bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a river flow forecast model by coupling a snow accumulation/melt model with a distributed run‐off model
Authors: Qiu C. , Hattori Y. , Kaji M. , Onodera M. , Hitokoto M.
Published: March 2013

To consider the contribution of snowmelt in flood forecast, this paper presents an integrated model, which combines a rigorous snow model with a distributed run‐off model, based on unstructured triangular meshes. Using precipitation, air temperature and wind speed as input data, the integrated model can continuously estimate temporal‐spatial variation of both snow depth and amount of snowmelt and subsequently forecast river flow caused by snowmelt. The result of a long‐term simulation of past floods showed a good match with observations. It is evinced that consideration of snowmelt in a flood forecast can help avoid incorrect prediction. This includes overestimation in the snow accumulation season and/or underestimation in the snowmelt season caused by using precipitation directly as the input data of the run‐off model. A real‐time flood forecasting system has been established for the Hii River basin, Japan, by using the model. This system now operates uninterruptedly to make a forecast 6 h ahead, with an interval of 10 min.
Multicultural Long‐Term Care Nurses' Perceptions of Factors Influencing Patient Dignity at the End of Life
Authors: Periyakoil Vyjeyanthi S. , Stevens Marguerite , Kraemer Helena
Published: March 2013

The goal of this mixed‐methods study was to characterize the perceptions of multicultural long‐term care nurses about patient dignity at the end‐of‐life (EOL). The study was conducted in a large, urban, long‐term care (LTC) facility. Participants were 45 long‐term care nurses and 26 terminally ill nursing home residents. Nurses completed an open‐ended interview about their perceptions of the concept of dying with dignity, and the data were analyzed using grounded theory methods. Main themes identified as promoting resident dignity at the EOL included treating them with respect, helping them prepare for the EOL, promoting shared decision‐making, and providing high‐quality care. The nurses' cultural and religious backgrounds influenced their perceptions of what constitutes dignity‐conserving care. Foreign‐born nurses stressed the need for EOL rituals, but this was strikingly absent in the statements of U.S.‐born nurses. Foreign‐born Catholic nurses stated that the dying experience should not be altered using analgesics to relieve suffering or by attempts to hasten death by forgoing curative therapy or by other means. Nurses and terminally ill individuals completed the Dignity Card‐sort Tool (DCT). A comparison of the DCT responses of the LTC nurses cohort with those of the terminally ill participants revealed that the nurses felt patient dignity was eroded when patient wishes were not followed and when they were treated without respect. In contrast, dying LTC residents felt that poor medical care and loss of ability to choose care options were the most important factors leading to erosion of dignity.
Uric Acid Measurement Improves Prediction of Cardiovascular Mortality in Later Life
Authors: Dutta Ambarish , Henley William , Pilling Luke C. , Wallace Robert B. , Melzer David
Published: March 2013

Objectives

To estimate the association between uric acid and cardiovascular mortality in older adults, independent of traditional risk factors, and to estimate the risk prediction gain by adding uric acid measurements to the Framingham Cardiovascular Risk Score (FCRS).

Design

Longitudinal observational study of two population‐based cohorts.

Setting

The Established Populations for Epidemiologic Studies of the Elderly, Iowa (Iowa‐EPESE) and the Third National Health and Nutritional Examination Survey (NHANES III).

Participants

One thousand twenty‐eight Iowa‐EPESE participants and 1,316 NHANES III participants. Selected participants were aged 70 and older without overt cardiovascular disease, renal dysfunction, or diuretic use who lived for 3 years or longer after baseline.

Measurements

Outcome was age at cardiovascular death during follow‐up (12–20 years). Uric acid and cardiovascular risk factors such as smoking, systolic blood pressure, diabetes mellitus, obesity, serum cholesterol, and high‐density lipoprotein cholesterol were measured at baseline.

Results

High serum uric acid (>7.0 mg/dL) was associated with male sex, obesity, lipid levels, and estimated glomerular filtration rate at baseline. Fully adjusted hazard ratios (HRs) for cardiovascular death with high uric acid versus normal were 1.36 (95% confidence interval (CI) = 1.10–1.69) in Iowa‐EPESE and 1.43 (95% CI = 1.04–1.99) in NHANES III; pooled HR was 1.38 (95% CI = 1.16–1.61). The net reclassification improvement achieved by adding uric acid measurement to the FCRS was 9% to 20%.

Conclusion

In individuals aged 70 and older without overt CVD, renal dysfunction, or diuretic use, serum uric acid greater than 7.0 mg/dL was associated with greater CVD mortality independent of classic CVD risk factors. Adding uric acid measurement to the FCRS would improve prediction in older adults.
A Systematic Review of the Probability of Repeated Admission Score in Community‐Dwelling Adults
Authors: Wallace Emma , Hinchey Tim , Dimitrov Borislav D. , Bennett Kathleen , Fahey Tom , Smith Susan M.
Published: March 2013

Objectives

To perform a systematic review of the Probability of Repeated Admission (Pra) score in community‐dwelling adults to assess its performance in a range of validation studies in the community setting.

Design

Systematic review and meta‐analysis.

Setting

Primary and community care.

Participants

Community‐dwelling older people.

Measurements

The primary outcome was hospital admission; secondary outcomes were mortality, hospital days, functional decline, other health service use, and costs.

