bluuebunny/crossref_metadata_2025 huggingface dataset:
Alcohol use disorders and mortality: a systematic review and meta‐analysis
Authors: Roerecke Michael , Rehm Jürgen
Published: April 2013

Aims

To conduct a systematic review and meta‐analysis on all‐cause mortality in people with alcohol use disorders.

Methods

Using the Meta‐analysis Of Observational Studies in Epidemiology (MOOSE) guidelines, studies were identified through MEDLINE, EMBASE, and Web of Science up to August, 2012. Prospective and historical cohort studies including a comparison of alcohol use disorder with a control group investigating all‐cause mortality risk were included.

Results

This meta‐analysis included 81 observational studies with 221 683 observed deaths among 853 722 people with alcohol use disorder. In men, the relative risk (RR) among clinical samples was 3.38 (95% confidence interval [CI]: 2.98–3.84); in women it was 4.57 (95% CI: 3.86–5.42). Alcohol use disorders identified in general population surveys showed a twofold higher risk compared with no alcohol use disorder in men; no data were available for women. RRs were markedly higher for those ≤40 years old (ninefold in men, 13‐fold in women) while still being at least twofold among those aged 60 years or older.

Conclusions

Mortality in people with alcohol use disorders is markedly higher than thought previously. Women have generally higher mortality risks than men. Among all people with alcohol use disorders, people in younger age groups and people in treatment show substantially higher mortality risk than others in that group.
Influence of the Surgical Education and Training programme on the Fellowship Examination
Authors: Beasley Spencer W. , Hardware Narelle
Published: April 2013

Introduction of an increasingly competence‐based Royal Australasian College of Surgeons (RACS) Surgical Education and Training (SET) programme has influenced the nature and conduct of the Fellowship Examination (FEX). The FEX is the final summative assessment taken near the completion of SET training, and is aligned to the other SET assessment processes. It mainly tests two of the nine RACS surgical competencies, focusing on professional judgement and the clinical application of knowledge. It is used to help determine whether candidates are safe to practise unsupervised at consultant level. There have been refinements to a number of the processes including standard setting, blueprinting, developing marking descriptors and improving the reliability and validity of the examination. An Examiners' Training Course has also been introduced.
The significance of pretransplant donor-specific antibodies reactive with intact or denatured human leucocyte antigen in kidney transplantation
Authors: Otten H G , Verhaar M C , Borst H P E , van Eck M , van Ginkel W G J , Hené R J , van Zuilen A D
Published: April 2013

Antibodies recognizing denatured human leucocyte antigen (HLA) can co-react with epitopes on intact HLA or recognize cryptic epitopes which are normally unaccessible to HLA antibodies. Their specificity cannot be distinguished by single antigen beads (SAB) alone, as they carry a mixture of intact and denatured HLA. In this study, we selected pretransplant sera containing donor-specific HLA class I antibodies (DSA) according to regular SAB analysis from 156 kidney transplant recipients. These sera were analysed using a SAB preparation (iBeads) which is largely devoid of denatured HLA class I, and SAB coated with denatured HLA class I antigens. A total of 241 class I DSA were found by regular SAB analysis, of which 152 (63%) were also found by iBeads, whereas 28 (11%) were caused by reactivity with denatured DNA. Patients with DSA defined either by regular SAB or iBeads showed a significantly lower graft survival rate (P = 0·007) compared to those without HLA class I DSA, whereas reactivity to exclusively denatured HLA was not associated with decreased graft survival. In addition, DSA defined by reactivity to class I SAB or class I iBeads occurred more frequently in female patients and in patients with historic HLA sensitization, whereas reactivity to denatured HLA class I was not associated with any of these parameters. Our data suggest that pretransplant donor-specific antibodies against denatured HLA are clinically irrelevant in patients already sensitized against intact HLA.
Calcitonin measurement in aspiration needle washout fluids has higher sensitivity than cytology in detecting medullary thyroid cancer: a retrospective multicentre study
Authors: Trimboli Pierpaolo , Cremonini Nadia , Ceriani Luca , Saggiorato Enrico , Guidobaldi Leo , Romanelli Francesco , Ventura Claudio , Laurenti Oriana , Messuti Ilaria , Solaroli Erica , Madaio Raffaele , Bongiovanni Massimo , Orlandi Fabio , Crescenzi Anna , Valabrega Stefano , Giovanella Luca
Published: April 2013

Objective

Only few studies analysed the capability of cytology in detecting medullary thyroid cancer (MTC), and they reported a low accuracy of this diagnostic technique. Recently, calcitonin (CT) measurement in aspiration needle washout (FNA‐CT) of thyroid and neck lesions has been reported as a sensitive tool for MTC. The aim of this study is to compare the sensitivity of FNA‐CT and cytology in detecting MTC and to assess a cut‐off value of FNA‐CT for clinical practice.

Patients

Thirty‐eight MTC lesions from 36 patients were retrospectively studied, diagnosed and treated in four different centres. Furthermore, 52 nonmedullary lesions from subjects undergone biopsy following increased serum CT were collected as a control group.

