bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular findings and clinical data in a cohort of 150 patients with anophthalmia/microphthalmia
Authors: Chassaing N. , Causse A. , Vigouroux A. , Delahaye A. , Alessandri J.‐L. , Boespflug‐Tanguy O. , Boute‐Benejean O. , Dollfus H. , Duban‐Bedu B. , Gilbert‐Dussardier B. , Giuliano F. , Gonzales M. , Holder‐Espinasse M. , Isidor B. , Jacquemont M.‐L. , Lacombe D. , Martin‐Coignard D. , Mathieu‐Dramard M. , Odent S. , Picone O. , Pinson L. , Quelin C. , Sigaudy S. , Toutain A. , Thauvin‐Robinet C. , Kaplan Josseline , Calvas Patrick
Published: September 2013

Anophthalmia and microphthalmia (AM) are the most severe malformations of the eye, corresponding respectively to reduced size or absent ocular globe. Wide genetic heterogeneity has been reported and different genes have been demonstrated to be causative of syndromic and non‐syndromic forms of AM. We screened seven AM genes [GDF6 (growth differentiation factor 6), FOXE3 (forkhead box E3), OTX2 (orthodenticle protein homolog 2), PAX6 (paired box 6), RAX (retina and anterior neural fold homeobox), SOX2 (SRY sex determining region Y‐box 2), and VSX2 (visual system homeobox 2 gene)] in a cohort of 150 patients with isolated or syndromic AM. The causative genetic defect was identified in 21% of the patients (32/150). Point mutations were identified by direct sequencing of these genes in 25 patients (13 in SOX2, 4 in RAX, 3 in OTX2, 2 in FOXE3, 1 in VSX2, 1 in PAX6, and 1 in GDF6). In addition eight gene deletions (five SOX2, two OTX2 and one RAX) were identified using a semi‐quantitative multiplex polymerase chain reaction (PCR) [quantitative multiplex PCR amplification of short fluorescent fragments (QMPSF)]. The causative genetic defect was identified in 21% of the patients. This result contributes to our knowledge of the molecular basis of AM, and will facilitate accurate genetic counselling.
Systematic review of anorectal varices
Authors: Maslekar S. , Toh E.‐W. , Adair R. , Bate J. P. , Botterill I.
Published: September 2013

Aim

Anorectal varices are an uncommon, but significant, source of bleeding in patients with portal hypertension. The aim of this article was to review systematically the available literature on the aetiology, clinical presentation and management of anorectal varices, and to suggest a simple treatment algorithm based on available evidence and local expertise.

Method

A systematic literature search was carried out to identify articles on anorectal varices, and the search strategy identified 57 relevant references. The inclusion criteria included a consecutive cohort of patients having treatment for anorectal varices with details of success rates and the number of different techniques used. Exclusion criteria included papers published in languages other than English with no English version and results not reported separately for anorectal varices.

Results

Anorectal varices can occur in up to 89% of patients with portal hypertension, although the overall incidence in the general population is low. Diagnosis is best achieved with anoscopy or flexible sigmoidoscopy. The current evidence supports the use of local procedures, such as endoscopic band ligation, to arrest bleeding where feasible, with radiological or surgical procedures used in the event of failure.

Conclusion

As there are no large series on this pathology, we present a systematic approach for the patient with anorectal varices.
Adaptive genetic markers discriminate migratory runs of Chinook salmon (Oncorhynchus tshawytscha) amid continued gene flow
Authors: O'Malley Kathleen G. , Jacobson Dave P. , Kurth Ryon , Dill Allen J. , Banks Michael A.
Published: September 2013

Neutral genetic markers are routinely used to define distinct units within species that warrant discrete management. Human‐induced changes to gene flow however may reduce the power of such an approach. We tested the efficiency of adaptive versus neutral genetic markers in differentiating temporally divergent migratory runs of Chinook salmon (Oncorhynchus tshawytscha) amid high gene flow owing to artificial propagation and habitat alteration. We compared seven putative migration timing genes to ten microsatellite loci in delineating three migratory groups of Chinook in the Feather River, CA: offspring of fall‐run hatchery broodstock that returned as adults to freshwater in fall (fall run), spring‐run offspring that returned in spring (spring run), and fall‐run offspring that returned in spring (FRS). We found evidence for significant differentiation between the fall and federally listed threatened spring groups based on divergence at three circadian clock genes (OtsClock1b, OmyFbxw11, and Omy1009UW), but not neutral markers. We thus demonstrate the importance of genetic marker choice in resolving complex life history types. These findings directly impact conservation management strategies and add to previous evidence from Pacific and Atlantic salmon indicating that circadian clock genes influence migration timing.
The ways in which fish use estuaries: a refinement and expansion of the guild approach
Authors: Potter Ian C , Tweedley James R , Elliott Michael , Whitfield Alan K
Published: September 2013