Results

Nine validation studies describing 11 cohorts of individuals aged 65 and older were identified. A meta‐analysis of the Pra score in five cohorts (8,843 individuals) with comparable and available data revealed good discrimination performance (summary area under the receiver operating characteristic curve 69.7% (standard error 2.8%)). Pooled specificity was high (96%, 95% confidence interval (CI)=95.8–96.7%), indicating that a Pra score of 0.5 or greater effectively rules in the likelihood of admission, but pooled sensitivity was low (12%, 95% CI=10.5–13.6%). Calibration performance was good, with an overall risk ratio of 1.12 (95% CI=0.89–1.42), indicating that the Pra score reliably predicted hospital admissions.

Conclusion

The Pra score performs well in predicting hospital admission in community‐dwelling adults categorized as high risk according to the score. This tool has clinical and healthcare policy utility in terms of targeting elderly people at highest risk of hospital admission, but the low pooled sensitivity of the score indicates that it is not a reliable way of excluding hospital admission in those stratified as low risk.
Kindergarteners' Entrée Intake Increases When Served a Larger Entrée Portion in School Lunch: A Quasi‐Experiment
Authors: Ramsay Samantha , Safaii SeAnne , Croschere Tom , Branen Laurel J. , Wiest Michelle
Published: March 2013

BACKGROUND

The influence of portion size on children's intake and self‐regulation of food has gained attention; however, few studies have examined portion sizes in school lunch. This study investigated kindergarteners' intake when they were given different entrée portion sizes from the lunch menu.

METHODS

Plate waste was used as a proxy to measure intake. A standardized lunch of chicken nuggets, rice, green beans, applesauce, and milk was served every Tuesday for 5 consecutive weeks at a Kinder Center. All menu items and the self‐selection of 2, 3, or 4 nuggets were served the first week as a pilot. In the second and fourth weeks, trained servers preportioned kindergarteners' plates with 4 nuggets. In the third and fifth weeks, kindergarteners verbally self‐selected 2, 3, or 4 chicken nuggets. A Mann‐Whitney test was used to determine a significant difference in intake between the 2 days kindergarteners were allowed to select the portion size and the 2 days they were preportioned.

RESULTS

A significant difference (p < .009) in intake was found between the self‐selection of entrée portion size and the preportioned entrée regardless of sex or whether kindergarteners attended the am or pm session. No significant difference was found in milk, fruit, vegetable, or rice intake between choice and nonchoice lunches. In this study, kindergarteners ate more chicken nuggets when they were offered a larger portion size.

CONCLUSIONS

Further investigation is needed on the impact of letting kindergarteners self‐select portion sizes, and the potential negative outcomes of larger portion sizes on children's caloric consumption in elementary schools.
Exploring Effective Strategies for Increasing the Amount of Moderate‐to‐Vigorous Physical Activity Children Accumulate During Recess: A Quasi‐Experimental Intervention Study
Authors: Efrat Merav W.
Published: March 2013

BACKGROUND

Less than half of elementary children meet the physical activity recommendations of 30 to 60 minutes of moderate‐to‐vigorous physical activity (MVPA) on a daily basis. Recess provides the single biggest opportunity for children to accumulate MVPA. This study explored whether a teacher's social prompting to be active during recess alone and modeling of active recess‐time games alone may increase the amount of MVPA children accumulate during recess.

METHODS

Three demographically matched schools were randomly assigned to receive a social prompting intervention, modeling intervention, or to serve as a comparison group. Pre‐ and postintervention physical activity data was collected utilizing accelerometers.

RESULTS

Compared with preintervention, MVPA during recess increased significantly in the social prompting group and decreased significantly in the modeling group. There were no significant changes in the comparison group. There was a significant interaction between time and intervention: pre‐ to postintervention change between interventions was significant for modeling versus comparison and modeling versus social prompting, but not for social prompting versus comparison.

CONCLUSIONS

Modeling was not an effective strategy for increasing MVPA during recess. Social prompting may be an effective strategy for increasing MVPA during recess. However, larger studies are needed to determine whether social prompting increases MVPA during recess. In light of evidence suggesting that MVPA is linked to lower obesity rates, and a substantial number of health and academic benefits, social prompting may be a useful strategy to further explore to address the childhood obesity epidemic, and improve students' health and academic outcomes.
Evaluation of three paediatric weight estimation methods in Singapore
Authors: Loo Pei Ying , Chong Shu‐Ling , Lek Ngee , Bautista Dianne , Ng Kee Chong
Published: March 2013

Aim

Rapid paediatric weight estimation methods in the emergency setting have not been evaluated for South East Asian children. This study aims to assess the accuracy and precision of three such methods in Singapore children: Broselow‐Luten (BL) tape, Advanced Paediatric Life Support (APLS) (estimated weight (kg) = 2 (age + 4)) and Luscombe (estimated weight (kg) = 3 (age) + 7) formulae.

Methods

We recruited 875 patients aged 1–10 years in a Paediatric Emergency Department in Singapore over a 2‐month period. For each patient, true weight and height were determined. True height was cross‐referenced to the BL tape markings and used to derive estimated weight (virtual BL tape method), while patient's round‐down age (in years) was used to derive estimated weights using APLS and Luscombe formulae, respectively. The percentage difference between the true and estimated weights was calculated. For each method, the bias and extent of agreement were quantified using Bland–Altman method (mean percentage difference (MPD) and 95% limits of agreement (LOA)). The proportion of weight estimates within 10% of true weight (p10) was determined.

