bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Skin‐to‐Skin Contact, Rooming‐in, and Breastfeeding: A Comparison of the 2004 and 2011 National Surveys in Taiwan
Authors: Chiou Shu‐Ti , Chen Li‐Chuan , Yeh Hsing , Wu Shu‐Ru , Chien Li‐Yin
Published: March 2014

Objectives

We examined progress in the practice of early skin‐to‐skin contact and rooming‐in, and their association with breastfeeding, using national samples of postpartum women in the years 2004 and 2011 in Taiwan.

Methods

This study was a secondary data analysis using 2004 and 2011 national surveys of 12,201 and 12,405 postpartum women, respectively.

Results

More women had early skin‐to‐skin contact in 2011 than in 2004 (54.9% vs 20.6%, p < 0.001). Although fewer women practiced rooming‐in in 2011 than in 2004 (33.8% vs 45.8%, p < 0.001), the percentage of women rooming‐in for 24 hours improved from 6.1 percent to 22.7 percent from 2004 to 2011, and for rooming‐in from 12 to less than 24 hours, the percentage improved from 4.3 percent to 10.9 percent (p < 0.001). The rate of breastfeeding increased by 50 percent during hospitalization (from 57.4% to 85.6%) and by 150 percent at 6 months postpartum (from 20.1% to 50.2%). After adjustment for background characteristics, women who had early skin‐to‐skin contact were more than twice as likely to breastfeed their infants during hospitalization, and about 1.2 times as likely to breastfeed at 6 months postpartum. The odds ratio for breastfeeding at 6 months generally increased as the duration of rooming‐in increased in 2004 (OR ranged from 1.37 to 2.47). In 2011, only rooming‐in for 12 to less than 24 hours (OR = 1.31) and 24 hours (OR = 1.98) daily significantly increased the odds ratio for breastfeeding at 6 months postpartum.

Conclusions

Significant improvements in early skin‐to‐skin contact, the duration of rooming‐in, and breastfeeding were observed in Taiwan. Early skin‐to‐skin contact and rooming‐in for more than 12 hours were associated with increased chances for exclusive breastfeeding and breastfeeding at 6 months postpartum.
Creating a Safe Haven—Women's Experiences of the Midwife's Professional Skills During Planned Home Birth in Four Nordic Countries
Authors: Sjöblom Ingela , Idvall Ewa , Lindgren Helena ,   Nordic Homebirth Research Group
Published: March 2014

Objective

The midwife assisting a birth has a considerable influence on the woman's experience of the birth. The aim of this study was to investigate the experience of the midwife's professional skills among women in Norway, Denmark, Iceland, and Sweden who chose a planned home birth.

Design and Setting

All known home birth midwives were asked to inform the mothers about the project and invite them to complete a questionnaire about different aspects of their home birth experience.

Method

The women were asked to assess 10 different aspects of the midwives' professional skills on a 4‐graded scale below the main question: What was your experience of the midwife who assisted the labor? Furthermore, the mothers' experiences with the attending midwives were identified in the free text birth stories. The chosen method was a mixed method design.

Findings

The home birth midwives' professional skills were generally high scored. No statistically significant differences were found with respect to the assessment of the midwife. The content analyses yielded one overarching theme: The competence and presence of the midwife creates a safe haven, and three categories, midwife's safe hand, midwife's caring approach, and midwife's peaceful presence.

Conclusion

Women choosing a home birth in the four Nordic countries experienced that their midwives were highly skilled and they found the presence of the midwives valuable in helping them to feel safe and confident during birth. Despite differences in organization and guidelines for home births, the women's experience of the midwife's professional skills did not differ between the four countries.
Sotatercept in patients with osteolytic lesions of multiple myeloma
Authors: Abdulkadyrov Kudrat M. , Salogub Galina N. , Khuazheva Nuriet K. , Sherman Matthew L. , Laadem Abderrahmane , Barger Rachel , Knight Robert , Srinivasan Shankar , Terpos Evangelos
Published: March 2014

This phase IIa study evaluated the safety and tolerability of sotatercept, and its effects on bone metabolism and haematopoiesis in newly diagnosed and relapsed multiple myeloma (MM) patients. Patients were randomized (4:1) to receive four 28‐d cycles of sotatercept (0·1, 0·3, or 0·5 mg/kg) or placebo. Patients also received six cycles of combination oral melphalan, prednisolone, and thalidomide (MPT). Thirty patients were enrolled; six received placebo and 24 received sotatercept. Overall, 25% of patients received all four sotatercept doses; 71% of sotatercept‐treated patients had ≥1 dose interruption mainly due to increases in haemoglobin levels. Grade ≥3 adverse events (AEs) were reported in 17% of patients receiving placebo and 58% receiving sotatercept. Grade 4 AEs in sotatercept‐treated patients were neutropenia, granulocytopenia, and atrial fibrillation (one patient each). In patients without bisphosphonate use, anabolic improvements in bone mineral density and in bone formation relative to placebo occurred, whereas bone resorption was minimally affected. Increases in haemoglobin levels, versus baseline, and the duration of the increases, were higher in the sotatercept‐treated patients, with a trend suggesting a dose‐related effect. Multiple doses of sotatercept plus MPT appear to be safe and generally well‐tolerated in MM patients.
First‐time viewers' comprehension of films: Bridging shot transitions
Authors: Ildirar Sermin , Schwan Stephan
Published: March 2014

