bluuebunny/crossref_metadata_2025 huggingface dataset:
Welfare Reform and the Shifting Threshold of Support for Disabled People
Authors: Harris Neville
Published: November 2014

Among the highly significant changes to the benefits system made by theWelfareReformAct 2012 is provision for a new disability benefit, personal independence payment (PIP).PIPis replacing disability living allowance (DLA), received by three million people, as the principal form of state financial support towards disability‐related care and mobility costs for those of working age. The legislation, including regulations prescribing a new disability assessment framework, plays its traditional role in this field of rationing access to benefit and directing front‐line policy implementation. This article examines how, in the context of the Coalition government's welfare reforms,PIPshifts the threshold of entitlement for people with disabilities and it assessesPIP's potential impact on equality and the right to independent living, to whose realisation disability benefits may be expected to contribute significantly. It also considers the impact on disabled people of other relevant reforms, including the controversial ‘bedroom tax’.
The House Mouse (Mus musculus L.) Exerts Strong Differential Grain Consumption Preferences among Hard Red and White Spring Wheat (Triticum aestivum L.) Varieties in a Single‐Elimination Tournament Design
Authors: Morris Craig F. , Fuerst E. Patrick , McLean Derek J. , Momont Kathleen , James Caleb P.
Published: November 2014

Wheat (Triticum aestivum L.) plays a central role in the health and nutrition of humans. Yet, little is known about possible flavor differences among different varieties. We have developed a model system using the house mouse (Mus musculus L.) to determine feeding preferences as a prelude to extending results to human sensory analysis. Here, we examine the application of a single‐elimination tournament design to the analysis of consumption preferences of a set of hard red and hard white spring wheat varieties. A single‐elimination tournament design in this case pairs 2 wheat varieties and only 1 of the 2 is advanced to further tests. Preferred varieties were advanced until an overall “winner” was identified; conversely, less desirable varieties were advanced such that an overall “loser” was identified. Hollis and IDO702 were the winner and loser, respectively, for the hard red varieties, and Clear White 515 and WA8123 were the winner and loser, respectively, for the hard white varieties. When using the more powerful protocol of 14 mice and a 4‑d trial, differences in mean daily consumption preferences of 2 varieties were separated at P‐values as small as 2 × 10−8. The single‐elimination tournament design is an efficient means of identifying the most and least desirable varieties among a larger set of samples. One application for identifying the 2 extremes in preference within a group of varieties would be to use them as parents of a population to identify quantitative trait loci for preference.
How Ought War To Be Remembered in Schools?
Authors: Aldridge David
Published: November 2014

Each year a national day of commemoration of the war dead is celebrated on 11th November in the United Kingdom. Despite public controversy about the nature and purpose of remembrance, there has been no significant discussion of the role schools should play in this event. In this centenary year of the outbreak of the First World War, with the government planning to send groups from every secondary school in Britain to tour the battlefields of the western front over the next four years, the question of how war should be remembered in schools is more pressing than ever.

In this bold and rigorous pamphlet, David Aldridge takes a hard look at the reasons usually advanced for involving children and young people in commemorating the war dead, and finds many of them wanting. He critically examines the high profile in schools of charities, like the Royal British Legion, with vested interests in certain kinds of commemoration. And he argues forcefully for a justification of remembrance in schools that requires a major rethink of established rituals and practices.

This is a compelling treatment of a topic high on the agenda of teachers and education policy‐makers and will be an invaluable resource for anyone involved in planning centenary commemorative events for children and young people.
The response of barley to rainfall and temperature in different tillage and crop rotation systems in semi‐arid conditions
Authors: Fernández‐Getino A.P. , Santín‐Montanyá M.I. , Zambrana E. , de Andrés E.F. , Tenorio J. L.
Published: November 2014

Barley is a widespread crop of choice in the Spanish agricultural farming. A 7‐year field study was realised to examine the barley yield data. Weather conditions were analysed and taken into account when considering the influence of the tillage systems (TS) and previous crop on barley. In general, barley yield increased with tillage intensity; however the analysis of tiller‐count and thousand‐grain weight of barley did not present significant differences within the different TS. Barley monoculture presented lower yield than the barley in rotation with fallow or vetch, especially in those years characterised by a greater annual rainfall than average over the 7 years of study (290 mm). Also, we observed that the presence of weeds was strongly influenced by the combined effects of the environmental conditions, TS, and previous crop.

It was observed that high rainfall during sowing period or shortly after had a high positive impact on production efficiency and yields. Unexpectedly, the study demonstrated positive correlation between high December temperatures and resulting barley yield. It would be useful to take into account these results when selecting the crop variety for conservation planning in Mediterranean areas.
Impaired Cardiac Autonomic Functions in Apparently Healthy Subjects with Vitamin D Deficiency
Authors: Canpolat Uğur , Özcan Fırat , Özeke Özcan , Turak Osman , Yayla Çağr , Açıkgöz Sadık Kadri , Çay Serkan , Topaloğlu Serkan , Aras Dursun , Aydoğdu Sinan
Published: November 2014

Objectives

Vitamin D (VitD) deficiency affects the cardiovascular system via endocrine, paracrine, and autocrine pathways. Limited data are available regarding cardiac autonomic dysfunction in VitD deficiency. The aim of this study was to assess the cardiac autonomic functions by using heart rate recovery index (HRRI) and heart rate variability (HRV) in apparently healthy subjects with VitD deficiency.