This study refines, clarifies and, where necessary, expands details of the guild approach developed by Elliott et al. (2007, Fish and Fisheries 8: 241–268) for the ways in which fish use estuaries. The estuarine usage functional group is now considered to comprise four categories, that is, marine, estuarine, diadromous and freshwater, with each containing multiple guilds. Emphasis has been placed on ensuring that the terminology and definitions of the guilds follow a consistent pattern, on highlighting the characteristics that identify the different guilds belonging to the estuarine category and in clarifying issues related to amphidromy. As the widely employed term ‘estuarine dependent’ has frequently been imprecisely used, the proposal that the species found in estuaries can be regarded as either obligate or facultative users of these systems is supported and considered in the guild context. Thus, for example, species in the five guilds comprising the diadromous category and those in the guilds containing species or populations confined to estuaries are obligate users, whereas those in the marine and freshwater estuarine‐opportunistic guilds are facultative users.
Genome‐wide association study of shared components of reading disability and language impairment
Authors: Eicher J. D. , Powers N. R. , Miller L. L. , Akshoomoff N. , Amaral D. G. , Bloss C. S. , Libiger O. , Schork N. J. , Darst B. F. , Casey B. J. , Chang L , Ernst T. , Frazier J. , Kaufmann W. E. , Keating B. , Kenet T. , Kennedy D. , Mostofsky S. , Murray S. S. , Sowell E. R. , Bartsch H. , Kuperman J. M. , Brown T. T. , Hagler D. J. , Dale A. M. , Jernigan T. L. , St. Pourcain B. , Davey Smith G. , Ring S. M. , Gruen J. R. ,   for the Pediatric Imaging, Neurocognition, and Genetics Study
Published: September 2013

Written and verbal languages are neurobehavioral traits vital to the development of communication skills. Unfortunately, disorders involving these traits—specifically reading disability (RD) and language impairment (LI)—are common and prevent affected individuals from developing adequate communication skills, leaving them at risk for adverse academic, socioeconomic and psychiatric outcomes. Both RD and LI are complex traits that frequently co‐occur, leading us to hypothesize that these disorders share genetic etiologies. To test this, we performed a genome‐wide association study on individuals affected with both RD and LI in the Avon Longitudinal Study of Parents and Children. The strongest associations were seen with markers in ZNF385D (OR = 1.81, P = 5.45 × 10−7) and COL4A2 (OR = 1.71, P = 7.59 × 10−7). Markers within NDST4 showed the strongest associations with LI individually (OR = 1.827, P = 1.40 × 10−7). We replicated association of ZNF385D using receptive vocabulary measures in the Pediatric Imaging Neurocognitive Genetics study (P = 0.00245). We then used diffusion tensor imaging fiber tract volume data on 16 fiber tracts to examine the implications of replicated markers. ZNF385D was a predictor of overall fiber tract volumes in both hemispheres, as well as global brain volume. Here, we present evidence for ZNF385D as a candidate gene for RD and LI. The implication of transcription factor ZNF385D in RD and LI underscores the importance of transcriptional regulation in the development of higher order neurocognitive traits. Further study is necessary to discern target genes of ZNF385D and how it functions within neural development of fluent language.
National survey of the prevalence of swallowing difficulty and tube feeding use as well as implementation of swallowing evaluation in long‐term care settings in Japan
Authors: Sugiyama Michiko , Takada Kento , Shinde Manami , Matsumoto Nana , Tanaka Kazumi , Kiriya Yumiko , Nishimoto Etsuko , Kuzuya Masafumi
Published: September 2013

Aim

The present study was carried out to clarify tube feeding utilization and the prevalence of swallowing difficulty among residents in geriatric long‐term settings, and to elucidate the implementation of swallowing assessment at four different types of facilities in Japan.

Methods

We mailed a questionnaire to a total of 4334 facilities.

Results

We received responses from 1137 (26.2%) facilities, including 440 (29.0%) from 1517 nursing homes, 275 (29.2%) from 941 long‐term care facilities, 205 (18.1%) from 1134 sanatorium medical facilities and 217 (29.2%) from 742 rehabilitation hospitals. The number of tube‐fed residents per 100 beds in each facility was 11.6 at the nursing homes, 7.4 at the long‐term care facilities, 36.3 at the sanatorium medical facilities and 7.9 at the rehabilitation facilities. The number of residents per 100 beds with swallowing difficulty was 23.7 in the nursing homes, 15.6 in the long‐term care facilities, 19.2 in the sanatorium medical facilities and 15.4 in the rehabilitation hospitals. The percentages of facilities that assessed swallowing difficulty were 31.8% of the nursing homes, 63.0% of the long‐term care facilities, 77.9% of the sanatorium medical facilities and 91.7% of the rehabilitation hospitals.

Conclusion

A large number of residents using a feeding tube and with difficult swallowing were observed in geriatric long‐term settings without adequate evaluation of swallowing function. Geriatr Gerontol Int 2014; 14: 577–581.
Auriculotemporal Neuralgia Secondary to TMJ Synovial Cyst: A Rare Presentation of a Rare Entity
Authors: Ansari Hossein , Robertson Carrie E. , Lane John I. , Viozzi Christopher F. , Garza Ivan
Published: September 2013

Synovial cysts of the temporomandibular joint are rare, and to our knowledge, only 14 cases have been reported. The most common presentation is local pain and swelling. We present a case of a synovial cyst presenting with neuralgia in the distribution of the auriculotemporal nerve, initially misdiagnosed as trigeminal neuralgia.
Host Cell Contact Induces Fur‐dependent Expression of Virulence Factors CagA and VacA in Helicobacter pylori
Authors: Raghwan  , Chowdhury Rukhsana
Published: September 2013

Background

Helicobacter pylori, a gram negative bacterium, colonizes the stomach in a majority of the world population. The two major virulence factors of H. pylori VacA and CagA, thought to be associated with chronic inflammation and disease, have been extensively studied, but the regulation of the expression of these virulence genes in H. pylori remains poorly understood.

