bluuebunny/crossref_metadata_2025 huggingface dataset:
A method for designing complex biosecurity surveillance systems: detecting non‐indigenous species of invertebrates on Barrow Island
Authors: Whittle Peter J. L. , Stoklosa Richard , Barrett Susan , Jarrad Frith C. , Majer Jonathan D. , Martin P. A. J. , Mengersen Kerrie
Published: May 2013

Aim

We developed a new method to design objective, risk‐based surveillance systems for non‐indigenous species of invertebrates, vertebrates and plants, which might be introduced to a natural area through an industrial project; here, we provide the invertebrate case study. The method addresses issues common to complex surveillance design problems: a statistical standard (e.g. power); information gaps; multiple targets of unclear identity; a large surveillance area of heterogeneous risk of invasion; integrating multiple sources of surveillance data; optimizing for cost.

Location

Barrow Island, Western Australia.

Methods

We mapped the surveillance area for risk to target surveillance activities. An expert group identified a set of exemplar species and identified and characterized a set of detection methods for each, such that all potential invaders would be detected. We devised multi‐element surveillance systems to detect each exemplar to the design power (0.8), then integrated them to a single system that was optimized for cost.

Results

The surveillance system was deployed on the island to specification over 1 year, then reviewed for redesign in a second period.

Main conclusions

The new method provided practical, risk‐based surveillance system designs that met application requirements and overcame complex issues common to many surveillance applications. A review of experiences from surveillance in the first year led to practical improvements and design efficiencies.
Uncertainties in coupled species distribution–metapopulation dynamics models for risk assessments under climate change
Authors: Naujokaitis‐Lewis Ilona R. , Curtis Janelle M. R. , Tischendorf Lutz , Badzinski Debbie , Lindsay Kathryn , Fortin Marie‐Josée
Published: May 2013

Aim

Species distribution models (SDMs) coupled with metapopulation dynamics models can integrate multiple threats and population‐level processes that influence species distributions. However, multiple sources of uncertainties could lead to substantial differences in model outputs and jeopardize risk assessments. We evaluate uncertainties in coupled species distribution–metapopulation dynamics models and focus on two often underappreciated sources of uncertainty: the choice of general circulation model (GCM) and demographic parameter uncertainty of the metapopulation model. We rank the risks associated with potential climate changes and habitat loss on projected range margin dynamics of the Hooded Warbler (Setophaga citrina).

Location

Breeding range of the Hooded Warbler, North America.

Methods

Using SDMs, we quantified variability in projected future distributions using four GCMs and a consensus model at the biogeographic scale and assessed the propagation of uncertainty through to metapopulation viability projections. We applied a global sensitivity analysis to the coupled species distribution–metapopulation models to rank the influence of choice of GCM, parameter uncertainty and simulated effects of habitat loss on metapopulation viability, thereby addressing error propagation through the whole modelling process.

Results

The Hooded Warbler range was consistently projected to shift north: choice of GCMs influenced the magnitude of change, and variability was spatially structured. Variability in the choice of GCMs propagated through to metapopulation viability at the northern range boundary. Although viability measures were sensitive to the GCM used, measures of direct habitat loss were more influential. Despite the high ranking of vital rates in the global sensitivity analysis, direct habitat loss had a larger negative influence on extinction risk than potential future climate changes.

Main conclusions

This work underscores the importance of a global sensitivity analysis framework applied to coupled models to disentangle the relative influence of uncertainties on projections. The use of multiple GCMs enabled the exploration of a range of possible outcomes relative to the consensus GCM, helping to inform risk estimates. Ranking uncertainties informs the prioritization of management actions for species affected by dynamic anthropogenic threats over multiple spatial scales.
Model‐based search strategies for plant diseases: a case study using citrus canker (Xanthomonas citri)
Authors: Potts Joanne M. , Cox Martin J. , Barkley Patricia , Christian Rochelle , Telford Grant , Burgman Mark A.
Published: May 2013

Aim

Biosecurity responses to incursions aim to achieve pest‐ or disease‐free status as quickly as possible. One of the critical initial response activities involves tracing known movements (trace events) to and from an infected or infested property (IP) that could spread the pest or pathogen. During an incursion response, managers allocate surveillance resources to follow up trace events in order of priority. Prioritizing trace events is difficult and typically subjective. We present a simulation model where several dispersal mechanisms spread a pest between areas. We use model outputs to test different search strategies, using citrus canker (caused by Xanthomonas citri) as a case study. Model scenarios are based on an outbreak of citrus canker that occurred in Queensland in 2004.

Location

Australia.

Methods

Model parameters were extracted from published scientific reports and elicited from experts. We used model outputs to assess three search strategies to determine how best to monitor citrus canker spread. Parameters governing disease detectability and host susceptibility were varied in a sensitivity analysis.

Results

In all simulation scenarios, the ‘adaptive radius’ rule performed best, whereby a circular search area was placed around the IP where the disease outbreak was first detected, with a radius proportional to the estimated number of months the property was infected. Importantly, none of the search rules tested detected all IPs without searching all areas with susceptible hosts in the region.