Results

Cytology detected MTC in 21/37 lesions with 56·8% sensitivity. The median FNA‐CT value was 2000 pg/ml (range 58–10 000 pg/ml) in MTC and 2·7 pg/ml (range <2–13 pg/ml) in controls (P < 0·001). Using a cut‐off of 39·6 pg/ml, MTC lesions could be identified with 100% sensitivity and specificity. As the most important finding, 14 histologically proved MTC lesions could be detected by FNA‐CT, despite they were cytologically diagnosed as benign or nonconclusive.

Conclusions

This study shows, as the first in a multicentre series, that FNA‐CT sensitivity is higher than that of cytology in diagnosing MTC. To avoid false‐negative MTC by cytology, CT measurement in aspiration needle washout is to be performed in all patients undergoing biopsy following high serum CT.
Supervised surgical training and its effect on the short‐term outcome in laparoscopic colorectal surgery
Authors: Krishna A. , Russell M. , Richardson G. L. , Rickard M. J. F. X. , Keshava A.
Published: April 2013

Aim

Laparoscopic colorectal surgery requires supervised training. In this paper we examine the short‐term outcome following a component‐based training in laparoscopic colorectal surgery.

Method

Surgical outcome following laparoscopic colorectal resection was recorded on a prospective database. Patients were divided into three groups, including those performed by the fellows, those completed by the consultant and those completed by a combination of both. Analysis of data was carried out for all colorectal resections and the subgroup with colorectal cancer.

Results

511 operations were examined between June 2006 and January 2011. There was no statistically significant difference in operating time between fellows and consultants but it was significantly longer for procedures where consultants and fellows performed components. Conversion rate, postoperative morbidity, recovery and length of stay were similar for all three groups for the whole patient cohort and also the subgroup of cancer patients. In the cancer subgroup, there was no difference in the pathological stage in the three groups.

Conclusion

Closely supervised training in laparoscopic colorectal surgery is not associated with any adverse effect on the short‐term outcome.
Neutrophil gelatinase‐associated lipocalin and end‐stage renal disease: it is not all about the kidneys!
Authors: Rau Simon , Habicht Antje , Kauke Teresa , Hillmer Andreas , Wessely Matthias , Stangl Manfred , Guba Markus , Fischereder Michael , Schönermarck Ulf
Published: April 2013

Introduction

Neutrophil gelatinase‐associated lipocalin (NGAL) is a powerful biomarker for the early detection of acute kidney injury. However, recent data suggest that NGAL also plays an important role in chronic kidney disease (CKD), reflecting the level of acute kidney damage within the CKD condition. To study whether elevated NGAL levels in CKD are a consequence of damaged tubular cells or rather due to extrarenal production, we investigated NGAL levels in anephric patients on dialysis.

Methods

Plasma NGAL levels were investigated in 14 dialysis patients who underwent bilateral nephrectomy (anephric group), 18 anuric dialysis patients with remaining kidneys (dialysis group) and 12 healthy patients (healthy group).

Results

Plasma NGAL levels were significantly lower in the healthy group compared with the anephric group (143 vs. 981 ng/mL; P < 0·001) or the dialysis group (143 vs. 838 ng/mL; P < 0·001), respectively. However, NGAL levels did not differ between the anephric group and the dialysis group (981 vs. 838 ng/mL; P = 0·19).

Discussion

Assuming that NGAL is highly expressed in chronically damaged kidneys due to tubular stress, there should be significantly less NGAL in anephric patients compared with anuric dialysis patients with remaining kidneys. In contrast to this hypothesis, we found no difference in NGAL expression between these two groups, proving the entire extrarenal NGAL production in anephric patients and suggesting that the tubular NGAL expression seems to be negligible in anuric dialysis patients.
Interactive effects of life history and season on size‐dependent growth in juvenile Atlantic salmon
Authors: Sigourney Douglas B. , Letcher Benjamin H. , Obedzinski Mariska , Cunjak Richard A.
Published: April 2013

Size‐dependent growth (SDG) is an important process in structuring populations as well as determining life history outcomes. Despite its importance, there have been few investigations from observational studies focusing on the interaction between life history decisions and SDG. In this study, we used data on individually tagged Atlantic salmon from both the laboratory and the field to investigate differences in SDG among two life history groups, parr and smolts. In the laboratory, we found little evidence of SDG in parr but seasonally dependent SDG in the smolt group. Smolts showed at strong compensatory response over the winter months just prior to the smolt transformation window. In the field, we found little evidence of SDG early in ontogeny (i.e., age 0+ fall and winter). There was some evidence of depensatory growth (positive SDG) during the age 1+ spring among both life history groups that may reflect random habitat variation or the monopolisation of resources. After the age 1+ spring, we found that smolts were more likely to show a compensatory effect (negative SDG) than parr. This effect was strongest, as they approached the smolt window in the spring of their age 2+ year. These results suggest (i) SDG is common in Atlantic salmon; however, the form and extent of life history depends on (ii) season and (iii) life history. For individuals that adopt a smolt life history, trade‐offs between freshwater survival and sea survival may lead to a convergent growth pattern, as they approach the smolt migration window.
Regulation of Jealousy Protest in the Context of Reunion Following Differential Treatment
Authors: Hart Sybil L. , Behrens Kazuko Y.
Published: April 2013

