bluuebunny/crossref_metadata_2025 huggingface dataset:
Whether in life or in death: fresh perspectives on how plants affect biogeochemical cycling
Authors: Austin Amy T. , Zanne Amy E.
Published: October 2015

Plants have numerous impacts on biogeochemical cycling across both aquatic and terrestrial ecosystems. These effects extend well beyond the critical role of carbon (C) fixation through photosynthesis that provides the basis for ecosystem energy flow. While foliar and root traits of senescent plant material (litter) have been explored in detail in terrestrial ecosystems, there is a resurgence of interest in how plants modulate biogeochemical cycling in ways other than litter quality effects on C and nutrient mineralization.

This Special Feature represents a collection of ‘fresh’ perspectives on how plants alone, or in interaction with other organisms, have important and lasting impacts on biogeochemical cycles of C and nutrients in a range of terrestrial and aquatic environments.

We begin in the open ocean and then peer from the forest edge before moving into forest understoreys and grasslands to examine the control by live terrestrial plants on ecosystem C and nutrient cycling. Plants directly affect biogeochemical cycling while living through their diversity and composition, nutrient capture and strategies for assimilating C, and by altering the microclimate for decomposition. In addition, how they construct their tissues and alter the abiotic environment has large impacts on the turnover of C and nutrients once plants have senesced or died. From the direct impact of plants, we move onto the influence of plant–insect interactions, which effectively determine changes in plant stoichiometry in grasslands of varying diversity. Finally, looking directly in the soil, it is clear that plant–mycorrhizae interactions are important in modulating the response of litter decomposition to nutrient addition and the nature of C metabolism in the soil.

Synthesis. The papers here highlight careful matching between how plants live and their biotic and abiotic contexts. Taken together, it appears that the dynamic, rather than passive, nature of plant responses to variable environments is key in affecting ecosystem level processes of C and nutrient turnover. This Special Feature highlights a diversity of connections between plants and their environment and demonstrates that in both life and death, how plants respond to these changes differs among plant lineages and this diversity will play a central role in determining biogeochemical cycling in the future in aquatic and terrestrial ecosystems.
Skin Perfusion Pressure and the Prevalence of Atherothrombosis in Hemodialysis Patients
Authors: Hiratsuka Maki , Koyama Katsushi , Yamamoto Jun , Narita Aiko , Sasakawa Yuji , Shimogushi Hiroya , Ogawa Atsushi , Kimura Tomomi , Mizuguchi Ken , Mizuno Masashi
Published: October 2015

End‐stage renal disease is associated with atherothrombosis (ATIS), which, in turn, can promote peripheral arterial occlusive disease (PAOD), coronary artery disease (CAD), and/or cerebrovascular disease (CVD). The aim of this study was to determine whether low plantar skin perfusion pressure (SPP) was related to ATIS among 122 patients receiving maintenance hemodialysis (HD) from March to November 2013 at our outpatient facility. We routinely measured SPP and used the value for analysis. In addition, we retrospectively evaluated the prevalence of ATIS with patients categorized to CAD, CVD, or PAOD groups. Of the 122 outpatients, ATIS was diagnosed in about half (N = 60, 49.2% vs. 62, 50.8%; average SPP, 56.6 vs. 72.9 mm Hg, respectively). These data show that SPP was significantly lower in patients with ATIS (difference, 16.3 mm Hg; P < 0.001) and there was a negative relationship between average SPPs and past history of ATIS complications. When the patients were stratified by the presence of diabetes mellitus, this trend was stronger. Particularly, receiver operating characteristic analysis of HD patients with diabetes revealed a cutoff point of 53.0 mm Hg and an area under the curve value of 0.84, with a sensitivity of 77.0% and specificity of 91.3%. Therefore, we concluded that SPP enables the evaluation of not only local PAOD, but also systemic ATIS. Moreover, we found that a cutoff point of 53.0 mm Hg was useful for detection of ATIS in HD patients.
TOWARD A BETTER UNDERSTANDING OF POLITICIZED POLICING ATTITUDES: CONFLICTED CONSERVATISM AND SUPPORT FOR POLICE USE OF FORCE
Authors: SILVER JASON R. , PICKETT JUSTIN T.
Published: October 2015

America is in the midst of an extraordinary public debate about police policy. “Conflicted conservatives,” who are symbolically conservative but operationally liberal, may have a disproportionate influence on policy making. Specifically, conflicted conservatives may be more likely to vote across party lines because they attend more to utilitarian concerns about social conditions and government performance than to symbolic issues. Prior criminological research, however, typically has treated conservatives as a homogenous group. We use data from the General Social Survey to explore the extent and correlates of global and situational support for police use of force among conflicted conservatives and other political groups. The findings from logistic regression models estimated with two analytic samples (N = 11,119 and 2,069) indicate that conflicted conservatives’ attitudes about police use of force are distinct from those of “consistent conservatives” who are both symbolically and operationally conservative, but do not reflect a unique consideration of utilitarian concerns over symbolic beliefs. Two other notable findings emerged: 1) Racial attitudes predicted support for police use of excessive force invariably across political groups and 2) public support for excessive force increased substantially during the first decade of the twenty‐first century, sharply contrasting trends in general punitive sentiment.
An Observational Study of 2,248 Patients Presenting With Headache, Suggestive of Subarachnoid Hemorrhage, Who Received Lumbar Punctures Following Normal Computed Tomography of the Head
Authors: Sayer David , Bloom Ben , Fernando Katalin , Jones Stuart , Benton Sally , Dev Shumontha , Deverapalli Sathish , Harris Tim
Published: October 2015

Objectives

The objective was to determine the incidence of subarachnoid hemorrhage (SAH) diagnosed by lumbar puncture (LP) when the head computed tomography (CT) was reported as demonstrating no subarachnoid blood.

