General Results for the Transmuted Family of Distributions and New Models

The transmuted family of distributions has been receiving increased attention over the last few years. For a baseline G distribution, we derive a simple representation for the transmuted-G family density function as a linear mixture of the G and exponentiated-G densities. We investigate the asymptotes and shapes and obtain explicit expressions for the ordinary and incomplete moments, quantile and generating functions, mean deviations, Rényi and Shannon entropies, and order statistics and their moments. We estimate the model parameters of the family by the method of maximum likelihood. We prove empirically the flexibility of the proposed model by means of an application to a real data set.

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Comparison of Statistical Downscaling Methods for Monthly Total Precipitation: Case Study for the Paute River Basin in Southern Ecuador

Downscaling improves considerably the results of General Circulation Models (GCMs). However, little information is available on the performance of downscaling methods in the Andean mountain region. The paper presents the downscaling of monthly precipitation estimates of the NCEP/NCAR reanalysis 1 applying the statistical downscaling model (SDSM), artificial neural networks (ANNs), and the least squares support vector machines (LS-SVM) approach. Downscaled monthly precipitation estimates after bias and variance correction were compared to the median and variance of the 30-year observations of 5 climate stations in the Paute River basin in southern Ecuador, one of Ecuador’s main river basins. A preliminary comparison revealed that both artificial intelligence methods, ANN and LS-SVM, performed equally. Results disclosed that ANN and LS-SVM methods depict, in general, better skills in comparison to SDSM. However, in some months, SDSM estimates matched the median and variance of the observed monthly precipitation depths better. Since synoptic variables do not always present local conditions, particularly in the period going from September to December, it is recommended for future studies to refine estimates of downscaling, for example, by combining dynamic and statistical methods, or to select sets of synoptic predictors for specific months or seasons.

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Features of Microsystems for Cultivation and Characterization of Stem Cells with the Aim of Regenerative Therapy

Stem cells have infinite potential for regenerative therapy thanks to their advantageous ability which is differentiable to requisite cell types for recovery and self-renewal. The microsystem has been proved to be more helpful to stem cell studies compared to the traditional methods, relying on its advantageous feature of mimicking in vivo cellular environments as well as other profitable features such as minimum sample consumption for analysis and multiprocedures. A wide variety of microsystems were developed for stem cell studies; however, regenerative therapy-targeted applications of microtechnology should be more emphasized and gain more attractions since the regenerative therapy is one of ultimate goals of biologists and bioengineers. In this review, we introduce stem cell researches harnessing well-known microtechniques (microwell, micropattern, and microfluidic channel) in view point of physical principles and how these systems and principles have been implemented appropriately for characterizing stem cells and finding possible regenerative therapies. Biologists may gain information on the principles of microsystems to apply them to find solutions for their current challenges, and engineers may understand limitations of the conventional microsystems and find new chances for further developing practical microsystems. Through the well combination of engineers and biologists, the regenerative therapy-targeted stem cell researches harnessing microtechnology will find better suitable treatments for human disorders.

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Protective Effects of L-Malate against Myocardial Ischemia/Reperfusion Injury in Rats

Objective. To investigate the protective effects of L-malate against myocardial ischemia/reperfusion (I/R) injury in rats. Methods. Male Sprague-Dawley rats were randomly assigned to the following groups: sham (sham), an ischemia/reperfusion (I/R) model group (model), an DMF pretreated group (DMF), and 5 L-malate pretreated groups (15, 60, 120, 240, or 480 mg/kg, gavage) before inducing myocardial ischemia. Plasma LDH, cTn-I, TNF-, hs-CRP, SOD, and GSH-PX were measured 3 h later I/R. Areas of myocardial infarction were measured; hemodynamic parameters during I/R were recorded. Hearts were harvested and Western blot was used to quantify Nrf2, Keap1, HO-1, and NQO-1 expression in the myocardium. Results. L-malate significantly reduced LDH and cTn-I release, reduced myocardial infarct size, inhibited expression of inflammatory cytokines, and partially preserved heart function, as well as increasing antioxidant activity after myocardial I/R injury. Western blot confirmed that L-malate reduced Kelch-like ECH-associated protein 1 in ischemic myocardial tissue, upregulated expression of Nrf2 and Nrf2 nuclear translocation, and increased expression of heme oxygenase-1 and NAD(P)H:quinone oxidoreductase 1, which are major targets of Nrf2. Conclusions. L-malate may protect against myocardial I/R injury in rats and this may be associated with activation of the Nrf2/Keap1 antioxidant pathway.

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Prevalence of Helminths in Dogs and Owners’ Awareness of Zoonotic Diseases in Mampong, Ashanti, Ghana

Dogs are popular pets that live closely with humans. However, this cohabitation allows for the transmission of zoonotic parasites to humans. In Ghana, very little is known about zoonotic parasites in dogs. We examined excrements of 154 dogs for intestinal helminthes using saturated sodium chloride as a floatation medium and further interviewed 100 dog owners regarding knowledge on zoonosis and pet management practices. Thirteen parasite species were identified, with an overall prevalence of 52.6%. Nematodes were more common than cestodes, with Toxocara canis being the most prevalent helminth (18.8%). Age (; ) and location (; ) of dogs were significant risk factors of helminthic infections, while mode of housing, function, and gender of dogs were not. Knowledge on zoonosis and pet management practices were poor, including irregular deworming and feeding of animals off the bare ground. Dogs may play an active role in the transmission of zoonotic diseases in the area, given the cohabitation of infected dogs with humans; irregular deworming pattern of dogs; and rampant excretion of helminth-infested dog excreta into the environment.

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Evaluation of the Larvicidal Efficacy of Five Indigenous Weeds against an Indian Strain of Dengue Vector, Aedes aegypti L. (Diptera: Culicidae)

Background and Objectives. Aedes aegypti, dengue fever mosquito, is primarily associated with the transmission of dengue and chikungunya in tropical and subtropical regions of the world. The present investigations were carried out to assess the larvicidal efficiency of five indigenous weeds against Ae. aegypti. Methods. The 1,000 ppm hexane and ethanol extracts prepared from the leaves and stem of five plants (Achyranthes aspera, Cassia occidentalis, Catharanthus roseus, Lantana camara, and Xanthium strumarium) were screened for their larvicidal activity against early fourth instars of dengue vector. The extracts which could cause 80–100% mortality were further investigated for their efficacy. Results. The preliminary screening established the efficacy of hexane extracts as compared to the ethanol extracts. Further investigations revealed the highest larvicidal potential of A. aspera extracts exhibiting LC50 value of 82.555 ppm and 68.133 ppm, respectively. Further, their leaf extracts showed 5–85.9% higher larvicidal activity and stem extracts exhibited 0.23- to 0.85-fold more efficiency than the other four extracts. Conclusion. The present investigations suggest the possible use of A. aspera as an ideal ecofriendly, larvicidal agent for the control of dengue vector, Ae. aegypti. Future studies are, however, required to explore and identify the bioactive component involved and its mode of action.

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Square Wave Voltammetric Determination of Residues of Carbendazim Using a Fullerene/Multiwalled Carbon Nanotubes/Nafion/Coated Glassy Carbon Electrode

A glassy carbon electrode (GCE) was modified with a fullerene/Multiwalled Carbon Nanotubes (MWCNTs)/Nafion composite and applied to the determination of carbendazim, a fungicide. The voltammetric behavior of the analyte was investigated using Cyclic Voltammetry (CV), on the bare GCE and on the same electrode coated by a thin film of the composite material. The electrode response was more than fourfold important on the modified electrode, due to electrical conductivity of fullerene and MWCNT and to favorable electrostatic interaction between the negatively charged Nafion and the protonated fungicide. A sensitive electroanalytical procedure based on Square Wave Voltammetry (SWV) was then developed to detect the analyte. Under the optimum conditions, a linear relationship was obtained between the peak current and the concentration of carbendazim, in the range from 2.0 × 10−8 mol/L to 3.5 × 10−7 mol/L, leading to a detection limit of 1.7 × 10−8 mol/L and to a quantification limit of 5.57 × 10−8 mol/L. The developed procedure was successfully applied to detect carbendazim upon adsorption by some ferritic soils.

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Kubo Fluctuation Relations in the Generalized Elastic Model

The generalized elastic model encompasses several linear stochastic models describing the dynamics of polymers, membranes, rough surfaces, and fluctuating interfaces. In this paper we show that the Fractional Langevin Equation (FLE) is a suitable framework for the study of the tracer (probe) particle dynamics, when an external force acts only on a single point (tagged probe) belonging to the system. With the help of the Fox function formalism we study the scaling behaviour of the noise- and force-propagators for large and short times (distances). We show that the Kubo fluctuation relations are exactly fulfilled when a time periodic force is exerted on the tagged probe. Most importantly, by studying the large and low frequency behaviour of the complex mobility we illustrate surprising nontrivial physical scenarios. Our analysis shows that the system splits into two distinct regions whose size depends on the applied frequency, characterized by very different response to the periodic perturbation exerted, both in the phase shift and in the amplitude.

