bluuebunny/crossref_metadata_2025 huggingface dataset:
Defining and Evaluating the Umbrella Species Concept for Conserving and Restoring Landscape Connectivity
Authors: BRECKHEIMER IAN , HADDAD NICK M. , MORRIS WILLIAM F. , TRAINOR ANNE M. , FIELDS WILLIAM R. , JOBE R. TODD , HUDGENS BRIAN R. , MOODY AARON , WALTERS JEFFREY R.
Published: August 2014

Conserving or restoring landscape connectivity between patches of breeding habitat is a common strategy to protect threatened species from habitat fragmentation. By managing connectivity for some species, usually charismatic vertebrates, it is often assumed that these species will serve as conservation umbrellas for other species. We tested this assumption by developing a quantitative method to measure overlap in dispersal habitat of 3 threatened species—a bird (the umbrella), a butterfly, and a frog—inhabiting the same fragmented landscape. Dispersal habitat was determined with Circuitscape, which was parameterized with movement data collected for each species. Despite differences in natural history and breeding habitat, we found substantial overlap in the spatial distributions of areas important for dispersal of this suite of taxa. However, the intuitive umbrella species (the bird) did not have the highest overlap with other species in terms of the areas that supported connectivity. Nevertheless, we contend that when there are no irreconcilable differences between the dispersal habitats of species that cohabitate on the landscape, managing for umbrella species can help conserve or restore connectivity simultaneously for multiple threatened species with different habitat requirements.

Definición y Evaluación del Concepto de Especie Paraguas para Conservar y Restaurar la Conectividad de Paisajes
Conservation Benefits of Marine Reserves are Undiminished Near Coastal Rivers and Cities
Authors: Huijbers Chantal M. , Connolly Rod M. , Pitt Kylie A. , Schoeman David S. , Schlacher Thomas A. , Burfeind Dana D. , Steele Chantel , Olds Andrew D. , Maxwell Paul S. , Babcock Russell C. , Rissik David
Published: August 2014

Recent assessments of marine reserves have emphasized the importance of socio‐economic factors in reserve performance. Debates continue, however, about whether we should avoid or promote the placement of reserves near potentially detrimental forces, including coastal cities or rivers. We performed a global meta‐analysis to test whether proximity to major coastal influences affected the ability of marine reserves to enhance the abundance of organisms relative to surrounding areas. A strong effect of reserve performance was evident for a range of trophic groups. Positive effects of reserves were undiminished by proximity to coastal cities or river discharges for the majority of taxonomic groups under conservation. We conclude that reserves placed in coastal areas are likely to protect marine populations to a similar extent as reserves in remote or less‐developed locations. Marine reserves in coastal settings can be an important tool to protect species and ecosystems in places threatened by human activities.
Cell blocks in cytopathology: a review of preparative methods, utility in diagnosis and role in ancillary studies
Authors: Jain D. , Mathur S. R. , Iyer V. K.
Published: August 2014

The cell block (CB) is a routine procedure in cytopathology that has gained importance because of its pivotal role in diagnosis and ancillary studies. There is no precise review in the published literature that deals with the various methods of preparation of CB, its utility in diagnosis, immunocytochemistry (ICC) or molecular testing, and its drawbacks. An extensive literature search on CB in cytology using internet search engines was performed for this review employing the following keywords: cell block, cytoblock, cytology, cytopathology, methods, preparation, fixatives, diagnostic yield, ancillary and molecular studies. Ever since its introduction more than a century ago, the CB technique has undergone numerous modifications to improve the quality of the procedure; however, the overall principle remains the same in each method. CBs can be prepared from virtually all varieties of cytological samples. In today's era of personalized medicine, cytological specimens, including CBs, augment the utility of cytological samples in analysing the molecular alterations as effectively as surgical biopsies or resection specimens. With the availability of molecular targeted therapy for many cancers, a large number of recent studies have used cytological material or CBs for molecular characterization. The various techniques of CB preparation with different fixatives, their advantages and limitations, and issues of diagnostic yield are discussed in this review.
Efficacy and safety of dipeptidyl peptidase‐4 inhibitors as an add‐on to insulin treatment in patients with Type 2 diabetes: a review
Authors: Frandsen C. S. S. , Madsbad S.
Published: August 2014

Aim

To review and discuss the results from the clinical controlled trials comparing a dipeptidyl peptidase‐4 inhibitor with placebo treatment as add‐on to insulin treatment with respect to changes in HbA1c, weight, fasting plasma glucose, risk of hypoglycaemia and safety in patients with Type 2 diabetes.

Methods

We searched the MEDLINE and PubMed databases to identify all randomized controlled clinical trials evaluating dipeptidyl peptidase‐4 inhibitors as an add‐on to insulin in patients with Type 2 diabetes, which were selected for review. The abstracts and posters of the recent annual meetings of the American Diabetes Association and European Association for the Study of Diabetes were hand searched, as were the reference lists of articles identified.