Emotion regulation strategies and variation in their presentation were explored toward understanding infants' responses during reunion with mother (Re) following baseline mother–infant interaction (Bl) and differential treatment (DT) episodes. Correlation analyses revealed cohesion among distress and mother‐directed touch and proximity‐seeking during DT and Re, mother‐directed gaze during DT, and resistance during Re. The association between mother‐directed gaze during DT and distress during Re suggests that visual inattention during DT serves as a regulatory strategy. Overall, these linkages yield expanded understanding of jealousy protest as a constellation of responses that endures beyond the eliciting condition and includes regulatory behaviors. Cross‐context comparisons revealed that distress was lower during Re than during DT, but not as low as Bl, suggesting that DT poses challenge to interactive repair. Inquiry into individual variation revealed that distress during Re was augmented in laterborn males and with risk influences of dysregulated fear, and maternal insensitivity and hostility. Conversely, maternal depression was associated with less distress; later judgment as insecure, especially insecure‐avoidance, was associated with less mother‐directed behaviors. These findings suggest that dysregulation following DT is indicated by both resistance and passivity. In sum, the results highlight emotion regulation as a powerful framework for addressing recovery following DT.
Intra‐Articular Use of a Platelet‐Rich Product in Normal Horses: Clinical Signs and Cytologic Responses
Authors: Textor Jamie A. , Tablin Fern
Published: April 2013

Objectives

(1) To report the clinical and synovial effects of a platelet‐rich product (PRPr) in normal equine joints, (2) to assess the persistence of platelets within synovial fluid after intra‐articular injection, (3) to compare responses to different preparations of that product, and (4) to evaluate a gravity filtration system for PRPr preparation in horses.

Study Design

Experimental.

Methods

A platelet‐rich saline product (PRPr) was prepared from 7 normal horses using a proprietary preparation device and was divided into 3 treatments: resting, CaCl2‐activated (23 mM, final), and bovine thrombin‐activated (10 U/mL, final). Each horse had 3 concurrent randomly assigned intra‐articular PRPr treatments administered in their metacarpophalangeal/metatarsophalangeal joints; the fourth limb was injected with saline (0.9% NaCl) solution as a control. Clinical assessments, cytologic analysis of synovial fluid and hemograms were performed at 6, 24, 48, and 96 hours after injection. PRPr composition and growth factor content were analyzed.

Results

The gravity filtration system produced a moderately concentrated PRPr. At 6 and 24 hours, when compared to control values, all PRPr treatments caused a significant increase in synovial WBC concentration (P < .0059) and neutrophil percentage (P < .0005). Bovine thrombin‐activated PRPr injection consistently caused increased effusion scores and periarticular signs. At all time points, the synovial WBC concentration after thrombin‐activated PRPr was significantly greater (P < .001) than for the control, CaCl2‐activated or resting PRPr. Intact platelets could be observed in synovial fluid for up to 5 days after intra‐articular PRPr injection.

Conclusions

Resting and CaCl2‐activated PRPr may be safely used to treat equine joints, but bovine thrombin activation is not recommended at 10 U/mL. A PRPr can be prepared using a gravity filtration system, eliminating the need for centrifugation.
Litter and seed burying alter food availability and foraging efficiency of granivorous birds in the Monte desert
Authors: Cueto Víctor R. , Milesi Fernando A. , Marone Luis
Published: April 2013

We assessed experimentally if the main granivorous bird species that feed on the ground in the central Monte desert are able to detect and consume seeds buried in the soil or trapped within litter. Understanding seed vulnerability to birds allows 1) a better understanding of how seed abundance translates into seed availability, a necessary step to assess seed limitation scenarios, and 2) whether birds alter the distribution of soil seeds through their consumption. Rufous‐collared sparrows found and consumed high proportions of buried seeds, though less seeds were eaten at increasing depths. In contrast, many‐colored chaco‐finches, common diuca‐finches and cinnamon warbling‐finches did not find buried seeds. All bird species fed on every substrate offered but, as a whole, birds reduced by 50% their seed consumption in Prosopis litter, and by 30% in Larrea litter, compared to consumption in bare soil. This effect was less notable for rufous‐collared sparrows, whose ‘double scratch’ foraging method would contribute to its great diet breath and abundance in the Monte desert. As birds do not reach a fraction of seeds buried and trapped by litter, seeds readily available for them may be scarcer than previously estimated through soil seed bank studies. Furthermore, since the four bird species detect and consume seeds from littered microhabitats, seed consumption by them surely affects the seasonal dynamics of the soil seed bank in all microhabitat types of the Monte desert.
The vigilance components of begging and sibling competition
Authors: Dreiss Amélie N. , Calcagno Marco , Brink Valentijn van den , Laurent Aurélie , Almasi Bettina , Jenni Lukas , Roulin Alexandre
Published: April 2013