Results

The BL tape method marginally underestimated weights (MPD +0.6%; 95% LOA −26.8% to +28.1%; p10 58.9%). The APLS formula underestimated weights (MPD +7.6%; 95% LOA −26.5% to +41.7%; p10 45.7%). The Luscombe formula overestimated weights (MPD −7.4%; 95% LOA −51.0% to +36.2%; p10 37.7%).

Conclusions

Of the three methods we evaluated, the BL tape method provided the most accurate and precise weight estimation for Singapore children. The APLS and Luscombe formulae underestimated and overestimated the children's weights, respectively, and were considerably less precise.
Diagnosing gastro‐oesophageal reflux disease or lactose intolerance in babies who cry alot in the first few months overlooks feeding problems
Authors: Douglas Pamela Sylvia
Published: March 2013

This paper explores two areas in which the translation of research into practice may be improved in the management of cry‐fuss behaviours in the first few months of life. Firstly, babies who cry excessively are often prescribed proton pump inhibitors, despite evidence that gastro‐oesophageal reflux disease is very rarely a cause. The inaccuracy of commonly used explanatory mechanisms, the side‐effects of acid‐suppressive medications, and the failure to identify treatable problems, including feeding difficulty when the diagnosis of ‘reflux’ is applied, are discussed. Secondly, crying breastfed babies are still prescribed lactase or lactose‐free formula, despite evidence that the problem of functional lactose overload is one of breastfeeding management. The mechanisms and management of functional lactose overload are discussed. These two problems of research translation need to be addressed because failure to identify and manage other causes of cry‐fuss problems, including feeding difficulty, may have adverse outcomes for a small but significant minority of families.
Fusarium cerealis Associated with Barley Seeds in Argentina
Authors: Castañares Eliana , Dinolfo María Inés , Moreno María Virginia , Berón Corina , Stenglein Sebastián Alberto
Published: March 2013

Fusarium head blight is a fungal disease caused by a complex of Fusarium species on cereals, such as barley and wheat. It has economic impacts due to yield reductions and mycotoxin contamination. As barley production has increased considerably in the last 5 years in Argentina, a survey was conducted for identifying Fusarium species associated with barley grains. Fusarium cerealis was isolated and identified based on morphological and molecular analysis. The potential production of nivalenol and zearalenone was assessed using specific PCR assays. Koch′s postulates were carried out to confirm the pathogenicity of the fungus.
Melatonin protects against ischemic heart failure in rats
Authors: Şehirli Ahmet Özer , Koyun Derya , Tetik Şermin , Özsavcı Derya , Yiğiner Ömer , Çetinel Şule , Tok Olgu Enis , Kaya Zehra , Akkiprik Mustafa , Kılıç Ertugrul , Şener Göksel
Published: March 2013

Ischemic injury, which occurs as a result of sympathetic hyperactivity, plays an important role in heart failure. Melatonin is thought to have antiatherogenic, antioxidant, and vasodilatory effects. In this study, we investigated whether melatonin protects against ischemic heart failure (HF). In Wistar albino rats, HF was induced by left anterior descending (LAD) coronary artery ligation and rats were treated with either vehicle or melatonin (10 mg/kg) for 4 weeks. At the end of this period, echocardiographic measurements were recorded and the rats were decapitated to obtain plasma and cardiac tissue samples. Lactate dehydrogenase, creatine kinase, aspartate aminotransferase, alanine aminotransferase, and lysosomal enzymes (β‐D‐glucuronidase, β‐galactosidase, β‐D‐N‐acetyl‐glucosaminidase, acid phosphatase, and cathepsin‐D) were studied in plasma samples, while malondialdehyde and glutathione levels and Na+, K+‐ATPase, caspase‐3 and myeloperoxidase activities were determined in the cardiac samples. Sarco/endoplasmic reticulum calcium ATPase (SERCA) and caveolin‐3 levels in cardiac tissues were evaluated using Western blot analyses. Furthermore, caveolin‐3 levels were also determined by histological analyses. In the vehicle‐treated HF group, cardiotoxicity resulted in decreased cardiac Na+, K+‐ATPase and SERCA activities, GSH contents and caveolin‐3 levels, while plasma LDH, CK, and lysosomal enzyme activities and cardiac MDA and Myeloperoxidase (MPO) activities were found to be increased. On the other hand, melatonin treatment reversed all the functional and biochemical changes. The present results demonstrate that Mel ameliorates ischemic heart failure in rats. These observations highlight that melatonin is a promising supplement for improving defense mechanisms in the heart against oxidative stress caused by heart failure.
Unit root testing with stationary covariates and a structural break in the trend function
Authors: Fossati Sebastian
Published: March 2013

The issue of testing for a unit root allowing for a structural break in the trend function is considered. The focus is on the construction of more powerful tests using the information in relevant multi‐variate data sets. The proposed test adopts the generalized least squares detrending approach and uses correlated stationary covariates to improve power. As it is standard in the literature, the break date is treated as unknown. Asymptotic distributions are derived, and a set of asymptotic and finite sample critical values are tabulated. Asymptotic local power functions show that power gains can be large. Finite sample results show that the test exhibits small‐size distortions and power that can be far beyond what is achievable by univariate tests.
Genetic variations in host IL28B links to the detection of peripheral blood mononuclear cells–associated hepatitis C virus RNA in chronically infected patients
Authors: Angulo J. , Pino K. , Pavez C. , Biel F. , Labbé P. , Miquel J. F. , Soza A. , López‐Lastra M.
Published: March 2013