Main conclusions

We identify a simple rule of thumb for searching during a citrus canker outbreak that is robust to uncertainty. We cannot generalize the results of this study for tracing other pests or pathogens. The model has created a framework that may be used to explore other contexts and disease dynamics, leading perhaps to more general rules for disease outbreak management.
Epidemiology and risk factors for chronic kidney disease in patients with ischaemic stroke
Authors: Bao Yu‐Shi , Song Li‐Ting , Zhong Di , Song A‐Xia , Jia Xi‐Bei , Liu Rui‐Chan , Xie Ru‐Juan , Na Shi‐Ping
Published: May 2013

Background

There is growing evidence for an association between chronic renal disease (CKD) and adverse cerebrovascular events because of the overlap of several risk factors. The purpose of this study is to examine the epidemiology of CKD and the characteristics of risk factors for CKD in the population with ischaemic stroke.

Methods

This retrospective study included 571 patients with ischaemic stroke. Estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease (MDRD) study equation. Renal function was assessed according to the Kidney Disease Outcomes Quality Initiative (K/DOQI)‐CKD classification.

Results

Study demonstrated that the major factors associated with CKD in the ischaemic stroke patients were age, diabetes mellitus, hypertension, systolic blood pressure, LDL cholesterol and serum uric acid. Diabetes mellitus (OR 4·146, 95% CI 1·047–16·418, P = 0·043), hypertension and diabetes mellitus (OR 3·574, 95% CI 1·248–10·234, P = 0·018), serum uric acid (OR 1·010, 95% CI 1·006–1·013, P < 0·001) and LDL cholesterol (OR 1·431, 95% CI 1·063–1·928, P = 0·018) were independent risk factors associated with CKD in the patients with ischaemic stroke.

Conclusions

The patients with ischaemic stroke may be considered as a high‐risk population for CKD and be aggressively managed for CKD prevention. The high prevalence of CKD in population with ischaemic stroke prompts the need for greater public awareness about risks of CKD.
ProHNPs are the principal α‐defensins of human plasma
Authors: Glenthøj Andreas , Glenthøj Anders J. , Borregaard Niels
Published: May 2013

Background

Human neutrophil peptides (HNPs) were discovered as abundant antimicrobial peptides of azurophil granules. Later studies revealed that most HNPs were produced by myelocytes and metamyelocytes and secreted into the bone marrow plasma as the inert proforms, proHNPs. Despite the vast amounts of proHNPs released into bone marrow plasma, little has been done to characterize these. Numerous studies have investigated HNPs in plasma, linking them to a variety of diseases, but without distinguishing between HNPs and their proforms.

Materials and methods

We used an antibody with specificity against the propiece of proHNPs to investigate proHNPs in plasma and tissue.

Results

In contrast to previous studies using HNP antibodies, we found proHNPs to be many‐fold more abundant than HNPs in plasma with a mean concentration of 2 μg/mL. The concentration was substantially higher in bone marrow plasma in accordance with the bone marrow being the site of origin of plasma proHNPs. ProHNPs were not bound to high molecular weight plasma proteins. Accordingly, proHNPs were filtered in the kidneys and resorbed in the proximal tubules.

Conclusions

Most HNPs in plasma are in fact proHNPs, which is important given the differences in their origin and biological activities.
Transcranial color‐coded sonography to predict recurrent transient ischaemic attack/stroke
Authors: Nasr N. , Ssi‐Yan‐Kai G. , Guidolin B. , Bonneville F. , Larrue V.
Published: May 2013

Background and purpose

Patients with transient ischaemic attack (TIA) with a high risk of imminent stroke can be identified with the ABCD2 score and findings on MRI and CT angiography. The predictive value of transcranial color‐coded sonography (TCCS) has not been evaluated in this setting.

Methods

A retrospective analysis was conducted of patients consecutively treated for TIA or minor stroke in a TIA clinic within 24 h of symptom onset. Agreement between TCCS and MRI three‐dimensional time‐of‐flight images for the diagnosis of proximal (internal carotid artery, vertebral artery, basilar artery, circle of Willis and main stem of the middle cerebral artery) >50% stenosis or occlusion of the intracranial symptomatic artery was evaluated. The sensitivity, specificity, predictive values and likelihood ratio of TCCS for predicting recurrent TIA/stroke at 7 days were calculated.

Results

Of 159 patients with a TIA or minor stroke within the last 24 h, 142 had a readable acoustic temporal bone window (89.3%). TCCS and MRI were performed within 4 h of each other in 116 patients. MRI showed a symptomatic proximal intracranial steno‐occlusive lesion in six patients. Agreement between MRI and TCCS was perfect (κ coefficient = 1). Recurrent TIA/stroke occurred in 10 patients (eight TIA and two minor strokes). All recurrences occurred within 24 h of symptom onset. A symptomatic proximal intracranial steno‐occlusive lesion was found on TCCS in 4/10 patients with recurrence and 3/132 patients without recurrence [sensitivity 40%; specificity 97.7%; likelihood ratio 18.1; odds ratio (95% CI) adjusted for ABCD2 score 31.5 (4.5–218.6)].

Conclusion

Our study shows that TCCS can be used to guide triage of patients with TIA.
Bronchial collapse during bronchoalveolar lavage in horses is an indicator of lung inflammation
Authors: Koblinger K. , Hecker K. , Nicol J. , Wasko A. , Fernandez N. , Léguillette R.
Published: May 2013

Reasons for performing study

The bronchoalveolar lavage (BAL) procedure can return variable volumes of fluid, possibly depending on the presence of bronchial collapse during fluid aspiration and on the severity of lung inflammation.

