bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skeletal muscle mass is associated with higher dietary protein intake and lower body fat in postmenopausal women: a cross-sectional study
Authors: Silva Thaís R. , Spritzer Poli M. 
Published: December 2016

Abstract

Objective:
We investigated the association between skeletal muscle mass and dietary protein intake, habitual physical activity, body composition, and metabolic variables.

Methods:
One hundred three healthy postmenopausal women from southern Brazil (age 55.2 ± 4.9 y, body mass index 27.2 ± 4.6 kg/m2) were enrolled. Bone mineral density, %body fat, %trunk fat mass, and appendicular lean mass were assessed by dual-energy x-ray absorptiometry, resting metabolic rate by indirect calorimetry, and habitual physical activity by pedometer. Skeletal muscle mass index (SMI) was expressed as appendicular lean mass standardized to body mass index. The cutoff for low lean mass was <0.512. Protein intake was measured by a validated food frequency questionnaire and categorized into tertiles: ≤0.93 g/kg body weight (BW), 0.94 to 1.29 g/kg BW, and ≥1.3 g protein/kg BW.

Results:
The prevalence of low lean mass (SMI <0.512) was 7%. Waist circumference, %body fat, trunk fat mass, and diastolic blood pressure were higher, whereas SMI and mean daily steps were lower in women with protein intake ≤0.93 g/kg BW. SMI was positively correlated with physical activity (r = 0.205, P = 0.038) and protein intake (r = 0.334, P = 0.001), and negatively correlated with waist circumference (r = −0.505, P < 0.001) and %body fat (r = 0.808, P < 0.001). Linear regression analysis adjusted for age, time since menopause, previous smoking behavior, and energy intake showed an independent, positive contribution of protein intake (mean difference 0.007, 95% CI, 0.001-0.014, P = 0.044) and an independent, negative contribution of %body fat (mean difference −0.010, 95%CI, −0.011 to −0.008, P < 0.001) to SMI.

Conclusions:
In our healthy postmenopausal women, SMI was positively associated with protein intake and negatively associated with %body fat.
Telomere length is longer in women with late maternal age
Authors: Fagan Erin , Sun Fangui , Bae Harold , Elo Irma , Andersen Stacy L. , Lee Joseph , Christensen Kaare , Thyagarajan Bharat , Sebastiani Paola , Perls Thomas , Honig Lawrence S. , Schupf Nicole 
Published: December 2016

Abstract

Objective:
Maternal age at birth of last child has been associated with maternal longevity. The aim of this study was to determine whether older women with a history of late maternal age at last childbirth had a longer leukocyte telomere length than those with maternal age at last childbirth of 29 years or less.

Methods:
A nested case control study was conducted using data from the Long Life Family Study. Three hundred eighty-seven women who gave birth to at least one child and lived to the top fifth percentile of their birth cohort, or died before the top fifth percentile of their birth cohort died, but were at least 70 years old, were studied. Logistic regression models using generalized estimating equations were used to determine the association between tertiles of telomere length and maternal age at last childbirth, adjusting for covariates.

Results:
Age at birth of the last child was significantly associated with leukocyte telomere length. Compared with women who gave birth to their last child before the age of 29, women who were past the age of 33 when they had their last child were two to three times more likely to have leukocyte telomere length in the second and third tertiles than in the first tertile.

Conclusions:
These findings show an association between longer leukocyte telomere length and a later maternal age at birth of last child, suggesting that extended maternal age at last childbirth may be a marker for longevity.
Robotically Assisted Thoracic Surgery: Proposed Guidelines for Privileging and Credentialing
Authors: Bhora Faiz Y. , Al-Ayoubi Adnan M. , Rehmani Sadiq S. , Forleiter Craig M. , Raad Wissam N. , Belsley Scott G. 
Published: December 2016

