bluuebunny/crossref_metadata_2025 huggingface dataset:
An evaluation of the effect of a topical product containing C‐xyloside and blueberry extract on the appearance of type II diabetic skin
Authors: Draelos Zoe Diana , Yatskayer Margarita , Raab Susana , Oresajo Christian
Published: June 2009

Background  Diabetes is a multisystem disease caused by the presence of chronic hyperglycemia, which leads to increased oxidative stress. Many of the changes observed in type II diabetic patients can be traced to the increased production of advanced glycation end products, also known as AGEs. AGEs are produced as a result of a nonenzymatic reaction with glucose interacting with proteins, lipids, and nucleic acids. AGEs are also present in normal skin with advancing age and contribute to the senescence of many body organs, including the skin.

Aims  This research evaluated the effect of a topical product formulation containing blueberry extract, an AGE inhibitor, and C‐xyloside, a GAG synthesis stimulator, applied twice daily on the hand, arm, and facial skin of 20 type II diabetic females. Diabetic skin was chosen for evaluation because AGEs are found in increased concentration in diabetic skin, representing a model for accelerated aging.

Materials and Methods  This single‐center study enrolled 20 female type II diabetics aged 55+ years with mild to moderate fine lines, wrinkles, and hyperpigmentation on the face and hands. Subjects used the study product on their face, hand, and inner forearm twice daily for 12 weeks. Ordinal grading on a 4‐point scale (0 =  none, 1 =  mild, 2 =moderate, 3 =  severe) of facial fine lines, wrinkles, firmness, radiance, skin tone, skin smoothness, hyperpigmentation, creping, density, sagging, and overall appearance was performed by the investigator at baseline, week 4, week 8, and week 12. Tolerability, subject assessments, digital photography, AGE measurements, skin caliper measurements, and corneometry were also performed at each time point.

Results  19/20 subjects successfully completed the study. The presence of AGEs was documented by skin autofluorescence. The 12‐week duration of the study was insufficient to measure a change in skin AGEs, but longer application of the study product might produce different results. No tolerability issues were noted. There was a statistically significant increase in skin caliper measurements on the face (P = 0.004) and arm (P = 0.014) as well as corneometry measurements (P < 0.001) consistent with enhanced moisturization at week 12. The dermatologist investigator also found statistically significant improvement in fine lines (P = 0.01), firmness (P = 0.011), radiance (P < 0.001), skin tone (P = 0.014), skin smoothness (P < 0.001), creping (P < 0.004), and overall appearance (P < 0.001).

Conclusion  This study examined a topical product containing an AGE inhibitor and a GAG synthesis stimulator designed for the unique needs of diabetic skin.
A new source of aging?
Authors: Knaggs Helen
Published: June 2009

There has been a considerable increase in understanding how skin ages, along with significant progress toward the correction and prevention of the visible signs of aging. However, there are still many unknown factors regarding why we age – and why we all seem to age differently. An area of high interest is the biological or intrinsic processes that affect our appearance over time. This article describes a recent discovery of a membrane bound enzyme proven to be present in skin and increases its activity as biological age increases. The enzyme is located on the external surface of both fibroblast and keratinocytes, and generates free radicals. Therefore, as we age there appears to be a biological mechanism that further increases the production of free radicals. Additionally, there appears to be a relationship between activity of the enzyme and appearance. Data showed that subjects who look younger than their biological age had lower enzyme activity and conversely, subjects who looked older than their biological age had higher enzyme activity. Free radicals are believed to be a major contributing factor in the production of fine lines and wrinkles by destroying the collagen and elastin network keeping skin supple and firm.
Loose anagen hair syndrome in children of Upper Egypt
Authors: Abdel‐Raouf Hamza , El‐Din Wael Hosam , Awad Sherif S , Esmat Ashraf , Al‐Khiat Mohammad , Abdel‐Wahab Hosam , Fakahani Hasan , Al‐Domyati Moetaz , El‐Din Anber Tag , El‐Tonsy Mohammad Hany
Published: June 2009

Background  Loose anagen hair (LAH) syndrome is a phenomenon in early childhood characterized by the presence of easily pluckable hair, where hair tufts can be pulled out easily and painlessly.

Aims  All reports in the English literature described mainly white patients with blond hair. We present the first report of LAH syndrome in dark‐skinned children of Upper Egypt.

Patients and methods  Twenty‐eight children with LAH were diagnosed and examined from 1996 to 2007. The main complaints were patchy or diffuse alopecia and/or slow growth of hair. Clinical examination, hair pull test, trichogram, and scanning electron microscopy (SEM) were performed.

Results  Children with LAH included 21 girls (75%) and seven boys (25%). Light microscopy of hair pull tests and trichograms disclosed a striking predominance of anagen hairs (90–100%) with misshapen hair bulbs and absent inner and outer root sheaths. SEM confirmed the misshapen anagen bulbs with ruffled appearance of cuticle and the longitudinal groove parallel to the long axis of the hair shaft. Most children improved spontaneously within few years, however, hair shed continued.

