bluuebunny/crossref_metadata_2025 huggingface dataset:
Ineffective Breathing Pattern: Defining Characteristics in Children With Acute Respiratory Infection
Authors: Pascoal Livia Maia , Lopes Marcos Venícios de Oliveira , da Silva Viviane Martins , Beltrão Beatriz Amorim , Chaves Daniel Bruno Resende , de Santiago Juliana Maria Vieira , Herdman T. Heather
Published: July 2013

Purpose

To determine the accuracy ofNANDA‐Idefining characteristics for the nursing diagnosis, ineffective breathing pattern, in children with acute respiratory infection.

Methods

This was a prospective cohort study in 136 children. Measures of accuracy were calculated for the defining characteristics.

Findings

Use of accessory muscles to breathe presented the best measure of accuracy. Alterations in depth of breathing presented a high value of sensitivity. Altered chest excursion and orthopnea presented high values of specificity.

Conclusions

Use of accessory muscles to breathe showed the best predictive capacity for ineffective breathing pattern.

Implications for Nursing Practice

Measures of accuracy can contribute to an accurate diagnostic inference process, improving patient assessment and facilitating rapid, accurate diagnosis.

Objetivo

Determinar a acurácia das características definidoras para o diagnóstico de enfermagem Padrão respiratório ineficaz em crianças com infecção respiratória aguda.

Métodos

Este foi um estudo de coorte prospectiva aberta com um grupo de 136 crianças. Medidas de acurácia foram calculadas para as características definidoras.

Resultados

Uso de musculatura acessória para respirar apresentou a melhor medida de acurácia. Alteração na profundidade respiratória apresentou elevado valor de sensibilidade. Excursão torácica alterada e Ortopneia apresentaram altos valores de especificidade.

Conclusão

Uso de musculatura acessória para respirar apresentou melhor capacidade preditiva para Padrão respiratório ineficaz.

Implicações Para A Prática De Enfermagem

Medidas de acurácia podem contribuir para um processo de inferência diagnostica acurado. Educadores podem usar o conhecimento de características definidoras críticas para ensinar aos alunos técnicas de avaliação adequadas, e os enfermeiros na prática clínica podem estar mais atentos a essas características, a fim de facilitar o diagnóstico rápido e preciso. Pesquisa adicional deve procurar replicar esse trabalho em populações semelhantes e diferentes, e identificar as características do diagnóstico ao longo do tempo.
Adipose tissue insulin resistance in adolescents with and without type 2 diabetes
Authors: Kelsey M. M. , Forster J. E. , Van Pelt R. E. , Reusch J. E. B. , Nadeau K. J.
Published: July 2013

What is already known about this subject

Type 2 diabetes is increasing in youth, but little is known about the underlying pathophysiology.

Elevated fasting free fatty acids and failure of insulin to suppress lipolysis are well described in adults.

Small studies suggest that obese youth with and without type 2 diabetes have impaired suppression of lipolysis, but there are little data on associated factors.

What this study adds

Assessment of insulin suppression of lipolysis in a larger cohort of adolescents using hyperinsulinaemic euglycaemic clamp technique at higher insulin doses than have been previously reported.

Novel finding that some obese youth with and without type 2 diabetes have impaired suppression of lipolysis even at very high doses of insulin.

Factors associated with impaired insulin suppression of lipolysis include high triglycerides, high alanine aminotransferase and high low‐density lipoprotein cholesterol.

Background

The incidence of type 2 diabetes mellitus (T2D) is increasing in youth, yet little is known about the underlying pathophysiology. Decreased insulin suppression of lipolysis and elevated non‐esterified free fatty acid (NEFA) concentrations are known to be associated with insulin resistance and T2D in adults, but less is known about the relationship in adolescents.

Objectives

This study aimed to assess adipose tissue insulin resistance (IR; insulin suppression of lipolysis) and its metabolic correlates in lean, obese and T2D adolescents.

Methods

Forty‐seven lean, obese and T2D youth underwent hyperinsulinaemic (80 mU*m−2*min−1) euglycaemic clamps. NEFAs were measured at baseline and during steady state. Insulin‐mediated suppression of lipolysis (%NEFA suppression from baseline) was calculated, and metabolic risk factors were assessed by %NEFA suppression tertile.

Results

There was expected variability in %NEFA suppression within obese and T2D youth, but a subset had significantly reduced suppression of lipolysis. NEFA suppression tertile was significantly inversely associated with fasting triglycerides (P = 0.0001), log alanine aminotransferase (ALT; P = 0.02) and low‐density lipoprotein cholesterol (P = 0.0002).

