bluuebunny/crossref_metadata_2025 huggingface dataset:
Iron deficiency anemia and anemia of chronic disease in geriatric hospitalized patients: How frequent are comorbidities as an additional explanation for the anemia?
Authors: Joosten Etienne , Lioen Pieter
Published: September 2014

Aim

Anemia is an important clinical problem in older patients. The aim of the present study was to investigate whether comorbidities as an additional explanation for the severity of the anemia are frequent, and might help to explain the anemia severity in older patients with iron deficiency anemia (IDA) and the anemia of chronic disease (ACD).

Methods

In the present prospective study, 191 consecutive hospitalized older patients with IDA and the ACD were investigated. A peripheral blood count, C‐reactive protein, standard iron parameters, serum vitamin B12 and folate, and renal and thyroidal function tests were analyzed. The attending geriatrician was responsible for the medical diagnosis and follow up.

Results

A total of 56 patients with IDA and 135 with the ACD were investigated. Just 24 patients with IDA had normal serum folate, vitamin B12 and thyroid‐stimulating hormone levels without laboratory evidence of inflammation or chronic renal failure, but one of these patients was diagnosed with hemolytic anemia. Hence, 23 patients (41%) were diagnosed with “IDA only”. “ACD only” was diagnosed in 104 patients (77%), and 22 patients (16%) with ACD had chronic renal failure. A myelodysplastic syndrome was found in two patients.

Conclusions

Additional etiologies are often diagnosed in anemic older patients, but it remains unknown to what extent these diseases might influence the pathogenesis of the anemia. Individual and clinical judgment remain crucial to evaluating and treating older anemic patients. Geriatr Gerontol Int 2015; 15: 931–935.
Exposing hidden endemism in a Neotropical forest raptor using citizen science
Authors: Lees Alexander C. , Martin Robert W.
Published: September 2014

Gaps in our knowledge of the geographical distribution of species represent a fundamental challenge to biogeographers and conservation biologists alike, and are particularly pervasive in the tropics. Here we highlight the case of the Rufous‐thighed KiteHarpagus diodon, a South American raptor commonly mapped as resident across half the continent. Recent observations at migration watch points have indicated it may be partially migratory in the southernmost parts of its range. To investigate this possibility, we collated contemporary and historical specimen records, published sight records and ‘digital vouchers’ – photographs and sound‐recordings archived online (from citizen science initiatives) – and explored the spatiotemporal distribution of records. We were unable to trace any documented records of this species from Amazonia during the austral summer (October–March), or records from the Atlantic Forest biome during the peak of the Austral winter (June–August), and all proven breeding records stem from the Atlantic Forest region. We compared this pattern with that of a ‘control’ species, the congeneric Double‐toothed KiteH. bidentatus, again using specimens and digital vouchers. For this species we found no evidence of seasonality between biomes and can disregard spatiotemporal variation in observer effort as a cause of seasonal biases. We consider that all populations of Rufous‐thighed Kites are fully migratory, wintering in Equatorial forests in the Amazonian basin. We provide evidence that this pattern was previously obscured by erroneous undocumented records and poor or erroneous specimen metadata, and its discovery was primarily facilitated by digital vouchers. This discovery requires a reassessment of the species’ global conservation status as an Atlantic Forest breeding endemic, threatened by habitat loss and degradation, as it was previously considered to be resident across large swathes of undisturbed Amazonian Forest on the Guiana Shield. The bulk of the digital voucher data used to elucidate this pattern were extracted from a Brazilian citizen science initiativeWikiAves,which may serve as a model for collating biodiversity data in megadiverse countries and help catalyse environmental awareness.
MicroRNAs affect dendritic cell function and phenotype
Authors: Smyth Lesley A. , Boardman Dominic A. , Tung Sim L. , Lechler Robert , Lombardi Giovanna
Published: September 2014

MicroRNA (miRNA) are small, non‐coding RNA molecules that have been linked with immunity through regulating/modulating gene expression. A role for these molecules in T‐cell and B‐cell development and function has been well established. An increasing body of literature now highlights the importance of specific miRNA in dendritic cell (DC) development as well as their maturation process, antigen presentation capacity and cytokine release. Given the unique role of DC within the immune system, linking the innate and adaptive immune responses, understanding how specific miRNA affect DC function is of importance for understanding disease. In this review we summarize recent developments in miRNA and DC research, highlighting the requirement of miRNA in DC lineage commitment from bone marrow progenitors and for the development of subsets such as plasmacytoid DC and conventional DC. In addition, we discuss how infections and tumours modulate miRNA expression and consequently DC function.
High‐Precision Iron Isotope Analysis of Geological Reference Materials by High‐Resolution MC‐ICP‐MS
Authors: He Yongsheng , Ke Shan , Teng Fang‐Zhen , Wang Tiantian , Wu Hongjie , Lu Yinhuai , Li Shuguang
Published: September 2014