Conclusion  LAH syndrome occurs in dark‐skinned children and could be under‐diagnosed. The condition is of cosmetic concern and does not affect the general health.
Age‐associated loss of Sirt1‐mediated enhancement of glucose‐stimulated insulin secretion in beta cell‐specific Sirt1‐overexpressing (BESTO) mice
Authors: Ramsey Kathryn Moynihan , Mills Kathryn F. , Satoh Akiko , Imai Shin‐ichiro
Published: June 2009

The Sir2 (silent information regulator 2) family of NAD‐dependent deacetylases regulates aging and longevity across a wide variety of organisms, including yeast, worms, and flies. In mammals, the Sir2 ortholog Sirt1 promotes fat mobilization, fatty acid oxidation, glucose production, and insulin secretion in response to nutrient availability. We previously reported that an increased dosage of Sirt1 in pancreatic β cells enhances glucose‐stimulated insulin secretion (GSIS) and improves glucose tolerance in beta cell‐specific Sirt1‐overexpressing (BESTO) transgenic mice at 3 and 8 months of age. Here, we report that as this same cohort of BESTO mice reaches 18–24 months of age, the GSIS regulated by Sirt1 through repression of Ucp2 is blunted. Increased body weight and hyperlipidemia alone, which are observed in aged males and also induced by a Western‐style high‐fat diet, are not enough to abolish the positive effects of Sirt1 on β cell function. Interestingly, plasma levels of nicotinamide mononucleotide (NMN), an important metabolite for the maintenance of normal NAD biosynthesis and GSIS in β cells, are significantly reduced in aged BESTO mice. Furthermore, NMN administration restores enhanced GSIS and improved glucose tolerance in the aged BESTO females, suggesting that Sirt1 activity decreases with advanced age due to a decline in systemic NAD biosynthesis. These findings provide insight into the age‐dependent regulation of Sirt1 activity and suggest that enhancement of systemic NAD biosynthesis and Sirt1 activity in tissues such as β cells may be an effective therapeutic intervention for age‐associated metabolic disorders such as type 2 diabetes.
The association between leukocyte telomere length and cigarette smoking, dietary and physical variables, and risk of prostate cancer
Authors: Mirabello Lisa , Huang Wen‐Yi , Wong Jason Y.Y. , Chatterjee Nilanjan , Reding Douglas , David Crawford E. , De Vivo Immaculata , Hayes Richard B. , Savage Sharon A.
Published: June 2009

Telomeres consist of nucleotide repeats and a protein complex at chromosome ends that are essential to maintaining chromosomal integrity. Several studies have suggested that subjects with shorter telomeres are at increased risk of bladder and lung cancer. In comparison to normal tissues, telomeres are shorter in high‐grade intraepithelial neoplasia and prostate cancer. We examined prostate cancer risk associated with relative telomere length as determined by quantitative PCR on prediagnostic buffy coat DNA isolated from 612 advanced prostate cancer cases and 1049 age‐matched, cancer‐free controls from the PLCO Cancer Screening Trial. Telomere length was analyzed as both a continuous and a categorical variable with adjustment for potential confounders. Statistically significant inverse correlations between telomere length, age and smoking status were observed in cases and controls. Telomere length was not associated with prostate cancer risk (at the median, OR = 0.85, 95% CI: 0.67, 1.08); associations were similar when telomere length was evaluated as a continuous variable or by quartiles. The relationships between telomere length and inflammation‐related factors, diet, exercise, body mass index, and other lifestyle variables were explored since many of these have previously been associated with shorter telomeres. Healthy lifestyle factors (i.e., lower BMI, more exercise, tobacco abstinence, diets high in fruit and vegetables) tended to be associated with greater telomere length. This study found no statistically significant association between leukocyte telomere length and advanced prostate cancer risk. However, correlations of telomere length with healthy lifestyles were noted, suggesting the role of these factors in telomere biology maintenance and potentially impacting overall health status.
Flow mediated vasodilation and circulating concentrations of high sensitive C‐reactive protein, interleukin‐6 and tumor necrosis factor‐α in normal pregnancy – The Cardiovascular Risk in Young Finns Study
Authors: Saarelainen Heli , Valtonen Pirjo , Punnonen Kari , Laitinen Tomi , Raitakari Olli T. , Juonala Markus , Heiskanen Nonna , Lyyra‐Laitinen Tiina , Viikari Jorma S. A. , Heinonen Seppo
Published: June 2009

Background:  Traditional risk factors such as hyperlipidemia induce a state of inflammation that impairs vascular function. Despite marked maternal hyperlipidemia, endothelial function improves during pregnancy. In non‐pregnant state increased circulating levels of pro‐inflammatory cytokines and high sensitive C‐reactive protein (hsCRP) lead to attenuated flow mediated vasodilation. Relation between endothelial function and pro‐inflammatory cytokines has not been studied thoroughly in pregnancy. The aim of this study was to evaluate the effect of pregnancy on hsCRP and pro‐inflammatory cytokines and their associations with vascular endothelial function.

Methods:  As part of population‐based, prospective cohort Cardiovascular Risk in Young Finns study conducted in Finland we measured brachial artery flow mediated dilation (FMD) and serum concentrations of hsCRP, interleukin‐6 (IL‐6) and tumor necrosis factor‐α (TNF‐α) in 57 pregnant Finnish women throughout gestation and 62 control women matched for age and smoking.