Conclusions

Marked adipose tissue IR occurs in some obese and T2D adolescents, which may result in release of triglycerides into the circulation and liver deposition of fatty acids, as evidenced by higher ALT in poor NEFA suppressors.
Hedging Rules for the Operation of Lake Okeechobee in Southern Florida
Authors: You Gene J.‐Y.
Published: July 2013

Lake Okeechobee is the major source of freshwater in Southern Florida. With the increasing possibility of water stress, determining how to manage water during drought periods is essential to the operation of the Lake. This study deals with operational problems related to the management of Lake Okeechobee and the challenges involved in the implementation of hedging policy. We examine the implications of applying a theoretical hedging rule approach, comprising inter‐ and intrayear models, for the management of Lake Okeechobee and explore several optional hedging policies. The results demonstrate that hedging rules could reduce profit loss particularly under serious water stress, and might be applied sooner to mitigate the risk of severe water shortages. We suggested that the management of Lake Okeechobee should consider both short‐ and long‐term hedging nested. It is also demonstrated that the practical applicability of rolling decision making with updated forecast. Based on the results of the model, the merits of explicit optional hedging rules are demonstrated.
Environmental determinants of population divergence in life‐history traits for an invasive species: climate, seasonality and natural enemies
Authors: Seiter S. , Kingsolver J.
Published: July 2013

Invasive species cope with novel environments through both phenotypic plasticity and evolutionary change. However, the environmental factors that cause evolutionary divergence in invasive species are poorly understood. We developed predictions for how different life‐history traits, and plasticity in those traits, may respond to environmental gradients in seasonal temperatures, season length and natural enemies. We then tested these predictions in four geographic populations of the invasive cabbage white butterfly (Pieris rapae) fromNorthAmerica. We examined the influence of two rearing temperatures (20 and 26.7 °C) on pupal mass, pupal development time, immune function and fecundity. As predicted, development time was shorter and immune function was greater in populations adapted to longer season length. Also, phenotypic plasticity in development time was greater in regions with shorter growing seasons. Populations differed significantly in mean and plasticity of body mass and fecundity, but these differences were not associated with seasonal temperatures or season length. Our study shows that some life‐history traits, such as development time and immune function, can evolve rapidly in response to latitudinal variation in season length and natural enemies, whereas others traits did not. Our results also indicate that phenotypic plasticity in development time can also diverge rapidly in response to environmental conditions for some traits.
Evidence for adaptive phenotypic differentiation inBalticSea sticklebacks
Authors: DeFaveri J. , Merilä J.
Published: July 2013

The evidence for adaptive phenotypic differentiation in mobile marine species remains scarce, partly due to the difficulty of obtaining quantitative genetic data to demonstrate the genetic basis of the observed phenotypic differentiation. Using a combination of phenotypic and molecular genetic approaches, we elucidated the relative roles of natural selection and genetic drift in explaining lateral plate number differentiation in threespine sticklebacks (Gasterosteus aculeatus) across the entireBalticSea basin (approximately 392 000 km2). We found that phenotypic differentiation (PST = 0.213) in plate number exceeded that in neutral markers (FST = 0.008), suggesting an adaptive basis for the observed differentiation. Because a close correspondence was found between plate phenotype and genotype at a quantitative trait loci (QTL;STN381) tightly linked to the gene (Ectodysplasin) underlying plate variation, the evidence for adaptive differentiation was confirmed by comparison ofFSTat theQTL(FSTQ = 0.089) withFSTat neutral marker loci. Hence, the results provide a comprehensive demonstration of adaptive phenotypic differentiation in a high‐gene‐flow marine environment with direct, rather than inferred, verification for the genetic basis of this differentiation. In general, the results illustrate the utility ofPST–FST–FSTQcomparisons in uncovering footprints of natural selection and evolution and add to the growing evidence for adaptive genetic differentiation in high‐gene‐flow marine environments, including that of the relatively young Baltic Sea.
The role of Bh4 in parallel evolution of hull colour in domesticated and weedy rice
Authors: Vigueira C. C. , Li W. , Olsen K. M.
Published: July 2013

The two independent domestication events in the genus Oryza that led to African and Asian rice offer an extremely useful system for studying the genetic basis of parallel evolution. This system is also characterized by parallel de‐domestication events, with two genetically distinct weedy rice biotypes in the US derived from the Asian domesticate. One important trait that has been altered by rice domestication and de‐domestication is hull colour. The wild progenitors of the two cultivated rice species have predominantly black‐coloured hulls, as does one of the two U.S. weed biotypes; both cultivated species and one of the US weedy biotypes are characterized by straw‐coloured hulls. Using Black hull 4 (Bh4) as a hull colour candidate gene, we examined DNA sequence variation at this locus to study the parallel evolution of hull colour variation in the domesticated and weedy rice system. We find that independent Bh4‐coding mutations have arisen in African and Asian rice that are correlated with the straw hull phenotype, suggesting that the same gene is responsible for parallel trait evolution. For the U.S. weeds, Bh4 haplotype sequences support current hypotheses on the phylogenetic relationship between the two biotypes and domesticated Asian rice; straw hull weeds are most similar to indica crops, and black hull weeds are most similar to aus crops. Tests for selection indicate that Asian crops and straw hull weeds deviate from neutrality at this gene, suggesting possible selection on Bh4 during both rice domestication and de‐domestication.
Divergent sexual selection via male competition: ecology is key
Authors: Lackey A. C. R. , Boughman J. W.
Published: July 2013

