bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Life in Elderly Kidney Transplant Recipients
Authors: Weber Marc , Faravardeh Arman , Jackson Scott , Berglund Danielle , Spong Richard , Matas Arthur J. , Gross Cynthia R. , Ibrahim Hassan N. 
Published: October 2014

ObjectivesTo evaluate quality of life (QOL) in kidney transplant recipients aged 65 and older, identify predictors of impaired physical and mental QOL cross‐sectionally and compare QOL over time with that of younger transplant recipients and general population controls.DesignComparison of serial Medical Outcomes Study 36‐item Short‐Form Survey (SF‐36) QOL scores in transplant recipients aged 65 and older with those of transplant recipients younger than 65 and with those of general population controls from the National Health Measurement Study (NHMS).SettingUniversity of Minnesota.ParticipantsIndividuals aged 65 and older (n = 150) and younger than 65 (n = 1,544) who received a primary kidney transplant between 1963 and 2009.MeasurementsTwo‐sample t‐tests and logistic regression were used to assess the risk of significant impairment in physical and mental QOL, defined as 1 standard deviation below the general population norms (<40 points) for the SF‐36 Physical (PCS) and Mental Component Subscale (MCS) scores.ResultsPCS scores were 39.3 for transplant recipients aged 65 and older, 43.5 for recipients younger than 65, and 49.2 for NHMS controls (P < .005 for each pairwise comparison). MCS scores were 54.6 for transplant recipients aged 65 and older, 51.0 for recipients younger than 65, and 53.8 for NHMS controls (P < .005 for ≥65 vs <65 and NHMS vs <65). These scores did not change significantly from the first (3.6 years after transplant) to the last (6.2 years after transplant) survey. Longer time since transplantation in elderly participants was associated with having significantly impaired physical QOL, but no predictors were associated with significantly impaired mental QOL. In younger recipients, rejection, diabetes mellitus, delayed graft function, coronary artery disease, and longer time on dialysis were associated with impaired physical QOL. Rejection, smoking, diabetes mellitus, and longer time on dialysis were predictors of impaired mental QOL.ConclusionPhysical QOL is lower in elderly recipients but mental QOL is maintained and is higher than in younger recipients.
Gastroprotective Agent Underuse in High‐Risk Older Daily Nonsteroidal Anti‐Inflammatory Drug Users over Time
Authors: Marcum Zachary A. , Hanlon Joseph T. , Strotmeyer Elsa S. , Newman Anne B. , Shorr Ronald I. , Simonsick Eleanor M. , Bauer Douglas C. , Boudreau Robert , Donohue Julie M. , Perera Subashan ,   the Health, Aging and Body Composition Study
Published: October 2014

ObjectivesTo examine whether older adults taking nonsteroidal anti‐inflammatory drugs (NSAIDs) decreased the underuse of gastroprotective agents over time.DesignBefore‐and‐after study.SettingHealth, Aging and Body Composition Study.ParticipantsDaily users of a NSAID (prescription and over the counter (OTC)) at visits in 2002–03 (preperiod; n = 404) and 2006–07 (postperiod; n = 172). The sample had a mean ± standard deviation age of 78.2 ± 2.7 at the preperiod visit and 81.9 ± 2.7 at the postperiod visit. The majority were white and female and had 12 or more years of education.MeasurementsUnderusers were defined as persons taking nonselective NSAIDs who were at risk of peptic ulcer disease (PUD; because of current warfarin or glucocorticoid use or history of PUD) and not using a proton pump inhibitor (PPI) or persons taking cyclooxygenase 2 (COX‐2) selective NSAIDs and aspirin who were at risk of PUD (having at least one risk factor) and not using a PPI.ResultsDaily NSAID use decreased from 17.6% to 11.3% (P < .001), and gastroprotective agent underuse decreased from 23.5% to 15.1% (P = .008). Controlling for important covariates, having prescription insurance was somewhat protective against underuse in the preperiod (adjusted odds ratio (AOR) = 0.78, 95% confidence interval (CI) = 0.46–1.34; P = .37), but more so and significantly in the postperiod (AOR = 0.41, 95% CI = 0.18–0.93; P = .03). Having prescription insurance was more protective in the post‐ than in the preperiod (less gastroprotective agent underuse; adjusted ratio of OR = 0.53, 95% CI = 0.22–1.29; P = .16), but this increased protection was not statistically significant.ConclusionIn older daily NSAID users at high risk of PUD, having prescription insurance and adequate gastroprotective use was more common in the post‐ than in the preperiod.
Cumulative Associations Between Midlife Health Behaviors and Physical Functioning in Early Old Age: A 17‐Year Prospective Cohort Study
Authors: Sabia Séverine , Elbaz Alexis , Rouveau Nicolas , Brunner Eric J. , Kivimaki Mika , Singh‐Manoux Archana 
Published: October 2014