Objectives

We tested the hypothesis that horses with bronchial collapse duringBALare at higher risk of having severe lung inflammation.

Study design

Prospective field study.

Methods

Bronchial collapse was graded using a new simple scoring method (0, 1 or 2) during a standardisedBALprocedure in the field on 131 horses with normal, mild/moderate or severe lower airway inflammation on cytology ofBALfluid.

Results

Of the 131 horses, 37 (28%), 55 (42%) and 39 (30%) horses had bronchial collapse scores of 0, 1 and 2, respectively. There was a difference in collapse scores between all theBALinflammation categories (P<0.001). Severe collapse had a positive predictive value of 0.95 for both mild/moderate and severeBALinflammation, with a prevalence of 63% and 20%, respectively. TheBALfluid return volume in the horses with severe collapse scores was lower than volumes in the partial (score 1/2) and no collapse (score 0/2) groups (P<0.001). TheBALfluid volume was negatively correlated withBALneutrophil percentage (P<0.001).

Conclusions

Airway collapse duringBALis associated with airway inflammation and neutrophilia.

Potential relevance

During a standardisedBALprocedure, clinicians can expect lung inflammation in horses that have bronchial collapse and bronchial collapse in horses with lung inflammation. Lung inflammation may be a contributing factor in the mechanism of bronchial collapse duringBALin horses.

The Summary is available inChinese – see Supporting information.
Methods of hair loss evaluation: a comparison of TrichoScan® with the modified wash test
Authors: Guarrera Marcella , Fiorucci Maria Cristina , Rebora Alfredo
Published: May 2013

The reliability of the methods currently used for diagnosing hair loss is ill defined. We studied 41 subjects complaining of hair loss, including androgenetic alopecia and telogen effluvium, and compared the results obtained with the modified wash test (MWT) and TrichoScan®. Data were analysed statistically with the t‐test and the Cohen κ statistic. The concordance between the clinical diagnosis and that of MWT (5% cut‐off) was fair (κ = 0.32) and that between clinical diagnosis and TrichoScan® was still fair though less satisfactory (κ = 0.22). Only in 17 patients (41%) were the MWT and TrichoScan® diagnoses concordant. MWT was better in general and especially at detecting telogen effluvium (TE) (29% vs 19%). In conclusion, the clinical observation should be assisted by MWT and dermoscopy, leaving the biopsy for very difficult cases. TrichoScan® is less useful and may be even misleading in TE.
Telomere shortening in human diseases
Authors: Kong Chiou Mee , Lee Xiao Wen , Wang Xueying
Published: May 2013

The discovery of telomeres dates back to the early 20th century. In humans, telomeres are heterochromatic structures with tandem DNA repeats of 5′‐TTAGGG‐3′ at the chromosomal ends. Telomere length varies greatly among species and ranges from 10 to 15 kb in humans. With each cell division, telomeres shorten progressively because of the ‘end‐replication problem’. Short or dysfunctional telomeres are often recognized as DNA DSBs, triggering cell‐cycle arrest and result in cellular senescence or apoptotic cell death. Therefore, telomere shortening serves as an important tumor‐suppressive mechanism by limiting cellular proliferative capacity by regulating senescence checkpoint activation. Although telomeres serve as a mitotic clock to cells, they also confer capping on chromosomes, with help from telomere‐associated proteins. Over the past decades, many studies of telomere biology have demonstrated that telomeres and telomere‐associated proteins are implicated in human genetic diseases. In addition, it has become more apparent that accelerated telomere erosion is associated with a myriad of metabolic and inflammatory diseases. Moreover, critically short or unprotected telomeres are likely to form telomeric fusions, leading to genomic instability, the cornerstone for carcinogenesis. In light of these, this minireview summarizes studies on telomeres and telomere‐associated proteins in human diseases. Elucidating the roles of telomeres involved in the mechanisms underlying pathogenesis of these diseases may open up new possibilities for novel molecular targets as well as provide important diagnostic and therapeutic implications.
Exclusively membrane‐inserted state of an uncleavable Tat precursor protein suggests lateral transfer into the bilayer from the translocon
Authors: Ren Chao , Patel Roshani , Robinson Colin
Published: May 2013

In bacteria, the export of proteins by the twin‐arginine translocase (Tat) pathway is directed by cleavable N‐terminal signal peptides. We studied the relationship between transport and maturation using a substrate, YedY, that contains an Ala > Leu substitution at the ‐1 position of the signal peptide. This blocks maturation and leads to the accumulation of a membrane‐bound precursor form with the mature domain exposed to the periplasm. Its accumulation does not block transport of other Tat substrates, indicating that exit from the translocation channel has taken place, and the precursor protein is fir mLy integrated into the membrane bilayer. The membrane‐integrated nature of the precursor, and complete absence of precursor protein in the periplasm, strongly suggest that the precursor has undergone lateral transfer into the bilayer during translocation. We propose that subsequent proteolytic processing releases the mature protein into the periplasm. A delay in processing results in an inhibition of cell growth, emphasizing a requirement for efficient maturation of Tat substrates.
Linking geology, fluid chemistry, and microbial activity of basalt‐ and ultramafic‐hosted deep‐sea hydrothermal vent environments
Authors: Perner M. , Hansen M. , Seifert R. , Strauss H. , Koschinsky A. , Petersen S.
Published: May 2013