Methods

A total of 24 VitD deficient and 50 age‐, gender‐, and body mass index–matched VitD sufficient healthy participants who admitted to outpatient clinics at a tertiary centre were enrolled. All study participants underwent Treadmill exercise test and 24‐hour Holter recording to assess cardiac autonomic functions. HRRIs were calculated by subtracting first, second, and third minute heart rates during recovery period from maximal heart rate.

Results

Mean HRR1 (28.0 ± 8.3 vs 42.8 ± 6.4, P < 0.001), HRR2 (41.1 ± 11.2 vs 60.8 ± 10.4, P < 0.001), and HRR3 (44.9 ± 13.3 vs 65.9 ± 9.8, P < 0.001) were significantly higher in VitD sufficient group compared to VitD deficient group. HRV parameters as, SDNN (P = 0.040), SDANN (P < 0.001), RMSSD (P < 0.001), PNN50 (P < 0.001), and HF (P < 0.001) were significantly decreased in patients with VitD deficiency; but LF (P < 0.001) and LF/HF (P = 0.003) were significantly higher in VitD deficient group. Serum 25(OH)D level was positively correlated with HRRIs (P < 0.001), PNN50, RMSSD, SDANN, and HFnu; negatively correlated with LFnu and LF/HF (P < 0.05). Also, multivariate linear regression analysis showed that serum 25(OH)D level was significantly associated with HRRIs and HRV parameters (P < 0.001).

Conclusion

Our study results suggest that cardiac autonomic functions are impaired in patients with VitD deficiency despite the absence of overt cardiac involvement and symptoms. Further studies are needed to elucidate the prognostic significance and clinical implications of impaired autonomic functions in patients with VitD deficiency.
Early and exudative age‐related macular degeneration is associated with increased plasma levels of soluble TNF receptor II
Authors: Faber Carsten , Jehs Tina , Juel Helene Bæk , Singh Amardeep , Falk Mads Krüger , Sørensen Torben Lykke , Nissen Mogens Holst
Published: November 2014

Purpose

We have recently identified homeostatic alterations in the circulating T cells of patients with age‐related macular degeneration (AMD). In cultures of retinal pigment epithelial cells, we have demonstrated that T‐cell‐derived cytokines induced the upregulation of complement, chemokines and other proteins implicated in AMD pathogenesis. The purpose of this study was to test whether increased plasma levels of cytokines were present in patients with AMD.

Methods

We conducted a case–control study. Age‐related macular degeneration status was assessed using standardized multimodal imaging techniques. Plasma was isolated from freshly drawn peripheral venous blood samples and analysed for interleukin (IL)15, IL18, interferon (IFN)γ, soluble tumour necrosis factor (TNF) receptor II (sTNFRII) and complement factor H (CFH) Y402H genotype.

Results

We included 136 individuals with early or late forms of AMD and 74 controls. Significantly increased levels of sTNFRII were observed in patients with early or exudative AMD (p < 0.01). After adjusting for CFH Y402H genotype, age, sex and smoking history, the level of sTNFRII remained a significant predictor for prevalence of AMD with odds ratios at 3.0 in the middle and 3.6 in the highest tertiles. Levels of IL15, IL18 and IFNγ were low and not associated with AMD.

Conclusions

Increased plasma level of sTNFRII is found to be associated with AMD. The data supports the observations of low‐grade, systemic inflammatory alterations in patients with AMD. However, it remains to be determined whether increased levels of TNFα can be found, which directly reflects an increased activity of macrophages and T cells.
Effect of basal ganglia calcification on its glucose metabolism and dopaminergic function in idiopathic hypoparathyroidism
Authors: Modi Sagar , Arora Geetanjali , Bal Chandra Shekhar , Sreenivas Vishnubhatla , Kailash Suparna , Sagar Rajesh , Goswami Ravinder
Published: November 2014

Background

The functional significance of basal ganglia calcification (BGC) in idiopathic hypoparathyroidism (IH) is not clear.

Objective

To assess the effect of BGC on glucose metabolism and dopaminergic function in IH.

Methods

18F‐FDG and 99mTc‐TRODAT‐1 nuclear imaging were performed in 35 IH patients with (n = 26) and without (n = 9) BGC. Controls were subjects without hypoparathyroidism or BGC (nine for 18F‐FDG and 12 for 99mTc‐TRODAT‐1). Relationship of the glucose metabolism and dopaminergic function was assessed with the neuropsychological and biochemical abnormalities.

Results

18F‐FDG uptake in IH patients with calcification at caudate and striatum was less than that of IH patients without calcification (1·06 ± 0·13 vs 1·24 ± 0·09, P = <0·0001 and 1·06 ± 0·09 vs 1·14 ± 0·08, P = 0·03, respectively). 18F‐FDG uptake did not correlate with neuropsychological dysfunctions. 18F‐FDG uptake in IH without BGC was significantly lower than that of controls. The mean 99mTc‐TRODAT‐1 uptake at basal ganglia was comparable between IH with and without BGC and between IH without BGC and controls. Serum calcium–phosphorus ratio maintained by the patients correlated with 18F‐FDG uptake at striatum (r = 0·57, P = 0·001). For every 0·1 unit reduction in calcium–phosphorus ratio, 18F‐FDG uptake decreased by 2·5 ± 0·68% (P = 0·001).

