bluuebunny/crossref_metadata_2025 huggingface dataset:
Macrophage colony‐stimulating factor plays a pivotal role in chemically induced hepatocellular carcinoma in mice
Authors: Hara Michio , Kono Hiroshi , Furuya Shinji , Hirayama Kazuyoshi , Tsuchiya Masato , Fujii Hideki
Published: May 2013

Aim

The specific purpose of this study was to investigate the role of macrophage colony‐stimulating factor (M‐CSF) in initiation and progression of hepatocellular carcinoma usingM‐CSF‐deficient mice.

Methods

M‐CSF‐deficient (osteopetrotic: op/op) and their littermate (LM) mice were i.p. injected with diethylnitrosamine (DEN) to induce hepatocellular carcinoma. Twenty‐eight weeks afterDENadministration, the tumor incidence rate and serumM‐CSFlevels were assessed. Furthermore, distribution of the activated macrophages and the mRNAexpression ofCD163andCD204were evaluated. Moreover, angiogenesis was analyzed in tumors. In another set of experiments, apoptosis and proliferation of the hepatocytes were examined in the acute phase afterDENadministration. Isolated hepatic macrophages were cultured with or withoutM‐CSF, and vascular endothelial growth factor (VEGF) production was assessed by enzyme‐linked immunoassay.

Results

Tumor incidence was significantly reduced in the op/op compared with theLMmice. SerumM‐CSFlevels were increased in the carcinogenesis models of theLMmice. Hepatic macrophages were found only in tumors in the op/op but in both normal liver tissue and tumors in theLMmice. In the op/op group, the mRNAexpression of inflammatory cytokines was significantly lower compared with theLMmice. Furthermore, apoptosis was significantly increased in the op/op than theLMmice. Angiogenesis increased in liver tumors from theLMcompared with the op/op mice. Production ofVEGFwas greater in the hepatic macrophages incubated withM‐CSFcompared with those withoutM‐CSF.

Conclusion

Thus,M‐CSFis involved in the progression of chemically induced hepatocarcinogenesis.
Health literacy among consumers in community pharmacy: perceptions of pharmacy staff
Authors: Kairuz Therese E. , Bellamy Kim M. , Lord Elisabeth , Ostini Remo , Emmerton Lynne M.
Published: May 2013

Background

Low health literacy has important consequences for health status, medication adherence and use of health services. There is little insight from the perspective of pharmacy staff into how they identify the information needs of consumers and particularly the signals and risk factors of limited health literacy that they encounter in their day‐to‐day communication with consumers.

Objective

To investigate factors impacting on consumer health literacy, from the perspective of pharmacy staff.

Methods

The research comprised semi‐structured interviews conducted in a convenience sample of pharmacies in the south‐east region of Queensland, Australia. Eleven pharmacists and nine pharmacy assistants agreed to participate. Interviews were audio‐recorded and transcribed verbatim. Initial coding of the anonymized transcripts was performed using NVivo®. Codes were analysed into overarching themes and subthemes, which were then re‐named and refined through consensus discussion.

Results

Three overarching themes were identified from the coding process: complexity of the health system, clarity of information, and dialogue among consumers and health‐care professionals. Two of the themes were system related, namely the health system and pharmacy labels; the health literacy issues included lack of clarity, complexity and misunderstanding. The third theme was related to communication.

Conclusions

Complexity of the health system, clarity of information and dialogue among consumers and health‐care professionals were identified as factors associated with consumers' health literacy. We call for increased engagement between pharmacy staff and consumers with improved focus on areas of potential confusion, such as medicine labels and navigation of the health system, aiming to minimize negative consequences of limited health literacy and optimize patient health outcomes.
Aiming for inclusion: a case study of motivations for involvement in mental health‐care governance by ethnic minority users
Authors: de Freitas Cláudia
Published: May 2013

Objective

To examine the motivations for involvement in mental health‐care governance by socially disadvantaged ethnic minority users.

Design and setting

A qualitative case study approach was employed to investigate the involvement of minority north‐eastern users in mental health‐care governance atCAPS PedroPellegrino inRio deJaneiro,Brazil. Semi‐structured interviews with minorityNortheasterners (n = 12) and institutional stakeholders (n = 26) were complemented by participant observation of user assembly and user movement meetings.

Findings

MinorityNortheasterners express both individual and collective motivations for involvement in mental health‐care governance. Individual motivations include the desire to increase social interaction, acquire meaningful social roles and overcome the stigma attached to mental illness. Collective motivations include the intent to improve the responsiveness of mental health care and achieve social justice for people with mental problems. Taken together, these motivations demonstrate a strong aspiration by users to promote their social inclusion and the inclusion of others who also experience marginalization. Results also reveal that the involvement of long‐term participants is driven mostly by collective goals while early‐stage participants focus predominantly in dealing with individual concerns. This is at odds with the mutual incentives theory, which postulates that collective motivations prevail over individual motivations in explaining user involvement.

Conclusion

Groups historically excluded from decision‐making processes may identify social inclusion as the core goal of their involvement. Initiatives aiming to increase user participation in health‐care governance must address the range of motivations driving the involvement of users, instead of focusing solely on issues related to health‐care management and provision.
The care delivery experience of hospitalized patients with complex chronic disease
Authors: Kuluski Kerry , Hoang Sylvia N. , Schaink Alexis K. , Alvaro Celeste , Lyons Renee F. , Tobias Roy , Bensimon Cécile M.
Published: May 2013

Objective

This study investigated what is important in care delivery from the perspective of hospital inpatients with complex chronic disease, a currently understudied population.