The conflict between siblings over how parental resources are divided has promoted the evolution of specific behaviour to outcompete each other. Young animals look out for parents’ arrival in order to start begging as quickly as possible, since a rapid begging reaction increases the likelihood of being fed before nestmates. If the young can physically intercept the parents, selection might be operating on the offspring ability to monitor parent arrival (vigilance towards parents) and any sudden modifications in siblings’ behaviour (vigilance towards siblings). To investigate the adaptive value of nestling vigilance in the context of family interactions, we recorded which direction barn owl Tyto alba siblings were facing in 89 two‐chick broods before the first parental feeding visit of the night. Nestlings were more vigilant towards nest entrance than expected by chance suggesting that vigilance towards parents is an important component of sibling competition. When positioned near the nest‐box entrance where parents predictably deliver food, the younger individual (i.e. junior) looked more towards the entrance than its older sibling. Thus, when the likelihood of obtaining a food item is relatively high, juniors are more vigilant than seniors to detect the incoming parent. When positioned at the back of the nest, the senior looked relatively more frequently towards its sibling than the junior did in the same situation. This suggests that when the likelihood of obtaining a food item is relatively low, seniors are more vigilant than juniors to observe their sibling. Because vigilance was not related to hunger level and prey obtaining, we propose the hypothesis that vigilance towards parents and siblings only indirectly influences the outcome of sibling competition.
Exercise and negative energy balance in males who perform mental work
Authors: Lemay V. , Drapeau V. , Tremblay A. , Mathieu M.‐E.
Published: April 2013

What is already known about this subject

Achievement of a stressful mental task leads to increased energy intake over a short period of time.

Given that mental work does not increase energy expenditure, a positive energy balance is observed.

What this study adds

The single fact of waiting and relaxing after mental work does not reduce energy intake.

Thirty minutes of physical activity performed at moderate/high intensity between mental work and a meal is enough to create a energy deficit compare to a situation where the meal directly follows mental work.

Background

Although energy expenditure during mental work is not higher than energy expenditure at rest, a stressful mental task is related to an increase in energy intake. It is suggested that mental work produces physiological changes, thereby influencing food intake.

Objective

Because physical activity can influence hunger, the aim of the study was to determine if the introduction of an active pause could counteract the negative effects of mental work on energy intake and energy balance.

Method

Twelve male students, of normal weight, between 15 and 20 years old were evaluated. All subjects participated in three different sessions realized in a randomized order: (i) without pause = relaxation/mental work/meal; (ii) relaxation pause = mental work/relaxation/meal; and (iii) exercise pause = mental work/exercise/meal. Energy expenditure was measured with indirect calorimetry, energy intake was measured with a cold buffet‐type meal of 40 items, and appetite‐related sensations were measured with visual analogue scales. The effect of introducing an active pause in energy intake and energy balance was studied.

Results

The introduction of an active pause did not influence energy intake; although, higher appetite‐related sensations were observed (16–26 mm on a 150‐mm scale; P < 0.05). After accounting for the energy expenditure related to physical activity, a lower energy balance was measured for the exercise pause visit compared with the visit without a pause (−1137 kJ; P < 0.05).

Conclusion

This study indicates that being active between mental work and a meal could represent a strategy to create a negative energy balance following mental work via an increased energy expenditure and a maintenance of energy intake. Globally, these results could help individuals attain and/or maintain a healthy body weight in a context where mental work is omnipresent.
Association between sweet drink intake and adiposity in Danish children participating in a long‐term intervention study
Authors: Jensen B. W. , Nielsen B. M. , Husby I. , Bugge A. , El‐Naaman B. , Andersen L. B. , Trolle E. , Heitmann B. L.
Published: April 2013

What is already known about this subject

In several studies direct associations between intake of sugar‐sweetened beverages and adiposity have been reported.

However, most previous studies were conducted among Americans and assessed the intake in the sub‐categories of soft drinks and sugar‐sweetened beverages, only, rather than the total intake of sweet drinks.

What this study adds

We examined associations between total intake of sweet drinks and body mass index (BMI) and body fat in a non‐US population.

Using a longitudinal design increased sweet drink consumption was generally unassociated with subsequent change in BMI or sum of four skin‐folds.

Background

In some previous studies direct associations between intake of soft drinks, sugar‐sweetened beverages and adiposity have been reported. The majority of these studies were, however, conducted in the USA and it is uncertain if the results are applicable to non‐US countries.

Objective

To assess the association between sweet drink intake at age 6 and 9 years and the subsequent 3‐ to 7‐year changes in body mass index (BMI) and sum of four skin‐folds (Σ4SF).

Methods

Information on sweet drink intake (7 days food record) and physical activity (accelerometer) was obtained at age 6 years (n = 366) [Correction made here after initial online publication.] and 9 years (n = 269). Weight, height and Σ4SF were measured at age 6, 9 and 13 years. Additional information on socio‐economic status, maternal BMI and pubertal status was obtained.

Results

No associations were observed between sweet drink intake at age 6 years and change in BMI or logΣ4SF from age 6 to 9 years or 6 to 13 years. Also, no associations were observed between change in sweet drink intake from age 6 to 9 years and subsequent change in BMI or logΣ4SF from age 9 to 13 years. A weak direct association was observed between sweet drink intake at age 9 years and change in logΣ4SF from age 9 to 13 years (per 100 g ∼ 3.38 fl oz) (β: 0.014, 95% confidence interval [CI]: −0.001 to 0.029, P = 0.06), while no association was seen for BMI. In supplementary analyses a similar association was observed for soft drinks (β: 0.087, 95% CI: 0.048 to 0.126, P = 0.001) but only in the intervention group.