Conclusion

BGC was associated with modest reduction (15%) in 18F‐FDG uptake at basal ganglia in IH but did not affect dopaminergic function. 18F‐FDG uptake did not correlate with neuropsychological dysfunctions. Interestingly, chronic hypocalcaemia–hyperphosphataemia also contributed to reduction in 18F‐FDG uptake which was independent of BGC.
Spread of Paraleyrodes minei Iaccarino (nesting whitefly) in Italian citrus groves
Authors: Longo S. , Rapisarda C.
Published: November 2014

Outbreaks of Paraleyrodes minei Iaccarino have been noted on citrus in a wide area along the whole eastern coast of Sicily (South Italy), in the districts of Catania, Messina and Siracusa. Until this year, the whitefly was only reported in Italy from a few samples collected on a limited number of ornamental sour orange trees in a town park in Portici, in the district of Naples. Findings in 2014 of the insect in Sicily were made not only on ornamental citrus trees in urban areas, but more importantly in orange, lemon and mandarin commercial orchards. This severe and extremely rapid spread of P. minei in Sicily (where more than half of Italian citrus are produced) represents a potential threat for the local citrus industry and requires careful monitoring to define both the actual pest status of the whitefly as well as the occurrence and role of eventual natural enemies. Brief notes on morphology, bio‐ecology and present geographical distribution of P. minei are given in this paper, together with details on the occurrences in Sicily and short considerations on the pest importance and control possibilities for this insect.
Epidemiological characteristics and outcome in elderly patients sustaining non‐simultaneous bilateral hip fracture: A systematic review and meta‐analysis
Authors: Zhu Yanbin , Chen Wei , Sun Tao , Zhang Qi , Liu Song , Zhang Yingze
Published: November 2014

Objectives

The present study aimed to quantitatively and comprehensively conclude the epidemiological characteristics and outcome in elderly patients with non‐simultaneous bilateral hip fractures.

Methods

A search was applied to Medline, Embase and Cochrane central database (all up to February 2014). All the studies on non‐simultaneous bilateral hip fractures in elderly patients without language restriction were reviewed, and qualities of included studies were assessed using the Newcastle–Ottawa Scale. All the data were carefully and independently abstracted by two reviewers, any disagreement was settled by discussion. Data were pooled and a meta‐analysis completed.

Results

A total of 23 studies (all were observational) including 2168 cases with bilateral hip fractures were identified, showing an accumulated incidence of 8.54%, and of them 71.4% were symmetrical. A total of 70.4% of cases occurred in the first 3 years, especially 36.3% in the first year. Results of meta‐analyses showed that patients of female sex (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.10–1.99), advanced age (standardized mean difference 0.25, 95% CI 0.15–0.36), initial trochanteric fractures (OR 1.15, 95% CI 1.01–1.32) and osteoporosis (Singh Index 1–3) (OR 10.02, 95% CI 5.41–18.57) were more likely to sustain a second contralateral hip fracture.

Conclusions

Non‐simultaneous bilateral hip fracture accounts for a high proportion of hip fractures, and most of the second hip fractures occurred in the first 3 years. Patients of female sex, having initial trochanteric fractures, of more advanced age and having osteoporosis are more likely to sustain a second contralateral hip fracture, and risk‐reduction strategies should be implemented. Geriatr Gerontol Int 2015; 15: 11–18.
Relationship between chewing ability and sarcopenia in Japanese community‐dwelling older adults
Authors: Murakami Masaharu , Hirano Hirohiko , Watanabe Yutaka , Sakai Katsuhiko , Kim Hunkyoung , Katakura Akira
Published: November 2014

Aim

It has been reported that if nutrient intake is unbalanced, muscle mass, muscle strength and physical performance declines, and therefore it is important to maintain chewing ability to keep a balanced nutrient intake. However, the relationship between chewing ability and sarcopenia has not been previously reported. Therefore, the present study investigated the relationship between chewing ability and sarcopenia in addition to known sarcopenia‐related factors.

Methods

We examined 761 participants (average age 73.0 ± 5.1 years), who lived in the Itabashi city of Tokyo. Our research was designed to examine the relationship between chewing ability and sarcopenia. We carried out regression analysis to analyze the relationship with sarcopenia‐related factors with consideration of the age of the participants.

Results

The 761 participants were divided into two groups in terms of the stage of sarcopenia according to whether there was a deterioration of muscle strength or physical performance. Furthermore, we carried out logistic regression analyses on the value as a dependent variable, including known sarcopenia‐related factors. There were significant correlations of sarcopenia with age (odds ratio 2.37, 95% confidence interval 1.52–3.70), body mass index (odds ratio 0.75, 95% confidence interval 0.69–0.81) and chewing ability (odds ratio 2.18, 95% confidence interval 1.21–3.93).

