bluuebunny/crossref_metadata_2025 huggingface dataset:
Specific suppression of insulin sensitivity in growth hormone receptor gene‐disrupted (GHR‐KO) mice attenuates phenotypic features of slow aging
Authors: Arum Oge , Boparai Ravneet K. , Saleh Jamal K. , Wang Feiya , Dirks Angela L. , Turner Jeremy G. , Kopchick John J. , Liu Jun‐Li , Khardori Romesh K. , Bartke Andrzej
Published: September 2014

In addition to their extended lifespans, slow‐aging growth hormone receptor/binding protein gene‐disrupted (knockout) (GHR‐KO) mice are hypoinsulinemic and highly sensitive to the action of insulin. It has been proposed that this insulin sensitivity is important for their longevity and increased healthspan. We tested whether this insulin sensitivity of the GHR‐KO mouse is necessary for its retarded aging by abrogating that sensitivity with a transgenic alteration that improves development and secretory function of pancreatic β‐cells by expressing Igf‐1 under the rat insulin promoter 1 (RIP::IGF‐1). The RIP::IGF‐1 transgene increased circulating insulin content in GHR‐KO mice, and thusly fully normalized their insulin sensitivity, without affecting the proliferation of any non‐β‐cell cell types. Multiple (nonsurvivorship) longevity‐associated physiological and endocrinological characteristics of these mice (namely beneficial blood glucose regulatory control, altered metabolism, and preservation of memory capabilities) were partially or completely normalized, thus supporting the causal role of insulin sensitivity for the decelerated senescence of GHR‐KO mice. We conclude that a delayed onset and/or decreased pace of aging can be hormonally regulated.
Model‐based Prediction In Ecological Surveys Including Those with Incomplete Detection
Authors: Melville Gavin J. , Welsh Alan H.
Published: September 2014

This paper explores and develops model‐based predictors for surveys of plants and wildlife including those with incomplete detection. The methodology allows for estimating a detection function to account for objects which were not detected at the time of the survey. The model‐based theory utilises generalized linear models (GLMs) and is either new or adapted from other areas of sampling. A simulation study is used to validate the estimators and comparisons are made with an integrated likelihood approach. An aerial survey of kangaroos in western New South Wales is used to illustrate the theory. The area within 50m of the aircraft is treated as a strip transect and mark‐recapture methods are used to estimate the detection function.
Non‐Governmental Organizations' Role for Social Capital and Community Empowerment in Community Development: Experience from Bangladesh
Authors: Islam M. Rezaul
Published: September 2014

The purpose of this study was to investigate contributions by non‐governmental organizations (NGOs) to social capital and community empowerment that facilitate community development. A multi‐method research approach was conducted, where a number of qualitative data collection methods were employed. Data was collected from two indigenous communities, goldsmith and blacksmith, served by two NGOs—Proshika and Practical Action Bangladesh (PAB). The findings showed that both NGOs played a substantial role in social capital development and community empowerment toward community development. The findings of this study will provide valuable input to the community development field.
Innovations in Practice: Supporting parent and teen communication during outpatient psychotropic medication appointments
Authors: O'Brien Megan , Holmes Cheryl , Chapman Kyle , Rosen Michael , Lee Jaehoon , Crickard Elizabeth
Published: September 2014

Background

Encouragement of youth participation in mental health treatment is relatively new and there have been few specific interventions to improve engagement, particularly as it relates to medication management. This article describes the development of a tool to support engagement during medication appointments by identifying areas of agreement/disagreement between parents and teens.

Method

Data were analyzed from 240 parent/teen dyads visiting an outpatient community mental health center for medication management. Frequencies and percentages were calculated for all items. Kappa scores were used to assess agreement between parent and teen dyads.

Results

The level of agreement between parents and teens was low. Overall, teens expressed preference for discussion of ‘positive’ aspects of treatment such as what is going well, whereas parents preferred to focus on ‘negative’ aspects of treatment such as problematic symptoms. The lowest level of agreement was found for the item: ‘My teen seems to be having problems with energy levels’ (Kappa = .19; 95% CI = .05–.34). The strongest level of agreement was for the question ‘How has your teen been using the medication since the last appointment?’ (Kappa = .56; 95% CI = .44–.69).

Conclusions

The findings support the utility of the tool for illustrating the variation in needs of teens and parents during medication appointments. Knowledge of these differences can be used by providers to encourage teen participation and may enhance overall communication.
Antitumor effects of tyropeptin‐boronic acid derivatives: New proteasome inhibitors
Authors: Momose Isao , Abe Hikaru , Watanabe Takumi , Ohba Shun‐ichi , Yamazaki Kanami , Dan Shingo , Yamori Takao , Masuda Tohru , Nomoto Akio
Published: September 2014

