bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐Term Impact of Medicare Payment Reductions on Patient Outcomes
Authors: Wu Vivian Y. , Shen Yu‐Chu
Published: May 2014

Objective

To examine the long‐term impact of Medicare payment reductions on patient outcomes for Medicare acute myocardial infarction (AMI) patients.

Data Sources

Analysis of secondary data compiled from 100 percent Medicare Provider Analysis and Review between 1995 and 2005, Medicare hospital cost reports, Inpatient Prospective Payment System Payment Impact Files, American Hospital Association annual surveys, InterStudy, Area Resource Files, and County Business Patterns.

Study Design

We used a natural experiment—the Balanced Budget Act (BBA) of 1997—as an instrument to predict cumulative Medicare revenue loss due solely to the BBA, and basing on the predicted loss categorized hospitals into small, moderate, or large payment‐cut groups and followed Medicare AMI patient outcomes in these hospitals over an 11‐year panel between 1995 and 2005.

Principal Findings

We found that while Medicare AMI mortality trends remained similar across hospitals between pre‐BBA and initial‐BBA periods, hospitals facing large payment cuts saw smaller improvement in mortality rates relative to that of hospitals facing small cuts in the post‐BBA period. Part of the relatively higher AMI mortalities among large‐cut hospitals might be related to reductions in staffing levels and operating costs, and a small part might be due to patient selection.

Conclusions

We found evidence that hospitals facing large Medicare payment cuts as a result of BBA of 1997 were associated with deteriorating patient outcomes in the long run. Medicare payment reductions may have an unintended consequence of widening the gap in quality across hospitals.
Modulation of immune responses of Rhynchophorus ferrugineus (Insecta: Coleoptera) induced by the entomopathogenic nematode Steinernema carpocapsae (Nematoda: Rhabditida)
Authors: Mastore Maristella , Arizza Vincenzo , Manachini Barbara , Brivio Maurizio F.
Published: May 2014

Aim of this study was to investigate relationships between the red palm weevil (RPW) Rhynchophorus ferrugineus (Olivier) and the entomopathogenic nematode Steinernema carpocapsae (EPN); particularly, the work was focused on the immune response of the insect host in naive larvae and after infection with the EPN. Two main immunological processes have been addressed: the activity and modulation of host prophenoloxidase‐phenoloxidase (proPO) system, involved in melanization of not‐self and hemocytes recognition processes responsible for not‐self encapsulation. Moreover, immune depressive and immune evasive strategies of the parasite have been investigated. Our results suggest that RPW possess an efficient immune system, however in the early phase of infection, S. carpocapsae induces a strong inhibition of the host proPO system. In addition, host cell‐mediated mechanisms of encapsulation, are completely avoided by the parasite, the elusive strategies of S. carpocapsae seem to be related to the structure of its body‐surface, since induced alterations of the parasite cuticle resulted in the loss of its mimetic properties. S. carpocapsae before the release of its symbiotic bacteria, depress and elude RPW immune defenses, with the aim to arrange a favorable environment for its bacteria responsible of the septicemic death of the insect target.
Changing patterns of injury associated with low‐energy falls in the elderly: a 10‐year analysis at an Australian Major Trauma Centre
Authors: Lee Hugo , Bein Kendall J. , Ivers Rebecca , Dinh Michael M.
Published: May 2014

Background

The rate of hospitalization in elderly patients because of falls is increasing. The objective of this study was to investigate long‐term trends in injury profiles of low‐energy falls and to identify injuries associated with need for in‐patient rehabilitation.

Methods

A single‐centre retrospective study was performed at an inner city Major Trauma Centre in Sydney. Trauma registry data were obtained from patients who were 65 years of age or over with low‐energy falls (trip and fall from height ≤1 m, including falls from standing) from the trauma registry between January 2000 and December 2011. Demographic data, time and date of presentation and injury characteristics were collected. Outcomes of interests were proportions of hip fractures, head injuries and discharge to in‐patient rehabilitation facilities.

Results

A total of 4964 cases were identified. There was a 6.5% per annum decrease in the proportion of elderly patients with low‐energy falls who sustained hip fractures compared with a relative increase in severe head injuries, 5.7% per annum. Around 25% of patients were transferred to in‐patient rehabilitation. Severe head injuries and lower‐limb injuries were the two injuries most associated with transfer to in‐patient rehabilitation.

Conclusion

In elderly patients with low‐energy falls, a significant decrease in hip fractures was associated with a rise in severe head injuries over the past decade.
Extracorporeal Membrane Oxygenation Support in Refractory Cardiogenic Shock: Treatment Strategies and Analysis of Risk Factors
Authors: Loforte Antonio , Marinelli Giuseppe , Musumeci Francesco , Folesani Gianluca , Pilato Emanuele , Martin Suarez Sofia , Montalto Andrea , Lilla Della Monica Paola , Grigioni Francesco , Frascaroli Guido , Menichetti Antonio , Di Bartolomeo Roberto , Arpesella Giorgio
Published: May 2014