Sexual selection and ecological differences are important drivers of speciation. Much research has focused on female choice, yet the role of male competition in ecological speciation has been understudied. Here, we test how mating habitats impact sexual selection and speciation through male competition. Using limnetic and benthic species of threespine stickleback fish, we find that different mating habitats select differently on male traits through male competition. In mixed habitat with both vegetated and open areas, selection favours two trait combinations of male body size and nuptial colour: large with little colour and small with lots of colour. This matches what we see in reproductively isolated stickleback species, suggesting male competition could promote trait divergence and reproductive isolation. In contrast, when only open habitat exists, selection favours one trait combination, large with lots of colour, which would hinder trait divergence and reproductive isolation. Other behavioural mechanisms in male competition that might promote divergence, such as avoiding aggression with heterospecifics, are insufficient to maintain separate species. This work highlights the importance of mating habitats in male competition for both sexual selection and speciation.
Investigation on the governance model and effect of medical schools merged with comprehensive universities in China
Authors: Bai Ge , Luo Li
Published: July 2013

This investigation analyzes the management of medical schools merged with comprehensive universities through internet search and research review to reveal management model and effect of the merger. The conclusion is safely reached that governance models are divided into two different patterns: centralized management and decentralized management. Eight universities, representing the two models, were selected and evaluated comprehensively. Among them, the universities that carried out decentralized management have greater development after the merger based on a quality comparison concerning freshmen, faculty, teaching, and research between the two patterns.
Erythropoietin in Friedreich ataxia
Authors: Mariotti Caterina , Nachbauer Wolfgang , Panzeri Marta , Poewe Werner , Taroni Franco , Boesch Sylvia
Published: July 2013

In Friedreich ataxia (FRDA), several candidate substances including erythropoietin (EPO) focus on increase in the amount of frataxin and aim to counteract the consequences of frataxin deficiency. Evidence for recombinant human erythropoietin (rHuEPO) in FRDA is based on in vitro studies using mouse neuronal cell lines, human fibroblasts, cardiomyocytes, and primary lymphocytes from FRDA patients or control subjects which showed a dose‐dependent increase of frataxin after incubation with different erythropoietins. The mechanism by which EPO induces frataxin increase remains to be elucidated, but may involve post‐transcriptional and/or post‐translational modifications of frataxin or alterations in frataxin half‐life and metabolism. In vivo data on rHuEPO's ability to increase frataxin in FRDA patients is contradictory as studies on the effect of EPO derivatives in FRDA differ in treatment regimen, sample size, and duration. Open‐label studies indicate for sustained frataxin increase, decrease of oxidative stress, and clinical improvement in FRDA patients after administration of rHuEPO. Two randomized controlled studies found acceptable safety and tolerability of EPO derivatives in FRDA. Secondary outcome measures, however, such as frataxin up‐regulation and clinical efficacy were not met. This review will focus on (i) pre‐clinical work on erythropoietins in FRDA and (ii) clinical studies in FRDA patients exposed to erythropoietins.
Monitoring progression in Friedreich ataxia (FRDA): the use of clinical scales
Authors: Bürk Katrin , Schulz Stefanie R. , Schulz Jörg B.
Published: July 2013

Friedreich ataxia (FRDA) is a progressive neurodegenerative disorder associated with ataxia, dysarthria, pyramidal tract signs, sensory loss, cardiomyopathy and diabetes. There is no cure for FRDA so far. Studies of the natural history of the disease and future therapeutic trials require development of appropriate outcome markers. Since any therapeutic benefit is expected to modulate deterioration over time rather than to reverse disability, potential outcome measures must be sensitive instruments carefully analysed for their significance. Clinical scales may represent an appropriate measuring tool. Over the last few years the construction, evaluation and validation of sensitive clinical scales for the assessment of disease severity and progression in ataxia have had considerable impact on our understanding of the disease. Currently, there are three different scales that are most frequently applied: The International Cooperative Ataxia Rating Scale (ICARS), the Friedreich Ataxia Rating Scale (FARS) and the Scale for the Assessment and Rating of Ataxia (SARA). All scales have been validated and compared with regard to their testing properties.
Co‐enzyme Q10 and idebenone use in Friedreich's ataxia
Authors: Parkinson Michael H , Schulz Jörg B. , Giunti Paola
Published: July 2013

Friedreich's ataxia is a debilitating progressive neurodegenerative disease associated with cardiomyopathy and other features. The underlying cause is a deficiency of the mitochondrial protein frataxin which causes mitochondrial iron deposition, increased oxidative stress and impaired adenosine triphosphate production. Over the last 15 years, multiple clinical trials have assessed the efficacy of antioxidant agents in this disease. This article reviews trials of the two most important agents, namely co‐enzyme Q10 and idebenone.
‘Stigma: the cul‐de‐sac of the double bind’ the perspective of Turkiye; a phenomenological study
Authors: Yuksel C. , Bingol F. , Oflaz F.
Published: July 2013

Accessible summary

The aim of this study was to explore and describe the stigmatization experienced by individuals with mental health problems (IMHP) and the relationships between stigmas associated with mental health problems, psychiatric diagnoses, treatments, and social environments and their consequences.

Our findings show that almost all IMHP were concerned about being stigmatized by others, society, their family, and health care professionals. Another concern that IMHP reported was self‐stigmatization. Stigmatization serves as a barrier to treatment adherence and socialization in IMHP. Furthermore, stigmatization has a significant impact on the lives of IMHP, and methods of coping with stigmatization are commonly ineffective.

It is important for the nurses to reduce stigma by dealing with the illness, IMHP, their relatives, and professionals in an unprejudiced manner.

