bluuebunny/crossref_metadata_2025 huggingface dataset:
The quality of internal medicine hospital care during summer holiday season
Authors: Sipilä Jussi , Kauko Tommi , Kytö Ville , Stormi Teija , Rautava Päivi
Published: April 2014

Rationale, aims and objectives

The July/August Phenomenon is a period when the quality of care in hospitals is thought to decrease due to summer vacation stand‐ins and new staff. The results of studies on the veracity of this claim have been conflicting. This study investigates the situation in internal medicine.

Methods

Registry data of patients treated in internal medicine wards between 1 July 2000 and 30 November 2009 were obtained and analysed.

Results

There were no differences in mortality during the July admissions compared with those in November when adjusting for age, diagnosis, gender and year [for the overall data risk ratio (RR) = 1.10, 95% confidence interval (CI) 1.00–1.23, P = 0.06; for the university hospitals RR = 1.10, 95% CI 0.91–1.33, P = 0.34; for the non‐university hospitals RR = 1.10, 95% CI 0.97–1.26, P = 0.13]. The duration of admission (overall mean 4.5, standard deviation 6.0) was equal between July and November when adjusted for age, diagnosis, gender and year in all groups (overall data: RR = 1.00, 95% CI 0.99–1.02, P = 0.83; university hospitals RR = 1.02, 95% CI 0.99–1.04, P = 0.13; non‐university hospitals RR = 1.00, 95% CI 0.98–1.01, P = 0.67).

Conclusions

The quality of care in Finnish internal medicine wards in July seems to equal November. Our results do not support the existence of a July Phenomenon in Finland.
Financial consequences of the implementation of a rapid response system on a surgical ward
Authors: Simmes Friede , Schoonhoven Lisette , Mintjes Joke , Adang Eddy , van der Hoeven Johannes G.
Published: April 2014

Rationale, aims and objectives

Rapid response systems (RRSs) are recommended by the Institute for Healthcare Improvement and implemented worldwide. Our study on the effects of an RRS showed a non‐significant decrease in cardiac arrest and/or unexpected death from 0.5% to 0.25%. Unplanned intensive care unit (ICU) admissions increased significantly from 2.5% to 4.2% without a decrease in APACHE II scores. In this study, we estimated the mean costs of an RRS per patient day and tested the hypothesis that admitting less severely ill patients to the ICU reduces costs.

Methods

A cost analysis of an RRS on a surgical ward, including costs for implementation, a 1‐day training programme for nurses, nursing time for extra vital signs observation, medical emergency team (MET) consults and differences in unplanned ICU days before and after RRS implementation. To test the hypothesis, we performed a scenario analysis with a mean APACHE II score of 14 points instead of the empirical 17.6 points for the unplanned ICU admissions, including 33% extra MET consults and 22% extra unplanned ICU admissions.

Results

Mean RRS costs were €26.87 per patient‐day: implementation €0.33 (1%), training €0.90 (3%), nursing time spent on extended observation of vital signs €2.20 (8%), MET consults €0.57 (2%) and increased number of unplanned ICU days after RRS implementation €22.87 (85%). In the scenario analysis mean costs per patient‐day were €10.18.

Conclusions

The costs for extra unplanned ICU days were relatively high but the remaining RRS costs were relatively low. The ‘APACHE II 14’ scenario confirmed the hypothesis that costs for the number of unplanned ICU days can be reduced if less severely ill patients are referred to the ICU. Based upon these findings, our hospital stimulates earlier referral to the ICU, although further implementation strategies are needed to achieve these aims.
Intensive care unit readmission prevention checklist: is it worth the effort?
Authors: Smischney Nathan J. , Cawcutt Kelly A. , O'Horo John C. , Sevilla Berrios Ronaldo A. , Whalen Francis X.
Published: April 2014

Rationale, aims and objectives

Checklists have been adopted by various institutions to improve patient outcomes. In particular, readmission prevention checklists may be of potential value to improve patient care and reduce medical costs. As a result, a prior quality improvement study was conducted to create an intensive care unit readmission prevention checklist. The previous pilot demonstrated zero readmissions when the readmission prevention checklist was utilized but yielded low compliance (30%). Thus, a subsequent quality initiative was undertaken to refine the readmission prevention checklist with the primary aim of improved compliance while maintaining a reduced readmission rate that was observed with the original quality improvement study.

Method

A single‐centre, cross‐sectional study for assessing baseline data and a prospective observational study to assess the effectiveness of a refined readmission prevention checklist tool in a 20‐bed tertiary medical‐surgical intensive care unit at an academic medical centre in Rochester, MN was conducted. Medical patients admitted through the emergency department, upon direct transfer from outside facility, and post‐operative surgical patients at our institution were included. A refined readmission prevention checklist tool was administered during an 8‐week pilot period for medical and post‐operative surgical patients.

Results

The refined readmission prevention checklist resulted in an even lower compliance (10.5%) from the initial phase likely resulting from utilization of a paper readmission prevention checklist in an electronic medical environment. Moreover, the refined readmission prevention checklist demonstrated a 22% unplanned readmission rate for patients in which the tool was utilized.

Conclusions

In conclusion, the findings of the current quality improvement study may serve to rethink the process of health care delivery that applies paper tools in an electronic medical environment.
Medication administration accuracy: using clinical observation and review of patient records to assess safety and guide performance improvement
Authors: Gunningberg Lena , Pöder Ulrika , Donaldson Nancy , Leo Swenne Christine
Published: May 2014

Rationale, aims and objectives

Medication‐related errors are common and can occur at every step of the medication process. The aim was to explore (1) the extent to which nurses perform fundamental safe practices related to medication administration (MA); (2) the frequency and characteristics of MA errors; and (3) the clinical significance of medication types (classes) subject to error.