Conclusions

The present study shows that chewing ability is related to sarcopenia, which is equal to the relationship with the known factor of age by odds ratio. Geriatr Gerontol Int 2015; 15: 1007–1012.
A Plains‐wanderer (Pedionomidae) that did not wander plains: a new species from the Oligocene of South Australia
Authors: De Pietri Vanesa L. , Camens Aaron B. , Worthy Trevor H.
Published: November 2014

The remarkable fauna of Australia evolved in isolation from other landmasses for millions of years, yet understanding the evolutionary history of endemic avian lineages on the continent is confounded by the ability of birds to disperse over geographical barriers even after vicariance events. The Plains‐wanderer Pedionomus torquatus (Charadriiformes) is an enigmatic, predominantly sedentary, quail‐like bird that occurs exclusively in sparse native grasslands of southeastern Australia. It is the only known species of its family (Pedionomidae), and its closest relatives are the South American seedsnipes (Thinocoridae). Here we describe a further representative of this lineage, Oligonomus milleri gen. et sp. nov., from the Late Oligocene of South Australia (26–24 Ma), which pre‐dates the earliest record of P. torquatus by c. 22 Ma and attests to the presence of this lineage during Australia's period of isolation (50–15 Ma). Based on the morphology of the coracoid and the palynological record, we propose that O. milleri and P. torquatus were ecologically disparate taxa and that, similar to coeval marsupials, O. milleri inhabited well‐wooded habitats, suggesting that the preference for grassland in the extant P. torquatus and thinocorids is likely to be convergent and not ancestral. The speciation event leading to the evolution of the extant Plains‐wanderer was probably triggered by the spread of grasslands across Australia in the Late Miocene–Pliocene, which this record pre‐dates. The presence of a pedionomid in the Late Oligocene of Australia strengthens the hypothesis of a Gondwanan divergence of the lineages giving rise to Thinocoridae and Pedionomidae.
Effects of Different Surfactants on Humidity Sensing Properties of CeO2 Nanobelts Thin Film Prepared by Hydrothermal Method
Authors: Wang Chunjie , Wang Yue
Published: November 2014

CeO2 nanobelts were synthesized with three different types of surfactants (polyethyleneglycol [PEG], cetyltrimethyl ammonium bromide [CTAB], and sodium dodecylbenzene sulfonate [SDBS]) via hydrothermal method. X‐ray diffraction (XRD), Raman spectroscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM) were utilized to characterize the phase structures and morphologies of the products. CeO2‐C (the sample with CTAB as surfactant) has the largest specific surface area among three samples. The humidity sensing performances of the corresponding sensors were also investigated. CeO2‐C shows high humidity sensitivity (the impedance decreases by about five orders of magnitude), rapid response–recovery characteristics (6 and 7 s), and narrow hysteresis loop (4%) at 100 Hz in the relative humidity range from 11% to 95%. Such results indicate that the cationic surfactant (CTAB) can effectively improve on the performance of CeO2 humidity sensors.
Eram, ergo sum? A 1-year retrospective study of General Pharmaceutical Council fitness to practise hearings
Authors: Gallagher Cathal T , Greenland Victoria A M , Hickman Adrienne C
Published: November 2014

Objectives

The principal aims of this research were: to assess whether aggravating and mitigating circumstances considered by the General Pharmaceutical Council (GPhC) when imposing sanctions are considered when determining impairment of fitness to practise and to determine whether those circumstances described by the GPhC in their Indicative Sanctions Guidance (ISG) as warranting erasure from the Register of Pharmacists lead to that outcome.

Methods

The consideration of specific aggravating circumstances or points of mitigation in determining impairment of fitness to practise were compared with their subsequent consideration when determining the severity of sanction. Additionally, the proportion of cases that highlighted aggravating circumstances deemed by the GPhC as serious enough to warrant the sanction of erasure were monitored to determine if they were more likely to give rise to this sanction.

Key findings

Fifty-one cases heard by the GPhC between 1 October 2011 and 30 September 2012 met with the inclusion criteria. Pearson’s χ2 test was used to detect a variation from the expected distribution of data. Of the four aggravating/mitigating circumstances considered, all but one was more likely to be heard when determining sanction having first been factored in to the consideration of impairment. There was a statistically significant correlation between both risk of harm and dishonesty as aggravating factors and the sanction erasure from the Medical Register.

Conclusions

The GPhC do, in general, consider relevant factors at all stages of their deliberations into practitioner misconduct, as required by the determinations in the cases of Cohen, Zygmunt, and Azzam, and subsequently consider their ISG regarding dishonesty as an aggravating circumstance in determining which sanction to apply.
Physicians’ attitudes towards provision of primary care services in community pharmacy in the United Arab Emirates
Authors: Hasan Sanah , Stewart Kay , Chapman Colin B , Hasan Mohammed Yousif , Kong David C M
Published: November 2014

Objectives

This study aims to explore physicians' views of pharmacists' roles in providing primary care services through community pharmacies in the United Arab Emirates (UAE).

Methods

A qualitative approach involving semi-structured interviews conducted one-to-one or in group discussions was employed. The interviews explored participants' views of pharmacists' primary care services including screening and monitoring of disease, health advice, referral, lifestyle and preventive care, supply of printed information, counselling on medications, patient record keeping, and pharmacist intervention in chronic disease management. Data were analysed using the Framework approach.

Key findings

Fifty-three physicians participated; 27 were interviewed individually and 26 participated in five group discussions. Four major themes were identified: competence, business orientation, territorial control and service delivery. Participants were supportive of verbal counselling about medications, checking for drug dosing, interactions, duplications and errors, and keeping patient medication profiles. Physicians generally did not favour pharmacists' involvement in screening or monitoring of disease, providing information about diseases, diagnosis or long-term management of disease, or intervention directly with patients, mainly due to perceived lack of competence, territorial encroachment and business orientation of community pharmacy.