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quality of care; +33 new citations

33 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

quality of care

These pubmed results were generated on 2016/01/31

PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Legendary Irish broadcaster Terry Wogan dies aged 77 after cancer battle - Irish Independent

Irish Independent

Legendary Irish broadcaster Terry Wogan dies aged 77 after cancer battle Irish Independent WATCH: Leonardo DiCaprio thanks fellow The Revenant cast member 'Dumble Gleeson' in... Aoife Kelly Yet another Irish name has left a Hollywood star tongue-tied on stage at an awards ceremony. Making A Murder follows the case of Steven Avery (AP) ... Sir Terry Wogan's 10 best TV momentsTelegraph.co.uk Graham Norton pays tribute to Sir Terry Wogan: 'He made it seem possible'The Independent all 286 news articles »

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Reinforcement of Multiwalled Carbon Nanotube in Nitrile Rubber: In Comparison with Carbon Black, Conductive Carbon Black, and Precipitated Silica

The properties of nitrile rubber (NBR) reinforced by multiwalled carbon nanotube (MWCNT), conductive carbon black (CCB), carbon black (CB), and precipitated silica (PSi) were investigated via viscoelastic behavior, bound rubber content, electrical properties, cross-link density, and mechanical properties. The filler content was varied from 0 to 15 phr. MWCNT shows the greatest magnitude of reinforcement considered in terms of tensile strength, modulus, hardness, and abrasion resistance followed by CCB, CB, and PSi. The MWCNT filled system also exhibits extremely high levels of filler network and trapped rubber even at relatively low loading (5 phr) leading to high electrical properties and poor dynamic mechanical properties. Although CCB possesses the highest specific surface area, it gives lower level of filler network than MWCNT and also gives the highest elongation at break among all fillers. Both CB and PSi show comparable degree of reinforcement which is considerably lower than CCB and MWCNT.

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Compressed Sensing/Sparse-Recovery Approach for Improved Range Resolution in Narrow-Band Radar

A compressed sensing/sparse-recovery procedure is adopted to obtain enhanced range resolution capability from the processing of data acquired with narrow-band SFCW radars. A mathematical formulation for the proposed approach is reported and validity limitations are fully discussed, by demonstrating the ability to identify a great number of targets, up to 20, in the range direction. Both numerical and experimental validations are presented, by assuming also noise conditions. The proposed method can be usefully applied for the accurate detection of parameters with very small variations, such as those involved in the monitoring of soil deformations or biological objects.

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Downregulation of Mitofusin 2 in Placenta Is Related to Preeclampsia

Background. Mitofusin 2 (Mfn2) is a novel mitochondrial protein that is implicated in cellular proliferation and metabolism; however, the role of Mfn2 in preeclampsia (PE) remains unknown. This study aimed to explore the relationship between Mfn2 and PE. Method. Preeclamptic and normal pregnancies were enrolled in a comparative study. The expression of Mfn2 in placenta was detected by qRT-PCR. And the mitochondrial function was detected by ATP assay. Then TEV-1 cells were cultured in hypoxic conditions. mRNA and protein expressions of Mfn2 were detected by qRT-PCR and western blot separately. Cells’ viability was detected by MTT. And the mitochondrial function was detected by ATP and mitochondrial membrane potential (MMP) assay. We further knocked down the Mfn2 gene in TEV-1 cells and evaluated the cells’ viability. Results. Mfn2 and ATP expressions were significantly decreased in preeclamptic placentae compared to normal placentae. Mfn2 expression level and the viability of TEV-1 cells were reduced during hypoxic conditions. TEV-1 cells’ viability, ATP, and MMP levels were also significantly decreased after knockdown of the Mfn2 gene. Conclusions. These results suggest that defects in Mfn2 could cause mitochondrial dysfunction and decrease trophoblastic cells’ viability. Therefore, Mfn2 may be functionally involved in the pathogenesis of PE.

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Overexpression of Soluble Recombinant Human Lysyl Oxidase by Using Solubility Tags: Effects on Activity and Solubility

Lysyl oxidase is an important extracellular matrix enzyme that has not been fully characterized due to its low solubility. In order to circumvent the low solubility of this enzyme, three solubility tags (Nus-A, Thioredoxin (Trx), and Glutathione-S-Transferase (GST)) were engineered on the N-terminus of mature lysyl oxidase. Total enzyme yields were determined to be 1.5 mg for the Nus-A tagged enzyme (0.75 mg/L of media), 7.84 mg for the Trx tagged enzyme (3.92 mg/L of media), and 9.33 mg for the GST tagged enzyme (4.67 mg/L of media). Enzymatic activity was calculated to be 0.11 U/mg for the Nus-A tagged enzyme and 0.032 U/mg for the Trx tagged enzyme, and no enzymatic activity was detected for the GST tagged enzyme. All three solubility-tagged forms of the enzyme incorporated copper; however, the GST tagged enzyme appears to bind adventitious copper with greater affinity than the other two forms. The catalytic cofactor, lysyl tyrosyl quinone (LTQ), was determined to be 92% for the Nus-A and Trx tagged lysyl oxidase using the previously reported extinction coefficient of 15.4 mM−1 cm−1. No LTQ was detected for the GST tagged lysyl oxidase. Given these data, it appears that Nus-A is the most suitable tag for obtaining soluble and active recombinant lysyl oxidase from E. coli culture.

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Direct hydrogel encapsulation of pluripotent stem cells enables ontomimetic differentiation and growth of engineered human heart tissues.

Direct hydrogel encapsulation of pluripotent stem cells enables ontomimetic differentiation and growth of engineered human heart tissues.

Biomaterials. 2015 Dec 18;83:383-395

Authors: Kerscher P, Turnbull IC, Hodge AJ, Kim J, Seliktar D, Easley CJ, Costa KD, Lipke EA

Abstract
Human engineered heart tissues have potential to revolutionize cardiac development research, drug-testing, and treatment of heart disease; however, implementation is limited by the need to use pre-differentiated cardiomyocytes (CMs). Here we show that by providing a 3D poly(ethylene glycol)-fibrinogen hydrogel microenvironment, we can directly differentiate human pluripotent stem cells (hPSCs) into contracting heart tissues. Our straight-forward, ontomimetic approach, imitating the process of development, requires only a single cell-handling step, provides reproducible results for a range of tested geometries and size scales, and overcomes inherent limitations in cell maintenance and maturation, while achieving high yields of CMs with developmentally appropriate temporal changes in gene expression. We demonstrate that hPSCs encapsulated within this biomimetic 3D hydrogel microenvironment develop into functional cardiac tissues composed of self-aligned CMs with evidence of ultrastructural maturation, mimicking heart development, and enabling investigation of disease mechanisms and screening of compounds on developing human heart tissue.

PMID: 26826618 [PubMed - as supplied by publisher]

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Partially reduced graphene oxide as highly efficient DNA nanoprobe.

Partially reduced graphene oxide as highly efficient DNA nanoprobe.

Biosens Bioelectron. 2016 Jan 21;80:140-145

Authors: Wang YH, Deng HH, Liu YH, Shi XQ, Liu AL, Peng HP, Hong GL, Chen W

Abstract
This work investigates the effect of reduction degree on graphene oxide (GO)-DNA interaction and the fluorescence quenching mechanism. Partial reduced graphene oxide (pRGO), which maintains well water-dispersibility, is synthesized using a mild reduction method by incubating GO suspension under alkaline condition at room temperature. The fluorescence quenching enhances with the restoration degree of sp(2) carbon bonds and follows the static quenching mechanism. The binding constant values imply that pRGO has much stronger affinity with ssDNA than GO. Utilizing this highly efficient nanoprobe, a universal sensing strategy is proposed for homogeneous detection of DNA. Compared with the reported GO-based DNA, this present strategy has obvious advantages such as requirement of low nanoprobe dosage, significantly reduced background, fast fluorescence quenching, and improved sensitivity. Even without any amplification process, the limit of detection can reach as low as 50pM.

PMID: 26826548 [PubMed - as supplied by publisher]

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Recombinant influenza virus expressing HIV-1 p24 capsid protein induces mucosal HIV-specific CD8 T-cell responses.

Recombinant influenza virus expressing HIV-1 p24 capsid protein induces mucosal HIV-specific CD8 T-cell responses.