We report high‐precision iron isotopic data for twenty‐two commercially available geological reference materials, including silicates, carbonatite, shale, carbonate and clay. Accuracy was checked by analyses of synthetic solutions with known Fe isotopic compositions but different matrices ranging from felsic to ultramafic igneous rocks, high Ca and low Fe limestone, to samples enriched in transition group elements (e.g., Cu, Co and Ni). Analyses over a 2‐year period of these synthetic samples and pure Fe solutions that were processed through the whole chemistry procedure yielded an average δ56Fe value of −0.001 ± 0.025‰ (2s, n = 74), identical to the expected true value of 0. This demonstrates a long‐term reproducibility and accuracy of < 0.03‰ for determination of 56Fe/54Fe ratios. Reproducibility and accuracy were further confirmed by replicate measurements of the twenty‐two RMs, which yielded results that perfectly match the mean values of published data within quoted uncertainties. New recommended values and associated uncertainties are presented for interlaboratory calibration in the future.
An Investigation of the Nanomechanical Properties of 0.5Ba(Ti0.8Zr0.2)O3–0.5(Ba0.7Ca0.3)TiO3 Thin Films
Authors: Cai Zhong‐Lan , Wang Zeng‐Mei , Wang Huan‐Huan , Cheng Zhen‐Xiang , Li Bao‐Wen , Guo Xin‐Li , Kimura Hideo , Kasahara Akira
Published: September 2014

For practical application, the functional piezoelectric film in microelectromechanical systems should meet the requirement of physical properties, as well as the mechanical properties. In this article, 0.5Ba(Ti0.8Zr0.2)O3–0.5(Ba0.7Ca0.3)TiO3 (0.5BZT–0.5BCT) thin films with varied properties were prepared on (100) Si substrates via a sol–gel technique at different annealing temperatures. The effects of the annealing temperature on the morphology, piezoelectricity, hardness, and elastic modulus were studied. Particular attention was paid to the surface frictional behavior of films, and the changes in the friction force can be radically explained in terms of differences in the hardness/elastic modulus ratio and the residual stress of films. And, it reveals that the higher ratio of hardness to elastic modulus and tensile residual stress can contribute to a lower friction force for 0.5BZT–0.5BCT film during sling friction.
Visible Quantum Cutting and Energy Transfer in Tb3+‐Doped KSr(Gd,Y)(PO4)2 Under VUV–UV Excitation
Authors: Zhao Lei , Wang Deyin , Wang Yuhua , Tao Ye
Published: September 2014

KSr(Gd,Y)(PO4)2: Tb3+ phosphors were synthesized using the high‐temperature solid‐state reaction method. The VUV–UV spectroscopic properties of these phosphors were studied. The results show that efficient energy transfer (ET) from Gd3+ to Tb3+ occurs in this system, and the ET efficiency increases with increasing of Tb3+ doping concentrations, which is evidenced that both the emission intensity and decay time of Gd3+ decreases with increasing Tb3+ doping concentrations. Visible quantum cutting via cross relaxation between the neighboring Tb3+ ions was observed in the high Tb3+ concentration doped sample. In addition, the emission color of KSr(Gd,Y)(PO4)2: Tb3+ phosphors can be tuned from blue to yellowish‐green by varying the doping concentration of Tb3+. Under 147 nm excitation, the sample KSrGd0.5(PO4)2: 0.5Tb3+ exhibits the strongest emission, which is about 70% of the commercial green‐emitting phosphor Zn2SiO4: Mn2+ indicating the potential application of this phosphor for plasma display panels, Hg‐free lamps, and three‐dimensional displays.
Varistor and Magnetic Properties of Nickel Copper Zinc Niobium Ferrite Doped with Bi2O3
Authors: Mei Li‐Then , Hsiang Hsing‐I , Hsu Wei‐Hung
Published: September 2014

Bi2O3 was added into nickel copper zinc niobium ferrite and treated with different thermal processes to change the grain‐boundary chemical composition. The relationship between the grain‐boundary composition and varistor properties were investigated using scanning electron microscopy, transmission electron microscopy, energy dispersion spectroscopy, and X‐ray photoelectric spectroscopy. The experimental results show that Bi2O3 reacts and diffuses into the spinel ferrite grain, forming bismuth iron compounds, causing the spinel ferrite chemical composition near grain boundary becomes iron deficient. The Fe deficiency spinel ferrite near the grain boundary then changes into p‐type conduction. The annealing process after sintering improves the bismuth oxide diffusion and chemical reaction near the grain boundary, which can increase the grain‐boundary resistivity. The n‐type semiconductive grain interior and p‐type spinel ferrite near the grain‐boundary combination can form a double Schottky barrier, leading the specimen to exhibit varistor properties. A multifunctional varistor‐magnetic material with a nonlinear coefficient of 10 and initial permeability of about 225 at 10 MHz can be successfully fabricated by sinteringNi0.2881Cu0.1825Zn0.4802Nb0.0096Fe2.0168O4 ferrites added with 5 mol% Bi2O3 sintered at 950°C, then annealed at 650°C for 1 h.
The influence of biogeographical barriers on the population genetic structure and gene flow in a coastal Pacific seabird
Authors: Wallace Sarah J. , Wolf Shaye G. , Bradley Russell W. , Laurie Harvey A. , Friesen Vicki L.
Published: September 2014

Aim

Our aim was to investigate the influence of biogeographical barriers along the Pacific coast of North America on population genetic structure and gene flow using Cassin's auklet (Ptychoramphus aleuticus) as a test case.

Location

We collected samples from 287 Cassin's auklets breeding along the Pacific coast of North America from the Aleutian Islands, Alaska, USA, to Baja California, Mexico.