Methods

Data were obtained on patients who received LP to diagnose or exclude SAH attending six hospitals over 5 years. Subsequent investigations and outcomes were reviewed in all patients with LPs that did not exclude SAH.

Results

A total of 2,248 patients were included. A total of 1,898 LPs were suitable for biochemical analysis, of which 92 (4.8%) were positive for blood, suggesting SAH; 1,507 (79.4%) were negative; and 299 (15.6%) were inconclusive. Of the 92 patients with positive cerebrospinal fluid analysis, eight patients (0.4%) had aneurysms on further imaging, and one had a carotid cavernous fistula.

Conclusions

In patients presenting to the emergency department with acute severe headache, LP to diagnose or exclude SAH after negative head CT has a very low diagnostic yield, due to low prevalence of the disease and uninterpretable or inconclusive samples. A clinical decision rule may improve diagnostic yield by selecting patients requiring further evaluation with LP following nondiagnostic or normal noncontrast CT brain imaging.
Do patients discussed at a lung cancer multidisciplinary team meeting receive guideline‐recommended treatment?
Authors: Boxer Miriam M , Duggan Kirsten J , Descallar Joseph , Vinod Shalini K
Published: October 2015

Aim

Clinical guidelines provide evidence‐based management recommendations to guide practice. This study aimed to evaluate whether patients discussed at a lung cancer multidisciplinary team meeting received guideline‐recommended treatment and determine reasons for not receiving guideline‐recommended treatment.

Methods

All new lung cancer patients discussed at the Liverpool/Macarthur lung cancer multidisciplinary team meeting between 1 December 2005 and 31 December 2010 were included. Guideline‐recommended treatment was assigned according to pathology, stage and ECOG (Eastern Co‐operative Oncology Group) performance status as per the 2004 Australian Lung Cancer Guidelines. This was compared with actual treatment received to determine adherence to guidelines. For those patients who did not receive guideline‐recommended treatment, the medical record was reviewed to determine the reason(s) for this. Survival was compared between those who did and did not receive guideline‐recommended treatment.

Results

808 new patients were discussed at the multidisciplinary team meeting. Guideline‐recommended treatment could not be assigned in 2% of patients due to missing data. 435 patients (54%) received guideline‐recommended treatment, and 356 (44%) did not. The most common reasons for not receiving guideline‐recommended treatment were a decline in ECOG performance status (24%), large tumor volume precluding radical radiotherapy (17%), comorbidities (15%) and patient preference (13%). Patients less than 70 years who received guideline‐recommended treatment had improved survival compared with those who did not.

Conclusions

A significant proportion of lung cancer patients did not receive guideline‐recommended treatment due to legitimate reasons. Alternative guidelines are needed for patients not suitable for current best practice. Treatment according to guidelines was a predictor for survival.
The Voters' Curses: Why We Need Goldilocks Voters
Authors: Prato Carlo , Wolton Stephane
Published: October 2015

Scholars have long deplored voters' lack of interest in politics and argued in favor of greater political engagement. We present a formal theory of elections where successful communication of campaign messages requires both effort by candidates and attention from voters. Voters' interest in politics affects their attention and impacts the effectiveness of the electoral process as a screening and disciplining device. In line with existing theories, there exists a curse of the uninterested voter: When voters have little interest in politics, the electoral process performs poorly, and voters' attention to politics is low. Surprisingly, we uncover a curse of the interested voter, by which the same happens when voters have a strong interest in politics. Our results highlight the importance of distinguishing between voters' interest and attention, two notions often conflated in empirical studies. Moreover, policy interventions aimed at subsidizing the cost of acquiring political information can have unintended consequences.
Increased health service use for allergy in adults: Northumbrian hospital episodes, 2010–2015
Authors: Shiue I.
Published: October 2015

Background

Little is known on the health service use for allergy. Therefore, the aim of this study was to investigate the hospital episode rates in allergy by sex and across age groups in order to understand whether and how the health service use for allergy might have changed in recent years in north‐east of England.

Methods

Hospital episode data in mid‐2010 to mid‐2015 covering five full calendar years were extracted from Northumbria Healthcare NHS Foundation Trust, which is serving nearly half of a million population and free from central government control. Hospital episode rates were calculated from all admissions divided by annual and area‐specific population size for each sex and age group, presented with per 100 000 person‐years using Microsoft Excel.

Results

Health service use for allergy in adults for both men and women has increased, with large increases in young adults aged 40–49 (both male and female), 50–59 (female) and 60–69 (male). In children, there were decreases in those aged 0–9, but increases in those aged 10–19. Emergency admissions due to allergy were only minimal. Higher admissions were observed in spring and autumn than in summer and winter.