Results

Adding a dipeptidyl peptidase‐4 inhibitor to insulin treatment resulted in a glucose‐lowering effect of ~ 6.6–8.7 mmol/mol (0.60–0.80%) from a baseline HbA1c of 67–78 mmol/mol (8.3–9.3%), without increasing the risk of hypoglycaemia. The dipeptidyl peptidase‐4 inhibitor treatment had no effect on body weight or daily dose of insulin. The frequency and severity of adverse events did not differ between dipeptidyl peptidase‐4 inhibitor and placebo treatment.

Conclusion

Adding a dipeptidyl peptidase‐4 inhibitor treatment to insulin has a moderate effect on HbA1c, a weight‐neutral effect and a good safety profile. The risk of hypoglycaemia is not increased despite a significant improvement in HbA1c.
Cause‐specific mortality by race in low‐income Black and White people with Type 2 diabetes
Authors: Conway B. N. , May M. E. , Fischl A. , Frisbee J. , Han X. , Blot W. J.
Published: August 2014

Aim

To investigate, with extended follow‐up, cause‐specific mortality among low‐income Black and White Americans with Type 2 diabetes who have similar socio‐economic status.

Methods

Black and White Americans aged 40–79 years with Type 2 diabetes (n = 12 498) were recruited from community health centres as part of the Southern Community Cohort Study. Multivariable Cox analysis was used to estimate mortality hazard ratios and 95% CIs for subsequent cause‐specific mortality, based on both underlying and contributing causes of death.

Results

During the follow‐up (median 5.9 years), 13.3% of the study population died. The leading causes of death in each race were ischaemic heart disease, respiratory disorders, cancer, renal failure and heart failure; however, Blacks were at a lower risk of dying from ischaemic heart disease (hazard ratio 0.70, 95% CI 0.54–0.91) or respiratory disorders (hazard ratio 0.70, 0.53–0.92) than Whites but had higher or similar mortality attributable to renal failure (hazard ratio 1.57, 95% CI 1.02–2.40), heart failure (hazard ratio 1.47, 95% CI 0.98–2.19) and cancer (hazard ratio 0.87, 95% CI 0.62–1.22). Risk factors for each cause of death were generally similar in each race.

Conclusions

These findings suggest that the leading causes of death and their risk factors are largely similar among Black and White Americans with diabetes. For the two leading causes of death in each race, however, ischaemic heart disease and respiratory disorders, the magnitude of risk is lower among Black Americans and contributes to their higher survival rates.
SECTORAL COMPOSITION OF GOVERNMENT SPENDING AND MACROECONOMIC (IN)STABILITY
Authors: Chang Juin‐Jen , Guo Jang‐Ting , Shieh Jhy‐Yuan , Wang Wei‐Neng
Published: August 2014

This article examines the quantitative interrelations between sectoral composition of public spending and equilibrium (in)determinacy in a two‐sector real business cycle model with positive productive externalities in investment. When government purchases of consumption and investment goods are set as constant fractions of their respective sectoral output, we show that the public‐consumption share plays no role in the model's local dynamics, and that a sufficiently high public‐investment share can stabilize the economy against endogenous belief‐driven cyclical fluctuations. When each type of government spending is postulated as a constant proportion of the economy's total output, we find that there exists a trade‐off between public consumption versus investment expenditures to yield saddle‐path stability and equilibrium uniqueness. (JEL E32, E62, O41)
Wilate use in 47 children with von Willebrand disease: the North London paediatric haemophilia network experience
Authors: Khair K. , Batty P. , Riat R. , Bowles L. , Burgess C. , Chen Y. ‐H. , Hart D. , Platton S. , Pasi J. , Liesner R.
Published: August 2014

Children with von Willebrand disease (VWD) in whom DDAVP is ineffective or contraindicated require treatment with a coagulation factor concentrate containing von Willebrand factor (VWF) and factor VIII (FVIII). The aim of this study was to monitor the safety, efficacy and tolerability of Wilate® (a VWF:FVIII concentrate with a 1:1 ratio) used across the North London Paediatric Haemophilia Network since May 2010. In total, 47 children (aged 0.0–17.0 years) with type 1 (n = 28), type 2 (n = 7), type 3 (n = 10) and acquired VWS (n = 2) have been treated for bleeds, surgery and/or prophylaxis using 260 000 IU Wilate®. Analysis of dose and frequency of treatment show expected responses to treatment with mean doses of 55, 50 and 50 IU kg−1 for bleeds, surgery and prophylaxis respectively. Most bleeds responded to a single treatment. Surgical procedures were covered with clinician approved dosing schedules with 95% (39/41) reported as having excellent or good efficacy. There was no accumulation of FVIII or VWF and no thromboembolic events. This case series confirms the efficacy, safety and tolerability of Wilate® in neonates, children and adolescents when used on‐demand, prophylactically and in the surgical setting.
Basic fibroblastic growth factor affects the osteogenic differentiation of dental pulp stem cells in a treatment‐dependent manner
Authors: Qian J. , Jiayuan W. , Wenkai J. , Peina W. , Ansheng Z. , Shukai S. , Shafei Z. , Jun L. , Longxing N.
Published: August 2014

Aim

To determine how basic fibroblastic growth factor (bFGF) affected the osteogenic differentiation of human dental pulp stem cells (DPSCs) in vitro and in vivo.