ObjectivesTo examine cumulative associations between midlife health behaviors and walking speed and upper‐limb strength in early old age.DesignProspective cohort study.SettingWhitehall II Study.ParticipantsIndividuals (mean age 49.1 ± 5.9 in 1991–93) with health behavior data for at least two of the three assessments (1991–93, 1997–99, 2002–04) and physical functioning measures in 2007–09 (mean age 65.9 ± 5.9) (N = 5,671).MeasurementsA trained nurse assessed walking speed and upper‐limb strength. Unhealthy behaviors were defined as current or recent smoking, nonmoderate alcohol consumption (abstinence or heavy drinking), fruit and vegetable consumption less than twice per day, and physical inactivity (<1 h/wk of moderate and <1 h/wk of vigorous physical activity). For each unhealthy behavior, a cumulative score was calculated as the number of times a person reported the behavior over the three assessments divided by 3. The score ranged between 0 (never) and 1 (all three times).ResultsIn linear regression models adjusted for age, sex, education, marital status, and height, all unhealthy behaviors in 1991–93 were associated with slower walking speed in 2007–09, with differences ranging from 0.10 (nonmoderate alcohol consumption) to 0.25 (physical inactivity) of a standard deviation between participants with and without the unhealthy behavior (Pt‐test<.001). For walking speed, the accumulation‐of‐risk model provided the best fit for unhealthy diet (β for a 1‐point increment in the low fruit and vegetable consumption score = −0.29, 95% confidence interval (CI) = −0.36 to −0.22) and physical inactivity (β = −0.37, 95% CI = −0.45 to −0.29). For smoking and nonmoderate alcohol consumption, a cumulative effect was also observed, but partial F‐tests did not suggest that it provided a better fit than models with behaviors in 1991–93, 1997–99, or 2002–04. All behavioral scores except smoking were associated with grip strength, but F‐tests supported the accumulation‐of‐risk hypothesis only for physical inactivity.ConclusionThese findings highlight the importance of duration of unhealthy behaviors, particularly for diet and physical activity, when examining associations with physical functioning.
High Prevalence of Falls, Fear of Falling, and Impaired Balance in Older Adults with Pain in the United States: Findings from the 2011 National Health and Aging Trends Study
Authors: Patel Kushang V. , Phelan Elizabeth A. , Leveille Suzanne G. , Lamb Sarah E. , Missikpode Celestin , Wallace Robert B. , Guralnik Jack M. , Turk Dennis C. 
Published: October 2014

ObjectivesTo determine the prevalence of clinically relevant falls‐related outcomes according to pain status in older adults in the United States.DesignCross‐sectional analysis of the 2011 National Health and Aging Trends Study, a sample of Medicare enrollees aged 65 and older (response rate 71.0%).SettingIn‐person assessments were conducted in the home or residential care facility of the sampled study participant.ParticipantsIndividuals aged 65 and older (n = 7,601, representing 35.3 million Medicare beneficiaries).MeasurementsParticipants were asked whether they had been “bothered by pain” and the location of pain, as well as questions about balance and coordination, fear of falling, and falls.ResultsFifty‐three percent of the participants reported bothersome pain. The prevalence of recurrent falls in the past year (≥2 falls) was 19.5% in participants with pain and 7.4% in those without (age‐ and sex‐adjusted prevalence ratio (PR) = 2.63, 95% confidence interval (CI) = 2.28–3.05). The prevalence of fear of falling that limits activity was 18.0% in those with pain and 4.4% in those without (adjusted PR = 3.98, 95% CI = 3.24–4.87). Prevalence of balance and falls outcomes increased with number of pain sites. For example, prevalence of problems with balance and coordination that limited activity was 6.6% in participants with no pain, 11.6% in those with one site of pain, 17.7% in those with two sites, 25.0% in those with three sites, and 41.4% in those with four or more sites (P < .001 for trend). Associations were robust to adjustment for several potential confounders, including cognitive and physical performance.ConclusionFalls‐related outcomes were substantially more common in older adults with pain than in those without. Accordingly, pain management strategies should be developed and evaluated for falls prevention.
Vitamin D Levels and Cognition in Elderly Adults in China
Authors: Chei Choy‐Lye , Raman Prassanna , Yin Zhao‐Xue , Shi Xiao‐Ming , Zeng Yi , Matchar David B. 
Published: October 2014

