bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysing family service needs of typically underserved families in the USA
Authors: Samuel P. S. , Hobden K. L. , LeRoy B. W. , Lacey K. K.
Published: December 2011

Background  Present day service systems evolved from the traditional model of disability intervention where the child with the disability and the family were viewed as pathological entities that needed to be fixed rather than supported. Scholars have increasingly called for a greater focus on the family in service delivery, but few studies have empirically examined the practical reality of such a shift. The present paper examines the disability‐related formal service supports within the family quality of life (FQOL) framework in a sample of predominantly low‐income, minority families in the USA.

Methods  Cross‐sectional data collected from a convenience sample of 149 families using the Family Quality of Life Survey (FQOLS‐2006) was analysed at the univariate, bivariate and multivariate levels.

Results  Over half of the families indicated that they needed more help from the service system, and the largest barrier to accessing services was a lack of information. Almost all families viewed service support as very important to their overall FQOL; however, only half of them were satisfied with the formal support that they were receiving. Less than half of the families reported having many service support opportunities and high attainment of service support, although most took high initiative in pursuing formal supports. The path model illustrated the complex inter‐relationships between the six dimensions of service support.

Conclusions  Findings underscore the need for resources to empower families and the value of using the FQOLS‐2006 to ascertain the service support needs and strengths of families.
Development of a standardised Occupational Therapy – Driver Off‐Road Assessment Battery to assess older and/or functionally impaired drivers
Authors: Unsworth Carolyn A. , Baker Anne , Taitz Carla , Chan Siew‐Pang , Pallant Julie F. , Russell Kay J. , Odell Morris
Published: December 2011

Introduction:  Research has been conducted over several years to develop a new off‐road assessment battery referred to as the Occupational Therapy ‐ Driver Off‐Road Assessment Battery. This article documents the development of the Battery, and provides preliminary research evidence to support its content and predictive validity.

Methods:  Literature reviews and a focus group with nine driver assessor occupational therapists were undertaken, as well as data collection using the Occupational Therapy ‐ Driver Off‐Road Assessment Battery with 246 clients. A Classification and Regression Tree model was constructed to ascertain the predictive validity of the Battery, with fitness‐to‐drive as the outcome.

Results:  Twenty‐one physical, 13 sensory and seven assessments of cognition/perception were identified as being reflective of the skills required for driving. Following rating of their psychometric properties, the best assessments were presented to focus group members. The driver assessors supported the inclusion of several assessments and encouraged the development of new assessments. A draft version of the Occupational Therapy ‐ Driver Off‐Road Assessment Battery was tested and found to have excellent predictive validity for client on‐road performance of 82.6%. The Classification and Regression Tree model showed that client performance on tests included in the Battery should be used together, rather than in isolation, to support fitness‐to‐drive recommendations.

Conclusion:  This research identified the most suitable physical, sensory and cognitive assessments to include in the Occupational Therapy ‐ Driver Off‐Road Assessment Battery, and provided support for its validity. The development of this standardised battery assists driver assessors to accurately and consistently assess and report the off‐road driving capacity of clients.
Anti‐platelet therapy and managing ulcer risk
Authors: Chan Francis K L
Published: December 2011

Low‐dose aspirin (ASA) has emerged as one of the most important causes of peptic ulcer bleeding in developed countries. Among the risk factors of ASA‐associated ulcer bleeding, Helicobacter pylori infection is one of the few that is treatable. Recent evidence showed that among patients with a history of ASA‐associated ulcer bleeding, the long‐term incidence of recurrent bleeding with ASA use is low after eradication of H. pylori alone. Thus, test‐and‐treat H. pylori is a potentially useful strategy for ASA users with high ulcer risk. However, the risk of bleeding is further increased by combining other anti‐platelet drugs (e.g. clopidogrel) with ASA in acute coronary syndromes and coronary stent placement. There is good evidence that co‐therapy with a proton‐pump inhibitor (PPI) reduces upper gastrointestinal bleeding with ASA alone or dual anti‐platelet therapy. Recently, several meta‐analyses of observational studies found that concurrent use of PPI and clopidogrel was associated with increased risk of major adverse cardiovascular events. Overall, the evidence does not suggest a clinically important interaction between PPIs and clopidogrel. However, there is a subset of patients who have reduced conversion of clopidogrel to its active metabolites due to genetic polymorphism of hepatic P‐450 (carriers of CYP2C19 loss‐of‐function alleles). Since PPIs are also metabolized by similar hepatic enzymes, it is uncertain whether patients carrying CY2C19 loss‐of‐function alleles are susceptible to concomitant PPI use. In the future, management of patients on dual anti‐platelet therapy needs to be individualized according to their thrombotic and bleeding risks.
Effect of endoscopic screening at 1‐year intervals on the clinicopathologic characteristics and treatment of gastric cancer in South Korea
Authors: Yoon Hyuk , Kim Nayoung , Lee Hye Seung , Shin Cheol Min , Park Young Soo , Lee Dong Ho , Park Do Joong , Kim Hyung Ho , Jung Hyun Chae
Published: December 2011

Background and Aim:  The recommended interval of endoscopic screening for gastric cancer (GC) in a general population is 2 years in Korea. However, it has not been determined whether endoscopic screening with a shorter interval is beneficial, especially for high‐risk groups.