Participants and Setting

One‐on‐one semi‐structured interviews were conducted with inpatients at a continuing care/rehabilitation hospital (n = 116) in Canada between February and July 2011.

Design

The study design was mixed methods and reports on patient characteristics and care delivery experiences. Basic descriptive statistics were run using SPSS version 17, and thematic analysis on the transcripts was conducted using NVivo9 software.

Results

Patients had an average of 5 morbidities and several illness symptoms including activity of daily living impairments, physical pain and emotional disturbance. Three broad themes (each with one or more subthemes) were generated from the data representing important components of care delivery: components of the care plan (a comprehensive assessment, supported transitions and a bio‐psycho‐social care package); care capacity and quality (optimal staff to patient ratios, quicker response times, better patient–provider communication and consistency between providers) and the patient–provider relationships (characterized by respect and dignity).

Conclusions

As health systems throughout the industrialized world move to sustain health budgets while optimizing quality of care, it is critical to better understand this population, so that appropriate metrics, services and policies can be developed. The study has generated a body of evidence on the important components of care delivery from the perspectives of a diverse group of chronically ill individuals who have spent a considerable amount of time in the health‐care system. Moving forward, exploration around the appropriate funding models and skill mix is needed to move the evidence into changed practice.
Lead Chalcogenide Quantum Dot‐Doped Glasses for Photonic Devices
Authors: Liu Chao , Heo Jong
Published: May 2013

Tunable absorption and photoluminescence (PL) of lead chalcogenide quantum dots (QDs) doped in glasses due to the quantum confinements effect have been actively investigated for application as saturable absorbers, laser sources, and fiber‐optic amplifiers. Optical properties of QDs have been carefully monitored by controlling their sizes through heat treatment and rare‐earth ion doping. Two‐ and three‐dimensional precipitation of lead chalcogenide QDs were also realized using silver ion exchange and femtosecond laser irradiation in combination with thermal treatment. Prototypes of microstructured single‐mode fibers and tapered fiber amplifiers containing QDs proved potentials of these materials for fiber‐optic amplifiers application. Further research works on QD‐doped solid core fibers, surface passivation of quantum dots and their application for the mid‐infrared optical devices are necessary.
Effect of defatting and decortication on distribution of fatty acids, phenolic and antioxidant compounds in sorghum (Sorghum bicolor) bran fractions
Authors: Buitimea‐Cantúa Nydia E. , Torres‐Chávez Patricia I. , Ledesma‐Osuna Ana I. , Ramírez‐Wong Benjamin , Robles‐Sánchez Rosario M. , Serna‐Saldívar Sergio O.
Published: May 2013

Sorghum bran components could be a potential source of nutrients and phytochemicals for industrial applications. The effect of defatting with hexane and different degrees of decortication on distribution of fatty acids, phenolic compounds, colour (L, a and b) and antioxidant activity (DPPH) of red (RS) and white (WS) sorghums was studied. The decortication process was carried out at time intervals of 1–6 min. Defatted and nondefatted fractions were analysed. The content of polyunsaturated fatty acids (PUFA) was higher than monounsaturated fatty acids (MUFA); the content of MUFA was higher than saturated fatty acids (SFA). Linoleic, oleic and palmitic acids predominated in all fractions. Significant differences in the content of palmitic and linolenic acids between sorghums were found. RS had higher content of palmitic, and WS was higher in linoleic acid. Defatted samples contained lower amounts of phenolic compounds and higher antioxidant activities, than nondefatted samples. RS was a better source of total phenolic compounds and antioxidant activity compared with WS, but WS presented a more suitable profile of fatty acids. In conclusion, fractions of both types of sorghums can be used in cereal‐based products to enhance their phytochemical profile.
Comparison of lipid and protein oxidation, total iron content and fatty acid profile of conventional and organic pork
Authors: Karwowska Małgorzata , Dolatowski Zbigniew J.
Published: May 2013

The aim of the research was to compare differences in lipid and protein oxidation, total iron content and fatty acid profile in pork loin obtained from organic and conventionally reared pigs. The samples of organic meat were taken from breeding certified by the polish certifying body according to the Council Regulation (EC) no 834/2007 on organic production and labelling of organic products. The meat samples were examined at the following times post‐mortem: 2, 4, 7 days. Measurements of lipid oxidation showed that the organic meat samples were characterised by lower TBARS values during whole storage period (0.78–0.81 mg kg−1) compared with those of conventional system production (0.95–0.99 mg kg−1). Results of protein oxidation measurements of the organic meat sample were significantly lower (0.43 nmol mg−1 protein) at the beginning of experiment than those for the conventional meat sample (0.66 nmol mg−1 protein). It was also indicated that the production system had no effect on iron content and myoglobin oxidation during storage. In conclusion, obtained results pointed out that the organic pig meat was characterised by higher lipid stability during the whole storage time compared with meat from conventional production system.
The global, the social and rights. New perspectives on social citizenship
Authors: Davy Benjamin , Davy Ulrike , Leisering Lutz
Published: May 2013

ThisGuestEditorial explores whether the concept of citizenship, which originated in the city and the nation‐state, travels to the globe and what global citizenship could mean. Introducing a collection of related articles, we focus onsocialcitizenship. We discuss conceptual issues, including modifications ofT. H. Marshall's concept of social citizenship, and point at empirical evidence that global social citizenship is taking shape: International human rights have come to be interpreted as encapsulating social citizenship, and are part of multi‐tiered social citizenship; ‘having rights’ is a meaningful expression in the global realm, including binding obligations of states under international human rights, negotiations in multiple sites or even ‘insurgent citizenship’ from below; institution building in the globalSouth – social cash transfers for the poor, land rights or non‐state welfare production in informal settings – is transformingEuropean conceptions of ‘the social’. Global social citizenship materially underpins notions of cosmopolitan belonging and activism.
Cry Babies and Pollyannas: Infants Can Detect Unjustified Emotional Reactions
Authors: Chiarella Sabrina S. , Poulin‐Dubois Diane
Published: May 2013