Hepatitis C virus (HCV) is mainly hepatotropic; however, several reports document the presence of genomic viral RNA in extrahepatic sites including peripheral blood mononuclear cells (PBMCs). In this study, the presence of HCV RNA was initially evaluated in the plasma and peripheral blood mononuclear cells (PBMCs) of 53 HCV‐infected patients who were treated per protocol. PBMC‐associated HCV RNA was detectable in 79% of patients. Early virological response to combined pegylated interferon‐α (PegIFN) and ribavirin (RBV) therapy in patients with undetectable levels of PBMCs‐associated HCV RNA was 100%, while it was 60% (P = 0.003) in those who had detectable levels of PBMC‐associated HCV RNA. A sustained virological response was observed in 35% of patients with detectable PBMC‐associated HCV RNA, but was 70% in patients with undetectable levels of PBMC‐associated HCV RNA (P = 0.07). In a multivariate analysis incorporating parameters such as HCV genotype, viral load, presence of cirrhosis and absence of PBMC‐associated HCV RNA, a significant relationship was observed between the detection of PBMC‐associated HCV RNA and the sustained virological response (OR 19.4, 95% CI: 2.1–486.2, P = 0.0061). The association between single nucleotide polymorphism (SNP) in IL28B, known predictor of antiviral therapy outcome, and the occurrence of HCV RNA in PBMC in 84 chronically infected patients was then evaluated. Results suggest that the presence of a G allele in rs8099917, known to associate to a poor response to PegIFN/RBV therapy, also predicts an increased association of HCV RNA with PBMC (OR: 3.564; 95% CI: 1.114–11.40, P = 0.0437).
Hepatic steatosis estimated microscopically versus digital image analysis
Authors: Hall Andrew R. , Dhillon Amar P. , Green Anna C. , Ferrell Linda , Crawford James M. , Alves Venancio , Balabaud Charles , Bhathal Prithi , Bioulac‐Sage Paulette , Guido Maria , Hytiroglou Prodromos , Nakanuma Yasuni , Paradis Valerie , Quaglia Alberto , Snover Dale , Theise Neil , Thung Swan , Tsui Wilson , van Leeuwen Dirk J.
Published: March 2013

Background & Aims

Evaluate in liver biopsies: (i) interobserver agreement of estimates of fat proportionate area (eFPA) and steatosis grading, (ii) the relationship between steatosis grades and measured fat proportionate area (mFPA, digital image analysis), (iii) the accuracy of eFPA, (iv) to present images to aid standardization and accuracy of eFPA.

Methods

Twenty‐one liver biopsies were selected from the Royal Free Hospital (RFH) histopathology archive to represent the full range of histopathological steatosis severity. As many non‐overlapping fields of parenchyma as possible were photographed at ×20 objective magnification from the biopsies (n = 651). A total of 15 sample images were selected to represent the range of steatosis seen.

Twelve hepatopathologists from 11 sites worldwide independently evaluated the sample images for steatosis grade [normal (none)/mild/moderate/severe], and eFPA (% area of liver parenchyma occupied by fat).

Results

The hepatopathologists had good linear correlation between eFPA and mFPA for sample images (r = 0.924, P < .001) and excellent concordance (kappa = 0.91, P < 0.001). Interobserver concordance of steatosis grade showed ‘substantial agreement’ (kappa = 0.64).

There was significant difference between eFPA and mFPA in the sample images for mild, moderate and severe steatosis (P = 0.024, P < 0.001, P < 0.001 respectively): the observers consistently over‐estimated the eFPA.

Conclusion

Hepatopathologists showed ‘excellent’ interobserver agreement in eFPA and ‘substantial’ agreement in assigning steatosis grade (precision was high). However, compared with mFPA, eFPA was inaccurate. eFPA systematically exceeds mFPA; generally the overestimation increases with severity of steatosis. Considering that non‐invasive technologies for estimating liver fat utilize histopathology as reference, such assessments would benefit from quantitative validation of visually estimated microscopic liver fat percentages.
Gliotoxin‐induced changes in rat liver regeneration after partial hepatectomy
Authors: Nejak‐Bowen Kari N. , Orr Anne V. , Bowen Jr William C. , Michalopoulos George K.
Published: March 2013

Background

Hepatic non‐parenchymal cells (NPCs), encompassing hepatic stellate cells (HSCs), macrophages and endothelial cells, synthesize new hepatocyte growth factor (HGF) during liver regeneration (LR), and also play an important function in matrix production at the end of regeneration.

Aims

The aim of this study was to determine whether ablating NPCs either during hepatocyte proliferation or during matrix resynthesis will have any effect on LR.

Methods

Rats were injected with either gliotoxin (which induces NPC apoptosis) or vehicle control at various stages during partial hepatectomy (PH). NPCs and hepatocytes were also treated in vitro with gliotoxin.

Results

Proliferating cells were abundant in control livers 24 h after PH, while in gliotoxin‐treated rats, mitosis was absent, apoptotic NPCs were apparent and HGF was decreased. In vitro studies demonstrated a > 50% decrease in cell viability in NPC cultures, while hepatocyte viability and proliferation were unaffected. Chronic elimination of NPCs over a period of 5 days after PH led to increased desmin‐positive HSCs and fewer alpha smooth muscle actin‐expressing HSCs. Finally, there was continued proliferation of hepatocytes and decreased collagen I and TGF‐β when HSCs, the matrix‐producing NPCs, were ablated during later stages of LR.