Conclusion

Allergy admissions have increased in adults. For future research, local health policy could benefit from annual clinical records on health service use due to allergy. For clinical practice, in addition to increasing and improving the role of health and nursing professionals to reduce burden and rehabilitation, public awareness, attitude and knowledge should be continuously raised and improved as well.
Reexamining Healthcare Justice in the Light of Empirical Data
Authors: de Hoyos Adalberto , Monteón Yareni , Altamirano‐Bustamante Myriam M.
Published: October 2015

This article discusses the notion of justice from a capabilities approach. We undertake an empirical analysis of the concepts of justice held by healthcare personnel, gleaned from a qualitative analysis of interviews on the subject of ethical dilemmas in everyday practice. The article states that Justice undoubtedly presents a work in progress, which implicates the link between justice as capability and human dignity.

We empirically found a contrast between the views of justice based on the patient's own perceptions and those based on the perceptions of healthcare personnel. We establish the kind of actions, communication skills and justice required to build a stronger relationship between patients and healthcare professionals, which would improve prognosis, treatment efficiency and therapeutic adhesion.
Burden of Proof in Bioethics
Authors: Koplin Julian J. , Selgelid Michael J.
Published: October 2015

A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof (that this policy should be rejected) falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision‐makers (i.e. policy‐makers) to choose the policy supported by the best reasons.
The complementary use of audience response systems and online tests to implement repeat testing: A case study
Authors: Stratling Rebecca
Published: October 2015

Although learning theories suggest that repeat testing can be highly beneficial for students' retention and understanding of material, there is, so far, little guidance on how to implement repeat testing in higher education. This paper introduces one method for implementing a three‐stage model of repeat testing via computer‐aided formative assessment by employing audience response systems (ARS) and online tests complementarily. The first stage utilises ARS for immediate testing throughout lectures, the second stage facilitates delayed testing using online tests between lectures and the third stage employs ARS to aid in‐class revision of the previously studied material at the beginning of subsequent lectures. Using the example of a Business Economics course taught to MBA students at a UK university, the study investigates how two cohorts of students (n1 = 46, n2 = 48) perceived repeat testing to affect their understanding of the subject as well as their learning motivation and behaviour. The exploratory research indicates that most students perceived all three test stages as helpful to develop their understanding of the subject. However, students who favoured a deep approach to learning (DA) rated testing more positively than students who preferred a surface approach to learning (SA). Surprisingly, students who favoured a DA also reported a greater influence of the tests on their learning motivation and behaviour than students who preferred an SA. These findings mitigate concerns that experienced, effective learners might perceive repeated, multiple‐choice‐based testing as unhelpful or disruptive to their learning.
Distinct kinetics of DNA repair protein accumulation at DNA lesions and cell cycle‐dependent formation of γH2AX‐ and NBS1‐positive repair foci
Authors: Suchánková Jana , Kozubek Stanislav , Legartová Soňa , Sehnalová Petra , Küntziger Thomas , Bártová Eva
Published: October 2015

Background Information

The DNA damage response is a fundamental, well‐regulated process that occurs in the genome to recognise DNA lesions. Here, we studied kinetics of proteins involved in DNA repair pathways and their recruitment to DNA lesions during the cell cycle. In non‐irradiated and irradiated cells, we analysed the distribution pattern and spatiotemporal dynamics of γH2AX, 53BP1, BMI1, MDC1, NBS1, PCNA, coilin and BRCA1 proteins.

Results

We observed that spontaneous and irradiation‐induced foci (IRIF) demonstrated a high abundance of phosphorylated H2AX, which was consistent with 53BP1 and BMI1 protein accumulation. However, NBS1 and MDC1 proteins were recruited to nuclear bodies (NBs) to a lesser extent. Irradiation by γ‐rays significantly increased the number of 53BP1‐ and γH2AX‐positive IRIF, but cell cycle‐dependent differences were only observed for γH2AX‐positive foci in both non‐irradiated and γ‐irradiated cells. In non‐irradiated cells, the G2 phase was characterised by an increased number of spontaneous γH2AX‐foci; this increase was more pronounced after γ‐irradiation. Cells in G2 phase had the highest number of γH2AX‐positive foci. Similarly, γ‐irradiation increased the number of NBS1‐positive NBs only in G2 phase. Moreover, NBS1 accumulated in nucleoli after γ‐irradiation showed the slowest recovery after photobleaching. Analysis of protein accumulation kinetics at locally induced DNA lesions showed that in HeLa cells, BMI1, PCNA and coilin were rapidly recruited to the lesions, 10–15 s after UVA‐irradiation, whereas among the other proteins studied, BRCA1 demonstrated the slowest recruitment: BRCA1 appeared at the lesion 20 min after local micro‐irradiation by UVA laser.

Conclusion

We show that the kinetics of the accumulation of selected DNA repair‐related proteins is protein specific at locally induced DNA lesions, and that the formation of γH2AX‐ and NBS1‐positive foci, but not 53BP1‐positive NBs, is cell cycle dependent in HeLa cells. Moreover, γH2AX is the most striking protein present not only at DNA lesions, but also spreading out in their vicinity.