Which perceptual and cognitive prerequisites must be met in order to be able to comprehend a film is still unresolved and a controversial issue. In order to gain some insights into this issue, our field experiment investigates how first‐time adult viewers extract and integrate meaningful information across film cuts. Three major types of commonalities between adjacent shots were differentiated, which may help first‐time viewers with bridging the shots: pictorial, causal, and conceptual. Twenty first‐time, 20 low‐experienced and 20 high‐experienced viewers from Turkey were shown a set of short film clips containing these three kinds of commonalities. Film clips conformed also to the principles of continuity editing. Analyses of viewers' spontaneous interpretations show that first‐time viewers indeed are able to notice basic pictorial (object identity), causal (chains of activity), as well as conceptual (links between gaze direction and object attention) commonalities between shots due to their close relationship with everyday perception and cognition. However, first‐time viewers' comprehension of the commonalities is to a large degree fragile, indicating the lack of a basic notion of what constitutes a film.
The homozygous p.V37I variant of GJB2 is associated with diverse hearing phenotypes
Authors: Chai Y. , Chen D. , Sun L. , Li L. , Chen Y. , Pang X. , Zhang L. , Wu H. , Yang T.
Published: March 2014

The homozygous p.V37I variant of GJB2 is frequent in East Asians and has been reported to have a pathogenic role in mild‐to‐moderate hearing impairment (HI). In this study, we investigated the prevalence and phenotypic spectrum of homozygous p.V37I in three Chinese Han cohorts with severe‐to‐profound HI (n = 857, Cohort S), mild‐to‐moderate HI (n = 88, Cohort M) and normal hearing (n = 1550, Cohort N). Sequencing of GJB2 showed that homozygous p.V37I was detected in 1.63% (14/857), 12.5% (11/88) and 0.32% (5/1550) of subjects in Cohorts S, M and N, respectively. It was strongly associated with both mild‐to‐moderate (p = 2.0 × 10−11) and severe‐to‐profound (p = 0.001) HI, but was estimated to have a rather low penetrance (17%). Among the hearing impaired subjects with homozygous p.V37I, the onset of HI was congenital in 65% (11/17) and delayed in 35% (6/17). By targeted next‐generation sequencing of 79 known deafness genes, we identified an additional homozygous pathogenic mutation of CDH23 in 1 of 14 p.V37I homozygous subjects from Cohort S. Our study suggested that homozygous p.V37I is associated with a broader spectrum of hearing phenotypes than previously revealed. Data presented in this study can be effectively applied to clinical evaluation and genetic counseling of people carrying this variant.
Inverse Procedural Modelling of Trees
Authors: Stava O. , Pirk S. , Kratt J. , Chen B. , Měch R. , Deussen O. , Benes B.
Published: March 2014

Procedural tree models have been popular in computer graphics for their ability to generate a variety of output trees from a set of input parameters and to simulate plant interaction with the environment for a realistic placement of trees in virtual scenes. However, defining such models and their parameters is a difficult task. We propose an inverse modelling approach for stochastic trees that takes polygonal tree models as input and estimates the parameters of a procedural model so that it produces trees similar to the input. Our framework is based on a novel parametric model for tree generation and uses Monte Carlo Markov Chains to find the optimal set of parameters. We demonstrate our approach on a variety of input models obtained from different sources, such as interactive modelling systems, reconstructed scans of real trees and developmental models.
THE TAYLOR PRINCIPLE IN THE LONG RUN: AN EMPIRICAL PERSPECTIVE
Authors: Chou Yu‐Hsi , Wu Jyh‐Lin
Published: March 2014

In this paper, we empirically assess the Taylor principle in the long run with a small‐scale, trivariate structural vector autoregression. Using U.S. data spanning the period from 1959Q1 to 2010Q2 and different measures of inflation and the output gap, we find that the Taylor principle is supported in the long run for the post‐1979 era, but the principle is unlikely to hold in the long run for the pre‐1979 era. (JEL E52, E58)
ARE TELEVISION AND VIDEO GAMES REALLY HARMFUL FOR KIDS?
Authors: Nakamuro Makiko , Inui Tomohiko , Senoh Wataru , Hiromatsu Takeshi
Published: March 2014

Are watching television (TV) and playing video games really harmful for children's development? By using a unique longitudinal dataset with detailed information on children's development and health, we examined the causal effect of hours of TV watched or of video games played on school‐aged children's problem behavior, orientation to school, and obesity. The results suggested that the answer to the question is yes, but the magnitude of the effect is sufficiently small to be considered as negligible. The results were robust to within‐twin‐fixed effects. (JEL I10, I20)
High impact of rejection therapy on the incidence of post‐transplant diabetes mellitus after kidney transplantation
Authors: Schweer Torben , Gwinner Wilfried , Scheffner Irina , Schwarz Anke , Haller Hermann , Blume Cornelia
Published: March 2014

Background

Although major risk factors for post‐transplant diabetes (PTDM) after kidney transplantation have been identified, a systematic study on the impact of rejection and rejection therapy is missing so far.

Methods

Five hundred and twenty‐six kidney transplant recipients transplanted in the years 2000–2007 were included. PTDM was defined according to WHO guidelines, and patients' data were compared with special attention to protocol and for cause biopsies and rejection therapies. Survival analyses were made for graft loss and patient death.