The proteasome degrades numerous regulatory proteins that are critical for tumor growth. Thus, proteasome inhibitors are promising antitumor agents. New proteasome inhibitors, such as tyropeptins and tyropeptin‐boronic acid derivatives, have a potent inhibitory activity. Here we report the antitumor effects of two new tyropeptin‐boronic acid derivatives, AS‐06 and AS‐29. AS‐06 and AS‐29 significantly suppress the degradation of the proteasome‐sensitive fluorescent proteins in HEK293PS cells, and induce the accumulation of ubiquitinated proteins in human multiple myeloma cells. We show that these derivatives also suppress the degradation of the NF‐κB inhibitor IκB‐α and the nuclear translocation of NF‐κB p65 in multiple myeloma cells, resulting in the inhibition of NF‐κB activation. Furthermore, we demonstrate that AS‐06 and AS‐29 induce apoptosis through the caspase‐8 and caspase‐9 cascades. In a xenograft mouse model, i.v. administration of tyropeptin‐boronic acid derivatives inhibits proteasome in tumors and clearly suppresses tumor growth in mice bearing human multiple myeloma. Our results indicate that tyropeptin‐boronic acid derivatives could be lead therapeutic agents against human multiple myeloma.
Case–controlled identification of colorectal cancer based on proteomic profiles and the potential for screening
Authors: Huijbers A. , Mesker W. E. , Mertens B. J. , Bladergroen M. R. , Deelder A. M. , van der Burgt Y. E. M. , Tollenaar R. A. E. M.
Published: September 2014

Aim

Colorectal cancer (CRC) screening programmes detect early cancers but unfortunately have limited sensitivity and specificity. Mass spectrometry‐based determination of serum peptide and protein profiles provides a new approach for improved screening.

Method

Serum samples were obtained from 126 CRC patients before treatment and 277 control individuals. An additional group of samples from 50 CRC patients and 82 controls was used for validation. Peptide and protein enrichments were carried out using reverse‐phase C18 and weak‐cation exchange magnetic beads in an automated solid‐phase extraction and spotting procedure. Profiles were acquired on a matrix‐assisted laser desorption/ionization time‐of‐flight system. Discriminant rules using logistic regression were calibrated for the peptide and protein signatures separately, followed by combining the classifications to obtain double cross‐validated predicted class probabilities. Results were validated on an identical patient set.

Results

A discriminative power was found for patients with CRC representative for all histopathological stages compared with controls with an area under the curve of 0.95 in the test set (0.93 for the validation set) and with a high specificity (94–95%).

Conclusion

The study has shown that a serum peptide and protein biomarker signature can be used to distinguish CRC patients from healthy controls with high discriminative power. This relatively simple and cheap test is promising for CRC screening.
Growth, head growth, and neurocognitive outcome in children born very preterm: methodological aspects and selected results
Authors: Ranke Michael B , Krägeloh‐Mann Ingeborg , Vollmer Brigitte
Published: September 2014

In light of the growing number of surviving children born very preterm, there is an increasing focus on their long‐term outcomes in terms of growth, metabolic status, and neurocognitive development. Therefore, it is of importance to follow such children from birth onwards with the aim of identifying the causes of atypical development, developing preventative measures, and improving outcomes. Since such long‐term follow‐up needs to be conducted with the least possible burden, clinical investigations such as anthropometry and neurocognitive tests, if conducted rigorously, will continue to have a predominant role. The aim of this review is to discuss the complexity of longitudinal anthropometry in children born very preterm and to provide an overview of the main studies that have examined associations between growth, in particular head growth, and neurocognitive outcomes at around school age.
New spatial and temporal perspectives on the assembly of biotas and communities. Special issue: International Biogeography Society, 6th biennial International Conference
Authors: Svenning Jens‐Christian
Published: September 2014

The International Biogeography Society's biennial conferences are renown for being highly interdisciplinary and inspiring meetings. Biogeography is by its nature a holistic and interdisciplinary field and the conferences bring together biologists from a broad range of fields, e.g. experimental ecologists, historical biogeographers, evolutionary biologists, ecological modelers, conservation biologists, and paleobiologists, and covering essentially all types of organisms and ecosystems. The different backgrounds and perspectives combined with shared interests in terms of the basic research questions offer fertile grounds for developing new ideas. This was also the case for the 6th International Conference of the International Biogeography Society took place in Miami, Florida in January 2013. Ecography provided economic support, acting as a sponsor. In addition, Ecography was the officially designated journal for publishing some of the many exciting talks and posters presented at the conference. All of the papers in this special issue of Ecography arose from the IBS conference and reflect its combined high diversity in backgrounds and perspectives and high congruence in research questions. The papers have all been subject to external peer review, subsequent revision, and final editorial decisions of acceptance or rejection.
In search of the holy grail of fly motion vision
Authors: Borst Alexander
Published: September 2014

Detecting the direction of image motion is important for visual navigation as well as predator, prey and mate detection and, thus, essential for the survival of all animals that have eyes. However, the direction of motion is not explicitly represented at the level of the photoreceptors: it rather needs to be computed by subsequent neural circuits, involving a comparison of the signals from neighbouring photoreceptors over time. The exact nature of this process as implemented at the neuronal level has been a long‐standing question in the field. Only recently, much progress has been made in Drosophila by genetically targeting individual neuron types to block, activate or record from them. The results obtained this way indicate that: (i) luminance information from fly photoreceptors R1–6 is split into two parallel motion circuits, specialized to detect the motion of luminance increments (ON‐Channel) and decrements (OFF‐Channel) separately; (ii) lamina neurons L1 and L2 are the primary input neurons to these circuits (L1 → ON‐channel, L2 → OFF‐channel); and (iii) T4 and T5 cells carry their output signals (ON → T4, OFF → T5).
High‐frequency electrical stimulation suppresses cholinergic accumbens interneurons in acute rat brain slices through GABAB receptors
Authors: Xie Yijing , Heida Tjitske , Stegenga Jan , Zhao Yan , Moser Andreas , Tronnier Volker , Feuerstein Thomas J. , Hofmann Ulrich G.
Published: September 2014