Two centrifugal pumps, the RotaFlow (Maquet, Jostra Medizintechnik AG, Hirrlingen, Germany) and Levitronix CentriMag (Levitronix LCC, Waltham, MA, USA), used in central or peripheral veno‐arterial extracorporeal membrane oxygenation (ECMO) support systems have been investigated, in terms of double‐center experience, as treatment for patients with refractory cardiogenic shock (CS). Between January 2006 and December 2012, 228 consecutive adult patients were supported on RotaFlow (n = 213) or CentriMag (n = 15) ECMO, at our institutions (155 men; age 58.3 ± 10.5 years, range: 19–84 years). Indications for support were: failure to wean from cardiopulmonary bypass in the setting of postcardiotomy (n = 118) and primary donor graft failure (n = 37); postacute myocardial infarction CS (n = 27); acute myocarditis (n = 6); and CS on chronic heart failure (n = 40). A peripheral ECMO setting was established in 126 (55.2%) patients while it was established centrally in 102 (44.7%). Overall mean support time was 10.9 ± 9.7 days (range: 1–43 days). Eighty‐four (36.8%) patients died on ECMO. Overall success rate, in terms of survival on ECMO (n = 144), weaning from mechanical support (n = 107; 46.9%), bridge to mid‐long‐term ventricular assist device (n = 6; 2.6%), and bridge to heart transplantation (n = 31; 13.5%), was 63.1%. One hundred twenty‐two (53.5%) patients were successfully discharged. Stepwise logistic regression identified blood lactate level and MB isoenzyme of creatine kinase (CK‐MB) relative index at 72 h after ECMO initiation, and number of packed red blood cells (PRBCs) transfused on ECMO as significant predictors of mortality on ECMO (P = 0.010, odds ratio [OR] = 2.94; 95% confidence interval [CI] = 1.10–3.14; P = 0.010, OR = 2.82, 95% CI = 1.014–3.721; and P = 0.011, OR = 2.69; 95% CI = 1.06–4.16, respectively). Central ECMO population had significantly higher rate of continuous veno‐venous hemofiltration need and bleeding requiring surgery events compared with the peripheral ECMO setting population. No significant differences were seen by comparing the RotaFlow and CentriMag populations in terms of device performance. At follow‐up, persistent heart failure with left ventricle ejection fraction (LVEF) ≤40% was a risk factor after hospital discharge. Patients with a poor hemodynamic status may benefit from rapid central or peripheral insertion of ECMO. The blood lactate level, CK‐MB relative index, and PRBCs transfused should be strictly monitored during ECMO support. In addition, early ventricular assist device placement or urgent listing for heart transplant should be considered in patients with persistent impaired LVEF after ECMO.
Establishing the Framework to Support Bioartificial Heart Fabrication Using Fibrin‐Based Three‐Dimensional Artificial Heart Muscle
Authors: Hogan Matthew , Mohamed Mohamed , Tao Ze‐Wei , Gutierrez Laura , Birla Ravi
Published: May 2014

Only 3000 heart transplants are performed in the USA every year, leaving some 30 000–70 000 Americans without proper care. Current treatment modalities for heart failure have saved many lives yet still do not correct the underlying problems of congestive heart failure. Tissue engineering represents a potential field of study wherein a combination of cells, scaffolds, and/or bioreactors can be utilized to create constructs to mimic, replace, and/or repair defective tissue. The focus of this study was to generate a bioartificial heart (BAH) model using artificial heart muscle (AHM), composed of fibrin gel and neonatal rat cardiac myocytes, and a decellularized scaffold, formed by subjecting an adult rat heart to a series of decellularization solutions. By suturing the AHM around the outside of the decellularized heart and culturing while suspended in media, we were able to retain functional cardiac cells on the scaffold as evinced by visible contractility. Observed contractility rate was correlated with biopotential measurements to confirm essential functionality of cardiac constructs. Cross‐sections of the BAH show successful decellularization of the scaffold and contiguous cell‐rich AHM around the perimeter of the heart.
Effect of dietary astaxanthin rich yeast, Phaffia rhodozyma, on meat quality of broiler chickens
Authors: Perenlei Ganzaya , Tojo Hitomi , Okada Toru , Kubota Masatoshi , Kadowaki Motoni , Fujimura Shinobu
Published: May 2014

We evaluated effects of dietary supplementation with astaxanthin (Ax)‐rich yeast, Phaffia rhodozyma (Xanthophyllomyces dendrorhous), on broiler chicken meat quality. Fourteen‐day‐old female Ross broilers were divided into three groups: control group, Ax‐free diet; Ax 10 group, 10 mg/kg Ax diet; and Ax 20 group, 20 mg/kg Ax diet for 28 days. At 42 days old, chickens were slaughtered, and then growth performance, meat quality and sensory attributes were analyzed. Compared with the control, a* values increased significantly after slaughter and 48 h postmortem for Ax 20 samples (P < 0.05) and for b* values in Ax 20 and Ax 10 groups (P < 0.05). Cooking loss decreased in the Ax 20 group (P < 0.05). After 120 h aging, contents of several free amino acids and total free amino acid content of Ax 20 group were significantly higher than the control (P < 0.05). In sensory evaluation, meat texture attributes improved significantly in the Ax 20 group (P < 0.01). No significant changes occurred in flavor attribute scores of meat soup from the Ax 20 group compared with the control even though most assessors preferred meat soup from the Ax 20 group. Overall, Ax‐rich yeast in the diet improves broiler chicken meat quality.
Isolation of chicken taste buds for real‐time Ca2+ imaging
Authors: Kudo Ken‐ichi , Kawabata Fuminori , Nomura Toumi , Aridome Ayumi , Nishimura Shotaro , Tabata Shoji
Published: May 2014