Methods:  A total of 415 patients with GC were categorized according to whether they had (vigilant screening group) or not (non‐vigilant screening group) undergone endoscopic screening within 1 year before being diagnosed with GC. Clinicopathologic GC characteristics of the two groups were compared. Next, the same analyses were conducted in subgroups of patients with high risk for GC including males, current smokers, first‐degree relatives of GC; and patients with Helicobacter pylori infection, gastric atrophy, or intestinal metaplasia (IM).

Results:  The proportion of vigilant screening patients was 36.1%. Early gastric cancer (EGC) was more frequently observed in the vigilant screening group than the non‐vigilant screening group (62.7% vs 49.4%, P = 0.009). In the high‐risk factor analyses, EGC was more frequently detected among patients with severe IM in the vigilant screening group than the non‐vigilant screening group (66.7% vs 35.5%, P = 0.047). In addition, more patients in the vigilant screening group had undergone endoscopic submucosal dissection (ESD; 26.7% vs 0%, P = 0.008) and had stage I (84.6% vs 41.7%, P = 0.012) than in the non‐vigilant screening group.

Conclusions:  Endoscopic screening for GC at 1‐year intervals would be beneficial for patients with severe IM in South Korea; this method could detect EGC for which the curative modality would be ESD.
Risk factors for perforation and delayed bleeding associated with endoscopic submucosal dissection for early gastric neoplasms: Analysis of 1123 lesions
Authors: Toyokawa Tatsuya , Inaba Tomoki , Omote Shizuma , Okamoto Akiko , Miyasaka Rika , Watanabe Kazuo , Izumikawa Koichi , Horii Joichiro , Fujita Isao , Ishikawa Shigenao , Morikawa Tamiya , Murakami Takako , Tomoda Jun
Published: December 2011

Background and Aim:  Endoscopic submucosal dissection (ESD) is a useful procedure for the treatment of early gastric neoplasms; however, this advanced technique has also resulted in an increase in serious complications such as perforation and delayed bleeding. This study aimed to elucidate the risk factors for these complications.

Methods:  A total of 1123 lesions diagnosed with early gastric neoplasms and treated by ESD at three institutions were investigated. Retrospectively, patients with or without these complications were compared on the basis of the patient characteristics and treatment results.

Results:  Perforation occurred in 27 lesions (2.4%) and delayed bleeding in 56 lesions (5.0%). Multivariate analysis indicated that lesions located in the upper area of the stomach (odds ratio [OR]: 4.88, 95% confidence interval [CI]: 2.21–10.75) was associated with a significantly higher risk of perforation, and that age ≥ 80 years (OR: 2.15, 95% CI: 1.18–3.90) and a long procedure time (OR: 1.01, 95% CI: 1.001–1.007) were associated with a significantly higher risk of delayed bleeding after ESD. The en bloc resection rate (74% vs 94%) and curative resection rate (48% vs 85%) of lesions with perforation were significantly lower than those without perforation. The rate of residual disease or recurrence after ESD was significantly higher in lesions with delayed bleeding than that without delayed bleeding (5.4% vs 0.84%).

Conclusions:  This study demonstrated risk factors for perforation and delayed bleeding associated with ESD. Furthermore, it was clarified that perforation and delayed bleeding influenced post‐procedure results and prognosis after ESD.
T. Philip Ayre and the T Piece
Authors: Brown Thomas C.K.
Published: December 2011

There are some names that are well known in pediatric anesthesia but who were these people? For 60 years before work stations appeared, the Ayre’s T Piece was widely used. Appropriately initialed, T.P. Ayre (Philip) (Figure 1) was a Newcastle anesthetist who gave several hundred anesthetics as a student, so it was natural that he should become an anesthetist. Ayre’s T Piece was developed about 1937. It allowed fresh gas to be delivered to an endotracheal tube, allowing the anesthetist to be distanced from the operative field. The original T Piece was derived from part of a Phillips airway, which Ayre had been using. It had a bend in the side arm within the lumen of the connecting tube so that the gas could be delivered flowing toward or away from the patient. Ayre soon realized that patients did better when the flow was directed toward the patient. He thought that this aided inspiration. More importantly, although he may not have understood the reason, it kept the airways open preventing alveolar collapse and a reduction in functional residual capacity (FRC). This was unwittingly the first step in the development of the use of positive end expiratory pressure (PEEP). However, when it came to manufacturing the T piece, the makers preferred the simplicity of a tube attached at right angles to the airway (Figure 2), and hence, the advantage was lost until an angled side arm was developed.