Methods

qRT‐PCR was performed to quantify gene expression in unadhered and AGS‐adhered H. pylori. Δfur mutant was constructed by splicing by overlap extension PCR and allelic exchange.

Results

Adherence of H. pylori to the gastric epithelial cell line AGS strongly induces the expression of both cagA and vacA. Induction of cagA and vacA in the AGS cell‐adhered H. pylori Δfur mutant strain was consistently lower than in the adhered parent strain. However, expression of the genes was similar between the wild‐type and Δfur mutant strains in the unadhered state, suggesting that Fur has a role in the upregulation of cagA and vacA expression, especially in AGS‐adhered H. pylori. Consistent with these results, microscopic observations revealed that infection of AGS cells with H. pylori Δfur mutant strain produced much less damage as compared to that produced by the wild‐type H. pylori strain.

Conclusions

These results suggested that cagA and vacA gene expression is upregulated in H. pylori, especially by host cell contact, and Fur has a role in the upregulation.
The wrath of Erdoğan
Authors: Rodrik Dani
Published: September 2013

Dani Rodrik argues that in coming down hard on the Gezi protesters the Turkish PM was more concerned about his ‘loyal opposition’ than any new liberal political force.
Syndicated Leveraged Loans During and After the Crisis and the Role of the Shadow Banking System
Authors: Culp Christopher L.
Published: September 2013

In an article published in this journal in 1998, Nobel laureate Merton Miller argued that one of the best weapons available to national economies in their defense against the macroeconomic effects of banking crises is the availability of non‐bank financial institutions and products—or what we now refer to as the “shadow banking system.” Although Miller may have exaggerated the independence of bank‐ and market‐based sources of financing, the author argues that events during and after the recent crisis have shown Miller's claims about the importance of non‐bank investors in the provision of credit to be fundamentally correct.

Critics of securitization and the shadow banking system tend to focus on the subprime mortgage story in which the sudden re‐pricing of credit risk and the resulting disappearance of investment demand for ABCP, private‐label mortgage‐related ABS, and ABS CDOs created unexpected and significant downward price pressure on those asset types. But the leveraged loan market tells a very different story. In contrast to the near complete disappearance of private mortgage securitizations, the extraordinary recovery of the U.S. syndicated leveraged loan market demonstrates that the relation between commercial and shadow banking has proved to be a highly productive and resilient one—and very much a two‐way street. When leveraged loans and CLOs experienced problems from 2007 through 2009 due primarily to the widespread liquidity and credit market disruptions that affected essentially all structured credit products, institutional investors in leveraged loans disappeared and the leveraged loan primary market imploded. But when institutional participants recognized the value of the underlying asset—corporate loans—and regained confidence in shadow‐banking products, leveraged lending by banks recovered quickly and dramatically.

This outcome is viewed as vindicating Professor Miller's statement about the benefits of shadow markets and securitization— namely, the role of non‐bank investors in diversifying the risk of credit creation while at the same time improving the price discovery process in different markets. The recent history of the U.S. leveraged loan market demonstrates that shadow banking system participants play a critical role in meeting the total demand for such loans, and that the ebbs and flows from institutional leveraged loan markets are strongly connected with the health and integrity of the underlying leveraged bank loan market.
How to take care of nurses in your organization: two types of exchange relationships compared
Authors: Veld Monique , Van De Voorde Karina
Published: September 2013

Aim

To explore the relationships between climate for well‐being, economic and social exchange, affective ward commitment and job strain among nurses in the Netherlands.

Background

This study focuses on the immediate work environment of nurses by exploring the way nurse perceptions about the extent to which the ward values and cares for their welfare influence their levels of affective ward commitment and job strain. Second, this study extends previous research on exchange relationships by examining the potential differential impact of social and economic exchange relationships on commitment and job strain.

Design

A cross‐sectional survey among nurses.

Methods

The study was conducted in the Netherlands in 2011. Validated measures of climate for well‐being, social exchange, economic exchange, ward commitment and job strain were used. Hypotheses were tested using regression analyses. MacKinnon et al.'s (2007) guidelines to assess mediation were used.

Results

The response rate was 41% (271 questionnaires). The results show that climate for well‐being positively influences social exchange relationships, which are in turn associated with enhanced ward commitment and reduced strain. Climate for well‐being negatively influences evaluations of economic exchange, which are in turn negatively related to ward commitment.