Methods

A descriptive, exploratory cross sectional design with point in time sampling was used combining direct observations, conducted by naïve observers, and medical record review. A convenience sample of three adult surgical units was drawn from a 1000‐bed university hospital. Seventy‐two patient–nurse MA encounters were observed including 306 MA doses based on a minimum sample of 100 doses per unit. The Medication Administration Accuracy Assessment developed by the Collaborative Alliance for Nursing Outcomes in the United States was used.

Results

Observed adherence to MA safe practices varied between units. Identity control (9%), explaining medication to patient (11%) and medication labelled throughout the process (25%) were found to be safe practices with greatest deviation. 18% of doses involved a MA error (n = 54). Wrong time (9%) was the most common MA error, typically involving analgesics.

Conclusions

Given recent reports suggesting MA safe practices are strongly associated with MA errors, it is timely to strengthen RN awareness of the critical role of safe practices in MA safety. In nursing education, clinical examination using the six safe practices studied herein may enhance medication administration accuracy.
Sclerostin in Institutionalized Elderly Women: Associations with Quantitative Bone Ultrasound, Bone Turnover, Fractures, and Mortality
Authors: Amrein Karin , Dobnig Harald , Wagner Doris , Piswanger‐Sölkner Claudia , Pieber Thomas R. , Pilz Stefan , Tomaschitz Andreas , Dimai Hans Peter , Fahrleitner‐Pammer Astrid
Published: April 2014

Objectives

To evaluate the association between levels of circulating sclerostin (an emerging biomarker and important regulator of bone formation) and laboratory parameters of bone and mineral metabolism, bone mineral density and quality measured using quantitative ultrasound (QUS), fracture risk, and mortality.

Design

Prospective cohort study.

Setting

Austrian nursing homes (N = 95).

Participants

Female nursing home residents aged 70 and older (mean 84 ± 6; N = 539).

Measurements

Serum sclerostin, bone turnover markers, and bone mineral density and quality were measured at baseline. Participants were followed for clinical fractures and all‐cause mortality.

Results

Partial correlation analysis adjusted for age, weight, and renal function revealed a significant positive correlation between sclerostin levels and calcaneal stiffness and radial and phalangeal speed of sound (all P < .01) and a significant negative correlation between sclerostin levels and osteocalcin, serum C‐terminal telopeptide of type I collagen, and parathyroid hormone (PTH; P < .05). After a mean follow‐up of 27 ± 8 months, 139 participants (26%) had died and 64 had a hip or other nonvertebral fracture (12%). Sclerostin was not predictive of mortality. In women with a negative fracture history, it was significantly but not linearly associated with fracture risk.

Conclusion

In institutionalized elderly women, there is a significant relationship between serum sclerostin levels and QUS indices, bone turnover, and PTH, but sclerostin was not strongly associated with important clinical outcomes. Thus, it remains unclear whether sclerostin is a clinically useful predictor of fractures or mortality, at least in this setting.
Association Between Hearing Impairment and Self‐Reported Difficulty in Physical Functioning
Authors: Chen David S. , Genther Dane J. , Betz Joshua , Lin Frank R.
Published: April 2014

Objectives

To determine whether hearing impairment, defined by using objective audiometry, is associated with multiple categories of self‐reported physical functioning in a cross‐sectional, nationally representative sample of older adults.

Design

Multivariate secondary analysis of cross‐sectional data.

Setting

The 2005–06 and 2009–10 cycles of the National Health and Nutrition Examination Survey.

Participants

Adults aged 70 and older who completed audiometric testing (N = 1,669).

Measurements

Hearing was measured using pure‐tone audiometry. Physical functioning was assessed using a structured interview.

Results

In a model adjusted for age and demographic and cardiovascular risk factors, greater hearing impairment (per 25 dB hearing level (HL)) was associated with greater odds of physical disability in activities of daily living (odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.1–1.9), instrumental activities of daily living (OR = 1.6, 95% CI = 1.2–2.2), leisure and social activities (OR = 1.5, 95% CI = 1.1–2.0), lower extremity mobility (OR = 1.4, 95% CI = 1.1–1.7), general physical activities (OR = 1.3, 95% CI = 1.1–1.6), work limitation (OR = 1.4, 95% CI = 1.0–1.9), walking limitation (OR = 1.6, 95% CI = 1.3–2.0), and limitation due to memory or confusion (OR = 1.4, 95% CI = 1.1–1.8). Hearing impairment was not associated with limitations in amount or type of work done (OR = 1.2, 95% CI = 1.0–1.6).