 T. Philip Ayre.

image

 The golden Ayre’s T Piece presented to him on retirement.

image
THE IMPACT OF INSURANCE SUBSIDIES ON SELF‐EMPLOYMENT: DO STATE NON‐GROUP HEALTH INSURANCE REGULATIONS MATTER?
Authors: HEIM BRADLEY T. , LURIE ITHAI Z.
Published: December 2011

This paper tests whether the effect of tax‐based subsidies for self‐employed health insurance on the level of self‐employment differs with the type of non‐group insurance regulatory regime at the state level. Using a panel of tax returns from 1999 to 2004, we estimate fixed effects instrumental variable regressions for the probability of being self‐employed, allowing the effect of the after‐tax price of self‐employed health insurance to differ by regulatory regime. Our results suggest that states with community rating and guaranteed issue regulations had significantly smaller increases in the fraction of taxpayers reporting some amount of self‐employment income as a result of a decrease in the after‐tax price of self‐employed health insurance. However, there is suggestive evidence that heavily regulated states experienced a larger increase in exclusive self‐employment, particularly among older taxpayers. (JEL J24, H24, I18)
A Path to Understanding Guanxi in China's Transitional Economy: Variations on Network Behavior
Authors: Chang Kuang-Chi
Published: December 2011

Current research on guanxi (Chinese social connections) suffers from conceptual confusion. This article presents a new theoretical framework for understanding guanxi in the face of China's economic and social transformations. Guanxi is viewed as a purposive network behavior that can take different “strategic” forms, such as accessing, bridging, and embedding. Pairing this conceptualization with a social-evolutionary framework, I argue that the emergence and increasing or decreasing prevalence of each form over time result from (1) a combination of factors at three analytical levels—microagency, mesonetwork, and macroinstitutional—and (2) endogenous processes of selection. By focusing on behavioral forms and their evolution, this framework is able to bridge divides in the guanxi literature, provide a foundation for comparative studies of network behavior across societies, and connect the study of guanxi with economic sociology more broadly.
European Union Economies Facing ‘Baumol's Disease’ within the Service Sector*
Authors: FERNANDEZ RAFAEL , PALAZUELOS ENRIQUE
Published: December 2011

This article analyzes the productivity of the service sector within the countries of the European Union during the period 1994–2005. After disaggregating the sector into 11 branches, the article quantifies the relative contribution of each branch to the growth of service sector aggregate productivity. The main conclusion is that the structure of the industry is increasingly dependent on those branches which have lower growth in labour productivity. This conclusion reveals that the EU service sector suffers from ‘Baumol's disease’, which helps to accentuate the slow productivity growth that characterizes this sector.
Modulation of glutamate release from parallel fibers by mGlu4 and pre‐synaptic GABAA receptors
Authors: Antflick Jordan E. , Hampson David R.
Published: December 2011

J. Neurochem. (2012) 120, 552–563.

The regulation of pre‐synaptic glutamate release is important in the maintenance and fidelity of excitatory transmission in the nervous system. In this study, we report a novel interaction between a ligand‐gated ion channel and a G‐protein coupled receptor which regulates glutamate release from parallel fiber axon terminals. Immunocytochemical analysis revealed that GABAA receptors and the high affinity group III metabotropic glutamate receptor subtype 4 (mGlu4) are co‐localized on glutamatergic parallel fiber axon terminals in the cerebellum. GABAA and mGlu4 receptors were also found to co‐immunoprecipitate from cerebellar membranes. Independently, these two receptors have opposing roles on glutamate release: pre‐synaptic GABAA receptors promote, while mGlu4 receptors inhibit, glutamate release. However, coincident activation of GABAA receptors with muscimol and mGlu4 with the agonist (2S)‐S‐2‐amino‐4‐phosphonobutanoic acid , increased glutamate release from [3H]glutamate‐loaded cerebellar synaptosomes above that observed with muscimol alone. Further support for an interaction between GABAA and mGlu4 receptors was obtained in the mGlu4 knockout mouse which displayed reduced binding of the GABAA ligand [35S]tert‐butylbicyclophosphorothionate, and decreased expression of the α1, α6, β2 GABAA receptor subunits in the cerebellum. Taken together, our data suggest a new role for mGlu4 whereby simultaneous activation with GABAA receptors acts to amplify glutamate release at parallel fiber‐Purkinje cell synapses.
Leaching of nitrate and phosphorus after autumn and spring application of separated solid animal manures to winter wheat
Authors: Sørensen P. , RubÆk G. H.
Published: December 2011