We isolated chicken taste buds and used a real‐time Ca2+ imaging technique to investigate the functions of the taste cells. With RT‐PCR, we found that isolated chicken taste bud‐like cell subsets express chicken gustducin messenger RNA. Immunocytochemical techniques revealed that the cell subsets were also immunopositive for chicken gustducin. These results provided strong evidence that the isolated cell subsets contain chicken taste buds. The isolated cell subsets were spindle‐shaped and approximately 61–75 μm wide and 88–98 μm long, and these characteristics are similar to those of sectional chicken taste buds. Using Ca2+ imaging, we observed the buds' response to 2 mmol/L quinine hydrochloride (a bitter substance) and their response to a mixture of 25 mmol/L L‐glutamic acid monopotassium salt monohydrate and 1 mmol/L inosine 5′‐monophosphate disodium salt, umami substances. The present study is the first morphological demonstration of isolated chicken taste buds, and our results indicate that the isolated taste buds were intact and functional approaches for examining the taste senses of the chicken using Ca2+ imaging can be informative.
Analysis of glycosuria in okapi (Okapia johnstoni): Examination of urinaryN‐acetyl‐β‐D‐glucosaminidase
Authors: Kawasaki Ryuta , Azumano Akinori , Ueda Miya , Tanaka Souhei , Yokota Aya , Katoh Kazuo , Hagino Akihiko
Published: May 2014

We analyzed the urinary excretion of glucose andN‐acetyl‐β‐D‐glucosaminidase (NAG) in six okapis (Okapia johnstoni) in captivity to investigate the cause of their urinary sugar excretion. The urinary glucose‐positive okapi had significantly higher urinaryNAGindices than the urinary glucose‐negative okapi. There was also a positive correlation between urinary glucose levels and urinaryNAGindices. These results suggest that the proximal tubular function of the glycosuric okapi may have been obstructed, which impaired glucose reabsorption.
Community Engagement in the CTSA Program: Stakeholder Responses from a National Delphi Process
Authors: Freeman Elmer , Seifer Sarena D. , Stupak Matthew , Martinez Linda Sprague
Published: May 2014

In response to the Institute of Medicine (IOM) Committee's December 2012 public request for stakeholder input on the Clinical and Translational Science Award (CTSA) program, two nonprofit organizations, the Center for Community Health Education Research and Service, Inc. (CCHERS) and Community‐Campus Partnerships for Health (CCPH), solicited feedback from CTSA stakeholders using the Delphi method. Academic and community stakeholders were invited to participate in the Delphi, which is an exploratory method used for group consensus building. Six questions posed by the IOM Committee to an invited panel on community engagement were electronically sent to stakeholders. In Round 1 stakeholder responses were coded thematically and then tallied. Round 2 asked stakeholders to state their level of agreement with each of the themes using a Likert scale. Finally, in Round 3 the group was asked to rank the Round 2 based on potential impact for the CTSA program and implementation feasibility. The benefits of community engagement in clinical and translational research as well as the need to integrate community engagement across all components of the CTSA program were common themes. Respondents expressed skepticism as to the feasibility of strengthening CTSA community engagement.
A comparative study of opioid substitution therapy utilisation among opioid‐dependent men and women
Authors: Gisev Natasa , Degenhardt Louisa , Larney Sarah , Larance Briony , Gibson Amy , Kimber Jo , Burns Lucy
Published: May 2014

Introduction and Aims

Few population‐based studies have examined differences in opioid substitution therapy (OST) treatment utilisation between men and women. Using a population of opioid‐dependent people in New South Wales, Australia, first‐episode and long‐term OST treatment utilisation profiles were compared between men and women, differentiating between treatment initiation in the community and in custody.

Design and Methods

Retrospective data linkage study using records of new OST entrants (2001–2010) and custody episodes (2000–2012). First OST treatment episode and overall treatment utilisation characteristics were compared between men and women initiating treatment in the community or in custody. Treatment retention was evaluated at 3, 6, 9 and 12 months after first commencing OST and overall, as the median proportion of follow‐up time spent in treatment.

Results

There were 15 600 new OST entrants in the cohort—10 930 were men (70.1%) and 4670 women (29.9%); 12 584 (80.7%) initiated treatment in the community and 3016 (19.3%) in custody. More men initiated OST in custody (24.0% vs. 8.3%, P < 0.001) and only received OST in custody (57.5% vs. 41.8%, P < 0.001). Women were retained longer in their first OST treatment episode at all four time points in both treatment settings and in treatment overall (community: 46.6% vs. 39.1%, P < 0.001; custody: 41.3% vs. 30.8%, P < 0.001).

Discussion and Conclusions

There are a number of key differences in OST treatment utilisation profiles between men and women. Whereas men commonly initiate and only receive OST in custody, treatment retention is higher among women, independent of the setting treatment is initiated. [Gisev N, Degenhardt L, Larney S, Larance B, Gibson A, Kimber J, Burns L. A comparative study of opioid substitution therapy utilisation among opioid‐dependent men and women. Drug Alcohol Rev 2014;33:499–505]
Estimation of length or height in infants and young children using ulnar and lower leg length with dual‐energy X‐ray absorptiometry validation
Authors: Weidauer Lee , Wey Howard , Slater Hillarie , Moyer‐Mileur Laurie , Specker Bonny
Published: May 2014

Aim

We compared the accuracy and reproducibility of using ulnar and lower leg length measurements to predict length and height in infants and children aged 0 to 6 years.