Conclusion

This study shows that nurses use the information available in their immediate work environment to evaluate their exchange relationship with the organization. Second, the findings point towards the importance of economic and social exchange relationships as a mechanism between climate for well‐being on the one hand and affective ward commitment and job strain on the other hand.
Attachment in Adults with Intellectual Disabilities: Preliminary Investigation of the Psychometric Properties of the Manchester Attachment Scale–Third Party Observational Measure
Authors: Penketh Victoria , Hare Dougal Julian , Flood Andrea , Walker Samantha
Published: September 2013

Background

The Manchester Attachment Scale–Third party observational measure (MAST) was developed to assess secure attachment style for adults with intellectual disabilities. The psychometric properties of theMASTwere examined.

Materials and Methods

Professional carers (N = 40) completed theMASTand measures related to the construct of attachment theory [Edward Zigler‐Yale Personality Questionnaire (EZPQ), Emotional Rating Scale (ERS) and the Learning Disability Casemix Scale (LDCS)] regarding individuals with an intellectual disability (N = 57). Individuals with an intellectual disability (N = 14) completed the Self‐report Assessment of Attachment Security (SRAAS).

Results

TheMASTwas found to have good internal consistency, test–retest reliability and convergent validity.MASTscores were negatively correlated with level of intellectual disability and challenging behaviour (CB) as measured byLDCS.

Conclusions

Support was provided for the reliability and validity of theMASTand a relationship between attachment security, level of intellectual disability andCB. The results of the study and implications of attachment theory for service provision are discussed.
Mindfulness‐based cognitive therapy for adults with intellectual disabilities: an evaluation of the effectiveness of mindfulness in reducing symptoms of depression and anxiety
Authors: Idusohan‐Moizer H. , Sawicka A. , Dendle J. , Albany M.
Published: September 2013

Background

Mindfulness‐based interventions have been shown to be effective in the treatment of a range of health and psychological disorders in adults and young people without intellectual disabilities (ID). Clinical studies are emerging reporting on the efficacy of mindfulness‐based interventions as a stand‐alone treatment for common clinical disorders in adults withID.

Method

This paper aims to evaluate the efficacy of an innovative structured mindfulness‐based cognitive therapy (MBCT) group programme adapted for adults withIDwith a diagnosis of either recurrent depression, anxiety or both clinical conditions and a history of deliberate self‐harm behaviour. Two groups ran consecutively consisting of a total of fifteen participants and seven carers. All participants were recorded as having either a borderline, mild, or moderateID. The group programme ran over a period of 9 weeks with a follow‐up session at 6 weeks post group intervention. Outcome measures included theHospitalAnxiety andDepressionScale and two sub‐scales from theSelf‐CompassionScale administered at baseline, post therapy and at 6‐week follow‐up.

Results

The evaluation showed that participants reported an improvement in their experience of depression, anxiety, self‐compassion and compassion for others. The most significant impact was in the reduced levels of anxiety reported. Improvements across all outcomes were maintained at 6‐week follow‐up.

Conclusion

The results of the evaluation suggest that people with intellectual disabilities benefit from a structuredMBCTgroup intervention and the results are maintained at 6‐week follow‐up.
Early achievements in cardiovascular care as reflected in theJournal ofInternalMedicine
Authors: Rydén L.
Published: September 2013

This review mirrors progress in cardiovascular medicine as reflected by scientific contributions published in theJournal of Internal Medicine(from 1989),Acta Medica Scandinavica(from 1919 until 1989) andNordiskt Medicinskt Arkiv(before 1919). A total of 149 articles were identified within this field since the first, published work in this field 1877–1970. The latter year was set as and end for the review since this was the year the first contribution by the author of this review was published in the journal. To cope with the large number individual publications related to different aspects of cardiovascular medicine were grouped together into fields in which Scandinavian contributions were pioneering or for other reasons of particular interest. These articles were briefly summarized together with some information of the author(s) and the contributions were put into the perspective of subsequent importance and/or scientific and clinical development. Among topics with insightful contributions published in the journal are electrophysiology, diagnostic techniques including standardization, endurance exercise and the heart, electrocardiography, myocardial infarction, atrio‐ventricular block and cardiac pacing. Some of these early contributions were indeed, considering the methods available at the time for the investigations impressive and many predictions truly insightful and imaginative. Other contributions may, at least by the present day reader, seem somewhat odd.
Relationship between microRNA expression levels and histopathological features of dysplasia in oral leukoplakia
Authors: Brito João A. R. , Gomes Carolina C. , Guimarães André L. S. , Campos Kelma , Gomez Ricardo S.
Published: September 2013

Background

Increased expression of microRNAs (miRNAs), miR‐21, miR‐345, and miR‐181b has been demonstrated in oral leukoplakia (OL) that progresses to oral squamous cell carcinoma (OSCC), suggesting a miRNA signature with potential prognostic value. On the basis of these findings, this pilot study aimed to investigate the cytological and histopathological features that are used to grade oral dysplasia and determine associations with the expression of these 3 potentially cancer‐related miRNAs. We also compared the expression levels of these miRNAs in OL with normal oral mucosa and OSCC.

Methods

We evaluated miRNA expression by qPCR in 22 samples of OL demonstrating different grades of dysplasia, as well as 17 cases of OSCC, and 6 samples of normal oral mucosa. We associated the miRNAs expression profiles with cytological and histopathological features of OL.