Conclusion

We observed associations between intake of sweet drinks and soft drinks and change in skin‐fold thickness in a group of Danish children. However, as the associations did not remain significant when multiple testing was considered or was only significant among children from the intervention group, the results do not confirm or refute the direct association reported in previous studies.
Differences in generosity between smokers and nonsmokers in an upcoming smoking ban
Authors: Lueke Adam , Fitzgerald Carey J. , Wickwire John , Welton Craig
Published: April 2013

The stigmatization of smokers has become a social norm as new information about its health effects continues to be uncovered. This study investigated smokers in terms of their generosity as a means of stigma management. A field study was undertaken in which the experimenters frequented local establishments in the eight days prior to the 2010 Michigan antismoking legislation taking effect. Experimenters, sometimes while smoking and sometimes while not smoking, approached patrons of the establishments who were either smokers or nonsmokers and asked them for a dollar. Results indicated smokers were more likely to give a dollar than nonsmokers, regardless of whether or not the experimenters were smoking. This was interpreted as a strategy smokers use to combat social stigma.
The effects of periodontal treatment on pregnancy outcomes
Authors: Michalowicz Bryan S. , Gustafsson Anders , Thumbigere‐Math Vivek , Buhlin Kåre
Published: April 2013

Background

Preterm infants are at greater risk than term infants for physical and developmental disorders. Morbidity and mortality increases as gestational age at delivery decreases. Observational studies indicate an association between poor periodontal health and risk for preterm birth or low birthweight, making periodontitis a potentially modifiable risk factor for prematurity.

Aim

To identify randomized controlled trials (RCTs) published between January 2011 and July 2012 and discuss all published RCTs testing whether periodontal therapy reduces rates of preterm birth and low birthweight.

Methods

Search of databases including PubMed, ISI Web of Science and Cochrane Library.

Results

The single RCT identified showed no significant effect of periodontal treatment on birth outcomes.

Discussion

All published trials included non‐surgical periodontal therapy; only two included systemic antimicrobials as part of test therapy. The trials varied substantially in terms of sample size, obstetric histories of subjects, study preterm birth rates and the periodontal treatment response. The largest trials – also judged to be high‐quality and at low risk of bias – have yielded consistent results, and indicate that treatment does not alter rates of adverse pregnancy outcomes.

Conclusion

Non‐surgical periodontal therapy, scaling and root planing, does not improve birth outcomes in pregnant women with periodontitis.
Periodontitis and systemic diseases: a record of discussions of working group 4 of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases
Authors: Linden Gerry J. , Herzberg Mark C. ,   working group 4 of the joint EFP/AAP workshop
Published: April 2013

Background

There has been an explosion in research into possible associations between periodontitis and various systemic diseases and conditions.

Aim

To review the evidence for associations between periodontitis and various systemic diseases and conditions, including chronic obstructive pulmonary disease (COPD), pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer, and to document headline discussions of the state of each field. Periodontal associations with diabetes, cardiovascular disease and adverse pregnancy outcomes were not discussed by working group 4.

Results

Working group 4 recognized that the studies performed to date were largely cross‐sectional or case‐control with few prospective cohort studies and no randomized clinical trials. The best current evidence suggests that periodontitis is characterized by both infection and pro‐inflammatory events, which variously manifest within the systemic diseases and disorders discussed. Diseases with at least minimal evidence of an association with periodontitis include COPD, pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer. The working group agreed that there is insufficient evidence to date to infer causal relationships with the exception that organisms originating in the oral microbiome can cause lung infections.

Conclusions

The group was unanimous in their opinion that the reported associations do not imply causality, and establishment of causality will require new studies that fulfil the Bradford Hill or equivalent criteria. Precise and community‐agreed case definitions of periodontal disease states must be implemented systematically to enable consistent and clearer interpretations of studies of the relationship to systemic diseases. The members of the working group were unanimous in their opinion that to develop data that best inform clinicians, investigators and the public, studies should focus on robust disease outcomes and avoid surrogate endpoints. It was concluded that because of the relative immaturity of the body of evidence for each of the purported relationships, the field is wide open and the gaps in knowledge are large.
Hepatopancreas and Gonad Quality of Chinese Mitten Crabs Fattened with Natural and Formulated Diets
Authors: Shao Luchang , Wang Chun , He Jie , Wu Xugan , Cheng Yongxu
Published: April 2013

After 42 days of feeding on either a Huayi formulated diet (HY) or trash fish (TF), the hepatopancreas and gonad quality of the Chinese mitten crab, Eriocheir sinensis were compared. The hepatosomatic index (HSI), gonadosomatic index (GSI) and proximate composition of both genders were similar. There were no significant differences in the total collagen content in the hepatopancreas between both dietary treatments, but collagen content was dramatically higher in the ovaries compared to the testes. Diets had no significant effect on the free amino acid content (FAA) of the hepatopancreas and gonads, but gender significantly affected the contents of certain amino acids. Compared to females, the hepatopancreas and gonads of males had significantly higher docosahexaenoic acid (DHA), long‐chain polyunsaturated fatty acids (ΣLcPUFA), omega‐3 polyunsaturated fatty acids (Σn‐3PUFA) content as well as DHA/eicosapentaenoic acid (EPA), n‐3/n‐6‐values.