Infants are attuned to emotional facial and vocal expressions, reacting most prominently when they are exposed to negative expressions. However, it remains unknown if infants can detect whether a person's emotions are justifiable given a particular context. The focus of the current paper was to examine whether infants react the same way to unjustified (e.g., distress following a positive experience) and justified (e.g., distress following a negative experience) emotional reactions. Infants aged 15 and 18 months were shown an actor experiencing negative and positive experiences, with one group exposed to an actor whose emotional reactions were consistently unjustified (i.e., did not match the event), while the other saw an actor whose emotional reactions were justified (i.e., always matched the event). Infants' looking times and empathic reactions were examined. Only 18‐month‐olds detected the mismatching facial expressions: Those in the unjustified group showed more hypothesis testing (i.e., checking) across events than the justified group. Older infants in the justified group also showed more concerned reactions to negative expressions than those in the unjustified group. The present findings indicate that infants implicitly understand how the emotional valence of experiences is linked to subsequent emotional expressions.
Patterns and predictors of non‐use of family planning methods in Ethiopian women: a panel survey
Authors: Lee H. , Lee T. , Shin H. , Ahn H. , Kim M. , Lee M.
Published: May 2013

Purpose

Family planning (FP) is a key global health issue for achieving millennium development goals by 2015. The aim of this study was to identify predictors of changes in FP practice before and after interventions among Ethiopian women of reproductive age in a rural area.

Methods

This study used a panel survey to identify predictors that placed women at greater risk for non‐use of FP methods. The sample consisted of 407 women aged 19–49 years old living in a rural community of Ethiopia who completed both a baseline and follow‐up survey. Trained local enumerators conducted face‐to‐face interviews during home visits. Patterns of FP practice were categorized into four groups: FP use at both baseline and follow‐up; use at baseline but non‐use at follow‐up; non‐use at baseline but use at follow‐up; non‐use at both baseline and follow‐up. Logistic regression and classification and regression tree analyses were used.

Results

In a binary logistic regression, women over 35 years old with a negative attitude towards FP and resided in the Sibu area were less likely to start FP practice. Women over 35 years who were in poor health and resided in Sibu were less likely to continue FP practice. For the decision tree, age was the primary node for FP non‐users at baseline while area of residence was the primary node for FP users at baseline.

Conclusion

Age, health status, attitude towards FP, and area of residence are the primary considerations when developing FP interventions for Ethiopian women in a resource‐limited rural area.
Is dental caries experience associated with adiposity status in preschool children?
Authors: Peng Si‐Min , Wong Hai Ming , King Nigel M. , McGrath Colman
Published: May 2013

Background

To date, research on the relationship between dental caries experience and adiposity status is debated.

Aim

To determine associations between dental caries experience and adiposity status among a community sample of preschool children in Hong Kong.

Design

Among a random sample of 5‐year‐old children, clinical assessment for dental caries was conducted using WHO criteria. Anthropometric measurements for body weight, body height, waist circumference (WC), hip circumference, and triceps skinfold thickness (TRSKF) were performed to assess general adiposity, central adiposity, and peripheral adiposity. Associations between adiposity status and caries were examined in regression analyses.

Results

The response rate was 83.1% (324/390). Regression analyses (adjusted for tooth brushing habits, snacking habits, and socio‐demographic factors) identified that weight/height ratio z‐score was associated with caries experience: prevalence of dental caries experience (dmft > 0), OR 1.41 (95% CI 1.04, 1.91), and ‘very high’ caries experience (dmft ≥ SiC10 Index value), OR 1.62, (95% CI 1.05, 2.50). In addition, WC z‐score was associated with ‘very high’ caries experience (dmft ≥ SiC10 Index value), OR 1.72, 95% CI 1.06, 2.81.

Conclusion

In a Hong Kong community sample of preschool children, dental caries experience was associated with general adiposity (as assessed by weight/height ratio) and central adiposity (as assessed by WC).
Intranasal influenza vaccination using a new synthetic mucosal adjuvant SF‐10: induction of potent local and systemic immunity with balanced Th1 and Th2 responses
Authors: Kimoto Takashi , Mizuno Dai , Takei Tsunetomo , Kunimi Takuya , Ono Shinji , Sakai Satoko , Kido Hiroshi
Published: May 2013

Background

We found previously that bovine pulmonary Surfacten® used in newborns with acute respiratory distress syndrome is a safe and efficacious antigen vehicle for intranasal vaccination.

Objectives

The objective of this study was to industrially produce a synthetic adjuvant mimicking Surfacten® for clinical use without risk of bovine spongiform encephalopathy.

Methods

We selected three Surfacten lipids and surfactant protein (SP)‐C as essential constituents for adjuvanticity. For replacement of the hydrophobic SP‐C, we synthesized SP‐related peptides and analyzed their adjuvanticity. We evaluated lyophilization to replace sonication for the binding of influenza virus hemagglutinin (HA) to the synthetic adjuvant. We also added a carboxy vinyl polymer (CVP) to the synthetic adjuvant and named the mixture as SF‐10 adjuvant. HA combined with SF‐10 was administered intranasally to mice, and induction of nasal‐wash HA‐specific secretory IgA (s‐IgA) and serum IgG with Th1‐/Th2‐type cytokine responses in nasal cavity and virus challenge test were assessed.