Results

OSCC cases showed increased expression of all 3 miRNAs when compared with OL and normal oral mucosa. Increased expression of miR‐21 was also observed in OL when compared with normal oral mucosa. We found a higher expression of miR‐21 and miR‐181b in OL that presented with an increased number of mitotic figures, increased nuclear/cytoplasmic ratio, or hyperchromasia. Increased expression of miR‐21 was also detected in OL with abnormally superficial mitosis. Higher expression of miR‐345 was observed in OL with an increased number and size of nucleoli or increased nuclear/cytoplasmic ratio.

Conclusions

In conclusion, the present study shows that some cytological and histopathological parameters used to grade dysplasia are associated with altered miRNA expression.
Multilevel Analysis of the Impact of School‐Level Tobacco Policies on Adolescent Smoking: The Case of Michigan
Authors: Paek Hye‐Jin , Hove Thomas , Oh Hyun Jung
Published: September 2013

BACKGROUND

In efforts to curb and prevent youth smoking, school tobacco policies have become an important and effective strategy. This study explores the degrees and types of tobacco‐free school policy (TFSP) enforcement that are associated with adolescent smoking.

METHODS

A multilevel analysis was performed using 983 students who are nested in 14 schools. The individual‐level data are drawn from the 2009 Michigan Youth Risk Behavior Survey. The school‐level data are drawn from the 2008 School Health Profiles survey.

RESULTS

Two factors are associated with lower adolescent smoking: greater punishment for TFSP violation and more tobacco control communication efforts. By contrast, the factors associated with higher adolescent smoking are designation of a tobacco‐free school zone and school‐level smoking.

CONCLUSIONS

This study theoretically and methodologically guides researchers to test TFSP effectiveness in other states. Three strategic implications emerge: (1) schools should provide a consistent antismoking message in smoke‐free environments; (2) schools should integrate TFSP into a comprehensive tobacco control initiative, including community‐wide tobacco control programs and messages; and (3) the way a specific TFSP is promoted and communicated could determine how effective it is.
Behavioral Health Emergencies Managed by School Nurses Working With Adolescents
Authors: Ramos Mary M. , Greenberg Cynthia , Sapien Robert , Bauer‐Creegan Judith , Hine Beverly , Geary Cathy
Published: September 2013

BACKGROUND

As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health emergencies managed by school nurses.

METHODS

We used data from a New Mexico public school nurse workforce survey to describe the involvement of school nurses in managing adolescent behavioral health emergencies. We included all respondents who self‐identified as working in a secondary school (N = 186). We conducted descriptive analyses.

RESULTS

Two thirds of survey respondents had provided emergency management in the prior school year for child abuse or neglect, depression, and violence at school. Over 40% had provided emergency management for a suicidal student in the prior school year. Although almost 80% of respondents identified “violence at school” as a very important continuing education topic, 40% reported having received continuing education on this topic in the prior 5 years.

CONCLUSIONS

In New Mexico, public school nurses provide substantial amounts of emergency management for adolescent behavioral health problems. Continuing education received by school nurses on behavioral health emergencies may not be commensurate with their clinical responsibilities.
The Sound of Temperature: What Information do Pouring Sounds Convey Concerning the Temperature of a Beverage
Authors: Velasco Carlos , Jones Russ , King Scott , Spence Charles
Published: September 2013

We report a series of three experiments designed to assess the extent to which people can infer the temperature of water on the basis of the sound that can be heard when it is poured from one vessel into another. Experiment 1 demonstrates that people can tell whether water is hot or cold solely on the basis of the sound that it makes when poured into a receptacle made from one of four different materials (glass, porcelain, paper and plastic). Experiment 2 reveals the existence of an implicit association between the pouring sounds and the notion of a particular temperature (hot or cold). Finally, experiment 3 demonstrates that the perception of temperature can be changed by artificially modifying the sonic properties of the sound that hot and cold water makes when poured into a receptacle. Potential applications for these results in terms of sensory marketing and modernist dining are discussed.

Practical Applications

The idea that temperature is a multisensory construct could be of particular interest to contexts such as food and drink perception, media (e.g., radio, television and digital environments), electronic drinks dispensers and household appliances, where the apparent temperature of a beverage could potentially be modified in order to create (or modify) particular consumption experiences.
Inequality in dental caries distribution at noncavitated and cavitated thresholds in preschool children
Authors: Piovesan Chaiana , Tomazoni Fernanda , Del Fabro Joana , Buzzati Bruna Cássia Schmidt , Mendes Fausto Medeiros , Antunes José Leopoldo Ferreira , Ardenghi Thiago Machado
Published: September 2013

Objective

To evaluate the inequality in dental caries distribution according to different thresholds assessed using theInternationalCariesDetection andAssessmentSystem (ICDAS) and to investigate the associations of socioeconomic factors with caries lesions at both noncavitated and cavitated thresholds.