Conclusions

Ablation of NPCs at early time points after PH interferes with liver regeneration, while their ablation at late stages causes impairment in the termination of LR, demonstrating a time‐dependent regulatory role of NPCs in the regenerative process.
The origin of the serpentine endemic Minuartia laricifolia subsp. ophiolitica by vicariance and competitive exclusion
Authors: Moore Abigail J. , Merges Dominik , Kadereit Joachim W.
Published: March 2013

Serpentine soils harbour a unique flora that is rich in endemics. We examined the evolution of serpentine endemism in Minuartia laricifolia, which has two ecologically distinct subspecies with disjunct distributions: subsp. laricifolia on siliceous rocks in the western Alps and eastern Pyrenees and subsp. ophiolitica on serpentine in the northern Apennines. We analysed AFLPs and chloroplast sequences from 30 populations to examine their relationships and how their current distributions and ecologies were influenced by Quaternary climatic changes. Minuartia laricifolia was divided into four groups with a BAPS cluster analysis of the AFLP data, one group consisted only of subsp. ophiolitica, while three groups were found within subsp. laricifolia: Maritime Alps, north‐western Alps and central Alps. The same groups were recovered in a neighbour‐joining tree, although subsp. ophiolitica was nested within the Maritime Alps group of subsp. laricifolia. Subspecies ophiolitica contained three different chloroplast haplotypes, which were also found in the Maritime Alps group of subsp. laricifolia. Given its high genetic diversity, subsp. ophiolitica appears to have arisen from subsp. laricifolia by vicariance instead of by long‐distance dispersal. Genetic and geographic evidence point to the Maritime Alps populations of subsp. laricifolia as the closest relatives of subsp. ophiolitica. We hypothesize that M. laricifolia was also able to grow on nonserpentine rocks in the northern Apennines during glacial periods when the vegetation was more open, but that only the serpentine‐adapted populations were able to persist until the present due to their competitive exclusion from more favourable habitats.
Next‐generation dynamic global vegetation models: learning from community ecology
Authors: Scheiter Simon , Langan Liam , Higgins Steven I.
Published: March 2013

Dynamic global vegetation models (DGVMs) are powerful tools to project past, current and future vegetation patterns and associated biogeochemical cycles. However, most models are limited by how they define vegetation and by their simplistic representation of competition.

We discuss how concepts from community assembly theory and coexistence theory can help to improve vegetation models. We further present a trait‐ and individual‐based vegetation model (aDGVM2) that allows individual plants to adopt a unique combination of trait values. These traits define how individual plants grow and compete. A genetic optimization algorithm is used to simulate trait inheritance and reproductive isolation between individuals. These model properties allow the assembly of plant communities that are adapted to a site's biotic and abiotic conditions.

The aDGVM2 simulates how environmental conditions influence the trait spectra of plant communities; that fire selects for traits that enhance fire protection and reduces trait diversity; and the emergence of life‐history strategies that are suggestive of colonization–competition trade‐offs.

The aDGVM2 deals with functional diversity and competition fundamentally differently from current DGVMs. This approach may yield novel insights as to how vegetation may respond to climate change and we believe it could foster collaborations between functional plant biologists and vegetation modellers.
Issues in caregiving for older people with intellectual disabilities and their ageing family carers: a review and commentary
Authors: Ryan Assumpta , Taggart Laurence , Truesdale‐Kennedy Maria , Slevin Eamonn
Published: March 2013

Background

In keeping with worldwide demographic changes and an ageing population, people with intellectual disabilities are living longer and all the evidence suggest that this trend will continue. This ‘new’ population of older people and their carers will pose challenges for health and social care providers.

Aim

This paper presents a review of the literature on key issues influencing caregiving for older people with intellectual disabilities and their ageing family carers.

Methods

The review was undertaken using a framework adapted from the NHS Centre for Reviews and Dissemination. Papers were identified through the use of databases including CINAHL, Science Direct, PsychoInfo, Blackwell Synergy, the Cochrane Library and MEDLINE.

Findings

The key themes which emerged from the literature and which consequently form the basis of this review include: ageing family carers, future planning and support services. In the context of family caregiving, older people with intellectual disabilities represent a unique group insofar as they are unlikely to be married and therefore have no spouse or dependents to care for them in later life. As a result, parents (usually mothers) have to continue caring for their son or daughter with an intellectual disability as they both grow older, often resulting in a mutually dependent relationship. The caregiving situation is further complicated by poor emergency and future planning and by a lack of appropriate services for this group of individuals.

Conclusions

In light of the emergence of a ‘new’ population of older people with intellectual disabilities, there is an urgent need to develop services and support structures which will enable these individuals and their ageing carers to x91age in placex92 and when this is no longer possible, to have appropriate alternatives that recognise the duality of their needs as older people and as people with intellectual disabilities.