Results

16.7% of all patients developed PTDM. Among common risk factors as higher age, body mass index (BMI), and others, the factor “acute cellular rejections” was comparably most relevant with a hazard ratio of 3.7. Consequently, antirejective treatment with steroid pulses and conversion to tacrolimus was the factor with the highest relative risk for the onset of PTDM (RR 3.5). PTDM itself had no impact on graft or patients' survival, but the decreased graft survival in PTDM patients was dominantly influenced by the higher frequency of acute cellular rejections, and patients' survival was reduced due to higher age.

Conclusion

Based upon a higher rate of acute rejections (AR), the necessity of frequent antirejective treatments was more relevant for the induction of PTDM than age or BMI.
Pancreatic autoantibodies after pancreas–kidney transplantation – do they matter?
Authors: Martins La Salete , Henriques Antonio C. , Fonseca Isabel M. , Rodrigues Anabela S. , Oliverira José C. , Dores Jorge M. , Dias Leonidio S. , Cabrita Antonio M. , Silva José D. , Noronha Irene L.
Published: March 2014

Type 1 diabetes recurrence has been documented in simultaneous pancreas–kidney transplants (SPKT), but this diagnosis may be underestimated. Antibody monitoring is the most simple, noninvasive, screening test for pancreas autoimmune activity. However, the impact of the positive autoimmune markers on pancreas graft function remains controversial. In our cohort of 105 SPKT, we studied the cases with positive pancreatic autoantibodies. They were immunosuppressed with antithymocyte globulin, tacrolimus, mycophenolate, and steroids. The persistence or reappearance of these autoantibodies after SPKT and factors associated with their evolution and with graft outcome were analyzed. Pancreatic autoantibodies were prospectively monitored. Serum samples were collected before transplantation and at least once per year thereafter. At the end of the follow‐up (maximum 138 months), 43.8% of patients were positive (from pre‐transplant or after recurrence) for at least one autoantibody – the positive group. Antiglutamic acid decarboxylase was the most prevalent (31.4%), followed by anti‐insulin (8.6%) and anti‐islet cell autoantibodies (3.8%). Bivariate analysis showed that the positive group had higher fasting glucose, higher glycated hemoglobin (HbA1c), lower C‐peptide levels, and a higher number of HLA‐matches. Analyzing the sample divided into four groups according to pre‐/post‐transplant autoantibodies profile, the negative/positive group tended to present the higher HbA1c values. Multivariate analysis confirmed the significant association between pancreas autoimmunity and HbA1c and C‐peptide levels. Positivity for these autoantibodies pre‐transplantation did not influence pancreas survival. The unfavorable glycemic profile observed in the autoantibody‐positive SPKT is a matter of concern, which deserves further attention.
Factors associated with breastfeeding at discharge differ by maternal diabetes type
Authors: Kachoria R. , Oza‐Frank R.
Published: March 2014

Aims

To investigate the factors associated with breastfeeding initiation in mothers with gestational and prepregnancy diabetes mellitus vs those without diabetes.

Methods

Ohio Vital Statistics birth certificate data from 2006 to 2011 on all singleton births to women resident in Ohio aged 16–44 years were used to determine the factors associated with breastfeeding initiation by diabetes status. Logistic regression models stratified by diabetes status were used to analyse the association of breastfeeding with characteristics of the mother and infant.

Results

Among the 792 730 infants born in Ohio between 2006 and 2011 used in the analysis, 5.3% were born to mothers with gestational diabetes and 0.8% to mothers with prepregnancy diabetes. Although some associations of breastfeeding initiation with maternal and infant characteristics were similar across all diabetes statuses, they differed by maternal prepregnancy weight, age and race, prenatal care, county type and infant's gestational age. Unlike mothers without diabetes, overweight mothers with gestational diabetes were equally likely to breastfeed compared with those of normal weight (odds ratio 0.95; 95% CI 0.87, 1.03) and mothers in rural (odds ratio 1.0; 95% CI 0.9, 1.1) and metropolitan counties (OR 1.1; 95% CI 1.0, 1.1) were equally likely to breastfeed compared with those in suburban counties. Although significantly associated with breastfeeding initiation among mothers without diabetes, the mother's prepregnancy weight status and age, county type and prenatal care were not found to be significant factors among mothers with prepregnancy diabetes.

Conclusions

Further research is needed to understand how these factors influence the initiation of breastfeeding decisions made by mothers.
Diagnostic values of different definitions of metabolic syndrome to detect poor health status in Iranian adults without diabetes
Authors: Amiri P. , Deihim T. , Hosseinpanah F. , Barzin M. , Hasheminia M. , Montazeri A. , Azizi F.
Published: March 2014

Aims

This study aimed to compare the diagnostic impact of four definitions of the metabolic syndrome for detection of poor health status in adults without diabetes living in Tehran.

Methods

A representative sample of 950 individuals (64% women), aged ≥ 20 years, participants of the Tehran Lipid and Glucose Study in 2005–2007, were recruited for the study. Health status was assessed using the Iranian version of the 36‐item Short Form Health Survey. We assessed the detectability of poor health status by definitions of the National Cholesterol Education Program Adult Treatment Panel III, the International Diabetes Federation, the American Heart Association/National Heart, Lung, and the Blood Institute and the Joint Interim Statement.