Hydrothermal fluids passing through basaltic rocks along mid‐ocean ridges are known to be enriched in sulfide, while those circulating through ultramafic mantle rocks are typically elevated in hydrogen. Therefore, it has been estimated that the maximum energy in basalt‐hosted systems is available through sulfide oxidation and in ultramafic‐hosted systems through hydrogen oxidation. Furthermore, thermodynamic models suggest that the greatest biomass potential arises from sulfide oxidation in basalt‐hosted and from hydrogen oxidation in ultramafic‐hosted systems. We tested these predictions by measuring biological sulfide and hydrogen removal and subsequent autotrophic CO2 fixation in chemically distinct hydrothermal fluids from basalt‐hosted and ultramafic‐hosted vents. We found a large potential of microbial hydrogen oxidation in naturally hydrogen‐rich (ultramafic‐hosted) but also in naturally hydrogen‐poor (basalt‐hosted) hydrothermal fluids. Moreover, hydrogen oxidation–based primary production proved to be highly attractive under our incubation conditions regardless whether hydrothermal fluids from ultramafic‐hosted or basalt‐hosted sites were used. Site‐specific hydrogen and sulfide availability alone did not appear to determine whether hydrogen or sulfide oxidation provides the energy for primary production by the free‐living microbes in the tested hydrothermal fluids. This suggests that more complex features (e.g., a combination of oxygen, temperature, biological interactions) may play a role for determining which energy source is preferably used in chemically distinct hydrothermal vent biotopes.
On the homogeneity of fluids forming bedding‐parallel veins
Authors: Smith A. P. , Fischer M. P. , Evans M. A.
Published: May 2013

A group of 400–500 m long, bedding‐parallel calcite veins are exposed in the central La Popa Basin of northeastern Mexico. These veins provide a unique opportunity to determine the kilometer‐scale fluid–rock system associated with bedding‐parallel vein formation, and to test for sampling bias in studies that often use one or two samples to constrain the characteristics of regional‐scale paleohydrogeological systems. We use fluid inclusion microthermometry in conjunction with measurements of δ13C, δ18O, and 87Sr/86Sr ratios to constrain the vein‐forming fluid temperatures, compositions and sources, and compare these values along and between the veins to establish the homogeneity of the vein‐forming fluids and fluid–rock system. The δ13C values of the veins are close to those of the host rock, and average – 3.96‰ (PDB). The δ18O values of the veins are typically 1‰ lower than those of the host rocks, and average – 9.54‰ (PDB). Fluid inclusion homogenization temperatures average 137°C and inclusion salinities are all <6 wt% NaCl equivalent. The 87Sr/86Sr ratios of the veins average 0.70731 and are substantially lower than the values expected for the host rock. Calculated fluid δ18O values range from 4 to 10‰ (SMOW). The isotopic and microthermometric data indicate the veins most likely formed at depths of 3–4 km when meteoric water mixed with upward migrating, warm basinal brines. Vein microstructures and field characteristics indicate they formed from multiple slip events that most likely were associated with transport of individual fluid pulses that migrated along bedding planes. The large‐scale homogeneity of vein geochemistry is remarkable and demonstrates that only one or two samples would be sufficient to accurately characterize the kilometer‐scale paleohydrogeological system for these veins.
Migraine and vascular risk factors in the elderly
Authors: Gilad Ronit , Boaz Mona , Dabby Ron , Finkelstein Vitali , Rapoport Abraham , Lampl Yair
Published: May 2013

Aim

The association between migraine and cerebrovascular disease is well documented in younger migraine patients, especially those with aura. Prevalence estimates of vascular risk factors among elderly migraine sufferers are lacking. The present study was designed to estimate the prevalence of vascular risk factors in the elderly population with late onset of migraine without aura.

Methods

The medical records of 163 patients aged 50 years and older suffering from migraine without aura were assessed for vascular risk factors, including hypertension, elevated serum lipid levels, diabetes mellitus and cardiovascular disease. Prevalence was estimated and compared with age‐ and sex‐matched vascular risk factor estimates for the general population extracted from the 2003–2004 Israeli National Health Interview Survey, and to a group of patients matched by age suffering from migraine with aura.

Results

Among women with migraine without aura, hypertension, hyperlipidemia and diabetes mellitus were significantly less prevalent than among women without migraine without aura. Prevalence estimates for vascular risk factors did not differ by migraine among males. The group of older patients suffering from migraine with aura showed a higher incidence of vascular risk factors in respect to the group of migraine patients without aura.

Conclusions

The findings of the present study might have an important clinical relevance, suggesting another pathophysiological process in respect to patients suffering from migraine with aura, and this evidence might have different therapeutic implications. Geriatr Gerontol Int 2014; 14: 220–225.
HER2 and EGFR gene copy number alterations are predominant in high‐grade salivary mucoepidermoid carcinoma irrespective of MAML2 fusion status
Authors: Nakano Takafumi , Yamamoto Hidetaka , Hashimoto Kazuki , Tamiya Sadafumi , Shiratsuchi Hideki , Nakashima Torahiko , Nishiyama Ken‐ichi , Higaki Yuichiro , Komune Shizuo , Oda Yoshinao
Published: May 2013

Aims

In this study, we aimed to investigate the molecular mechanisms underlying the development of mucoepidermoid carcinoma (MEC).