Conclusion

Hearing impairment in older adults is independently associated with greater disability and limitations in multiple self‐reported categories of physical functioning.
Electronic Health Record Adoption among Obstetrician/Gynecologists in the United States: Physician Practices and Satisfaction
Authors: Raglan Greta B. , Margolis Benyamin , Paulus Ronald A. , Schulkin Jay
Published: April 2014

Implementation of electronic health records (EHRs) has historically been lower among obstetrician‐gynecologists (ob‐gyns) than many physician groups. This study described ob‐gyns’ adoption and use of EHR systems in practice, as well as barriers and benefits to implementation. Surveys asking about the physicians’ use of EHR, satisfaction with systems, and what features they found most or least helpful were mailed to 1,200 ob‐gyns. An overall response rate of 57.4% was achieved, with 559 returning completed surveys. Over three‐quarters of responders reported that they used an EHR system or planned to implement one. Physicians without EHR tended to be older, were more likely to be male, have a solo practice, and describe themselves as Asian/Pacific Islander. Over 63% of those physicians who use EHR reported being satisfied with their system, while 30.8% were not satisfied. Ob‐gyns who reported satisfaction had a younger mean age (M = 52.98, SD = 8.87) than those not satisfied (M = 56.30, SD = 8.59; p = .002). Use of EHR systems among ob‐gyns has increased in recent years and overall satisfaction with these systems is high. In spite of this, barriers to implementation are still present and increased outreach to certain groups of ob‐gyns, including older practitioners and those in solo practices, is needed.
Utilizing Electronic Health Record Information to Optimize Medication Infusion Devices: A Manual Data Integration Approach
Authors: Chuk Amanda , Maloney Robert , Gawron Joyce , Skinner Colin
Published: April 2014

Health information technology is increasingly utilized within healthcare delivery systems today. Two examples of this type of technology include the capture of patient‐specific information within an electronic health record and intravenous medication infusion devices equipped with dose error reduction software known as drug libraries. Automatic integration of these systems, termed intravenous (IV) interoperability, should serve as the goal toward which all healthcare systems work to maximize patient safety. For institutions lacking IV interoperability, we describe a manual approach of querying the electronic health record to incorporate medication administration information with data from infusion device software to optimize drug library settings. This approach serves to maximize utilization of available information to optimize medication safety provided by drug library software.
Clumsiness in fine motor tasks: evidence from the quantitative drawing evaluation of children with Down Syndrome
Authors: Vimercati S. L. , Galli M. , Stella G. , Caiazzo G. , Ancillao A. , Albertini G.
Published: April 2014

Introduction

Drawing tests are commonly used for the clinical evaluation of cognitive capabilities in children with learning disabilities. We analysed quantitatively the drawings of children with Down Syndrome (DS) and of healthy, mental age‐matched controls to characterise the features of fine motor skills in DS during a drawing task, with particular attention to clumsiness, a well‐known feature of DS gross movements.

Methods

Twenty‐three children with DS and 13 controls hand‐copied the figures of a circle, a cross and a square on a sheet. An optoelectronic system allowed the acquisition of the three‐dimensional track of the drawing. The participants' posture and upper limb movements were analysed as well.

Results

Results showed that the participants with DS tended to draw faster but with less accuracy than controls.

Discussion

While clumsiness in gross movements manifests mainly as slow, less efficient movements, it manifests as high velocity and inaccurate movements in fine motor tasks such as drawing.
Impaired development of fetal serotonergic neurons in intrauterine growth restricted baboons
Authors: Ye Wenrui , Xie Lynn , Li Cun , Nathanielsz Peter W. , Thompson Brent J.
Published: April 2014

Background

Famine and poor maternal nutrition have been associated with an increased risk for offspring developing psychiatric disorders later in life. Interestingly, impaired serotonergic signaling has been implicated in the etiology of multiple psychiatric conditions.

Methods

We studied development of the fetal serotonergic central nervous system in a baboon, non‐human primate model of intrauterine growth restriction (IUGR).

Results and Conclusions

Fetal (90% of full‐term) IUGR brains were comparable in size to controls, but have reduced expression of serotonergic proteins and mRNAs, as well as having fewer serotonergic neurons.
SHIV susceptibility changes during the menstrual cycle of pigtail macaques
Authors: Kersh Ellen N. , Henning Tara , Vishwanathan Sundaram A. , Morris Monica , Butler Katherine , Adams Debra R. , Guenthner Patricia , Srinivasan Priya , Smith James , Radzio Jessica , Garcia‐Lerma J. Gerardo , Dobard Charles , Heneine Walid , McNicholl Janet
Published: April 2014

Background

Hormonal changes during menstrual cycling may affect susceptibility to HIV.

Methods

We determined the simian human immunodeficiency virus (SHIV) acquisition time point in 43 cycling pigtail macaques infected by repeated vaginal virus exposures initiated randomly in the cycle.

Results

SHIV infection was first detected in the follicular phase in 38 macaques (88%), and in the luteal phase in five macaques (12%), indicating a statistically significant timing difference. Assuming a 7‐day eclipse phase, most infections occurred during or following a high‐progesterone period associated with menstruation, vaginal epithelium thinning, and suppressed mucosal immunity.

Conclusions

This raises questions whether other high‐progesterone conditions (pregnancy, hormonal contraception) similarly affect HIV risk.
Heat shock protein 70 induction by valproic acid delays photoreceptor cell death by N‐methyl‐N‐nitrosourea in mice
Authors: Koriyama Yoshiki , Sugitani Kayo , Ogai Kazuhiro , Kato Satoru
Published: April 2014