Results

Compared with other definitions, the Joint Interim Statement identified more participants (46.9%) having the metabolic syndrome. Using the National Cholesterol Education Program Adult Treatment Panel III, the International Diabetes Federation and the Joint Interim Statement, the metabolic syndrome was significantly related to poor physical health status, even after adjustment for confounding variables, in women, but not in men. None of the four definitions of the metabolic syndrome was related to the mental health status in either gender. The receiver operating characteristic curves showed no significant difference in the discriminative power of the metabolic syndrome definitions in detecting poor health status in either gender. However, women showed a higher area under the curve for all definitions, in comparison with men.

Conclusion

There was no difference in the four different definitions of the metabolic syndrome in detecting poor health status among Iranian adults.
Effects of advanced carbohydrate counting in patients with Type 1 diabetes: a systematic review
Authors: Schmidt S. , Schelde B. , Nørgaard K.
Published: March 2014

Aim

Advanced carbohydrate counting, a systematic method for insulin bolus calculation, is recommended in the management of Type 1 diabetes. The aim of this systematic review was to summarize all available evidence from randomized and observational studies of the effects of advanced carbohydrate counting on glycaemic control (HbA1c), psychosocial measures, weight and hypoglycaemic events in patients of all age groups with Type 1 diabetes on a basal–bolus insulin regimen.

Methods

An electronic search of Scopus, MEDLINE and The Cochrane Library conducted in January 2013 identified 27 relevant articles. Six were randomized controlled trials and 21 were observational studies. Large heterogeneity existed across studies with regard to study design and patient populations. Reporting of statistical measures was insufficient to serve as a basis for a meta‐analysis.

Results

Overall, the studies demonstrated a positive trend in change in HbA1c after introduction of advanced carbohydrate counting. Reductions in HbA1c ranged from 0.0 to 13 mmol/mol (0.0–1.2%). Most psychosocial measures improved; however, only few improvements were considered clinically relevant. Both weight gain and reduction were registered, but most studies found no significant weight changes. The majority of studies assessing the incidence of hypoglycaemic events found a significant reduction in the event rate and none reported an increase in the incidence.

Conclusions

In summary, the currently available literature does not provide sufficient evidence to definitively determine the effects of advanced carbohydrate counting on HbA1c, psychosocial measures, weight or hypoglycaemic events. Nevertheless, the method still appears preferable to other insulin dosing procedures, which justifies continued use and inclusion of advanced carbohydrate counting in clinical guidelines.
Untangling food‐web structure in an ephemeral ecosystem
Authors: O'Neill Brian J. , Thorp James H.
Published: March 2014

Scientists know relatively little about the ecology of ephemeral aquatic habitats beyond the importance of hydroperiod and vertebrate predators, especially regarding trophic structure. We used playa wetlands, ephemeral habitats common in arid to semi‐arid regions, as our study ecosystem. We predicted that larger, more species‐rich playas would have food webs with larger dimensions (longer food chains and more energy sources used), more variation (more niches filled) and more redundancy (niche overlap).

We used geometric properties of stable C and N isotope biplots to explore: (i) what regulates trophic structure in ephemeral wetlands, (ii) the role of anthropogenic forces in altering factors controlling trophic structure and (iii) how trophic structure in ephemeral systems differs from that typical of permanent systems.

We sampled aquatic animal food webs of 21 playa wetlands located mostly in the short‐grass prairies of the Pawnee National Grassland in Colorado, U.S.A.

Playas with higher insect diversity had more complex trophic structures than those dominated by large branchiopods (tadpole, clam and fairy shrimps). Insect diversity seemed dependent on length of the hydroperiod and time since filling, both of which are determined by playa depth. The key to understanding trophic structure in playas is an interaction between hydroperiod and the traits, lifespans and trophic niches of the species present.

The trophic structure of naturally created playas was marginally more complex than artificial playas, and playas buffered by native vegetation were more likely to have food webs that included unique trophic strategies. Food webs of playas influenced by row crop agriculture had a broader selection of food sources. Playas grazed by cattle had food‐web structures comparable to those in ungrazed playas, suggesting that playa biota may be adapted to large mammal disturbances.

The trophic structure of ephemeral aquatic habitats may not respond to disturbance in the same way as permanent systems. Indeed, food chain length in a playa can actually increase as the ephemeral ecosystem approaches the end of its hydroperiod.

Measures of ecosystem size need to include more than the two dimensions of surface area when being applied to general ecological theory. Food webs increase in complexity with time, and many of the same factors that control trophic structure in ephemeral habitats could be important at least at some time in the life of a relatively permanent ecosystem.
Organic matter sources and size structuring in stream invertebrate food webs across a tropical to temperate gradient
Authors: Jardine Timothy D.
Published: March 2014

Given large differences in species diversity across latitudinal gradients, it has been suggested that certain structural and functional attributes of fresh waters may differ over a latitudinal range, an important consideration for poorly known tropical systems undergoing major changes caused by human activities.

Two key features of aquatic ecosystems, the contribution of in situ production (periphyton) to community biomass and size structuring (individual body size versus trophic position), were measured in stream invertebrate food webs across a gradient of 15 degrees of latitude in Australia from the wet tropics to a temperate island.

Consistent with earlier work, crustaceans (Atyidae and Palaemonidae) were responsible for a large fraction of the community biomass at tropical and subtropical sites. Periphyton supported a large proportion of the biomass at intermediate latitudes (79% in the subtropics and 95% at temperate mainland sites), with lower contributions both in more northerly (51% in the tropics) and more southerly (31% on a temperate island) sites. These lower contributions were driven by the high biomass of large crustaceans in the tropics and by shredding and filtering insects on the temperate island and may have also been the result of local nutrient‐limitation.