Significance

Our conclusions highlight the significant role of the spatiotemporal dynamics of DNA repair‐related proteins and their specific assembly/disassembly at DNA lesions, which can be cell type‐ and cell cycle dependent.
Denudation rates of a subequatorial orogenic belt based on estimates of sediment yields: evidence from the Paleozoic Appalachian Basin, USA
Authors: Eriksson Kenneth A. , Romans Brian W.
Published: October 2015

The Upper Mississippian (ca. 325 Ma) Pride Shale and Glady Fork Member in the Central Appalachian Basin comprise an upward‐coarsening, ca. 60‐m‐thick succession of prodeltaic‐delta front, interlaminated fine‐grained sandstones and mudstones gradational upwards into mouth‐bar and distributary‐channel sandstones. Analysis of laminae bundling in the Pride Shale reveals a hierarchy of tidal cycles (semi‐diurnal, fortnightly neap‐spring) and a distinct annual cyclicity resulting from seasonal fluvial discharge. These tidal rhythmites thus represent high‐resolution chronometers that can be used in basin analysis. Annual cycles average 10 cm in thickness, thus the bulk of the Pride Shale‐Glady Fork Member in any one vertical section is estimated to have accumulated in ca. 600 years. Progradational clinoforms are assumed to have had dips of 0.3–3° with a median dip of 1.7°; the latter infilled a NE‐SW oriented foreland trough up to 300 km long by 50 km wide in the relatively short time period of 90 kyr. The total volume of sediment in the Pride basin is ca. 900 km3 which, for an average sediment density of 2700 kg m−3, equates to a total mass of ca. 2.4 × 106 Mt. Thus, mass sediment load can be estimated as 27 Mt yr−1. For a drainage basin area of 89 000 km2, based on the scale of architectural channel elements and cross‐set thicknesses in the incised‐valley‐fill deposits of the underlying Princeton Formation, suspended sediment yields are estimated at ca. 310 t km−2 yr−1 equating to a mechanical denudation rate of ca. 0.116 mm yr−1. Calculated sediment yields and inferred denudation rates are comparable to modern rivers such as the Po and Fly and are compatible with a provenance of significant relief and a climate characterized by seasonal, monsoonal discharge. Inferred denudation rates also are consistent with average denudation rates for the Inner Piedmont Terrane of the Appalachians based on flexural modelling. The integration of stratigraphic architectural analysis with a novel chronometric application highlights the utility of sedimentary archives as a record of Earth surface dynamics.
Regional magma plumbing and emplacement mechanisms of the Faroe‐Shetland Sill Complex: implications for magma transport and petroleum systems within sedimentary basins
Authors: Schofield Nick , Holford Simon , Millett John , Brown David , Jolley David , Passey Simon R. , Muirhead Dave , Grove Clayton , Magee Craig , Murray Joanne , Hole Malcolm , Jackson Christopher A.‐L. , Stevenson Carl
Published: October 2015

The movement of magma through the shallow crust and the impact of subsurface sill complexes on the hydrocarbon systems of prospective sedimentary basins has long been an area of interest and debate. Based on 3D seismic reflection and well data, we present a regional analysis of the emplacement and magmatic plumbing system of the Palaeogene Faroe‐Shetland Sill Complex (FSSC), which is intruded into the Mesozoic and Cenozoic sequences of the Faroe‐Shetland Basin (FSB). Identification of magma flow directions through detailed seismic interpretation of approximately 100 sills indicates that the main magma input zones into the FSB were controlled primarily by the NE–SW basin structure that compartmentalise the FSB into its constituent sub‐basins. An analysis of well data shows that potentially up to 88% of sills in the FSSC are <40 m in thickness, and thus below the vertical resolution limit of seismic data at depths at which most sills occur. This resolution limitation suggests that caution needs to be exercised when interpreting magmatic systems from seismic data alone, as a large amount of intrusive material could potentially be missed. The interaction of the FSSC with the petroleum systems of the FSB is not well understood. Given the close association between the FSSC and potential petroleum migration routes into some of the oil/gas fields (e.g. Tormore), the role the intrusions may have played in compartmentalisation of basin fill needs to be taken fully into account to further unlock the future petroleum potential of the FSB.
Gender and motor competence affects perceived likelihood and importance of physical activity outcomes among 14 year olds
Authors: Hands B. , Parker H. E. , Rose E. , Larkin D.
Published: October 2015

Background

Perceptions of the effects of physical activity could facilitate or deter future participation. This study explored the differences between gender and motor competence at 14 years of age in the perceptions of likelihood and importance of physical activity outcomes.

Method

The sample comprised 1582 14‐year‐old adolescents (769 girls) from the Western Australian Pregnancy Cohort (Raine) Study. Four motor competence groups were formed from a standardized Neuromuscular Developmental Index score (McCarron 1997). Perceptions of the likelihood and the importance of 15 physical activity outcomes were measured by a questionnaire developed for the NSW Schools Fitness and Physical Activity Survey (Booth et al. 1997). Gender (two) × motor competence (four) analyses of variance and Tukey post hoc were conducted on outcome scores (P < 0.02) using SPSS version 17.

Results

Gender differences were found in the perceived likelihood and importance of physical activity outcomes within competition, social friendships and injury domains. Motor competence was significant in the perceived likelihood of physical health (P < 0.001), psychosocial (P < 0.009) and competition (P < 0.002) outcomes, with lower perceptions by the least competent groups. Significantly lower importance was perceived for academic outcomes for 14 year olds categorized with low compared with high motor competence (P < 0.005). Regardless of motor competence and gender, the same health and fun outcomes were ranked the highest in likelihood and the highest in importance.