Methods

We amplified a 706 base pair fragment of the mitochondrial control region and 11 microsatellites to obtain independent estimates of population genetic structure and gene flow among colonies using programs based on coalescent and Bayesian theory. We tested whether genetic differentiation was related to geographical distance between sampling sites, and whether gene flow has occurred between differentiated groups.

Results

We found two distinct genetic groups along the Cassin's auklet breeding range. These clusters matched the current subspecies designations, except that individuals breeding in the Channel Islands, California, were traditionally classified with the northern subspecies but were more genetically similar to the Baja California subspecies. Population genetic differentiation was not evident within either of the two genetic groups, despite large geographical distances between sampling locations. Evidence suggests that gene flow has occurred from the northern genetic group (Aleutian Islands to Southeast Farallon Islands) into the southern genetic group (Channel Islands to San Benito Island) since divergence, but gene flow may not have occurred in the opposite direction. These results suggest that a barrier to gene flow from south to north may occur at Point Conception.

Main conclusions

Although a relatively short geographical distance occurs between sampling sites of Cassin's auklets across Point Conception, individuals breeding north of Point Conception are genetically differentiated from individuals breeding in southern California and Baja California. Population genetic differentiation of the southern genetic group provides support for a role of a barrier to gene flow around Point Conception in generating biodiversity in this area.
The influence of geological events on the endemism of East Asian birds studied through comparative phylogeography
Authors: Qu Yanhua , Song Gang , Gao Bin , Quan Qing , Ericson Per G. P. , Lei Fumin
Published: September 2014

Aim

East Asia is known for its exceptionally high biological diversity and endemism. Various geological and climatic events during the Pliocene and Pleistocene have been invoked to explain this high endemism, and these processes have had different impacts on different organisms. Herein, we investigate the relative role of these historical processes in the genetic evidence for endemism of intraspecific lineages of two East Asian species: the grey‐cheeked fulvetta (Alcippe morrisonia) and the red‐headed tree babbler (Stachyridopsis ruficeps).

Location

East Asia.

Methods

We studied the genetic structure based on mitochondrial and nuclear DNA and evaluated the phylogeographical lineages using coalescent species tree approaches. The influences of different historical processes on diversification among phylogeographical lineages were analysed using coalescent models. We tested correlations between ecological divergence and phylogeographical splits.

Results

The genetic structure analysis and species tree estimation revealed three deeply divergent lineages within both species. One lineage is endemic to the mountains of Southwest China and the other to Taiwan. Coalescent simulations suggested that lineage diversification mostly occurred during the late Pliocene. Within this time frame, uplift of the mountains of Southwest China and formation of the island of Taiwan are geological events consistent with the geographical isolation and ecological niche divergence of these phylogeographical lineages.

Main conclusions

Our results suggest that the main driver of avian endemism in East Asia was the formation of new montane and island habitats following the uplift of the mountains of Southwest China and formation of the island of Taiwan in the Pliocene. However, the populations in the two regions were affected differently by the climatic oscillations during the Pleistocene. The mountains of Southwest China were climatically stable during glaciations, allowing populations to persist throughout the Pleistocene and maintain their genetic uniqueness. In contrast, glaciations resulted in lowered sea levels, allowing dispersal between the island of Taiwan and mainland China, thus obscuring the genetic endemism of the Taiwanese populations.
Overseas dispersal of Hyperolius reed frogs from Central Africa to the oceanic islands of São Tomé and Príncipe
Authors: Bell Rayna C. , Drewes Robert C. , Channing Alan , Gvoždík Václav , Kielgast Jos , Lötters Stefan , Stuart Bryan L. , Zamudio Kelly R.
Published: September 2014

Aim

To infer the colonization history of reed frog species endemic to the oceanic islands of São Tomé and Príncipe, Hyperolius molleri and H. thomensis, we quantified phylogeographical structure in the closely related H. cinnamomeoventris species complex, which is broadly distributed across continental Central Africa.

Location

The Lower Guineo‐Congolian Forest and the Gulf of Guinea islands of São Tomé and Príncipe, Central Africa.

Methods

We combined gene and species tree analyses to investigate diversity and divergence among H. cinnamomeoventris populations, to identify the most likely dispersal route to the islands, and to infer the order in which the islands were colonized. One of the endemics (H. molleri) is distributed on both islands and we quantified genetic divergence between populations.

Results

We recovered three clades in H. cinnamomeoventris corresponding to West‐Central, North/East‐Central and South‐Central Africa. The island endemics form a monophyletic group most closely related to the West‐Central African H. cinnamomeoventris clade. Populations of H. molleri on São Tomé and Príncipe are reciprocally monophyletic at mitochondrial loci but nuclear gene trees do not support this divergence.