The nucleus accumbens is selected as a surgical target in deep brain stimulation for treating refractory obsessive‐compulsive disorder (OCD). One of the therapeutic benefits of this procedure is that the abnormal hyper‐functioning prefrontal cortex of patients with OCD is restored during stimulation. One hypothesis regarding the mechanism of deep brain stimulation is that the neuronal electrophysiological properties are directly altered by electrical stimulation; another hypothesis assumes that the stimulation induces selective neuron transmitter release, such as γ‐aminobutyric acid (GABA). In this study, we used multi‐electrode arrays with electrode size of 40 × 40 μm to record electrophysiological signals from the large nucleus accumbens neurons in acute rat brain slices while applying electrical stimulation simultaneously. We revealed that high‐frequency stimulation (HFS, 140 Hz) suppressed the spontaneous neuronal firing rate significantly, whereas low‐frequency stimulation (LFS, 10 Hz) did not. Both HFS and LFS have no effect on neuronal firing pattern or on neuronal oscillation synchrony. GABAB receptor antagonism reversed the HFS‐provoked neuronal inhibition, whereas GABAA receptor blockade failed to affect it. The recorded neurons were pharmacologically identified to be cholinergic interneurons. We propose that HFS has a direct suppressive effect on the identified accumbal acetylcholine (ACh) interneurons by enhancing GABA release in the stimulated region. Potentially, suppressed ACh interneurons decrease the disinhibiting function of medium‐sized spiny neurons in the striato‐thalamo‐cortical circuit. This finding might give an indication of the mechanism of the therapeutic effect of HFS in nucleus accumbens on restoring the abnormal hyperactive prefrontal cortex status in OCD.
Managing What We Can Measure: Quantifying the Susceptibility of Automated Scoring Systems to Gaming Behavior
Authors: Higgins Derrick , Heilman Michael
Published: September 2014

As methods for automated scoring of constructed‐response items become more widely adopted in state assessments, and are used in more consequential operational configurations, it is critical that their susceptibility to gaming behavior be investigated and managed. This article provides a review of research relevant to how construct‐irrelevant response behavior may affect automated constructed‐response scoring, and aims to address a gap in that literature: the need to assess the degree of risk before operational launch. A general framework is proposed for evaluating susceptibility to gaming, and an initial empirical demonstration is presented using the open‐source short‐answer scoring engines from the Automated Student Assessment Prize (ASAP) Challenge.
Nonadherence to treatment causing acute hospitalizations in people with epilepsy: An observational, prospective study
Authors: Samsonsen Christian , Reimers Arne , Bråthen Geir , Helde Grethe , Brodtkorb Eylert
Published: September 2014

The aim was to assess the clinical relevance of antiepileptic drug (AED) nonadherence by means of therapeutic drug concentration monitoring (TDM). Two hundred eighty‐two consecutive patients with epilepsy acutely admitted to hospital for seizures were included. Nonadherence was defined as having a serum concentration/dose ratio at admission of <75% of the patient's own control value (probable nonadherence: 50–75%; definite: <50%). Nonadherence was identified in 39% of patients (definite 24%; probable 15%). It was significantly more common in patients with generalized seizures compared to those with focal onset seizures, and in patients <30 years compared to older patients. When specifically asked, 44% of nonadherent patients claimed regular intake. Nonadherence is a major cause of seizure breakthrough in patients with epilepsy, particularly in young adults. Many patients seem to be unaware of missed drug intake. Prompt measurements of AED serum concentrations should be available as part of the emergency care for patients acutely hospitalized for seizures to permit this issue to be thoroughly addressed prior to discharge.
Mandibular condylectomy in a standing horse for treatment for osteoarthritis of the temporomandibular joint
Authors: Sanders R. E. , Schumacher J. , Brama P. A. J. , Zarelli M. , Kearney C. M.
Published: September 2014

An Irish Sport Horse mare presented for evaluation and treatment of inability to masticate effectively with subsequent severe weight loss. A slowly expanding, firm, nonpainful mass was noted at the left temporomandibular joint. Radiographic examination revealed extensive osteoarthritic changes of this joint. Due to the age and debilitated condition of the horse, along with financial constraints on the owner's behalf, the decision was made to perform a mandibular condylectomy as a standing procedure using sedation and local and regional anaesthesia techniques. The mare tolerated the procedure very well and post operatively improved significantly.
Management of chronic airway inflammation in the horse: A systematic review
Authors: Ivester K. M. , Couëtil L. L.
Published: September 2014