Animal slurry can be separated into solid and liquid manure fractions to facilitate the transport of nutrients from livestock farms. In Denmark, untreated slurry is normally applied in spring whereas the solid fraction may be applied in autumn, causing increased risk of nitrate and phosphorus (P) leaching. We studied the leaching of nitrate and P in lysimeters with winter wheat crops (Triticum aestivum L.) after autumn incorporation versus spring surface application of solid manure fractions, and we compared also spring applications of mineral N fertilizer and pig slurry. Leaching was compared on a loamy sand and a sandy loam soil. The leaching experiment lasted for 2 yr, and the whole experiment was replicated twice. Nitrate leaching was generally low (19–34 kg N/ha) after spring applications of mineral fertilizer and manures. Nitrate leaching increased significantly after autumn application of the solid manures, and the extra nitrate leached was equivalent to 23–35% of total manure N and corresponded to the ammonium content of the manures. After spring application of solid manures and pig slurry, only a slight rise in N leaching was observed during the following autumn/winter (<5% of total manure N). Total P leaching was 40–165 g P/ha/yr, and the application of solid manure in autumn did not increase P leaching. The nitrogen fertilizer replacement value of solid manure N was similar after autumn and spring application (17–32% of total N). We conclude that from an environmental perspective, solid manure fractions should not be applied to winter wheat on sandy and sandy loam soils under humid North European conditions.
The GPCR OGR1 (GPR68) mediates diverse signalling and contraction of airway smooth muscle in response to small reductions in extracellular pH
Authors: Saxena H , Deshpande DA , Tiegs BC , Yan H , Battafarano RJ , Burrows WM , Damera G , Panettieri RA , DuBose Jr TD , An SS , Penn RB
Published: December 2011

BACKGROUND AND PURPOSE

Previous studies have linked a reduction in pH in airway, caused by either environmental factors, microaspiration of gastric acid or inflammation, with airway smooth muscle (ASM) contraction and increased airway resistance. Neural mechanisms have been shown to mediate airway contraction in response to reductions in airway pH to < 6.5; whether reduced extracellular pH (pHo) has direct effects on ASM is unknown.

EXPERIMENTAL APPROACH

Intracellular signalling events stimulated by reduced pHo in human cultured ASM cells were examined by immunoblotting, phosphoinositide hydrolysis and calcium mobilization assays. ASM cell contractile state was examined using magnetic twisting cytometry. The expression of putative proton‐sensing GPCRs in ASM was assessed by real‐time PCR. The role of ovarian cancer G protein‐coupled receptor 1 (OGR1 or GPR68) in acid‐induced ASM signalling and contraction was assessed in cultures subjected to siRNA‐mediated OGR1 knockdown.

KEY RESULTS

ASM cells responded to incremental reductions in pHo (from pH 8.0 to pH 6.8) by activating multiple signalling pathways, involving p42/p44, PKB, PKA and calcium mobilization. Coincidently, ASM cells contracted in response to decreased pHo with similar ‘dose’‐dependence. Real‐time PCR suggested OGR1 was the only proton‐sensing GPCR expressed in ASM cells. Both acid‐induced signalling (with the exception of PKB activation) and contraction were significantly attenuated by knockdown of OGR1.

CONCLUSIONS AND IMPLICATIONS

These studies reveal OGR1 to be a physiologically relevant GPCR in ASM cells, capable of pleiotropic signalling and mediating contraction in response to small reductions in extracellular pH. Accordingly, ASM OGR1 may contribute to asthma pathology and represent a therapeutic target in obstructive lung diseases.
Clear‐Cell Papulosis: A Rare Entity That May Be Misconstrued Pathologically as Normal Skin
Authors: Wysong Ashley , Sundram Uma , Benjamin Latanya
Published: December 2011

Abstract:  We describe a case of multiple, discrete, hypopigmented macules in the suprapubic and axillary region in a healthy 3‐year‐old girl. The lesions first appeared at approximately 9 months of age and increased in number over time. Initial histopathologic examination by an outside dermatopathologist at 1 year of age was reported as showing nonspecific histologic changes. A repeat biopsy at 3 years of age showed large intraepidermal clear cells that expressed CKAE1/CAM5.2, CK7, and BRST2. These findings are diagnostic for clear‐cell papulosis, a rare condition that primarily affects children. Without great clinical and pathologic suspicion, this is a diagnosis that can often be overlooked because the histologic findings are virtually identical to those of normal skin.
Goal Setting and Student Achievement: A Longitudinal Study
Authors: MOELLER ALEIDINE J. , THEILER JANINE M. , WU CHAORONG
Published: December 2011

The connection between goals and student motivation has been widely investigated in the research literature, but the relationship of goal setting and student achievement at the classroom level has remained largely unexplored. This article reports the findings of a 5‐year quasi‐experimental study examining goal setting and student achievement in the high school Spanish language classroom. The implementation of LinguaFolio, a portfolio that focuses on student self‐assessment, goal setting, and collection of evidence of language achievement, was introduced into 23 high schools with a total of 1,273 students. By using a hierarchical linear model, researchers were able to analyze the relationship between goal setting and student achievement across time at both the individual student and teacher levels. A correlational analysis of the goal‐setting process and language proficiency scores reveals a statistically significant relationship between the goal‐setting process and language achievement (p < .01).
Mission or Empire, Word or Sword? The Human Capital Legacy in Postcolonial Democratic Development
Authors: Lankina Tomila , Getachew Lullit
Published: December 2011