Retinal degenerative diseases (RDs) are a group of inherited diseases characterized by the loss of photoreceptor cells. Selective photoreceptor loss can be induced in mice by an intraperitoneal injection of N‐methyl‐N‐nitrosourea (MNU) and, because of its selectivity, this model is widely used to study the mechanism of RDs. Although it is known that calcium‐calpain activation and lipid peroxidation are involved in the initiation of cell death, the precise mechanisms of this process remain unknown. Heat shock protein 70 (HSP70) has been shown to function as a chaperone molecule to protect cells against environmental and physiological stresses. In this study, we investigated the role of HSP70 on photoreceptor cell death in mice. HSP70 induction by valproic acid, a histone deacetylase inhibitor, attenuated the photoreceptor cell death by MNU through inhibition of apoptotic caspase signals. Furthermore, HSP70 itself was rapidly and calpain‐dependently cleaved after MNU treatment. Therefore, HSP70 induction by valproic acid was dually effective against MNU‐induced photoreceptor cell loss as a result of its anti‐apoptotic actions and its ability to prevent HSP70 degradation. These findings might help lead us to a better understanding of the pathogenic mechanism of RDs.

image

Retinal degenerative diseases are characterized by the loss of photoreceptor cells. We proposed the following cascade for N‐methyl‐N‐nitrosourea (MNU)‐induced photoreceptor cell death: MNU gives rise to cleavage of heat shock protein 70 (HSP70); HSP70 induction by valproic acid (VPA) is dually effective against MNU‐induced photoreceptor cell loss because of its anti‐apoptotic actions and its ability to prevent HSP70 degradation. We hope that the present study heralds a new era in developing therapeutic tools against retinal degenerative diseases.
The Potential for Consumer Segmentation in the Finnish Housing Market
Authors: GIBLER KAREN M. , TYVIMAA TANJA
Published: April 2014

This article examines whether cluster analysis can be used to identify groups of Finnish residents with similar housing preferences. Because homebuilders in Finland have been providing relatively homogeneous products to an increasingly diverse population, current housing may not represent the occupiers' preferences so a segmentation approach relying on socioeconomic characteristics and expressed preferences may not be sufficient. We use data collected via questionnaire in a principal component analysis followed by a hierarchical cluster analysis to determine whether different combinations of housing attributes are important to groups of residents. We can identify four clusters of housing residents based on important characteristics when looking for a house. The clusters describe Finnish people in different phases of the life cycle and with different preferences based on their recreational activities and financial expenditures. Mass customization of housing could be used to better appeal to these different clusters of consumers who share similar preferences, increasing consumer satisfaction and improving profitability.
Masticatory efficiency in complete denture wearers with reduced dental arches – a randomised cross‐over study
Authors: Iegami C. M. , Barbosa W. F. , Furuyama R. J. , Lima J. R. B. , de Campos T. T. , Minagi S. , Tamaki R.
Published: April 2014

One obstacle to placing artificial posterior teeth in manufacturing complete dentures is a reduction of the space between the maxilla and the mandible. Occasionally, second molar placement is not performed, as it does not affect aesthetics, phonetics or comfort. The aim of this study was to compare the masticatory efficiency between patients wearing maxillary and mandibular complete dentures with reduced dental arches (without second molars) (WSM) and with full dental arches (FDA). Twenty subjects were divided into two groups and randomly received new complete dentures. Patients in Group 1 were given dentures WSM, and those in Group 2 were given dentures with FDA. After the post‐placement visits, an initial masticatory efficiency test was performed with Optocal, an artificial test food. Fifteen days later, second molars were placed in Group 1 and removed from Group 2, and a new test was performed. Comminuted material was treated and sieved under vibration. The mean and standard deviation of masticatory efficiency with FDA were 10·4 and 8·1, respectively. In the tests WSM, the mean and standard deviation were 8·4 and 3·3, respectively. After removing the second molars in Group 2 and adding them in Group 1, the mean and standard deviation were 15·7 and 14·7 for Group 1 and 12·5 and 10·4 for Group 2, respectively. Within the limitations of this study, placing artificial teeth up to the first molars can be performed when needed without compromising masticatory efficiency.
Molecular Evidence for the Association of Tomato leaf curl Gujarat virus with a Leaf Curl Disease of Phaseolus vulgaris L.
Authors: Kamaal Naimuddin , Akram Mohammad , Agnihotri Aniruddha Kumar
Published: April 2014

A leaf curl disease with symptoms typical of begomoviruses was observed in bean (Phaseolus vulgaris) at the Main Research Farm of the Indian Institute of Pulses Research, Kanpur, India. Infected plants had severe distortion of leaves and the plants were unproductive. PCR indicated the involvement of French bean leaf curl virus (JQ866297), a recently described Begomovirus, and Tomato leaf curl Gujarat virus (ToLCGV). The full‐length genome of ToLCGV associated with leaf curl disease of bean was 2757 nucleotides long and had maximum identity (97–98%) with seven isolates of ToLCGV (AY234383, AF449999, EU573714, GQ994098, AY190290, FR819708, AF413671) and is designated as Tomato leaf curl Gujarat virus‐(IN:Knp:Bean:2013) (KF440686). To the best of our knowledge, this is the first record of ToLCGV infecting a leguminous host, P. vulgaris.
Development of a Loop‐Mediated Isothermal Amplification Assay to Detect Fusarium oxysporum
Authors: Lu Chenchen , Dai Tingting , Zhang HaiFeng , Wang YuanChao , Zheng XiaoBo
Published: April 2014

We report the development of a loop‐mediated isothermal amplification (LAMP) assay targeting the CYP51C element for visual detection of F. oxysporum which caused Fusarium wilt in soybean. The CYP51C‐LAMP assay efficiently amplified the target gene in 60 min at 62°C. And specificity was evaluated against F. oxysporum, Fusarium spp. and other fungal species. The detection limit of the CYP51C‐specific LAMP assay for F. oxysporum was four conidia per gram soil. The assay also detected F. oxysporum from inoculated soybean tissues and residues. These results suggest that this CYP51C‐LAMP assay can be used to detect residues on plants in the field.
Penetration Behaviour of Venturia nashicola, Associated with Hydrogen Peroxide Generation, in Asian and European Pear Leaves
Authors: Jiang Shan , Park Pyoyun , Ishii Hideo
Published: April 2014