Conclusion

Although level of motor competence at 14 years affected the perceived likelihood of health, social and fun outcomes from future participation in physical activity, adolescents highly valued these outcomes, whereas gender affected competition and winning, outcomes that were less valued. Physical activity that promotes these key and valued outcomes may encourage young people's ongoing involvement in physical activity, especially for those at risk of low participation.
A peptide mimic blocks the cross-reaction of anti-DNA antibodies with glomerular antigens
Authors: Xia Y , Eryilmaz E , Der E , Pawar R D , Guo X , Cowburn D , Putterman C
Published: October 2015

Anti-DNA antibodies play a pivotal role in the pathogenesis of lupus nephritis by cross-reacting with renal antigens. Previously, we demonstrated that the binding affinity of anti-DNA antibodies to self-antigens is isotype-dependent. Furthermore, significant variability in renal pathogenicity was seen among a panel of anti-DNA isotypes [derived from a single murine immunoglobulin (Ig)G3 monoclonal antibody, PL9-11] that share identical variable regions. In this study, we sought to select peptide mimics that effectively inhibit the binding of all murine and human anti-DNA IgG isotypes to glomerular antigens. The PL9-11 panel of IgG anti-DNA antibodies (IgG1, IgG2a, IgG2b and IgG3) was used for screening a 12-mer phage display library. Binding affinity was determined by surface plasmon resonance. Enzyme-linked immunosorbent assay (ELISA), flow cytometry and glomerular binding assays were used for the assessment of peptide inhibition of antibody binding to nuclear and kidney antigens. We identified a 12 amino acid peptide (ALWPPNLHAWVP, or ‘ALW’) which binds to all PL9-11 IgG isotypes. Preincubation with the ALW peptide reduced the binding of the PL9-11 anti-DNA antibodies to DNA, laminin, mesangial cells and isolated glomeruli significantly. Furthermore, we confirmed the specificity of the amino acid sequence in the binding of ALW to anti-DNA antibodies by alanine scanning. Finally, ALW inhibited the binding of murine and human lupus sera to dsDNA and glomeruli significantly. In conclusion, by inhibiting the binding of polyclonal anti-DNA antibodies to autoantigens in vivo, the ALW peptide (or its derivatives) may potentially be a useful approach to block anti-DNA antibody binding to renal tissue.
Language Experience Affects Grouping of Musical Instrument Sounds
Authors: Bhatara Anjali , Boll‐Avetisyan Natalie , Agus Trevor , Höhle Barbara , Nazzi Thierry
Published: October 2015

Language experience clearly affects the perception of speech, but little is known about whether these differences in perception extend to non‐speech sounds. In this study, we investigated rhythmic perception of non‐linguistic sounds in speakers of French and German using a grouping task, in which complexity (variability in sounds, presence of pauses) was manipulated. In this task, participants grouped sequences of auditory chimeras formed from musical instruments. These chimeras mimic the complexity of speech without being speech. We found that, while showing the same overall grouping preferences, the German speakers showed stronger biases than the French speakers in grouping complex sequences. Sound variability reduced all participants’ biases, resulting in the French group showing no grouping preference for the most variable sequences, though this reduction was attenuated by musical experience. In sum, this study demonstrates that linguistic experience, musical experience, and complexity affect rhythmic grouping of non‐linguistic sounds and suggests that experience with acoustic cues in a meaningful context (language or music) is necessary for developing a robust grouping preference that survives acoustic variability.
Glucose homeostasis after simultaneous pancreas and kidney transplantation: a comparison of subjects with C‐peptide‐positive non‐type 1 diabetes mellitus and type 1 diabetes mellitus
Authors: Chakkera Harini A. , Kudva Yogish C. , Chang Yu‐Hui H. , Heilman Raymond L. , Singer Andrew L. , Mathur Amit K. , Hewitt Winston R. , Khamash Hasan A. , Huskey Janna L. , Katariya Nitin N. , Moss Adyr A. , Behmen Senaida , Reddy Kunam S.
Published: October 2015

Background

While simultaneous pancreas kidney transplant (SPKTx) is a therapeutic option for patients with type 1 diabetes (T1DM) and renal failure, few centers offer SPKTx to “select” non‐T1DM patients. To address concerns that existing insulin resistance may limit the benefits of the pancreas allograft among non‐T1DM, we compared several indices of glucose homeostasis, in “select” non‐T1DM and T1DM patients who received SPKTx.

Methods

Criteria for “select” non‐T1DM included the following: positive C‐peptide, BMI <30 kg/m2, treatment with oral agents before insulin initiation, and insulin at <1 unit/kg/d. We compared several indices of glucose homeostasis within 1 yr post‐SPKTx among seven “select” patients with non‐T1DM and nine patients with T1DM with similar age, BMI, and immunosuppression. Measurements of insulin resistance included the following: homeostatic model, insulin sensitivity index, and insulin–glucose ratio; insulin secretion measures included the following: corrected insulin response.

Results

Non‐T1DM had similar pre‐transplant metabolic (fasting glucose, HbA1c, blood pressure, and lipid) parameters to the T1DM cohort. There were no significant differences in the various measures of insulin resistance and secretion between T1DM and “select” non‐T1DM patients.