ObjectivesTo evaluate the association between vitamin D level and cognitive impairment in individuals aged 60 and older.DesignCross‐sectional cohort study.SettingChinese Longitudinal Healthy Longevity Survey, a community‐based cohort study in areas in China where the density of centenarians is exceptionally high.ParticipantsIndividuals with mean age of 84.9 ± 12.7 (N = 2,004).MeasurementsParticipants’ cognitive state was evaluated using the Mini‐Mental State Examination (MMSE). Vitamin D was measured in plasma using an enzyme‐linked immunoassay.ResultsThe cross‐sectional association between quartiles of plasma vitamin D level and cognitive impairment (MMSE score <18) was modeled using logistic regressions. Plasma vitamin D levels were lower in individuals with cognitive impairment (31.9 ± 15.3 nmol/L) than in those without (45.6 ± 19.6 nmol/L). There was a reverse association between plasma vitamin D and cognitive impairment. After adjusting for age, sex, chronic conditions, smoking and drinking habits, outdoor activities, depression, and activity of daily living limitations, the association remained significant. The multivariable‐adjusted odds ratio for lowest versus highest vitamin D levels was 2.15 (95% confidence interval (CI) = 1.05–4.41) for cognitive impairment, and the multivariable odds ratio associated with a 1‐standard deviation decrement in plasma vitamin D was 1.32 (95% CI = 1.00–1.74) for cognitive impairment.ConclusionLow plasma vitamin D levels were associated with greater odds of cognitive impairment. Further prospective studies in Asian populations are needed to examine the causal direction of this association.
Earlier depression and later‐life self‐reported chewing difficulties: results from the Whitehall II study
Authors: AlJameel A. H. , Watt R. G. , Brunner E. J. , Tsakos G. 
Published: October 2014

SummaryThis study aimed to assess, whether depression in adulthood was associated with self‐reported chewing difficulties at older age, and examine whether the strength of the association differed according to the number of depression episodes in earlier adult life. We used Whitehall II study data from 277 participants who completed a questionnaire in 2011. Depression was measured with the Center for Epidemiologic Studies Depression Scale (CES‐D) in 2003 and 2008. The association between CES‐D depression and self‐reported chewing ability was assessed using regression models adjusted for some socio‐demographic factors. Participants with depression at some point in their earlier adulthood had an odds ratio (95% CI) of 2·01 (1·06, 3·82) for reporting chewing difficulties in older adulthood, compared to those without depression. The respective odds ratios were 1·42 (0·66, 3·04) for individuals with depression in only one phase, but 3·53 (1·51, 8·24) for those with depression in two phases. In conclusion, while further research is required, there was an association between depression and chewing difficulty that was independent of demographic and socio‐economic characteristics. Furthermore, this increased odds for chewing difficulties was primarily among adults that experienced two episodes or a prolonged period of depression.
Enhanced formation of aromatic amino acids increases fragrance without affecting flower longevity or pigmentation in Petunia × hybrida
Authors: Oliva Moran , Ovadia Rinat , Perl Avichai , Bar Einat , Lewinsohn Efraim , Galili Gad , Oren‐Shamir Michal 
Published: October 2014

SummaryPurple Petunia × hybrida V26 plants accumulate fragrant benzenoid‐phenylpropanoid molecules and anthocyanin pigments in their petals. These specialized metabolites are synthesized mainly from the aromatic amino acids phenylalanine. Here, we studied the profile of secondary metabolites of petunia plants, expressing a feedback‐insensitive bacterial form of 3‐deoxy‐di‐arabino‐heptulosonate 7‐phosphate synthase enzyme (AroG*) of the shikimate pathway, as a tool to stimulate the conversion of primary to secondary metabolism via the aromatic amino acids. We focused on specialized metabolites contributing to flower showy traits. The presence of AroG* protein led to increased aromatic amino acid levels in the leaves and high phenylalanine levels in the petals. In addition, the AroG* petals accumulated significantly higher levels of fragrant benzenoid‐phenylpropanoid volatiles, without affecting the flowers' lifetime. In contrast, AroG* abundance had no effect on flavonoids and anthocyanins levels. The metabolic profile of all five AroG* lines was comparable, even though two lines produced the transgene in the leaves, but not in the petals. This implies that phenylalanine produced in leaves can be transported through the stem to the flowers and serve as a precursor for formation of fragrant metabolites. Dipping cut petunia stems in labelled phenylalanine solution resulted in production of labelled fragrant volatiles in the flowers. This study emphasizes further the potential of this metabolic engineering approach to stimulate the production of specialized metabolites and enhance the quality of various plant organs. Furthermore, transformation of vegetative tissues with AroG* is sufficient for induced production of specialized metabolites in organs such as the flowers.
Site‐specific proteolytic degradation of IgG monoclonal antibodies expressed in tobacco plants
Authors: Hehle Verena K. , Lombardi Raffaele , van Dolleweerd Craig J. , Paul Mathew J. , Di Micco Patrizio , Morea Veronica , Benvenuto Eugenio , Donini Marcello , Ma Julian K‐C. 
Published: October 2014