Main conclusions

Genetic structure in the H. cinnamomeoventris species complex coincides with biogeographical barriers identified in previous studies of Central African rain forest taxa. Individual gene tree and species tree analyses support a single dispersal event from the Ogooué or Congo river basins (West‐Central Africa) to the island of São Tomé, with subsequent divergence within São Tomé and dispersal to Príncipe.
Efficacy and Tolerability of Triple‐Combination Therapy With Olmesartan, Amlodipine, and Hydrochlorothiazide: A Subgroup Analysis of Patients Stratified by Hypertension Severity, Age, Sex, and Obesity
Authors: Kreutz Reinhold , Ammentorp Bettina , Laeis Petra , de la Sierra Alejandro
Published: September 2014

This prespecified subgroup analysis of a phase III study examined the effect of adding hydrochlorothiazide (HCTZ) to olmesartan (OLM)/amlodipine (AML) in patients with moderate to severe hypertension stratified by age, sex, body mass index, and hypertension severity. A total of 2690 patients, aged 18 years and older, with seated blood pressure (SeBP) ≥160/100 mm Hg received placebo or OLM/AML 20/5 mg, 40/5 mg, or 40/10 mg during a 2‐week, double‐blind, run‐in period, after which they were allocated to one of eight treatment groups with the same OLM/AML dose or with HCTZ 12.5 mg or 25 mg added for 8 weeks. By week 10, greater reductions in SeBP were observed in each OLM/AML/HCTZ group (P<.05, respectively) compared with the corresponding dual dose. Adding HCTZ increased blood pressure–lowering efficacy in all subgroups, with a higher proportion of blood pressure goal achievement vs dual therapy. OLM/AML/HCTZ reduced SeBP to a greater extent than OLM/AML in patients with moderate to severe hypertensive; this was unaffected by baseline hypertension severity, age, sex, and obesity.
A randomized trial on the aesthetic outcomes of implant‐supported restorations with zirconia or titanium abutments
Authors: Carrillo de Albornoz Ana , Vignoletti Fabio , Ferrantino Luca , Cárdenas Eduardo , De Sanctis Massimo , Sanz Mariano
Published: September 2014

Aim

To evaluate the aesthetic outcomes of zirconia versus titanium abutments for single tooth implant‐supported crowns in the anterior maxilla.

Material & Methods

A parallel, double blind clinical trial was conducted at the Complutense University (Madrid), where 38 patients were recruited. After random allocation (via computer‐generated permuted blocks), either zirconia (test) or titanium (control) abutments were placed. Intra‐ and inter‐group differences in aesthetic (main outcome), clinical, radiographical, and patient‐centred outcomes were evaluated at baseline (crown placement) and at 1‐year follow‐up.

Results

At 1 year, 25 of the 30 randomized patients were analysed (11 test and 14 control). Using the Implant Crown Aesthetic Index (ICAI), the scoring at baseline and 1‐year were 7.9 and 7.6 for the test group and 10.6 and 11.3 for the control group, respectively. These differences were not statistically significant (sample size non‐contrasted). Patient satisfaction was similarly high in both groups (visual analogue scale 8.5). Furthermore, no differences were observed in the clinical or radiographical outcomes. Two abutment fractures were registered in the test group.

Conclusions

The use of zirconia abutments demonstrated a tendency towards better aesthetic outcomes although the differences were not statistically significant. However, more technical complications were noted with the use of zirconia abutments.
Why wait? Three mechanisms selecting for environment‐dependent developmental delays
Authors: Scott M. F. , Otto S. P.
Published: September 2014

Many species delay development unless particular environments or rare disturbance events occur. How can such a strategy be favoured over continued development? Typically, it is assumed that continued development (e.g. germination) is not advantageous in environments that have low juvenile/seedling survival (mechanism 1), either due to abiotic or competitive effects. However, it has not previously been shown how low early survival must be in order to favour environment‐specific developmental delays for long‐lived species. Using seed dormancy as an example of developmental delays, we identify a threshold level of seedling survival in ‘bad’ environments below which selection can favour germination that is limited to ‘good’ environments. This can be used to evaluate whether observed differences in seedling survival are sufficient to favour conditional germination. We also present mathematical models that demonstrate two other, often overlooked, mechanisms that can favour conditional germination in the absence of differences in seedling survival. Specifically, physiological trade‐offs can make it difficult to have germination rates that are equally high in all environments (mechanism 2). We show that such trade‐offs can either favour conditional germination or intermediate (mixed) strategies, depending on the trade‐off shape. Finally, germination in every year increases the likelihood that some individuals are killed in population‐scale disturbances before reproducing; it can thus be favourable to only germinate immediately after a disturbance (mechanism 3). We demonstrate how demographic data can be used to evaluate these selection pressures. By presenting these three mechanisms and the conditions that favour conditional germination in each case, we provide three hypotheses that can be tested as explanations for the evolution of environment‐dependent developmental delays.
Selective pressures onMHCclassIIgenes in the guppy (Poecilia reticulata) as inferred by hierarchical analysis of population structure
Authors: Herdegen M. , Babik W. , Radwan J.
Published: September 2014