Conclusion

Our results suggest SPKTx should be considered in the therapeutic armamentarium among carefully select non‐T1DM with features of minimal insulin resistance; however, a larger cohort with longer follow‐up is needed to confirm our results.
Traumatic dental injuries among 12‐ and 15‐year‐old adolescents in Georgia: results of the pathfinder study
Authors: Bilder Leon , Margvelashvili Vladimer , Sgan‐Cohen Harold , Kalandadze Manana , Levin Liran , Ivanishvili Rusudan , Machtei Eli E.
Published: October 2015

Background

Traumatic dental injuries (TDI) are a widespread pathology with serious dental public health concerns.

Objectives

The aim of this pathfinder study was to collect initial epidemiological data on oral health in Republic of Georgia. As part of this study, the prevalence and severity of TDI in permanent teeth among seventh‐ and tenth‐grade schoolchildren were evaluated.

Methods

Schoolchildren were examined in four schools in the capital city of Tbilisi, two schools in two other major cities, and one school in four additional villages. In addition to demographical data, the following parameters were collected and recorded: Overjet (OJ), lip competence, number and type/location of the teeth with TDI and Type of TDI. The study population comprised of children aged 12 (seventh grade) and 15 years old (10th grade).

Results

A total of 823 7th‐ and 10th‐grade schoolchildren were examined. The overall prevalence of TDI among Georgian population was found to be 10.4% (86 children). The prevalence of TDI was greater in the older age cohort (P < 0.05). Lip posture did not seem to have a marked effect on TDI. Children with an OJ greater than 5 mm were more likely to present with dental injuries compared to children with an OJ equal to or smaller than 5 mm (P < 0.05). Children from rural areas presented with greater prevalence of TDI compared to their urban counterparts (P < 0.05). The maxillary central incisors were the most common teeth to be affected by trauma accounting for 85.2% of the TDI cases. Enamel fracture was the main type of TDI (91.3%).

Conclusions

The prevalence of TDI in Georgian schoolchildren, as presented in this survey, population was found to be rather moderate and involved mainly minor superficial injuries. Rural communities have shown in this report substantial higher rates; thus, educational program might be directed mostly to these regions to children, teachers, and healthcare providers.
Regulating Hedge Funds for Systemic Stability: The EU's Approach
Authors: Johnston Andrew
Published: October 2015

This article offers a critical appraisal of the way in which the EU regulates hedge funds (HFs) in the Alternative Investment Fund Managers Directive (AIFM Directive) and its proposal to regulate the repo markets from which they obtain much of their leverage. It argues that the EU's scheme is not a radical departure from the pre‐crisis market liberalist approach and that its reliance on discretionary intervention is misplaced because it does not take account of the fundamental uncertainty that characterises financial markets. The article outlines the operations of HFs and explores the extent to which they pose a threat to systemic stability, paying particular attention to the use of leverage by HFs. It explores the background to the AIFM Directive and the post‐crisis international consensus on financial regulation and then evaluates the complex division of responsibility for regulating HFs between the national and supranational authorities. Finally, it discusses how HFs should be regulated. Drawing on the work of Minsky, it argues that a leverage cap would have been more likely to prevent HFs contributing to systemic instability than the scheme adopted. Nor are the proposed rules on mandatory ‘haircuts’ in repo markets or the AIFM Directive's rules on remuneration likely to prevent HFs contributing to systemic instability.
Systematic review of the barriers affecting medication adherence in older adults
Authors: Yap Angela Frances , Thirumoorthy Thiru , Kwan Yu Heng
Published: October 2015

Medication adherence is a crucial part in the management of chronic diseases. As older adults form a greater proportion of the population with chronic diseases and multiple morbidities, understanding medication adherence in older adults becomes important. In the present article, we aimed to systematically review the literature for the factors associated with medication adherence in the geriatric population. We carried out a literature search using electronic databases and related keywords. 17 391 articles were reviewed in total. 65 articles were found to be relevant to our objective. A total of 80 factors of five different categories were found to be associated with medication adherence in older adults. The factors, the types of studies and the number of studies that agreed or disagreed were presented. A flower model for medication adherence was also presented to allow clinicians to better understand the complex nature of medication adherence in this population. The 80 factors reviewed were categorized into five main categories; namely, patient factors, medication factors, physician factors, system‐based factors and other factors as factors affecting poor medication adherence in older adults. Clinicians need to be mindful of the complex nature of factors affecting medication adherence in this population to optimize therapeutic outcomes. Clinicians have to be more skillful to discover and to optimize the medication adherence factors in geriatric patients. The flower model is presented as a framework for clinicians to better understand the various factors affecting medication adherence in older adults. Geriatr Gerontol Int 2016; 16: 1093–1101.
Colombian Paramilitaries Since Demobilization: Between State Crackdown and Increased Violence
Authors: Krakowski Krzysztof
Published: October 2015

This article addresses the puzzle of heterogeneous trends in paramilitary violence on the Colombian Pacific Coast since the beginning of the disarmament, demobilization, and reintegration (DDR) process in 2003. The usual explanations derived from political conflict theories are improved with insights from organized crime research. The article argues that the occasional escalation of post-DDR paramilitary violence at the subregional level cannot be explained by the weakness of the state argument. Instead, the article demonstrates the counterintuitive evidence that paramilitary violence correlates positively with the incidence of state repressive intervention against paramilitary groups. More specifically, paramilitaries challenged by the state use more violence, either to replace their nonviolent resources most affected by law enforcement activities or to respond to crackdown-related intensification of predatory tendencies within their respective organizations.
An External Addition of Soy Protein Isolate Hydrolysate to Sourdough as a New Strategy to Improve the Quality of Chinese Steamed Bread
Authors: Liu Xiao , Li Teng , Liu Boyan , Zhao Hongfei , Zhou Fang , Zhang Bolin
Published: October 2015