Method

Length/height and ulnar and lower leg length were measured in 352 healthy preterm and term‐born children (167 males, 185 females) (Mean age= 2.6±1.6 years). Ulna length was measured as the distance between the proximal olecranon process and the distal styloid process of the ulna. Tibia length was measured as the distance from the proximal aspect of the medial condyle and the most distal aspect of the medial malleolus of the tibia using a segmometer. Length measurements were taken using an infant length board in children less than 24 months of age, whereas a portable stadiometer was used to measure height in older children. Equations were developed using ulnar and lower leg length and age. Intra‐ and inter‐examiner variability (n=167) was calculated, and dual‐energy X‐ray absorptiometry scans (n=126) were used to determine accuracy of limb lengths.

Results

Ulnar and lower leg length explained over 95% of the variability in length/height in term infants and children, but less in preterm infants (R2=0.80–0.87). In preterm infants, the limits of agreement (LOA) for males were −2.44 to 2.44cm and −2.88 to 2.88cm for the ulna and lower leg respectively, whereas the LOA for females were −1.90 to 1.90cm and −1.87 to 1.87cm respectively. In older children, the LOA for males were −5.53 to 4.48cm and −5.59 to 4.62cm for the ulna and lower leg respectively, whereas the LOA for females were −5.57 to 5.01cm and −6.02 to 5.02cm respectively. Intra‐ and inter‐examiner variability was low for all measurements in both sexes and age groups.

Interpretation

Length and height measurements using infant length board or stadiometer are reproducible. Because of the wide limits of agreement, estimation of length and height in children using ulnar and lower leg length is not an acceptable alternative to traditional methods.
Is autism curable?
Authors: Bölte Sven
Published: May 2014

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder of multifactorial origin. Today, ASD is generally not curable, although it is treatable to a varying degree to prevent worse outcomes. Some reports indicate the possibility of major improvements or even recovery in ASD. However, these studies are based on scientific shortcomings, and the lack of a clear definition of ‘cure' in ASD further compromises interpretation of research findings. The development of animal models and decreasing costs of genome sequencing provide new options for treatment research and individualized medicine in ASD. This article briefly reviews several issues related to the question whether there is recovery from ASD, starting with a short overview of the presumed aetiologies.
Association between restless legs syndrome and migraine: a population‐based study
Authors: Zanigni Stefano , Giannini Giulia , Melotti Roberto , Pattaro Cristian , Provini Federica , Cevoli Sabina , Facheris Maurizio F. , Cortelli Pietro , Pramstaller Peter P.
Published: May 2014

Background and purpose

A higher prevalence of restless legs syndrome (RLS) in migraineurs has been reported in clinical samples and in two large‐scale clinical trials performed on healthcare workers but general population‐based studies on this topic are lacking. The aim of this study was to assess the association between migraine and RLS in an Italian rural adult population‐based setting.

Methods

The presence of migraine and RLS was assessed via a computer‐assisted personal interview and self‐administered questionnaires according to current diagnostic criteria in 1567 participants of a preliminary phase of an adult population‐based study performed in South Tyrol, Italy.

Results

Migraineurs had an increased risk of having RLS also after adjustment for confounding factors such as age, sex, major depression, anxiety and sleep quality (odds ratio 1.79; confidence interval 1.00–3.19; P = 0.049). This association was not modified by aura status and possible causes of secondary RLS. RLS was not significantly associated with tension‐type headache.

Conclusions

Restless legs syndrome and migraine were associated in our rural adult population. This association could be explained by a possible shared pathogenic pathway which would implicate new management strategies of these two disorders.
A combination treatment strategy using pyrantel pamoate and oxibendazole demonstrates additive effects for controlling equine cyathostomins
Authors: Kaplan R. M. , West E. M. , Norat‐Collazo L. M. , Vargas J.
Published: May 2014

Anthelmintics of the avermectin/milbemycin class continue to demonstrate the highest efficacy against cyathostomin nematodes; however, over‐reliance on these drugs is increasing the likelihood that recent emerging resistance to these drugs will worsen. Use of benzimidazole and pyrantel compounds given concurrently may provide sufficiently high efficacy to serve as a viable treatment alternative to the avermectin/milbemycin drugs, thus reducing the selective pressures for resistance development. The study was conducted to determine if oxibendazole (OBZ) and pyrantel pamoate (PYR) would have greater efficacy when used in combination vs. what either drug could achieve individually, and to determine if the combination protocol would consistently achieve faecal egg count reduction (FECR) rates >90%, the general threshold for acceptable efficacy. Horses of various ages and breeds on 11 horse farms were assigned randomly to treatment withOBZ(n = 34),PYR(n = 35), or a combination of both (n = 61). A faecal egg count was performed for each horse prior to treatment and 9–14 days post treatment. MeanFECRpercentages were calculated for each treatment group on individual farms, and for each treatment group across all farms. Combination treatment achieved >90% meanFECRon all 11 farms, and >95% on 9 of the 11 farms. Overall arithmetic meanFECRrates were 90.03%, 81.10% and 96.35% for horses treated respectively withOBZ,PYR, and the 2 drugs in combination. Combination treatment withOBZandPYRdemonstrated an additive effect whereby horses given both anthelmintics concurrently had meanFECRpercentages that were significantly greater than in horses given either drug alone. Combination treatment withOBZandPYRcan be an efficacious and viable treatment choice for controlling cyathostomins, thereby reducing the over‐reliance on avermectin/milbemycin drugs.
Prevalence of Migraine in Patients With Restless Legs Syndrome: A Case–Control Study
Authors: Fernández‐Matarrubia Marta , Cuadrado María L. , Sánchez‐Barros Cristian M. , Martínez‐Orozco Francisco J. , Fernández‐Pérez Cristina , Villalibre Isabel , Ramírez‐Nicolás Belén , Porta‐Etessam Jesús
Published: May 2014