Although these taxonomic differences between regions did not translate into a latitudinal gradient in size structure, the larger individual body size of crustaceans compared with insects at a given trophic position suggests that the distribution of biomass in tropical and temperate food webs will differ, with implications for predators near the top of the web.

These results suggest that differences in species composition do not necessarily entail differences in stream food‐web structure and function and that local environmental factors are likely to be as important as broad‐scale biogeography and climate in driving food‐web patterns.
Abnormal vibrissa‐related behavior and loss of barrel field inhibitory neurons in 5xFAD transgenics
Authors: Flanigan T. J. , Xue Y. , Kishan Rao S. , Dhanushkodi A. , McDonald M. P.
Published: March 2014

A recent study reported lower anxiety in the 5xFAD transgenic mouse model of Alzheimer's disease, as measured by reduced time on the open arms of an elevated plus maze. This is important because all behaviors in experimental animals must be interpreted in light of basal anxiety and response to novel environments. We conducted a comprehensive anxiety battery in the 5xFAD transgenics and replicated the plus‐maze phenotype. However, we found that it did not reflect reduced anxiety, but rather abnormal avoidance of the closed arms on the part of transgenics and within‐session habituation to the closed arms on the part of wild‐type controls. We noticed that the 5xFAD transgenics did not engage in the whisker‐barbering behavior typical of mice of this background strain. This is suggestive of abnormal social behavior, and we suspected it might be related to their avoidance of the closed arms on the plus maze. Indeed, transgenic mice exhibited excessive home‐cage social behavior and impaired social recognition, and did not permit barbering by wild‐type mice when pair‐housed. When their whiskers were snipped the 5xFAD transgenics no longer avoided the closed arms on the plus maze. Examination of parvalbumin (PV) staining showed a 28.9% reduction in PV+ inhibitory interneurons in the barrel fields of 5xFAD mice, and loss of PV+ fibers in layers IV and V. This loss of vibrissal inhibition suggests a putatively aversive overstimulation that may be responsible for the transgenics' avoidance of the closed arms in the plus maze.
Effect of cerumen impaction on hearing and cognitive functions in Japanese older adults with cognitive impairment
Authors: Sugiura Saiko , Yasue Minori , Sakurai Takashi , Sumigaki Chieko , Uchida Yasue , Nakashima Tsutomu , Toba Kenji
Published: March 2014

Aim

To assess the effect of cerumen impaction and its removal on hearing ability and cognitive function in elderly patients with memory disorders in Japan.

Methods

Pure tone audiometry (PTA) and the Mini‐Mental State Examination (MMSE) were administered to participants before and after cerumen removal. Participants who had cerumen impaction in the better‐hearing ear comprised the case group; the control group consisted of participants who either did not have cerumen impaction or had it in the worse hearing ear. Hearing and cognition changes were compared between the groups after cerumen removal.

Results

A total of 55 patients who completed all examinations were assigned to the case group (29 patients) or the control group (26 patients). The average hearing change was 4.6 ± 7.4 in the case group and 0.9 ± 0.9 in the control group (P = 0.029). The average change in MMSE score was 0.7 ± 2.5 in the case group and −1.0 ± 4.1 in the control group (P = 0.068). The case group showed a significant improvement in MMSE scores after age adjustment compared with the control group (P = 0.049).

Conclusion

Hearing improved significantly in the case group relative to controls after cerumen removal. A significant cognitive improvement in the case group relative to controls was additionally observed after cerumen removal with age adjustment. Thus, the present results suggest routine ear canal examinations might benefit elderly individuals with memory disorders. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 56–61.
Current activities of medical centers for dementia in Japan
Authors: Awata Shuichi
Published: March 2014

Aim

We investigated the current activities of medical centers for dementia (MCD), and proposed recommendations for a national dementia strategy.

Methods

A questionnaire was mailed to 172 hospitals designated as MCD as of 7 August 2012.

Results

Data from 117 MCD that adequately responded and were designated by 1 April 2012 were analyzed. The mean and median numbers of medical consultations per MCD were 1035 and 595/year (range 114–8541/year), those of patients diagnosed with dementia‐related disorders were 266 and 231/year (range 3–1179/year), those of patients with dementia‐related disorders admitted to the MCD hospital were 89 and 47/year (0–1176/year), and mean and median proportions of patients discharged within 2 months were 45.5 and 36.8% (range 0–100%). Outreach services in collaboration with a community general support center were provided in 23.9%, while training for community general support center staff members was carried out in 66.7%. Of MCD hospitals, 31.6% were designated as an emergency medical hospital, and of these, specialist liaison‐team services for patients with dementia in the emergency room were provided in 56.8%.

Conclusions

Most MCD are considered to function fairly well in line with the guidelines published by the Ministry of Health, Labour and Welfare. However, there is a huge discrepancy in the number of patients diagnosed with dementia‐related disorders and the length of stay for inpatient care among facilities. To make all MCD function adequately, the activity of MCD should be monitored longitudinally using the standardized assessment methods. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 23–27.
Progressive fibrosis significantly correlates with hepatocellular carcinoma in patients with a sustained virological response
Authors: Tachi Yoshihiko , Hirai Takanori , Miyata Akihiro , Ohara Kei , Iida Tadashi , Ishizu Youji , Honda Takashi , Kuzuya Teiji , Hayashi Kazuhiko , Ishigami Masatoshi , Goto Hidemi
Published: March 2014

Aim

Hepatocellular carcinoma develops even in some patients who achieve a sustained virological response following treatment for hepatitis C virus infection. This study investigated the relationship between changes in fibrosis, as assessed by sequential biopsies, and development of hepatocellular carcinoma in patients who achieved a sustained virological response for hepatitis C virus.