The purpose of this article is to review available scientific reports on recurrent airway obstruction and inflammatory airway disease treatment efficacy. Critical evaluation of the quality and limitations of the evidence provided should provide equine practitioners with the tools to apply the latest scientific data to the management of individual clinical cases. While a large body of clinical research supports the efficacy of low‐dust environmental management and corticosteroid administration in the treatment of recurrent airway obstruction, limited clinical trials exist to evaluate the treatment of inflammatory airway disease.
Influence of surface recrystallization on the low cycle fatigue behaviour of a single crystal superalloy
Authors: Ma X. , Shi H.‐J. , Gu J. , Yang Z. , Chen G. , Luesebrink O. , Harders H.
Published: September 2014

This paper investigated the effect of surface recrystallization (RX) on the low cycle fatigue (LCF) behaviour of a single crystal (SX) superalloy. LCF tests on both raw and recrystallized samples showed that fatigue life was significantly reduced by surface RX. Fractography indicated that fatigue cracks initiated from the casting defects in RX layer and multiple crack initiations were commonly observed. Moreover, RX grains exhibited predominantly transgranular cracking, in contrast to the intergranular fracture reported in literature. The fatigue crack propagation behaviour was discussed in light of fracture mechanics and crack growth life model. The fatigue cycles required to penetrate RX layer were estimated to be about one magnitude lower than that in forming an equivalent crack in SX specimens. It is suggested that the earlier crack initiation and promoted crack propagation in RX layer, as well as the trend of multiple initiations, are responsible for the fatigue degradation by RX.
Role of machining defects and residual stress on the AISI 304 fatigue crack nucleation
Authors: Yahyaoui H. , Ben Moussa N. , Braham C. , Ben Fredj N. , Sidhom H.
Published: September 2014

Machining defects as rebuilt material and dislodgement were often induced by cutting of difficult to machining AISI 304 stainless steel. Their density increases with a decreasing of cutting speed. The effect of these defects on surface topography and residual stress was evaluated by roughness and X‐ray diffraction measurements coupled with numerical simulation. The role of the rebuilt material on the distribution of fatigue crack nucleation sites was investigated by scanning electron microscope examination of post fatigue samples loaded at different imposed strain amplitudes. The association of machining defects and fatigue crack nucleation sites was attributed to the contribution of additional tensile residual stresses induced by rebuilt material rather than local stress concentration. Moreover, the fatigue crack coalescence is promoted by increasing the rebuilt material density. When the machining defect density increases from 5 to 60 particles/mm2, the fatigue life decreases from −22% to −65% with respect to the electropolished surface.
The dynamic interplay between saline fluid flow and rock permeability in magmatic‐hydrothermal systems
Authors: Weis P.
Published: September 2014

Magmatic‐hydrothermal ore deposits document the interplay between saline fluid flow and rock permeability. Numerical simulations of multiphase flow of variably miscible, compressible H2O–NaCl fluids in concert with a dynamic permeability model can reproduce characteristics of porphyry copper and epithermal gold systems. This dynamic permeability model uses values between 10−22 and 10−13 m2, incorporating depth‐dependent permeability profiles characteristic for tectonically active crust as well as pressure‐ and temperature‐dependent relationships describing hydraulic fracturing and the transition from brittle to ductile rock behavior. In response to focused expulsion of magmatic fluids from a crystallizing upper crustal magma chamber, the hydrothermal system self‐organizes into a hydrological divide, separating an inner part dominated by ascending magmatic fluids under near‐lithostatic pressures from a surrounding outer part dominated by convection of colder meteoric fluids under near‐hydrostatic pressures. This hydrological divide also provides a mechanism to transport magmatic salt through the crust. With a volcano at the surface above the hydrothermal system, topography‐driven flow reverses the direction of the meteoric convection as compared to a flat surface, leading to discharge at distances of up to 7 km from the volcanic center. The same physical processes at similar permeability ranges, crustal depths, and flow rates are relevant for a number of active systems, including geothermal resources and excess degassing at volcanos. The simulations further suggest that the described mechanism can separate the base of free convection in high‐enthalpy geothermal systems from the magma chamber as a driving heat source by several kilometers in the vertical direction in tectonic settings with hydrous magmatism. These root zones of high‐enthalpy systems may serve as so‐called super‐critical geothermal resources. This hydrology would be in contrast to settings with anhydrous magmatism, where the base of the geothermal systems may be closer to the magma chamber.
Factors associated with self‐rated oral health among community‐dwelling older Japanese: A cross‐sectional study
Authors: Ohara Yuki , Hirano Hirohiko , Watanabe Yutaka , Obuchi Shuichi , Yoshida Hideyo , Fujiwara Yoshinori , Ihara Kazushige , Kawai Hisashi , Mataki Shiro
Published: September 2014

Objectives

A cross‐sectional study was carried out to investigate the determinants of self‐rated oral health among community‐dwelling older people in Japan.

Methods

The participants were 897 (357 men and 540 women) aged 65 years and over who participated in a comprehensive geriatric health examination, which included an oral examination, a face‐to‐face interview assessing cognitive function, questionnaires regarding depressive symptoms and functional capacity, and a medical examination. The oral examination measured indices of oral health status: number of present teeth, number of functional teeth, occlusal force and amount of resting saliva. Multiple logistic regression analyses were carried out to determine the factors associated with poor self‐rated oral health.