Methods

Study subjects were recruited inSantaMaria,Brazil, during theNationalDay ofChildren'sVaccination, and 639 children aged 12–59 months were included. Fifteen calibrated examiners performed the examinations usingICDAScriteria. Inequality in dental caries distribution was measured using theGini coefficient, and theSignificantCariesIndex was calculated for several thresholds ofICDAS. Poisson regression analysis was used to assess the associations of socioeconomic factors with the highest caries scores.

Results

The inequality in the distribution of dental caries was lower when precavitated caries were included; theGini coefficient decreased from 0.77 to 0.60 when noncavitated caries lesions were included in the analyses. Moreover, the inequalities were higher in the younger than in the older children for all thresholds. Socioeconomic factors were significantly (P < 0.001) associated with caries when anICDASscore of 3 was considered as the cut‐off point. Children whose mothers did not complete primary education (P < 0.001) and those with low household income (P < 0.001) were more likely to have increased dental caries.

Conclusion

Caries lesions were more equally distributed when noncavitated lesions were included in the dental survey. Socioeconomic factors are found to be associated with the inequalities in caries distribution in this age group.
Researching Policy and Practice to Safeguard People With Intellectual Disabilities from Abuse: Some Methodological Challenges
Authors: Northway Ruth , Jenkins Robert , Jones Victoria , Howarth Joyce , Hodges Zoe
Published: September 2013

Abuse of adults with intellectual disabilities can and does occur in many places, and as a result, many countries have instituted policies and enacted laws to address this problem. However, research concerning the impact of such policies on abuse remains largely limited to quantitative studies from the perspective of governmental or other authorities and is generally focused on one area or country. Absent are the views and experiences of people with intellectual disabilities with respect to real or perceived abuse. Given the dearth of research involving primary consumers, there is limited knowledge as to the success or failure of such policies and laws. Though carrying out such research can pose methodological and ethical challenges, not undertaking it can also have ethical and social consequences. An international research agenda that includes participatory research that both facilitates the active involvement of and investment in people with intellectual disabilities and views action as an essential outcome is thus proposed. The authors propose such an agenda and posit that along with the collection and analysis of substantially more robust quantitative data, this should facilitate comparison within and between countries.
Reducing Vulnerability to Harm in Adults With Cognitive Disabilities in the Australian Criminal Justice System
Authors: Baldry Eileen , Clarence Melissa , Dowse Leanne , Trollor Julian
Published: September 2013

Persons with cognitive disabilities such as intellectual disability, borderline intellectual disability, and acquired brain injury are overrepresented in Australian criminal justice systems both as victims and as offenders. Data obtained in Australia and internationally indicate that up to 12% of the prison population has an intelligence quotient (IQ) of less than 70, with up to 30% having an IQ of between 70 and 80, indicating substantially higher representation of intellectual disability and borderline intellectual disability than in the general population. Indigenous Australian adults in prison are significantly more likely to have intellectual disability than their non‐Indigenous counterparts. Points of intervention throughout individuals' trajectories into and through the criminal justice and human service system are investigated, allowing new ways of understanding how persons with intellectual and other cognitive disabilities are vulnerable to the harms of control‐and‐punishment systems. Using an innovative data‐linking and data‐merging method, the authors compiled longitudinal administrative data from all criminal justice and human service agencies in New South Wales, Australia, to create life‐course pathways for 2,731 persons who had served time in prison in New South Wales and whose mental health and cognitive disability diagnoses were available. Mapping service agency responses and institutional trajectories of these persons from an early age reveal a picture of early police contact and enmeshment in juvenile and adult corrections with high frequency, but often of low duration. Poor recognition of cognitive disability coupled with the presence of mental disorders and substance use disorders is associated with multiple and compounding social disadvantage and vulnerability to harm. This group is subject to multiple, simultaneous, and continuing human service agency interventions, which have only limited impact on their offending and (re)incarceration. Provision of appropriate support before, during, and after imprisonment is likely to reduce these individuals' vulnerability to harm and improve their experiences of community integration.
Assessing Understanding and Obtaining Consent From Adults With Intellectual Disabilities for a Health Promotion Study
Authors: Horner‐Johnson Willi , Bailey Danielle
Published: September 2013

People with intellectual disabilities are often excluded from research, in part because they may be perceived as lacking capacity to provide informed consent. A requirement of informed decision making about research participation is ability to understand the study description and disclosures presented during the consent process. The authors' aims were to determine the extent to which study participants with intellectual disabilities were able to answer questions about key aspects of study disclosures, identify ways in which people who provided appropriate answers for all of the questions differed from those who had difficulty with one or more of the questions, and examine patterns of responses to see if certain issues were more difficult to understand than others. The authors piloted a short set of questions to assess the extent to which adults with intellectual disabilities were able to answer questions about key aspects of a health promotion study. More than half of study participants correctly answered all of the questions. For those not able to answer all questions, identifying potential risks of being in the study proved the most challenging. The findings indicate that many people with intellectual disabilities likely can provide their own consent to participate in low risk studies.
Keeping Safe and Providing Support: A Participatory Survey About Abuse and People With Intellectual Disabilities
Authors: Northway Ruth , Bennett Davey , Melsome Mel , Flood Samantha , Howarth Joyce , Jones Richard
Published: September 2013