Objectives

To assess and compare the prevalence of migraine in patients with restless legs syndrome (RLS) and matched controls.

Background

Recent studies have suggested an association between migraine and RLS. Our work is the first case–control study on this subject performed in an RLS population.

Methods

A case–control study was conducted in 47 RLS patients (27 women and 20 men aged between 18 and 65 years) and 47 age‐ and sex‐matched controls. Validated questionnaires were used to investigate the presence of migraine, anxiety, and depression (Zung Self‐Rating Anxiety and Depression scales), sleep quality (Pittsburgh Sleep Quality Index), and RLS severity (International RLS scale).

Results

RLS patients had higher lifetime prevalence of migraine than non‐RLS controls (53.2% vs 25.5%, P = .005; matched‐OR 1.3 [P = .019]; adjusted odds ratio (OR) 3.8 [P = .03]). No significant associations were found between RLS and active migraine with aura or inactive migraine (no episodes in the previous year). However, active migraine without aura was significantly more prevalent in patients with RLS than in controls (40.4% vs 12.8%, P = .001; matched OR 1.5 [P = .001]; adjusted OR 2.7 [P = .04]). Within the RLS group, patients with migraine had poorer sleep quality than those without migraine (Pittsburgh Sleep Quality Index >5:100 vs 80.9%, P = .038) but did not differ in terms of RLS severity, anxiety and depression, use of dopaminergic agonists, and body mass index.

Conclusion

There appears to be a relationship between RLS and migraine, in particular for active migraine without aura.
Positive affect facilitates social problem solving
Authors: Nelson Donna Webster , Sim Erin K.
Published: May 2014

We conducted two experiments to test the impact of positive affect on social problem solving. In Experiment 1, participants induced to experience a positive (vs. neutral) affective state generated a greater number of relevant steps to solve fictitious interpersonal problems as well as more effective solutions to the problems. In Experiment 2, participants induced to experience a positive (vs. negative) affective state generated more functional solutions to their own social problems. The positive mood effects observed in Experiment 2 were moderated by dispositional optimism. Our findings have practical implications, as the extent to which individuals are able to generate effective solutions to social problems has far‐reaching consequences with respect to personal adjustment and social functioning.
Buyer beware of your shadow: how price moderates the effect of incidental similarity on buyer behavior
Authors: Kachersky Luke , Sen Sankar , Kim Hyeong Min , Carnevale Marina
Published: May 2014

Using both a lab experiment and actual transaction data, we investigated whether and how incidental similarities (e.g., shared letters between buyer and seller's name) might influence buyer behavior. Particularly, while prior work suggests that consumers generally prefer incidental similarity, we use the context of Internet auctions to show that this preference reverses when prices are high. Under these conditions, buyers avoid incidentally similar sellers. We speculate that this effect is tied to individuals' motive to self‐protect. Implications for theory and practice are discussed.
Challenging assignments and activating mood: the influence of goal orientation
Authors: Preenen Paul T. Y. , Van Vianen Annelies E. M. , De Pater Irene E.
Published: May 2014

We examined the impact of induced goal orientation on individuals' positive‐ and negative‐activating mood when taking part in high‐ or low‐challenging assignments. Results indicated that performing a low‐challenging assignment leads to a higher positive‐activating mood with a performance‐approach orientation than with a mastery approach, or no goal orientation. In contrast, conducting a high‐challenging assignment leads to a higher positive‐activating mood with a mastery approach than with a performance approach, or no goal orientation. These findings suggest that high‐challenging assignments are best instructed with a focus on learning whereas low‐challenging assignments are best instructed with a focus on superior performance.
The impact of perspective in visualizing health‐related behaviors: first‐person perspective increases motivation to adopt health‐related behaviors
Authors: Rennie Laura J. , Harris Peter R. , Webb Thomas L.
Published: May 2014

Two experiments investigated the effects of perspective and visualization on motivation to engage in health‐related behaviors. Participants visualized themselves donating blood (Experiment 1) or quitting smoking (Experiment 2) from either the first‐person (own) or third‐person (observer's) perspective. Subsequently, motivation to engage in the visualized behavior was assessed. Contrary to previous findings showing the benefits of taking a third‐person perspective on behaviors not related to health, visualizing using the first‐person perspective had greater effects on motivation than visualizing using the third‐person perspective. Indeed, visualizing using the third‐person perspective was no more effective than not visualizing anything (Experiment 2). The theoretical implications and potential applications of these findings are discussed.
Mild‐to‐moderate intensity exercise improves cardiac autonomic drive in type 2 diabetes
Authors: Goit Rajesh Kumar , Paudel Bishnu Hari , Khadka Rita , Roy Roshan Kumar , Shrewastwa Mukesh Kumar
Published: May 2014

Aims/Introduction

The aim of the present study was to determine the effect of moderate aerobic exercise on cardiac autonomic function in type 2 diabetic patients.