Results:  HsCRP‐concentration was greater in pregnancy compared to non‐pregnant controls (median hsCRP 2·52 mg l−1 versus 1·21 mg l−1, P<0·001). IL‐6‐concentration was slightly increased in pregnancy compared with the non‐pregnant controls (median 1·66 versus 1·32 mg l−1, non‐significant [NS]) and TNF‐α‐concentration was slightly decreased in pregnant group (2·11 versus 2·38 pg ml−1, NS). FMD increased during pregnancy and IL‐6 had a positive correlation to the FMD in pregnancy (R = 0·288, P = 0·031).

Conclusions:  Improvement of FMD in normal pregnancy was not affected by increase in hsCRP concentration. We found an association with IL‐6 and FMD but we believe that improvement in endothelial function during normal pregnancy is not caused by variation in hsCRP, IL‐6 or TNF‐α.
Intra‐observer and inter‐observer variation of Hertel exophthalmometry
Authors: Lam Andrew K. C. , Lam Chun‐fai , Leung Wai‐kit , Hung Pui‐kwan
Published: June 2009

Purpose:  This study investigated the intra‐observer and inter‐observer variation of Hertel exophthalmometry.

Methods:  Seventy normal Chinese adults had bilateral exophthalmometry performed by two examiners. The two examiners were masked to the measurement results. One examiner did the measurement twice and the other examiner measured it once; the order was randomised. The same Hertel exophthalmometer was used throughout the study. The Bland–Altman method was used to analyse the intra‐observer and inter‐observer agreement.

Results:  The mean intra‐observer and inter‐observer agreements on the interorbital distance (IOD) were ±3.31 mm and ±6.39 mm, respectively. The intra‐observer exophthalmometry difference was −0.01 ± 0.61 mm for the right eye and 0.09 ± 0.56 mm for the left eye. Agreements were ±1.19 mm and ±1.09 mm for the right and left eyes, respectively. The inter‐observer exophthalmometry difference was −0.61 ± 0.89 mm for the right eye and −0.49 ± 0.80 mm for the left eye. Agreements were ±1.74 mm and ±1.57 mm for the right and left eyes, respectively. There was no significant intra‐observer difference but the inter‐observer difference was significant on both the IOD and exophthalmometry.

Conclusion:  Good intra‐observer agreement was demonstrated using Hertel exophthalmometry. The inter‐observer agreement was clinically acceptable.
A pilot study on the corneal biomechanical changes in short‐term orthokeratology
Authors: Chen Davie , Lam Andrew K. C. , Cho Pauline
Published: June 2009

Purpose:  To investigate the biomechanical changes in the cornea, in terms of corneal hysteresis (CH) and corneal resistance factor (CRF), with short‐term orthokeratology (ortho‐k) treatment, using the Ocular Response Analyser (ORA; Reichert Ophthalmic Instruments, Buffalo, NY, USA).

Methods:  Twenty young myopes wore ortho‐k lenses in four different sessions: 15, 30, 60 min and overnight respectively. Except for the overnight session which was always the final trial, those sessions were randomly assigned with a 1‐week washout period in between. CH and CRF were measured using the ORA and results were compared between the baseline and after each wearing session.

Results:  The mean baseline CH and CRF were 11.1 ± 1.0 mmHg and 10.7 ± 1.3 mmHg, respectively. There was no significant change in CH throughout the study, while a decreasing trend of CRF was shown. Paired t‐test with Bonferroni correction found a significantly reduced CRF of 10.1 mmHg after overnight wear.

Conclusions:  Short‐term ortho‐k treatment was shown to alter some corneal biomechanical properties. CRF was shown to decrease with increasing duration of lens wear. Further study is warranted to investigate the long term effect on corneal biomechanics from ortho‐k treatment.
Autonomic correlates of ocular accommodation and cardiovascular function
Authors: Davies Leon N. , Wolffsohn James S. , Gilmartin Bernard
Published: June 2009

Purpose:  To evaluate the hypothesis that objective measures of open‐ and closed‐loop ocular accommodation are related to systemic cardiovascular function, and ipso facto autonomic nervous system activity.

Methods:  Sixty subjects (29 male; 31 female) varying in age from 18 to 33 years (average: 20.3 ± 2.9 years) with a range of refractive errors [mean spherical equivalent (MSE): −7.12 to +1.82 D] participated in the study. Five 20‐s continuous objective recordings of the accommodative response, measured with an open‐view IR autorefractor (Shin‐Nippon SRW‐5000), were obtained for a variety of open‐ and closed‐loop accommodative demands while simultaneous continuous measurement of heart rate was recorded with a finger‐mounted piezo‐electric pulse transducer for 5 min. Fast Fourier Transformation of cardiovascular function allowed the absolute and relative power of the autonomic components to be assessed in the frequency‐domain, whereas heart period gave an indication of the time‐domain response.

Results:  Increasing closed‐loop accommodative demand led to a concurrent increase in heart rate of approximately 2 beats/min for a 4.0 D increase in accommodative demand. The increase was attributable to a reduction in the absolute (p < 0.05) and normalised (p < 0.001) input of the systemic parasympathetic nervous system, and was unaffected by refractive group. The interaction with refractive group failed to reach significance.