The penetration behaviour of the pathogen Venturia nashicola, which causes scab disease in Asian pears, was studied at the ultrastructural and cytochemical levels in host and non‐host leaves. We show, for the first time, that before V. nashicola penetrated the cuticle of the epidermis of the pear leaf, the appressorial bottom of the pathogen invaginated to form a cavity that contains electron‐dense material. The leaf cuticle beneath the cavity also became highly electron dense following penetration by V. nashicola. The location of these electron‐dense materials at the sites of penetration of the pathogen into plant cell walls suggests that they might be related to enzymes capable of degrading cell walls and that the cavities might be needed for successful penetration of leaves by V. nashicola. The generation of hydrogen peroxide (H2O2) was observed in penetration‐related infection structures of V. nashicola, such as appressorial bottoms, infection sacs, penetration pegs and necks of subcuticular hyphae regardless of whether the interaction of V. nashicola with pear plants was compatible or incompatible. Nonetheless, more H2O2 was generated at the sites of the structures in scab‐inoculated susceptible leaves than that in scab‐inoculated resistant ones. Furthermore, the decrease in the level of H2O2 generation following treatment with the antioxidant ascorbic acid partially prevented the penetration of the cuticle. Therefore, the generation of H2O2 from the penetration‐related structures might be a pathogenicity factor that contributes to strengthening the penetration peg of V. nashicola.
Conjectures Concerning Cross-Sex Hormone Treatment of Aging Transsexual Persons
Authors: Gooren Louis , Lips Paul
Published: April 2014

Introduction

Guidelines for cross-sex hormone treatment of transsexual people are now in place. However, little attention has been paid to the issue of treatment suitability for older people. Does existing treatment need to be adapted as subjects age, and does it make a difference if treatment is only started when the subject is already older?

Aim

To assess the necessity of adapting cross-sex hormone administration for elderly transsexual people.

Main Outcome Measures

Risks/benefits of continued use of cross-sex hormones with regard to bone health, cardiovascular risks, and malignancies.

Methods

Due to lack of data on the subject population, sex hormone treatment of other conditions in older non-transsexual people has been taken as the best available analogy to determine the extent to which these might be applicable to comparable transsexual persons. Findings in transsexual people receiving cross-sex hormone treatment sometimes modified the above approach of applying guidelines for the elderly to the aging transsexual population.

Results

Testosterone administration to female-to-male transsexual persons (FtoM) carries little risk with regard to cardiovascular disease and cancer. For those with high hematocrit or cardiac insufficiency the dose can be reduced. Administration of estrogens to male-to-female transsexual persons (MtoF), particularly when combined with progestins, does significantly increase the risk of developing cardiovascular disease (almost a twofold incidence compared with the general population). This may require dose adjustment or changing from oral to safer transdermal estrogens. Tumors of the breasts, prostate and pituitary may occur. In FtoM, breast cancer can occur even after breast ablation. Older subjects can commence cross-sex hormone treatment without disproportionate risks.

Conclusion

Cross-sex hormones may be continued into old age but monitoring for cardiovascular disease and malignancies, both of the old and new sex, is recommended. MtoF will have more health complications in old age than FtoM requiring adaptations of treatment.
Hepatitis E infection in HIV‐infected liver and kidney transplant candidates
Authors: Sherman K. E. , Terrault N. , Barin B. , Rouster S. D. , Shata M. T.
Published: April 2014

Hepatitis E virus (HEV) has been reported to cause acute and chronic hepatitis in those with HIV infection and among solid organ transplant recipients in Europe. Limited data indicate that HEV is endemic in the United States, but the prevalence and significance of HEV infection among those with HIV and awaiting solid organ transplantation is unknown. We evaluated anti‐HEV IgM and IgG antibodies and HEV RNA in 166 HIV‐infected solid organ transplant candidates enrolled in the NIH HIV‐Transplant Cohort. Overall prevalence of anti‐HEV IgG approached 20% in both liver and renal transplant candidates. Evidence of recent infection was present in approximately 2% of liver transplant candidates and none of the kidney transplant candidates. HEV RNA was not detected in any patient. We conclude that markers of HEV infection are frequent among candidates for transplantation, but active, ongoing viremia is not seen. Evidence of recent infection (acute on chronic) liver disease was present in liver but not kidney recipients.
Predictive value of serum actin‐free Gc‐globulin for complications and outcome in acute liver failure
Authors: Bagchi A. , Kumar S. , Ray P. C. , Das B. C. , Gumma P. K. , Kar P.
Published: April 2014