The aim of this study was to explore and describe the stigmatization experienced by individuals with mental health problems (IMHP) and the relationships between stigmas associated with mental health problems, psychiatric diagnoses, treatments, and social environments and their consequences. Thirty‐three IMHP were recruited from outpatient and day clinics at the psychiatry department of a university hospital within a 5‐month time period for this qualitative, descriptive study. Data were gathered using a structured interview form with open‐ended questions to explore the changes in everyday life experienced by IMHP during the course of their illness. Data were analysed using the Colaizzi method of analysis. Our findings show that almost all IMHP were concerned about being stigmatized by others, society, their family, and health care professionals. Another concern that IMHP reported was self‐stigmatization. Stigmatization serves as a barrier to treatment adherence and socialization in IMHP. Furthermore, stigmatization has a significant impact on the lives of IMHP, and methods of coping with stigmatization are commonly ineffective. However, stigmatization can be reduced by dealing with the illness, IMHP, their relatives, and professionals in an unprejudiced manner.
Effect of dietary mannanase‐hydrolysed copra meal on growth performance and intestinal histology in broiler chickens
Authors: Ibuki M. , Fukui K. , Yamauchi K.
Published: July 2013

We investigated mannanase‐hydrolysed copra meal (MCM), which contains β‐1,4‐mannobiose (MNB), for its capacity to improve growth performance and activate intestinal villus function. Seven‐day‐old chicks were separated into four flocks with an equal mean body weight and then fed a basal diet (control) or a diet supplemented with 0.02% or 0.1% MCM. After 7 weeks, the feed intake and body weight were determined and then used to calculate the feed efficiency (FE). Moreover, the intestinal segments were examined by light microscopy and scanning electron microscopy (SEM) for cellular and morphological changes in the villus. Although feed intake was not significantly different among the experimental groups, the body weight gain and FE were significantly higher in the 0.1% MCM group than in the control group (p < 0.05), while feed intake tended to be higher in the 0.02% and 0.1% MCM groups. The cellular area of the ileum was significantly higher in the 0.02% and 0.1% groups in relation to that in the control group (p < 0.05). Furthermore, the cellular area of the duodenum and the jejunum tended to be higher in the 0.02% and 0.1% MCM groups. For the correlation analysis, a significant correlation was observed between the dosage of MCM and the cell area of the duodenum, jejunum and ileum. Moreover, the number of mitotic cells was higher in the 0.1% MCM group. As shown by SEM, the cells at the villi tips were protuberant in appearance in the 0.02% and 0.1% MCM treatments when compared with the relatively flat cells of the control. On the duodenal villus surface of the 0.1% MCM group, some cells devoid of microvilli were observed, suggesting that the increased protuberance of these cells represents increased absorption activity. Although intestinal villus height and area did not significantly differ among groups, the levels of these parameters tended to increase in the experimental groups relative to the control. The present morphological findings reveal that MNB might be effective for activating intestinal absorptive function, and that the functional activation promotes the growth of the chickens.
Transformation to approximate independence for locally stationary Gaussian processes
Authors: Guinness Joseph , Stein Michael L.
Published: July 2013

We provide new approximations for the likelihood of a time series under the locally stationary Gaussian process model. The likelihood approximations are valid even in cases when the evolutionary spectrum is not smooth in the rescaled time domain. We describe a broad class of models for the evolutionary spectrum for which the approximations can be computed particularly efficiently. In developing the approximations, we extend to the locally stationary case the idea that the discrete Fourier transform is a decorrelating transformation for stationary time series. The approximations are applied to fit non‐stationary time‐series models to high‐frequency temperature data. For these data, we fit evolutionary spectra that are piecewise constant in time and use a genetic algorithm to search for the best partition of the time interval.
The pharmacokinetics of methocarbamol and guaifenesin after single intravenous and multiple‐dose oral administration of methocarbamol in the horse
Authors: Rumpler M. J. , Colahan P. , Sams R. A.
Published: July 2013

A simpleLC/MSMSmethod has been developed and fully validated to determine concentrations and characterize the concentration vs. time course of methocarbamol (MCBL) and guaifenesin (GGE) in plasma after a single intravenous dose and multiple oral dose administrations ofMCBLto conditioned Thoroughbred horses. The plasma concentration–time profiles forMCBLafter a single intravenous dose of 15 mg/kg ofMCBLwere best described by a three‐compartment model. Mean extrapolated peak (C0) plasma concentrations were 23.2 (±5.93) μg/mL. Terminal half‐life, volume of distribution at steady‐state, mean residence time, and systemic clearance were characterized by a median (range) of 2.96 (2.46–4.71) h, 1.05 (0.943–1.21) L/kg, 1.98 (1.45–2.51) h, and 8.99 (6.68–10.8) mL/min/kg, respectively. Oral dose ofMCBLwas characterized by a median (range) terminal half‐life, mean transit time, mean absorption time, and apparent oral clearance of 2.89 (2.21–4.88) h, 2.67 (1.80–2.87) h, 0.410 (0.350–0.770) h, and 16.5 (13.0–20) mL/min/kg. Bioavailability of orally administeredMCBLwas characterized by a median (range) of 54.4 (43.2–72.8)%. Guaifenesin plasma concentrations were below the limit of detection in all samples collected after the single intravenous dose ofMCBLwhereas they were detected for up to 24 h after the last dose of the multiple‐dose oral regimen. This difference may be attributed to first‐pass metabolism ofMCBLtoGGEafter oral administration and may provide a means of differentiating the two routes of administration.
Fluoroquinolone levels in healthy dog urine following a 20‐mg/kg oral dose of enrofloxacin exceed mutant prevention concentration targets againstEscherichia coliisolated from canine urinary tract infections
Authors: Daniels J. B. , Tracy G. , Irom S. J. , Lakritz J.
Published: July 2013