Conclusions:  For sustained accommodation effort, the data demonstrate covariation between the oculomotor and cardiovascular systems which implies that a near visual task can significantly influence cardiovascular behaviour. Accommodative effort alone, however, is not a sufficient stimulus to induce autonomic differences between refractive groups. The data suggest that both the oculomotor and cardiovascular systems are predominantly attributable to changes in the systemic parasympathetic nervous system.
Axial length measurements before and after removal of silicone oil: a new method to correct the axial length of silicone‐filled eyes for optical biometry
Authors: Wang Kai , Yuan Meng‐Ke , Jiang Yan‐Rong , Bao Yong‐Zhen , Li Xiao‐Xin
Published: June 2009

A total of 67 eyes of 67 patients that have undergone vitrectomy and silicone oil tamponade for rhegmatogenous retinal detachment were included in this prospective clinical study. We measured the axial length (AL) and the anterior chamber depth (ACD) with A‐mode ultrasonography and IOL Master before and after removal of silicone oil. Phase refractive indices of silicone oil at different wavelengths from 400 nm to 1000 nm were measured with an Abbe refractometer and a series of equations were derived to adjust the AL values obtained with the IOL Master in silicone‐filled eyes. The instruments showed good agreement between the AL values measured before and after removal of silicone oil. The ACD values obtained with A‐mode ultrasonography were lower than the values obtained with the IOL Master (p < 0.01). The AL values obtained with the IOL Master after removal of silicone oil were lower than the values obtained preoperatively (p < 0.01). The AL values obtained with the IOL Master after adjustment are more accurate than A‐mode ultrasonography in silicone‐filled eyes.
How well does record abstraction quantify the content of optometric eye examinations in the UK?
Authors: Shah Rakhee , Edgar David F. , Evans Bruce J. W.
Published: June 2009

Background:  A recent review found standardised patient (SP) methodology to be the gold standard method for evaluating clinical care. We compared the clinical records describing the content of optometric eye examinations with the actual content, as revealed by SPs.

Methods:  We recruited 111 community optometrists in the South East of the UK who consented to be visited by unannounced actors for an eye examination. The actors received extensive training to enable accurate reporting of the content of the eye examinations, via an audio recording and a checklist completed for each clinical encounter. Each participating optometrist was visited by three standardised patients. Upon completion of the standardised patient visits, copies of the clinical records were requested. Using the SP findings as the gold standard, the information gathered from the clinical record was classified for each quality criterion as true positive (reported by SP and documented on the record card), false negative (reported by SP but not documented on the record card), false positive (not reported by SP but recorded on the record card) and true negative (not reported by SP and not recorded on the record card).

Results:  Compared to the gold standard, false positives were identified during record abstraction in 4% of cases and false negatives in 18% of cases. For symptoms and history, the proportion of false negatives ranged from 15% to 25% and 3 to 4% for false positives. The proportion of false negatives for tests performed during the eye examinations ranged from 12% to 22% and false positives ranged from 2% to 6%. Optometrists give patients more verbal advice than is indicated in their records (false negatives, 11–19%). Five to 15% of practitioners recorded patient management and advice that was not reported by the SPs.

Conclusions:  Our findings regarding optometric consultation mirror the findings in other healthcare disciplines: clinical records are an imperfect representation of the content of a clinical consultation. Clinical records are subject to a recording bias leading to both under‐ and over‐estimation of the care provided due to the presence of false negatives and false positives. This study has important implications for clinico‐legal cases, where clinical records are a key item of evidence; and our findings indicate that accurate record‐keeping should be a priority for optometric continuing education.
Product selection in Internet business: a fuzzy approach
Authors: Mohanty B. K. , Aouni B.
Published: June 2009

In this paper, we propose a methodology which helps customers buy products through the Internet. This procedure takes into account the customer's level of desire in the product attributes, which are normally fuzzy, or in linguistically defined terms. The concept of fuzzy number will be used to measure the degree of similarities of the available products to that of the customer's requirements. The degrees of similarities so obtained over all the attributes give rise to the fuzzy probabilities and hence the fuzzy expected values of availing a product on the Internet as per the customer's requirement. Attribute‐wise the fuzzy expected values are compared with those of the available products on the Internet and the product that is closest to the customer's preference is selected as the best product. The multi‐attribute weighted average method is used here to evaluate and hence to select the best product.
Community and participation in water resources management: gendering and naturing development debates from Bangladesh
Authors: Sultana Farhana
Published: June 2009

Community and participation have become popular in development discourse and practice, particularly in the global South and in relation to water resources management. Greater involvement of people in decisionmaking, implementation and evaluation of water management practices is expected to increase efficiency and equity in water projects. However, scholars have pointed out that such discourses are often problematically used and idealised, leading to the exacerbation of gender, class and other social differentiations. Drawing from a case study of drinking water contamination by arsenic in Bangladesh, this article examines the mobilisation and outcomes of participation and community in water provision and arsenic mitigation. Water hardship, conflicts and marginalisations are found to be products of social processes (that are gendered, classed and spatialised) as well as natural processes (local geohydrology, depth of arsenic sediments), in addition to the very ways that community and participation are conceptualised and practised. Nature/water comes to play a critical role in the ways that development interventions play out, thereby complicating the general debates around community and participation. This article seeks to problematise the ways that considerations of both the roles of nature and gender power relations can be more critically and productively engaged in development geography. As such, the article brings together debates in nature–society geography and development geography to argue that scholars studying community and participation need to pay greater attention not only to gender and spatial power relations, but also to the importance of geographical locations and the agency of heterogeneous nature in the ways water management and development interventions fail and succeed, and are thereby critiqued. More adaptive, reflexive and inclusive development realities that are simultaneously embedded in society and nature may then be envisioned, and more nuanced understandings of nature‐in‐development enabled.
Changes in Regional Variation of Medicare Home Health Care Utilization and Service Mix for Patients Undergoing Major Orthopedic Procedures in Response to Changes in Reimbursement Policy
Authors: FitzGerald John D. , Boscardin W. John , Ettner Susan L.
Published: June 2009