Genes of the major histocompatibility complex, which are the most polymorphic of all vertebrate genes, are a pre‐eminent system for the study of selective pressures that arise from host–pathogen interactions. Balancing selection capable of maintaining high polymorphism should lead to the homogenization ofMHCallele frequencies among populations, but there is some evidence to suggest that diversifying selection also operates on theMHC. However, the pattern of population structure observed atMHCloci is likely to depend on the spatial and/or temporal scale examined. Here, we investigated selection acting onMHCgenes at different geographic scales using Venezuelan guppy populations inhabiting four regions. We found a significant correlation betweenMHCand microsatellite allelic richness across populations, which suggests the role of genetic drift in shapingMHCdiversity. However, compared to microsatellites, moreMHCvariation was explained by differences between populations within larger geographic regions and less by the differences between the regions. Furthermore, among proximate populations, variation inMHCallele frequencies was significantly higher compared to microsatellites, indicating that selection acting onMHCmay increase population structure at small spatial scales. However, in populations that have significantly diverged at neutral markers, the population‐genetic signature of diversifying selection may be eradicated in the long term by that of balancing selection, which acts to preserve rare alleles and thus maintain a common pool ofMHCalleles.
Early diversification trend andAsian origin for extent bat lineages
Authors: Yu W. , Wu Y. , Yang G.
Published: September 2014

Bats are a unique mammalian group, which belong to one of the largest and most diverse mammalian radiations, but their early diversification is still poorly understood, and conflicting hypotheses have emerged regarding their biogeographic history. Understanding their diversification is crucial for untangling the enigmatic evolutionary history of bats. In this study, we elucidated the rate of diversification and the biogeographic history of extant bat lineages using genus‐level chronograms. The results suggest that a rapid adaptive radiation persisted from the emergence of crown bats until the Early Eocene Climatic Optimum, whereas there was a major deceleration in diversification around 35–49 Ma. There was a positive association between changes in the palaeotemperature and the net diversification rate until 35 Ma, which suggests that the palaeotemperature may have played an important role in the regulation of ecological opportunities. By contrast, there were unexpectedly higher diversification rates around 25–35 Ma during a period characterized by intense and long‐lasting global cooling, which implies that intrinsic innovations or adaptations may have released some lineages from the intense selective pressures associated with these severe conditions. Our reconstruction of the ancestral distribution suggests an Asian origin for bats, thereby indicating that the current panglobal but disjunct distribution pattern of extant bats may be related to events involving seriate cross‐continental dispersal and local extinction, as well as the influence of geological events and the expansion and contraction of megathermal rainforests during theTertiary.
Ecological and evolutionary drivers of range size inCoenagriondamselflies
Authors: Swaegers J. , Janssens S. B. , Ferreira S. , Watts P. C. , Mergeay J. , McPeek M. A. , Stoks R.
Published: September 2014

Geographic range size is a key ecological and evolutionary characteristic of a species, yet the causal basis of variation in range size among species remains largely unresolved. One major reason for this is that several ecological and evolutionary traits may jointly shape species' differences in range size. We here present an integrated study of the contribution of ecological (dispersal capacity, body size and latitudinal position) and macroevolutionary (species' age) traits in shaping variation in species' range size inCoenagriondamselflies. We reconstructed the phylogenetic tree of this genus to account for evolutionary history when assessing the contribution of the ecological traits and to evaluate the role of the macroevolutionary trait (species' age). The genus invaded the Nearctic twice independently from the Palearctic, yet this was not associated with the evolution of larger range sizes or dispersal capacity. Body size and species' age did not explain variation in range size. There is higher flight ability (as measured by wing aspect ratio) at higher latitudes. Species with a larger wing aspect ratio had a larger range size, also after correcting for phylogeny, suggesting a role for dispersal capacity in shaping the species' ranges. More northern species had a larger species' range, consistent with Rapoport's rule, possibly related to niche width. Our results underscore the importance of integrating macroecology and macroevolution when explaining range size variation among species.
Socioeconomic and Lifestyle Factors Related to Instrumental Activity of Daily Living Dynamics: Results from the English Longitudinal Study of Ageing
Authors: d'Orsi Eleonora , Xavier Andre Junqueira , Steptoe Andrew , de Oliveira Cesar , Ramos Luiz Roberto , Orrell Martin , Demakakos Panayotes , Marmot Michael Gideon
Published: September 2014

Objectives

To investigate socioeconomic, demographic, and lifestyle factors that predict incident instrumental activity of daily living (IADL) impairment and recovery.

Design

Data from English Longitudinal Study of Ageing (ELSA), a biennial prospective observational study.

Setting

Individuals aged 50 and older living in England.

Participants

A sample of 8,154 individuals without any difficulty in activities of daily living (ADLs) or IADLs was selected from the initial 11,391 participants.

Measurements

The first outcome was impairment in at least one IADL, and the second was IADL recovery. Main predictor: baseline socioeconomic position measured according to wealth. Outcomes and predictors were measured at each of the five follow‐up interviews. Unadjusted and adjusted incidence rate ratios (IRR) and 95% confidence intervals were calculated through 2‐year lagged Poisson regression in generalized estimating equation models, adjusted for sociodemographic, lifestyle, quality‐of‐life, and health variables.

Results

Between any two consecutive waves, 1,656 (20.3%) participants developed some IADL impairment. Those with higher socioeconomic position, better quality of life, vigorous physical activity, paid work, digital literacy (use of Internet or e‐mail), and cultural leisure activities had significantly lower risk of IADL impairment. There was a significant association between smoking, cardiovascular disease, arthritis, poor memory, diabetes mellitus, and depressive symptoms and IADL impairment. Better quality of life, good self‐rated memory and vigorous physical activity were independent predictors of IADL recovery.