Vaccine. 2016 Jan 27;

Authors: Tan HX, Gilbertson BP, Jegaskanda S, Alcantara S, Amarasena T, Stambas J, McAuley JL, Kent SJ, De Rose R

Abstract
Influenza viruses are promising mucosal vaccine vectors for HIV but their use has been limited by difficulties in engineering the expression of large amounts of foreign protein. We developed recombinant influenza viruses incorporating the HIV-1 p24 gag capsid into the NS-segment of PR8 (H1N1) and X31 (H3N2) influenza viruses with the use of multiple 2A ribosomal skip sequences. Despite the insertion of a sizable HIV-1 gene into the influenza genome, recombinant viruses were readily rescued to high titers. Intracellular expression of p24 capsid was confirmed by in vitro infection assays. The recombinant influenza viruses were subsequently tested as mucosal vaccines in BALB/c mice. Recombinant viruses were attenuated and safe in immunized mice. Systemic and mucosal HIV-specific CD8 T-cell responses were elicited in mice that were immunized via intranasal route with a prime-boost regimen. Isolated HIV-specific CD8 T-cells displayed polyfunctional cytokine and degranulation profiles. Mice boosted via intravaginal route induced recall responses from the distal lung mucosa and developed heightened HIV-specific CD8 T-cell responses in the vaginal mucosa. These findings demonstrate the potential utility of recombinant influenza viruses as vaccines for mucosal immunity against HIV-1 infection.

PMID: 26826545 [PubMed - as supplied by publisher]

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Abnormal functional connectivity density in first-episode, drug-naive adult patients with major depressive disorder.

Abnormal functional connectivity density in first-episode, drug-naive adult patients with major depressive disorder.

J Affect Disord. 2016 Jan 20;194:153-158

Authors: Ke Zou, Qing Gao, Zhiliang Long, Fei Xu, Xiao Sun, Huafu Chen, Xueli Sun

Abstract
Previous studies have found evidence of brain functional connectivity (FC) changes with pre-selected region-of-interest (ROI) method in major depressive disorder (MDD). However, these studies could not completely exclude personal inequality when drawing ROIs manually and did not measure the total number of FC for each voxel. Here, we firstly applied functional connectivity density (FCD) mapping, a voxel-based analysis to locate the hubs with amount changes of FC between 22 first-episode, drug-naive adult MDD patients and 22 healthy control (HC) subjects. Both short-range (local) FCD and long-range (distal) FCD were measured. The relationships of FCD changes with Hamilton Depression Rating Scale (HAMD) scores and illness duration were also explored. Compared with the HC group, MDD patients showed significantly decreased short-range FCD in the left superior temporal gyrus (STG), the right orbital frontal cortex (OFC) and bilateral precuneus, while significantly decreased long-range FCD was found in bilateral middle occipital gyrus (MOG), superior occipital gyrus (SOG) and right calcarine. These results firstly demonstrated both local and distal alterations of connection amount at voxel level, and highlighted that the OFC, the precuneus, the STG and the visual cortex were important brain network hubs for first-episode, drug-naive adult MDD patients. Our findings were complementary for previous structural and functional studies in MDD patients, and provided new evidence of the dysfunction of connection hubs in the pathophysiology of MDD at voxel level.

PMID: 26826535 [PubMed - as supplied by publisher]

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Combining pharmacotherapy and psychotherapy or monotherapy for major depression? A meta-analysis on the long-term effects.

Combining pharmacotherapy and psychotherapy or monotherapy for major depression? A meta-analysis on the long-term effects.

J Affect Disord. 2016 Jan 20;194:144-152

Authors: Karyotaki E, Smit Y, Holdt Henningsen K, Huibers MJ, Robays J, de Beurs D, Cuijpers P

Abstract
BACKGROUND: The present meta-analysis aimed to examine to what extent combined pharmacotherapy with psychotherapy results in a different response to treatment compared to psychotherapy or pharmacotherapy alone in adults with major depression at six months or longer postrandomization.
METHODS: A systematic literature search resulted in 23 randomized controlled trials with 2184 participants. Combined treatment was compared to either psychotherapy or anti-depressant medication alone in both the acute phase and the maintenance phase. Odds ratios of a positive outcome were calculated for all comparisons.
RESULTS: In acute phase treatment, combined psychotherapy with antidepressants outperformed antidepressants alone at six months or longer postrandomization in patients with major depressive disorder (OR=2.93, 95%CI 2.15-3.99, p<0.001). Heterogeneity was zero (95%CI 0-57%, p>0.05). However, combined therapy resulted in equal response to treatment compared to psychotherapy alone at six months or longer postrandomization. As for the maintenance treatment, combined maintenance psychotherapy with antidepressants resulted in better-sustained treatment response compared to antidepressants at six months or longer postrandomization (OR=1.61, 95%CI 1.14-2.27, p<0.05). Heterogeneity was zero (95%CI 0-68%, p>0.05).
CONCLUSIONS: Combined therapy results in a superior enduring effect compared to antidepressants alone in patients with major depression. Psychotherapy is an adequate alternative for combined treatment in the acute phase as it is as effective as combined treatment in the long-term.

PMID: 26826534 [PubMed - as supplied by publisher]

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Plants traditionally used as mosquito repellents and the implication for their use in vector control.

Plants traditionally used as mosquito repellents and the implication for their use in vector control.

Acta Trop. 2016 Jan 27;

Authors: Tisgratog R, Sanguanpong U, Grieco JP, Ngoen-Kluan R, Chareonviriyaphap T

Abstract
Numerous plants with insect repelling properties are native to the tropics where they are produced for a wide range of medicinal purposes. In Thailand, these native plant species have a history of use for personal protection against biting insects. From our investigation we identified 37 plant species within 14 plant families that showed some mosquito repellent properties. Of these, 9 plant species were characterized using an excito-repellency test system against several Thai mosquito species. Results from these studies revealed that five essential oils extracted from plants demonstrated promising insect repellent activity. These active ingredients show promise for further development into formulations that may serve as alternatives to DEET or possibly be used as natural bio-pesticides to kill mosquitoes.

PMID: 26826392 [PubMed - as supplied by publisher]

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CD4 Cell Count: Declining Value for Antiretroviral Therapy Eligibility.

CD4 Cell Count: Declining Value for Antiretroviral Therapy Eligibility.

Clin Infect Dis. 2016 Jan 29;

Authors: Ying R, Granich RM, Gupta S, Williams BG

Abstract
Antiretroviral therapy (ART) policy for people living with human immunodeficiency virus (HIV) has historically been based on clinical indications, such as opportunistic infections and CD4 cell counts. Studies suggest that CD4 counts early in HIV infection do not predict relevant public health outcomes such as disease progression, mortality, and HIV transmission in people living with HIV. CD4 counts also vary widely within individuals and among populations, leading to imprecise measurements and arbitrary ART initiation. To capture the clinical and preventive benefits of treatment, the global HIV response now focuses on increasing HIV diagnosis and ART coverage. CD4 counts for ART initiation were necessary when medications were expensive and had severe side effects, and when the impact of early ART initiation was unclear. However, current evidence suggests that although CD4 counts may still play a role in guiding clinical care to start prophylaxis for opportunistic infections, CD4 counts should cease to be required for ART initiation.

PMID: 26826372 [PubMed - as supplied by publisher]

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Towards a meaningful assessment of marine ecological impacts in life cycle assessment (LCA).

Towards a meaningful assessment of marine ecological impacts in life cycle assessment (LCA).

Environ Int. 2016 Jan 27;89-90:48-61

Authors: Woods JS, Veltman K, Huijbregts MA, Verones F, Hertwich EG

Abstract
Human demands on marine resources and space are currently unprecedented and concerns are rising over observed declines in marine biodiversity. A quantitative understanding of the impact of industrial activities on the marine environment is thus essential. Life cycle assessment (LCA) is a widely applied method for quantifying the environmental impact of products and processes. LCA was originally developed to assess the impacts of land-based industries on mainly terrestrial and freshwater ecosystems. As such, impact indicators for major drivers of marine biodiversity loss are currently lacking. We review quantitative approaches for cause-effect assessment of seven major drivers of marine biodiversity loss: climate change, ocean acidification, eutrophication-induced hypoxia, seabed damage, overexploitation of biotic resources, invasive species and marine plastic debris. Our review shows that impact indicators can be developed for all identified drivers, albeit at different levels of coverage of cause-effect pathways and variable levels of uncertainty and spatial coverage. Modeling approaches to predict the spatial distribution and intensity of human-driven interventions in the marine environment are relatively well-established and can be employed to develop spatially-explicit LCA fate factors. Modeling approaches to quantify the effects of these interventions on marine biodiversity are less well-developed. We highlight specific research challenges to facilitate a coherent incorporation of marine biodiversity loss in LCA, thereby making LCA a more comprehensive and robust environmental impact assessment tool. Research challenges of particular importance include i) incorporation of the non-linear behavior of global circulation models (GCMs) within an LCA framework and ii) improving spatial differentiation, especially the representation of coastal regions in GCMs and ocean-carbon cycle models.

PMID: 26826362 [PubMed - as supplied by publisher]

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Curcumin inhibits metastasis in human papillary thyroid carcinoma BCPAP cells via down-regulation of the TGF-β/Smad2/3 signalling pathway.

Curcumin inhibits metastasis in human papillary thyroid carcinoma BCPAP cells via down-regulation of the TGF-β/Smad2/3 signalling pathway.