Methodology

Basic fibroblastic growth factor stimulation of DPSCs was divided into a pre‐treatment period and an osteogenic differentiation period. Alizarin red quantification experiments and alkaline phosphatase activity quantification assay were performed to examine the osteogenic differentiation of DPSCs after different bFGF stimulation. Quantification reverse transcription polymerase chain reaction was used to analyze the osteogenic gene expression of DPSCs after different bFGF stimulation. In addition, DPSCs that received the 1 and 2 weeks bFGF pre‐treatments as in the in vitro experiments were mineralized for 1 week and seeded into hydroxyapatite/tricalcium phosphate (HA/TCP) pills and subcutaneously transplanted into naked mice for 2 or 3 months. The transplants were removed, sliced and stained using Modified Ponceau Trichrome Stain to observe the formation of mineralized tissue.

Results

Basic fibroblastic growth factor stimulation in the osteogenic differentiation period decreased the in vitro osteogenic differentiation ability of DPSCs. One week pre‐treatment with bFGF increased the in vitro osteogenic differentiation ability of DPSCs, whereas 2 weeks pre‐treatment with bFGF decreased the in vitro osteogenic differentiation ability of DPSCs. The pre‐treatment period was vital for the osteogenic differentiation of DPSCs in vitro. The in vivo results were similar to the in vitro results.

Conclusions

Basic fibroblastic growth factor affected the osteogenic differentiation of DPSCs in a treatment‐dependent manner both in vitro and in vivo.
Evaluation of apically extruded debris associated with several Ni–Ti systems
Authors: Üstün Y. , Çanakçi B. C. , Dinçer A. N. , Er O. , Düzgün S.
Published: August 2014

Aim

To evaluate the apical extrusion of debris associated with several root canal preparation systems in vitro.

Methodology

Forty‐five extracted human mandibular premolars with single canals and similar lengths were used. The root canals were instrumented using ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland), Twisted File (SybronEndo, Orange, CA, USA) or WaveOne (Dentsply Maillefer, Ballaigues, Switzerland). Debris extruded apically during instrumentation was collected into pre‐weighed Eppendorf tubes. The Eppendorf tubes were then stored in an incubator at 70 °C for 5 days. The Eppendorf tubes were weighed to obtain the final weight of the Eppendorf tubes plus extruded debris. Three consecutive weights were obtained for each tube. The groups were compared using the Kruskal–Wallis one‐way analysis of variance on Ranks and Tukey's test.

Results

The ProTaper Next group produced the highest mean extrusion value whilst WaveOne produced less debris compared with all the other instruments (P > 0.05). There was a significant difference between the ProTaper Next and WaveOne group (P < 0.05).

Conclusions

Apically extruded debris was associated with all instrumentation techniques. The WaveOne system extruded less debris compared with the Twisted File and ProTaper Next.
Hepatitis mouse models: from acute‐to‐chronic autoimmune hepatitis
Authors: Yüksel Muhammed , Laukens Debby , Heindryckx Femke , Van Vlierberghe Hans , Geerts Anja , Wong F. Susan , Wen Li , Colle Isabelle
Published: August 2014

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease associated with interface hepatitis, raised plasma liver enzymes, the presence of autoantibodies and regulatory T‐cell (Tregs) dysfunction. The clinical course is heterogeneous, manifested by a fulminant or indolent course. Although genetic predisposition is well accepted, the combination with currently undefined environmental factors is crucial for the development of the disease. Progress in the development of reliable animal models provides added understanding of the pathophysiology of AIH, and these will be very useful in evaluating potential therapeutics. It appears that artificially breaking tolerance in the liver is easy. However, maintaining this state of tolerance breakdown, to get chronic hepatitis, is difficult because liver immune homeostasis is strongly regulated by several immune response inhibitory mechanisms. For example, Tregs are crucial regulators in acute and chronic hepatitis, and C57BL/6 mice are most prone to experimental AIH. Immunization of C57BL/6 mice with liver (AIH) autoantigens (CYP2D6/FTCD or IL‐4R) and the disturbance of liver regulatory mechanism(s), leading to experimental AIH, are likely to be most representative of human AIH pathology.
Nutritional and physicochemical characteristics of wholemeal bread enriched with pea flour
Authors: Mastromatteo Marcella , Danza Alessandra , Lecce Lucia , Spinelli Sara , Lampignano Vincenzo , Laverse Janine , Conte Amalia , Del Nobile Matteo Alessandro
Published: August 2014

In this work, wholemeal bread enriched with hydrated and nonhydrated pea flour was investigated. Moreover, hydrocolloids, such as hydroxypropylcellulose, agar‐agar and guar seed flour, were added to the bread to improve its organoleptic properties. The bread samples were analysed from the nutritional, microstructural and textural properties point of view, and their correlations were also evaluated. Results showed that guar gum at 2% gave the better results. In particular, the overall quality of the bread enriched with hydrated pea flour and guar gum was statistically similar to that of the CTRL reference sample (7.70). The fibres and ash content of all pea‐enriched bread samples were significantly higher compared with the CTRL sample; moreover, all functional bread samples recorded significantly lower glycaemic response with respect to the CTRL sample. In addition, the mixture of both guar gum and hydrated pea flour significantly improved the dough properties and reduced the firmness of the bread.
A case for the use of autoethnography in nursing research
Authors: Peterson Ashley L.
Published: August 2014

Aims

This paper discusses the basis for and potential usefulness of autoethnography as a research method in nursing.