Practical Applications

Trash fish (TF), which are considered as standard food for fattening Eriocheir sinensis in China, have many disadvantages: they vary greatly in nutritional quality, decay rapidly and are not convenient to store over long periods. Thus, alternate supplies of cost‐efficient, easily‐modified and practical diets are highly preferred. To our knowledge, no study exists that has used formulated diets to find their effects on the product quality of the hepatopancreas and gonads on a commercial scale. The current study showed that the formulated diet could completely replace TF in fattening mitten crab without affecting hepatopancreas or gonad quality, and could provide an answer to the controversy over the use of formulated diets or TF for crab farmers. Various indices in this study also suggested that the hepatopancreas and gonads could be beneficial for human health and would be suitable for processing into different crab products.
Chemical, Functional and Sensory Properties of Carob Juice
Authors: Rababah Taha M. , Al‐u'datt Muhammad , Ereifej Khalil , Almajwal Ali , Al‐Mahasneh Majdi , Brewer Susan , Alsheyab Fawzi , Yang Wade
Published: April 2013

The chemical, functional and sensory properties of carob juice compared with grape juice were evaluated. Composition results showed that carob pods contained high concentrations of carbohydrate and phytochemicals, moderate amounts of proteins and fiber, and low amounts of fat and ash. Phytochemical results showed that carob particle and powder juices had significantly higher total phenolic (19.8 and 20.3 mg gallic acid equivalent [GAE]/g, respectively) and tannin (4.3 and 4.5 mg catechin equivalents [CE]/g, respectively) contents than grape juice (6.2 mg GAE/g and 0.43 mg CE/g), while grape juice was higher in IC50 (10.8 mg/mL) than carob particles and powder juices (9.1 and 9.4 mg/mL, respectively). Descriptive results showed minor differences between grape and carob juices. In terms of consumer evaluation, the carob juices were similar to grape juice despite small differences especially in carob particle juice. Although carob juice is not traditionally considered as grape juice, it was found to be of acceptable overall quality.

Practical Applications

Carob is produced by the evergreen sclerophyllous trees (Ceratonia siliqua L.), which are considered typical plants of Mediterranean countries. World production is estimated at about 315,000 tons per year. The carob pods are rich in carbohydrates, polyphenolic compounds, and antioxidant and free radical‐scavenging compounds and contain low amounts of insoluble dietary fibers, protein, minerals and lipids. Nowadays, the primary uses of the pods are as animal feed. For humans, carob pods have been used primarily in traditional foods such as confectioneries, beverages, bread or pasta in a few countries in the Mediterranean region because of their low price. Carob pods could be expected to produce high‐quality juice, which is acceptable to consumers with potential functional food impact. Thus, the present investigation evaluates the functional and sensory properties of newly developed carob juice.
Comparison of Cost‐Effectiveness of Vitamin D Screening with That of Universal Supplementation in Preventing Falls in Community‐Dwelling Older Adults
Authors: Lee Richard H. , Weber Thomas , Colón‐Emeric Cathleen
Published: April 2013

Objectives

To compare the cost‐effectiveness of population screening for vitamin D insufficiency with that of universal vitamin D supplementation in community‐dwelling older adults.

Design

A Markov decision model simulating follow‐up over a 36‐month period. Published data were used to estimate values for the model, including costs (measured in 2011 U.S. dollars), utilities (measured in quality‐adjusted life years (QALYs)), and probabilities.

Setting

Decision analysis simulation from a societal perspective.

Participants

Hypothetical cohort of community‐dwelling women and men aged 65 to 80.

Measurements

Net monetary benefit (NMB) was calculated by subtracting the incremental cost of the strategy from the product of incremental QALYs and willingness‐to‐pay threshold. A higher NMB indicates greater cost‐effectiveness.

Results

In women aged 65 to 80, population screening was slightly more cost‐effective than universal supplementation, with an incremental NMB of $224 compared with $189 (P < .001). Population screening in men was also more cost‐effective than universal supplementation (incremental NMB $298 vs $260, P < .001). Results differed according to age group. In those aged 65, population screening had cost‐effectiveness similar to that of universal supplementation in women ($59 vs $71) and men ($114 vs $120), whereas in those aged 80, population screening was substantially more cost‐effective than universal supplementation in women ($563 vs $428) and men ($703 vs $571).

Conclusion

Population screening and universal supplementation for vitamin D insufficiency are cost‐effective strategies in community‐dwelling older women and men. In the oldest old, population screening may be more cost‐effective than universal supplementation.
Nutritional screening of elderly patients: a health improvement approach to practice
Authors: Farrer K. , Donaldson E. , Blackett B. , Lloyd H. , Forde C. , Melia D. , Lal S.
Published: April 2013

Introduction

Almost 60% of elderly care in‐patients are at risk of malnutrition. Malnourished patients have poorer clinical outcomes and this is a key factor with respect to prolonging the length of stay. Since 2003, the Malnutrition Universal Screening Tool (MUST) has been advocated as a method for identifying these at‐risk patients. Screening should take place on admission; however, the Trust has set a stretch target of aiming to document the score accurately within 6 h of admission.