Exp Cell Res. 2016 Jan 27;

Authors: Zhang L, Cheng X, Gao Y, Zhang C, Bao J, Guan H, Yu H, Lu R, Xu Q, Sun Y

Abstract
Thyroid cancers usually possess a good prognosis while the risks of recurrence and metastasis turn out to be a disturbing issue. Curcumin [bis(4-hydroxy-3-methoxy-phenyl)-1,6-heptadiene-3,5-dione] is a natural polyphenolic compound mainly found in turmeric (Curcuma longa). Our previous studies have demonstrated that curcumin showed proliferation-inhibitory and apoptosis-inducing effects on K1 papillary thyroid cancer cells. However, the mechanism underlying the inhibition effects of curcumin on thyroid cancer cells remains unclear. Herein, we demonstrated that curcumin remarkably increased the expression of the epithelial marker E-cadherin and repressed the expression of the mesenchymal marker vimentin in human papillary thyroid carcinoma BCPAP cells. Curcumin also suppressed multiple metastatic steps of BCPAP cells, including cell attachment, spreading as well as migration. In addition, the transcription, secretion and activation of matrix metalloproteinases (MMPs) induced by transforming growth factor-β1 (TGF-β1) in BCPAP cells were mitigated upon curcumin treatment. Further evidence showed that curcumin decreased TGF-β1-mediated phosphorylation of Smad2 and Smad3. These results revealed that curcumin inhibited the TGF-β1-induced epithelial-mesenchymal transition (EMT) via down-regulation of Smad2/3 signalling pathways. Our findings provide new evidence that the anti-metastatic and anti-EMT activities of curcumin may contribute to the development of chemo-preventive agents for thyroid cancer treatment.

PMID: 26826337 [PubMed - as supplied by publisher]

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Access to and use of infertility services in the United States: framing the challenges.

Access to and use of infertility services in the United States: framing the challenges.

Fertil Steril. 2016 Jan 27;

Authors: Adashi EY, Dean LA

Abstract
An overview of access to and use of general infertility and assisted reproductive technology (ART) services in the United States shows the ever-use of infertility services features declining trends. Moreover, the use of ART services lags relative to other member nations of the Organization for Economic Co-operation and Development (OECD). Access to and use of general infertility and ART services is primarily undermined by a severely constrained underwriting universe dominated by self-insured employers and by a finite number of state infertility insurance mandates. The contribution of traditional public and private payers to the underwriting of ART is limited. As compared with OECD member nations wherein the access to and underwriting of general infertility and ART services is universal, the current status quo in the United States can only be characterized as lugubrious. Further, the current state of affairs is socially unjust in that the right to build a family in the face of infertility appears to have become a function of economic prowess. Given the dominance of the self-insured employers as underwriters of general infertility and ART services, advocacy directed at this interest group is likely to prove most productive. Improving the state of underwriting of general infertility and ART services in the United States must be embraced as a central moral imperative and as an unwavering strategic goal of the professional societies entrusted with the reproductive health of women and men.

PMID: 26826275 [PubMed - as supplied by publisher]

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Clusterin Modulates Allergic Airway Inflammation by Attenuating CCL20-Mediated Dendritic Cell Recruitment.

Clusterin Modulates Allergic Airway Inflammation by Attenuating CCL20-Mediated Dendritic Cell Recruitment.

J Immunol. 2016 Jan 29;

Authors: Hong GH, Kwon HS, Moon KA, Park SY, Park S, Lee KY, Ha EH, Kim TB, Moon HB, Lee HK, Cho YS

Abstract
Recruitment and activation of dendritic cells (DCs) in the lungs are critical for Th2 responses in asthma, and CCL20 secreted from bronchial epithelial cells (BECs) is known to influence the recruitment of DCs. Because asthma is a disease that is closely associated with oxidative stress, we hypothesized that clusterin, an oxidative stress regulatory molecule, may have a role in the development of allergic airway inflammation. The aim of this study was to examine whether clusterin regulates CCL20 production from the BECs and the subsequent DC recruitment in the lungs. To verify the idea, clusterin knockout (Clu(-/-)), clusterin heterogeneous (Clu(+/-)), and wild-type mice were exposed intranasally to house dust mite (HDM) extract to induce allergic airway inflammation. We found that the total number of immune cells in bronchoalveolar lavage fluid and the lung was increased in Clu(-/-) and Clu(+/-) mice. Of these immune cells, inflammatory DCs (CD11b(+)CD11c(+)) and Ly6C(high) monocyte populations in the lung were significantly increased, which was accompanied by increased levels of various chemokines, including CCL20 in bronchoalveolar lavage fluid, and increased oxidative stress markers in the lung. Moreover, HDM-stimulated human BECs with either up- or downregulated clusterin expression showed that CCL20 secretion was negatively associated with clusterin expression. Interestingly, clusterin also reduced the level of intracellular reactive oxygen species, which is related to induction of CCL20 expression after HDM stimulation. Thus, the antioxidant property of clusterin is suggested to regulate the expression of CCL20 in BECs and the subsequent recruitment of inflammatory DCs in the airway.

PMID: 26826245 [PubMed - as supplied by publisher]

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Psychological Interventions for Poor Oral Health: A Systematic Review.

Psychological Interventions for Poor Oral Health: A Systematic Review.

J Dent Res. 2016 Jan 29;

Authors: Werner H, Hakeberg M, Dahlström L, Eriksson M, Sjögren P, Strandell A, Svanberg T, Svensson L, Wide Boman U

Abstract
The aim of this systematic review and meta-analysis was to study the effectiveness of psychological interventions in adults and adolescents with poor oral health. The review follows the PRISMA guidelines for systematic reviews. The PICO format (population, intervention, comparison, and outcome) was used to define eligible studies. The populations were adults or adolescents (≥13 y of age and independent of others) with poor oral health (defined as dental caries, periodontal disease, and/or peri-implantitis). The interventions were psychological and/or behavioral models and theories, in comparison with traditional oral health education/information. The primary outcomes were dental caries, periodontitis, gingivitis, and peri-implantitis. Secondary outcomes were dental plaque, oral health-related behavior, health-related quality of life, health beliefs and attitudes, self-perceived oral health, and complications/risks. The systematic literature search identified 846 articles in December 2013 and 378 articles in July 2015. In total, 11 articles on 9 randomized controlled trials were found to meet the inclusion criteria. These reported on adults with periodontal disease, and several used motivational interviewing (MI) as their mode of intervention. The CONSORT guidelines and the GRADE approach were used for study appraisal and rating of evidence. The meta-analysis showed no statistically significant differences in gingivitis or plaque presence. In addition, a meta-analysis on MI compared with education/information found no statistically significant differences in gingivitis presence. Only 1 meta-analysis-on psychological interventions versus education/information regarding the plaque index-showed a small but statistically significant difference. There were also statistically significant differences reported in favor of psychological interventions in oral health behavior and self-efficacy in toothbrushing. However, the clinical relevance of these differences is difficult to estimate. The certainty of evidence was low. Future research needs to address several methodological issues and not only study adults with periodontal disease but also adolescents and patients with dental caries and peri-implantitis.

PMID: 26826109 [PubMed - as supplied by publisher]

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Risk factors for severity and mortality in patients with MERS-CoV: Analysis of publicly available data from Saudi Arabia.

Risk factors for severity and mortality in patients with MERS-CoV: Analysis of publicly available data from Saudi Arabia.

Virol Sin. 2016 Jan 25;

Authors: Banik GR, Alqahtani AS, Booy R, Rashid H

PMID: 26826080 [PubMed - as supplied by publisher]

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Management of dystonia in Europe: a survey of the European network for the study of the dystonia syndromes.

Management of dystonia in Europe: a survey of the European network for the study of the dystonia syndromes.

Eur J Neurol. 2016 Jan 29;

Authors: Valadas A, Contarino MF, Albanese A, Bhatia KP, Falup-Pecurariu C, Forsgren L, Friedman A, Giladi N, Hutchinson M, Kostic VS, Krauss JK, Lokkegaard A, Marti MJ, Milanov I, Pirtosek Z, Relja M, Skorvanek M, Stamelou M, Stepens A, Tamás G, Taravari A, Tzoulis C, Vandenberghe W, Vidailhet M, Ferreira JJ, Tijssen MA

Abstract
BACKGROUND AND PURPOSE: Dystonia is difficult to recognize due to its large phenomenological complexity. Thus, the use of experts in dystonia is essential for better recognition and management of dystonia syndromes (DS). Our aim was to document managing strategies, facilities and expertise available in various European countries in order to identify which measures should be implemented to improve the management of DS.
METHODS: A survey was conducted, funded by the Cooperation in Science and Technology, via the management committee of the European network for the study of DS, which is formed from representatives of the 24 countries involved.
RESULTS: Lack of specific training in dystonia by general neurologists, general practitioners as well as other allied health professionals was universal in all countries surveyed. Genetic testing for rare dystonia mutations is not readily available in a significant number of countries and neurophysiological studies are difficult to perform due to a lack of experts in this field of movement disorders. Tetrabenazine is only readily available for treatment of dystonia in half of the surveyed countries. Deep brain stimulation is available in three-quarters of the countries, but other surgical procedures are only available in one-quarter of countries.
CONCLUSIONS: Internationally, collaboration in training, advanced diagnosis, treatment and research of DS and, locally, in each country the creation of multidisciplinary teams for the management of dystonia patients could provide the basis for improving all aspects of dystonia management across Europe.