Background

While qualitative research in nursing has traditionally involved the researcher taking an objective stance, autoethnography, with roots in the social sciences, is an emerging method that examines the researcher's own experience in a cultural context.

Design

Discussion paper.

Data sources

Data sources from 1979–2013 in the CINAHL, Medline and PsycInfo databases were drawn on including articles from nursing and social science journals on autoethnography and related narrative‐based approaches.

Discussion

Autoethnography is based on the assumption that reality is multifaceted and the role of culture and context is crucial in understanding human experience. The reader is engaged through the evocation of emotion and the stimulation of reflection.

Implications for nursing

While autoethnography has thus far been little used in the discipline of nursing, it is a methodology that offers novel insights and an opportunity to examine the impact of nurses' personal and professional cultural identity on their practice.

Conclusion

Through the use of a subjective lens, autoethnography gives nurses the opportunity to tell stories that would otherwise not be heard. It involves a courageous laying bare of the self to gain new cultural understandings and it offers the potential for nurses to learn from the experiences and reflections of other nurses.
An integrative review of promoting trust in the patient–primary care provider relationship
Authors: Murray Billie , McCrone Susan
Published: August 2014

Aim

An integrative review of empirical studies on factors promoting trust in the patient–primary care provider relationship.

Background

Trust is essential to the patient–provider relationship. Patients with high trust in their healthcare providers have been found to have improved outcomes, including improved chronic disease management, increased use of preventative services and satisfaction with care. Breaches of trust in the healthcare system threaten trust. Exploring factors that promote trust in the patient–provider relationship is warranted.

Design

Integrative literature review.

Data sources

Electronic databases searched included CINAHL, MEDLINE and PsycARTICLES, using combinations of the key term ‘trust’ with: concept, practitioner, provider, physician, developing, creating, engendering, promoting and establishing. The results were limited to original publications in English, published between 1998–2013.

Review methods

A review of the literature was conducted by two independent reviewers based on the criteria established by Cooper; Whittemore and Knafl; and Polit and Beck. Methodological assessment tools were used to organize, evaluate the quality of and synthesize the data.

Results

A new conceptual definition of promoting trust is proposed that includes three core qualities: interpersonal and technical competence, moral comportment and vigilance. Gaps in the literature still exist related to rural, young adult, older adult and well patient populations.

Conclusion

The core qualities could serve as target areas for the development of interventions aimed at modifying provider behaviours so that trust can be established, maintained or improved. Future prospective longitudinal research studies are needed that enhance understanding of trust with multiple primary care provider types.
Conditional Water Rights in the Western United States: Introducing Uncertainty to Prior Appropriation?
Authors: Podolak Charles J.P. , Doyle Martin
Published: August 2014

In the prior‐appropriation water rights regimes that prevail in the arid western United States, claims to annually variable surface water flows are fulfilled based on the order of their establishment. The two‐step process used to establish an appropriative water right in all 17 conterminous western states creates a temporary phase, or conditional water right, which has a priority date but no actual water use. We provide a review of the legal basis for these conditional water rights and demonstrate the potential uncertainty they introduce to current water users. We then present a complete census of conditional water rights in Colorado, including their amounts, ages, and uses. At the end of 2012 there were a large number of conditional water rights in Colorado (some over 90 years old) equal to 61% of the perfected water rights. Many of the controversial conditional water rights in Colorado have been associated with unconventional oil production in the northwestern portion of the state; however, conditional water rights are ubiquitous across the state and across many use types. In several basins, their existence can introduce uncertainty to some of the most senior water rights holders. Nevertheless, in most of the state, the effects of conditional water rights are restricted to a relatively junior class of water users. This work quantifies for the first time the result, in one state, of a peculiar aspect of water law common across all western prior‐appropriation states.
Relationship Between Serum Gamma‐Glutamyltransferase Levels and Prehypertension in Chinese Adults: The Cardiometabolic Risk in Chinese Study
Authors: Zhu Yan , Gong Ying , Zhu Ruihua , Liu Xue‐kui , Sun Yu‐ting , Wang Yu , Qi Lu , Liang Jun
Published: August 2014

The authors aimed to investigate the relationship between serum gamma‐glutamyltransferase (GGT) and prehypertension, as well as the modification of other metabolic risk factors in a large cohort of Chinese individuals. The data were collected via a community‐based health examination survey in central China. Blood pressure, body mass index (BMI), and levels of GGT, fasting blood glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lipid indicators were measured. In total, data from 18,302 patients with available biomarkers were included in the present study. Elevated blood pressure was associated with increased GGT concentration (P<.001). After adjusting for age, sex, BMI, fasting blood glucose, lipid indicators, AST, and family history of hypertension, the association between GGT levels and prehypertension remained significant (P=.021). The adjusted odds ratios (95% confidence interval) for prehypertension across quintiles of GGT level were 1.00, 1.057 (1.012–1.334), 1.068 (0.916–1.254), 1.024 (0.851–1.368), and 1.272 (1.027–1.593), respectively. In stratified analyses, the association between GGT levels and prehypertension was significant in women but was not significant in men. Moreover, additive effect of BMI and age on the effect of GGT levels on prehypertension (both P for interaction <.001) was observed. In summary, GGT levels were positively associated with prehypertension in women, independent of other metabolic factors. Furthermore, BMI and age may amplify the effects of GGT levels on prehypertension. These findings suggest that monitoring the levels of GGT could help in the diagnosis and monitoring of prehypertension.
Characteristics, Treatment Practices, and In‐Hospital Outcomes of Older Adults Hospitalized with Acute Myocardial Infarction
Authors: Chen Han‐Yang , McManus David D. , Saczynski Jane S. , Gurwitz Jerry H. , Gore Joel M. , Yarzebski Jorge , Goldberg Robert J.
Published: August 2014