Why are some former colonies more democratic than others? The British Empire has been singled out in the debates on colonialism for its benign influence on democracy. Much of this scholarship has focused on colonialism's institutional legacies; has neglected to distinguish among the actors associated with colonialism; and has been nation‐state focused. Our subnational approach allows us to isolate the democracy effects of key actors operating in colonial domains—Christian missionaries—from those of colonial powers. Missionaries influenced democracy by promoting education; education promoted social inclusivity and spurred social reform movements. To make our case, we constructed colonial and postcolonial period district datasets of India and conducted panel analysis of literacy and democracy variations backed by case studies. The findings challenge the conventional wisdom of the centrality of the effects of British institutions on democracy, instead also highlighting the missionaries’ human capital legacies.
Factors Associated with Improvement in Guideline‐Based Use of ICDs in Eligible Heart Failure Patients
Authors: MEHRA MANDEEP R. , ALBERT NANCY M. , CURTIS ANNE B. , GHEORGHIADE MIHAI , HEYWOOD J. THOMAS , LIU YANG , O’CONNOR CHRISTOPHER M. , REYNOLDS DWIGHT , WALSH MARY NORINE , YANCY CLYDE W. , FONAROW GREGG C.
Published: December 2011

Background: IMPROVE HF, a 24‐month performance improvement initiative for outpatient cardiology and multispecialty practices, demonstrated significant improvement in guideline‐based use of implantable cardioverter‐defibrillators (ICDs) for patients with heart failure (HF). We investigated patient, physician, and practice factors associated with improvements in ICD use.

Methods: Patients with HF or postmyocardial infarction (MI) left ventricular systolic dysfunction who met eligibility criteria for ICDs at baseline and 24 months were analyzed. Multivariate analyses were performed to identify patient, physician, and practice characteristics associated with greater improvement in ICD therapy rates from baseline to 24 months.

Results: There were 4,058 patients eligible for ICD therapy at baseline and 24 months, with 2,600 (64.1%) treated at baseline and 3,361 (82.8%) treated at 24 months (+18.7%, P < 0.001). Practice heterogeneity in ICD use was significantly decreased after implementation of the performance improvement initiative. Characteristics independently associated with improvement in use of ICD therapy included race, history of MI, presence of edema, QRS duration, months since last measured left ventricular ejection fraction, and number of physicians in the practice. Improvement in ICD use was independent of other patient, physician, and practice characteristics, including age and sex.

Conclusions: The IMPROVE HF performance improvement initiative was associated with substantially improved adherence to guideline‐recommended ICD therapy. Certain patient and practice characteristics, including race, history of MI, edema, QRS duration, and number of physicians in the practice, were independently associated with improvement in ICD use. These findings highlight the need for ongoing quality improvement monitoring and performance improvement activities. (PACE 2012; 35:135–145)
A Socio‐Emotional Relational Framework for Infidelity: The Relational Justice Approach
Authors: Williams Kirstee
Published: December 2011

Current clinical models for addressing infidelity tend not to make social context issues a central focus; yet, societal gender and power structures, such as female responsibility for relationships and limited male vulnerability, affect the etiology of affairs and create power imbalances in intimate relationships. How therapists respond to these societal influences may either limit or enhance the mutual healing of both persons in the relationship. Thus attention to these societal processes is an ethical issue. This paper presents one perspective, the Relational Justice Approach, for working with infidelity. It places gender, power, and culture at the center of intervention in couple therapy, and includes three stages: (1) creating an equitable foundation for healing, (2) placing the infidelity in a societal context, and (3) practicing mutuality. Each stage is illustrated with case examples and contrasted with current practice regarding infidelity.
Spectrophotometric assessment of peri‐implant mucosa after restoration with zirconia abutments veneered with fluorescent ceramic: a controlled, retrospective clinical study
Authors: Happe Arndt , Schulte‐Mattler Verena , Fickl Stefan , Naumann Michael , Zöller Joachim E , Rothamel Daniel
Published: December 2011

Objectives

The purpose of this study was to investigate the optical appearance of the soft tissue labial to dental implants restored with fluorescent ceramic‐veneered zircona abutments. It was hypothesized that the tested abutment design leads to an increased brightness in the marginal peri‐implant tissue, which does not differ from that of natural teeth. Moreover, a reduction of the color difference that has been reported from other abutment materials was expected.

Materials and methods

A total of 12 patients with single titanium implants in the maxillary anterior region were recruited. All implants (N = 12) were restored with zirconia abutments veneered with fluorescent ceramic and full‐ceramic crowns. Color measurements of the peri‐implant mucosa at the test sites were made of the facial aspect of the teeth using a Spectroshade‐spectrophotometer. The gingiva of a contralateral or adjacent natural tooth served as a control.

Color data (CIE‐L*a*b*color coordinates) were obtained in five incremental areas of 1 × 2 mm in both test and control sites.∆E‐values were calculated from theΔL*,Δa*andΔb*values for each patient.