Implications for Practice

Opportunities for supervision could be one way to increase individuals' awareness of their own role in the team.
Biofortification of cereals to overcome hidden hunger
Authors: Rawat Nidhi , Neelam Kumari , Tiwari Vijay K. , Dhaliwal Harcharan S.
Published: March 2013

More than 60% of the world population suffers from iron deficiency, and over 30% of the global population has zinc deficiency. Micronutrient deficiency leads to compromised health and economic losses and is prevalent in populations depending on non‐diversified plant‐based diets. Increasing mineral content of staple food crops through biofortification is the most feasible strategy of combating micronutrient malnutrition. Additionally, it will also enhance the agronomic efficiency of crops on mineral poor soils. A multipronged strategy towards enhancing mineral content of cereal grains should involve increased uptake of minerals from soil, enhanced partitioning towards grain and improved sequestration in the edible tissues of grains. At the same time, it is essential to improve mineral absorption in vivo from cereal‐based diets. Both conventional and modern breeding approaches and genetic engineering are being employed for biofortification of crop plants. With increased understanding of mineral uptake and transport mechanisms in plants, it is becoming ever more possible to engineer biofortified crop plants with the ultimate goal of overcoming hidden hunger.
Pyloromyotomy versus i.v. atropine therapy for the treatment of infantile pyloric stenosis: Nationwide hospital discharge database analysis
Authors: Takeuchi Masato , Yasunaga Hideo , Horiguchi Hiromasa , Hashimoto Hideki , Matsuda Shinya
Published: March 2013

Background

Several studies have suggested that i.v. atropine has a potential role in treating infantile hypertrophic pyloric stenosis (IHPS). It remains unclear, however, whether surgery can be replaced by i.v. therapy.

Methods

Data were extracted on infants with IHPS who were treated with atropine and/or surgery, from a nationwide administrative database through 2006–2008. Patient demographic data, treatment effects and length of hospital stay were analyzed in each treatment group.

Results

A total of 585 infants met the criteria for IHPS; 188 patients (32%) were initially treated with atropine (i.v. form, n = 180; oral form, n = 8), while 397 were treated with surgery as a first‐line therapy. Of the 180 infants receiving i.v. atropine, 38 were withdrawn from medical management and subsequently underwent surgery. Thus, the overall success rate of i.v. atropine was 78.9% (142/180). Surgery had a success rate of 100%, and postoperative complications were found in 2.8% of patients (12/435). Medical management required longer hospital stay than surgery (mean, 13.5 days vs 8.0 days; P < 0.001).

Conclusion

Surgery remains the suitable standard management option for IHPS, with its high success rate, minimal complications and shorter hospital stay compared with i.v. atropine therapy.
Increased risk of gastrointestinal acute GVHD following the addition of melphalan to busulfan/cyclophosphamide conditioning
Authors: Mårtensson T. , Priftakis P. , Casswall T. , Ringdén O. , Mattsson J. , Remberger M. , Hassan M. , Gustafsson B.
Published: March 2013

Risk factors associated with the development of aGVHD in the gastrointestinal tract have not been studied in depth. We retrospectively assessed 25 pediatric patients with MDS and JMML and compared the treatment outcome of two different conditioning regimens. Seventeen children (68%) underwent conditioning with busulfan (Bu), cyclophosphamide (Cy), and melphalan (Mel) and eight children (32%) with Bu and Cy. Gastrointestinal aGVHD stages II–IV (day 0–100) were observed in 47% (eight of 17) of the patients in the BuCyMel group and in none (0 of 8) in the BuCy group (p < 0.05). In patients who developed gastrointestinal aGVHD stages III–IV, a 24‐h variation in the Bu concentration with a nighttime peak was noted. HC and liver aGVHD stages II–IV were observed in 47% (eight of 17) and 35% (six of 17) after BuCyMel conditioning and in 0% (0 of 17) and 12.5% (one of eight) after BuCy conditioning. The overall survival rate was 53% (nine of 17) in the BuCyMel group and 62.5% (five of eight) in the BuCy group. In conclusion, the addition of melphalan to the BuCy conditioning regimen resulted in severe gastrointestinal complications and did not improve overall survival.
A case of urothelial carcinoma, lipid cell variant
Authors: Kojima Yui , Takasawa Akira , Murata Masaki , Akagashi Keigo , Inoue Tomomi , Hara Mamie , Tokunaga Yuichi , Minase Takashi , Hasegawa Tadashi , Sawada Norimasa
Published: March 2013

The lipid cell variant of urothelial carcinoma is a rare variant of urinary bladder cancer, comprised of lipoblast‐like cells. In this report, we describe a case of the lipid cell variant of aggressive urothelial carcinoma. A 78‐year‐old man was admitted to the hospital because of gross hematuria. On cystoscopy, an ulcerative lesion, non‐papillary architecture, was observed in the lateral wall of the bladder. Transurethral resection was performed. Histopathological findings of the bladder tumor indicated neoplastic cells forming irregular solid nests and sheets. Lipoblast‐like neoplastic cells that had eccentric nuclei and cytoplasmic vacuoles were observed, not only in the resected specimen, but also in urine samples. On mucin histochemistry, the tumor cell cytoplasm contained no neutral or acidic mucus. The lipoblast‐like cells were positive for cytokeratins (AE1/AE3, CK7) and adipophilin, known as a protein associated with neutral lipid synthesis. In general, it is difficult to prove the existence of intracytoplasmic lipid in formalin‐fixed paraffin‐embedded materials. This is the first report in which the presence of lipid in vacuoles of the lipid cell variant has been verified by immunohistochemistry.
Apoptosis‐Related Protein Expression During Pre‐ and Post‐Natal Testicular Development After Administration of Glucocorticoid in utero in the Sheep
Authors: Pedrana G , Viotti MH , Souza E , Sloboda D , Martin GB , Cavestany D , Ortega HH
Published: March 2013