Conclusion

Better quality of life, vigorous physical activity, not smoking, paid work, cultural leisure activities, and digital literacy are modifiable factors that can decrease the incidence of IADL impairment. Good quality of life and vigorous physical activity have a significant role in recovery. Low socioeconomic position was a predictor of incident impairment of IADLs but not recovery.
Effect of the Overlap Syndrome of Depressive Symptoms and Delirium on Outcomes in Elderly Adults with Hip Fracture: A Prospective Cohort Study
Authors: Radinovic Kristina S. , Markovic‐Denic Ljiljana , Dubljanin‐Raspopovic Emilija , Marinkovic Jelena , Jovanovic Lepa B. , Bumbasirevic Vesna
Published: September 2014

Objectives

To analyze the incidence of the overlap syndrome of depressive symptoms and delirium, risk factors, and independent and dose‐response effect of the overlap syndrome on outcomes in elderly adults with hip fracture.

Design

Prospective cohort study.

Setting

University hospital.

Participants

Individuals with hip fracture without delirium (N = 277; aged 78.0 ± 8.2) consequently enrolled in a prospective cohort study.

Measurements

Depressive symptoms were assessed using the Geriatric Depression Scale and cognitive status using the Short Portable Mental Status Questionnaire upon hospital admission. Incident delirium was assessed daily during the hospital stay using the Confusion Assessment Method. Information on complications acquired in the hospital, severity of complications, re‐interventions, length of hospital stay, and 1‐month mortality was recorded.

Results

Thirty (10.8%) participants had depressive symptoms alone, 88 (31.8%) delirium alone, 60 (21.7%) overlap syndrome, and 99 (35.7%) neither condition. According to multivariate regression analysis, participants with the overlap syndrome had significantly higher incidence of vision impairment (P = .02), longer time‐to‐surgery (P = .03), and lower cognitive function (P < .001) than participants with no depressive symptoms and no delirium. In the adjusted regression analysis, participants with neither condition were at lower risk of complications than those with the overlap syndrome (P = .03). After adjustment, participants with the overlap syndrome were at higher risk of longer hospital stay independently (P = .003) and in a dose‐response manner in the following order: no depression and no delirium, depressive symptoms alone, delirium alone, and the overlap syndrome (P = .002).

Conclusion

Depressive symptoms and delirium increase the likelihood of adverse outcomes after hip fracture in a step‐wise manner when they coexist. To reduce the risk of adverse outcome in individuals with hip fracture, efforts to identify, prevent, and treat this condition need to be increased.
Subclinical Vascular Disease Burden and Longer Survival
Authors: Odden Michelle C. , Yee Laura M. , Arnold Alice M. , Sanders Jason L. , Hirsch Calvin , deFilippi Christopher , Kizer Jorge R. , Inzitari Marco , Newman Anne B.
Published: September 2014

Objectives

To determine the contribution of gradations of subclinical vascular disease (SVD) to the likelihood of longer survival and to determine what allows some individuals with SVD to live longer.

Design

Cohort study.

Setting

Cardiovascular Health Study.

Participants

Individuals born between June 30, 1918, and June 30, 1921 (N = 2,082; aged 70–75 at baseline (1992–93)).

Measurements

A SVD index was scored as 0 for no abnormalities, 1 for mild abnormalities, and 2 for severe abnormalities on ankle–arm index, electrocardiogram, and common carotid intima‐media thickness measured at baseline. Survival groups were categorized as 80 and younger, 81 to 84, 85 to 89, and 90 and older.

Results

A 1‐point lower SVD score was associated with 1.22 greater odds (95% confidence interval = 1.14–1.31) of longer survival, independent of potential confounders. This association was unchanged after adjustment for intermediate incident cardiovascular events. There was suggestion of an interaction between kidney function, smoking, and C‐reactive protein and SVD; the association between SVD and longer survival appeared to be modestly greater in persons with poor kidney function, inflammation, or a history of smoking.

Conclusion

A lower burden of SVD is associated with longer survival, independent of intermediate cardiovascular events. Abstinence from smoking, better kidney function, and lower inflammation may attenuate the effects of higher SVD and promote longer survival.
Follow‐up study of the general and mental health of people living in temporary housing at 10 and 20 months after the Great East Japan Earthquake
Authors: Nagata Satoko , Matsunaga Atsushi , Teramoto Chie
Published: September 2014

Aim

An earthquake of magnitude 9.0 and accompanying tsunami struck the Tohoku region in northeast Japan on 11 March 2011. The purpose of this study was to observe evacuees' health status such as general health, psychological distress, and feeling of isolation over time.

Methods

The authors distributed a questionnaire survey to residents of temporary housing in January to March (time 1) and again in October to December of 2012 (time 2).

Results

Two hundred respondents who filled out the questionnaire at both times were the subjects of this study. The self‐reported general health in 39% and mental health status in 43.5% of the participants were poor at time 2. In addition, a higher percentage of participants felt a sense of isolation at time 2 even though more of the participants participated in community activities at that time.

Conclusion

This result shows the evacuees' prolonged psychological distress and strengthening sense of isolation. It will be necessary to monitor them carefully and provide support continuously over the long term.
Nursing students' knowledge of and performance in communicating with patients with hearing impairment
Authors: Adib‐Hajbaghery Mohsen , Rezaei‐Shahsavarloo Zahra
Published: September 2014

Aim

The present study aimed to investigate nursing students' knowledge of and performance in communicating with patients with hearing impairment.