Objectives

To examine overall and decade‐long trends (1999–2009), characteristics, treatment practices, and hospital outcomes in individuals aged 65 and older hospitalized for acute myocardial infarction (AMI) and to describe how these factors varied in the youngest, middle, and oldest‐old individuals.

Design

Retrospective cohort study.

Setting

Population‐based Worcester Heart Attack Study.

Measurements

Analyses were conducted to examine the sociodemographic and clinical characteristics, cardiac treatments, and hospital outcomes of older adults in three age strata (65–74, 75–84, ≥85).

Participants

The study sample consisted of 3,851 individuals aged 65 and older hospitalized with AMI every other year between 1999 and 2009; 32% were aged 65 to 74, 43% aged 75 to 84, and 25% aged 85 and older.

Results

Advancing age was inversely associated with receipt of evidence‐based cardiac therapies. After multivariable adjustment, the odds of dying during hospitalization was 1.46 times as high in participants aged 75 to 84 and 1.78 times as high in those aged 85 and older as in those aged 65 to 74. The oldest‐old participants had approximately 25% lower odds of a prolonged hospital stay (>3 days) than those aged 65 to 74. Decade‐long trends in the principal study outcomes were also examined. Although the oldest‐old participants hospitalized for AMI were at the greatest risk of dying, persistent age‐related differences were observed in hospital treatment practices. Similar results were observed after excluding participants with a do‐not‐resuscitate order in their medical records.

Conclusion

Although there are persistent disparities in the care and outcomes of older adults hospitalized with AMI, additional studies are needed to delineate the extent to which less‐aggressive care reflects individual preferences and appropriate implementation of palliative care approaches.
Geriatric Emergency Department Innovations: Preliminary Data for the Geriatric Nurse Liaison Model
Authors: Aldeen Amer Z. , Courtney D. Mark , Lindquist Lee A. , Dresden Scott M. , Gravenor Stephanie J.
Published: August 2014

Older adults account for a large and growing segment of the emergency department (ED) population. They are often admitted to the hospital for nonurgent conditions such as dementia, impaired functional status, and gait instability. The aims of this geriatric ED innovations (GEDI) project were to develop GEDI nurse liaisons by training ED nurses in geriatric assessment and care coordination skills, describe characteristics of patients that these GEDI nurse liaisons see, and measure the admission rate of these patients. Four ED nurses participated in the GEDI training program, which consisted of 82 hours of clinical rotations in geriatrics and palliative medicine, 82 hours of didactics, and a pilot phase for refinement of the GEDI consultation process. Individuals were eligible for GEDI consultation if they had an Identification of Seniors At Risk (ISAR) score greater than 2 or at ED clinician request. GEDI consultation was available Monday through Friday from 9:00 a.m. to 8:00 p.m. An extensive database was set up to collect clinical outcomes data for all older adults in the ED before and after GEDI implementation. The liaisons underwent training from January through March 2013. From April through August 2013, 408 GEDI consultations were performed in 7,213 total older adults in the ED (5.7%, 95% confidence interval (CI) = 5.2–6.2%), 2,124 of whom were eligible for GEDI consultation (19.2%, 95% CI = 17.6–20.9%); 34.6% (95% CI = 30.1–39.3%) received social work consultation, 43.9% (95% CI = 39.1–48.7) received pharmacy consultation, and more than 90% received telephone follow‐up. The admission rate for GEDI patients was 44.9% (95% CI = 40.1–49.7), compared with 60.0% (95% CI = 58.8–61.2) non‐GEDI. ED nurses undergoing a 3‐month training program can develop geriatric‐specific assessment skills. Implementation of these skills in the ED may be associated with fewer admissions of older adults.
Anthropometric and craniofacial sexual dimorphism in obstructive sleep apnea patients: is there male–female phenotypical convergence?
Authors: Perri Rita A. , Kairaitis Kristina , Wheatley John R. , Amis Terence C.
Published: August 2014