Materials and Methods

Heart rate variability of 20 patients with type 2 diabetes was assessed. Resting electrocardiogram for the heart rate variability analysis at spontaneous respiration was recorded for 5 min in the supine position before and after 6 months of supervised aerobic training given three times per week.

Results

In time domain measures, the square root of the mean of the sum of the squares of differences between adjacent R‐R intervals (RMSSD; 29.7 [26–34.5] vs 46.4 [29.8–52.2] ms, P = 0.023) and the percentage of consecutive RR intervals that differ by more than 50 ms (pNN50; 10.7 [5.5–12.7] vs 26.1 [6.6–37.2]%, P = 0.025] were significantly increased after exercise. In frequency domain measures, low frequency (62.4 [59.1–79.2] vs 37 [31.3–43.3] nu, P = 0.003) and low frequency/high frequency (1.67 [1.44–3.8] vs 0.58 [0.46–0.59]%, P = 0.009) were significantly decreased, whereas high frequency (95 [67–149] vs 229 [98–427] ms2, P = 0.006) and high frequency (37.6 [20.8–40.9] vs 63 [56.7–68.7] normalized units, P = 0.003) were significantly increased after exercise. In a Poincaré plot, standard deviation perpendicular to the line of the Poincaré plot (SD1; 21.3 [18.5–24.8]–33.1 [21.5–37.2] ms, P = 0.027) was significantly increased after exercise.

Conclusions

These data suggest that three times per week moderate intensity aerobic exercise for 6 months improves cardiac rhythm regulation as measured by heart rate variability in type 2 diabetic patients.
A cDNA library from the antenna of Monochamus alternatus Hope and binding properties of odorant‐binding proteins
Authors: Gao X. , Wang M.‐Q.
Published: May 2014

Chemoreception is a key feature in selection of host plants by insects. We performed a preliminary functional characterization of olfactory proteins isolated from an antennal cDNA library of Monochamus alternatus. We identified four olfactory genes, including two encoding putative classic odorant‐binding proteins (OBPs) and two encoding minus‐C OBPs. We expressed two of the four OBPs, MaltOBP3 and MaltOBP5, in a bacterial system and assessed their ligand specificity by measuring the competitive binding of fluorescent probe, N‐phenyl‐1‐naph‐thylamine, in the presence of 17 volatile beetle‐ or host‐plant‐related ligands. The results indicated that although MaltOBP3 and MaltOBP5 bound a distinctly different group of competitors, both had relatively high binding affinities (Ki < 20 μm) for certain compounds. The differences in their binding affinities towards host‐plant ligands suggest the roles of MaltOBP3 and MaltOBP5 in host‐plant selection.
Identification, summary and comparison of tools used to measure organizational attributes associated with chronic disease management within primary care settings
Authors: Lukewich Julia , Corbin Renée , VanDenKerkhof Elizabeth G. , Edge Dana S. , Williamson Tyler , Tranmer Joan E.
Published: May 2014

Rationale, aims and objectives

Given the increasing emphasis being placed on managing patients with chronic diseases within primary care, there is a need to better understand which primary care organizational attributes affect the quality of care that patients with chronic diseases receive. This study aimed to identify, summarize and compare data collection tools that describe and measure organizational attributes used within the primary care setting worldwide.

Methods

Systematic search and review methodology consisting of a comprehensive and exhaustive search that is based on a broad question to identify the best available evidence was employed.

Results

A total of 30 organizational attribute data collection tools that have been used within the primary care setting were identified. The tools varied with respect to overall focus and level of organizational detail captured, theoretical foundations, administration and completion methods, types of questions asked, and the extent to which psychometric property testing had been performed. The tools utilized within the Quality and Costs of Primary Care in Europe study and the Canadian Primary Health Care Practice‐Based Surveys were the most recently developed tools. Furthermore, of the 30 tools reviewed, the Canadian Primary Health Care Practice‐Based Surveys collected the most information on organizational attributes.

Conclusions

There is a need to collect primary care organizational attribute information at a national level to better understand factors affecting the quality of chronic disease prevention and management across a given country. The data collection tools identified in this review can be used to establish data collection strategies to collect this important information.
Can complex health interventions be evaluated using routine clinical and administrative data? – a realist evaluation approach
Authors: Riippa Iiris , Kahilakoski Olli‐Pekka , Linna Miika , Hietala Minni
Published: May 2014

Rationale, aims and objectives

Interventions aimed at improving chronic care typically consist of multiple interconnected parts, all of which are essential to the effect of the intervention. Limited attention has been paid to the use of routine clinical and administrative data in the evolution of these complex interventions. The purpose of this study is to examine the feasibility of routinely collected data when evaluating complex interventions and to demonstrate how a theory‐based, realist approach to evaluation may increase the feasibility of routine data.

Methods

We present a case study of evaluating a complex intervention, namely, the chronic care model (CCM), in Finnish primary health care. Issues typically faced when evaluating the effects of a complex intervention on health outcomes and resource use are identified by using routine data in a natural setting, and we apply context‐mechanism‐outcome (CMO) approach from the realist evaluation paradigm to improve the feasibility of using routine data in evaluating complex interventions.