Results and Conclusions

Intranasal immunization with HA–SF–10 induced significantly higher levels of anti‐HA‐specific nasal‐wash s‐IgA and serum IgG than those induced by HA‐poly(I:C), a reported potent mucosal vaccine, and provided highly efficient protection against lethal doses of virus challenge in mice. Anti‐HA‐specific serum IgG levels induced by HA–SF–10 were almost equivalent to those induced by subcutaneous immunization of HA twice. Intranasal administration of HA–SF–10 induced balanced anti‐HA‐specific IgG1 and IgG2a in sera and IFN‐γ‐ and IL‐4‐producing lymphocytes in nasal cavity without any induction of anti‐HA IgE. The results suggest that HA–SF–10 is a promising nasal influenza vaccine and that SF‐10 can be supplied in large quantities commercially.
A randomised controlled trial of the effectiveness of soft silicone multi‐layered foam dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill patients: the border trial
Authors: Santamaria Nick , Gerdtz Marie , Sage Sarah , McCann Jane , Freeman Amy , Vassiliou Theresa , De Vincentis Stephanie , Ng Ai Wei , Manias Elizabeth , Liu Wei , Knott Jonathan
Published: May 2013

The prevention of hospital acquired pressure ulcers in critically ill patients remains a significant clinical challenge. The aim of this trial was to investigate the effectiveness of multi‐layered soft silicone foam dressings in preventing intensive care unit (ICU) pressure ulcers when applied in the emergency department to 440 trauma and critically ill patients. Intervention group patients (n = 219) had Mepilex® Border Sacrum and Mepilex® Heel dressings applied in the emergency department and maintained throughout their ICU stay. Results revealed that there were significantly fewer patients with pressure ulcers in the intervention group compared to the control group (5 versus 20, P = 0·001). This represented a 10% difference in incidence between the groups (3·1% versus 13·1%) and a number needed to treat of ten patients to prevent one pressure ulcer. Overall there were fewer sacral (2 versus 8, P = 0·05) and heel pressure ulcers (5 versus 19, P = 0·002) and pressure injuries overall (7 versus 27, P = 0·002) in interventions than in controls. The time to injury survival analysis indicated that intervention group patients had a hazard ratio of 0·19 (P = 0·002) compared to control group patients. We conclude that multi‐layered soft silicone foam dressings are effective in preventing pressure ulcers in critically ill patients when applied in the emergency department prior to ICU transfer.
Timing of puberty and physical growth in obese children: a longitudinal study in boys and girls
Authors: De Leonibus C. , Marcovecchio M. L. , Chiavaroli V. , de Giorgis T. , Chiarelli F. , Mohn A.
Published: May 2013

What is already known about this subject

There is emerging evidence suggesting that childhood obesity may influence the timing/tempo of puberty and growth patterns.

An earlier onset of puberty generally occurs in obese girls, whereas conflicting data are available for boys.

Obese children tend to be taller during pre‐puberty but lose this growth advantage during puberty.

What this study adds

Obese boys and girls present an earlier onset of puberty and completion of puberty, with a shorter duration of puberty compared to normal‐weight peers.

Obese children tend to have a similar adult height compared to normal‐weight children.

Background

There is emerging evidence suggesting that childhood obesity may influence the timing of puberty and growth patterns. However, there are scant and controversial data in this field.

Objective

To assess whether puberty and physical growth vary in obese when compared to normal‐weight children.

Methods

One hundred obese pre‐pubertal children (44 boys; mean age (±SD): 9.01 ± 0.62 years; 56 girls; 8.70 ± 0.57 years) were compared to 55 normal‐weight controls (27 boys; 9.17 ± 0.26 years; 28 girls; 8.71 ± 0.62 years). All study participants were followed prospectively with 6‐monthly follow‐up visits. At each study visit, height, weight, body mass index (BMI) and pubertal stage were assessed.

Results

Obese children entered puberty and achieved later stages of puberty earlier than controls (onset of puberty: boys: 11.66 ± 1.00 vs. 12.12 ± 0.91 years, P = 0.049; girls: 9.90 ± 0.78 vs. 10.32 ± 1.70, P = 0.016; late puberty: boys: 13.33 ± 0.71 vs. 14.47 ± 1.00 years, P < 0.001; girls: 11.54 ± 0.99 vs. 12.40 ± 1.02, P = 0.001). Pre‐pubertal BMI standard deviation score (SDS) was inversely associated with both age at the onset of puberty (β = −0.506, P < 0.001) and age at late puberty (β = −0.514, P < 0.001). Obese children also showed an earlier age at peak height velocity (PHV) (boys: 12.62 ± 0.82 vs. 13.19 ± 0.96 years, P = 0.01; girls: 11.37 ± 0.89 vs. 12.77 ± 0.76, P < 0.001) and a lower PHV (boys: 7.74 ± 1.49 vs. 9.28 ± 1.64 cm year−1, P < 0.001; girls: 7.60 ± 1.64 vs. 8.29 ± 1.03, P = 0.03). Height SDS progressively declined over the study period in the obese group (P for trend <0.001), whereas there were no significant changes in the control group (P for trend = 0.5).

Conclusions

Obese boys and girls presented an earlier onset of puberty and completion of puberty and an impaired height gain during puberty.
Dignity and the factors that influence it according to nursing home residents: a qualitative interview study
Authors: Oosterveld‐Vlug Mariska G. , Pasman H. Roeline W. , van Gennip Isis E. , Muller Martien T. , Willems Dick L. , Onwuteaka‐Philipsen Bregje D.
Published: May 2013

Aim

To gain insight in the way nursing home residents experience personal dignity and the factors that preserve or undermine it.