This prospective study was designed to evaluate whether early changes in actin‐free Gc‐globulin levels were associated with complications and outcomes and to identify factors associated with persistent low actin‐free Gc‐globulin levels in acute liver failure (ALF). Thirty‐two consecutive ALF patients admitted from October 2011 to December 2012 were followed up until death or complete recovery. All had serum actin‐free Gc‐globulin estimation at admission and at day three or expiry. Logistic regression analysis was performed to identify independent predictors of mortality. A receiver operating characteristic curve analysis was also performed. Nonsurvivors had significantly lower median actin‐free Gc‐globulin levels than survivors (87.32 vs 180 mg/L; P < 0.001). A receiver operating characteristic curve analysis revealed an area under curve (AUC) of 0.771 and showed that serum actin‐free Gc‐globulin level of ≤124 mg/L would predict mortality with 92% sensitivity and 71.4% specificity. Patients with lower serum actin‐free Gc‐globulin levels and decreasing trend in serum actin‐free Gc‐globulin levels were found to have more mortality and developed more complications. Logistic regression analysis showed that serum actin‐free Gc‐globulin, total leucocyte count and serum creatinine at admission were independent predictors of mortality. Incorporating these variables, a score predicting mortality risk at admission was derived. The scoring system was compared to MELD score and King's College Criteria as individual predictor of mortality. Serum actin‐free Gc‐globulin level at presentation is predictive of outcome and can be used for risk stratification. Its persistent low‐level predicts mortality and is correlated with various complications.
Transitions in the Labour Market: Discouragement Effect and Individual Characteristics
Authors: Baussola Maurizio , Mussida Chiara
Published: April 2014

The present work analyses the unemployment gender gap in Italy for the period 2004–11. We present a methodology for decomposing the natural rate of unemployment, thus defining it in terms of equilibrium labour market flows between the aggregate states of the labour market (Employment, Unemployment, Inactivity). In addition, we offer estimates of the determinants of the unemployment gender gap to pinpoint the relative role of individual characteristics and structural factors in determining this difference.
Lunar meteorite, Dhofar 1428: Feldspathic breccia containing KREEP and meteoritic components
Authors: Hidaka Yoshihiro , Yamaguchi Akira , Ebihara Mitsuru
Published: April 2014

We have studied the feldspathic lunar meteorite Dhofar 1428 chemically and petrologically to better understand the evolution of the lunar surface. Dhofar 1428 is a feldspathic regolith breccia derived from the lunar highland. Bulk chemical and mineral compositions of Dhofar 1428 are similar to those of other feldspathic lunar meteorites. We found a few clasts of evolved lithologies, such as K‐rich plagioclases and quartz monzogabbro. Dhofar 1428 contains approximately 1 wt% of chondritic materials like CM chondrite on the basis of abundances of platinum group elements (Ru, Rh, Pd, Os, Ir, and Pt).
Hydrothermal origin of hexagonal CaAl2Si2O8 (dmisteinbergite) in a compact type A CAI from the Northwest Africa 2086 CV3 chondrite
Authors: Fintor Krisztian , Park Changkun , Nagy Szabolcs , Pál‐Molnár Elemér , Krot Alexander N.
Published: April 2014

We report an occurrence of hexagonal CaAl2Si2O8 (dmisteinbergite) in a compact type A calcium‐aluminum‐rich inclusion (CAI) from the CV3 (Vigarano‐like) carbonaceous chondrite Northwest Africa 2086. Dmisteinbergite occurs as approximately 10 μm long and few micrometer‐thick lath‐shaped crystal aggregates in altered parts of the CAI, and is associated with secondary nepheline, sodalite, Ti‐poor Al‐diopside, grossular, and Fe‐rich spinel. Spinel is the only primary CAI mineral that retained its original O‐isotope composition (Δ17O ~ −24‰); Δ17O values of melilite, perovskite, and Al,Ti‐diopside range from −3 to −11‰, suggesting postcrystallization isotope exchange. Dmisteinbergite, anorthite, Ti‐poor Al‐diopside, and ferroan olivine have 16O‐poor compositions (Δ17O ~ −3‰). We infer that dmisteinbergite, together with the other secondary minerals, formed by replacement of melilite as a result of fluid‐assisted thermal metamorphism experienced by the CV chondrite parent asteroid. Based on the textural appearance of dmisteinbergite in NWA 2086 and petrographic observations of altered CAIs from the Allende meteorite, we suggest that dmisteinbergite is a common secondary mineral in CAIs from the oxidized Allende‐like CV3 chondrites that has been previously misidentified as a secondary anorthite.
Dynamic Modeling for Development and Education: From Concepts to Numbers
Authors: Van Geert Paul
Published: May 2014

The general aim of the article is to teach the reader how to transform conceptual models of change, development, and learning into mathematical expressions and how to use these equations to build dynamic models by means of the widely used spreadsheet program Excel. The explanation is supported by a number of Excel files, which the reader can download at
www.paulvangeert.nl/articles_appendices.htm. The article begins with a discussion of how to define variables in the context of modeling and the difference with the context of measurement. It proceeds with a simple dynamic model to give the reader a general idea, and continues with an explanation of the extended logistic model, which can be conceived of as a building block of more complex growth models pertaining to learning and development. The final section discusses the building of a concrete developmental model, answering the question of why girls like pink.
Specific domains of plant defensins differentially disrupt colony initiation, cell fusion and calcium homeostasis in Neurospora crassa
Authors: Muñoz Alberto , Chu Meiling , Marris Peter I. , Sagaram Uma S. , Kaur Jagdeep , Shah Dilip M. , Read Nick D.
Published: April 2014