Obstructive sleep apnea (OSA) is more common in men than women. Body size is greater in males (sexual dimorphism), but large body habitus is associated with OSA for both genders. We speculated that male–female phenotypical convergence (reduced sexual dimorphism via identical phenotype acquisition) occurs with OSA and tested hypotheses: (1) phenotypical features pathogenic for OSA differ between OSA and healthy subjects irrespective of gender; and (2) such characteristics exhibit phenotypical convergence. Utilizing an existing database, we calculated male–female (group average) ratios for eight anthropometric and 33 surface cephalometric variables from 104 Caucasian OSA patients [72 males; apnea–hypopnea index (events h−1): males: 42.3 ± 24.7 versus females: 42.6 ± 26.1 (P > 0.9)] and 85 Caucasian, healthy, non‐OSA, community volunteers (36 males). Log‐transformed data were analysed using a general linear model with post‐hoc unpaired t‐tests and significance at P < 0.0012 (Bonferroni multiple‐comparison correction). OSA patients were older (56.9 ± 14.4 versus 38.0 ± 13.8 years), but there were no within‐group gender‐based age differences. All anthropometric variables (except height), plus cranial base width, mandibular breadth and retromandibular width diagonal were larger in gender‐matched OSA versus healthy comparisons; thus satisfying hypothesis (1). Male–female ratios were mostly >1.0 across groups, but with no significant group × gender interactions no variable satisfied hypothesis (2). Thus, in this exploratory study, OSA patients had gender‐common phenotypical differences to healthy subjects, but sexual dimorphism was preserved. Lack of complete phenotypical convergence may indicate gender‐based critical phenotype‐level attainment for OSA and/or gender‐based OSA prevalence arises from factors other than those in this study.
Stress modulation of cellular metabolic sensors: interaction of stress from temperature and rainfall on the intertidal limpetCellana toreuma
Authors: Dong Yun‐wei , Han Guo‐dong , Huang Xiong‐wei
Published: August 2014

In the natural environment, organisms are exposed to large variations in physical conditions. Quantifying such physiological responses is, however, often performed in laboratory acclimation studies, in which usually only a single factor is varied. In contrast, field acclimatization may expose organisms to concurrent changes in several environmental variables. The interactions of these factors may have strong effects on organismal function. In particular, rare events that occur stochastically and have relatively short duration may have strong effects. The present experiments studied levels of expression of several genes associated with cellular stress and metabolic regulation in a field population of limpetCellana toreumathat encountered a wide range of temperatures plus periodic rain events. Physiological responses to these variable conditions were quantified by measuring levels of mRNAof genes encoding heat‐shock proteins (Hsps) and metabolic sensors (AMPKs andSirtuin 1). Our results reveal high ratios of individuals in upregulation group of stress‐related gene expression at high temperature and rainy days, indicating the occurrence of stress from both prevailing high summer temperatures and occasional rainfall during periods of emersion. At high temperature, stress due to exposure to rainfall may be more challenging than heat stress alone. The highly variable physiological performances of limpets in their natural habitats indicate the possible differences in capability for physiological regulation among individuals. Our results emphasize the importance of studies of field acclimatization in unravelling the effects of environmental change on organisms, notably in the context of multiple changes in abiotic factors that are accompanying global change.
The hidden history of the snowshoe hare, Lepus americanus: extensive mitochondrial DNA introgression inferred from multilocus genetic variation
Authors: Melo‐Ferreira José , Seixas Fernando A. , Cheng Ellen , Mills L. Scott , Alves Paulo C.
Published: August 2014

Hybridization drives the evolutionary trajectory of many species or local populations, and assessing the geographic extent and genetic impact of interspecific gene flow may provide invaluable clues to understand population divergence or the adaptive relevance of admixture. In North America, hares (Lepus spp.) are key species for ecosystem dynamics and their evolutionary history may have been affected by hybridization. Here we reconstructed the speciation history of the three most widespread hares in North America – the snowshoe hare (Lepus americanus), the white‐tailed jackrabbit (L. townsendii) and the black‐tailed jackrabbit (L. californicus) – by analysing sequence variation at eight nuclear markers and one mitochondrial DNA (mtDNA) locus (6240 bp; 94 specimens). A multilocus–multispecies coalescent‐based phylogeny suggests that L. americanus diverged ~2.7 Ma and that L. californicus and L. townsendii split more recently (~1.2 Ma). Within L. americanus, a deep history of cryptic divergence (~2.0 Ma) was inferred, which coincides with major speciation events in other North American species. While the isolation‐with‐migration model suggested that nuclear gene flow was generally rare or absent among species or major genetic groups, coalescent simulations of mtDNA divergence revealed historical mtDNA introgression from L. californicus into the Pacific Northwest populations of L. americanus. This finding marks a history of past reticulation between these species, which may have affected other parts of the genome and influence the adaptive potential of hares during climate change.
An evolving perspective about the origins of childhood undernutrition and nutritional interventions that includes the gut microbiome
Authors: Ahmed Tahmeed , Auble David , Berkley James A. , Black Robert , Ahern Philip P. , Hossain Muttaquina , Hsieh Andrea , Ireen Santhia , Arabi Mandana , Gordon Jeffrey I.
Published: August 2014