Background. Significant variation in regional utilization of home health (HH) services has been documented. Under Medicare's Home Health Interim and Prospective Payment Systems, reimbursement policies designed to curb expenditure growth and reduce regional variation were instituted.

Objective. To examine the impact of Medicare reimbursement policy on regional variation in HH care utilization and type of HH services delivered.

Research Design. We postulated that the reimbursement changes would reduce regional variation in HH services and that HH agencies would respond by reducing less skilled HH aide visits disproportionately compared with physical therapy or nursing visits. An interrupted time‐series analysis was conducted to examine regional variation in the month‐to‐month probability of HH selection, and the number of and type of visits among HH users.

Subjects. A 100 percent sample of all Medicare recipients undergoing either elective joint replacement (1.6 million hospital discharges) or surgical management of hip fracture (1.2 million hospital discharges) between January 1996 and December 2001 was selected.

Results. Before the reimbursement changes, there was great variability in the probability of HH selection and the number of HH visits provided across regions. In response to the reimbursement changes, though there was little change in the variation of probability of HH utilization, there were marked reductions in the number and variation of HH visits, with greatest reductions in regions with highest baseline utilization. HH aide visits were the source of the baseline variation and accounted for the majority of the reductions in utilization after implementation.

Conclusions. The HH interim and prospective payment policies were effective in reducing regional variation in HH utilization.
Does Deinstitutionalization Increase Suicide?
Authors: Yoon Jangho , Bruckner Tim A.
Published: June 2009

Objectives.(1) To test whether public psychiatric bed reduction may increase suicide rates; (2) to investigate whether the supply of private hospital psychiatric beds—separately for not‐for‐profit and for‐profit—can substitute for public bed reduction without increasing suicides; and (3) to examine whether the level of community mental health resources moderates the relationship between public bed reduction and suicide rates.

Methods.We examined state‐level variation in suicide rates in relation to psychiatric beds and community mental health spending in the United States for the years 1982–1998. We categorize psychiatric beds separately for public, not‐for‐profit, and for‐profit hospitals.

Principal Findings.Reduced public psychiatric bed supply was found to increase suicide rates. We found no evidence that not‐for‐profit or for‐profit bed supply compensates for public bed reductions. However, greater community mental health spending buffers the adverse effect of public bed reductions on suicide. We estimate that in 2008, an additional decline in public psychiatric hospital beds would raise suicide rates for almost all states.

Conclusions.Downsizing of public inpatient mental health services may increase suicide rates. Nevertheless, an increase in community mental health funding may be promising.
Health Care Expenditures for Urban and Rural Veterans in Veterans Health Administration Care
Authors: West Alan N. , Weeks William B.
Published: June 2009

Objective. To compare Veterans Health Administration (VA) patients, non‐VA‐using veterans, and nonveterans, separated by urban/rural residence and age group, on their use of major categories of medical care and payment sources.

Data Source. Expenditures for health care–using men in Medical Expenditure Panel Surveys from 1996 through 2004.

Study Design. Retrospective, cross‐sectional analysis.

Data Collection/Extraction Methods. Controlling for demographics, health status, and insurance, we compared groups on population‐weighted expenditures for inpatient, hospital‐based outpatient, office‐based, pharmacy, and other care, by major payers (self/family, private insurance, Medicare, other sources, and VA).

Results. VA users received most of their health care outside of the VA system, paid through private insurance or Medicare; self‐payments were substantial. VA users under 65 reported worse health if they were rural residents but also lower expenditures overall and less care through private insurance.

Conclusions. VA health care users get most of their medical care from non‐VA providers. Working‐age VA users have less insurance coverage and rely more on VA care if they live in rural areas.
Understanding organic nitrates – a vein hope?
Authors: Miller Mark R , Wadsworth Roger M
Published: June 2009

The organic nitrate drugs, such as glyceryl trinitrate (GTN; nitroglycerin), are clinically effective in angina because of their dilator profile in veins and arteries. The exact mechanism of intracellular delivery of nitric oxide (NO), or another NO‐containing species, from these compounds is not understood. However, mitochondrial aldehyde dehydrogenase (mtALDH) has recently been identified as an organic nitrate bioactivation enzyme. Nitrate tolerance, the loss of effect of organic nitrates over time, is caused by reduced bioactivation and/or generation of NO‐scavenging oxygen‐free radicals. In a recent issue of the British Journal of Pharmacology, Wenzl et al. show that guinea‐pigs, deficient in ascorbate, also have impaired responsiveness to GTN, but nitrate tolerance was not due to ascorbate deficiency that exhibited divergent changes in mtALDH activity. Thus, the complex function of mtALDH appears to be the key to activation of GTN, the active NO species formed and the induction of tolerance that can limit clinical effectiveness of organic nitrate drugs.