Background

Nursing home residents are exposed to diverse factors which may be associated with the loss of personal dignity. To help them maintain their dignity, it is important to investigate this concept from the residents' perspective.

Design

A qualitative descriptive study.

Methods

In‐depth interviews were conducted between May 2010–June 2011 with 30 recently admitted residents of the general medical wards of four nursing homes in The Netherlands.

Results

Illness‐related conditions were the starting point of a process which could affect personal dignity, by threatening aspects of one's individual self and social world. Living in a nursing home was not a reason in itself to feel less self‐worth, but rather seen as a consequence of functional incapacity. Nevertheless, many residents felt discarded by society and not taken seriously, simply because of their age or illness. Waiting for help, being dictated to by nurses and not receiving enough attention could undermine personal dignity, whereas aspects of good professional care (e.g. being treated with respect), a supportive social network and adequate coping capacities could protect it.

Conclusions

Contrary to the general view in society that living in a nursing home always undermines one's dignity, good professional care and a supportive social network can preserve dignity as well. To support residents in their challenge of maintaining dignity, nursing home staff, relatives and society should pay more attention to the way they treat them.
The tumourigenicity of iPS cells and their differentiated derivates
Authors: Liu Zhiqiang , Tang Yu , Lü Shuanghong , Zhou Jin , Du Zhiyan , Duan Cuimi , Li Zhiyan , Wang Changyong
Published: May 2013

Induced pluripotent stem cell (iPSC) provides a promising seeding cell for regenerative medicine. However, iPSC has the potential to form teratomas after transplantation. Therefore, it is necessary to evaluate the tumorigenic risks of iPSC and all its differentiated derivates prior to use in a clinical setting. Here, murine iPSCs were transduced with dual reporter gene consisting of monomeric red fluorescent protein (mRFP) and firefly luciferase (Fluc). Undifferentiated iPSCs, iPSC derivates from induced differentiation (iPSC‐derivates), iPSC‐derivated cardiomyocyte (iPSC‐CMs) were subcutaneously injected into the back of nude mice. Non‐invasive bioluminescence imaging (BLI) was longitudinally performed at day 1, 7, 14 and 28 after transplantation to track the survival and proliferation of transplanted cells. At day 28, mice were killed and grafts were explanted to detect teratoma formation. The results demonstrated that transplanted iPSCs, iPSC‐derivates and iPSC‐CMs survived in receipts. Both iPSCs and iPSC‐derivates proliferated dramatically after transplantation, while only slight increase in BLI signals was observed in iPSC‐CM transplanted mice. At day 28, teratomas were detected in both iPSCs and iPSC‐derivates transplanted mice, but not in iPSC‐CM transplanted ones. In vitro study showed the long‐term existence of pluripotent cells during iPSC differentiation. Furthermore, when these cells were passaged in feeder layers as undifferentiated iPSCs, they would recover iPSC‐like colonies, indicating the cause for differentiated iPSC's tumourigenicity. Our study indicates that exclusion of tumorigenic cells by screening in addition to lineage‐specific differentiation is necessary prior to therapeutic use of iPSCs.
Serum adiponectin levels predict the risk of coronary heart disease in Japanese patients with type 2 diabetes
Authors: Obata Yoshinari , Yamada Yuya , Kyo Mitsuaki , Takahi Yasumitsu , Saisho Kenji , Tamba Sachiko , Yamamoto Koji , Katsuragi Kiyonori , Matsuzawa Yuji
Published: May 2013

Aims/Introduction

An inverse association between adiponectin and coronary heart disease (CHD) has been found in Caucasians, but it is uncertain whether this association can be extrapolated to the East Asian population. The present study aimed to investigate whether serum adiponectin levels can predict CHD in Japanese patients with type 2 diabetes as observed in Caucasians.

Materials and Methods

This longitudinal study included 504 patients with type 2 diabetes (342 men and 162 women) who were admitted to Sumitomo Hospital between July 2005 and December 2006. We used Cox proportional hazard analysis to estimate the hazard ratio (HR) of CHD associated with serum adiponectin levels at baseline.

Results

During a median follow up of 5.7 years (2177 person‐years), 40 participants had new CHD and 10 had recurrent CHD. After multivariate adjustment, the highest compared with the lowest quartile of serum adiponectin levels had a significantly reduced risk of CHD (hazard ratio [HR] 0.35; 95% confidence interval [CI] 0.13–0.94; P = 0.017). The multivariate adjusted HR for the risk of CHD according to a doubling of adiponectin at baseline was 0.61 (95% CI 0.39–0.97; P = 0.037).

Conclusions

High serum adiponectin levels are significantly associated with a lower risk of CHD in Japanese patients with type 2 diabetes. This association is independent of other well‐known CHD risk factors.
Attention‐Deficit/Hyperactivity Disorder, Physical Health, and Lifestyle in Older Adults
Authors: Semeijn Evert J. , Sandra Kooij J.J. , Comijs Hannie C. , Michielsen Marieke , Deeg Dorly J.H. , Beekman Aartjan T.F.
Published: May 2013

Objectives

To increase insight into the effect of attention‐deficit/hyperactivity disorder (ADHD) on health in general in older adults.

Design

Two‐phase sampling side‐study.

Setting

Longitudinal Aging Study Amsterdam (LASA).

Participants

Two hundred twenty‐three randomly selected LASA respondents.