MsDef1 and MtDef4 from Medicago spp. are small cysteine‐rich defensins with potent antifungal activity against a broad range of filamentous fungi. Each defensin has a hallmark γ‐core motif (GXCX3–9C), which contains major determinants of its antifungal activity. In this study, the antifungal activities of MsDef1, MtDef4, and peptides derived from their γ‐core motifs, were characterized during colony initiation in the fungal model, Neurospora crassa. These defensins and their cognate peptides inhibited conidial germination and accompanying cell fusion with different potencies. The inhibitory effects of MsDef1 were strongly mediated by the plasma membrane localized sphingolipid glucosylceramide. Cell fusion was selectively inhibited by the hexapeptide RGFRRR derived from the γ‐core motif of MtDef4. Fluorescent labelling of this hexapeptide showed that it strongly bound to the germ tube plasma membrane/cell wall. Using N. crassa expressing the Ca2+ reporter aequorin, MsDef1, MtDef4 and their cognate peptides were each shown to perturb Ca2+ homeostasis in specific and distinct ways, and the disruptive effects of MsDef1 on Ca2+ were mediated by glucosylceramide. Together, our results demonstrate that MsDef1 and MtDef4 differ markedly in their antifungal properties and specific domains within their γ‐core motifs play important roles in their different modes of antifungal action.
Genetic differentiation among coastal and offshore common bottlenose dolphins, Tursiops truncatus, in the eastern North Pacific Ocean
Authors: Lowther‐Thieleking Janet L. , Archer Frederick I. , Lang Aimee R. , Weller David W.
Published: April 2014

Common bottlenose dolphins (Tursiops truncatus) are found worldwide in temperate and tropical regions, often occurring as distinct coastal and offshore ecotypes. Along the west coast of the United States, two stocks are recognized for management based on morphological and photo‐identification studies: a California coastal stock, estimated at 450–500 individuals, and a California/Oregon/Washington offshore stock of about 1,000 animals. This study is the first to analyze genetic differentiation between these stocks. We examined both the hypervariable portion of the mitochondrial DNA (mtDNA) control region and fifteen microsatellite markers for coastal (n = 64) and offshore (n = 69) dolphins. Significant genetic differentiation was found between the two stocks for mtDNA (ΦST = 0.30, P < 0.001; FST = 0.14, P < 0.001) and microsatellite loci (FST = 0.19, P < 0.001). Coastal dolphins had less genetic diversity than offshore dolphins. Further substructuring within the offshore stock was not detected. The level of genetic differentiation between the coastal and offshore dolphins is consistent with long‐term separation and reinforces recognizing them as separate stocks. These findings are particularly important for management of the smaller, less genetically diverse, coastal stock that is vulnerable to a variety of anthropogenic threats.
Survival and abundance of short‐finned pilot whales in the archipelago of Madeira, NE Atlantic
Authors: Alves Filipe , Dinis Ana , Nicolau Cátia , Ribeiro Cláudia , Kaufmann Manfred , Fortuna Caterina , Freitas Luís
Published: April 2014

Estimates of population parameters for the short‐finned pilot whale, Globicephala macrorhynchus, are scarce in literature, contributing to an International Union for Conservation of Nature (IUCN) status of Data Deficient. In this study, photo‐identification data collected over 7 yr from Madeira were used to estimate for the first time survivorship, capture probability, and abundance in this species using mark‐recapture methodology. The Cormack‐Jolly‐Seber model estimated that the adult island‐associated (i.e., resident and regular visitor) whales had a constant survival rate of 0.960 (95% CI: 0.853–0.990) and an annual capture probability varying between 0.372 (CI: 0.178–0.619) and 0.843 (CI: 0.619–0.947). A parameterization of the Jolly‐Seber model estimated that 140 island‐associated whales (CI: 131–151) used the area throughout the course of the study. Based on a closed population model, the most precise (lower CV) annual estimate of the total number of pilot whales using the southern and eastern waters of Madeira (~900 km2) in a 3 mo period covering summer/autumn was 334 animals (CI: 260–437). No trend was observed. Despite including biases, the approach used in this study provided plausible estimates of population parameters, which can contribute to the regional conservation strategies.
Asymmetric Quantile Persistence and Predictability: the Case of US Inflation
Authors: Manzan Sebastiano , Zerom Dawit
Published: April 2014

This article investigates the evidence of time‐variation and asymmetry in the persistence of US inflation. We compare the out‐of‐sample performance of different forecasting models and find that quantile forecasts from an Auto‐Regressive (AR) model with level‐dependent volatility are at least as accurate as the forecasts of the Quantile Auto‐Regressive model, in particular for the core inflation measures. Our results indicate that the persistence of core inflation has been relatively constant and high, but it declined for the headline inflation measures. We also find that the asymmetric persistence of inflation shocks can be mostly attributed to the positive relation between inflation level and its volatility.
Influence of age of onset on limbic and paralimbic structures in depression
Authors: Jaworska Natalia , MacMaster Frank P. , Yang Xiao‐Ru , Courtright Allegra , Pradhan Sarah , Gaxiola Ismael , Cortese Filomeno , Goodyear Bradley , Ramasubbu Rajamannar
Published: April 2014

Aim

Major depressive disorder (MDD) onset during childhood/adolescence is associated with a greater illness burden and distinct clinical profile. However, limited research exists on the effect of age of MDD onset on volumetric abnormalities in para/limbic structures during adulthood.

Methods

Subgenual anterior cingulate cortex (sgACC), hippocampus and caudate nucleus volumes were measured by manual tracing in depressed individuals (n = 45) and healthy controls (HC; n = 19). Volumetric comparisons were carried out between HC and MDD patients divided into those with pediatric (≤18 years; n = 17) and adult onset (≥19 years; n = 28).