Objective Increased use of robotically assisted thoracic surgery (RATS) necessitates effective credentialing guidelines to ensure safe outcomes. We provide a stepwise algorithm for granting privileges and credentials in RATS. This algorithm reflects graduated responsibility and complexity of the surgical procedures performed. Furthermore, it takes into account volume, outcomes, surgeon's competency, and appropriateness of robot usage. Methods We performed a literature review for available strategies to grant privileges and credentials for implementing robotic surgery. The following terms were queried: robot, robotic, surgery, and credentialing. We provide this algorithm on the basis of review of the literature, our institutional experience, and the experience of other medical centers around the United States. Results Currently, two pathways for robotic training exist: residency and nonresidency-trained. In the United Sates, Joint Commission: Accreditation, Health Care, Certification requires hospitals to credential and privilege physicians on their medical staff. In the proposed algorithm, a credentialing designee oversees and reviews all requests. Residency-trained surgeons must fulfill 20 cases with program directors’ attestation to obtain full privileges. Nonresidency-trained surgeons are required to fulfill simulation, didactics including online modules, wet laboratories (cadaver or animal), and observation of at least two cases before provisional privileges can be granted. A minimum number of cases (10 per year) are required to maintain privileges. All procedures are monitored via departmental QA/QI committee review. Investigational uses of the robot require institutional review board approval, and complex operations may require additional proctoring and QA/QI review. Conclusions Safety concerns with the introduction of novel and complex technologies such as RATS must be paramount. Our algorithm takes into consideration appropriate use and serves as a basic guideline for institutions that wish to implement a RATS program.
Scale-Up of an Human Papillomavirus Testing Implementation Program in El Salvador
Authors: Cremer Miriam , Maza Mauricio , Alfaro Karla , Morales Velado Mario , Felix Juan , Castle Philip E. , Kim Jane , Gage Julia C. 
Published: December 2016

Objective
The Cervical Cancer Prevention in El Salvador is a demonstration project to introduce a lower-cost human papillomavirus (HPV)-DNA test into a public sector project. Started in October 2012, The Cervical Cancer Prevention in El Salvador consists of 3 phases and will ultimately screen 30,000 women. Results of phase 2 of the project are presented. The objective of this project was to compare colposcopy and noncolposcopy-based management for HPV-positive women.

Material and Methods
In phase 2, a total of 8,050 women, aged 30 to 49 years, were screened; 6,761 provided both self- and provider-collected specimens and 1,289 provided only provider-testing specimens. HPV results from self-collected specimens were not used in clinical management decisions. Women with provider-collected HPV-positive results were treated based on the strategy assigned to their community; the strategy was colposcopy management (CM) or screen-and-treat (ST) management if they were cryotherapy eligible or colposcopy if not eligible. Outcomes were assessed 6 months after screening.

Results
Overall, 489 (12.3%) of 3,963 women receiving CM and 465 (11.4%) of 4,087 women receiving ST tested HPV positive. In the CM cohort, 216 (44.2%) of 489 completed their intervention (203 treated, 11 diagnosed negative, 2 pregnant). In the ST cohort, 411 (88.4%) of 465 completed their intervention (407 treated, 2 diagnosed negative, 1 pregnant). Overall agreement between HPV test results from self-collected and provider-collected specimens was 93.7%, with a κ value of 0.70 (95% CI = 0.68–0.73).

Conclusions
Human papillomavirus testing with ST management resulted in an approximately twice completion rate compared with CM management. Agreement between self- and provider-based sampling was good and might be used to extend screening to women in areas that are more difficult to reach.
Adherence to Oral Administration of Endocrine Treatment in Patients With Breast Cancer
Authors: Iacorossi Laura , Gambalunga Francesca , Fabi Alessandra , Giannarelli Diana , Marchetti Anna , Piredda Michela , De Marinis Maria Grazia 
Published: December 2016

Background:
Breast cancer is the most common cancer in women in the world, and it is also the leading cause of cancer deaths among women. Nevertheless, breast cancer survival has increased as a result of improvements in early diagnosis and therapy, for example, oral endocrine therapy. Despite the importance of adherence to endocrine therapy, its trend appears complex and multidimensional and therefore has many loopholes and missing information.

Objective:
The study aims to explore the experiences of adherence to endocrine therapy in women with breast cancer and their perceptions of the challenges they face in adhering to their medication prescribed.