Measurements

Information was collected during home visits on physical health, medication use, and lifestyle characteristics in Phase 1 and on ADHD diagnosis in Phase 2. The associations between independant variables and ADHD were examined with linear and logistic regression analyses.

Results

The adjusted regression estimates of the linear regression analysis showed that the number of ADHD symptoms was positively associated with the presence of chronic nonspecific lung diseases (CNSLD) (B = 2.58, P = .02), cardiovascular diseases (B = 2.18, P = .02), and number of chronic diseases (B = 0.69, P = .04) and negatively associated with self‐perceived health (B = −2.83, P = .002). Lifestyle is not a mediator of the association between ADHD and physical health.

Conclusion

Attention‐deficit/hyperactivity disorder in older adults was associated with chronic physical illness and poorer self‐perceived health. Contrary to expectations, there were no associations between symptoms of ADHD and lifestyle variables.
Frailty as a Novel Predictor of Mortality and Hospitalization in Individuals of All Ages Undergoing Hemodialysis
Authors: McAdams‐DeMarco Mara A. , Law Andrew , Salter Megan L. , Boyarsky Brian , Gimenez Luis , Jaar Bernard G. , Walston Jeremy D. , Segev Dorry L.
Published: May 2013

Objectives

To quantify the prevalence of frailty in adults of all ages undergoing chronic hemodialysis, its relationship to comorbidity and disability, and its association with adverse outcomes of mortality and hospitalization.

Design

Prospective cohort study.

Setting

Single hemodialysis center in Baltimore, Maryland.

Participants

One hundred forty‐six individuals undergoing hemodialysis enrolled between January 2009 and March 2010 and followed through August 2012.

Measurements

Frailty, comorbidity, and disability on enrollment in the study and subsequent mortality and hospitalizations.

Results

At enrollment, 50.0% of older (≥65) and 35.4% of younger (<65) individuals undergoing hemodialysis were frail; 35.9% and 29.3%, respectively, were intermediately frail. Three‐year mortality was 16.2% for nonfrail, 34.4% for intermediately frail, and 40.2% for frail participants. Intermediate frailty and frailty were associated with a 2.7 times (95% confidence interval (CI) = 1.02–7.07, P = .046) and 2.6 times (95% CI = 1.04–6.49, P = .04) greater risk of death independent of age, sex, comorbidity, and disability. In the year after enrollment, median number of hospitalizations was 1 (interquartile range 0–3). The proportion with two or more hospitalizations was 28.2% for nonfrail, 25.5% for intermediately frail, and 42.6% for frail participants. Although intermediate frailty was not associated with number of hospitalizations (relative risk = 0.76, 95% CI = 0.49–1.16, P = .21), frailty was associated with 1.4 times (95% CI = 1.00–2.03, P = .049) more hospitalizations independent of age, sex, comorbidity, and disability. The association between frailty and mortality (interaction P = .64) and hospitalizations (P = .14) did not differ between older and younger participants.

Conclusions

Adults of all ages undergoing hemodialysis have a high prevalence of frailty, more than five times as high as community‐dwelling older adults. In this population, regardless of age, frailty is a strong, independent predictor of mortality and number of hospitalizations.
Implementation of a Care Transitions Model for Low‐Income Older Adults: A High‐Risk, Vulnerable Population
Authors: Ohuabunwa Ugochi , Jordan Queenie , Shah Seema , Fost Michael , Flacker Jonathan
Published: May 2013

Low‐income older adults are particularly vulnerable during care transitions. The present study evaluated the effectiveness of a transitional care model in this population. A quasi‐experimental design was used to compare outcomes in the intervention group with historical controls at 30, 90, 180, and 365 days after discharge, along with a pre–postintervention evaluation of the intervention group. Eligible individuals were age 60 and older hospitalized between June 2008 and January 2009. Main outcome measures were readmissions, emergency department (ED) visits, and primary care services use.

Of 121 participants, 55% were female and 90% African American, with a mean age of 69. Readmission rates were generally but not significantly lower in the intervention group than in controls (Day 30, 9.6% vs 17.3%; Day 90, 28.9% vs 25.0%; Day 180, 32.7% vs 36.5%; Day 365, 44.2% vs 53.9%; P > .05), as were ED visit rates (Day 30, 17.3% vs 15.4%; Day 90, 32.7% vs 34.6%; Day 180, 38.5% vs 40.4%; Day 365, 50.0% vs 55.8%; P > .05). Primary care service utilization rates were significantly higher in the intervention group than in controls at Day 30 (40.4% vs 19.2%, P < .001), 90 (74.9% vs 32.7%, P < .001), and 180 (65.4% vs 32.7%, P < .001). The lack of statistically significant reduction in readmissions and ED visits with the intervention, may suggest the need for additional assistance during care transitions for this vulnerable population.
Utility of an Effect Size Analysis for Communicating Treatment Effectiveness: A Case Study of Cholinesterase Inhibitors for Alzheimer's Disease
Authors: Peters Kevin R.
Published: May 2013

Objectives

To highlight the utility of using an effect size analysis to communicate the effectiveness of treatment interventions.

Design

Secondary analysis.

Setting

Previously published systematic review on cholinesterase inhibitors (ChEIs) in Alzheimer's disease.

Participants

Individuals with mild to moderate Alzheimer's disease.

Intervention

Six‐month randomized controlled trials involving a placebo group and a ChEI group (donepezil, galantamine, or rivastigmine).