PMID: 26826067 [PubMed - as supplied by publisher]

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Association of sleep bruxism and dental plaque factors on signs of periodontal disease in children in the mixed dentition.

Association of sleep bruxism and dental plaque factors on signs of periodontal disease in children in the mixed dentition.

Int J Paediatr Dent. 2016 Jan 30;

Authors: Restrepo CC, Tirado M, Jimenez KJ

Abstract
BACKGROUND: Periodontal disease has a multifactorial etiology; however, dental plaque and possible sleep bruxism (SB) have not been tested together in children as predictors of periodontal disease.
AIM: To assess the variation of SB, dental biofilm (DBF), gingival index (GI), and plaque index (PI) between localized and generalized pathological probing depth (PPD), crestal bone loss (CBL), and lack of delineation of lamina dura (LD) and to establish the association of DBF, GI, PI and SB with PPD, CBL, and LD in children with mixed dentition.
METHODS: Fifty children were assessed for SB and underwent a clinical and radiographic periodontal examination. anova and three multiple variable analysis were used to analyze the data.
RESULTS: One-way anova was found to be statistically significant for SB, between localized and generalized PPD (P = 0.03), CBL (P = 0.01), and LD (P = 0.005) and for DBF between localized and generalized CBL (P = 0.02). The three multiple variable analysis showed statistically and clinically significant associations of DBF with PPD (OR = 3.33); GI (OR = 2.37), and PI (OR = 1.46) with CBL and SB (OR = 7.66) and DBF (OR = 9.87) with LD. PI presented statistically significant association with CBL.
CONCLUSION: Significant associations of SB, DBF, GI, and PI with PD, CBL, and LD and the variations of the same factors between localized and generalized PPD, CBL, and LD suggest the necessity of evaluating SB, DBF, GI, and PI when children are screened in regular dental visits.

PMID: 26826672 [PubMed - as supplied by publisher]

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India: not a country to die in.

India: not a country to die in.

Indian J Med Ethics. 2016 Jan-Mar;13(1):30-35

Authors: Gursahani R, Mani RK

Abstract
This commentary addresses the issue of disproportionate medical interventions for end-of-life patients. A complex mix of sociocultural and medical factors, against the backdrop of the legal milieu, has an impact on the quality of death. The barriers to appropriate end-of-life and palliative care in India are multilayered and not easy to dismantle. To raise the level of care for the dying in India, currently rated among the worst in the world, it would require no less than a nationwide movement. This paper attempts to bring into the open the areas of concern for discussion, and proposes appropriate legislation for a realistic solution.

PMID: 26826659 [PubMed - as supplied by publisher]

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Youth internalizing symptoms, sleep-related problems, and disordered eating attitudes and behaviors: A moderated mediation analysis.

Youth internalizing symptoms, sleep-related problems, and disordered eating attitudes and behaviors: A moderated mediation analysis.

Eat Behav. 2016 Jan 21;21:99-103

Authors: Chardon ML, Janicke DM, Carmody JK, Dumont-Driscoll MC

Abstract
PURPOSE: Internalizing symptoms increase the risk for disordered eating; however, the mechanism through which this relationship occurs remains unclear. Sleep-related problems may be a potential link as they are associated with both emotional functioning and disordered eating. The present study aims to evaluate the mediating roles of two sleep-related problems (sleep disturbance and daytime sleepiness) in the relationship between youth internalizing symptoms and disordered eating, and to explore if age moderates these relations.
METHODS: Participants were 225 youth (8-17years) attending a primary care appointment. Youth and legal guardians completed questionnaires about youth disordered eating attitudes and behaviors, internalizing symptoms, sleep disturbance, and daytime sleepiness. Mediation and moderated mediation analyses were utilized.
RESULTS: The mediation model revealed both youth sleep disturbance and daytime sleepiness independently mediated the association between internalizing symptoms and disordered eating attitudes and behaviors, and explained 18% of the variance in disordered eating. The moderated mediation model including youth age accounted for 21% of the variance in disordered eating; youth age significantly interacted with sleep disturbance, but not with daytime sleepiness, to predict disordered eating. Sleep disturbance only mediated the relationship between internalizing symptoms and disordered eating in youth 12years old and younger, while daytime sleepiness was a significant mediator regardless of age.
CONCLUSION: As sleep-related problems are frequently improved with the adoption of health behaviors conducive to good sleep, these results may suggest a relatively modifiable and cost-effective target to reduce youth risk for disordered eating.

PMID: 26826649 [PubMed - as supplied by publisher]

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Relation Between Health-Related Quality of Life and Sleep Quality With Adjustment for Comorbidity Among the Korean Elderly: Mixed-Effects Model With a 6-Year Follow-up Study.

Relation Between Health-Related Quality of Life and Sleep Quality With Adjustment for Comorbidity Among the Korean Elderly: Mixed-Effects Model With a 6-Year Follow-up Study.

Asia Pac J Public Health. 2016 Jan 29;

Authors: Kwon AM, Shin C

Abstract
It is an important public health problem to identify risk factors of health-related quality of life (HRQoL) among the elderly. We recruited subjects from Ansan, Korea, as a subset of the Korean Genome and Epidemiology Study (KoGES), which is an ongoing population study, and followed up their sleep quality for 6 years. Mixed effect models were used to estimate the association between sleep quality and HRQoL, and we found that overall HRQoL was significantly lower to the elderly having poor sleep quality with adjustment for significant covariates although sleep quality showed a significant interaction effect with time for the mental component summary of SF-12. In particular, the elderly having lack of quality sleep appeared to have good general health, but their functional performances were significantly poor.

PMID: 26826370 [PubMed - as supplied by publisher]

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How do doctors and nurses manage delirium in intensive care units? A qualitative study using focus groups.

How do doctors and nurses manage delirium in intensive care units? A qualitative study using focus groups.

BMJ Open. 2016;6(1):e009678

Authors: Palacios-Ceña D, Cachón-Pérez JM, Martínez-Piedrola R, Gueita-Rodriguez J, Perez-de-Heredia M, Fernández-de-Las-Peñas C

Abstract
OBJECTIVES: The aim of this study was to explore the experiences of doctors and nurses caring for patients with delirium in the intensive care unit (ICU) and to describe the process of delirium management.
SETTING: This study was performed in 5 ICUs located within 4 hospitals in Madrid (Spain).
PARTICIPANTS: Purposeful sampling was performed which included (1) doctors and nurses working in ICUs, (2) with >1 year experience in the ICU and (3) clinical experience with delirium. 38 professionals participated (19 doctors, 19 nurses), including 22 women and 16 men. The total mean age was 39 years.
DESIGN: A qualitative study using focus groups.
METHODS: 7 focus groups were held to collect data: 3 nurse focus groups, 3 doctor focus groups and 1 mixed focus group. Each group comprised 6-10 participants. A semistructured questions guide was used. Thematic analysis methods were used to analyse the data.
RESULTS: 3 themes were identified: (1) the professional perspective on delirium; (2) implementing pharmacological and non-pharmacological treatment for delirium and (3) work organisation in the ICU. The professionals regarded patients with delirium with uncertainty, and felt they were often underdiagnosed and poorly managed. Doctors displayed discrepancies regarding pharmacological prescriptions and decision-making. The choice of medication was determined by experience. Nurses felt that, for many doctors, delirium was not considered a matter of urgency in the ICU. Nurses encountered difficulties when applying verbal restraint, managing sleep disorders and providing early mobilisation. The lack of a delirium protocol generates conflicts regarding what type of care management to apply, especially during the night shift. A degree of group pressure exists which, in turn, influences the decision-making process and patient care.
CONCLUSIONS: Patients with delirium represent complex cases, requiring the implementation of specific protocols. These results serve to improve the process of care in patients with delirium.

PMID: 26826150 [PubMed - as supplied by publisher]

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Pulmonary Kaposi's Sarcoma and Its Complications in the HAART Era: A Contemporary Case-Based Review.

Pulmonary Kaposi's Sarcoma and Its Complications in the HAART Era: A Contemporary Case-Based Review.

Lung. 2016 Jan 29;

Authors: Epelbaum O, Go R, Patel G, Braman S

Abstract
The early years of the acquired immunodeficiency syndrome (AIDS) epidemic introduced the global medical community to Kaposi's sarcoma (KS), a heretofore seldom encountered angiosarcomatous neoplasm associated with human herpesvirus-8. At that time, clinicians treating these KS patients were routinely exposed to the pulmonary manifestations of this malignancy, including characteristic airway lesions, peribronchovascular opacities, and the typically hemorrhagic pleural effusions. They also witnessed uncommon complications of pulmonary KS such as chylous effusions, diffuse alveolar hemorrhage, and immune reconstitution inflammatory syndrome. Since the advent of highly active antiretroviral therapy, the incidence of KS has steadily declined and with that so has clinician familiarity with this disease. Herein, we present four KS cases recently encountered at our institution that illustrate both typical manifestations of pulmonary KS as well as its thoracic complications. The case descriptions are followed by a review of these clinical entities with the aim of restoring awareness among frontline physicians of what is now a rare but not quite extinct AIDS-defining neoplasm.

