurity may help the nurses and all health care providers to face with dysfunctional patients’ styles of manifesting distress, help seeking and expectations of health professionals.
Mannose‐binding lectin gene polymorphism in relation to periodontal infection
Authors: Liukkonen A. , He Q. , Gürsoy U. K. , Pussinen P. J. , Gröndahl‐Yli‐Hannuksela K. , Liukkonen J. , Sorsa T. , Suominen A. L. , Huumonen S. , Könönen E. 
Published: September 2016

Background and ObjectiveMannose‐binding lectin (MBL) plays an important role in innate immunity. MBL deficiency is usually caused by mutations in exon 1 of the MBL structural gene (MBL2). Our aim was to investigate MBL2 polymorphisms and their relation to salivary levels of periodontal inflammatory/tissue destruction markers and two major periodontitis‐associated bacteria.Material and MethodsSalivary samples from 222 subjects were available for genotyping by pyrosequencing. The subjects between 40 and 60 years of age and having a minimum of 20 teeth were divided into three periodontal groups: 80 had generalized periodontitis, 65 had localized periodontitis and 77 were periodontitis‐free. A comparison between their MBL2 genotypes and salivary detection rates and levels of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis as well as interleukin ‐1β, matrix metalloproteinase ‐8, and tissue inhibitor of matrix metalloproteinase (TIMP)‐1 was performed.ResultsThe frequencies of the MBL2 wild‐type (A/A), heterozygote variants (A/O) and homozygote variants (O/O) were 69.4%, 26.6% and 4%, respectively. In A. actinomycetemcomitans‐positive subjects having homozygote or heterozygote MBL2 variants, the salivary concentrations of IL‐1β (p = 0.010) were elevated and those of TIMP‐1 (p = 0.001) were decreased. In addition their matrix metalloproteinase ‐8/TIMP‐1 ratio was higher (p < 0.001) and they had more pocket teeth (p = 0.012) than subjects negative for A. actinomycetemcomitans.ConclusionOur findings indicate that the carriage of A. actinomycetemcomitans may facilitate extended periodontal inflammation and destruction in subjects with a variant form of human MBL2.
Occult hepatitis B virus infection: clinical implications in tuberculosis treatment
Authors: Trigo C. , do Brasil P. E. A. A. , Costa M. J. M. , de Castro L. 
Published: September 2016

SummaryOccult hepatitis B virus infection (OBI) is characterized by the absence of HBsAg and persistence of the virus genome (HBV‐DNA) in liver tissue and/or blood. OBI has been reported in several clinical contexts. However, the clinical significance of OBI in tuberculosis (TB) treatment is unknown. We investigated the OBI prevalence and its impact on the risk of drug‐induced liver injury (DILI) during TB treatment. This was a prospective cohort study with one hundred patients who were treated for TB from 2008 to 2015. Laboratory, clinical and demographic data of TB patients were extracted from medical records. Based on HBV‐DNA testing of serum samples, an OBI prevalence of 12% was established; almost half of these patients had both anti‐HBc and anti‐HBs serological markers. Low CD4+ cell counts have been shown to be a risk factor for OBI among TB patients co‐infected with HIV (P=.036). High DILI incidence was observed in this study. A multivariable Cox proportional hazard model was conducted and identified OBI (HR 2.98, 95% CI 1.30–6.86) as the strongest predictor for DILI when adjusted to CD4+ cell count (HR 0.38, 95% CI 0.17–0.90), ALT before TB treatment (HR 1.37, 95% CI 0.81–2.32) and TB extrapulmonary clinical form (HR 2.91, 95% CI 1.75–7.21). The main aim of this study was to highlight DILI as a clinical outcome during treatment of TB patients with OBI. Therefore, HBV‐DNA testing should be considered routinely in monitoring DILI, and also in other clinical implications associated with OBI, reduce morbidity and mortality.
An Approach to Dynamical Classification of Daily Traffic Patterns
Authors: García‐Ródenas Ricardo , López‐García María L. , Sánchez‐Rico María Teresa 
Published: September 2016