A 3‐day course of oral enrofloxacin is effective for treating uncomplicated urinary tract infection (UTI) in dogs when administered 20 mg/kgQ24H. However, emergence of fluoroquinolone‐resistant mutants of uropathogens is a concern. Urine concentrations of enrofloxacin and ciprofloxacin were measured in six healthy dogs following dose of enrofloxacin 20 mg/kg. Mutant prevention concentrations ofEscherichia coliisolated from canineUTIwere also determined against ciprofloxacin. UrineAUC(24)/MPCratios considering ciprofloxacin concentrations ranged 3819–7767, indicating that selection of resistantE. colimutants in dogs with uncomplicatedUTIs is unlikely in the bladder given that anAUC(24)/MPC = 39 is considered to be protective against mutant selection for ciprofloxacin. However, additional studies are required to evaluate the effects of this enrofloxacin treatment protocol on bacteria that colonize anatomic sites where fluoroquinolones achieve lower concentrations compared to the urinary bladder.
Temporal variation of ophiuroids associated with the macroalga Amphiroa fragilissima on a Southwest Atlantic coral reef
Authors: Lima Maria Lilian F. , Sovierzoski Hilda H. , Correia Monica D.
Published: July 2013

The species of Ophiuroidea that commonly occur on coral reefs can be found on different substrates and associated with other organisms including algae, sponges, and corals. This study evaluated the temporal variability of the ophiuroid fauna associated with the alga Amphiroa fragilissima on the Ponta Verde coral reef on the coast of Maceió in Alagoas, Northeastern Brazil. Replicate samples of algal substrate were collected at low tide during in the dry and rainy seasons, over a 10‐year period, from 1998–2007. Eight species of Ophiuroidea were identified, with a total of 8736 individuals associated with A. fragilissima. The most dominant and frequent species of Ophiuroidea were Amphipholis squamata and Ophiactis savignyi; all other species were rare. Cluster analysis and nMDS detected four groups, with two groups each occurring only in summer or winter periods, as well as other groups occurring in both periods.
Molecular characterization of the enzymes involved in the degradation of a brominated aromatic herbicide
Authors: Chen Kai , Huang Linglong , Xu Changfeng , Liu Xiaomei , He Jian , Zinder Stephen H. , Li Shunpeng , Jiang Jiandong
Published: July 2013

Dehalogenation is the key step in the degradation of halogenated aromatics, while reductive dehalogenation is originally thought to rarely occur in aerobes. In this study, an aerobic strain of Comamonas sp. 7D‐2 was shown to degrade the brominated aromatic herbicide bromoxynil completely and release two equivalents of bromides under aerobic conditions. The enzymes involved in the degradation of bromoxynil to 4‐carboxy‐2‐hydroxymuconate‐6‐semialdehyde, including nitrilase, reductive dehalogenase (BhbA), 4‐hydroxybenzoate 3‐monooxygenase and protocatechuate 4,5‐dioxygenase, were molecularly characterized. The novel dehalogenase BhbA was shown to be a complex of a respiration‐linked reductive dehalogenase (RdhA) domain and a NAD(P)H‐dependent oxidoreductase domain and to have key features of anaerobic respiratory RdhAs, including two predicted binding motifs for [4Fe‐4S] clusters and a close association with a hydrophobic membrane protein (BhbB). BhbB was confirmed to anchor BhbA to the membrane. BhbA was partially purified and found to use NAD(P)H as electron donors. Full‐length bhbA homologues were found almost exclusively in marine aerobic proteobacteria, suggesting that reductive dehalogenation occurs extensively in aerobes and that bhbA is horizontally transferred from marine microorganisms. The discovery of a functional reductive dehalogenase and ring‐cleavage oxygenases in an aerobe opens up possibilities for basic research as well as the potential application for bioremediation.
Treatment of experimental esophagogastric myotomy with bone marrow mesenchymal stem cells in a rat model
Authors: Mazzanti B. , Lorenzi B. , Lorenzoni P. , Borghini A. , Boieri M. , Lorenzi M. , Santosuosso M. , Bosi A. , Saccardi R. , Weber E. , Pessina F.
Published: July 2013

Background

Over the last 15 years, many studies demonstrated the myogenic regenerative potential of bone marrow mesenchymal stem cells (BM‐MSC), making them an attractive tool for the regeneration of damaged tissues. In this study, we have developed an animal model of esophagogastric myotomy (MY) aimed at determining the role of autologous MSC in the regeneration of the lower esophageal sphincter (LES) after surgery.