PMID: 26826066 [PubMed - as supplied by publisher]

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Circadian system - A novel diagnostic and therapeutic target in Parkinson's disease?

Circadian system - A novel diagnostic and therapeutic target in Parkinson's disease?

Mov Disord. 2016 Jan 30;

Authors: Videnovic A, Willis GL

Abstract
The circadian system regulates biological rhythmicity in the human body. The role of the circadian system in neurological disorders is a theme that is attracting an increasing amount of interest from the scientific community. This has arisen, in part, from emerging evidence that disorders such as Parkinson's disease (PD) are multifactorial with many features exhibiting diurnal fluctuations, thereby suggestive of circadian involvement. Although the importance of fluctuating motor and nonmotor manifestations in PD have been well acknowledged, the role of the circadian system has received little attention until recently. It is proposed that intervening with circadian function provides a novel research avenue down which new strategies for improving symptomatic treatment and slowing of the progressive degenerative process can be approached to lessen the burden of PD. In this article we review the literature describing existing circadian research in PD and its experimental models. © 2016 International Parkinson and Movement Disorder Society.

PMID: 26826022 [PubMed - as supplied by publisher]

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Pregnancy as a Window to Future Cardiovascular Health: Design and Implementation of the nuMoM2b Heart Health Study.

Pregnancy as a Window to Future Cardiovascular Health: Design and Implementation of the nuMoM2b Heart Health Study.

Am J Epidemiol. 2016 Jan 28;

Authors: Haas DM, Ehrenthal DB, Koch MA, Catov JM, Barnes SE, Facco F, Parker CB, Mercer BM, Bairey-Merz CN, Silver RM, Wapner RJ, Simhan HN, Hoffman MK, Grobman WA, Greenland P, Wing DA, Saade GR, Parry S, Zee PC, Reddy UM, Pemberton VL, Burwen DR, National Heart, Lung, and Blood Institute nuMoM2b Heart Health Study Network

Abstract
The National Institute of Child Health and Human Development's Nulliparous Pregnancy Outcomes Study-Monitoring Mothers-to-Be (nuMoM2b) Heart Health Study (HHS) was designed to investigate the relationships between adverse pregnancy outcomes and modifiable risk factors for cardiovascular disease. The ongoing nuMoM2b-HHS, which started in 2013, is a prospective follow-up of the nuMoM2b cohort, which included 10,038 women recruited between 2010 and 2013 from 8 centers across the United States who were initially observed over the course of their first pregnancies. In this report, we detail the design and study procedures of the nuMoM2b-HHS. Women in the pregnancy cohort who consented to be contacted for participation in future studies were approached at 6-month intervals to ascertain health information and to maintain ongoing contact. Two to 5 years after completion of the pregnancy documented in the nuMoM2b, women in the nuMoM2b-HHS were invited to an in-person study visit. During this visit, they completed psychosocial and medical history questionnaires and had clinical measurements and biological specimens obtained. A subcohort of participants who had objective assessments of sleep-disordered breathing during pregnancy were asked to repeat this investigation. This unique prospective observational study includes a large, geographically and ethnically diverse cohort, rich depth of phenotypic information about adverse pregnancy outcomes, and clinical data and biospecimens from early in the index pregnancy onward. Data obtained from this cohort will provide mechanistic and clinical insights into how data on a first pregnancy can provide information about the potential development of subsequent risk factors for cardiovascular disease.

PMID: 26825925 [PubMed - as supplied by publisher]

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Dry Eye Syndrome Risks in Patients With Fibromyalgia: A National Retrospective Cohort Study.

Dry Eye Syndrome Risks in Patients With Fibromyalgia: A National Retrospective Cohort Study.

Medicine (Baltimore). 2016 Jan;95(4):e2607

Authors: Chen CH, Yang TY, Lin CL, Chen CS, Lin WM, Kuo CN, Lin MC, Kao CH

Abstract
The coexistence of fibromyalgia (FM) and dry eye syndrome (DES) has been previously reported. However, there are few studies on how patients with FM may develop concomitant DES. Patients with chronic widespread pain, like FM, chronic fatigue syndrome, and irritable bowel syndrome (IBS), was concerned for the rheumatic or psychosomatic disorders which might adequately reflect the long-term risk of DES.We retrieved data on FM patients from the National Health Insurance Research Database of Taiwan covering the years 2000 to 2011. Our FM population consisted of 25,777 patients versus 103,108 patients in the non-FM group: the overall incidence of DES in these populations was 7.37/10,000 and 4.81/10,000, respectively.Male FM patients had a higher incidence of DES, with a 1.39-fold DES risk for males and a 1.45-fold for females after adjustment for confounding factor. Notably, FM patients aged ≤49 years had an elevated 80% risk of DES compared with the non-FM group. Without comorbidities, FM patients had an approximately 1.40-fold risk of DES than those without FM. The additive effects of FM and IBS or FM and sleep disturbance were pointed out that the risk for DES would be elevated when the FM patients with IBS or sleep disturbance.FM patients have a higher incidence of DES than that of non-FM patients. They carry long-term DES risks from a relatively young age, particularly those with psychiatric problems. Risk stratification for a timely psychiatric medication intervention and risk modifications are not intended.

PMID: 26825913 [PubMed - in process]

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Excessive Sleep and Lack of Sleep Are Associated With Slips and Falls in the Adult Korean Population: A Population-Based Cross-Sectional Study.

Excessive Sleep and Lack of Sleep Are Associated With Slips and Falls in the Adult Korean Population: A Population-Based Cross-Sectional Study.

Medicine (Baltimore). 2016 Jan;95(4):e2397

Authors: Kim SY, Kim SG, Sim S, Park B, Choi HG

Abstract
Few studies have evaluated the impacts of excessive sleep duration on falls. This study investigated the associations between sleep duration and falls among Korean adults in a wide range of age groups while adjusting for numerous confounding factors. Data collected from study participants ranging in age from 19 to 109 years old were analyzed from the 2013 Korean Community Health Survey (KCHS). Sleep duration was divided into 5 groups: ≤5, 6, 7, 8, and ≥9 hours per day. The relations between sleep duration and falls (≥1 time or ≥2 times per year) were analyzed using simple and multiple logistic regression analyses with complex sampling. Age, sex, days of vigorous or moderate physical activity, income, education, alcohol use, smoking, stress, obesity, hypertension, diabetes mellitus, hyperlipidemia, stroke, angina or myocardial infarction, arthritis, and asthma were controlled for as confounding factors. Associations between sleep duration and falls were analyzed in 19 to 40, 41 to 60, and 61+ year age groups. Furthermore, the relations between sleep duration and indoor versus outdoor falls were analyzed. Both ≤6 and ≥8 hours of sleep per day were significantly associated with an increased incidence of falls (≥1 time and ≥2 times per year) in the overall adult population (P < 0.001 in both instances). In a subgroup analysis, sleep durations of ≤5 and ≥9 hours were significantly associated with an increased incidence of falls (≥1 time a year) in each age group. Six hours of sleep was not significantly associated with falls (≥2 times per year) in the 61+ year age group, and 8 and 9 hours of sleep were not significantly associated with falls (≥2 times a year) in the 19 to 40 year age group. This study demonstrated that long as well as short sleep durations are associated with an increased incidence of falls. However, these relations were not evident in elderly populations with short sleep durations or in young adults with long sleep durations.

PMID: 26825881 [PubMed - in process]

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Long-term results of one staged multilevel surgery with tongue suspension surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea.

Long-term results of one staged multilevel surgery with tongue suspension surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea.

Eur Arch Otorhinolaryngol. 2016 Jan 29;

Authors: Yüksel A, Ugur KS, Kizilbulut G, Ark N, Kurtaran H, Kaya M, Gunduz M

Abstract
The objective of this study is to evaluate and compare the long-term efficacy of the one staged multilevel surgery (MLS) with tongue suspension (TBS) surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea (OSA). This is a prospective cross-sectional study.
SETTING: University hospital. Thirty-three patients diagnosed as moderate to severe OSA. Patients, with ≥50 % retropalopharyngeal obstruction on the Müller maneuver, were treated with palatal surgeries (PS) and patients, with ≥50 % retropalopharyngeal obstruction on the Müller maneuver with ≥50 % base of the tongue collapse, were treated with palatal surgeries and tongue suspension surgery (TBS). Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Nine-teen patients with a mean age of 46.1 ± 8.3 underwent palatal surgeries (PS) and 14 patients with a mean age of 41.4 ± 8.9 underwent PS plus TBS. Success rate in TBS+PS group was 57.1 % and in PS group was 42.1 %. In both groups total apnea-hypopnea index (AHI) values significantly decreased after 2 years (p < 0.025) but there was no statistically significant difference between TBS+PS and PS groups. Supine AHI levels were reduced statistically significant in both groups postoperatively (p < 0.025). There was not any significant difference postoperatively in non-supine AHI levels in both groups (p > 0.025). There were significant postoperative changes in ODI, AVO2, MOS, ESS, Snoring VAS values in PS group (p < 0.025). In TBS+PS group there was a significant difference postoperatively only in ODI values. Treatment of OSA patients with retropalatal or retropalatal and retroglossal obstruction, in a one staged surgery, is a safe and easy procedure. We have achieved favorable long-term outcomes in moderate-severe OSA patients undergoing both palatal surgery and tongue suspension surgery.