AbstractThis article proposes a prototype of an urban traffic control system based on a prediction‐after‐classification approach. In an off‐line phase, a repository of traffic control strategies for a set of (dynamic) traffic patterns is constructed. The core of this stage is the k‐means algorithm for daily traffic pattern identification. The clustering method uses the input attributes flow, speed, and occupancy and it transforms the dynamic traffic data at network level in a pseudo‐covariance matrix, which collects the dynamic correlations between the road links. A desirable number of traffic patterns is provided by Bayesian Information Criterion and the ratio of change in dispersion measurements. In an on‐line phase, the current daily traffic pattern is predicted within the repository and its associated control strategy is implemented in the traffic network. The dynamic prediction scheme is constructed on the basis of an existing static prediction method by accumulating the trials on set of patterns in the repository. This proposal has been assessed in synthetic and real networks testing its effectiveness as a data mining tool for the analysis of traffic patterns. The approach promises to effectively detect the current daily traffic pattern and is open to being used in intelligent traffic management systems.
Thiol‐based switch mechanism of virulence regulator AphB modulates oxidative stress response in Vibrio cholerae
Authors: Liu Zhi , Wang Hui , Zhou Zhigang , Sheng Ying , Naseer Nawar , Kan Biao , Zhu Jun 
Published: September 2016

SummaryBacterial pathogens display versatile gene expression to adapt to changing surroundings. For example, Vibrio cholerae, the causative agent of cholera, utilizes distinct genetic programs to combat reactive oxygen species (ROS) in aquatic environments or during host infection. We previously reported that the virulence activator AphB in V. cholerae is involved in ROS resistance. Here by performing a genetic screen, we show that AphB represses ROS resistance gene ohrA, which is also repressed by another regulator, OhrR. Reduced forms of both AphB and OhrR directly bind to the ohrA promoter and repress its expression, whereas organic hydroperoxides such as cumene hydroperoxide (CHP) deactivate AphB and OhrR. OhrA is critical for V. cholerae adult mouse colonization but is dispensable when the mice are treated with antioxidants. Furthermore, similar to our previous finding that AphB and OhrR exhibit different reduction rates during the shift from oxic to anoxic environments, we found that AphB is also oxidized more slowly than OhrR under peroxide stress or exposure to oxygen. This differential regulation optimizes the expression of ohrA and contributes to V. cholerae's ability to survive in a variety of environmental niches that contain different levels of ROS.
Off‐pathway assembly of fimbria subunits is prevented by chaperone CfaA of CFA/I fimbriae from enterotoxigenic E. coli
Authors: Bao Rui , Liu Yang , Savarino Stephen J. , Xia Di 
Published: September 2016

SummaryThe assembly of the class 5 colonization factor antigen I (CFA/I) fimbriae of enterotoxigenic E. coli was proposed to proceed via the alternate chaperone‐usher pathway. Here, we show that in the absence of the chaperone CfaA, CfaB, the major pilin subunit of CFA/I fimbriae, is able to spontaneously refold and polymerize into cyclic trimers. CfaA kinetically traps CfaB to form a metastable complex that can be stabilized by mutations. Crystal structure of the stabilized complex reveals distinctive interactions provided by CfaA to trap CfaB in an assembly competent state through donor‐strand complementation (DSC) and cleft‐mediated anchorage. Mutagenesis indicated that DSC controls the stability of the chaperone‐subunit complex and the cleft‐mediated anchorage of the subunit C‐terminus additionally assist in subunit refolding. Surprisingly, over‐stabilization of the chaperone‐subunit complex led to delayed fimbria assembly, whereas destabilizing the complex resulted in no fimbriation. Thus, CfaA acts predominantly as a kinetic trap by stabilizing subunit to avoid its off‐pathway self‐polymerization that results in energetically favorable trimers and could serve as a driving force for CFA/I pilus assembly, representing an energetic landscape unique to class 5 fimbria assembly.
Satellite telemetry reveals population specific winter ranges of beluga whales in the Bering Sea
Authors: Citta John J. , Richard Pierre , Lowry Lloyd F. , O'Corry‐Crowe Gregory , Marcoux Marianne , Suydam Robert , Quakenbush Lori T. , Hobbs Roderick C. , Litovka Denis I. , Frost Kathryn J. , Gray Tom , Orr Jack , Tinker Ben , Aderman Helen , Druckenmiller Matthew L. 
Published: September 2016