Methods

A cross‐sectional study was conducted on all senior nursing students (n = 71) in a nursing school in Iran in 2013. Data collection was performed with a demographics questionnaire, knowledge questionnaire, and performance assessment checklist. Two stages were designed to evaluate the students. In the first stage, students conducted an interview with a simulated patient with hearing impairment who experienced chest pain. In the second stage, students answered the knowledge questionnaire. Descriptive statistics, independent sample Student's t‐test, and Pearson correlation coefficient were used to analyze the data.

Results

In total, 11.3% of participants had a history of caring for a patient with hearing impairment. The majority of students evaluated their performance in communicating with such patients at a moderate level. A significant difference was observed between the mean score of knowledge in men and women (P = 0.05), and male students gained higher scores. In total, 61.5% of the students had low to very low levels of knowledge and 87.3% of them had weak to very weak performance in communicating with patients with hearing impairment.

Conclusion

Nursing students are lacking in knowledge and skills required for effective communication with patients with hearing impairment. Nurse educators should pay more attention to this issue as it is their responsibility to prepare nurses who are competent to deal with common issues they will face in practice.
Undergraduate nursing students' perceptions about disaster preparedness and response in Istanbul, Turkey, and Miyazaki, Japan: A cross‐sectional study
Authors: Öztekin Seher Deniz , Larson Eric Edwin , Yüksel Serpil , Altun Uğraş Gülay
Published: September 2014

Aim

Although the awareness of disasters has increased among nurses, the concept of disaster preparedness and response has not been sufficiently explored with undergraduate nursing students. The aim of this study was to assess and compare the perceptions of students regarding disaster preparedness and response that live in different earthquake‐prone cities; Istanbul, Turkey and Miyazaki, Japan.

Methods

A cross‐sectional study employing seven questions was conducted in a final group of 1053 nursing students from Istanbul, Turkey, and Miyazaki, Japan.

Results

Most study respondents were female, aged 18–22 years, with a high proportion of second year students in both cities. Istanbul's students had more knowledge about disaster preparedness and response in relation to age and year of university, showing statistically significant differences. Istanbul's highest rated responses to disaster characteristics were on structural elements and injuries/deaths, while Miyazaki's was “unpredictable/sudden/disorganized”. Respondents in Istanbul identified earthquakes as the disaster most likely to occur, while respondents in Miyazaki identified typhoon/hurricane. Study participants responded that they could provide caregiver roles during a disaster event rather than triage or managerial roles as disaster responders.

Conclusion

Disaster characteristics were not described by one third of the students. Of the two‐thirds that were described, most were of events that were highly predictable because of their frequencies in the given areas. Universities need to target and then focus on high‐risk factors in their areas and have disaster plans for students who can provide triage and managerial nursing roles as disaster responders.
Where Do We Go from Here? An inside Look into the Development of Georgia's Youth Concussion Law
Authors: Cook Amanda , King Harold , Polikandriotis John A.
Published: September 2014

Concussion is a form of mild traumatic brain injury (mTBI) that can occur as a result of contact to the head or other parts of the body that causes a rapid acceleration-deceleration force to the brain that may cause a functional disturbance in an individual’s ability to concentrate or learn new information. Contrary to popular belief, it is not a bruise to the brain, and there is usually nothing detectable on standard imaging such as a computed tomography or magnetic resonance imaging. Symptoms and signs are therefore important to detect and include decreased levels of consciousness, headache, nausea, difficulty concentrating, memory loss, and poor coordination. These signs and symptoms usually occur within minutes after the injury but may also appear several hours or even days later.
The Pan American Health Organization and the Mainstreaming of Human Rights in Regional Health Governance
Authors: Meier Benjamin Mason , Ayala Ana S.
Published: September 2014

In the development of a rights-based approach to global health governance, international organizations have looked to human rights under international law as a basis for public health. Operationalizing human rights law through global health policy, the World Health Organization (WHO) has faced obstacles in efforts to mainstream human rights across the WHO Secretariat. Without centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have sought to advance human rights in health governance and support states in realizing a rights-based approach to health. Examining the efforts of the Pan American Health Organization (PAHO), this article explores the evolution of human rights in PAHO policy, assesses the mainstreaming of human rights in the Pan American Sanitary Bureau (Bureau or PASB), and analyzes the future of the rights-based approach through regional health governance.
Role of first trimester total testosterone in prediction of subsequent gestational diabetes mellitus
Authors: Gözükara Yavuz M. , Aytan Hakan , Ertunc Devrim , Tok Ekrem C. , Demirtürk Fazli , Şahin Şemsettin , Aytan Pelin
Published: September 2014

Aim

To assess the role of first trimester maternal testosterone and dehydroepiandrosterone sulfate (DHEA‐S) levels in prediction of development of gestational diabetes mellitus (GDM).

Methods

Four hundred and fifty pregnant women were included in this prospective cohort study. All pregnant women with a singleton pregnancy who were not diabetic, had no family history of diabetes, had no history of previous GDM, were of white race and non‐smokers were enrolled. Total testosterone and DHEA‐S were measured at 11–14 weeks of gestation. The patients were called for routine pregnancy visits and followed accordingly. Forty‐two patients did not come to their visits and were excluded. During gestational weeks 24–28, the remaining 408 patients were screened for GDM. The total testosterone and DHEA‐S levels were compared between patients with and without GDM. Regression and receiver–operator curve analysis were performed.