Results

The mean age of the participants was 73.5 ± 5.0 years. The prevalence of poor and rather poor self‐rated oral health was 11.5% and 29.5%, respectively. Multiple logistic regression analyses showed that the number of present teeth (odds ratio [OR] 0.97, 95% confidence intervals [CI] 0.95–0.99), difficulty in mastication (OR 3.20, CI 2.18–4.70), presence of xerostomia (OR 1.43, CI 1.02–2.01), total score on the MoCA‐J (OR 1.06, CI 1.01–1.11), and reduction in frequency of leaving the house (OR 1.64, CI 1.12–2.41) were significantly associated with poor self‐rated oral health.

Conclusions

The present results suggested that self‐rated oral health was a significant factor in oral health status as well as overall well‐being among community‐dwelling older Japanese people. Geriatr Gerontol Int 2015; 15: 755–761.
Free and Cued Selective Reminding Test is superior to the Wechsler Memory Scale in discriminating mild cognitive impairment from Alzheimer's disease
Authors: Lemos Raquel , Cunha Catarina , Marôco João , Afonso Ana , Simões Mário R , Santana Isabel
Published: September 2014

Aim

The Logical Memory (LM) and the Verbal Paired Associative Learning (VPAL) are subtests from the Wechsler Memory Scale commonly used to characterize the memory deficit of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD). The Free and Cued Selective Reminding Test (FCSRT) was suggested to assess the memory impairment of AD spectrum patients by the International Working Group on AD. In the present study, we compared the properties of the tests and their accuracy in classifying aMCI and AD.

Methods

A group of aMCI patients (n = 85) and AD patients (n = 43) were included. The reliability and the validity of the three tests were analyzed.

Results

AD patients showed a significant pattern of worse impairment on all tests than aMCI. The FCSRT was able to classify more patients as having memory impairment in the aMCI group rather than the WMS subtests. The FCSRT proved to be good in discriminating the two groups in both lower and higher educational levels, whereas the LM was more useful in higher educated patients.

Conclusions

Although the instruments had good results, the FCSRT was more accurate in discriminating MCI from AD, and less influenced by the educational level. Geriatr Gerontol Int 2015; 15: 961–968.
Calf circumference as a surrogate marker of muscle mass for diagnosing sarcopenia inJapanese men and women
Authors: Kawakami Ryoko , Murakami Haruka , Sanada Kiyoshi , Tanaka Noriko , Sawada Susumu S , Tabata Izumi , Higuchi Mitsuru , Miyachi Motohiko
Published: September 2014

Aim

To examine the relationship between calf circumference and muscle mass, and to evaluate the suitability of calf circumference as a surrogate marker of muscle mass for the diagnosis of sarcopenia among middle‐aged and olderJapanese men and women.

Methods

A total of 526 adults aged 40–89 years participated in the present cross‐sectional study. The maximum calf circumference was measured in a standing position. Appendicular skeletal muscle mass was measured using dual‐energyX‐ray absorptiometry, and the skeletal muscle index was calculated as appendicular skeletal muscle mass divided by the square of the height (kg/m2). The cut‐off values for sarcopenia were defined as a skeletal muscle index of less than −2 standard deviations of the mean value for Japanese young adults, as defined previously.

Results

Calf circumference was positively correlated with appendicular skeletal muscle (r = 0.81 in men,r = 0.73 in women) and skeletal muscle index (r = 0.80 in men,r = 0.69 in women). In receiver operating characteristic analysis, the optimal calf circumference cut‐off values for predicting sarcopenia were 34 cm (sensitivity 88%, specificity 91%) in men and 33 cm (sensitivity 76%, specificity 73%) in women.

Conclusions

Calf circumference was positively correlated with appendicular skeletal muscle mass and skeletal muscle index, and could be used as a surrogate marker of muscle mass for diagnosing sarcopenia. The suggested cut‐off values of calf circumference for predicting low muscle mass are <34 cm in men and <33 cm in women.Geriatr Gerontol Int 2015; 15: 969–976.
Cavity use throughout the annual cycle of a migratory woodpecker revealed by geolocators
Authors: Gow Elizabeth A. , Wiebe Karen L. , Fox James W.
Published: September 2014

The importance of cavities as roost sites in migratory species is often unknown because it is challenging to monitor cavity use during the non‐breeding period. We documented cavity use throughout the annual cycle of a woodpecker using light‐level geolocators. Northern Flickers Colaptes auratus spent 63–90% of nights roosting in a cavity throughout the year, including during migration. The high frequency of year‐round cavity use by Flickers suggests that cavities provide benefits beyond nest‐sites. Our work highlights the potential use of geolocators to examine cavity use.
Three‐Dimensional Stereolithography of Alumina Photonic Crystals for Terahertz Wave Localization
Authors: Kirihara Soshu , Niki Toshiki
Published: September 2014