Methods:
The study used a qualitative exploratory design, with face-to-face semistructured interviews. Data were analyzed using framework analysis in accordance with Ritchie and Spencer’s approach.

Results:
The sample included 27 women. Seven themes were identified: the different faces of adherence, fear of the drug, adherence stimulates the balance of the experience of illness, adherence influences the future of disease, adherence requires attention to the person, knowledge seeking, and “forgetfulness” activates the search for functional strategies.

Conclusions:
This study shows that adherence assumes different connotations that are mainly influenced by the type of relationship established with health professionals the attention paid to the person, the information received, and the influence that the drug has on the disease.

Implications for Practice:
It appears that fear has a strong influence on the behaviors involved in taking the therapy. The only way to overcome irrational fear is to improve the patient’s knowledge.
Lifestyle Behaviors, Perceived Stress, and Inflammation of Individuals With Chronic Graft-Versus-Host Disease
Authors: Lynch Kelly Debra , Lyon Debra E. , Periera Deidre , Garvan Cynthia , Wingard John 
Published: December 2016

Background:
Stress is a potent immunomodulator contributing to chronic conditions. Chronic graft-versus-host disease (cGVHD) is a life-threatening late effect of allogeneic hematopoietic cell transplantation associated with stress and exaggerated immune response that may be associated to lifestyle behaviors.

Objective:
The aim of this study is to explore associations among lifestyle behaviors, perceived stress, and inflammation of individuals with cGVHD.

Methods:
A secondary analysis from a prospective observational study of 24 adults (≥18 years) with cGVHD was conducted. Demographic, clinical, and symptom data were assessed using medical records and validated self-report measures; inflammatory markers were assessed using multiplex and enzyme-linked-immunosorbent assays from plasma.

Results:
Spiritual growth and total perceived stress were correlated (P < .001). Nutrition and C-reactive protein were negatively correlated (P = .02). Physical activity and cytokines (interleukin [IL]-2, IL-4, IL-5, IL-7, IL-10, IL-12, IL-13, IL-17, and granulocyte colony-stimulating factor) were associated (P < .05). Perceived stress and inflammatory markers were not associated. Individuals did not routinely engage in assessed health-promoting lifestyle behaviors.

Conclusion:
Associations in this sample were noted among lifestyle behaviors, perceived stress, and inflammation. Given these promising findings, further research with a larger sample size is needed to test these associations. Activity, nutrition, stress management, and social support interventions may reduce stress and inflammation. Particularly, connecting with one’s higher-self may reduce levels of perceived stress. Finding ways to engage survivors in healthy lifestyle behaviors should be explored.

Implications for Practice:
Information from this study allows nurses to be informed about the role of lifestyle behaviors on inflammation and stress to provide anticipatory guidance to HCT survivors regarding lifestyle choices that may mitigate inflammation and stress to promote positive health outcomes.
Acculturation and Postpartum Depressive Symptoms among Hispanic Women in the United States
Authors: Alhasanat Dalia , Giurgescu Carmen 
Published: December 2016

Abstract

Purpose:
The purpose of this review was to evaluate studies that examined the relationship between acculturation and postpartum depression (PPD) among immigrant and/or refugee women in the United States.

Methods:
A systematic, computer-assisted search of quantitative, English-language, peer-reviewed, published research articles was conducted in the Scopus, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Maternity and Infant Care databases using the keyword terms of “postpartum depression” and “perinatal depression” in combination with “acculturation.” Studies were included if they were conducted in the United States.

Results:
Seven studies met inclusion criteria. Three studies used longitudinal designs and four used cross-sectional designs. All were conducted with Hispanic women. Only one study used a diagnostic tool to measure PPD; the remaining studies used screening tools to measure postpartum depressive symptoms. Most studies used country of birth, country of residence, and language preferences to measure acculturation. Five studies reported acculturation was positively related to risk of postpartum depressive symptoms, and two studies reported no relationship.