Methods and results

In 31 cases, we examined the MAML2 fusion status using reverse transcriptase–polymerase chain reaction, and HER2 and EGFR status using immunohistochemistry and chromogenic in‐situ hybridization. MAML2 fusions were detected in 15 (57.7%) of 26 MECs analysed, including 11 of 16 (68.8%) low‐grade, two of four (50%) intermediate‐grade and two of six (33.3%) high‐grade MECs. HER2 gene amplification and an increased EGFR gene copy number (with balanced chromosome 7 high‐polysomy) were each detected in four of 28 (14.3%) MECs analysed. Irrespective of MAML2 fusion status, all seven high‐grade MECs had an increased gene copy number of either HER2 or EGFR, in a mutually exclusive manner, whereas such abnormalities were extremely rare in low‐ and intermediate‐grade MEC.

Conclusions

These results suggest that HER2 or EGFR gene abnormality could play an important role in the development of high‐grade MEC, and also in the progression from MAML2 fusion‐positive low‐/intermediate‐grade to high‐grade in a subset of MEC. Furthermore, we suggest that high‐grade MEC comprises a heterogeneous group of tumours in terms of molecular pathogenesis, in particular MAML2 fusion status.
Prosocial Motivation, Stress and Burnout Among Direct Support Workers
Authors: Hickey Robert
Published: May 2013

Aim

This study explores whether the desire to engage in work that is beneficial to others moderates the effects of stress on burnout.

Method

Based on a survey of 1570 direct support professionals in Ontario, this study conducted linear regression analyses and tested for the interaction effects of prosocial motivation on occupational stress and burnout.

Results

Prosocial motivation significantly moderated the association of emotional exhaustion (EE) and role boundary stress with depersonalization (DP). Prosocial motivation also moderated the effects of role ambiguity stress with a direct support worker's sense of personal accomplishment. In contrast, prosocial motivation magnified feelings of EE when interacted with a sense of personal accomplishment.

Conclusions

Prosocial motivation plays an important role in explaining the relatively low levels of DP in the sector. The study advances our understanding of the key components of burnout among direct support workers.
Relationship Between Oral Health and Frailty in Community‐Dwelling Elderly Individuals in Brazil
Authors: de Andrade Fabíola Bof , Lebrão Maria Lúcia , Santos Jair Lício Ferreira , de Oliveira Duarte Yeda Aparecida
Published: May 2013

Objectives

To test the hypothesis that clinical oral health conditions are associated with frailty independent of socioeconomic and general health status.

Design

Cross‐sectional.

Setting

Population‐based cohort study of health, well‐being, and aging.

Participants

One thousand three hundred seventy‐four community‐dwelling individuals representing 998,528 individuals aged 60 and older in the city of São Paulo, Brazil.

Measurements

Frailty was defined on the basis of five characteristics: weight loss, weakness, slowness, exhaustion, and low level of physical activity. Participants with three or more characteristics were classified as frail, with one or two as prefrail, and with zero as nonfrail. Oral health measures were number of teeth, use of dental prostheses, need for dental prostheses, presence of decayed teeth, clinical attachment loss of 4 mm or greater, and periodontal pocket of 4 mm or greater. Data on sociodemographic (age, sex, and schooling) and general health (number of self‐reported chronic diseases and smoking status) data were assessed.

Results

The prevalence of frailty was 8.5%, with 50.8% considered nonfrail. Elderly individuals with a need for dental prostheses were significantly more likely to be prefrail and frail. Participants with 20 or more teeth had a lower chance of being frail than edentulous individuals.

Conclusion

The need for dental prostheses was significantly associated with frailty, independent of socioeconomic and general health status.
Mild Physical Impairment Predicts Future Diagnosis of Dementia of the Alzheimer's Type
Authors: Wilkins Consuelo H. , Roe Catherine M. , Morris John C. , Galvin James E.
Published: May 2013

Objectives

To determine whether mildly impaired physical function (based on performance‐based assessment) is associated with development of dementia of the Alzheimer's type (DAT) in cognitively normal older adults.

Design

Longitudinal, observational study with yearly assessments of physical and cognitive function. Mean follow‐up was 5 years.

Setting

Knight Alzheimer's Disease Research Center at Washington University, St. Louis, Missouri.

Participants

Four hundred thirty‐five cognitively normal adults aged 60 and older participating in longitudinal studies of aging.

Measurements

Survival analyses were used to examine whether scores on the 9‐item Physical Performance Test (PPT) predicted time to DAT diagnosis. Cox proportional hazards models were used to examine associations between PPT total scores and time to cognitive impairment and DAT; as well as the association between time and these events, adjusting for and simultaneously testing the effects of age, sex, education, and presence of one or more apolipoprotein (APOE) ε4 alleles.

Results

During the follow‐up period, 81 participants developed DAT. Participants diagnosed with DAT were older (81.0 vs 74.2, P = .001) and had worse performance on the PPT (25.5 vs 28.1, P = .009) than those who remained cognitively normal. Time to DAT diagnosis was associated with PPT total score (hazard ratio (HR) = 0.89, 95% confidence interval (CI) = 0.86–0.93, P < .001) such that time to DAT diagnosis was longer for participants with higher physical performance scores. In the adjusted analysis, PPT score significantly predicted time to DAT diagnosis (HR = 0.94, 95% CI = 0.89–0.99, P = .02).