Using stereolithography as an additive manufacturing (AM) process, photonic crystals, with a diamond‐like structure composed of alumina microlattices, were fabricated and their electromagnetic band gap profiles, in terahertz frequency ranges, were investigated. Acrylic resins with dispersed alumina particles were fabricated by stereolithography with micrometer‐order accuracy. After dewaxing and sintering processes, alumina lattices were obtained with high relative densities that reflected the terahertz waves, through Bragg diffraction, perfectly in all directions. Twinned crystal structures with mirror symmetric diamond lattices were designed to introduce defect interfaces. Double‐cavity defects consisting of unit cells hollowed from the diamond lattices formed the coupled resonation modes.
Anticoagulation management by community pharmacists in New Zealand: an evaluation of a collaborative model in primary care
Authors: Harrison Jeff , Shaw John P , Harrison Jenny E
Published: September 2014

Objectives

Despite the introduction of new oral anticoagulants, vitamin K antagonists remain the mainstay of the prevention and treatment of thromboembolism. The advent of affordable point-of-care testing presents an opportunity for community pharmacists to provide anticoagulation management services, better utilizing their training, reducing the workload on medical practices and improving accessibility and convenience for patients. This study aimed to determine the effectiveness of anticoagulation management by community pharmacists.

Methods

All patients enrolled in a pilot programme for a community pharmacy anticoagulation management service using point-of-care international normalized ratio testing and computer-assisted dose adjustment were included in a follow-up study, including before–after comparison. Outcomes included time in therapeutic range (TTR), time above and below range, number and proportion of results outside efficacy and safety thresholds, and a comparison of care led by pharmacists and care led by a primary-care general practitioner (GP).

Key findings

A total of 693 patients were enrolled, predominantly males over 65 years of age with atrial fibrillation. The mean TTR was 78.6% (95% CI 49.3% to 100%). A subgroup analysis (n = 221) showed an increase in mean TTR from 61.8% under GP-led care to 78.5% under pharmacist-led care (P < 0.001), reflecting a reduction in the time above and, in particular, below the range. The mean TTR by pharmacy ranged from 71.4% to 84.1%. The median number of tests per month was not statistically different between GP- and pharmacist-led care.

Conclusions

Community-pharmacist-led anticoagulation care utilizing point-of-care testing and computerized decision support is safe and effective, resulting in significant improvements in TTR. Our results support wider adoption of this model of collaborative care.
Contact‐dependent suppression of CD4 T‐cell activation and proliferation by B cells activated through IgD cross‐linking
Authors: Preciado‐Llanes Lorena , Wing James B. , Foster Rachel A. , Carlring Jennifer , Lees Andrew , Read Robert C. , Heath Andrew W.
Published: September 2014

Although the co‐stimulatory interaction between B and T cells is well defined, recent evidence suggests that B cells also have a regulatory role. Here, we show that B cells activated using anti‐IgD conjugated to dextran (α‐δ‐dex) directly inhibit T‐cell receptor‐induced CD4 T‐cell activation, proliferation and cytokine production. This effect was observed in CD4 T cells activated both with and without CD28 co‐stimulation. T‐cell viability was unaffected, and the T‐cell suppressive effect was mediated by contact with IgD‐activated purified B cells and not by interleukin‐10 or other soluble factors. This is the first evidence of IgD‐activated B cells mediating inhibition of activation and proliferation of CD4 T cells in humans.
Physical and Thermal Properties of Oregano (Origanum vulgare L.) Essential Oil Microparticles
Authors: Toledo Hijo Ariel Antonio Campos , da Costa Joyce Maria Gomes , Silva Eric Keven , Azevedo Viviane Machado , Yoshida Maria Irene , Borges Soraia Vilela
Published: September 2014

In this study, the physical and thermal properties of essential oil microparticles of oregano (Origanum vulgare L.) dried via spray drying were examined. The product was characterized by morphology, mean diameter, particle size distribution, moisture sorption curve, differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). The process promoted the formation of spherical capsules with high polydispersity. The isotherm exhibited type II behavior (sigmoidal curve), and the best fit was obtained by the Guggenheim–Anderson–de Boer (GAB) model (E = 6.748%). The DSC analysis showed that the increase equilibrium moisture content reduced the Tg value of the microparticles (164.47–91.29C). The samples stored at low humidity resulted in more thermally stable particles, and the samples with equilibrium moisture content of 4.74% showed higher thermal stability.

Practical Applications

The applications of essential oils with relevant antioxidant activities, such as oregano essential oil, as a food additive is limited in the conventional form, due to their fast degradation triggered by temperature, light, presence of oxygen and humidity, among others. The encapsulation technique by spray drying has been successfully used to overcome this drawback. However, the spray‐dried products may present some technological problems, such as high hygroscopicity and low resistance when subjected to high temperatures. The evaluation of microparticle stability is a relevant and important issue when desiring to ensure their quality and application. Studies of the functional properties such as hygroscopicity, sorption behavior and thermal resistance determine the ideal conditions for the storage of this type of product.
Barcelona Clinic Liver Cancer staging system and survival of untreated hepatocellular carcinoma in a hepatitis B virus endemic area
Authors: Lee Jeong‐Hoon , Kim Hwi Young , Kim Yoon Jun , Yoon Jung‐Hwan , Chung Jin Wook , Lee Hyo‐Suk
Published: September 2014

Background and Aim

A uniform staging system for hepatocellular carcinoma (HCC) is needed. In this study, the discrimination abilities of HCC staging systems (American Joint Committee on Cancer [AJCC], Barcelona Clinic Liver Cancer [BCLC], Cancer of the Liver Italian Program, and Okuda stage) were compared during the course of untreated HCC.