Measurements

Cognitive function was assessed according to performance on the cognition subscale of the Alzheimer's Disease Assessment Scale (ADAS‐Cog). Global Function was quantified using the Clinician's Interview‐Based Impression of Change—Plus (CIBIC‐Plus). Harm was defined as withdrawal from a trial because of an adverse event. Several effect size indices were computed based on these domains: the success rate difference (SRD), the harm rate difference (HRD), the number needed to treat (NNT) or harm (NNH), and the area under the curve (AUC). Harm:benefit ratios were also computed to compare effect size indices across domains of function.

Results

In terms of benefit, the NNT for cognition ranged from 4 to 14 (corresponding AUC values: 0.64–0.54), and the NNT for global function ranged from 6 to 100 (corresponding AUC 0.59–0.51). In terms of harm, the NNH ranged from 6 to 20 (corresponding AUC 0.58–0.53). Only one of the four studies had favorable harm:benefit ratios in both the cognition and global function domains.

Conclusion

Effect size indices should be reported in clinical trials because they provide important insight into the clinical meaningfulness of results. Additional benefit is gained by comparing effect size indices across domains of function to reveal harm:benefit ratios.
Teaching Medical Student Geriatrics Competencies in 1 Week: An Efficient Model to Teach and Document Selected Competencies Using Clinical and Community Resources
Authors: Atkinson Hal H. , Lambros Ann , Davis Brooke R. , Lawlor Janice S. , Lovato James , Sink Kaycee M. , Demons Jamehl L. , Lyles Mary F. , Watkins Franklin S. , Callahan Kathryn E. , Williamson Jeff D.
Published: May 2013

The Association of American Medical Colleges (AAMC) and the John A. Hartford Foundation published geriatrics competencies for medical students in 2008 defining specific knowledge and skills that medical students should be able to demonstrate before graduation. Medical schools, often with limited geriatrics faculty resources, face challenges in teaching and assessing these competencies. As an initial step to facilitate more‐efficient implementation of the competencies, a 1‐week geriatrics rotation was developed for the third year using clinical, community, and self‐directed learning resources. The Wake Forest University School of Medicine Acute Care for the Elderly Unit serves as home base, and each student selects a half‐day outpatient or long‐term care experience. Students also perform a home‐based falls‐risk assessment with a Meals‐on‐Wheels client. The objectives for the rotation include 20 of the 26 individual AAMC competencies and specific measurable tracking tasks for seven individual competencies. In the evaluation phase, 118 students completed the rotation. Feedback was positive, with an average rating of 7.1 (1 = worst, 10 = best). Students completed a 23‐item pre‐ and post‐knowledge test, and average percentage correct improved by 15% (P < .001); this improvement persisted at graduation (2 years after the pretest). On a 12‐item survey of attitudes toward older adults, improvement was observed immediately after the rotation that did not persist at graduation. Ninety‐seven percent of students documented completion of the competency‐based tasks. This article provides details of development, structure, evaluation, and lessons learned that will be useful for other institutions considering a brief, concentrated geriatrics experience in the third year of medical school.
Quality of Hospice Care for Individuals with Dementia
Authors: Albrecht Jennifer S. , Gruber‐Baldini Ann L. , Fromme Erik K. , McGregor Jessina C. , Lee David S. H. , Furuno Jon P.
Published: May 2013

Background

Patients with dementia constitute an increasing proportion of hospice enrollees, yet little is known about the quality of hospice care for this population. The aim of this study was to quantify differences in quality of care measures between hospice patients with and without dementia.

Design

Cross‐sectional analysis of data.

Setting

2007 National Home and Hospice Care Survey.

Participants

Four thousand seven hundred eleven discharges from hospice care.

Measurements

A primary diagnosis of dementia at discharge was defined according to International Classification of Diseases, Ninth Revision, codes (290.0–290.4x, 294.0, 294.1, 294.8, 331.0–331.2, 331.7, and 331.8). Quality‐of‐care measures included enrollment in hospice in the last 3 days of life, receiving tube feeding, depression, receiving antibiotics, lack of advanced directive or do not resuscitate order, Stage II or greater pressure ulcers, emergency care, lack of continuity of residence, and a report of pain at last assessment.

Results

Four hundred fifty (9.5%) individuals were discharged with a primary diagnosis of dementia. In multivariable analysis, individuals with dementia were more likely to receive tube feeding (odds ratio (OR) = 2.6, 95% confidence interval (CI) = 1.4–4.5) and to have greater continuity of residence (OR = 1.8, 95% CI = 1.1–3.0) than other individuals in hospice and less likely to have a report of pain at last assessment (OR = 0.6, 95% CI = 0.3–0.9).

Conclusions

The majority of quality‐of‐care measures examined did not differ between individuals in hospice with and without dementia. Use of tube feeding in hospice care and methods of pain assessment and treatment in individuals with dementia should be considered as potential quality‐of‐care measures.
A window into the Early to mid‐Cretaceous infrastructure of the Yukon‐Tanana terrane recorded in multi‐stage garnet of west‐central Yukon, Canada
Authors: Staples R. D. , Gibson H. D. , Berman R. G. , Ryan J. J. , Colpron M.
Published: May 2013