Contents

Pre‐natal glucocorticoids are used in women at risk of preterm delivery to induce foetal lung maturation. However, glucocorticoids can produce negative outcomes for other tissues such as the reproductive system. We therefore tested the effects of pre‐natal betamethasone on testicular morphology and apoptotic protein immune expression during pre‐ and post‐natal development. Pregnant ewes (n = 42) bearing singleton male foetuses were randomly allocated to receive intramuscular injections of saline or betamethasone (0. 5 mg/kg) at 104, 111 and 118 days of gestation (DG). Testes were collected at 121 and 132 DG, and at 45 and 90 post‐natal days (PD) and subjected to morphometric analysis (volume densities of sex cords and interstitial tissues; sex cord diameter). Immunohistochemistry (% stained area) was used to assess active caspase‐3, Bax, Bcl‐2 and cell‐cycle proteins (PCNA). Compared with control values, betamethasone treatment decreased sex cord diameter at 121 DG, 45 and 90 PD, and sex cord volume at 90 PD. Active caspase‐3 was decreased by betamethasone at 121 DG and 90 PD, but Bax was increased in all betamethasone groups. Bcl‐2 and PCNA decreased in the betamethasone groups at 121 DG and 45 PD, but increased at 132 DG and 90 PD. We conclude that high levels of pre‐natally administered glucocorticoid reduce foetal testicular development, perhaps via changes in the balance between pro‐ and anti‐apoptotic proteins and cell‐cycle proteins. These outcomes could compromise the future spermatogenic potential of male offspring.
Professional support and emergency visits during the first 2 weeks postpartum
Authors: Barimani Mia , Oxelmark Lena , Johansson Sven‐Erik , Langius‐Eklöf Ann , Hylander Ingrid
Published: March 2013

Objectives

The aim of the study was to assess mothers' perceived satisfaction with professional support during the first 2 weeks after childbirth and the extent to which mothers seek emergency care during the same period.

Design

A cross‐sectional study was conducted of all mothers (n = 546) in Stockholm County, Sweden, who gave birth to a live baby during the same week in 2009.

Ethical issues

The study was approved by the regional Research and Ethics Committee at the Karolinska Insititutet, Sweden.

Methods

The mothers responded to a study‐specific questionnaire on perceived satisfaction with professional support and the sense of coherence scale, which measures coping strategies. The mothers also provided information about their socio‐demographic background, obstetric and infant data, and visits to hospital emergency departments. Descriptive and logistic regression analyses were performed.

Results

Fifty‐three percent of the mothers rated the support received as sufficient or more than sufficient, 29.7% as neither sufficient nor insufficient and 17.7% as insufficient or completely insufficient. The results indicate a lack of continuity in postpartum care. As many as 17% of the mothers in the study population visited hospital emergency departments during the first 2 weeks after childbirth, as a result of problems related to delivery, breastfeeding or infant health. A higher frequency of such emergency visits was associated with poor perception of professional support, low sense of coherence and delivery complications.

Conclusions

Relative to otherwise comparable mothers, mothers who experience complications with delivery are less satisfied with professional support and turn more frequently to hospital emergency departments for support.
Motor control of the trunk during a modified clean and jerk lift
Authors: Eriksson Crommert M. , Ekblom M. M. , Thorstensson A.
Published: March 2013

The purpose of the present study was to investigate the pattern of trunk muscle activation and intra‐abdominal pressure (IAP) in a somewhat modified version of the clean and jerk lift. Nine healthy physically active male amateurs performed the exercise with a 30‐kg barbell. Muscle activity was registered with electromyography from transversus abdominis (TrA) and obliquus internus (OI) using intramuscular electrodes and from rectus abdominis (RA) and erector spinae (ES) with surface electrodes. IAP was recorded with a nasogastric catheter. Measurements were made in various static positions throughout the lift and in the transitional phases separating them, both during lifting and lowering. The results demonstrated that the innermost abdominal muscle, TrA, showed increased activation levels in the two highest positions, whereas ES was most active, together with the highest IAP, in the lowest position. OI and RA showed generally little activation and no obvious trend throughout the lift. The results strengthen the view of a contributing role of TrA to the upright control of the trunk and indicate that the clean and jerk lift might constitute a whole‐body exercise, still targeting the TrA muscle, in late‐stage rehabilitation, especially for athletes during return to sports.
Does exercise reduce brain oxidative stress? A systematic review
Authors: Camiletti‐Moirón D. , Aparicio V. A. , Aranda P. , Radak Z.
Published: March 2013

The aim of the present systematic review was to investigate the influence of different exercise programs on brain oxidative stress. A search of the literature was conducted up to 1 December 2012 across five databases: PUBMED, SCOPUS, SPORTS DISCUS, Web of Science, and The Cochrane Library. The search strategy used in the electronic databases mentioned was established as: (swim* OR exercise OR training) AND (“oxidative stress” AND brain) for each database. A methodological quality assessment valuation/estimation was additionally carried out in the final sample of studies. Of 1553 potentially eligible papers, 19 were included after inclusion and exclusion criteria. The methodological quality assessment showed a total score in the Quality Index between 40% and 80%, with a mean quality of 56.8%. Overall, regular moderate aerobic exercise appears to promote antioxidant capacity on brain. In contrast, anaerobic or high‐intensity exercise, aerobic‐exhausted exercise, or the combination of both types of training could deteriorate the antioxidant response. Future investigations should be focused on establishing a standardized exercise protocol, depending on the exercise metabolism wanted to test, which could enhance the objective knowledge in this topic.
Peak oxygen uptake and regional oxygenation in response to a 10‐day confinement to normobaric hypoxia
Authors: Kounalakis S. N. , Keramidas M. E. , Eiken O. , Jaki Mekjavic P. , Mekjavic I. B.
Published: March 2013