People with intellectual disabilities are at increased risk of abuse, but their views regarding this have not been explored. The authors undertook a study in Wales to examine what help people with intellectual disabilities feel they need to keep safe and, if they are abused, what support they need. A questionnaire was distributed to 47 participants with intellectual disabilities attending a residential research event and as a postal survey across Wales. From this, 107 (56%) usable questionnaires were returned. Respondents identified most strategies for keeping safe as being useful but were more likely to identify personal strategies rather than actions other people could take. When abuse does occur, having a trusted person to speak to and one who will believe you were viewed as the most important aspects. The authors noted that people with intellectual disabilities can identify personal safety strategies and their views and experiences should inform personal safety courses and staff training. Furthermore, they recommend that effective circles of support need to be developed both to protect against abuse and to provide support should it occur.
The limited role of snow water in the growth and development of ephemeral plants in a cold desert
Authors: Fan Lian‐Lian , Tang Li‐Song , Wu Lin‐Feng , Ma Jian , Li Yan
Published: September 2013

Question

The ephemeral layer is an important component of the plant community in cold deserts. Conventional wisdom has it that the ephemeral layer primarily depends on early spring snowmelt water for germination and development. However, this hypothesis has never been subjected to rigorous testing.

Location

Southern edge of the Gurbantunggut Desert, a cold desert and a natural habitat of ephemeral plants (the inter‐sand dune lowland), in the far northwest of China and around the geographical centre of the Eurasian continent.

Methods

At the end of the snow cover season between 2009 and 2011, four different snow treatments (0, 50, 100 and 200% snow cover, with 100% representing the natural amount of snow) were applied, using five replicates. Seedling establishment, species diversity and plant growth, population, cover and productivity were monitored throughout or sampled at the end of the growing season.

Results

The ephemeral plant germination and seedling density were significantly influenced by changes in snow cover. Germination, density of mature ephemeral plants and plant coverage rose as snow cover depth increased. However, the height, rooting depth, numbers of lateral roots and above‐ground biomass of individual plants decreased as snow cover increased, and plant size was negatively correlated with plant density. At the ephemeral layer level, above‐ground biomass showed no significant variation between snow treatments. There was also no significant difference in species richness among the snow treatments.

Conclusions

Increased snow resulted in higher plant density of ephemerals. However, this high density induced strong competition, reducing the body size of individual plants. By the end of the growing season, snow treatments did not induce significant changes in primary productivity of the ephemeral layer. Primary productivity or growth after seedling establishment depended mainly on rainfall that occurred after the snow had melted, not on snowmelt water itself. Thus conventional wisdom was shown to be only partially true. Snow was important to these ephemeral plants, but its role was limited to seedling establishment.
Serum liver enzymes are associated with all‐cause mortality in an elderly population
Authors: Koehler Edith M. , Sanna Donatella , Hansen Bettina E. , van Rooij Frank J. , Heeringa Jan , Hofman Albert , Tiemeier Henning , Stricker Bruno H. , Schouten Jeoffrey N. L. , Janssen Harry L. A.
Published: September 2013

Background & Aims

Little is known about the association of serum liver enzymes with long‐term outcome in the elderly. We sought to clarify the association of serum gamma‐glutamyltransferase (GGT), alkaline phosphatase (ALP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) with all‐cause and cause‐specific mortality in an elderly population.

Methods

This study was embedded in the Rotterdam Study, a large population‐based cohort of persons aged 55 years or older. Cox‐regression analyses were performed to examine the association of baseline serum GGT, ALP, and aminotransferase levels with mortality, adjusted for age, sex, education, smoking status, alcohol intake, hypertension, diabetes mellitus, body mass index and total cholesterol levels. Liver enzyme levels were categorized according to sample percentiles; levels <25th percentile were taken as a reference.

Results

During a follow‐up of up to 19.5 years, 2997 of 5186(57.8%) participants died: 672 participants died of causes related to cardiovascular diseases (CVD) and 703 participants died of cancer. All serum liver enzymes were associated with all‐cause mortality (all P < 0.001). Moreover, GGT was associated with increased CVD mortality (P < 0.001), and ALP and AST with increased cancer‐related mortality (P = 0.03 and P = 0.005 respectively). Participants with GGT and ALP in the top 5% had the highest risk for all‐cause mortality (HR1.55; 95%CI 1.30–1.85 and HR1.49; 95%CI 1.25–1.78 respectively). AST and ALT <25th percentile were also associated with a higher risk of all‐cause mortality.

Conclusions

All serum liver enzymes were positively associated with long‐term mortality in this elderly population. Why participants with low ALT and AST levels have higher risk of mortality remains to be elucidated.
Hepatitis C virus‐specific cellular immune responses in sustained virological responders with viral persistence in peripheral blood mononuclear cells
Authors: Roque‐Cuéllar María C. , Sánchez Berta , García‐Lozano José R. , Praena‐Fernández Juan M. , Márquez‐Galán José L. , Núñez‐Roldán Antonio , Aguilar‐Reina José
Published: September 2013

Background & Aims

Hepatitis C virus (HCV)‐RNA detection in peripheral blood mononuclear cells (PBMCs) after recovery from HCV infection, is a type of occult HCV infection although is unclear how the viral persistence in PBMCs affects HCV‐specific T‐cell responses. The aim of this study was to investigate if cellular immune responses are modified by HCV persistence in PBMCs.