PMID: 26825802 [PubMed - as supplied by publisher]

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Beta EEG reflects sensory processing in active wakefulness and homeostatic sleep drive in quiet wakefulness.

Beta EEG reflects sensory processing in active wakefulness and homeostatic sleep drive in quiet wakefulness.

J Sleep Res. 2016 Jan 30;

Authors: Grønli J, Rempe MJ, Clegern WC, Schmidt M, Wisor JP

Abstract
Markers of sleep drive (<10 Hz; slow-wave activity and theta) have been identified in the course of slow-wave sleep and wakefulness. So far, higher frequencies in the waking electroencephalogram have not been examined thoroughly as a function of sleep drive. Here, electroencephalogram dynamics were measured in epochs of active wake (wake characterized by high muscle tone) or quiet wake (wake characterized by low muscle tone). It was hypothesized that the higher beta oscillations (15-35 Hz, measured by local field potential and electroencephalography) represent fundamentally different processes in active wake and quiet wake. In active wake, sensory stimulation elevated beta activity in parallel with gamma (80-90 Hz) activity, indicative of cognitive processing. In quiet wake, beta activity paralleled slow-wave activity (1-4 Hz) and theta (5-8 Hz) in tracking sleep need. Cerebral lactate concentration, a measure of cerebral glucose utilization, increased during active wake whereas it declined during quiet wake. Mathematical modelling of state-dependent dynamics of cortical lactate concentration was more precisely predictive when quiet wake and active wake were included as two distinct substates rather than a uniform state of wakefulness. The extent to which lactate concentration declined in quiet wake and increased in active wake was proportionate to the amount of beta activity. These data distinguish quiet wake from active wake. Quiet wake, particularly when characterized by beta activity, is permissive to metabolic and electrophysiological changes that occur in slow-wave sleep. These data urge further studies on state-dependent beta oscillations across species.

PMID: 26825702 [PubMed - as supplied by publisher]

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Definition of nocturnal gastroesophageal reflux for studies on respiratory diseases.

Definition of nocturnal gastroesophageal reflux for studies on respiratory diseases.

Scand J Gastroenterol. 2016 May;51(5):524-30

Authors: Emilsson ÖI, Benediktsdóttir B, Ólafsson Í, Cook E, Júlíusson S, Berg S, Nordang L, Björnsson ES, Guðlaugsdóttir S, Guðmundsdóttir AS, Janson C, Gislason T

Abstract
Objective Nocturnal gastroesophageal reflux (nGER) has been associated with respiratory diseases. Our aim was to study a questionnaire method to identify nGER subjects with respiratory involvement in a general population. Material and methods A subgroup of Icelandic participants in the European Community Respiratory Health Survey III (ECRHS III) reporting symptoms of nGER (n  =  48) as well as age and gender paired controls (n  =  42) were studied further by a structured interview, questionnaires, laryngeal fibrescopy, and exhaled breath condensate. A subgroup underwent 24-h oesophageal pH impedance (24-h MII-pH) measurements. Symptoms of nGER were assessed with a modified version of the reflux disease questionnaire (RDQ), where symptoms were divided into daytime and nocturnal. A report of nGER both at baseline and at follow-up was defined as persistent nGER. Results Participants reporting persistent nGER had significantly more signs of laryngopharyngeal reflux according to the reflux finding score than those without nGER (Mean ± SD: 5.1 ± 2.3 vs. 3.9 ± 2.2, p  =  0.02). Of the 16 persistent nGER subjects that underwent 24-h MII-pH, 11 had abnormal gastroesophageal reflux, but none of three control subjects (69% vs. 0%). Pepsin was more commonly found in exhaled breath condensate in the nGER group (67% vs. 45%, p  =  0.04). Conclusions Participants with nGER symptoms at least once a month, reported on two occasions, had a high level of positive 24-h MII-pH measurements, laryngeal inflammation and pepsin in exhaled breath condensate. This nGER definition identified a representable group for studies on nGER and respiratory diseases in a general population.

PMID: 26825677 [PubMed - in process]

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Anterior Insula Regulates Multiscale Temporal Organization of Sleep and Wake Activity.

Anterior Insula Regulates Multiscale Temporal Organization of Sleep and Wake Activity.

J Biol Rhythms. 2016 Jan 29;

Authors: Chen MC, Chiang WY, Yugay T, Patxot M, Özçivit İB, Hu K, Lu J

Abstract
The role of specific cortical regions in sleep-regulating circuits is unclear. The anterior insula (AI) has strong reciprocal connectivity with wake and sleep-promoting hypothalamic and brainstem regions, and we hypothesized that the AI regulates patterns of sleep and wakefulness. To test this hypothesis, we lesioned the AI in rats (n = 8) and compared sleep, wake, and activity regulation in these animals with nonlesioned controls (n = 8) with 24-h sleep recordings and chronic infrared activity monitoring. Compared to controls, animals with AI lesions had decreased wakefulness and increased rapid eye movement (REM) sleep and non-REM (NREM) sleep. AI-lesioned animals had shorter wake bouts, especially during the active dark phase. AI-lesioned animals also had more transitions from NREM to REM sleep, especially during the inactive light phase. Chronic infrared monitoring revealed that AI-lesioned animals also had a disturbed temporal organization of locomotor activity at multiple time scales with more random activity fluctuations from 4 to 12 h despite intact circadian rhythms. These results suggest that the AI regulates sleep and activity and contributes to the regulation of sleep and motor behavior rhythmicity across multiple time scales. Dysfunction of the AI may underlie changes in sleep-wake patterns in neurological diseases.

PMID: 26825619 [PubMed - as supplied by publisher]

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Chronotype, Light Exposure, Sleep, and Daytime Functioning in High School Students Attending Morning or Afternoon School Shifts: An Actigraphic Study.

Chronotype, Light Exposure, Sleep, and Daytime Functioning in High School Students Attending Morning or Afternoon School Shifts: An Actigraphic Study.

J Biol Rhythms. 2016 Jan 29;

Authors: Martin JS, Gaudreault MM, Perron M, Laberge L

Abstract
Adolescent maturation is associated with delays of the endogenous circadian phase. Consequently, early school schedules may lead to a mismatch between internal and external time, which can be detrimental to adolescent sleep and health. In parallel, chronotype is known to play a role in adolescent health; evening chronotype adolescents are at higher risk for sleep problems and lower academic achievement. In the summer of 2008, Kénogami High School (Saguenay, Canada) was destroyed by fire. Kénogami students were subsequently relocated to Arvida High School (situated 5.3 km away) for the 2008-2009 academic year. A dual school schedule was implemented, with Arvida students attending a morning schedule (0740-1305 h) and Kénogami students an afternoon schedule (1325-1845 h). This study aimed to investigate the effects of such school schedules and chronotype on sleep, light exposure, and daytime functioning. Twenty-four morning and 33 afternoon schedule students wore an actigraph during 7 days to measure sleep and light exposure. Academic achievement was obtained from school. Subjects completed validated questionnaires on daytime sleepiness, psychological distress, social rhythms, school satisfaction, alcohol, and chronotype. Overall, afternoon schedule students had longer sleep duration, lower sleepiness, and lower light exposure than morning schedule students. Evening chronotypes (E-types) reported higher levels of sleepiness than morning chronotypes (M-types) in both morning and afternoon schedules. Furthermore, M-types attending the morning schedule reported higher sleepiness than M-types attending the afternoon schedule. No difference was found between morning and afternoon schedule students with regard to academic achievement, psychological distress, social rhythms, school satisfaction, and alcohol consumption. However, in both schedules, M-type had more regular social rhythms and lower alcohol consumption. In summary, this study emphasizes that an early school schedule is associated with detrimental effects in terms of sleep deprivation and daytime sleepiness, even for M-types. Furthermore, irrespective of school schedule, E-type adolescents face an increased risk for poor daytime functioning.

PMID: 26825618 [PubMed - as supplied by publisher]

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Sleep and academic performance in later adolescence: results from a large population-based study.

Sleep and academic performance in later adolescence: results from a large population-based study.