SummaryPlants are promising hosts for the production of monoclonal antibodies (mAbs). However, proteolytic degradation of antibodies produced both in stable transgenic plants and using transient expression systems is still a major issue for efficient high‐yield recombinant protein accumulation. In this work, we have performed a detailed study of the degradation profiles of two human IgG1 mAbs produced in plants: an anti‐HIV mAb 2G12 and a tumour‐targeting mAb H10. Even though they use different light chains (κ and λ, respectively), the fragmentation pattern of both antibodies was similar. The majority of Ig fragments result from proteolytic degradation, but there are only a limited number of plant proteolytic cleavage events in the immunoglobulin light and heavy chains. All of the cleavage sites identified were in the proximity of interdomain regions and occurred at each interdomain site, with the exception of the VL/CL interface in mAb H10 λ light chain. Cleavage site sequences were analysed, and residue patterns characteristic of proteolytic enzymes substrates were identified. The results of this work help to define common degradation events in plant‐produced mAbs and raise the possibility of predicting antibody degradation patterns ‘a priori’ and designing novel stabilization strategies by site‐specific mutagenesis.
The cell size distribution of tomato fruit can be changed by overexpression of CDKA1
Authors: Czerednik Anna , Busscher Marco , Angenent Gerco C. , de Maagd Ruud A. 
Published: October 2014

SummaryTomato is one of the most cultivated vegetables in the world and an important ingredient of the human diet. Tomato breeders and growers face a continuous challenge of combining high quantity (production volume) with high quality (appearance, taste and perception for the consumers, processing quality for the processing industry). To improve the quality of tomato, it is important to understand the regulation of fruit development and of fruit cellular structure, which is in part determined by the sizes and numbers of cells within a tissue. The role of the cell cycle therein is poorly understood. Plant cyclin‐dependent kinases (CDKs) are homologues of yeast cdc2, an important cell cycle regulator conserved throughout all eukaryotes. CDKA1 is constitutively expressed during the cell cycle and has dual functions in S‐ and M‐phase progression. We have produced transgenic tomato plants with increased expression of CDKA1 under the control of the fruit‐specific TPRP promoter, which despite a reduced number of seeds and diminished amount of jelly, developed fruits with weight and shape comparable to that of wild‐type fruits. However, the phenotypic changes with regard to the pericarp thickness and placenta area were remarkable. Fruits of tomato plants with the highest expression of CDKA1 had larger septa and columella (placenta), compared with wild‐type fruits. Our data demonstrate the possibility of manipulating the ratio between cell division and expansion by changing the expression of a key cell cycle regulator and probably its activity with substantial effects on structural traits of the harvested fruit.
Overexpression of a NF‐YC transcription factor from bermudagrass confers tolerance to drought and salinity in transgenic rice
Authors: Chen Miao , Zhao Yujuan , Zhuo Chunliu , Lu Shaoyun , Guo Zhenfei 
Published: October 2014