Soy protein isolate (SPI) was hydrolyzed and then its hydrolysate (Hyd‐SPI) was supplemented to dough. The dough fermented by a starter consisting of Lactobacillus paralimentarius 412 and Anqi's yeast was applied to manufacture Chinese steamed bread. Addition of 1% Hyd‐SPI to dough is found to significantly improve the farinograph and extensograph values. Moreover, 1% Hyd‐SPI stimulates the growth and metabolism of the starter culture better compared with the control and thus improves the sourdough fermentation. The sourdough supplemented with 1% Hyd‐SPI observed by scanning electron microscopy contains starch granules that are largely hydrolyzed. Additionally, the sourdough has more free amino acids than the control. A total of 45 volatile compounds are recognized in the Chinese steamed breads containing 1% Hyd‐SPI. This is the first report that SPI hydrolysate is used to improve the quality of Chinese steamed bread products.

Practical Applications

Chinese steamed bread, as a traditional grain product that is made with sourdough, has been widely consumed in Northern China and many Southeastern Asian countries for its taste and rich nutrition. The better the performance of the sourdough, the better the quality of the Chinese steamed bread. This study uses a hydrolyzed soy protein isolate (Hyd‐SPI) as an external supplement to enhance the fermentation performance and rheological properties of sourdough. Currently, this technique has been extended to local producers for the manufacture of the sourdough‐based steamed bread.
Intervention to Reduce Ventilator‐Associated Pneumonia in Individuals on Long‐Term Ventilation by Introducing a Customized Bundle
Authors: Shitrit Pnina , Meirson Michal , Mendelson Gad , Chowers Michal
Published: October 2015

Objectives

To evaluate the effectiveness of a modified bundle of preventative measures to decrease ventilator‐associated pneumonia (VAP) in chronically ventilated long‐term care facility (LTCF) residents.

Design

Cohort before‐and‐after study.

Setting

Geriatric hospital ward.

Participants

LTCF residents on long‐term ventilation.

Intervention

The modified bundle included hand hygiene before patient care, elevation of the head of the bed to more than 30° for individuals who are supine, chlorhexidine oral care at the beginning of each nursing shift, keeping tracheostomy cannula balloon pressure at 20 to 30 cm H2O, and measuring nasogastric food remnants before every meal for individuals fed through a nasogastric tube.

Measurements

Number of VAP episodes was determined prospectively, and rates were calculated as episodes per 1,000 ventilation days.

Results

VAP rate decreased from 5.97 before the intervention to 2.34 after the intervention (P < .001). The use of broad‐spectrum antibiotics decreased from 1,788 defined daily doses before the intervention to 1,093 after (P = .04).

Conclusion

A modified bundle successfully decreased VAP rates in chronically ventilated elderly LTCF residents.
Concordance Between Anticholinergic Burden Scales
Authors: Naples Jennifer G. , Marcum Zachary A. , Perera Subashan , Gray Shelly L. , Newman Anne B. , Simonsick Eleanor M. , Yaffe Kristine , Shorr Ronald I. , Hanlon Joseph T. ,   the Health, Aging and Body Composition Study
Published: October 2015

Objectives

To evaluate concordance of five commonly used anticholinergic scales.

Design

Cross‐sectional secondary analysis.

Setting

Pittsburgh, Pennsylvania, and Memphis, Tennessee.

Participants

Community‐dwelling adults aged 70 to 79 with baseline medication data from the Health, Aging, and Body Composition Study (N = 3,055).

Measurements

Any anticholinergic use, weighted scores, and total standardized daily dosage were calculated using five anticholinergic measures (Anticholinergic Cognitive Burden (ACB) Scale, Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS), Drug Burden Index anticholinergic component (DBI‐ACh), and Summated Anticholinergic Medications Scale (SAMS)). Concordance was evaluated using kappa statistics and Spearman rank correlations.

Results

Any anticholinergic use in rank order was 51% for the ACB, 43% for the ADS, 29% for the DBI‐ACh, 23% for the ARS, and 16% for the SAMS. Kappa statistics for all pairwise use comparisons ranged from 0.33 to 0.68. Similarly, concordance as measured using weighted kappa statistics ranged from 0.54 to 0.70 for the three scales not incorporating dosage (ADS, ARS, ACB). Spearman rank correlation between the DBI‐ACh and SAMS was 0.50.