Results

GDM developed in 22 women (5.7%). Compared with women without GDM, first trimester total testosterone levels were higher among women in whom GDM subsequently developed. The DHEA‐S level did not differ. Age, total testosterone and body mass index were found to be independent predictors of GDM development. A total testosterone value of 0.45 ng/mL was found to predict development of GDM with a sensitivity of 63.6% and a specificity of 62.7%.

Conclusion

First trimester total testosterone has a low testing power for GDM screening with low sensitivity and specificity values and cannot be used as a marker alone. It may have a role in combination with other markers.
Manganese Encephalopathy among Ephedron Abusers‐Case Reports
Authors: Janocha‐Litwin Justyna , Marianska Katarzyna , Serafinska Sylwia , Simon Krzysztof
Published: September 2014

Ephedrone encephalopathy is referred to as a group of symptoms of manganese deposition within the central nervous system (CNS), resulting from the abuse of ephedrone (methcathinone), obtained in reaction using the excess amount of manganese‐containing oxidants. The diagnosis is based on the contrast‐enhanced head MRI findings characteristic for this syndrome, clinical manifestation and history of ephedrone use. The syndrome has been reported in recent years in young people from Eastern Europe and Russia with a history of ephedrone overuse. However, no report has ever been published on ephedrone encephalopathy in Polish patients.
The pigment composition of Phaeocystis antarctica (Haptophyceae) under various conditions of light, temperature, salinity, and iron
Authors: van Leeuwe Maria A. , Visser Ronald J.W. , Stefels Jacqueline
Published: September 2014

The pigment composition of Phaeocystis antarctica was monitored under various conditions of light, temperature, salinity, and iron. 19′‐Hexanoyloxyfucoxanthin (Hex‐fuco) always constituted the major light‐harvesting pigment, with remarkably stable ratios of Hex‐fuco‐to‐chl a under the various environmental conditions. Increased pigment‐to‐chl a ratios at low irradiance confirmed the light‐harvesting function of Fucoxanthin (Fuco), 19′‐Hexanoyloxy‐4‐ketofucoxanthin (Hex‐kfuco), 19′‐butanoyloxyfucoxanthin (But‐fuco), and chl c2 and c3. Increased pigment‐to‐chl a ratios at high irradiance, low iron concentrations, and to a lesser extent at high salinity confirmed the photoprotective function of diadinoxanthin, diatoxanthin, and ß,ß‐carotene. Pigment ratios were not always according to expectations. The consistent increase in But‐fuco/chl at high temperature, high salinity, and low iron suggests a role in photoprotection rather than in light harvesting. Low Hex‐kfuco/chl ratios at high salinity were consistent with a role as light harvester, but the high ratios at high temperature were not, leaving the function of Hex‐kfuco enigmatic. Dedicated experiments were performed to test whether or not the light‐harvesting pigment Fuco could be converted into its structural relative Hex‐fuco, and vice versa, in response to exposure to light shifts. Rapid conversions could not be confirmed, but long‐term conversions cannot be excluded. New pigment ratios are proposed for chemotaxonomic applications. The ratios will improve pigment‐based diagnosis of algal species in waters dominated by P. antarctica.
Interleukin‐8 induces DNA synthesis, migration and down‐regulation of cleaved caspase‐3 in cultured human gingival epithelial cells
Authors: Fujita T. , Yoshimoto T. , Matsuda S. , Kajiya M. , Kittaka M. , Imai H. , Iwata T. , Uchida Y. , Shiba H. , Kurihara H.
Published: September 2014

Background and Objective

Migration of the junctional epithelium occurs in association with the formation of a periodontal pocket. Although the migration of junctional epithelium is known to be related to the proliferation and migration of gingival junctional epithelial cells, the mechanism has not been clarified. In patients with periodontitis, the levels of interleukin‐8 (IL‐8) in both gingival tissue and gingival crevicular fluid are dramatically increased. IL‐8 has broad bioactive functions. In this study, we examined the role of IL‐8 in DNA synthesis, migration and protection against apoptosis in cultured human gingival epithelial cells (HGEC).

Material and Methods

DNA synthesis was estimated by measuring the incorporation of bromodeoxyuridine. The migration of gingival epithelial cells was assessed in a wound‐healing assay. The expression of integrin beta‐1 was analyzed using immunofluorescence confocal microscopy and western blotting. Cleaved caspase‐3 was detected using western blotting and a Caspase‐Glo assay kit.

Results

IL‐8 increased the synthesis of DNA in HGEC, and the maximal effect was seen at 25 or 50 ng/mL of IL‐8. In addition, 50 ng/mL of IL‐8 induced cell migration, and a neutralizing antibody of integrin beta‐1 inhibited the migration. IL‐8 also activated expression of integrin beta‐1. Furthermore, IL‐8 reduced the Aggregatibacter actinomycetemcomitans‐induced increase in caspase‐3 expression in HGEC.

Conclusion

IL‐8 may facilitate the migration of gingival junctional epithelium by enhancing DNA synthesis, migration and preventing apoptosis of gingival epithelial cells.