Conclusions

Despite some reservations, participants showed support for pharmacist involvement in providing primary care services, provided certain quality and territorial issues were addressed. Understanding physicians' attitudes will facilitate interventions to enhance the contribution of community pharmacists to primary care in the UAE, and possibly in other regions with similar healthcare systems.
Visualization of granzyme B‐expressing CD8 T cells during primary and secondary immune responses to Listeria monocytogenes
Authors: Mouchacca Pierre , Chasson Lionel , Frick Melissa , Foray Chloé , Schmitt‐Verhulst Anne‐Marie , Boyer Claude
Published: November 2014

CD8 T cells contribute to long‐term protection against Listeria monocytogenes infection by differentiating into memory T cells. These rapidly respond to antigen or inflammation upon secondary infection. In this study we used CD8 T cells from OT1 mice and CD4 T cells from OT2 mice expressing a fluorescent chimeric granzyme (GZMB‐Tom) protein to monitor the primary response to infection with ovalbumin‐expressing L. monocytogenes (Lm‐OVA). We show that, unlike poorly responding CD4 T cells, CD8 T cells readily proliferated and expressed high levels of GZMB‐Tom as early as 2 days after infection. FACS analysis showed GZMB‐Tom expression in undivided CD8 T cells, with its level increasing over one to four divisions. OT1 T cells were visualized in the T‐cell zone by confocal microscopy. This showed GZMB‐Tom‐containing granules oriented towards MHCII‐positive cells. Twenty hours later, most OT1 T cells had divided but their level of GZMB‐Tom expression was reduced. Recently divided OT1 cells failed to express GZMB‐Tom. Fourteen hours after secondary infection, GZMB‐Tom was re‐expressed in memory OT1 T cells responding either to Lm‐OVA or L. monocytogenes. Differences in the activation phenotype and in the splenic distribution of OT1 T cells were observed, depending on the challenge. Notably, OTI T cells with polarized granules were only observed after challenge with cognate antigen. This work showed that the GZMB‐Tom knock‐in mice in which GZMB‐Tom faithfully reproduced GZMB expression, provide useful tools to dissect mechanisms leading to the development of anti‐bacterial effector and memory CD8 T cells and reactivation of the memory response to cognate antigen or inflammatory signals.
Synthesis of Biopolymer‐Derived Zirconium Carbide Powder by Facile One‐Pot Reaction
Authors: Patra Niranjan , Jayaseelan Daniel Doni , Lee William Edward
Published: November 2014

Zirconium carbide (ZrC) was synthesized by polycondensation and carbothermal reduction reactions from an organic–inorganic hybrid complex. A natural biopolymer Gum Karaya (GK) and zirconyl oxychloride octahydrate (ZOO) were used as the sources of carbon and zirconium, respectively. FTIR of as‐synthesized dried complexes revealed formation of Zr–O. Pyrolysis of the complexes at 1200°C/1 h under argon resulted in tetragonal and monoclinic zirconia which after heat treatment at 1400°C–1550°C transformed to zirconium carbide. Thermal analysis shows that the GK–ZOO complexes lost less mass than the pristine GK to 600°C. The intensity of exothermic decomposition decreases and shifted to higher temperature for the hybrid complexes indicating that zirconia induced thermal stability. A maximum ZrC yield of ~60 wt% is obtained for the intermediate GK–ZOO ratio of 1:2. Particles pyrolyzed for 1 h at 1550°C were coarser (5–10 μm) with flakes for lower GK–ZOO weight ratio, but were spheroidal with narrow size distribution (~1 μm) with increasing GK–ZOO weight ratio.
Electronic Surveillance and Pharmacist Intervention for Vulnerable Older Inpatients on High‐Risk Medication Regimens
Authors: Peterson Josh F. , Kripalani Sunil , Danciu Ioana , Harrell Debbie , Marvanova Marketa , Mixon Amanda S. , Rodriguez Carmen , Powers James S.
Published: November 2014

Objectives

To develop and evaluate an electronic tool to assist clinical pharmacists with reviewing potentially inappropriate medications (PIMs) in hospitalized elderly adults.

Design

Pilot intervention.

Setting

Academic tertiary care hospital.

Participants

Hospitalized adults aged 65 and older admitted to the general medicine, orthopedics, and urology services during a 3‐week period in 2011 who were administered at least one medication from a list of 240 PIMs.

Intervention

A computerized PIMS dashboard flagged individuals with at least one administered PIM or a high calculated anticholinergic score. The dashboard also displayed 48‐hour cumulative narcotic and benzodiazepine administration. Participants were ranked to reflect the estimated risk of an adverse event using logical combinations of data (e.g., use of multiple sedatives in a nonmonitored location). In a pilot implementation, a clinical pharmacist reviewed the flagged records and delivered an immediate point‐of‐care intervention for the treating physician.

Measurements

Clinician response to pharmacist intervention.

Results

The PIMS dashboard flagged 179 of 797 individuals (22%) admitted over a 3‐week period and 485 participant‐medication pairs for review by the clinical pharmacist. Seventy‐one participant records with 139 participant–medication pairs required additional manual review of the electronic medical record. Twenty‐two participants receiving 40 inappropriate medication orders were judged to warrant an intervention, which was delivered by personal communication over the telephone or text message. Clinicians enacted 31 of 40 (78%) pharmacist recommendations.