The Sackler Institute for Nutrition Science and the World Health Organization (WHO) have worked together to formulate a research agenda for nutrition science. Undernutrition of children has profound effects on health, development, and achievement of full human capacity. Undernutrition is not simply caused by a lack of food, but results from a complex interplay of intra‐ and intergenerational factors. Representative preclinical models and comprehensive well‐controlled longitudinal clinical studies are needed to further understand the contributions and the interrelationships among these factors and to develop interventions that are effective and durable. This paper summarizes work on mechanisms underlying the varied manifestations of childhood undernutrition and discusses current gaps in knowledge and challenges to our understanding of undernutrition and infection/immunity throughout the human life cycle, focusing on early childhood growth. It proposes a series of basic and clinical studies to address this global health challenge.
Behavioural weight management programmes for adults assessed by trials conducted in everyday contexts: systematic review and meta‐analysis
Authors: Hartmann‐Boyce J. , Johns D. J. , Jebb S. A. , Summerbell C. , Aveyard P. ,   Behavioural Weight Management Review Group
Published: August 2014

This systematic review and meta‐analysis of effectiveness trials comparing multicomponent behavioural weight management programmes with controls in overweight and obese adults set out to determine the effectiveness of these interventions implemented in routine practice. To be included, interventions must have been multicomponent, delivered by the therapists who would deliver the intervention in routine practice and in that same context, and must be widely available or feasible to implement with little additional infrastructure or staffing. Searches of electronic databases were conducted, and augmented by screening reference lists and contacting experts (November 2012). Data were extracted by two reviewers, with mean difference between intervention and control for 12‐month change in weight, blood pressure, lipids and glucose calculated using baseline observation carried forward. Data were also extracted on adverse events, quality of life and mood measures. Although there were many published efficacy trials, only eight effectiveness trials met the inclusion criteria. Pooled results from five study arms providing access to commercial weight management programmes detected significant weight loss at 12 months (mean difference −2.22 kg, 95% confidence interval [CI] −2.90 to −1.54). Results from two arms of a study testing a commercial programme providing meal replacements also detected significant weight loss (mean difference −6.83 kg, 95% CI −8.39 to −5.26). In contrast, pooled results from five interventions delivered by primary care teams showed no evidence of an effect on weight (mean difference −0.45 kg, 95% CI −1.34 to 0.43). One study testing an interactive web‐based intervention detected a significant effect in favour of the intervention at 12 months, but the study was judged to be at high risk of bias and the effect did not persist at 18 months. Few studies reported other outcomes, limiting comparisons between interventions. Few trials have examined the effectiveness of behavioural weight loss programmes delivered in everyday contexts. These trials suggest that commercial interventions delivered in the community are effective for achieving weight loss. There is no evidence that interventions delivered within primary care settings by generalist primary care teams trained in weight management achieve meaningful weight loss.
Improving Atrial Fibrillation Detection in Patients with Implantable Cardiac Devices by Means of a Remote Monitoring and Management Application
Authors: ZOPPO FRANCO , FACCHIN DOMENICO , MOLON GIULIO , ZANOTTO GABRIELE , CATANZARITI DOMENICO , ROSSILLO ANTONIO , BACCILLIERI MARIA STELLA , MENARD CECILE , COMISSO JENNIFER , GENTILI ALESSANDRA , GRAMMATICO ANDREA , BERTAGLIA EMANUELE , PROCLEMER ALESSANDRO
Published: August 2014

Background

Atrial fibrillation (AF) is common in patients with cardiac implantable electronic devices (CIED) and has been associated with an increased stroke risk. The aim of our project was to assess the clinical value of a web‐based application, Discovery Link AFinder, in improving AF detection in CIED patients.

Methods and Results

Seven Italian hospitals performed an observational study consisting of four phases. During phase 1, expert nurses and cardiologists prospectively followed‐up CIED patients via in‐hospital examinations and remote monitoring, and classified clinically relevant events, particularly AF occurrence. During phase 2, Discovery Link AFinder was exploited to identify patients who had suffered AF in the previous 12 months through the systematic scanning of device data remote transmissions. Phases 3 and 4 were repetitions of phases 1 and 2, respectively, and were implemented 6 months after the previous phases. A total of 472 consecutive patients were included in phase 1; AF occurred in 170 patients, 61 of whom were identified as new AF patients. Evidence of AF during this phase prompted prescription of oral anticoagulation (OAC) therapy in 30 patients. In phase 2, AFinder uncovered new AF, unidentified in phase 1, in 54 patients and prompted implementation of OAC therapy in 11 patients. During phase 3, 30 new AF patients were identified by means of remote monitoring, while during phase 4, a further three AF patients were identified by AFinder only.

Conclusions

The AFinder web‐based software, applied on top of standard in‐hospital and remote monitoring, improved AF detection and enabled OAC treatment to be undertaken.
Association between non‐medical prescription drug use and personality traits among young Swiss men
Authors: N'Goran Alexandra A. , Baggio Stéphanie , Deline Stéphane , Studer Joseph , Mohler‐Kuo Meichun , Daeppen Jean‐Bernard , Gmel Gerhard
Published: August 2014

Aim

To investigate the relationships between six classes of non‐medical prescription drug use (NMPDU) and five personality traits.

Methods

Representative baseline data on 5777 Swiss men around 20 years old were taken from the Cohort Study on Substance Use Risk Factors. NMPDU of opioid analgesics, sedatives/sleeping pills, anxiolytics, antidepressants, beta‐blockers and stimulants over the previous 12 months was measured. Personality was assessed using the Brief Sensation Seeking Scale; attention deficit–hyperactivity (ADH) using the Adult Attention‐Deficit–Hyperactivity Disorder Self‐Report Scale; and aggression/hostility, anxiety/neuroticism and sociability using the Zuckerman–Kuhlmann Personality Questionnaire. Logistic regression models for each personality trait were fitted, as were seven multiple logistic regression models predicting each NMPDU adjusting for all personality traits and covariates.