We investigated the effect of hypoxic acclimatization per se, without any concomitant influence of strenuous physical activity on muscle and cerebral oxygenation. Eight healthy male subjects participated in a crossover‐designed study. In random order, they conducted a 10‐day normoxic (CON) and a 10‐day hypoxic (EXP) confinement. Pre and post both CON and EXP confinements, subjects conducted two incremental‐load cycling exercises to exhaustion; one under normoxic, and the other under hypoxic (FIO2 = 0.154) conditions. Oxygen uptake (), ventilation (), and relative changes in regional hemoglobin oxygenation (Δ([HbO2]) in the cerebral cortex and in the serratus anterior (SA) and vastus lateralis (VL) muscles were measured. No changes were observed in the CON confinement. Peak work rate and were similar pre and post in the EXP confinement, whereas increased in the EXP post normoxic and hypoxic trials (P < 0.05). The exercise‐induced drop in VL Δ[HbO2] was less in the post‐ than pre‐EXP trial by 4.0 ± 0.4 and 4.2 ± 0.6 μM during normoxic and hypoxic exercise, respectively. No major changes were observed in cerebral or SA oxygenation. These results demonstrate that a 10‐day hypoxic exposure without any concomitant physical activity had no effect on normoxic or hypoxic , despite the enhanced VL oxygenation.
Obtaining Party Positions on Immigration in Switzerland: Comparing Different Methods
Authors: Ruedin Didier
Published: March 2013

The position of political parties on policy issues is crucial for many questions of political science, including studies of political representation. This research note examines different methods for obtaining party positions on immigration in retrospective. Party positions are obtained using pooled expert surveys, manual coding of party manifestos with a conventional codebook, manual coding of manifestos using check‐lists, and automatic coding of manifestos using Wordscores and a dictionary of keywords respectively. In addition, positions from a media analysis and a retrospective evaluation of researchers in the field of immigration are used. The results suggest that most methods differentiate the same order of party positions. While there are high correlations between many methods, the different methods tend not to agree on the exact positions. The automatic dictionary approach does not seem to measure party positions reliably.
Determination of Ductile Fracture Parameters of a Dual‐Phase Steel by Optical Measurements
Authors: Gruben G. , Vysochinskiy D. , Coudert T. , Reyes A. , Lademo O.‐G.
Published: March 2013

Marciniak–Kuczynski and Nakajima tests of the dual‐phase steel Docol 600DL (www.ssab.com/) have been carried out for a range of stress‐states spanning from uniaxial tension to equi‐biaxial tension. The deformation histories of the specimens have been recorded by digital images, and the displacement and strain fields have been determined by post‐processing the images with digital image correlation software. The fracture characteristics of the material are presented by means of the stress triaxiality, the Lode parameter and the equivalent strain. These parameters are evaluated on the surface of the specimens based on the optical field measurements and assumptions regarding the mechanical behaviour of the material. Additionally the minor versus major principal strains up to fracture are presented. It is found that the material displays a significantly lower ductility in plane‐strain tension than in uniaxial tension and equi‐biaxial tension, and that it, in the tests exposed to local necking, undergoes large strains between the onset of necking and fracture. Fractographs of selected specimens reveal that fracture is due to growth and coalescence of voids that occur in localised areas governed by shear‐band instability.
Identification of the novel HLA‐B allele, HLA‐B*39:42, in a Chinese individual
Authors: Ni L. , Shan X. , Wang L. , Zhixin Z. , Gong Z.
Published: March 2013

The HLA‐B*39:42 allele differs from the closest matching allele B*39:01:01:01 by two nucleotide substitutions in exon 3.
A novel allele: HLA‐B*13:01:06, identified by sequence‐based typing in a Chinese individual
Authors: Huang Y. F. , Tan Y. , Ding H. , Wei Y. , Ye X.
Published: March 2013

HLA‐B*13:01:06 has one nucleotide acid change (G→A) at position 219, at codon 49 (GCG→GCA) in exon2 without amino acid change (Ala→Ala).
The Cimmerian geopuzzle: new data from South Pamir
Authors: Angiolini Lucia , Zanchi Andrea , Zanchetta Stefano , Nicora Alda , Vezzoli Giovanni
Published: March 2013

Based on its Permian‐Triassic stratigraphic and biotic evolution, we correlate the SE Pamir to the Karakoram terrane, and we consider them equivalent, along with the Central Pamir, to the Qiantang Terrane of Tibet, all of Palaeozoic Gondwanan ancestry. We prove the occurrence of a marked Cimmerian unconformity, documented by lowermost Jurassic deposits suturing intensively faulted and folded Permian and Triassic units, which suggests that the South Pamir collided around the T‐J boundary with the Central Pamir along the Rushan‐Pshart suture. Collision of the Karakoram to the South Pamir happened slightly later along the Wakhan‐Tirich Boundary Zone. Progressive time shifting of deformation can be related to the complex setting of the Cimmerian belt, which was subdivided into minor blocks by incipient oceanic basins, providing strong crustal mobility.