Methods

We enrolled 97 patients with sustained virological response who had undergone initial biopsies before therapy and sequential biopsies at an average of 5.8 ± 1.9 years after the initial biopsy. Factors associated with hepatocellular carcinoma were retrospectively analyzed.

Results

The liver fibrotic stage regressed in 44 patients (45%), remained stable in 47 patients (48%) and progressed in six patients (6%). The fibrotic stage significantly decreased, from 1.54 ± 0.86 to 1.16 ± 1.07 units. Hepatocellular carcinoma was identified in 12 patients (12.4%). The cumulative incidence of hepatocellular carcinoma in patients with progressive fibrosis was significantly higher than that in patients with regressed or stable fibrosis (P < 0.001). A Cox proportional hazards regression analysis confirmed that progressive fibrosis in sequential liver biopsies (hazard ratio [HR], 8.30; P = 0.001) and low platelet counts before treatment (HR, 8.69; P = 0.006) were significant independent factors associated with the development of hepatocellular carcinoma in patients with a sustained virological response.

Conclusion

Progressive fibrosis, assessed by sequential biopsies, was significantly correlated with development of hepatocellular carcinoma in patients who had achieved a sustained virological response for hepatitis C virus.
Short‐term administration of steroids does not affect postoperative complications following liver resection: Evidence from a meta‐analysis of randomized controlled trials
Authors: Li Ning , Gu Wei‐Li , Weng Jie‐Feng , Lin Fan , Zhu Guang‐Hui , Lu Min‐Qiang , Cao Jie
Published: March 2014

Aim

Although perioperative short‐term administration of steroids can attenuate surgical stress response following liver resection, there is no consensus concerning the effect on postoperative complications. This study aims to use meta‐analysis to quantitatively investigate the effect of perioperative short‐term administration of steroids on postoperative complications following liver resection.

Methods

A systematic published work search was performed to detect randomized controlled trials (RCT) assessing the effect of perioperative short‐term administration of steroids on outcomes following liver resection. Parameters of surgical stress, hospital stay and postoperative complications were analyzed. Two authors independently assessed study quality and extracted data. All data were analyzed using RevMan version 5 and meta‐analyses were performed using a random‐effects model.

Results

Five RCT published between 2001 and 2011 containing a total of 379 patients were eligible for final analysis. Serum total bilirubin, interleukin‐6 and C‐reactive protein were significantly lower in the steroid than in the control group on postoperative day 1 (P = 0.02, 0.004 and 0.02, respectively). There was no difference in duration of hospital stay between the steroid and control group (P = 0.37). The analysis of end‐points including infective complications (odds ratio [OR], 0.95), wound complications (OR, 0.67), bile leakage (OR, 0.58) and overall complications (OR, 0.50) revealed no difference between steroid administration and no treatment. There was no postoperative death or adverse effect attributable to steroid treatment in all patients.

Conclusion

On currently available evidence, short‐term administration of steroids does not increase incidence of complications in patients undergoing liver resection.
Rituximab‐mediated Raf kinase inhibitor protein induction modulates NF‐κB in Sjögren syndrome
Authors: Sisto Margherita , Lisi Sabrina , D'Amore Massimo , Lofrumento Dario D.
Published: March 2014

Primary Sjögren syndrome (pSS) is an autoimmune disorder characterized by an epithelial injury surrounded by dense lymphocytic infiltrates. The conditions for the long‐term maintenance of human salivary gland epithelial cells from pSS patients and a co‐culture system with pSS lymphocytes were used to assess the effect of Rituximab (RTX) on the inflammatory condition and progression in pSS. Quantitative real‐time PCR, genes and protein array analysis, Western blot, flow cytometry, small interfering RNA transfection and nuclear factor‐κB (NF‐κB) DNA binding assays were used as methods. Supporting the benefits of RTX, this study demonstrates that RTX decreases NF‐κB activity and interrupts the NF‐κB signalling pathway through the up‐regulation of the Raf‐1 kinase inhibitor protein (RKIP). Over‐expression of RKIP down‐regulates interleukins, their receptors and the expression of genes encodes proteins that attracted lymphocytes. Silencing of the RKIP gene leads to significantly increased expression and release of pro‐inflammatory mediators supporting that RKIP expression could be involved in the suppression of NF‐κB activation in pSS salivary gland epithelial cells.
What Determines CDS Prices? Evidence from the Estimation of Protection Demand and Supply
Authors: Miyakawa Daisuke , Watanabe Shuji
Published: March 2014

This paper examines the determinants of credit default swap (CDS) premiums by applying a limited dependent variable simultaneous equation system to a unique set of time series data for the Japanese credit market. The estimation results indicate that CDS premiums decrease as a result of an increase in the supply of protection due, for example, to fewer opportunities for investment in other assets (e.g., loans). We also find that premiums increase when the demand for protection increases due, for example, to larger short‐cover needs. Further, the quantitative impact of factors accounting for the supply and demand of protection is likely to be misestimated unless the simultaneous determination of supply and demand is taken into account. This indicates that it is necessary to include demand and supply factors to understand fluctuations in CDS premiums.
Boron Isotope Analysis of Silicate Glass with Very Low Boron Concentrations by Secondary Ion Mass Spectrometry
Authors: Marschall Horst R. , Monteleone Brian D.
Published: March 2014