Results

Data acquisition from the test site demonstrated lower mean values ofL*,a*andb*than the control site. Statistical significance between the test site and control site was reached in theL*values only in the second of the five incremental areas (P < 0.05, Wilcoxon test). However, discrepancies ina*‐andb*‐values reached a statistically significant difference in the incremental areas 1, 2 and 4, and inb* in area 5 (P < 0.05, Wilcoxon test). Medians of the∆E‐values in all five increments were found to be higher than the clinical perceptual threshold of 3.7. However, considering the original data, five individual patients did not reach the threshold in increment 1 and 2, two in increment 3 and three in increment 4. None of the patients showed lower∆E‐values than the perceptual threshold of 3.7 in increment 5, which had the largest distance from the gingival margin.

Conclusion

The tested abutment design leads to a peri‐implant soft tissue color that, in the critical marginal area, in five of 12 patients did not statistically differ from the tissue of the gingiva of natural teeth. Particularly, the brightness of the peri‐implant soft‐tissue seemed to be more adapted to the natural situation using a fluorescent abutment design.
Synergistic induction of periodontal tissue regeneration by binary application of human osteogenic protein‐1 and human transforming growth factor‐β3 in Class II furcation defects of Papio ursinus
Authors: Teare J. A. , Petit J.‐C. , Ripamonti U.
Published: December 2011

Teare JA, Petit J‐C, Ripamonti U. Synergistic induction of periodontal tissue regeneration by binary application of human osteogenic protein‐1 and human transforming growth factor‐β

3

in Class II furcation defects of Papio ursinus. J Periodont Res 2012; 47: 336–344. © 2011 John Wiley & Sons A/S

Background and Objective:  Binary applications of recombinant human osteogenic protein‐1 (hOP‐1) and transforming growth factor‐β3 (hTGF‐β3) synergize to induce pronounced bone formation. To induce periodontal tissue regeneration, binary applications of hOP‐1 and hTGF‐β3 were implanted in Class II furcation defects of the Chacma baboon, Papio ursinus.

Material and Methods:  Defects were created bilaterally in the furcation of the first and second mandibular molars of three adult baboons. Single applications of 25 μg hOP‐1 and 75 μg hTGF‐β3 in Matrigel® matrix were compared with 20:1 binary applications, i.e. 25 μg hOP‐1 and 1.25 μg hTGF‐β3. Morcellated fragments of autogenous rectus abdominis striated muscle were added to binary applications. Sixty days after implantation, the animals were killed and the operated tissues harvested en bloc. Undecalcified sections were studied by light microscopy, and regenerated tissue was assessed by measuring volume and height of newly formed alveolar bone and cementum.

Results:  The hOP‐1 and hTGF‐β3 induced periodontal tissue regeneration and cementogenesis. Qualitative morphological analysis of binary applications showed clear evidence for considerable periodontal tissue regeneration. Quantitatively, the differences in the histomorphometric values did not reach statistical significance for the group size chosen for this primate study. The addition of morcellated muscle fragments did not enhance tissue regeneration. Binary applications showed rapid expansion of the newly formed bone against the root surfaces following fibrovascular tissue induction in the centre of the treated defects.

Conclusion:  Binary applications of hOP‐1and hTGF‐β3 in Matrigel® matrix in Class II furcation defects of P. ursinus induced substantial periodontal tissue regeneration, which was tempered, however, by the anatomy of the furcation defect model, which does not allow for the rapid growth and expansion of the synergistic induction of bone formation, particularly when additionally treated with responding myoblastic stem cells.
Visual and confocal microscopic interpretation of patch tests to benzethonium chloride and benzalkonium chloride
Authors: Benjamin Bohaty , Chris Fricker , Salvador González , Melissa Gill , Susan Nedorost
Published: December 2011

Background

Quaternary ammonium compounds (Quats), such as benzalkonium chloride (BAC) and benzethonium chloride (BEC), are widely used as antibacterial active ingredients and preservatives in personal care products, disinfectants, and ophthalmic preparations. BAC is known to be a marginal irritant when patch tested at 0.15% aq. Data on BEC are limited.

Objective

To differentiate irritant from allergic patch test reactions to quaternary ammonium compounds.

Methods

Eight subjects who were considered likely to react based on history of rash after exposure to disinfectants or a history of prior positive patch test to BAC were recruited, as well as two patients undergoing routine patch testing. BAC (0.15% aq), BAC (0.15% pet), BEC (0.05% aq), BEC (0.15% pet), BEC (0.15% aq), BEC (0.5% aq), sodium lauryl sulfate (2.0%), and deionized water were applied under Finn chambers for 48 h. Four days and 7 days after application, the sites were examined visually and then by in vivo reflectance confocal microscopy (RCM) which was interpreted by blinded experts.

Results

Two patients with definite allergic reactions according to visual patch test reads and RCM were clinically relevant. Cross‐reaction between BEC and BAC was demonstrated in one patient. RCM imaging correlated well with clinical scoring and interpretation of patch test reactions in terms of irritancy vs. allergy for BEC and BAC.