British Journal of Pharmacology (2009) 157, 565–567; doi:10.1111/j.1476‐5381.2009.00193.x

This article is part of a themed section on Endothelium in Pharmacology. For a list of all articles in this section see the end of this paper, or visit: http://www3.interscience.wiley.com/journal/121548564/issueyear?year=2009 The paper by Wenzl et al. is available from http://www3.interscience.wiley.com/cgi‐bin/fulltext/122221718/PDFSTART
Vascular KATP channels: dephosphorylation and deactivation
Authors: Tammaro Paolo
Published: June 2009

Vascular ATP‐sensitive potassium (KATP) channels (Kir6.1/SUR2B) are regulated by both cell metabolism and chemical transmitters. They are the target for a number of vasodilators and vasoconstrictors whose mechanisms of action involve activation of protein kinase A (PKA) and protein kinase C (PKC), respectively. The article by Orie et al. in this issue of the BJP sheds new light on the (opposing) role of protein phosphatases in the regulation of this ion channel activity. Their data suggest that calcineurin, a Ca2+‐dependent protein phosphatase, modulates Kir6.1/SUR2B by inhibiting PKA‐dependent phosphorylation of the channel. This novel mechanism may provide a modulation opposing the action of vasodilators on the KATP channel.

British Journal of Pharmacology (2009) 157, 551–553; doi:10.1111/j.1476‐5381.2009.00204.x

This article is a commentary on Orie et al., pp. 554–564 of this issue and is part of a themed section on Endothelium in Pharmacology. For a list of all articles in this section see the end of this paper, or visit: http://www3.interscience.wiley.com/journal/121548564/issueyear?year=2009
Endothelium in pharmacology: 30 years on
Authors: McGrath JC
Published: June 2009

In this issue, BJP is proud to publish an Endothelium Themed Section to celebrate the life of Robert F. Furchgott, who died on May 19th 2009. It is 30 years since he discovered endothelium‐derived relaxant factor and a decade since he was awarded the Nobel Prize for this work. His discovery has led to an array of new therapeutic targets. The themed section includes three reviews on the pathophysiology of the endothelium and the drug targets that this presents, four research papers and three commentaries on research.

This themed section also forms the nucleus of an online Virtual Issue that collects in one place further reviews and research papers on the topic of the ‘Endothelium’ that BJP and our sister journal BJCP have published in the past year, and that should help researchers and students to find the latest work in this field.

To view the entire Endothelium Themed Section and the Endothelium Virtual Issue, please visit: http://www3.interscience.wiley.com/journal/121548564/issueyear?year=2009

British Journal of Pharmacology (2009) 157, 491–493; doi:10.1111/j.1476‐5381.2009.00366.x

This article is part of a themed section on Endothelium in Pharmacology. For a list of all articles in this section see the end of this paper, or visit: http://www3.interscience.wiley.com/journal/121548564/issueyear?year=2009
Lithostratigraphy of the Late Saalian to Middle Weichselian Skærumhede Group in Vendsyssel, northern Denmark
Authors: LARSEN NICOLAJ KROG , KROHN CHARLOTTE FOG , KRONBORG CHRISTIAN , NIELSEN OLE BJØRSLEV , KNUDSEN KAREN LUISE
Published: June 2009

The Quaternary sedimentary succession in Vendsyssel, northern Denmark, contains a unique, high‐resolution record of the last interglacial and glacial periods. There is still much debate, however, about the timing and ice extent in this southwestern part of the Scandinavian Ice Sheet, particularly during the Middle Weichselian. In this study, a detailed lithostratigraphical subdivision is established for the Late Saalian to Middle Weichselian Skærumhede Group on the basis of numerous, up to 250 m deep, boreholes in Vendsyssel. The sediments mainly consist of marine clays, glaciolacustrine sediments and tills, and the total thickness of the Skærumhede Group is up to 140 m. Marine intervals have been used as stratigraphical marker units to separate the formations indicative of ice‐sheet activity in Vendsyssel, and the timing of the events has been constrained by a large number of optically stimulated luminescence (OSL) and radiocarbon ages. The Skærumhede Group is subdivided into seven formations and two members, reflecting shifts between marine and terrestrial sedimentation caused by fluctuations of the Scandinavian Ice Sheet and changes in sea level. The lowermost Skærumhede Till Formation was deposited directly on top of the bedrock during the Warthe advancec. 160–140 kyr BP. Above, there are fine‐grained marine sediments, subdivided into the Lower, Middle and Upper Skærumhede Clay Formations. The marine formations are separated by the Brønderslev Formation related to the Sundsøre ice advance from the northc. 65–60 kyr BP, and the Åsted Formation, deposited during the Ristinge advance from an east–southeastern directionc. 55–50 kyr BP. The uppermost formation in the group is the Lønstrup Klint Formation, which is an upwards‐coarsening sequence of mainly glaciolacustrine sediments deposited prior to the Kattegat advancec. 30–29 kyr BP. The new evidence from Vendsyssel has shown that the Skærumhede Group covers a large area, and that it can be used as a regional stratigraphical marker horizon. Furthermore, it contributes to a better understanding of the timing and extent of glacial events during the Late Saalian to Middle Weichselian in southwest Scandinavia.
Litho‐ and chronostratigraphy of the Late Weichselian in Vendsyssel, northern Denmark, with special emphasis on tunnel‐valley infill in relation to a receding ice margin
Authors: KROHN CHARLOTTE FOG , LARSEN NICOLAJ KROG , KRONBORG CHRISTIAN , NIELSEN OLE BJØRSLEV , KNUDSEN KAREN LUISE
Published: June 2009