Conclusion

Mild physical impairment in cognitively normal older adults is associated with subsequent development of DAT. Although the physical impairment may be sufficiently mild that it is recognized only using performance‐based assessments, its presence may predate clinically detectable cognitive decline.
Optimal Blood Pressure for Cognitive Function: Findings from an Elderly African‐American Cohort Study
Authors: Liu Hai , Gao Sujuan , Hall Kathleen S. , Unverzagt Frederick W. , Lane Kathleen A. , Callahan Christopher M. , Hendrie Hugh C.
Published: May 2013

Objectives

To report the results from a prospective cohort study on the association between blood pressure (BP) and cognitive function in elderly African Americans.

Design

Prospective cohort study conducted from 1997 to 2009.

Setting

Community‐based study in Indianapolis.

Participants

African Americans aged 65 years or older (N = 3,145).

Measurements

At each assessment, participant cognitive function was measured using the Community Screening Interview for Dementia. Other measurements included BP, height, weight, education level, antihypertensive medication use, alcohol use, smoking, and history of chronic medical conditions.

Results

Longitudinal assessments (n = 5,995) contributed by 2,721 participants with complete independent variables were analyzed using a semiparametric mixed‐effects model. Systolic BP (SBP) of approximately 135 mmHg and diastolic BP (DBP) of approximately 80 mmHg were associated with optimal cognitive function after adjusting for other variables (P = .02). Weight loss with body mass index < 30.0 kg/m2 was significantly related to poorer cognitive performance (P < .001). Older age at first assessment, lower education level; smoking; and history of depression, stroke, and diabetes mellitus were related to worse cognitive function; taking antihypertensive medication and drinking alcohol were associated with better cognitive function.

Conclusion

High and low BP were associated with poorer cognitive performance. A joint optimal region of SBP and DBP for cognitive function has been identified, which may provide useful clinical information on optimal BP control in cognitive health and lead to better quality of life for elderly adults.
Variation in the Prevalence of Sarcopenia and Sarcopenic Obesity in Older Adults Associated with Different Research Definitions: Dual‐Energy X‐Ray Absorptiometry Data from the National Health and Nutrition Examination Survey 1999–2004
Authors: Batsis John A. , Barre Laura K. , Mackenzie Todd A. , Pratt Sarah I. , Lopez‐Jimenez Francisco , Bartels Stephen J.
Published: May 2013

Objectives

To determine the prevalence range for sarcopenic obesity and its relationship with sex, age, and ethnicity.

Design

Cross‐sectional analysis of a population‐based sample.

Setting

Noninstitutionalized persons in the United States participating in the National Health and Nutrition Examination Surveys 1999–2004.

Participants

Subsample of 4,984 subjects aged 60 and older with dual‐energy X‐ray absorptiometry body composition data.

Measurements

Eight definitions of sarcopenic obesity identified from six studies found using a systematic literature review (Baumgartner, Bouchard, Davison, Zoico, Levine, Kim‐1,2,3) were applied to the sample. Results were stratified according to sex, age, and ethnicity.

Results

Prevalence of sarcopenic obesity ranged from 4.4% to 84.0% in men and from 3.6% to 94.0% in women. Prevalence was higher in men using definitions from Baumgartner (17.9% vs 13.3%, P < .001), Levine (14.2% vs 6.6%, P < .001), and Kim‐1 (30.0% vs 9.3%, P < .001); lower for men using the Davison (4.4% vs 11.1%, P < .001) and Kim‐2 (83.7% vs 94.0%) definitions; and the same for men and women using the Bouchard (45.3% vs 44.3%, P = .32) and Kim‐3 (75.6% vs 77.0%, P = .51) definitions. For all but one definition, sarcopenic obesity increased with each decade and was lower in non‐Hispanic blacks than whites.

Conclusion

Prevalence of sarcopenic obesity in older adults varies up to 26‐fold depending on current research definitions. Such a high degree of variability suggests the need to establish consensus criteria that can be reliably applied across clinical and research settings.
Thyroid Status and 6‐Year Mortality in Elderly People Living in a Mildly Iodine‐Deficient Area: The Aging in the Chianti Area Study
Authors: Ceresini Graziano , Ceda Gian Paolo , Lauretani Fulvio , Maggio Marcello , Usberti Elisa , Marina Michela , Bandinelli Stefania , Guralnik Jack M. , Valenti Giorgio , Ferrucci Luigi
Published: May 2013

Objectives

To test the hypothesis that, in older adults, living in a mildly iodine‐deficient area, thyroid dysfunction may be associated with mortality independent of potential confounders.

Design

Longitudinal.

Setting

Community‐based.

Participants

Nine hundred fifty‐one individuals aged 65 and older.

Measurements

Plasma thyrotropin, free thyroxine, and free triiodothyronine concentrations and demographic features were evaluated in participants of the Invecchiare in Chianti Study aged 65 and older. Participants were classified according to thyroid function test. Kaplan‐Meier survival and Cox proportional hazards models adjusted for confounders were used in the analysis.