Results

From an experimentalist approach that dominates the medical literature, routine data collected from a single centre offered a poor starting point for evaluating complex interventions. However, the CMO approach offered tools for identifying indicators needed to evaluate complex interventions.

Conclusions

Applying the CMO approach can aid in a typical evaluation setting encountered by primary care managers: one in which the intervention is complex, the primary data source is routinely collected clinical and administrative data from a single centre, and in which randomization of patients into two research arms is too resource consuming to arrange.
Occurrence and Characterization of Enterotoxigenic Potential of Staphylococcus Isolated from Dairy Products
Authors: Martins Isabela Mateus , Kabuki Dirce Yorika , Miya Norma Teruko Nago , Pereira José Luiz
Published: May 2014

Staphylococcus deserves our close attention because of its ability to produce a large amount of enterotoxins, which, if ingested, cause staphylococcal food poisoning. Cross‐contamination after milk pasteurization, caused especially by improper handling, is considered the most recurrent source of contamination of dairy products. Therefore, this research aimed to quantify and analyze the presence of coagulase‐positive and coagulase‐negative staphylococci from 104 dairy products samples to identify phenotypically the species and to evaluate the in vitro production of classical enterotoxins (SEA, SEB, SEC, SED and SEE) and the presence of possible coding genes of these enterotoxins. The average staphylococcal count values in different food groups ranged from 3.7 to 6.15 log colony‐forming units (cfu)/g. Among the staphylococcal strains, 74.3% (110/148) were coagulase‐negative Staphylococcus and 25.7% (38/148) were coagulase‐positive Staphylococcus, and 13 species were identified. From the 111 selected isolates, one (0.9%) strain produced enterotoxin, which was identified as S. aureus, coagulase positive, isolated from “Minas” half‐cured cheese, whose count was 6.28 log cfu/g. Contrary to expectations, no coding genes were present in the isolate analyzed. For this research, the analyzed samples showed high staphylococcal concentrations that do not exclude a possible risk of producing the already described enterotoxins. They also demonstrated poor hygiene during the production and commercialization of dairy products.

Practical Applications

Staphylococcus aureus is one of the most common agents in bacterial food poisoning outbreaks. As milk is a major nutrient for infants, children, convalescents and old people, the presence of classical enterotoxins in milk and dairy products is a matter of concern. The information present in this research is important to alert about the inadequate quality of Brazilian milk products, and efforts from the government and the entire productive chain are required to attain consumer safety.
Competencies for Addressing Gender and Power in Couple Therapy: A Socio Emotional Approach
Authors: Knudson‐Martin Carmen , Huenergardt Douglas , Lafontant Ketsia , Bishop Les , Schaepper Johannes , Wells Melissa
Published: May 2014

Power imbalances between partners are intrinsic to relationship distress and intricately connected to emotional experience, couple communication processes, and socio cultural contexts such as gender. The ability to work with the power dynamics between partners is thus critical to the practice of couple therapy. However, few practical guidelines for dealing with this issue are available. The authors present seven clinical competencies regarding gender and power issues that they identified by examining their own work: (a) identify enactments of cultural discourse, (b) attune to underlying socio cultural emotion, (c) name underlying power processes, (d) facilitate relational safety, (e) foster mutual attunement, (f) create a model of equality, and (g) facilitate shared relationship responsibility. Each competency is illustrated through a case example. The competencies represent an over‐arching guide to practice that may be integrated with other clinical approaches and is particularly useful for training and supervision.
Three‐dimensional shape variation of talar surface morphology in hominoid primates
Authors: Parr W. C. H. , Soligo C. , Smaers J. , Chatterjee H. J. , Ruto A. , Cornish L. , Wroe S.
Published: May 2014

The hominoid foot is of particular interest to biological anthropologists, as changes in its anatomy through time reflect the adoption of terrestrial locomotion, particularly in species ofAustralopithecusandHomo. Understanding the osteological morphology associated with changes in whole foot function and the development of the plantar medial longitudinal foot arch are key to understanding the transition through habitual bipedalism in australopithecines to obligate bipedalism and long‐distance running inHomo. The talus is ideal for studying relationships between morphology and function in this context, as it is a major contributor to the adduction–abduction, plantar–dorsal flexion and inversion–eversion of the foot, and transmits all forces encountered from the foot to the leg. The talar surface is predominantly covered by articular facets, which have different quantifiable morphological characters, including surface area, surface curvature and orientation. The talus also presents challenges to the investigator, as its globular shape is very difficult to quantify accurately and reproducibly. Here we apply a three‐dimensional approach using type 3 landmarks (slid semilandmarks) that are geometrically homologous to determine overall talar shape variations in a range of living and fossil hominoid taxa. Additionally, we use novel approaches to quantify the relative orientations and curvatures of talar articular facets by determining the principal vectors of facet orientation and fitting spheres to articular facets. The resulting metrics are analysed using phylogenetic regressions and principal components analyses. Our results suggest that articular surface curvatures reflect locomotor specialisations with, in particular, orang‐utans having more highly curved facets in all but the calcaneal facet. Similarly, our approach to quantifying articular facet orientation appears to be effective in discriminating between extant hominoid species, and may therefore provide a sound basis for the study of fossil taxa and evolution of bipedalism inAustralopithecusandHomo.
Evolution of the auditory ossicles in extant hominids: metric variation in African apes and humans
Authors: Quam Rolf M. , Coleman Mark N. , Martínez Ignacio
Published: May 2014