Clinical Implications:
Higher levels of acculturation were related to higher risk of postpartum depressive symptoms in Hispanic women living in the United States. Nurses should have an understanding of stressors of immigrant women to guide their assessment and screening for postpartum depressive symptoms and make appropriate referrals. More research is needed to confirm the relationship between acculturation and PPD among immigrant women from different cultural backgrounds.
Project Shikamana: Baseline Findings From a Community Empowerment–Based Combination HIV Prevention Trial Among Female Sex Workers in Iringa, Tanzania
Authors: Kerrigan Deanna , Mbwambo Jessie , Likindikoki Samuel , Beckham Sarah , Mwampashi Ard , Shembilu Catherine , Mantsios Andrea , Leddy Anna , Davis Wendy , Galai Noya 
Published: December 2016

Background:
Community empowerment approaches have been found to be effective in responding to HIV among female sex workers (FSWs) in South Asia and Latin America. To date, limited rigorous evaluations of these approaches have been conducted in sub-Saharan Africa.

Methods:
A phase II community randomized controlled trial is being conducted in Iringa, Tanzania, to evaluate the effectiveness of a community empowerment–based combination HIV prevention model (Project Shikamana) among a stratified sample of HIV-infected and HIV-uninfected FSWs. Cohort members were recruited from entertainment venues across 2 communities in the region using time-location sampling. All study participants gave consent, and were surveyed and screened for HIV at baseline. Primary biological study outcomes are viral suppression among the HIV-infected and remaining free of HIV among HIV-uninfected women.

Results:
A cohort of 496 FSWs was established and is currently under follow-up. Baseline HIV prevalence was 40.9% (203/496). Among HIV-infected FSWs, 30.5% (62/203) were previously aware of their HIV status; among those who were aware, 69.4% were on antiretroviral therapy (43/62); and for those on antiretroviral therapy, 69.8% (30/43) were virally suppressed. Factors associated with both HIV infection and viral suppression at baseline included community, age, number of clients, and substance use. Amount of money charged per client and having tested for sexually transmitted infection in the past 6 months were protective for HIV infection. Social cohesion among FSWs was protective for viral suppression.

Conclusions:
Significant gaps exist in HIV service coverage and progress toward reaching the 90-90-90 goals among FSWs in Iringa, Tanzania. Community empowerment approaches hold promise given the high HIV prevalence, limited services and stigma, discrimination, and violence.
The Analgesic Effect of Ropivacaine Combined With Dexmedetomidine for Incision Infiltration After Laparoscopic Cholecystectomy
Authors: Yu Jun-Ma , Sun Hao , Wu Chao , Dong Chun-Shan , Lu Yao , Zhang Ye 
Published: December 2016

Background:
Local anesthetics infiltration is one consensus efficient strategy for pain relief after laparoscopic cholecystectomy (LC). The aim of this study was to investigate analgesia efficacy of incisional infiltration with ropivacaine plus dexmedetomidine.

Methods:
Patients scheduled for LC were assigned to 4 groups by different medications for trocar wound infiltration. The incidence of adverse events and the analgesic effect of ropivacaine combined with dexmedetomidine for incision infiltration were recorded.

Results:
Incisional infiltration of ropivacaine combining with dexmedetomidine could significantly reduce postoperative pain and the amount of pethidine requirement. Furthermore, it could also reduce time to walk without assistance, improve the efficacy of analgesia and sleep quality during the first night after LC, but did not increase the incidence of surgical adverse events.

Conclusions:
The use of ropivacaine and dexmedetomidine may be considered as an alternative treatment for postoperative pain in patients undergoing LC.
Effect of Pectoral Electrostimulation on Reduction of Mammary Ptosis After Bariatric Surgery
Authors: Ruiz-Tovar Jaime , Llavero Carolina 
Published: December 2016

Background:
Over 90% of women report to be very dissatisfied with the aspect of their breast after bariatric surgery. Breast reconstructive surgeries are often not funded by the National Health Service or private health insurances in many countries and the patient must pay a high economic amount to undergo it.

Patients and Methods:
A prospective randomized clinical trial of patients undergoing bariatric surgery was performed. Patients were randomly assigned into 3 groups: patients undergoing percutaneous electrostimulation of the pectoral muscle combined with specific training (group 1), patients doing the specific training alone (group 2), and patients without any specific treatment (group 3). The assigned treatment began 15 days after surgery and was maintained during 12 weeks.