Lithostratigraphy and chronostratigraphy of samples from 18 deep boreholes in Vendsyssel have resulted in new insight into the Late Weichselian glaciation history of northern Denmark. Prior to the Late Weichselian Main advancec. 23–21 kyr BP, Vendsyssel was part of an ice‐dammed lake where the Ribjerg Formation was depositedc. 27–23 kyr BP. The timing of the Late Weichselian deglaciation is well constrained by the Main advance and the Lateglacial marine inundationc. 18 kyr BP, and thus spans only a few millennia. Rapid deposition of more than 200 m of sediments took place mainly in a highly dynamic proglacial and ice‐marginal environment during the overall ice recession. Mean retreat rates have been estimated as 45–50 m/yr in Vendsyssel with significantly higher retreat rates between periods of standstill and re‐advance. The deglaciation commenced in Vendsysselc. 20 kyr BP, and the Troldbjerg Formation was depositedc. 20–19 kyr BP in a large ice‐dammed lake in front of the receding ice sheet, partly as glaciolacustrine sediments and partly as rapid and focused sedimentation in prominent ice‐contact fans, which make up the Jyske Ås and Hammer Bakker moraines. In the northern part of central Vendsyssel, at least four generations of north–south orientated tunnel valleys are identified, each generation related to a recessional ice margin. This initial deglaciation was interrupted by a major re‐advance from the eastc. 19 kyr BP, which covered most of Vendsyssel. An ice‐dammed lake formed in front of the ice sheet as it retreated towards the east; the Morild Formation was deposited herec. 19–18 kyr BP. Related to this stage of deglaciation, eight ice‐marginal positions have been identified based on the distribution of large tunnel‐valley systems and pronounced recessional moraines. The Morild Formation consists of glaciolacustrine sediments, including the sediment infill of more than 190 m deep tunnel valleys, as well as the sediments in recessional moraines, which were formed as ice‐contact sedimentary ridges, possibly in combination with glaciotectonic deformation. The character of the tunnel‐valley infill sediments was determined by proximity to the ice margin. During episodes of rapid retreat of the ice margin, tunnel valleys were quickly abandoned and filled with fine‐grained sediments in a distal setting. During slow retreat of the ice margin, tunnel valleys were filled in an ice‐proximal environment, and the infill consists of alternating layers of fine‐ to coarse‐grained sediments. Atc. 18 kyr BP, Vendsyssel was inundated by the sea, when the Norwegian Channel Ice Stream broke up, and a succession of marine sediments (Vendsyssel Formation) was deposited during a forced regression.
Rapid tunnel‐valley formation beneath the receding Late Weichselian ice sheet in Vendsyssel, Denmark
Authors: SANDERSEN PETER B. E. , JØRGENSEN FLEMMING , LARSEN NICOLAJ KROG , WESTERGAARD JOAKIM H. , AUKEN ESBEN
Published: June 2009

Interpretation of Transient ElectroMagnetic (TEM) data and wire‐line logs has led to the delineation of an intricate pattern of buried tunnel valleys, along with new evidence of glaciotectonically dislocated layers in recessional moraines in the central part of Vendsyssel, Denmark. The TEM data have been compared with recent results of stratigraphical investigations based on lithological and biostratigraphical analyses of borehole samples and dating with Optically Stimulated Luminescence (OSL) and radiocarbon. This has provided an overview of the spatial distribution of the late Quaternary lithostratigraphical formations, and the age of the tunnel valleys has been estimated. The tunnel valleys are typically 5–10 km long, 1 km wide and are locally eroded to depths of more than 180 m b.s.l. The valleys are interpreted to have been formed by subglacial meltwater erosion beneath the outermost part of the ice sheet during temporary standstills and minor re‐advances during the overall Late Weichselian recession of the Scandinavian Ice Sheet. The formation of the tunnel valleys occurred after the retreat of the Main ice advance c. 20 kyr BP and before the Lateglacial marine inundation c. 18 kyr BP. Based on the occurrence of the tunnel valleys and the topography, four ice‐marginal positions related to the recession of the northeastern Main advance and seven ice‐marginal positions related to the recession from the following eastern re‐advance across Vendsyssel are delineated. All the tunnel valleys were formed within a time interval of a few thousand years, giving only a few hundred years or less for the formation of the tunnel valleys at each ice‐marginal position.
Caregiver perceptions of seizure severity in pediatric epilepsy
Authors: Wagner Janelle L. , Smith Gigi M. , Ferguson Pamela L. , Wannamaker Braxton B.
Published: June 2009

Purpose:  Seizure severity has been investigated using multiple tools over the years, and its defining features continue to be debated. Severity ratings are necessary for medical, psychological, and epidemiologic investigations. Adults with epilepsy have been evaluated more than youth with epilepsy.