The auditory ossicles in primates have proven to be a reliable source of phylogenetic information. Nevertheless, to date, very little data have been published on the metric dimensions of the ear ossicles in African apes and humans. The present study relies on the largest samples of African ape ear ossicles studied to date to address questions of taxonomic differences and the evolutionary transformation of the ossicles in gorillas, chimpanzees and humans. Both African ape taxa show a malleus that is characterized by a long and slender manubrium and relatively short corpus, whereas humans show the opposite constellation of a short and thick manubrium and relatively long corpus. These changes in the manubrium are plausibly linked with changes in the size of the tympanic membrane. The main difference between the incus in African apes and humans seems to be related to changes in the functional length. Compared with chimpanzees, human incudes are larger in nearly all dimensions, except articular facet height, and show a more open angle between the axes. The gorilla incus resembles humans more closely in its metric dimensions, including functional length, perhaps as a result of the dramatically larger body size compared with chimpanzees. The differences between the stapedes of humans and African apes are primarily size‐related, with humans being larger in nearly all dimensions. Nevertheless, some distinctions between the African apes were found in the obturator foramen and head height. Although correlations between metric variables in different ossicles were generally lower than those between variables in the same bone, variables of the malleus/incus complex appear to be more strongly correlated than those of the incus/stapes complex, perhaps reflecting the different embryological and evolutionary origins of the ossicles. The middle ear lever ratio for the African apes is similar to other haplorhines, but humans show the lowest lever ratio within primates. Very low levels of sexual dimorphism were found in the ossicles within each taxon, but some relationship with body size and several dimensions of the ear bones was found. Several of the metric distinctions in the incus and stapes imply a slightly different articulation of the ossicular chain within the tympanic cavity in African apes compared with humans. The limited auditory implications of these metric differences in the ossicles are also discussed. Finally, the results of this study suggest that several plesiomorphic features for apes may be retained in the ear bones of the early hominin taxa Australopithecus and Paranthropus as well as in the Neandertals.
Acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia
Authors: Yamashita M. , Yokoyama K. , Takei Y. , Furuya N. , Nakamichi Y. , Ihara Y. , Takahashi K. , Groher M. E.
Published: May 2014

This research was designed to investigate the acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia. Forty‐nine patients with complaints of swallow difficulty received a videofluorographic (VF) examination. They were divided into three groups: nine who did not have any apparent disease (Group N), 22 patients with head and neck cancer (Group H&N) and 18 patients with other diseases including cerebrovascular disease (Group OD). After liquid barium swallows, they exhaled voluntarily without voicing. Videofluorographic findings were classified into four groups: normal (Normal), acceptable swallow (Acceptable), swallow with residue (Resid) and swallows with penetration or aspiration (Pen/Asp). The duration of expiratory sounds was measured on the time waveform. Frequency characteristics of expiratory sounds were obtained using one‐third octave band analysis ranging from 62·5 to 2000·0 Hz of central frequency. The averaged level of the 1000·0‐Hz band was chosen as the reference band level (RB level). The revised averaged level of each band was obtained by subtracting the RB level from the averaged level of each band. Zero decibel of the revised magnitude of the 125·0‐Hz band was set as the critical value to differentiate dysphagia (Resid or Pen/Asp) from no dysphagia (Normal or Acceptable). Comparison of this assessment with VF findings showed a significant percentage agreement (85·4%). These results suggest that frequency characteristics of post‐swallow expiratory sounds can differentiate dysphagia from no dysphagia among multiple dysphagic patient groups.
Bisexuality and Suicide: A Systematic Review of the Current Literature
Authors: Pompili Maurizio , Lester David , Forte Alberto , Seretti Maria Elena , Erbuto Denise , Lamis Dorian A. , Amore Mario , Girardi Paolo
Published: May 2014

Introduction

Many studies of lesbian, gay, and bisexual youth have demonstrated that individuals reporting a bisexual orientation have a particularly high risk of suicidal behavior and substance abuse. It has been also suggested that bisexual individuals (both men and women) have higher rates of depression and anxiety compared with homosexual and heterosexual groups.

Aim

The aim of the present article was to determine whether or not an association between bisexuality and suicidal behavior exists and to analyze risk factors for suicidal behavior in bisexual individuals.

Main Outcome Measures

The combined search strategies yielded a total of 339 records screened from PubMed, Scopus, and Web of Knowledge. Duplicate articles, articles that were not in English, and those that did not analyze bisexuality separately from homosexuality were excluded. A quality assessment was performed for each study included.

Methods

A careful systematic review of the literature was conducted investigating the potential bisexuality-suicidal behavior link. A total of 77 articles from peer-reviewed journals were considered, and the most relevant (N = 19) were selected for this review.

Results

Individuals reporting a bisexual orientation had an increased risk of suicide attempts and ideation compared with their homosexual and heterosexual peers. Risk factors included related victimization, peer judgments, and family rejection. Bisexual individuals also reported higher rates of mental illness and substance abuse.

Conclusions

Bisexual individuals may experience more psychological distress and mental health problems than individuals who identify with a homosexual or heterosexual orientation. Clinicians should consider the potential for suicidal behaviors in bisexual individuals and be alert for increased mental health problems and poor social integration.