Results:
Twenty-five women were included in each group. In the posttreatment anthropometric measures significant differences between groups could be observed in Regnault classification (P=0.014), ptosis (P=0.017), and projection (P=0.025). Multiple comparisons revealed that there were no significant differences in all these variables between group 2 and group 3, whereas a significant difference could be observed between groups 1 and 2 and 1 and 3. Median satisfaction score with the prescribed treatment was significantly better in group 1 than in the other groups.

Conclusions:
Percutaneous electrostimulation of the pectoral muscle combined with specific training achieves a reduction in the breast ptosis and an increased projection, resulting in greater satisfaction of the patients, when compared with only specific training or without any specific activity.
Effects of exercise interventions and physical activity behavior on cancer-related cognitive impairments: an update
Authors: Schaffrath Nils , Oberste Max , Zimmer Philipp 
Published: December 2016

Purpose of review
The purpose of this review is to give an update on studies investigating the influence of physical activity behavior and exercise interventions on cancer-related cognitive impairments.

Recent findings
Cross-sectional and observational studies underline previous findings, revealing an association of cancer patients’ fitness and their cognitive functions. Results from interventional studies are sparse. Only one study investigated self-perceived cognitive function in breast cancer patients as a secondary outcome, indicating no effects.

Summary
Recent research on physical activity and exercise interventions is still restricted by methodological limitations, including the wide variation in assessments and the lack of adequate control groups.
Urban driven phenotypic changes: empirical observations and theoretical implications for eco-evolutionary feedback
Authors: Alberti Marina , Marzluff John , Hunt Victoria M. 
Published: December 2016

Emerging evidence that cities drive micro-evolution raises the question of whether rapid urbanization of Earth might impact ecosystems by causing systemic changes in functional traits that regulate urban ecosystems' productivity and stability. Intraspecific trait variation—variation in organisms' morphological, physiological or behavioural characteristics stemming from genetic variability and phenotypic plasticity—has significant implications for ecological functions such as nutrient cycling and primary productivity. While it is well established that changes in ecological conditions can drive evolutionary change in species' traits that, in turn, can alter ecosystem function, an understanding of the reciprocal and simultaneous processes associated with such interactions is only beginning to emerge. In urban settings, the potential for rapid trait change may be exacerbated by multiple selection pressures operating simultaneously. This paper reviews evidence on mechanisms linking urban development patterns to rapid phenotypic changes, and differentiates phenotypic changes for which there is evidence of micro-evolution versus phenotypic changes which may represent plasticity. Studying how humans mediate phenotypic trait changes through urbanization could shed light on fundamental concepts in ecological and evolutionary theory. It can also contribute to our understanding of eco-evolutionary feedback and provide insights for maintaining ecosystem function over the long term.
This article is part of the themed issue ‘Human influences on evolution, and the ecological and societal consequences’.
The eco-evolutionary impacts of domestication and agricultural practices on wild species
Authors: Turcotte Martin M. , Araki Hitoshi , Karp Daniel S. , Poveda Katja , Whitehead Susan R. 
Published: December 2016

Agriculture is a dominant evolutionary force that drives the evolution of both domesticated and wild species. However, the various mechanisms of agriculture-induced evolution and their socio-ecological consequences are not often synthetically discussed. Here, we explore how agricultural practices and evolutionary changes in domesticated species cause evolution in wild species. We do so by examining three processes by which agriculture drives evolution. First, differences in the traits of domesticated species, compared with their wild ancestors, alter the selective environment and create opportunities for wild species to specialize. Second, selection caused by agricultural practices, including both those meant to maximize productivity and those meant to control pest species, can lead to pest adaptation. Third, agriculture can cause non-selective changes in patterns of gene flow in wild species. We review evidence for these processes and then discuss their ecological and sociological impacts. We finish by identifying important knowledge gaps and future directions related to the eco-evolutionary impacts of agriculture including their extent, how to prevent the detrimental evolution of wild species, and finally, how to use evolution to minimize the ecological impacts of agriculture.
This article is part of the themed issue ‘Human influences on evolution, and the ecological and societal consequences’.