Amphibolite facies metasedimentary schists within the Yukon‐Tanana terrane in the northern Canadian Cordillera reveal a two‐stage, polymetamorphic garnet growth history. In situ U‐Th‐Pb Sensitive High Resolution Ion Microprobe dating of monazite provide timing constraints for the late stages of garnet growth, deformation and subsequent decompression. Distinct textural and chemical growth zoning domains, separated by a large chemical discontinuity, reveal two stages of garnet growth characterized in part by: (i) a syn‐kinematic, inclusion‐rich stage‐1 garnet core; and (ii) an inclusion‐poor, stage‐2 garnet rim that crystallized with syn‐ to post‐kinematic staurolite and kyanite. Phase equilibria modelling of garnet molar and compositional isopleths suggest stage‐1 garnet growth initiated at ~600 °C, 8 kbar along a clockwise P–T path. Growth of the compositionally distinct, grossular‐rich, pyrope‐poor inner portion of the stage‐2 overgrowth is interpreted to have initiated at higher pressure and/or lower temperature than the stage‐1 core along a separate P–T loop, culminating at peak P–T conditions of ~650–680 °C and 9 kbar. Stage‐2 metamorphism and the waning development of a composite transposition foliation (ST) are dated at c. 118 Ma from monazite aligned parallel to ST, and inclusions in syn‐ to post‐ST staurolite and kyanite. Slightly younger ages (c. 112 Ma) are obtained from Y‐rich monazite that occurs within resorbed areas of both stage‐1 and stage‐2 garnet, together with retrograde staurolite and plagioclase. The younger ages obtained from these texturally and chemically distinct grains are interpreted, with the aid of phase equilibria calculations, to date the growth of monazite from the breakdown of garnet during decompression at c. 112 Ma. Evidence for continued near‐isothermal decompression is provided by the presence of retrograde sillimanite, and cordierite after staurolite, which indicates decompression below ~4–5 kbar prior to cooling below ~550 °C. As most other parts of the Yukon‐Tanana terrane were exhumed to upper crustal levels in the Early Jurassic, these data suggest this domain represents a tectonic window revealing a much younger, high‐grade tectono‐metamorphic core (infrastructure) within the northern Cordilleran orogen. This window may be akin to extensional core complexes identified in east‐central Alaska and in the southeastern Canadian Cordillera.
Cellular distribution of AMPA receptor subunits and mGlu5 following acute and repeated administration of morphine or methamphetamine
Authors: Herrold Amy A. , Persons Amanda L. , Napier T. Celeste
Published: May 2013

Ionotropic AMPA receptors (AMPAR) and metabotropic glutamate group I subtype 5 receptors (mGlu5) mediate neuronal and behavioral effects of abused drugs. mGlu5 stimulation increases expression of striatal‐enriched tyrosine phosphatase isoform 61 (STEP61) which internalizes AMPARs. We determined the rat brain profile of these proteins using two different classes of abused drugs, opiates, and stimulants. STEP61 levels, and cellular distribution/expression of AMPAR subunits (GluA1, GluA2) and mGlu5, were evaluated via a protein cross‐linking assay in medial prefrontal cortex (mPFC), nucleus accumbens (NAc), and ventral pallidum (VP) harvested 1 day after acute, or fourteen days after repeated morphine (8 mg/kg) or methamphetamine (1 mg/kg) (treatments producing behavioral sensitization). Acute morphine decreased GluA1 and GluA2 surface expression in mPFC and GluA1 in NAc. Fourteen days after repeated morphine or methamphetamine, mGlu5 surface expression increased in VP. In mPFC, mGlu5 were unaltered; however, after methamphetamine, STEP61 levels decreased and GluA2 surface expression increased. Pre‐treatment with a mGlu5‐selective negative allosteric modulator, blocked methamphetamine‐induced behavioral sensitization and changes in mPFC GluA2 and STEP61. These data reveal (i) region‐specific distinctions in glutamate receptor trafficking between acute and repeated treatments of morphine and methamphetamine, and (ii) that mGlu5 is necessary for methamphetamine‐induced alterations in mPFC GluA2 and STEP61.
Optimal CEO Compensation with Search: Theory and Empirical Evidence
Authors: CAO MELANIE , WANG RONG
Published: May 2013

We integrate an agency problem into search theory to study executive compensation in a market equilibrium. A CEO can choose to stay or quit and search after privately observing an idiosyncratic shock to the firm. The market equilibrium endogenizes CEOs’ and firms’ outside options and captures contracting externalities. We show that the optimal pay‐to‐performance ratio is less than one even when the CEO is risk neutral. Moreover, the equilibrium pay‐to‐performance sensitivity depends positively on a firm's idiosyncratic risk and negatively on the systematic risk. Our empirical tests using executive compensation data confirm these results.
A cross‐sectional study of the relationship between serum sexual hormone levels and internal derangement of temporomandibular joint
Authors: Madani A. S. , Shamsian A. A. , Hedayati‐Moghaddam M. R. , Fathi‐Moghadam F. , Sabooni M. R. , Mirmortazavi A. , Golmohamadi M.
Published: May 2013

Temporomandibular disorders (TMD) are defined as clinical conditions that involve the masticatory muscles, temporomandibular joint (TMJ) or both. The aim of this study was to evaluate serum 17β‐oestradiol and progesterone levels in menstruating women affected by internal derangement of the TMJ. A total of 142 women (mean age 30·2 ± 6·7) who referred to medical diagnostic laboratory of Iranian Academic Centre for Education, Culture and Research (ACECR), Mashhad Branch, were enrolled during 2007 and 2008. Forty‐seven individuals had disc displacement with reduction (Group IIa) according to Research Diagnostic Criteria (RDC)/TMD Axis I diagnosis. Radioimmunoassay was used for the detection of serum 17β‐oestradiol and progesterone levels in all 142 subjects. The mean progesterone level was significantly higher in control group (11·6 ± 10·4 ng mL−1) compared to women with TMD (8·4 ± 6·8 ng mL−1, P = 0·03). No significant difference was found in two groups regarding 17β‐oestradiol level. Lower progesterone level in women with TMD can suggest the more important role of this hormone in the development of the disorder.