AbstractAt least five populations (stocks) of beluga whales (Delphinapterus leucas) are thought to winter in the Being Sea, including the Bristol Bay, Eastern Bering Sea (Norton Sound), Anadyr, Eastern Chukchi Sea, and Eastern Beaufort Sea (Mackenzie) populations. Belugas from each population have been tagged with satellite‐linked transmitters, allowing us to describe their winter (January–March) distribution. The objectives of this paper were to determine: (1) If each population winters in the Bering Sea, and if so, where? (2) Do populations return to the same area each year (i.e., are wintering areas traditional)? (3) To what extent do the winter ranges of different populations overlap? Tagged belugas from all five populations either remained in, or moved into, the Bering Sea and spent the winter there. Each population wintered in a different part of the Bering Sea and populations with multiple years of data (four of five) returned to the same regions in multiple years. When data were available from two populations that overlapped in the same year, they did not occupy the shared area at the same time. Although our sample sizes were small, the evidence suggests belugas from different populations have traditional winter ranges that are mostly exclusive to each population.
Prevalence and lethality among patients with histoplasmosis and AIDS in the Midwest Region of Brazil
Authors: Silva Thaísa C. , Treméa Carolina M. , Zara Ana Laura S. A. , Mendonça Ana Flávia , Godoy Cássia S. M. , Costa Carolina R. , Souza Lúcia K. H. , Silva Maria R. R. 
Published: September 2016

SummaryHistoplasmosis is a systemic mycosis that is considered an important public health problem. In this work, we performed a descriptive, observational, cross‐sectional and retrospective study with a secondary data analysis of medical records from 2000 to 2012 at a tertiary hospital. The study sample consisted of 275 patients with laboratory‐confirmed Disseminated Histoplasmosis (DH)/AIDS. The results showed that the prevalence of DH associated with AIDS was 4.4%. The majority of patients were young adult men with fever in 84.2%, cough in 63.4%, weight loss in 63.1%, diarrhoea in 44.8% and skin manifestations in 27.6% of patients. In the overall cohort, the CD4 counts were low, but not significantly different in survivors and non‐survivors. Higher levels of urea and lower levels of haemoglobin and platelets were observed in non‐survivor patients (<.05). The global lethality was 71.3% (196/275). The results with high prevalence and lethality highlight the need to adopt measures to facilitate early diagnosis, proper treatment and improved prognosis.
Bilaterally Primary Cementless Total Hip Arthroplasty for Severe Hip Ankylosis with Ankylosing Spondylitis
Authors: Feng Dong‐xu , Zhang Kun , Zhang Yu‐min , Nian Yue‐wen , Zhang Jun , Kang Xiao‐min , Wu Shu‐fang , Zhu Yang‐jun 
Published: September 2016

ObjectivesTotal hip arthroplasty is a reliable therapeutic intervention in patients with ankylosing spondylitis, in whom the aims of surgery are to reduce pain, restore hip function and improve quality of life. The current study is a retrospective analysis of the clinical and radiographic findings in a consecutive series of patients with hip ankylosis associated with severe ankylosing spondylitis who underwent bilateral primary total hip arthroplasty using non‐cemented components.MethodsFrom June 2008 to May 2012, total hip arthroplasty was performed on 34 hips in 17 patients with bilateral ankylosis caused by ankylosing spondylitis. The study patients included 13 men and 4 women with a mean age of 24.2 years. The mean duration of disease was 8.3 years and the average duration of hip involvement was 7.6 years. All patients had severe hip pain and dysfunction with bilateral bony ankylosis and no range of motion preoperatively and all underwent bilateral cementless total hip arthroplasty performed by a single surgeon. Joint pain, range of motion (ROM), and Harris hip scores were assessed to evaluate the postoperative results.ResultsAt a mean follow‐up of 31.7 months, all patients had experienced significant clinical improvement in function, ROM, posture and ambulation. At the final follow‐up, the mean postoperative flexion ROM was 134.4° compared with 0° preoperatively. Similar improvements were seen in hip abduction, adduction, internal rotation and external rotation. Postoperatively, 23 hips were completely pain‐free, six had only occasional discomfort, three mild to moderate pain and two severe pain. The average Harris Hip Score improved from 23.7 preoperatively to 65.8 postoperatively. No stems had loosened at the final follow‐up in any patient, nor had any revision surgery been required.ConclusionsBilateral severe hip ankylosis in patients with ankylosing spondylitis can be treated with cementless bilateral synchronous total hip arthroplasty, which can greatly improve hip joint function and relieve pain without significant complications. Provided the overall physical condition of a patient and their economic situation make surgery a feasible option and the surgeon is experienced, this treatment is a worthwhile surgical intervention for bilateral hip bony ankylosis. However, the technically demanding nature of the procedure and potential pre‐ and post‐operative problems should not be underestimated.