Methods

HCV‐specific CD4+ and CD8+ T‐cell responses against six HCV peptides, situated within the non‐structural (NS) proteins NS3, NS4b and NS5b, were measured by flow cytometry‐through intracellular detection of gamma interferon (IFN‐γ) or interleukin 4 (IL‐4) and CD69 expression‐ in 27 sustained virological responders (SVR): 13 with and 14 without occult HCV infection in PBMCs, detected by strand‐specific real‐time PCR. Ten healthy individuals and 14 chronically infected patients with viraemia, were included as controls.

Results

SVR without occult infection showed a higher percentage of activated CD4+ cells against peptides belonging to NS3 (p124, p153) and NS5b (p257, p294), activated CD8+ cells against NS3 (p124, p153, p158) and NS5b‐p294, as well as an elevated percentage of CD4+ cells releasing IFN‐γ + IL‐4 against NS3‐p153, and by CD8+ cells against NS3 (p124, p153). SVR without occult infection showed a higher percentage of activation and release of IFN‐γ + IL‐4 by both cell subpopulations than the two group of controls, in contrast to SVR with occult infection.

Conclusion

The lower HCV‐specific T‐cell response found in SVR with occult infection indicates that the immune response may be impaired when the virus persists in PBMCs.
Keratin‐18 and microRNA‐122 complement alanine aminotransferase as novel safety biomarkers for drug‐induced liver injury in two human cohorts
Authors: Thulin Petra , Nordahl Gunnar , Gry Marcus , Yimer Getnet , Aklillu Eleni , Makonnen Eyasu , Aderaye Getachew , Lindquist Lars , Mattsson C. Mikael , Ekblom Björn , Antoine Daniel J. , Park B. Kevin , Linder Stig , Harrill Alison H. , Watkins Paul B. , Glinghammar Björn , Schuppe‐Koistinen Ina
Published: September 2013

Background & Aims

There is a demand for more sensitive, specific and predictive biomarkers for drug‐induced liver injury (DILI) than the gold standard used today, alanine aminotransferase (ALT). The aim of this study was to qualify novel DILI biomarkers (keratin‐18 markers M65/M30, microRNA‐122, glutamate dehydrogenase and alpha‐foetoprotein) in human DILI.

Methods

Levels of the novel biomarkers were measured by enzyme‐linked immunosorbent assay or real‐time quantitative reverse‐transcription PCR (qRT‐PCR) in two human DILI cohorts: a human volunteer study with acetaminophen and a human immunodeficiency virus (HIV)/tuberculosis (TB) study.

Results

In the acetaminophen study, serum M65 and microRNA‐122 levels were significantly increased at an earlier time point than ALT. Furthermore, the maximal elevation of M65 and microRNA‐122 exceeded the increase in ALT. In the HIV/TB study, all the analysed novel biomarkers increased after 1 week of treatment. In contrast to ALT, the novel biomarkers remained stable in a human cohort with exercise‐induced muscular injury.

Conclusions

M65 and microRNA‐122 are potential biomarkers of DILI superior to ALT with respect to sensitivity and specificity.
Coenzyme Q in pregnant women and rats with intrahepatic cholestasis
Authors: Martinefski Manuela R. , Contin Mario D. , Rodriguez Myrian R. , Geréz Estefanía M. , Galleano Mónica L. , Lucangioli Silvia E. , Bianciotti Liliana G. , Tripodi Valeria P.
Published: September 2013

Background & Aims

Intrahepatic cholestasis of pregnancy is a high‐risk liver disease given the eventual deleterious consequences that may occur in the foetus. It is accepted that the abnormal accumulation of hydrophobic bile acids in maternal serum are responsible for the disease development. Hydrophobic bile acids induce oxidative stress and apoptosis leading to the damage of the hepatic parenchyma and eventually extrahepatic tissues. As coenzyme Q (CoQ) is considered an early marker of oxidative stress in this study, we sought to assess CoQ levels, bile acid profile and oxidative stress status in intrahepatic cholestasis.

Methods

CoQ, vitamin E and malondialdehyde were measured in plasma and/or tissues by HPLC‐UV method whereas serum bile acids by capillary electrophoresis in rats with ethinyl estradiol‐induced cholestasis and women with pregnancy cholestasis.

Results

CoQ and vitamin E plasma levels were diminished in both rats and women with intrahepatic cholestasis. Furthermore, reduced CoQ was also found in muscle and brain of cholestatic rats but no changes were observed in heart or liver. In addition, a positive correlation between CoQ and ursodeoxycholic/lithocholic acid ratio was found in intrahepatic cholestasis suggesting that increased plasma lithocholic acid may be intimately related to CoQ depletion in blood and tissues.

Conclusion

Significant CoQ and vitamin E depletion occur in both animals and humans with intrahepatic cholestasis likely as the result of increased hydrophobic bile acids known to produce significant oxidative stress. Present findings further suggest that antioxidant supplementation complementary to traditional treatment may improve cholestasis outcome.