Conclusion

Only low to moderate concordance was found between the five anticholinergic scales. Future research is needed to examine how these differences in measurement affect their predictive validity with respect to clinically relevant outcomes, such as cognitive impairment.
Recognition and Management of Hypertension in Older Persons: Focus on African Americans
Authors: Still Carolyn H. , Ferdinand Keith C. , Ogedegbe Gbenga , Wright Jackson T.
Published: October 2015

Hypertension is the most commonly diagnosed condition in persons aged 60 and older and is the single most important risk factor for cardiovascular disease (ischemic heart disease, heart failure, and stroke), kidney disease, and dementia. More than half of individuals with hypertension in the United States are aged 60 and older. Hypertension disproportionately affects African Americans, with all age groups, including elderly adults, having a higher burden of hypertension‐related complications than other U.S. populations. Multiple clinical trials have demonstrated the beneficial effects of blood pressure (BP) reduction on cardiovascular morbidity and mortality, with most of the evidence in individuals aged 60 and older. Several guidelines have recently been published on the specific management of hypertension in individuals aged 60 and older, including in high‐risk groups such as African Americans. Most recommend careful evaluation, thiazide diuretics and calcium‐channel blockers for initial drug therapy in most African Americans, and angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers in those with chronic kidney disease or heart failure. Among the areas of controversy is the recommended target BP in African Americans aged 60 and older. A recent U.S. guideline recommended raising the systolic BP target from less than 140 mmHg to less than 150 mmHg in this population. This article will review the evidence and current guideline recommendations for hypertension treatment in older African Americans, including the rationale for continuing to recommend a SBP target of less than 140 mmHg in this population.
A General Nonlinear Least Squares Data Reconciliation and Estimation Method for Material Flow Analysis
Authors: Kopec Grant M. , Allwood Julian M. , Cullen Jonathan M. , Ralph Daniel
Published: October 2015

The extraction, transformation, use, and disposal of materials can be represented by directed, weighted networks, known in the material flow analysis (MFA) community as Sankey or flow diagrams. However, the construction of such networks is dependent on data that are often scarce, conflicting, or do not directly map onto a Sankey diagram. By formalizing the forms of data entry, a nonlinear constrained optimization program for data estimation and reconciliation can be formulated for reconciling data sets for MFA problems where data are scarce, in conflict, do not directly map onto a Sankey diagram, and are of variable quality. This method is demonstrated by reanalyzing an existing MFA of global steel flows, and the resulting analytical solution measurably improves upon their manual solution.
Loss‐of‐function mutation of serine racemase attenuates excitotoxicity by intravitreal injection of N‐methyl‐D‐aspartate
Authors: Jiang Haiyan , Wang Xianwei , Zhang He , Chang Yuhua , Feng Meiling , Wu Shengzhou
Published: October 2015

Convincing data demonstrate that D‐serine, a racemized product of serine racemase (SR), contributes to neurotoxicity. Furthermore, a line of evidence suggests that SR/D‐serine contributes to retinal neurodegeneration in a diabetic retinopathy rat model and diabetic retinopathy patients. However, the connection between SR/D‐serine and retinal neurodegeneration remains unclear. Herein, we report that intravitreal injection of N‐methyl‐D‐aspartate (NMDA) induces excitotoxicity in rodent retina; this retinal neurodegeneration was attenuated in retina carrying a loss‐of‐function of mutation in Srr, the gene for SR, termed Srrochre269. Under the condition of NMDA injection, either posterior pole or middle – but not peripheral – retina from Srrochre269 mice was found to retain more retinal ganglion cells (RGC) than the counterpart from w/t (RGCs were identified with retrograde labeling). Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining further demonstrated reduced RGC apoptosis from Srrochre269 compared to w/t mice under the condition of NMDA injection. Collectively, our studies demonstrate a pivotal role of SR/D‐serine in retinal neurotoxicity.

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We demonstrated that loss‐of‐function mutation of the gene encoding serine racemase significantly attenuates excitotoxicity in retina; excitotoxicity accounts for retinal ganglion cell (RGC) demise in diabetic retinopathy (DR). We think that our findings deepen the current knowledge of the mechanisms of RGC degeneration.
Insulin Does Not Target CamkIIα Neurones to Critically Regulate the Neuroendocrine Reproductive Axis in Mice
Authors: Evans M. C. , Rizwan M. Z. , Anderson G. M.
Published: October 2015

Insulin signalling in the brain plays an important role in the central regulation of energy homeostasis and fertility, such that mice exhibiting widespread deletion of insulin receptors (InsR) throughout the brain and peripheral nervous system display diet sensitive obesity and hypothalamic hypogonadism. However, the specific cell types mediating the central effects of insulin on fertility remain largely unidentified. To date, the targeted deletion of InsR from individual neuronal populations implicated in the metabolic control of fertility has failed to recapitulate the hypogonadic and subfertile phenotype observed in brain‐specific InsR knockout mice. Because insulin and leptin share similar roles as centrally‐acting metabolic regulators of fertility, we used the Cre‐loxP system to generate mice with a selective inactivation of the Insr gene from the same widespread neuronal population previously shown to mediate the central effects of leptin on fertility by crossing Insr‐flox mice with calcium/calmodulin‐dependent protein kinase type IIα (CamkIIα)‐Cre mice. Multiple reproductive and metabolic parameters were then compared between male and female Insr‐flox/Cre‐positive (CamK‐IRKO) and Insr‐flox/Cre‐negative control mice. Consistent with brain‐specific InsR knockout mice, CamK‐IRKO mice exhibited a mild but significant obesogenic phenotype. Unexpectedly, CamK‐IRKO mice exhibited normal reproductive maturation and function compared to controls. No differences in the age of puberty onset, oestrous cyclicity or fecundity were observed between CamK‐IRKO and control mice. We conclude that the central effects of insulin on the neuroendocrine reproductive axis are not critically mediated via the same neuronal populations targeted by leptin.