We present an improved method for the determination of the boron isotopic composition of volcanic glasses with boron concentrations of as low as 0.4–2.5 μg g−1, as is typical for mid‐ocean ridge basalt glasses. The analyses were completed by secondary ion mass spectrometry using a Cameca 1280 large‐radius ion microprobe. Transmission and stability of the instrument and analytical protocol were optimised, which led to an improvement of precision and reduction in surface contamination and analysis time compared with earlier studies. Accuracy, reproducibility (0.4–2.3‰, 2 RSD), measurement repeatability (2 RSE = 2.5–4.0‰ for a single spot with [B] = 1 μg g−1), matrix effects (≪ 0.5‰ among komatiitic, dacitic and rhyolitic glass), machine drift (no internal drift; long‐term drift: ~ 0.1‰ hr−1), contamination (~ 3–8 ng g−1) and machine background (0.093 s−1) were quantified and their influence on samples with low B concentrations was determined. The newly developed set‐up was capable of determining the B isotopic composition of basaltic glass with 1 μg g−1 B with a precision and accuracy of ± 1.5‰ (2 RSE) by completing 4–5 consecutive spot analyses with a spatial resolution of 30 μm × 30 μm. Samples with slightly higher concentrations (≥ 2.5 μg g−1) could be analysed with a precision of better than ± 2‰ (internal 2 RSE) with a single spot analysis, which took 32 min.
Analysis of testicular‐internal spermatic vein variation and the recreation of varicocoele in a Sprague‐Dawley rat model
Authors: Zhang L. T. , Kim H. K. , Choi B. R. , Zhao C. , Lee S. W. , Jang K. Y. , Park J. K.
Published: March 2014

Many laboratories tried to recreate the varicocoele model have met with varied success. To recreate a consistent varicocoele model by exploring the anatomic variability of the testicular‐spermatic venous system in Sprague‐Dawley (SD) rats. Seventy‐two sexually mature SD male rats were randomly divided into three groups containing 24 rats per group. Partial ligation of the left renal vein and internal spermatic vein (ISV) communicating branches to common iliac vein and ISV communicating branches ligation (RVISVCBCIV) or partial ligation of the left renal vein and ISV communicating branches ligation (RVISVCB). The results showed that the mean diameter of the left ISV was significantly increased in the RVISVCBCIV group compared with the control and RVISVCB groups (p < 0.001). Using ISV as the reference, the sensitivity of varicocoele was 71.43%, and the specificity was 80%. In addition, the positive predictive value was 83.33%, and the negative predictive value was 66.67%. Sperm count, motility, Johnsen score and the spermatogenic cell density were lower in the RVISVCBCIV group compared with the control (p < 0.01). The apoptotic index was higher in the RVISVCBCIV group compared with control groups (p < 0.01). The RVISVCBCIV provides a more effective method for establishing a varicocoele‐induced model.
Low INSL3 in Klinefelter syndrome is related to osteocalcin, testosterone treatment and body composition, as well as measures of the hypothalamic–pituitary–gonadal axis
Authors: Overvad S. , Bay K. , Bojesen A. , Gravholt C. H.
Published: March 2014

Klinefelter syndrome (KS) is characterized by infertility and hypogonadism associated with increased prevalence of osteoporosis, diabetes and metabolic syndrome. Insulin‐like factor 3 (INSL3) is produced in the Leydig cells. INSL3 has been suggested to play a role in bone health. Here, we studied INSL3 in relation to bone markers, body composition, the metabolic syndrome and diabetes. This was a case–control study. Sex hormones, anthropometric measures, vitamin D metabolites, parathyroid hormone, growth factors, muscle strength, maximal oxygen consumption and BMD were measured. We included 70 adult KS patients and 71 age‐matched controls. INSL3 was lower in testosterone‐treated KS compared with untreated KS. Correlation analyses showed a positive correlation between INSL3 and osteocalcin among KS, but not in controls; a significant positive correlation between INSL3 and testosterone in controls and in untreated KS, but not in treated KS men. Among controls a negative correlation was found between INSL3 and lipids, and glucose, but not in KS. HOMA2‐B and impaired fasting glycaemia was positively correlated with INSL3 in controls. Among KS males we found a negative correlation between INSL3 and BMI, weight and waist/hip ratio, as well as positive correlations between INSL3 and FSH, LH, SHBG and testis volume. Multivariate analyses showed that age, testosterone and HDL cholesterol were the principal independent variables among healthy controls, whereas the determinants of INSL3 concentration among KS were age, LH, current testosterone treatment and testicular volume. INSL3 in KS is influenced by testosterone treatment and INSL3 is correlated with measures of bone metabolism, body composition and the metabolic syndrome. This may suggest that low INSL3 concentration is related to the pathogenesis behind an unfavourable change in body composition and bone metabolism among KS patients.
Age‐specific survival and recruitment of piping ploversCharadrius melodusin the Great Lakes region
Authors: Saunders Sarah P. , Arnold Todd W. , Roche Erin A. , Cuthbert Francesca J.
Published: March 2014