J Sleep Res. 2016 Jan 30;

Authors: Hysing M, Harvey AG, Linton SJ, Askeland KG, Sivertsen B

Abstract
The aim of the current study was to assess the association between sleep duration and sleep patterns and academic performance in 16-19 year-old adolescents using registry-based academic grades. A large population-based study from Norway conducted in 2012, the youth@hordaland-survey, surveyed 7798 adolescents aged 16-19 years (53.5% girls). The survey was linked with objective outcome data on school performance. Self-reported sleep measures provided information on sleep duration, sleep efficiency, sleep deficit and bedtime differences between weekday and weekend. School performance [grade point average (GPA)] was obtained from official administrative registries. Most sleep parameters were associated with increased risk for poor school performance. After adjusting for sociodemographic information, short sleep duration and sleep deficit were the sleep measures with the highest odds of poor GPA (lowest quartile). Weekday bedtime was associated significantly with GPA, with adolescents going to bed between 22:00 and 23:00 hours having the best GPA. Also, delayed sleep schedule during weekends was associated with poor academic performance. The associations were somewhat reduced after additional adjustment for non-attendance at school, but remained significant in the fully adjusted models. In conclusion, the demonstrated relationship between sleep problems and poor academic performance suggests that careful assessment of sleep is warranted when adolescents are underperforming at school. Future studies are needed on the association between impaired sleep in adolescence and later functioning in adulthood.

PMID: 26825591 [PubMed - as supplied by publisher]

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Coping Strategies for Possible Flare-Ups and Their Perceived Effectiveness in Patients With Inflammatory Bowel Disease.

Coping Strategies for Possible Flare-Ups and Their Perceived Effectiveness in Patients With Inflammatory Bowel Disease.

Gastroenterol Nurs. 2016 Jan-Feb;39(1):42-7

Authors: Tanaka M, Kawakami A, Iwao Y, Fukushima T, Yamamoto-Mitani N

Abstract
The study objective was to investigate the nature and perceived effectiveness of strategies that patients with inflammatory bowel disease (IBD) use in response to worsening symptoms. Questionnaires to investigate the use and perceived effectiveness of 11 types of strategies for coping with possible flare-ups were mailed to 1,641 members of the Crohn's and Colitis Foundation of Japan. The responses were analyzed separately by disease type: ulcerative colitis (UC) and Crohn disease (CD). A total of 400 questionnaires were analyzed from 260 UC and 140 CD patients. The strategies used most by both patient groups were "change contents of meals" and "get more sleep." In addition, "skip some meals" was commonly used by CD patients. The most effective strategies were "use extra topical corticosteroids" (30 of the 56 subjects, 53.6%) among UC patients, and "skip some meals" (70 of the 114 subjects, 61.4%), and "take/add to the elemental diet" (53 of 89 subjects, 59.6%) among CD patients. The coping strategies used most by patients with IBD involved lifestyle modifications. However, the additional use of medications was regarded as the most effective, despite the small number of patients who used this strategy. Additional use of topical medications for UC patients and diet modifications for CD patients should be emphasized in self-management education for patients.

PMID: 26825563 [PubMed - in process]

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Feasibility of self-administered sleep assessment in older women in the Women's Health Initiative (WHI).

Feasibility of self-administered sleep assessment in older women in the Women's Health Initiative (WHI).

Sleep Breath. 2016 Jan 29;

Authors: Vaughan L, Redline S, Stone K, Ulanski J, Rueschman M, Dailey H, Rapp SR, Snively BM, Baker LD, Shumaker SA

Abstract
PURPOSE: Laboratory-based polysomnography (PSG) is the gold standard assessment of sleep disordered breathing (SDB). In large cohort studies and clinical trials, however, these overnight procedures can be expensive and burdensome to participants, especially older adults. In preparation for a large observational study, we determined the feasibility of self-administering two devices mailed to participants' homes that estimate indices of SDB.
METHODS: In two separate studies, older women enrolled in the Women's Health Initiative (WHI) Memory Study extension aged mean (SD) 85.77 (2.98) years who were not using supplemental oxygen and consented to being in the feasibility study completed either an in-home, self-administered overnight sleep assessment using a multi-sensor device that measured oximetry, nasal pressure, chest effort, and snoring (ApneaLink(TM)) (N = 58), or a wrist-worn oximeter (NoninWristOx2(TM)) (N = 33). A follow-up questionnaire assessed the devices' acceptability and important sleep-related exposures.
RESULTS: Although the multi-sensor device was assessed only in older women with no cognitive impairment, the proportion of completed interpretable sleep studies was low (54 %) and participants reported needing help to administer the device successfully. In contrast, the wrist-worn device was used in women with either no or mild cognitive impairment (MCI), completion rates were higher (100 %), and women reported being able to administer the device independently.
CONCLUSIONS: These studies demonstrated that home-based self-administered assessments of SDB are feasible in older adults with and without cognitive impairment using wrist-worn oximetry. These data support the feasibility of using simple oximetry measurements to provide indices of overnight intermittent hypoxemia in large observational studies and clinical trials.

PMID: 26825380 [PubMed - as supplied by publisher]

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Non-motor and Extracerebellar Features in Spinocerebellar Ataxia Type 2.

Non-motor and Extracerebellar Features in Spinocerebellar Ataxia Type 2.

Cerebellum. 2016 Jan 29;

Authors: Pedroso JL, Braga-Neto P, Escorcio-Bezerra ML, Abrahão A, de Albuquerque MV, Filho FM, de Souza PV, de Rezende Pinto WB, Borges FR, Saraiva-Pereira ML, Jardim LB, Barsottini OG

Abstract
Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant degenerative disease. Pathological studies have demonstrated not only cerebellar and brainstem atrophy, but substantia nigra, motoneurons, basal ganglia, thalamus, and peripheral nerves involvement. These findings may explain non-motor and extra-cerebellar features in SCA2. We accessed the non-motor symptoms and extra-cerebellar signs in SCA2 patients in order to provide a better understanding on pathophysiological mechanisms and natural history of brain degeneration in the disease. Thirty-three SCA2 patients were evaluated and compared with 26 healthy subjects. We investigated the following variables: sleep disorders, cognitive deficit, olfactory impairment, urinary dysfunction, psychiatric symptoms, cramps, pain, movement disorders, and weight loss. SCA2 had a high frequency of REM sleep behavior disorder (48.48 %, N = 16) as well as excessive daytime sleepiness (42.42 %, N = 14). Chorea was present in 15.15 % (N = 5), dystonia in 27.27 % (N = 9), and parkinsonism in 27.27 % (N = 9). Slow saccadic pursuit was present in 87.87 % (N = 29) and ophtalmoparesis in 78.78 % (N = 26) of patients. Regarding sleep disorders, 18.18 % (N = 6) of patients had restless leg syndrome. Dysphagia was present in 39.39 % (N = 13), weight loss 24.24 % (N = 8), and urinary dysfunction 27.27 % (N = 9). Cramps was present in only 6 % of patients (N = 2). This study highlighted the high frequency of non-motor symptoms and extra-cerebellar signs in SCA2. Our findings demonstrate the widespread of nervous system involvement in SCA2 patients and contribute to better understand the natural history of brain degeneration in this genetic condition.

PMID: 26825292 [PubMed - as supplied by publisher]

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Teaching Parents How to Prevent Acquired Cranial Asymmetry in Infants.

Teaching Parents How to Prevent Acquired Cranial Asymmetry in Infants.

J Pediatr Nurs. 2016 Jan 26;

Authors: Lennartsson F, Nordin P, Wennergren G

Abstract
Acquired cranial asymmetry is prevalent in infants today. This is largely attributed to the supine sleep position recommended for infant safety. The condition can become permanent, so prevention and early detection are important. A prevention project was initiated where guidelines for Swedish child health nurses were developed, tested in a pilot study, revised, and then incorporated into a short cranial asymmetry prevention program for nurses. The program included detailed information on what to teach parents of newborns. An intervention study was initiated where one group of nurses was taught according to the program and the other group followed the standard recommendations. The aim of this survey was to compare intervention and control group parents' responses regarding the cranial asymmetry prevention information that they had received from their nurses during their infant's first four months. Participants included 272 parents (180 intervention group, 92 control group) at 26 child health centers. A checklist was distributed to parents in conjunction with infants' four month health checkup. A significantly higher percentage of intervention group parents were aware of regular recommendations - alternate direction of the infant's head when putting the child to bed (82%: 64%, p=0.001), which pillow to use (92%: 80%, p=0.01), and when to remove the pillow (48%: 31%, p=0.006) - and five newly introduced recommendations compared to controls. Results indicate that educating child health nurses on prevention of cranial asymmetry works to increase parental awareness of what to do and how to do it safely.

PMID: 26825249 [PubMed - as supplied by publisher]

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Live-Blogging Richard Waitt's In the Path of Destruction IX: "Is This What Pompeii Was Like?"

USGS Geologist Richard Waitt's In the Path of Destruction chronicles the cataclysmic May 18th, 1980 eruption of Mount St. Helens. Join us for nail-biting survivors' stories and explosive volcanic...

-- Read more on ScientificAmerican.com

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En kontrollert risikotaker

Han kan mer om beslutninger og risiko enn de aller fleste, men Peder Halvorsen følger ikke alltid sin egen lære.

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