Conclusion

An electronic PIM dashboard provided an efficient mechanism for clinical pharmacists to rapidly screen the medication regimens of hospitalized elderly adults and deliver a timely point‐of‐care intervention when indicated.
Identifying Landmark Articles for Advancing the Practice of Geriatrics
Authors: Vaughan Camille P. , Fowler Rachel , Goodman Richard A. , Graves Taylor R. , Flacker Jonathan M. , Johnson Theodore M.
Published: November 2014

Landmark articles from the peer‐reviewed literature can be used to teach the fundamental principles of geriatric medicine. Three approaches were used in sequential combination to identify landmark articles as a resource for geriatricians and other healthcare practitioners. Candidate articles were identified first through a literature review and expert opinion survey of geriatric medicine faculty. Candidate articles in a winnowed list (n = 30) were then included in a bibliometric analysis that incorporated the journal impact factor and average monthly citation index. Finally, a consensus panel reviewed articles to assess each manuscript's clinical relevance. For each article, a final score was determined by averaging, with equal weight, the opinion survey, bibliometric analysis, and consensus panel review. This process ultimately resulted in the identification of 27 landmark articles. Overall, there was weak correlation between articles that the expert opinion survey and bibliometric analysis both rated highly. This process demonstrates a feasible method combining subjective and objective measures that can be used to identify landmark papers in geriatric medicine for the enhancement of geriatrics education and practice.
Restricting Back Pain and Subsequent Mobility Disability in Community‐Living Older Persons
Authors: Makris Una E. , Fraenkel Liana , Han Ling , Leo‐Summers Linda , Gill Thomas M.
Published: November 2014

Objectives

To evaluate the relationship between back pain severe enough to restrict activity (restricting back pain) and subsequent mobility disability in community‐living older persons.

Design

Prospective cohort study.

Setting

Greater New Haven, Connecticut.

Participants

Community‐living men and women aged 70 and older (n = 709).

Measurements

Restricting back pain and mobility disability (defined as needing help with or unable to walk one‐quarter of a mile, climb a flight of stairs, or lift and carry 10 pounds) were assessed during monthly telephone interviews for up to 159 months. The association between restricting back pain and subsequent mobility disability was evaluated using a recurrent‐events Cox model. Secondary analyses evaluated the association between restricting back pain and mobility disability for two or more consecutive months (persistent mobility disability). Additional analyses were repeated in participants without baseline mobility disability.

Results

The event rate for mobility disability was 7.26 per 100‐person months (95% confidence interval (CI) = 6.89–7.64). Mobility disability episodes lasted for a median of 2 months (interquartile range (IQR) 1–4). In a recurrent‐event Cox regression analysis, after adjusting for 11 covariates, restricting back pain was strongly associated with mobility disability (hazard ratio (HR) = 3.23, 95% CI = 2.87–3.64). The association was maintained when the outcome was defined as persistent mobility disability (adjusted HR = 3.63, 95% CI = 3.15–4.20) and when participants with baseline mobility disability were omitted (adjusted HR = 3.71, 95% CI = 3.22–4.28).

Conclusion

Restricting back pain was strongly associated with mobility disability. Interventions that prevent or ameliorate restricting back pain may be effective for reducing the burden of mobility disability in older persons.
Outcome of conservative laparoscopic surgery for adnexal torsion through one‐stage or two‐stage operation
Authors: Fujishita Akira , Araki Hiroyuki , Yoshida Shiko , Hamaguchi Daisuke , Nakayama Daisuke , Tsuda Nobuo , Khan Khaleque Newaz
Published: November 2014

Aim

We investigated the outcome on ovarian appearance and occurrence of adhesion after conservative laparoscopic surgery for adnexal torsion during reproductive age.

Material and Methods

From April 2009 to September 2012, we treated patients with clinically suspected adnexal torsion who desired future pregnancy. We performed conservative surgery, such as cystectomy or detorsion at one‐stage operation, but switched to salpingo‐oophorectomy in complicated cases. We evaluated adnexal condition and pattern of adhesion by careful assessment with two‐stage laparoscopy or second‐look laparoscopy after first surgery.

Results

Mean age of patients was 25 ± 8 years. Among 37 patients with suspected adnexal torsion, 18 (49%) had adnexal torsion at first surgery. Conservative treatment was carried out in 14 of 18 cases. We obtained informed consent for second‐look laparoscopy or two‐stage operation in six of these 14 cases. Among these six patients, two cases were treated with only detorsion by one‐stage operation and cystectomy was performed in the other four cases at first operation. At subsequent surgery, the ovary appeared normal in six cases with occurrence of mild to moderate adhesion around the adnexal lesion. Of note, two cases with para‐ovarian cyst had torsion that showed complete tubal occlusions and associated severe adhesions. No major complications (peritonitis, thrombotic emboli) were observed after conservative laparoscopic surgery.

Conclusion

Conservative laparoscopic surgery is a safe procedure to preserve ovarian function in women with adnexal torsion. Careful attention and measures should be considered during follow‐up management with the fact in mind that adhesion is a common occurrence and even tubal occlusion may occur in some cases.
Interleukin‐6 and neopterin levels in the serum and saliva of patients with Lichen Planus and oral Lichen Planus
Authors: Abdel‐Haq Ayman , Kusnierz‐Cabala Beata , Darczuk Dagmara , Sobuta Eliza , Dumnicka Paulina , Wojas‐Pelc Anna , Chomyszyn‐Gajewska Maria
Published: November 2014

Background

Lichen planus together with its oral variant is a chronic, inflammatory disease of the skin and the mucosa of unclear aetiology and with an unpredictable course that still poses a major problem in terms of diagnosis and treatment. The objective of this study was to assess the concentrations of interleukin‐6 (IL‐6) and neopterin in saliva and serum of patients with lichen planus (including reticular and erosive form of oral lichen planus) and to compare them with the concentrations observed in healthy controls.