Conclusion

Relevant allergic reactions to quats occur in humans. Possible cross‐reaction was noted to occur between BAC and BEC. RCM appears to be a useful tool in distinguishing between irritancy and sensitization during patch testing to BAC and BEC. Further study of prevalence and best test concentration and vehicle is needed.
The Female Sexual Function Index: Translation and Validation of an Iranian Version
Authors: Fakhri Ahmad , Pakpour Amir H. , Burri Andrea , Morshedi Hadi , Zeidi Isa Mohammadi
Published: December 2011

Introduction

Female sexual dysfunction (FSD) is a prevalent problem in the female population in Iran. A subjective assessment instrument that allows cross-cultural comparison of FSD is urgently needed.

Aim

The aims of the study were to translate, validate, and enhance cross-cultural comparability of an Iranian version (IV) of the Female Sexual Function Index (FSFI)—the IV-FSFI.

Methods

A total of 448 women (19–54 years, mean 29.7, standard deviation 7.3) from five different Iranian outpatient obstetrics and gynecology clinics were eligible for this study. The IV-FSFI was developed through forward and backward translation, revision by a research team, and a subsequent pilot study. After an interview for clinical diagnosis of FSD based on the Diagnostic and Statistical Manual of Mental Disorders, all participants completed the IV-FSFI for the validation study. Three hundred sixty-two women completed the IV-FSFI again, 4 weeks after the first visit.

Main Outcome Measures

Test–retest reliability was determined by Pearson’s product-moment correlations. Reliability was tested using Cronbach’s alpha coefficient. Construct validity was evaluated by principal component analysis using varimax rotation and by subsequent confirmatory factor analysis (CFA). Discriminant validity was assessed with between-groups analysis of variance.

Results

The overall test–retest reliability coefficients were high for each domain of the IV-FSFI (r ranging from 0.73 to 0.86) and the internal consistencies within the acceptable range (α from 0.72 to 0.90). Principal component analysis with varimax rotation revealed a best fitting five-factor structure similar to the original FSFI (χ2 = 2.1, degree of freedom = 17, P < 0.001). CFA confirmed the underlying domain structure, supporting the factorial validity of the IV-FSFI.

Conclusions

In conclusion, the newly developed IV-FSFI has demonstrated to be a reliable and valid instrument with good psychometric properties that allows a quick and accurate preliminary screening of women with unknown sexual health status in clinics and other medical settings.
Exercise is Associated with Better Erectile Function in Men Under 40 as Evaluated by the International Index of Erectile Function
Authors: Hsiao Wayland , Shrewsberry Adam B. , Moses Kelvin A. , Johnson Timothy V. , Cai Amanda W. , Stuhldreher Peter , Dusseault Beau , Ritenour Chad W.M.
Published: December 2011

Introduction

Studies have shown an association between erectile dysfunction and sedentary lifestyle in middle-aged men, with a direct correlation between increased physical activity and improved erectile function. Whether or not this relationship is present in young, healthy men has yet to be demonstrated.

Aim

The aim of this study was to assess the association between physical activity and erectile function in young, healthy men.

Main Outcome Measures

The primary end points for our study were: (i) differences in baseline scores of greater than one point per question for the International Index of Erectile Function (IIEF); (ii) differences in baseline scores of greater than one point per question for each domain of the IIEF; (iii) exercise energy expenditure; and (iv) predictors of dysfunction as seen on the IIEF.

Methods

The participants were men between the ages of 18 and 40 years old at an academic urology practice. Patients self-administered the Paffenbarger Physical Activity Questionnaire and the IIEF. Patients were stratified by physical activity into two groups: a sedentary group (≤1,400 calories/week) and an active group (>1,400 calories/week). Men presenting for the primary reason of erectile dysfunction or Peyronie’s disease were excluded.

Results

Seventy-eight patients had complete information in this study: 27 patients (34.6%) in the sedentary group (≤1,400 kcal/week) and 51 patients (65.4%) in the active group (>1,400 kcal/week). Sedentary lifestyle was associated with increased dysfunction in the following domains of the IIEF: erectile function (44.4% vs. 21.6%, P = 0.04), orgasm function (44.4% vs. 17.7%, P = 0.01), intercourse satisfaction (59.3% vs. 35.3%, P = 0.04), and overall satisfaction (63.0% vs. 35.3%, P = 0.02). There was a trend toward more dysfunction in the sedentary group for total score on the IIEF (44.4% vs. 23.5%, P = 0.057), while sexual desire domain scores were similar in both groups (51.9% vs. 41.2%, P = 0.37).

Conclusions

We have demonstrated that increased physical activity is associated with better sexual function measured by a validated questionnaire in a young, healthy population. Further studies are needed on the long-term effects of exercise, or lack thereof, on erectile function as these men age.
School‐Related Assets and Youth Risk Behaviors: Alcohol Consumption and Sexual Activity
Authors: Aspy Cheryl B. , Vesely Sara K. , Oman Roy F. , Tolma Eleni , Rodine Sharon , Marshall LaDonna , Fluhr Janene
Published: December 2011

BACKGROUND: Two risk behaviors, alcohol consumption and early initiation of sexual intercourse (ISI), can have devastating consequences for youth. The purpose of this study was to determine the association of school connectedness and school‐related behaviors (eg, academic performance, skipping school, getting into trouble at school) with these 2 risk behaviors.