Methods

Syngeneic BM‐MSC were locally injected at the site of MY. Histological and functional analysis were performed to evaluate muscle regeneration, contractive capacity, and the presence of green fluorescent protein–positive BM‐MSC (BM‐MSC‐GFP+) in the damaged area at different time points from implantation.

Key Results

Treatment with syngeneic BM‐MSC improved muscle regeneration and increased contractile function of damaged LES. Transplanted BM‐MSC‐GFP+ remained on site up to 30 days post injection. Immunohistochemical analysis demonstrated that MSC maintain their phenotype and no differentiation toward smooth or striated muscle was shown at any time point.

Conclusions & Inferences

Our data support the use of autologous BM‐MSC to both improve sphincter regeneration of LES and to control the gastro‐esophageal reflux after MY.
The disproportionate economic burden associated with severe and complicated obesity: a systematic review
Authors: Grieve E. , Fenwick E. , Yang H‐C. , Lean M.
Published: July 2013

Burden of disease studies typically classify individuals with a body mass index (BMI) ≥ 30 kg m−2 as a single group (‘obese’) and make comparisons to those with lower BMIs. Here, we review the literature on the additional economic burden associated with severe obesity or classes 3 and 4 obesity (BMI ≥ 40 kg m−2), the fastest growing category of obesity, with the aim of exploring and disaggregating differences in resource use as BMI increases beyond 40 kg m−2. We recognize the importance of comparing classes 3 and 4 obesity to less severe obesity (classes 1 and 2) as well as quantifying the single sub‐class impacts (classes 3 and 4). Although the latter analysis is the aim of this review, we include results, where found in the literature, for movement between the recognized subclasses and within classes 3 and 4 obesity. Articles presenting data on the economic burden associated with severe obesity were identified from a search of Ovid MEDLINE, EMBASE, EBSCO CINAHL and Cochrane Library databases. Data were extracted on the direct costs, productivity costs and resource use associated with severe obesity along with estimates of the multiplier effects associated with increasing BMI. Fifteen studies were identified, of which four disaggregated resource use for BMI ≥ 40 kg m−2. The multiplier effects derived for a variety of different types of costs incurred by the severely obese compared with those of normal weight (18.5 kg m−2 < BMI < 25 kg m−2) ranged from 1.5 to 3.9 for direct costs, and from 1.7 to 8.0 for productivity costs. There are few published data on the economic burden of obesity disaggregated by BMI ≥ 40 kg m−2. By grouping people homogenously above a threshold of BMI 40 kg m−2, the multiplier effects for those at the highest end of the spectrum are likely to be underestimated. This will, in turn, impact on the estimates of cost‐effectiveness for interventions and policies aimed at the severely obese.
Prevalence and patterns of psychiatric disorders in referred adolescents with Internet addiction
Authors: Bozkurt Hasan , Coskun Murat , Ayaydin Hamza , Adak İbrahim , Zoroglu S. Salih
Published: July 2013

Aim

To investigate prevalence and patterns of psychiatric disorders in young subjects with Internet addiction (IA).

Methods

Subjects were taken from a sample of patients, aged 10–18 years old, referred to Istanbul Medical Faculty, Child and Adolescent Psychiatry Department due to a variety of behavioral and emotional problems alongside problematic Internet use. Inclusion criteria included IQ ≥70 and score ≥80 on Young's Internet Addiction Scale (YIAS). Psychiatric comorbidity was assessed using the Turkish version of the Schedule for Affective Disorders and Schizophrenia for School Age Children–Present and Lifetime Version.

Results

Subjects were 45 boys (75%) and 15 girls (25%) with an age range of 10–18 years old (mean age, 13.38 ± 1.79 years). A total of 60% (n = 36) had been using Internet for ≥5 years. Mean hours/week spent on the Internet was 53.7 (range, 30–105 h) and the average YIAS score was 85. All subjects (100%) had at least one and 88.3% (n = 53) had at least two comorbid psychiatric disorders. The frequency of diagnostic groups were as follows: behavioral disorder, n = 52 (86.7%); anxiety disorder, n = 43 (71.7%); mood disorder, n = 23 (38.3%); elimination disorder, n = 16 (26.7%); tic disorder, n = 10 (16.7%); and substance use disorder, n = 4 (6.7%). The most common psychiatric disorders were attention‐deficit hyperactivity disorder (n = 53; 83.3%), social phobia (n = 21; 35.0%) and major depressive disorder (n = 18; 30.0%).

Conclusion

High rates of psychiatric comorbidity, particularly behavioral, anxiety and mood disorders were found in young subjects with IA. Because the presence of psychiatric disorders may affect the management /prognosis of IA, assessment should include that for other psychiatric disorders.
Abortion and subsequent mental health: Review of the literature
Authors: Bellieni Carlo V. , Buonocore Giuseppe
Published: July 2013