Results

Around 10.7% of participants reported NMPDU in the last 12 months, with opioid analgesics most prevalent (6.7%), then sedatives/sleeping pills (3.0%), anxiolytics (2.7%), and stimulants (1.9%). Sensation seeking (SS), ADH, aggression/hostility, and anxiety/neuroticism (but not sociability) were significantly positively associated with at least one drug class (OR varied between 1.24, 95%CI: 1.04–1.48 and 1.86, 95%CI: 1.47–2.35). Aggression/hostility, anxiety/neuroticism and ADH were significantly and positively related to almost all NMPDU. Sociability was inversely related to NMPDU of sedatives/sleeping pills and anxiolytics (OR, 0.70; 95%CI: 0.51–0.96 and OR, 0.64; 95%CI: 0.46–0.90, respectively). SS was related only to stimulant use (OR, 1.74; 95%CI: 1.14–2.65).

Conclusion

People with higher scores for ADH, aggression/hostility and anxiety/neuroticism are at higher risk of NMPDU. Sociability appeared to protect from NMPDU of sedatives/sleeping pills and anxiolytics.
Exploring Precarious Employment and Women's Health within the Context of U.S. Microenterprise Using Focus Groups
Authors: Salt Rebekah , Lee Jongwon
Published: August 2014

Objective

Nursing has been a leader in exploring social determinants of health within the context of U.S. microenterprise and women's health. The purpose of this study was to explore precarious employment within the context of microenterprise and women's health using focus groups with clientele from New Mexico (NM). The specific aims were to identify (1) the health concerns of low‐income women who utilized resources from Women's Economic Self‐Sufficiency Team (WESST), and (2) the meaning of precarious employment in low‐income women's lives.

Design and strategy

Fourteen women, ranging in age from 21–65 years, who were affiliated with regional WESST sites around NM participated in focus groups and completed a demographic questionnaire.

Measures

Focus group data were analyzed using content analysis. The degree of interrater agreement was determined by calculating the Cohen's kappa, percentage agreement, and prevalence‐adjusted and bias‐adjusted kappa (PABAK).

Results

Two broad themes emerged from these data: (1) Working for Yourself and (2) Strategies. Although the women identified concerns about participation in microenterprise, flexibility, freedom, and feeling purposeful were motivators to pursue a small business. The kappa statistics on the five transcripts revealed poor inter‐rater agreement, yet PABAK, which is a more sophisticated inter‐rater reliability index, indicated that inter‐rater agreement between the two raters was satisfactory.

Conclusion

Despite the challenges associated with microenterprise in the US, women found value in working for themselves.
Proanthocyanidins from Grape Seeds Inhibit UV–Radiation‐Induced Immune Suppression in Mice: Detection and Analysis of Molecular and Cellular Targets
Authors: Katiyar Santosh K.
Published: August 2014

Ultraviolet (UV)–radiation‐induced immunosuppression has been linked with the risk of skin carcinogenesis. Approximately, 2 million new cases of skin cancers, including melanoma and nonmelanoma, diagnosed each year in the USA and therefore have a tremendous bad impact on public health. Dietary phytochemicals are promising options for the development of effective strategy for the prevention of photodamaging effects of UV radiation including the risk of skin cancer. Grape seed proanthocyanidins (GSPs) are such phytochemicals. Dietary administration of GSPs with AIN76A control diet significantly inhibits UV‐induced skin tumor development as well as suppression of immune system. UV‐induced suppression of immune system is commonly determined using contact hypersensitivity (CHS) model which is a prototype of T–cell‐mediated immune response. We present evidence that inhibition of UV‐induced suppression of immune system by GSPs is mediated through: (i) the alterations in immunoregulatory cytokines, interleukin (IL)‐10 and IL‐12, (ii) DNA repair, (iii) stimulation of effector T cells and (iv) DNA repair‐dependent functional activation of dendritic cells in mouse model. These information have important implications for the use of GSPs as a dietary supplement in chemoprevention of UV‐induced immunosuppression as well as photocarcinogenesis.
Violators amongst Us: International Regimes and the Role of Compliance, a Case Study on Official Development Assistance
Authors: Dobransky Steve
Published: August 2014

This article extensively reviews and evaluates international regime theory and the importance of noncompliance. It uses international foreign aid, specifically official development assistance (ODA), to test regime theory and compliance levels. Many scholars have argued that states tend to comply fully with regime tenets based upon rationality, common values, and other reasons. TheODAcase study presents a strong argument against past claims, as it demonstrates that regimes can have large‐scale violations from the beginning and over the long term. This study measures the limits and effectiveness of regime theory and develops a more comprehensive and current perspective. I propose a new definition of international regimes and offer a concise description of the purposes and characteristics of regimes. This is the first major study emphasizing noncompliance as a key theoretical and real‐world issue. It hopes to encourage the continued search to improve understanding of international regimes and their operations.

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