Methods

We included consecutive 80 patients diagnosed with HCC, but were not treated for HCC, at a single medical center in Korea. In addition, 177 treated patients matched by prognostic factors were included to evaluate the survival gain owing to locoregional treatment.

Results

The mean age of untreated patients was 58.7 years. During the observation period (median = 41.1 months), 72 patients died (median survival = 2.1 months; range = 1.6–33.7 months). Among various staging systems, the BCLC system had the best discrimination ability (linear trend χ2 = 16.35). Multivariate analysis indicated that the intrahepatic tumor classification (AJCC T classification) was an independent predictor of overall survival (OS) (P = 0.001). However, either node or metastasis classification failed to affect the OS significantly (both P > 0.05). Patients undergoing intrahepatic tumor control with locoregional therapy showed prolonged survival in those patients with nodal involvement (hazard ratio = 0.315; P = 0.004) and extrahepatic metastasis (hazard ratio = 0.658; P = 0.258), respectively, after adjustment for independent prognostic factors. Compared with untreated patients, BCLC stage A and B patients had > 1 year of survival gain but those with stage C and D did not, owing to locoregional therapy.

Conclusion

The BCLC system had the best discrimination among untreated HCC patients. However, re‐evaluation of the clinical importance of nodal and metastasis classification might be required.
Assessment of liver fibrosis: The relationship between point shear wave elastography and quantitative histological analysis
Authors: Ding Hong , Ma Jiao‐jiao , Wang Wen‐ping , Zeng Wen‐jiao , Jiang Tao , Huang Bei‐jian , Chen Shi‐yao
Published: September 2014

Background and Aim

Traditional pathological scoring systems for liver fibrosis progression are predominantly based on the description of architectural changes with no consideration of the amount of collagen fiber deposition. Our purpose was to explore a true histological standard in accordance with the liver stiffness measured by point shear wave elastography (PSWE) in patients with chronic hepatitis B.

Methods

A total of 78 patients with liver neoplasms underwent liver stiffness measurements with PSWE as well as biochemical investigations within 3 days before partial hepatectomy. One tissue section of the liver specimens was stained with HE trichrome and evaluated traditionally with the Scheuer scoring system. The other tissue section was stained with picroSirius red and was evaluated according to the semiquantitative Chevallier et al. scoring system. In addition, this second tissue section was evaluated for the collagen proportionate area (CPA) with computer‐assisted digital image analysis. The reproducibility of PSWE technology was explored through the intra‐class correlation coefficient of a reliability analysis.

Results

The PSWE technology revealed good reproducibility in liver stiffness measurements, and the PSWE values increased with the pathological severity of liver fibrosis on both the Scheuer scoring system and the semiquantitative Chevallier et al. scoring system. PSWE values exhibited more reasonable relationships with CPA (r = 0.628, P = 0.00 < 0.05) than with the Scheuer scoring system (r = 0.473, P = 0.00 < 0.05) or the Chevallier et al. semiquantitative scoring system (r = 0.487, P = 0.00 < 0.05).

Conclusion

CPA is a better pathological parameter than traditional semiquantitative scoring systems in accordance with liver stiffness measured by PSWE technology.
Type 2 diabetes: A risk factor for liver mortality and complications in hepatitis B cirrhosis patients
Authors: Hsiang John C , Gane Edward J , Bai Wayne W , Gerred Stephen J
Published: September 2014

Background and Aim

The effect of type 2 diabetes mellitus (DM) on morbidity and mortality among hepatitis B virus (HBV) cirrhosis patients is poorly defined. We assess the effect of DM on the HBV cirrhosis outcomes and survival.

Methods

A retrospective study of HBV cirrhosis patients who sought care at a sole public hospital in a geographically defined region, from year 2000 to 2012. Cirrhosis complications, liver transplantations, and mortality were reviewed. Primary outcome is the composite of liver‐related and overall mortality or orthotopic liver transplantation (OLT).

Results

Two hundred twenty‐three patients entered into the final analysis; 50 patients (22.4%) have DM at cirrhosis diagnosis. Seventy‐two percent of DM patients have DM for more than 5 years at cirrhosis diagnosis. The incidence of hepatocellular carcinoma (HCC) was 25.4 and 60.5 per 1000 patient‐years for non‐DM and DM patients, respectively (P = 0.006). In multivariate analysis, DM was a predictor of HCC (hazard ratio [HR] 2.36, [1.14–4.85], P = 0.02), hepatic complications (HR 2.04, [1.16–3.59], P = 0.01), liver mortality or OLT (HR 2.26, [1.05–4.86], P = 0.04), and overall mortality or OLT (HR 2.25, [1.96–4.22], P = 0.01). Insulin and/or sulphonylurea use and poor diabetic control (glycosylated hemoglobin ≥ 7.0%) were predictors of HCC and cirrhosis complications (all P < 0.05). The 5‐year liver‐related mortality or OLT rate was 23.4% for DM patients and 9.4% for non‐DM patients, respectively (P = 0.009).