Methods

Three ‘care of the elderly’ wards participated in the project. Each month, the timeliness (within 6 h of admission) and accuracy (compared to a dietician assessment) of the MUST scores on the wards were reviewed. Plan–Do–Study–Act cycles were used to rapidly test changes in the ward areas. Tests included a study day, one‐to‐one ward‐based nutrition training, a focus on the use of alternative anthropometric measurements, the development of a training pack and the identification of the challenges for undertaking accurate and timely assessments.

Results

Baseline data identified that a MUST was documented in <60% of patients within 6 h of admission and that only 70% were accurate. After implementation of the change package, all the wards achieved an improvement and documented MUST within 6 h of admission; one ward achieved 90% accuracy in the scores.

Conclusions

Ward teams receiving training and monthly feedback of their results creates ownership, momentum and maintains enthusiasm for striving to reach stretch targets. The team continues to work on improving accurate nutritional screening across the Trust by using quality improvement methodologies.
ON THE POPULATION DENSITY DISTRIBUTION ACROSS SPACE: A PROBABILISTIC APPROACH
Authors: Epifani Ilenia , Nicolini Rosella
Published: April 2013

Working within a Bayesian parametric framework, we develop a novel approach to studying the distribution of regional population density across space. By exploiting the Gamma distribution, we are able to introduce heterogeneity across space without incurring ana prioridefinition of territorial units. Our contribution also permits the inclusion of an approximation of individual preferences as a further driving force in location choices. We perform an empirical application to the case of Massachusetts. Our results demonstrate that a subjective measure of distance performs well in replicating the population distribution across Massachusetts.
Primate laterality and the biology and evolution of human handedness: a review and synthesis
Authors: Fitch W. Tecumseh , Braccini Stephanie N.
Published: April 2013

We review evidence for and against lateralization of manual control, communication, visual processing, and auditory processing in nonhuman primates. Compared to humans and some other vertebrate species, manual specialization in nonhuman primates is relatively weak. A right‐bias in chimpanzees may exist, but is so weak that many studies using simple tasks fail to reveal it. Slightly stronger biases may exist in baboons and chimpanzees for communicative signals in the manual and facial domains. Several studies have found robust visual side biases that depend on the object being viewed, in primates including chimpanzees. Evidence for lateralization of auditory processing remains inconclusive. We conclude that the robust, species‐wide lateralization that exists in humans is unusual, and perhaps unique among primates, and discuss several possible evolutionary explanations for this strong asymmetry. In particular, we consider the hypothesis that preexisting hemispheric asymmetry for perception and language processing drove the evolution of human handedness.
Dendritic cells and their role in periodontal disease
Authors: Wilensky A , Segev H , Mizraji G , Shaul Y , Capucha T , Shacham M , Hovav A‐H
Published: April 2013

T cells, particularly CD4+ T cells, play a central role in both progression and control of periodontal disease, whereas the contribution of the various CD4+ T helper subsets to periodontal destruction remains controversial, the activation, and regulation of these cells is orchestrated by dendritic cells. As sentinels of the oral mucosa, dendritic cells encounter and capture oral microbes, then migrate to the lymph node where they regulate the differentiation of CD4+ T cells. It is thus clear that dendritic cells are of major importance in the course of periodontitis, as they hold the immunological cues delivered by the pathogen and the surrounding environment, allowing them to induce destructive immunity. In recent years, advanced immunological techniques and new mouse models have facilitated in vivo studies that have provided new insights into the developmental and functional aspects of dendritic cells. This progress has also benefited the characterization of oral dendritic cells, as well as to their function in periodontitis. Here, we provide an overview of the various gingival dendritic cell subsets and their distribution, while focusing on their role in periodontal bone loss.
Continuity in care trajectories of older chronically ill patients in a battlefield of competing rationales
Authors: Kjerholt Mette , Wagner Lis , Delmar Charlotte , Clemensen Jane , Lindhardt Tove
Published: April 2013

Background

Continuity is crucial when caring for older chronically ill patients. Research has shown that the integration of patients' own perspectives on their situation is of utmost importance for continuity and quality of care. Studies have, however, demonstrated a number of problems with health professionals' communication concerning older patients, leading to lack of continuity and integration of the patient perspective in care and treatment. In spite of these problems being well investigated, they continue to prevail.

Objectives

To examine conditions for continuity and integration of the patient perspective in older, chronically ill patients' care as reflected in nursing staff's communication about the patients.

Design

Explorative Participatory Action Research (PAR).

Setting

An acute, general medical ward at a Danish university hospital.

Participants

Hospital and municipality nurses (n = 29). Nursing records (n = 12).

Method

Field studies: observations, interviews, nursing records audits and logs. Data were subject to manifest and latent content analysis.