The risk that abortion may be correlated with subsequent mental disorders needs a careful assessment, in order to offer women full information when facing a difficult pregnancy. All research papers published between 1995 and 2011, were examined, to retrieve those assessing any correlation between abortion and subsequent mental problems. A total of 36 studies were retrieved, and six of them were excluded for methodological bias. Depression, anxiety disorders (e.g. post‐traumatic stress disorder) and substance abuse disorders were the most studied outcome. Abortion versus childbirth: 13 studies showed a clear risk for at least one of the reported mental problems in the abortion group versus childbirth, five papers showed no difference, in particular if women do not consider their experience of fetal loss to be difficult, or if after a fetal reduction the desired fetus survives. Only one paper reported a worse mental outcome for childbearing. Abortion versus unplanned pregnancies ending with childbirth: four studies found a higher risk in the abortion groups and three, no difference. Abortion versus miscarriage: three studies showed a greater risk of mental disorders due to abortion, four found no difference and two found that short‐term anxiety and depression were higher in the miscarriage group, while long‐term anxiety and depression were present only in the abortion group. In conclusion, fetal loss seems to expose women to a higher risk for mental disorders than childbirth; some studies show that abortion can be considered a more relevant risk factor than miscarriage; more research is needed in this field.
DFG-Förderung in den Wirtschaftswissenschaften: Fakten und Mythen zur Förderpraxis
Authors: Joerk Christiane , Wambach Achim
Published: July 2013

Academics in the field of economic sciences are increasingly expected to solicit (research based) third party funding, even in competition with other disciplines. The recent Excellence Initiative in Germany, in which economic sciences have performed disappointingly, has shown this pressure quite plainly. This article gives an overview of the main funding programmes of the DFG (German Research Association), the assessment and decision-making process in these programmes and discusses the position of economics in the DFG funding context.
Geldwertsicherung im internationalen Goldstandard und in einer Währungsunion von Staaten mit Papierstandard aus institutionenökonomischer Sicht
Authors: Richter Rudolf
Published: July 2013

Economists have a hard time to predict macro-institutional developments. Missing are predictions based on tried and tested hypotheses. Why not apply proved microinstitutional hypotheses to macro-institutional problems like the European Economic Union (EMU)? We try to do that. The international gold standard serves only as counterexample. We discuss the sustainability of EMU (= stability of the euro) using a number of welltested hypotheses of institutional economics - up to the explanation of firm mergers. Yet different from business mergers, to endure, mergers of states must become self-enforcing entities, which requires ideological (cultural) integration of its citizens.
Community‐Based Health and Schools of Nursing: Supporting Health Promotion and Research
Authors: Shannon Crystal
Published: July 2013

Objective

This article examines the role of community‐based schools of nursing in the promotion of public health and research in poverty‐stricken areas.

Design and Sample

This was a three‐phase study (questionnaire and key‐informants' interviews) that surveyed representatives of prelicensure associate and baccalaureate nursing schools (n=17), nursing‐school key informants (n=6) and community leaders (n=10).

Measures

A 13‐question web‐based survey and semi‐structured interview of key informants elicited data on demographics, nursing program design, exposure of faculty and students to various research and health promotion methods, and beliefs about student involvement.

Results

Nursing schools participated minimally in community‐based health promotion (CBHP) and community‐based participatory research saw reduced need for student involvement in such activities, cited multiple barriers to active community collaboration, and reported restricted community partnerships. CBHP was recognized to be a valuable element of health care and student education, but is obstructed by many barriers.

Conclusions

This study suggests that nursing schools are not taking full advantage of relationships with community leaders. Recommendations for action are given.
Integration of End‐of‐Life Education into a Community Health Nursing Course
Authors: Pullis Bridgette Crotwell
Published: July 2013

Student nurses and novice nurses report that they received little in their nursing education to adequately prepare them for the death of a patient. The American Association of Colleges of Nursing's (AACN) competencies for end‐of‐life care assert the need for competent nursing care at the time of death. To prepare students to care for dying patients and their families, a hospice clinical experience in a community health nursing course was designed to facilitate the development of competence in caring for adults and children at the end of life. At the end of the semester, the students were able to demonstrate principles of pain and symptom management and to communicate the goals and philosophy of hospice care to dying patients and their families. The students also demonstrated the ability to advocate for individuals at the end of life through the provision of information about hospice care, especially the benefits for timely referral to hospice and palliative care. The incorporation of a clinical experience into a community health nursing course that focuses on end‐of‐life care is an effective approach to teaching both community health concepts and care of dying patients. Such an approach incorporates essential content without adding to already extensive nursing curricula.
Perspectives on the reduction in cardiovascular mortality with oral appliance therapy for patients with severe obstructive sleep apnoea intolerant to continuous positive airway pressure
Authors: Vanderveken Olivier M.
Published: July 2013

See article, page 1184
Net Fiscal Stimulus during the Great Recession
Authors: Aizenman Joshua , Pasricha Gurnain Kaur
Published: July 2013

This paper studies the patterns of government expenditure stimuli among Organisation for Economic Co‐operation and Development (OECD) countries during the Great Recession (2007–2009). Overall, we find that the USA net fiscal stimulus was modest relative to peers, despite it being the epicenter of the crisis, and having access to relatively cheap funding of its twin deficits. Of the 28 countries in the sample, the USA is ranked among the bottom third in terms of the rate of expansion of consolidated government consumption and investment expenditures. Contrary to historical experience, emerging markets had strongly countercyclical policy during the period immediately preceding the Great Recession and the Great Recession itself. Federal unions, emerging markets and countries with very high gross domestic product (GDP) growth during the pre‐recession period saw larger net fiscal stimulus on average than their counterparts. We also find that greater net fiscal stimulus was associated with lower flow costs of general government debt in the same or subsequent period.
Does Learning by Exporting Happen? Evidence from the Automobile Industry in China
Authors: Luong Tuan Anh
Published: July 2013