Methods:  Seizure severity was evaluated as part of a larger study that included youth and caregiver self‐report measures of the emotional and social variables that occur in epilepsy.

Results:  The results indicate that a longer recovery time from the last seizure and a longer duration of seizure influence how severe a caregiver judges seizures. The usual elements such as type of epilepsy, frequency of seizures, and most recent seizure were not significantly related to severity rating. Behavior ratings were also not related to severity rating.

Discussion:  Clinicians often rely heavily on caregiver information during clinic visits to help inform treatment decisions; therefore, a standard measure of seizure severity from the caregivers’ perception has clinical utility. Rather than assuming what makes a seizure severe to a parent, more research should be conducted on what elements contribute to severity, as judged by both the parent and youth.
BIOLOGICAL WEIGHTING FUNCTIONS FOR UV INHIBITION OF PHOTOSYNTHESIS IN THE KELP LAMINARIA HYPERBOREA (PHAEOPHYCEAE)1
Authors: Miller III Harlan L. , Neale Patrick J. , Dunton Kenneth H.
Published: June 2009

Different wavelengths of sunlight either drive or inhibit macroalgal production. Ultraviolet radiation (UVR) effectively disrupts photosynthesis, but since UVR is rapidly absorbed in coastal waters, macroalgal photoinhibition and tolerance to UVR depend on the depth of attachment and acclimation state of the individual. The inhibition response to UVR is quantified with a biological weighting function (BWF), a spectrum of empirically derived weights that link irradiance at a specific wavelength to overall biological effect. We determined BWFs for shallow (0 m, mean low water [MLW]) and deep (10 m) Laminaria hyperborea (Gunnerus) Foslie collected off the island of Finnøy, Norway. For each replicate sporophyte, we concurrently measured both O2 evolution and 13C uptake in 48 different light treatments, which varied in UV spectral composition and irradiance. The relative shape of the kelp BWF was most similar to that of a land plant, and the absolute spectral weightings and sensitivity were typically less than phytoplankton, particularly in the ultraviolet radiation A (UVA) region. Differences in BWFs between O2 and 13C photosynthesis and between shallow (high light) and deep (low light) kelp were also most significant in the UVA. Because of its greater contribution to total incident irradiance, UVA was more important to daily loss of production in kelp than ultraviolet radiation B (UVB). Photosynthetic quotient (PQ) also decreased with increased UVR stress, and the magnitude of PQ decline was greater in deepwater kelp. Significantly, BWFs assist in the comparison of biological responses to experimental light sources versus in situ sunlight and are critical to quantifying kelp production in a changing irradiance environment.
A Cluster‐Randomized Trial of an Educational Intervention to Reduce the Use of Physical Restraints with Psychogeriatric Nursing Home Residents
Authors: Huizing Anna R. , Hamers Jan P. H. , Gulpers Math J. M. , Berger Martijn P. F.
Published: June 2009

OBJECTIVES: To investigate the effects of an educational intervention on the use of physical restraints with psychogeriatric nursing home residents.

DESIGN: Cluster‐randomized trial.

SETTING: Fifteen psychogeriatric nursing home wards in the Netherlands.

PARTICIPANTS: In total, 432 psychogeriatric nursing home residents from 15 psychogeriatric nursing home wards in seven nursing homes were selected for participation; 404 consented, and 371 of these were available at baseline. Two hundred forty‐one from 14 wards had complete data and were included in the data analyses.

INTERVENTION: The nursing home wards were assigned at random to educational intervention or control status. The educational intervention consisted of an educational program for nursing staff combined with consultation with a nurse specialist (registered nurse (RN) level).

MEASUREMENTS: Data were collected at baseline and 1, 4, and 8 months postintervention. At each measurement, the use of physical restraints was measured using observations of blinded, trained observers on four separate occasions over a 24‐hour period. Other resident characteristics, such as cognitive status, were determined using the Minimum Data Set.

RESULTS: Logistic and linear regression analyses showed no treatment effect on restraint status, restraint intensity, or multiple restraint use in any of the three postintervention measurements. Furthermore, only small changes occurred in the types of restraints used with residents in the experimental group.

CONCLUSION: An educational program for nursing staff combined with consultation with a nurse specialist (RN level) had no effect on the use of physical restraints with psychogeriatric nursing home residents. In addition to restraint education and consultation, new measures to reduce the use of physical restraints with psychogeriatric nursing home residents should be developed.
Senior Health Clinics: Are They Financially Viable?
Authors: McAtee Robin E. , Crandall Debra , Wright Larry D. , Beverly Claudia J.
Published: June 2009

Are hospital‐based outpatient interdisciplinary clinics a financially viable alternative for caring for our burgeoning population of older adults in America? Although highly popular, with high patient satisfaction rates among older adults and their families, senior health clinics (SHCs) can be expensive to operate, with limited quantifiable health outcomes. This study analyzed three geriatric hospital‐based interdisciplinary clinics in rural Arkansas by examining their patient profiles, revenues, and expenses. It closely examined the effects of the downstream revenue using the multiplier effect and acknowledged other factors that weigh heavily on the success of SHCs and the care of older adults. The findings highlight the similarities and differences in the three clinics' operating and financial structures in addition to the clinics' and providers' productivity. The analysis presents an evidence‐based illustration that SHCs can break even or lose large amounts of money.