Results

Participants were aware of the importance of ensuring continuity, a comprehensive approach and integration of the patient perspective in care trajectories of older, chronically ill patients. Although they adhered to these ideals, they rarely pursued them in practice. Hindering factors were: organisational values, episodic focus on patients and lack of time. They felt caught in a value conflict between nursing professional values and system values, which caused a feeling of powerlessness, maintaining status quo in their clinical practice.

Conclusion

The prevailing episodic focus and the competing rationales on the ward constituted a barrier to continuity and integration of the patient perspective in a comprehensive way.

Implications for practice

In order to change actual practice management and staff must demand and act on a practice based on professional nursing values, for instance by using PAR due to the empowered and innovative processes involved.
Bridging the gap between localization and diagnosis of peripheral pulmonary nodules
Authors: Akulian Jason
Published: April 2013

See article, page 784
Are Reports of Life Event Stress among Suicidal Youth Subject to Cognitive Bias?
Authors: Hartley Chelsey M. , Grover Kelly E. , Pettit Jeremy W. , Morgan Sharon T. , Schatte Dawnelle J.
Published: April 2013

Severity of depressive symptoms, hopelessness, and suicidal ideation were examined to determine whether they were significantly associated with the accuracy of suicidal adolescents' ratings of stressful life events. The sample included 130 inpatient adolescents who endorsed suicide‐related behaviors. Stress interviews were administered, and the severity of stressful events was rated separately by adolescents and an independent team. A residualized cognitive bias score was created by regressing adolescents' severity ratings to the independent team's severity ratings of the same events. Depressive symptoms, but not hopelessness or suicidal ideation, were significantly associated with cognitive bias scores. A negative cognitive bias in adolescents' reports of life stress may be present at higher levels of depression relative to minimal levels of depression. Further research on the relations between stress and suicide‐related behaviors is encouraged to include independent ratings of stress severity.
Multiple Sluicing in English?
Authors: Lasnik Howard
Published: April 2013

Several cases have been discovered where syntactic violations seem to be “repaired” by sluicing. One such case is repair of island violations, first observed by Ross (1969). Another is situations in which a normally obligatory movement fails to apply and the derivation is seemingly salvaged by ellipsis. Another potential instance of repair by ellipsis involves cases where an element moves although it should not have, but the violation is seemingly ameliorated by sluicing. That type is the focus of this article. In particular, English does not generally allow multiplewh‐movement, but under some circumstances it seems to allow multiple sluicing. I explore the properties of this apparent multiple sluicing in English and argue instead for a rightward movement account of the secondwh‐expression, especially based on “Right Roof” effects and on a constraint on P‐stranding.
An approach to estimate Lower Jurassic seawater oxygen‐isotope composition using δ18O and Mg/Ca ratios of belemnite calcites (Early Pliensbachian, northern Spain)
Authors: Armendáriz Maider , Rosales Idoia , Bádenas Beatriz , Piñuela Laura , Aurell Marc , García‐Ramos José Carlos
Published: April 2013

Palaeotemperature estimates from the oxygen‐isotope compositions of belemnites have been hampered by not knowing ancient seawater isotope compositions well enough. We have tackled this problem using Mg/Ca as a proxy for temperature and here, we present a ~2 Ma record of paired Mg/Ca and δ18O measurements of Jurassic (Early Pliensbachian) belemnites from the Asturian basin as a palaeo‐proxy of seawater oxygen‐isotope composition. From the combined use of the two approaches, we suggest a δ18Ow composition of about −0.1‰ for the Jamesoni–Ibex zones. This value may have been increased by about 0.6‰ during the Davoei Zone due to the effect of waters with a different δ18Ow composition. These findings illustrate the inaccuracy of using a globally homogeneous ice‐free value of δ18Ow = −1‰ for δ18Ocarb‐based palaeotemperature reconstructions. Our data suggest that previous palaeotemperatures calculated in the region from δ18O values of belemnites may have been underestimated as the seawater oxygen isotopic composition could have been higher.
Automated Manufacturing Planning Approach Based on Volume Decomposition and Graph-Grammars
Authors: Fu Wentao , Eftekharian Ata A. , Campbell Matthew I.
Published: April 2013

A new graph grammar based reasoning is proposed to reason about the manufacturability of 3D solid models. The knowledge captured in the graph grammar rules serves as a virtual machinist in its ability to recognize arbitrary geometries and match them to various machining operations. For a given part, its 3D CAD geometry is first decomposed into multiple subvolumes, where each is assumed to be machined in one operation. The decomposed part is then converted into a graph so that the graph-grammar rules can perform further reasoning and determine the machining details. A candidate plan is a feasible sequence of all of the necessary machining operations needed to manufacture this part. For each operation, the rules determine the face on the part that the tool enters, the type of tools used, the type of machine used, and how the part is fixed within the machine. If a given geometry is not machinable, the rules will fail to find a complete manufacturing plan for all of the subvolumes. As a result of this reasoning, designers can quickly get insights into how a part can be made and how it can be improved (e.g., change features to reduce time and cost) based upon the feedback of the rules. A variety of tests on this algorithm on both simple and complex engineering parts show its effectiveness and efficiency.