Methods

The study material comprised serum and saliva samples from 56 patients diagnosed with lichen planus and 56 healthy volunteers. The ELISA test was used to measure concentrations of IL‐6 and neopterin in the serum and saliva of the study participants.

Results

The concentrations of IL‐6 in saliva and serum of patients with lichen planus were significantly higher than in controls (P = 0.0002; P < 0.0001). The difference remains significant after adjustment for gingivitis and age. Patients with atrophic‐erosive oral lichen planus had significantly higher IL‐6 concentrations in their saliva compared to patients with reticular form of disease (P = 0.01). The concentrations of neopterin were significantly higher in the serum but not in saliva of lichen planus patients vs. controls (P <0.0001).

Conclusions

Serum levels of proinflammatory cytokines IL‐6 and neopterin are increased in lichen planus as well as the salivary concentrations of IL‐6. The differences observed in IL‐6 levels in patients with erosive‐atrophic forms of oral lichen planus may indicate a substantial role played by the cytokine in the disease.
Decreasing prevalence of HCV coinfection in all risk groups for HIV infection between 2004 and 2011 in Spain
Authors: Serrano‐Villar S. , Sobrino‐Vegas P. , Monge S. , Dronda F. , Hernando A. , Montero M. , Viciana P. , Clotet B. , Pineda J. A. , del Amo J. , Moreno S.
Published: November 2014

While hepatitis C virus (HCV) infection seems to be expanding among HIV‐infected men who have sex with men (MSM), the rate of coinfection in intravenous drug users (IDU) is assumed to remain constant. We evaluated the serial prevalence of HIV/HCV coinfection across all risk groups for HIV infection in Spain. We used data from 7045 subjects included in the multicentre, prospective Spanish Cohort of Adult HIV‐infected Patients (CoRIS) between 2004 and 2011. We analysed risk factors for HIV/HCV coinfection by logistic regression analyses. The prevalence of HIV/HCV coinfection decreased from 25.3% (95% CI, 23.1–27.5) in 2004–2005 to 8.2% (95% CI, 6.9–9.5) in 2010–2011. This trend was consistently observed from 2004 to 2011 among all risk groups: IDU, 92.4% to 81.4%; MSM, 4.7% to 2.6%; heterosexual men, 13.0–8.9%; and heterosexual women, 14.5–4.0% (all P < 0.05). Strongest risk factors for HIV/HCV coinfection were IDU (OR, 54.9; 95% CI, 39.4–76.4), birth decade 1961–1970 (OR, 2.1; 95% CI, 1.1–3.7) and low educational level (OR, 2.4; 95% CI, 1.6–3.5). Hence, the prevalence of HIV/HCV coinfection decreased in Spain between 2004 and 2011. This decline was observed across all risk groups and is likely to be explained by a declining burden of HCV in the general population.
Efficacy and acceptability of the new oral phosphate binder Lenziaren® in healthy cats fed a renal diet
Authors: King J. N. , Delport P. C. , Luus H. G. , Erasmus H. L. , Barnes P. M. , Speranza C.
Published: November 2014

The efficacy and acceptability of the new oral phosphate binder Lenziaren® (SBR759) were evaluated in healthy cats fed with a commercial diet containing low amounts of phosphate (‘renal diet’). Lenziaren® at 0.125, 0.25, 0.5 and 1 g/day was compared to a reference product Lantharenol® (3.0 g/day) and a placebo in a masked, randomized, parallel‐group design study in 36 cats (n = 6 per group). All products were mixed with the ration which was fed once daily for 28 days. Lenziaren® produced significant dose‐related reductions in serum and urine phosphate concentrations, faecal apparent phosphorus digestibility and fractional urinary phosphate excretion. Cats administered Lenziaren® consumed significantly less food than the placebo group, but this had no negative impact on body weight or acceptability assessments. When compared to the positive control, Lantharenol®, Lenziaren® was significantly more acceptable (0.125, 0.5 and 1.0 g/day doses), was associated with higher food consumption (0.125, 0.5 and 1.0 g/day doses) and had greater efficacy in reducing serum phosphate (0.5 and 1.0 g/day) and urine phosphate concentrations (1.0 g/day). In conclusion, Lenziaren® was an effective oral phosphate binder in healthy cats fed with a renal diet. Lenziaren® was well accepted and tolerated. Dosages of 0.25–1.0 g/cat per day are recommended for clinical testing.
Systems and synthetic biology approaches to alter plant cell walls and reduce biomass recalcitrance
Authors: Kalluri Udaya C. , Yin Hengfu , Yang Xiaohan , Davison Brian H.
Published: November 2014

Fine‐tuning plant cell wall properties to render plant biomass more amenable to biofuel conversion is a colossal challenge. A deep knowledge of the biosynthesis and regulation of plant cell wall and a high‐precision genome engineering toolset are the two essential pillars of efforts to alter plant cell walls and reduce biomass recalcitrance. The past decade has seen a meteoric rise in use of transcriptomics and high‐resolution imaging methods resulting in fresh insights into composition, structure, formation and deconstruction of plant cell walls. Subsequent gene manipulation approaches, however, commonly include ubiquitous mis‐expression of a single candidate gene in a host that carries an intact copy of the native gene. The challenges posed by pleiotropic and unintended changes resulting from such an approach are moving the field towards synthetic biology approaches. Synthetic biology builds on a systems biology knowledge base and leverages high‐precision tools for high‐throughput assembly of multigene constructs and pathways, precision genome editing and site‐specific gene stacking, silencing and/or removal. Here, we summarize the recent breakthroughs in biosynthesis and remodelling of major secondary cell wall components, assess the impediments in obtaining a systems‐level understanding and explore the potential opportunities in leveraging synthetic biology approaches to reduce biomass recalcitrance.
Association of NFKB1 and NFKBIA Polymorphisms in Relation to Susceptibility of Behçet's Disease
Authors: Yenmis G. , Oner T. , Cam C. , Koc A. , Kucuk O. S. , Yakicier M. C. , Dizman D. , Kanigur Sultuybek G.
Published: November 2014