Results

The adult MDD‐onset group had smaller sgACC volumes than the pediatric‐onset and HC groups (age, sex controlled). No differences in caudate and hippocampus volumes existed. sgACC and hippocampal volumes were inversely correlated with depression severity.

Conclusions

Surprisingly, pediatric MDD‐onset was not associated with more pronounced sgACC, hippocampus and caudate volume reductions. Nevertheless, age of illness onset appears to be a meaningful dimension of study in efforts to understand the neurobiological heterogeneity of MDD.
Serum levels of desacyl ghrelin in patients with schizophrenia on clozapine monotherapy
Authors: Wysokiński Adam , Kowalski Marek L. , Kłoszewska Iwona
Published: April 2014

Aim

Desacyl ghrelin is a hormone that might be a functional inhibitor of ghrelin, a potent hunger‐stimulating peptide.

Methods

We determined fasting serum desacyl ghrelin levels in 24 subjects with schizophrenia on clozapine monotherapy and 24 healthy, age‐ and sex‐matched controls. Biochemical and anthropometric measurements were combined with body composition determined using bioelectric impedance analysis.

Results

There were no differences in desacyl ghrelin levels between patients taking clozapine and the control group (272.09 ± 137.96 vs 259.62 ± 140.91 pg/mL, z = 0.17, P = 0.87). In the clozapine group, there were no differences between men and women for ghrelin levels (246.66 ± 123.17 vs 295.39 ± 151.77 pg/mL, z = −0.98, P = 0.32). In the clozapine group, fasting serum levels of ghrelin negatively correlated with waist‐to‐hip ratio (WHR) (r = −0.45, P = 0.03) and ionized calcium (r = −0.45, P = 0.03). Levels of ghrelin were lower in patients with WHR above World Health Organization‐defined cut‐off points (246.84 ± 114.34 [Q1 = 152.18, Q2 = 220.92, Q3 = 327.85] vs 400.30 ± 123.36 [Q1 = 283.73, Q2 = 414.03, Q3 = 485.8] pg/mL, z = 2.52, P = 0.01). In the clozapine group, there were no correlation with age, height, weight, body mass index, abdominal circumference, waist circumference, hip circumference, WHR, blood pressure, total cholesterol, high‐density lipoproteins, low‐density lipoproteins, triglycerides, uric acid, homocysteine, glucose, insulin, clozapine dose, duration of treatment with antipsychotics, duration of treatment with clozapine, total fat, target fat, basal metabolic rate, target weight, lean weight, body water, homoeostasis model assessment of insulin resistance (HOMA) 1‐IR, HOMA2‐IR and quantitative insulin sensitivity check index.

Conclusion

Based on our results, we cannot conclude that treatment with clozapine affects levels of desacyl ghrelin. Also, in our study population we did not confirm previously described associations between desacyl ghrelin and various metabolic parameters.
Photooxidation of Tetrahydrobiopterin under UV Irradiation: Possible Pathways and Mechanisms
Authors: Buglak Andrey A. , Telegina Taisiya A. , Lyudnikova Tamara A. , Vechtomova Yulia L. , Kritsky Mikhail S.
Published: April 2014

Tetrahydrobiopterin (H4Bip) is a cofactor for several key enzymes, including NO synthases and aromatic amino acid hydroxylases (AAHs). Normal functioning of the H4Bip regeneration cycle is extremely important for the work of AAHs. Oxidized pterins may accumulate if the H4Bip regeneration cycle is disrupted or if H4Bip autoxidation occurs. These oxidized pterins can photosensitize the production of singlet molecular oxygen 1O2 and thus cause oxidative stress. In this context, we studied the photooxidation of H4Bip in phosphate buffer at pH 7.2. We found that UV irradiation of H4Bip affected its oxidation rate (quantum yield Φ300 = (2.7 ± 0.4) × 10−3). The effect of UV irradiation at λ = 350 nm on H4Bip oxidation was stronger, especially in the presence of biopterin (Bip) (Φ350 = (9.7 ± 1.5) × 10−3). We showed that the rate of H4Bip oxidation linearly depends on Bip concentration. Experiments with KI, a selective quencher of triplet pterins at micromolar concentrations, demonstrated that the oxidation is sensitized by the triplet state biopterin 3Bip. Apparently, electron transfer sensitization (Type‐I mechanism) is dominant. Energy transfer (Type‐II mechanism) and singlet oxygen generation play only a secondary role. The mechanisms of H4Bip photooxidation and their biological meaning are discussed.
Michelangelo'sChildren's Bacchanal: an allegory of the intemperate soul?
Authors: Pestilli Livio
Published: April 2014

The Children's Bacchanal is not only the most consummate but also the most baffling of the drawings Michelangelo executed for Tommaso de' Cavalieri. This article provides a new reading of the work by undertaking a thorough analysis of the compositional elements. In the process, the significance of some previously misunderstood details are clarified and the allegory made more pertinent to the artist's life and work. The article posits that the drawing was a visual exemplum of what Ficino considered the threats posed to the human soul by the excess of love for the elemental body. While in the upper half of the sheet Michelangelo may have alluded to the ‘incontinent man’, an individual in whom the ‘tumultuous corporeal passion prevails’, in the sleeping youth depicted in the lower portion he may have referred to ‘the intemperate man’. For such a person ‘reason slept entirely or completely succumbed to desire’ during his lifetime while ‘after death it is weighed down by an even deeper slumber and troubled by even more frightening dreams’. If the interpretation here adduced is closer to the artist's intentions, it may be more appropriate to define the drawing an Allegory of the Intemperate Soul.