Juvenile survival and age at first breeding (i.e. recruitment) are critical parameters affecting population dynamics in birds, but high levels of natal dispersal preclude measurement of these variables in most species. We used multi‐state capture–recapture models to measure age‐specific survival and recruitment probabilities of piping ploversCharadrius melodusin the Great Lakes region during 1993–2012. This federally endangered population is thoroughly monitored throughout its entire breeding range, minimizing concerns that measures of survival and recruitment are confounded by temporary or permanent emigration. First‐year survival (± SE) averaged 0.284 ± 0.019 from mean banding age (9 d) and 0.374 ± 0.023 from fledging age (23 d). Factors that increased first‐year survival during the pre‐fledging period (9–23 d) included earlier hatching dates, older age at banding, greater number of fledglings at a given site, and better body condition at time of banding. However, when chicks that died prior to fledging were excluded from analysis, only earlier hatching dates improved first‐year survival estimates. Females had a higher probability (0.557 ± 0.066) of initiating breeding at age one than did males (0.353 ± 0.052), but virtually all plovers began breeding by age three. Adult survival was reduced by increased hurricane activity on the southeast U.S. Atlantic coast where Great Lakes piping plovers winter and by higher populations of merlinsFalco columbarius. Mean annual adult survival declined from 1993 to 2012, and did not differ between males and females. Enhanced body condition led to higher survival to fledge and early breeding led to improved first‐year survival; therefore, management actions focused on ensuring access to quality feeding habitat for growing young and protecting early nests may increase recruitment in this federally endangered population.
Improved 1‐Year Clinical Success Rate of Pulmonary Vein Isolation with the Second‐Generation Cryoballoon in Patients with Paroxysmal Atrial Fibrillation
Authors: FÜRNKRANZ ALEXANDER , BORDIGNON STEFANO , DUGO DANIELA , PEROTTA LAURA , GUNAWARDENE MELANIE , SCHULTE‐HAHN BRITTA , NOWAK BERND , SCHMIDT BORIS , CHUN JULIAN K.R.
Published: March 2014

Improved Efficacy of Second‐Generation Cryoballoon

Background

The second‐generation cryoballoon (CB2) has recently been introduced featuring improved surface cooling. Increased procedural efficacy of pulmonary vein isolation (PVI) when compared to the first‐generation balloon (CB1) has been reported. The aim of the study was to investigate the clinical outcome of cryoballoon PVI after 1 year using the CB2 as compared to the CB1.

Methods and Results

A total of 105 consecutive patients with paroxysmal atrial fibrillation (AF) were studied. Cryoballoon PVI (28 mm) was performed in 50 patients using the CB1, and in 55 patients using the CB2. Patients were scheduled for 72‐hour Holter ECG recording at 3, 6, 9, and 12 months and every 6 months thereafter. The study endpoint was defined as recurrent AF or atrial tachycardia >30 seconds documented after a blanking period of 90 days after the procedure. Complete PVI was achieved in 49/50 (98%) and 55/55 (100%) patients in the CB1 and CB2 group, respectively. After a mean follow‐up of 416 ± 75 days, 21 (CB1 group) and 10 (CB2 group) patients reached the study endpoint. Kaplan–Meier estimates of arrhythmia‐free survival after a single procedure without AAD therapy after 1 year were 63.9% versus 83.6% (P = 0.008) in the CB1 and CB2 group, respectively. Persistent phrenic nerve palsy with delayed healing occurred in 2 (CB1 group) and 3 (CB2 group) patients.

Conclusion

Clinical outcome of PVI using the CB2 was significantly improved when compared to the CB1.
Comparative squamation of the lateral line canal pores in sharks
Authors: Mckenzie R. W. , Motta P. J. , Rohr J. R.
Published: March 2014

The current study collected the first quantitative data on lateral line pore squamation patterns in sharks and assessed whether divergent squamation patterns are similar to experimental models that cause reduction in boundary layer turbulence. In addition, the hypothesis that divergent orientation angles are exclusively found in fast‐swimming shark species was tested. The posterior lateral line and supraorbital lateral line pore squamation of the fast‐swimming pelagic shortfin mako shark Isurus oxyrinchus and the slow‐swimming epi‐benthic spiny dogfish shark Squalus acanthias was examined. Pore scale morphology and pore coverage were qualitatively analysed and compared. In addition, pore squamation orientation patterns were quantified for four regions along the posterior lateral line and compared for both species. Isurus oxyrinchus possessed consistent pore scale coverage among sampled regions and had a divergent squamation pattern with multiple scale rows directed dorsally and ventrally away from the anterior margin of the pore with an average divergent angle of 13° for the first row of scales. Squalus acanthias possessed variable amounts of scale coverage among the sampled regions and had a divergent squamation pattern with multiple scale rows directed ventrally away from the anterior margin of the pore with an average angle of 19° for the first row of scales. Overall, the squamation pattern measured in I. oxyrinchus fell within the parameters used in the fluid flow analysis, which suggests that this pattern may reduce boundary layer turbulence and affect lateral line sensitivity. The exclusively ventral oriented scale pattern seen in S. acanthias possessed a high degree of divergence but the pattern did not match that of the fluid flow models. Given current knowledge, it is unclear how this would affect boundary layer flow. By studying the relationship between squamation patterns and the lateral line, new insights are provided into sensory biology that warrant future investigation due to the implications for the ecology, morphology and sensory evolution of sharks.