Conclusion

The presence of DM and poor diabetic control at cirrhosis diagnosis significantly increase the rate of cirrhosis complications and reduced survival in patients with HBV cirrhosis. Improving diabetic control should be essential part of the cirrhosis care in these patients.
Rural Geriatric Glue: A Nurse Practitioner–Led Model of Care for Enhancing Primary Care for Frail Older Adults within an Ecosystem Approach
Authors: Prasad Sadhana , Dunn Wendy , Hillier Loretta M. , McAiney Carrie A. , Warren Rex , Rutherford Paul
Published: September 2014

Objectives

This article describes the implementation of the Care for Seniors model of care, an innovative approach to improving care coordination and integration, and provides preliminary evidence of effective use of specialist resources and acute care services.

Design

Retrospective.

Setting

Primary care; cross‐sector.

Participants

Older adults living in a rural area in southwestern Ontario, Canada.

Measurements

Number of new geriatrician referrals and follow‐up visits before and after the launch of the Care for Seniors program, number of Nurse Practitioner visits in a primary care setting, in‐home, retirement home and hospital, number of discharges home from hospital and length of hospital stay between.

Results

In the 2 years before the launch of the program, the total number of visits to the geriatrician for individuals from this FHT was relatively low, 21 and 15, respectively for 2005–06 and 2006–07, increasing to 73 for the 2011–12 year. Although the absolute number of individuals supported by the NP‐Geri has remained relatively the same, the numbers seen in the primary care office or in the senior's clinic has declined over time, and the number of home visits has increased, as have visits in the retirement homes. The percentage of individuals discharged home increased from 19% in 2008–09 to 31% in 2009–10 and 26% in 2011–12 and the average length of stay decreased over time.

Conclusions

This model of care represents a promising collaboration between primary care and specialist care for improving care to frail older adults living in rural communities, potentially improving timely access to health care and crisis intervention.
Intervention with the Screening Tool of Older Persons Potentially Inappropriate Prescriptions/Screening Tool to Alert Doctors to Right Treatment Criteria in Elderly Residents of a Chronic Geriatric Facility: A Randomized Clinical Trial
Authors: Frankenthal Dvora , Lerman Yaffa , Kalendaryev Edward , Lerman Yehuda
Published: September 2014

Objectives

To assess the effect of a Screening Tool of Older Persons potentially inappropriate Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) medication intervention on clinical and economic outcomes.

Design

Parallel‐group randomized trial.

Setting

Chronic care geriatric facility.

Participants

Residents aged 65 and older prescribed with at least one medication (N = 359) were randomized to receive usual pharmaceutical care or undergo medication intervention.

Intervention

Screening medications with STOPP/START criteria followed up with recommendations to the chief physician.

Measurements

The outcome measures assessed at the initiation of the intervention and 1 year later were number of hospitalizations and falls, Functional Independence Measure (FIM), quality of life (measured using the Medical Outcomes Study 12‐item Short‐Form Health Survey), and costs of medications.

Results

The average number of drugs prescribed was significantly lower in the intervention than in the control group after 1 year (P < .001). The average drug costs in the intervention group decreased by 103 shekels (US$29) per participant per month (P < .001). The average number of falls in the intervention group dropped significantly (P = .006). Rates of hospitalization, FIM scores, and quality of life measurements were similar for both groups.

Conclusion

Implementation of STOPP/START criteria reduced the number of medications, falls, and costs in a geriatric facility. Their incorporation in those and similar settings is recommended.
Prospective Observational Study of Delirium Recovery Trajectories and Associated Short‐Term Outcomes in Older Adults Admitted to a Specialized Delirium Unit
Authors: Lam Ching‐yu , Tay Laura , Chan Mark , Ding Yew Yoong , Chong Mei Sian
Published: September 2014

Objectives

To describe the recovery trajectories of delirium and to determine factors predicting the course of recovery and adverse outcome.

Design

A prospective observational study.

Setting

Geriatric monitoring unit (GMU), a five‐bed unit specializing in managing older adults with delirium.

Participants

Individuals admitted to theGMUbetween December 2010 and August 2012 (N = 234; mean age 84.1 ± 7.4).

Measurements

Information was collected on demographic characteristics; comorbidities; severity of illness; functional status; and daily cognitive, Delirium Rating Scale, Revised‐98 (DRS‐R98) severity, and functional scoring. Resolution of delirium, and thusGMUdischarge, was determined according to clinical assessment. The primary outcome was residual subsyndromal delirium (SSD) (DRS‐R98 severity ≥13) uponGMUdischarge. Univariate and multivariate methods were used to determine the predictors of residualSSDand adverse outcomes (inpatient mortality and incident nursing home admission upon discharge).

Results

Participants with residualSSDhad a slower recovery in terms of delirium severity, cognition, and functional status than those with no residualSSD. ResidualSSDpredictors included underlying dementia, admissionDRS‐R98 severity,DRS‐R98 severity on Day 1 minus Day 3 ofGMUstay, and admission modified Barthel Index. Only presence of residualSSDat discharge predicted adverse outcomes (odds ratio = 5.27, 95% confidence interval = 1.43–19.47).

Conclusion

Individuals with residualSSDhad prolonged recovery trajectory of delirium. These new insights into the recovery trajectories of delirium may help formulate early discharge planning and provide the basis for future research on delirium treatment.