Behçet's disease (BD) is a chronic inflammatory autoimmune disease. Although raised levels of proinflammatory cytokines in BD have been reported, the pathogenesis is still unknown. The aim of this study was to investigate the association of NFKB1 and NFKBIA polymorphisms and their single and combined analysis effects on susceptibility of BD in Turkish population. We analysed the distribution of NFKB1 ‐94 ins/del ATTG (rs28362491) and NFKBIA 3′ UTR A→G (rs696) polymorphisms using PCR‐RFLP method in 89 patients with BD and 190 controls in this population. Statistical analysis of the results was performed by calculating OR, and 95% CI via χ2 test and using Bonferroni correction. According to the significant results of both single and combined genotype analysis, the frequencies of ins/ins genotype and ins allele of rs28362491 were significantly higher in patients with BD (Pc = 0.003, 0.004, respectively). Also, higher frequencies of the rs696 variant containing AA genotype was found in patients with BD (Pc = 0.0033), whereas no statistical significant differences in distribution of the alleles of rs696 polymorphism in patients and controls. In addition, according to the combined genotype analysis, the wild type of both rs28362491 and rs696 polymorphisms (ins/ins/AA genotype) was also significantly higher in BD cases (Pc = 0.044). Our findings prove that both single and combined genotype analysis of rs28362491 and rs696 polymorphisms indicate that the wild genotypes of both two SNPs (ins/ins and AA genotypes) and ins/ins/AA combined genotype are strongly associated with enhanced risk of BD in a Turkish population.
Laplace Error Penalty‐based Variable Selection in High Dimension
Authors: Wen Canhong , Wang Xueqin , Wang Shaoli
Published: November 2014

We propose the Laplace Error Penalty (LEP) function for variable selection in high‐dimensional regression. Unlike penalty functions using piecewise splines construction, the LEP is constructed as an exponential function with two tuning parameters and is infinitely differentiable everywhere except at the origin. With this construction, the LEP‐based procedure acquires extra flexibility in variable selection, admits a unified derivative formula in optimization and is able to approximate theL0penalty as close as possible. We show that the LEP procedure can identify relevant predictors in exponentially high‐dimensional regression with normal errors. We also establish the oracle property for the LEP estimator. Although not being convex, the LEP yields a convex penalized least squares function under mild conditions ifpis no greater thann. A coordinate descent majorization‐minimization algorithm is introduced to implement the LEP procedure. In simulations and a real data analysis, the LEP methodology performs favorably among competitive procedures.
How Party Affiliation Conditions the Experience of Dissonance and Explains Polarization and Selective Exposure*
Authors: Vraga Emily K.
Published: November 2014

Objectives

Dissonance theory has been widely studied in the social sciences, especially given its implications for polarization and selective exposure. This study expands previous research by investigating how this process may differ when a foundational political identity such as party affiliation is at stake.

Methods

This study adapts a classic dissonance paradigm—writing a counterattitudinal essay under conditions of high versus low choice—to a political context by manipulating the topic of the essay to advocating membership in the opposing political party.

Results

In this context, party affiliation conditions response to writing a counterattitudinal essay: only Republican respondents demonstrate heightened dissonance, selective exposure, and polarization as a result of this task, particularly when the essay is political.

Conclusions

Dissonance may not be a universal response to potentially arousing tasks, but if only some groups experience dissonance and polarization after enumerating the benefits of an opposing party, it may bias democratic functioning.
Hearing Clergy Speak About Social and Political Issues: Examining the Effects of Religious Tradition and Personal Interest*
Authors: Scheitle Christopher P. , Cornell Nicole
Published: November 2014

Objective

The goal of this research is to identify factors that affect the likelihood that a congregational attendee will report hearing their clergyperson speak about certain social or political issues.

Methods

The data used for this research come from the 2010 Religion and Public Life Survey. We examine three outcomes measuring whether the respondent reports hearing his or her clergy speak about abortion, homosexuality, or the environment.

Results

We find that an individual's personal interest in particular social issues increases the likelihood of reporting hearing about those issues from his or her clergyperson. There are also significant religious tradition effects, with Catholics being most likely to report hearing about abortion.

Conclusion

These findings shed light on what congregational attendees say they are hearing from their clergy about key social and political issues, which could be very different from what clergy report they are saying, as attendees’ reports will be shaped by their attention to, interest in, and interpretation of the clergy's messages.
Presentism, Truthmaking and Necessary Connections
Authors: Tallant Jonathan
Published: November 2014

Ross Cameron puts forward a novel solution to the truthmaker problem facing presentism. I claim that, by Cameron's own lights, the view is not in fact a presentist view at all, but rather requires us to endorse a form ofPriority Presentism, whereby past objects are derivative and depend for their existence upon present objects. I argue that this view should be rejected.