The concept that exporters learn from their exporting experience is a theoretical result that needs to be tested empirically. However, the literature provides mixed evidence. In this paper, to estimate productivity, an approach suggested by De Loecker is applied, which corrects for econometric and consistency problems. Using a dataset for the Chinese automobile between 1998 and 2007, no evidence of learning by exporting was found. The data also suggests explanations for why it does not support this hypothesis.
Characteristics of Acquirers and Targets in Domestic and Cross‐border Mergers and Aquisitions
Authors: Liu Qing , Qiu Larry D.
Published: July 2013

To help understand mergers and acquisitions (M&As), this paper utilizes the most recent M&A data (1991–2007) to establish empirical facts on a variety of performance measures for M&A acquirers, targets, and non‐participants. Unlike the finance literature which mainly focuses on abnormal returns, our performance measures include firm size, technology, productivity, and profitability. Generally, in domestic M&As, in cross‐border M&As, in the pre‐merger period and in the post‐merger period, acquirers perform better than targets, whereas targets perform better than non‐participants. Firms' performance is improved after the M&As. We also find that in the pre‐merger period, US firms that acquire foreign firms in developing countries are significantly better than those that acquire foreign firms in developed countries.
An Application of the Melitz Model to Chinese Firms
Authors: Sun Churen , Tian Guoqiang , Zhang Tao
Published: July 2013

When the Melitz model is implemented in practice, the industrial productivity distribution is often assumed to be of Pareto form. In this case, a fundamental relationship κ > σ − 1 must hold to guarantee the convergence of the industrial average productivity, where κ is the concentration degree of the industrial productivity Pareto distribution and σ is the substitution elasticity across varieties in the industry. This paper estimates the concentration degrees of the Pareto distribution in industrial productivity and industrial substitution elasticities using firm‐level data of 40 Chinese manufacturing industries between 1998 and 2007. However, the paper shows that the above fundamental assumption κ > σ − 1 does not hold for nearly all the industries for Chinese firm‐level data. An explanation is proposed as a result of the distorted firm size and productivity for Chinese characteristics.
The Dynamics of Expansion to Emerging Markets: Evidence from Canadian Exporters
Authors: Sui Sui , Yu Zhihao
Published: July 2013

This study investigates the expansion patterns of Canadian firms towards emerging markets. A unique large‐scale longitudinal (1997–2004) dataset which includes 2600 Canadian exporters is constructed by linking multiple administrative databases at Statistics Canada. Our results suggest traditional sequential exporting patterns do not apply to all Canadian exporters. Since 2001, there has been an increasing trend among a new generation of exporters to target emerging markets as their initial export destination; and both macroeconomic and firm‐specific factors seem to account for this development. Compared with foreign‐controlled firms, Canadian‐controlled firms are less likely to export to the emerging markets. In order to successfully expand into emerging markets, Canadian firms have had to improve their productivity and reduce their labor costs.
Occupational Choice, Aggregate Productivity, and Trade
Authors: Meckl Jürgen , Weigert Benjamin
Published: July 2013

We propose occupational decisions of heterogeneous individuals as an alternative mechanism of explaining the distribution of firm productivities emphasized by empirical studies. Thus, we integrate the frameworks of Melitz (Econometrica 71 (2003):1695–725), and of Manasse and Turrini (Journal of International Economics 54 (2001):97–117) that establish the theoretical base of trade models with heterogeneous firms. Our model is technically much simpler than the Melitz approach while preserving the main results on firm‐selection effects caused by international market integration. Our approach paves the way for detailed analysis of institutions in a heterogeneous firm model to better understand the link between institutions and an economy's productivity distribution.
Does Human Capital Endowment of Foreign Direct Investment Recipient Countries Really Matter? Evidence from Cross‐country Firm Level Data
Authors: Bhaumik Sumon Kumar , Dimova Ralitza
Published: July 2013

The stylized literature on foreign direct investment (FDI) suggests that developing countries should invest in the human capital of their labor force in order to attract FDI. However, if educational quality in developing country is uncertain such that formal education is a noisy signal of human capital, it might be rational for multinational enterprises to focus more on job‐specific training than on formal education of the labor force. Using cross‐country data from the textiles and garments industry, we demonstrate that training indeed has a greater impact on firm efficiency in developing countries than formal education of the workforce.
On the State Advertising Policy under Quality Information Bias
Authors: Ishii Yasunori
Published: July 2013

This paper analyzes the effects of the state advertising policy of a developing country on the quality–price competition between its firm and a developed country's firm in an international duopoly. It considers the quality information bias under which the product quality of the developing country's firm is underestimated and the state advertising policy that is implemented by the developing country in order to improve such information bias at a national expense. We show that while a rise in the state advertising expense of the developing country raises (reduces) the quality, price, and profit of the firm in the developing (developed) country, it makes the firms’ quality–price competition more intense, and vice versa. We also find that the developing country's state advertising policy is an incomplete‐bias‐adjusting policy that does not completely eradicate the quality information bias of its firm.