Results

Eight hundred nineteen participants were euthyroid, 83 had subclinical hyperthyroidism (SHyper), and 29 had subclinical hypothyroidism (SHypo). Overt hypo‐ and hyperthyroidism were found in five and 15 subjects, respectively. During a median of 6 years of follow‐up, 210 deaths occurred (22.1%), 98 (46.6%) of which were from cardiovascular causes. Kaplan‐Meier analysis revealed higher overall mortality for SHyper (P = .04) than euthyroid subjects. After adjusting for multiple confounders, participants with SHyper (hazard ratio (HR) = 1.65, 95% confidence interval (CI) = 1.02–2.69) had significantly higher all‐cause mortality than those with normal thyroid function. No significant association was found between SHyper and cardiovascular mortality. In euthyroid subjects, thyrotropin was found to be predictive of lower risk of all‐cause mortality (HR = 0.76, 95% CI = 0.57–0.99).

Conclusion

SHyper is an independent risk factor for all‐cause mortality in older adults. Low to normal circulating thyrotropin should be carefully monitored in elderly euthyroid individuals.
Modified Taylor Complex Figure: Normative data from 290 adults
Authors: Casarotti Alessandra , Papagno Costanza , Zarino Barbara
Published: May 2013

Data for copying and delayed recall (after a 15‐min delay) of the Modified Taylor Complex Figure (MTCF), an alternative form of the Rey‐Osterrieth Complex Figure (ROCF), were collected from 290 healthy participants. Normative data are provided. Age and education were significantly correlated with MTCF scores and must be corrected for to interpret results accurately. More specifically, increasing age adversely affected performance, whereas a higher education resulted in a better performance. Twenty‐five participants were tested with both complex figures (MTCF and ROCF) in two separate sessions to assess correlation, which proved to be high. The collected data allow using the MTCF as a valid alternative material for testing visual long‐term memory avoiding implicit learning that can occur when the same version of the ROCF is used for repeated testing sessions.
‘Tolerating violence’: a qualitative study into the experience of professionals working within one UK learning disability service
Authors: Lovell Andrew , Skellern Joanne
Published: May 2013

Aims and objectives

To explore this complexity further, enhancing understanding of professionals' experience of violence and reasons for non‐reporting with regard to people with a learning disability.

Background

This article reports on a qualitative follow‐up study to a whole‐population survey investigating the under‐reporting of violence within one learning disability service. The survey had identified a pronounced level of under‐reporting but suggested an unexpected degree of complexity around the issue, which warranted further study.

Design

A qualitative research design was employed.

Methods

Semi‐structured interviews were conducted with 22 professionals working in learning disability services; data were subsequently transcribed verbatim and subject to stringent thematic analysis.

Results

The findings confirmed that the decision to report an incident or not was complicated by professional interpretation of violence. Three themes were produced by the analysis: the reality of violence, change over time and (zero) tolerance.

Conclusion

The study indicates that both experience of violence and ways of understanding it in relation to learning disability are shared across professional groups, although nurses are both more inured and generally more accepting of it. The study suggests that the relationship between learning disability nurses and service users with a propensity for violence is complicated by issues of professional background and concerns about the pertinence of zero tolerance.

Relevance to clinical practice

The availability of effective protocols and procedures is important, but services need also to acknowledge the more ambiguous aspects of the therapeutic relationship to fully understand under‐reporting of service user violence in the context of learning disability.
Intensive care delirium – effect on memories and health‐related quality of life – a follow‐up study
Authors: Svenningsen Helle , Tønnesen Else K , Videbech Poul , Frydenberg Morten , Christensen Doris , Egerod Ingrid
Published: May 2013

Aims and objectives

To investigate the effects of delirium in the intensive care unit on health‐related quality of life, healthcare dependency and memory after discharge and to explore the association between health‐related quality of life and memories, patient diaries and intensive care unit follow‐up.

Background

Up to 83% of intensive care unit patients experience delirium. In addition to increased risk of mortality, morbidity and cognitive impairment, the experience itself is unpleasant. A number of studies have focused on memories associated with delirium, but the association between delirium, memories and health‐related quality needs further investigation.

Design

We used an observational multicentre design with telephone interviews.

Methods

Adult intensive care unit patients (n = 360) were consecutively recruited and interviewed using the intensive care unit‐Memory Tool one week after intensive care unit. Interviews were repeated after two and six months and supplemented with Short Form‐36 and the Barthel Index.

Results

Delirium was detected in 60% of the patients in our study, and delirious patients had significantly fewer factual memories and more memories of delusion than nondelirious patients up to six months postintensive care unit discharge. Delirium, memories and intensive care unit diaries with follow‐up did not affect health‐related quality of life and healthcare dependency. Memories of delusions might have an impact on patients assessed as nondelirious.

Conclusions

More than half of the patients in intensive care unit experience delirium, which is associated with fewer factual memories and more memories of delusions. Short Form‐36 might not be sensitive to delirium‐related outcomes. Future research should include the development of better assessment tools to determine the long‐term consequences of intensive care unit delirium.