SummaryNuclear factor Y (NF‐Y) is a ubiquitous transcription factor formed by three distinct subunits, namely NF‐YA, NF‐YB and NF‐YC. A stress‐responsive cDNA of NF‐YC (Cdt‐NF‐YC1) was isolated from triploid bermudagrass (Cynodon dactylon × Cynodon transvaalensis), and its role in abiotic stress tolerance was investigated in this study. Cdt‐NF‐YC1 transcript was detected in all vegetative tissues with higher levels being observed in roots. Transcription of Cdt‐NF‐YC1 in leaves was induced by dehydration, salinity, and treatments with abscisic acid (ABA), hydrogen peroxide (H2O2) or nitric oxide (NO), but not altered by cold. The dehydration‐ or salt‐induced transcription of Cdt‐NF‐YC1 was blocked by inhibitor of ABA synthesis and scavenger of H2O2 or NO, indicating that ABA, H2O2 and NO were involved in the dehydration‐ and salt‐induced transcription of Cdt‐NF‐YC1. Overexpression of Cdt‐NF‐YC1 resulted in elevated tolerance to drought and salt stress and increased sensitivity to ABA in transgenic rice. Transcript levels of stress/ABA responsive genes (OsLEA3, OsRAB16A, OsLIP9 and OsP5CS1), ABA synthesis and signalling genes (OsNCED3 and OsABI2), and ABA‐independent genes (OsDREB1A, OsDREB1B and OsDREB2A) were substantially higher in transgenic rice than in wild‐type plants. The results suggested that that Cdt‐NF‐YC1 is a good candidate gene to increase drought and salinity tolerance in transgenic rice through modulating gene regulation in both ABA‐dependent and ABA‐independent pathways.
Interleukin‐2 receptor antagonists for pediatric liver transplant recipients: A systematic review and meta‐analysis of controlled studies
Authors: Crins Nicola D. , Röver Christian , Goralczyk Armin D. , Friede Tim 
Published: October 2014

AbstractIL‐2RA are frequently used as induction therapy in liver transplant recipients to decrease the risk of AR while allowing the reduction of concomitant immunosuppression. The exact association with the use of IL‐2RA, however, is uncertain. We performed a systematic literature search for relevant studies. Random effects models were used to assess the incidence of AR, steroid‐resistant rejection, graft loss, patient death, and adverse drug reaction, with or without IL‐2RA. Six studies (two randomized and four non‐randomized) met the eligibility criteria. Acute rejection at six months or later favored the use of IL‐2RA significantly (RR 0.38; 95% CI 0.22–0.66, p = 0.0005). Although not statistically significant, IL‐2RA showed a substantial reduction of the risk of steroid‐resistant rejection (RR 0.32; CI 0.19–1.03, p = 0.0594). Graft loss and patient death showed a reductive tendency through the use of IL‐2RA. The use of IL‐2RA is safe and is associated with a statistically significantly lower incidence of AR after transplantation and substantial reduction of steroid‐resistant rejection, graft loss, and patient death.
A struggle to survive: The experience of awaiting pediatric heart transplantation
Authors: Anthony Samantha J. , Nicholas David B. , Regehr Cheryl , West Lori J. 
Published: October 2014

AbstractDespite the establishment of heart transplantation as a life‐saving therapy for children and adolescents, little research has focused on the biopsychosocial impact of the transplant process. Few studies have captured the subjective experiences of young heart transplant recipients. This study examined the experiences and perspectives of children and adolescents during the pretransplant phase of waiting for a donor organ. Grounded theory methods guided data collection and analysis. A total of 27 adolescents participated in semistructured qualitative interviews. Findings illuminate the waiting period for pediatric heart transplantation to be a pervasive experience, with consequent impact on physical, psychological, and social well‐being. Participants described various biopsychosocial processes and experiences that occurred during this time, with data analysis yielding themes reflecting notions of “struggling to survive,” including physical limitations, lethargy, social isolation, discomfort with physical appearance, and academic issues. This research identifies the pretransplant experience as a period framed within a text of debilitation and negative self‐perceptions related to health and well‐being. Supporting children and their families as they navigate this complex and uncertain journey is merited, and results invite further interventional development and research.
Tacrolimus therapeutic drug monitoring and pediatric renal transplant graft outcomes
Authors: Larkins Nicholas , Matsell Douglas G. 
Published: October 2014

AbstractPredose monitoring of tacrolimus levels is standard practice in the care of pediatric renal transplant patients. This is despite a paucity of data investigating the ideal target range in children, and controversy as to whether tacrolimus levels correlate with renal transplant outcomes. We performed a retrospective cohort analysis of 48 renal transplant patients at a single Canadian pediatric transplant center following the initiation of a tacrolimus–mycophenolate–prednisone‐based IS protocol. We analyzed the relationship of graft function, as defined by GFR up to five yr post‐transplant, to the preceding mean tacrolimus level. There was no significant correlation between absolute GFR and mean tacrolimus levels (r = 0.206, p = 0.38). However, a higher mean tacrolimus level, particularly ≥10 ng/mL in the first three months after transplantation, was associated with a slower rate of decline in GFR with time (r = 0.608, p = 0.004) and with a less likelihood of developing CKD five yr after transplant. We suggest that the optimal target range for tacrolimus levels may be at the upper end of what is currently practiced and that further research to validate these findings would be useful.