Relevance to clinical practice

We recommend regular assessment to prevent, detect and treat delirium. We also recommend an intensive care unit follow‐up programme providing an opportunity for postintensive care unit patients, particularly previously delirious patients, to discuss their memories and experiences with intensive care unit professionals.
Analysis of saliva samples from oncological patients treated with 5‐fluorouracil and leucovorin calcium by scanning electron microscopy with energy dispersive system
Authors: Mazzeo Marcelo Adrián , Linares Jorge Alberto , López María Marcela , Bachmeier Evelin , Wietz Fernando Martín , Galván Víctor , Valentinuzzi María Cecilia , Riveros José Alberto , Finkelberg Ana
Published: May 2013

This work presents a chemical and morphological analysis of samples of saliva taken from patients who were under treatment with intravenous chemotherapy with 5‐fluorouracil and leucovorin calcium. Samples of saliva were extracted from fifteen patients during the three stages of the treatment: The initial stage (previous to the chemotherapy), the intermediate stage (during the chemotherapy), and the final stage (twenty‐one days after finishing the treatment). An amount of 50 μl was collected in each visit. Chemical contrast images were taken by means of scanning electron microscopy, and X‐ray characteristic spectra were obtained from all the studied samples by using an energy dispersive system from all the studied samples. Images that correspond to the intermediate stage showed important differences with respect to the initial and final stages. In addition, X‐ray spectra provided information about the present elements in saliva and their relative abundance allowed us to determine variations in the chemical composition. The backscattered electron images and X‐ray spectra from the intermediate stage showed clusters of crystals with fluorine content higher than those obtained in initial and final stages. This fact probably indicates the passage of metabolites of 5‐fluorouracil and leucovorin calcium from the plasma to the oral cavity. This finding enhances the hypothesis proposed by other authors about the secondary effects of the drugs on the stomatognathic system such as oral mucositis, dysgeusia, and xerostomia with or without hyposalivation.
Physical and cognitive effort discounting of hypothetical monetary rewards
Authors: Ostaszewski Paweł , Bąbel Przemysław , Swebodziński Bartłomiej
Published: May 2013

Effort discounting refers to the decrease in the subjective value of a reward as the effort required to obtain the reward increases. The main aims of this study were to ascertain whether the amount of the reward affects the steepness of the effort discounting process for hypothetical monetary rewards, to identify whether this steepness depends on the type of effort that is required, and to determine whether the steepness of different types of effort covary at the individual level. Two types of effort were studied under hypothetical choice situations: physical effort and cognitive effort. Both physical and cognitive effort discounting were well described by the hyperbolic model. Large rewards were discounted less steeply than small rewards for both types of effort. This finding agrees with the results of prior studies which have found that larger rewards have greater motivational power. In addition, the steepness of physical effort discounting was positively correlated with the steepness of cognitive effort discounting, which suggests that the effort discounting process is a trait‐like characteristic within an individual.
Successful transendoscopic oesophageal mass ablation in two dogs with Spirocerca lupi associated oesophageal sarcoma
Authors: Yas E. , Kelmer G. , Shipov A. , Ben‐Oz J. , Segev G.
Published: May 2013

This report describes two cases of oesophageal tumours managed by transendoscopic neodymium:yttrium‐aluminum‐garnet laser ablation and polypectomy snare electrocautery. In each dog oesophagoscopy revealed caudal oesophageal masses, suspected to be Spirocerca lupi‐induced oesophageal neoplasia. To resect the masses, transendoscopic neodymium:yttrium‐aluminum‐garnet laser ablation was used in the first case and polypectomy snare electrocautery in the second. Recovery was uneventful. Histopathology was consistent with oesophageal fibrosarcoma and osteosarcoma in each case, respectively. Follow‐up oesophagoscopy revealed apparently healthy oesophageal tissue except for focal scar tissue in the first case. Transendoscopic laser ablation and polypectomy snare electrocautery is a potential non‐invasive, cost effective alternative for surgical oesophageal mass resection.
A Single Sample Method for Estimating Glomerular Filtration Rate in Cats
Authors: Finch N.C. , Heiene R. , Elliott J. , Syme H.M. , Peters A.M.
Published: May 2013

Background

Validated methods of estimating glomerular filtration rate (GFR) in cats requiring only a limited number of samples are desirable.

Hypothesis/Objectives

To test a single sample method of determining GFR in cats.

Animals

The validation population (group 1) consisted of 89 client‐owned cats (73 nonazotemic and 16 azotemic). A separate population of 18 healthy nonazotemic cats (group 2) was used to test the methods.

Methods

Glomerular filtration rate was determined in group 1 using corrected slope‐intercept iohexol clearance. Single sample clearance was determined using the Jacobsson and modified Jacobsson methods and validated against slope‐intercept clearance. Extracellular fluid volume (ECFV) was determined from slope‐intercept clearance with correction for the 1 compartment assumption and by deriving a prediction formula for ECFV (ECFVPredicted) based on the body weight. The optimal single sample method was tested in group 2.

Results

A blood sample at 180 minutes and ECFVPredicted were optimal for single sample clearance. Mean ± SD GFR in group 1 determined using the Jacobsson and modified Jacobsson formulae was 1.78 ± 0.70 and 1.65 ± 0.60 mL/min/kg, respectively. When tested in group 2, the Jacobsson method overestimated multisample clearance. The modified Jacobsson method (mean ± SD 2.22 ± 0.34 mL/min/kg) was in agreement with multisample clearance (mean ± SD 2.19 ± 0.34 mL/min/kg).

Conclusions and Clinical Importance

The modified Jacobsson method provides accurate estimation of iohexol clearance in cats, from a single sample collected at 180 minutes postinjection and using a formula based on the body weight to predict ECFV. Further validation of the formula in patients with very high or very low GFR is required.