METHODS: The Youth Asset Survey (YAS) was administered to 1117 youth/parent pairs in their homes using Computer‐Assisted Personal/Self‐Interviewing (CAPI/CASI). The YAS measures 17 youth assets and risk behaviors including alcohol consumption and sexual activity.

RESULTS: The mean age of the sample was 14.3 years; 53% were female; and 70% were from 2‐parent homes. Five school‐related behaviors were positively associated with no ISI. Four school‐related behaviors were positively associated with reporting no alcohol consumption in the past 30 days, including the School Connectedness asset (only among 12‐ to 13‐year‐olds), not skipping school (only among non‐Hispanic Caucasians), staying out of trouble, and paying attention.

CONCLUSIONS: School is very much a part of the lives of youth and therefore the relationship they have with their school experience is important and may influence their involvement in risk behaviors. Feeling connected to school is a positive asset that can protect youth from such risky behaviors as sexual initiation and alcohol consumption.
Evaluating the effects of climate change on the water resources for the city of Birmingham, UK
Authors: Warren Andrew J. , Holman Ian P.
Published: December 2011

Climate change is expected to affect precipitation patterns and may therefore impact upon water resource availability. The city of Birmingham in central England receives its public water supply from a catchment in the Elan Valley, mid‐Wales. Baseline and future climate projections generated from a stochastic weather generator within the United Kingdom Climate Projections 2009 and a daily soil water balance model (WaSim) were used to determine the potential impacts of climate change on hydrologically effective rainfall (HER). Annual HER is likely to decrease from baseline conditions (> 90% likelihood that HER will be reduced), with more frequent and persistent very dry spells and increasing seasonality. It is concluded that climate change will put additional stress on water resources for the city of Birmingham so that, coupled with expected increases in demand, adaptation measures to increase supply and/or reduce demand are likely to be needed.
Cytokines and growth factors modify the upregulation of contractile endothelinETAandETBreceptors in rat cerebral arteries after organ culture
Authors: Ahnstedt H. , Stenman E. , Cao L. , Henriksson M. , Edvinsson L.
Published: December 2011

Aim:

Experimental cerebral ischaemia and organ culture of cerebral arteries induce an increased endothelinETBreceptor–mediated contraction. The aim of this study was to examine whether cytokines and growth factors, known to be activated in ischaemia, can influence the expression and function of endothelin receptors after organ culture.

Methods:

Rat middle cerebral arteries were cultured for 24 h at 37 °C in humidified 5% CO2and air in culture medium alone, or with tumour necrosis factor‐α (TNF‐α), interleukin‐1β (IL‐1β), platelet‐derived growth factor (PDGF), epidermal growth factor (EGF) or basic fibroblast growth factor (bFGF). Concentration–response curves were obtained for sarafotoxin 6c (ETBreceptor agonist) and endothelin‐1 (hereETAreceptor agonist, because ofETBreceptor desensitization). The receptormRNAexpression was examined by real‐timePCRand the protein expression by immunohistochemistry andWestern blot.

Results:

Tumour necrosis factor‐α (100 ng mL−1) andEGF(20 ng mL−1) potentiated theETBreceptor–mediated contraction (increase inpEC50without change inEmax).bFGF(10 ng mL−1) and IL‐1β (10 ng mL−1) induced an enhancedETAreceptor–mediated contraction.bFGF(10 ng mL−1) significantly increased theETBmRNAlevel, andEGF(20 ng mL−1) increased theETAreceptor protein. IncreasedETBreceptormRNAand protein level also were observed after treatment withIL‐1β (10 ng mL−1).

Conclusion:

This study shows thatTNF‐α,IL‐1β,EGFandbFGFcan modify the expression and function of endothelin receptors during organ culture. Because there is similar receptor upregulation in experimental stroke, the effect of cytokines and growth factors on endothelin receptor upregulation is an interesting aspect to studyin vivo.
Does the orbitofrontal cortex signal value?
Authors: Schoenbaum Geoffrey , Takahashi Yuji , Liu Tzu‐Lan , McDannald Michael A.
Published: December 2011

The orbitofrontal cortex (OFC) has long been implicated in associative learning. Early work by Mishkin and Rolls showed that the OFC was critical for rapid changes in learned behavior, a role that was reflected in the encoding of associative information by orbitofrontal neurons. Over the years, new data—particularly neurophysiological data—have increasingly emphasized the OFC in signaling actual value. These signals have been reported to vary according to internal preferences and judgments and to even be completely independent of the sensory qualities of predictive cues, the actual rewards, and the responses required to obtain them. At the same time, increasingly sophisticated behavioral studies have shown that the OFC is often unnecessary for simple value‐based behavior and instead seems critical when information about specific outcomes must be used to guide behavior and learning. Here, we review these data and suggest a theory that potentially reconciles these two ideas, value versus specific outcomes, and bodies of work on the OFC.
Behavioral outcomes of late‐onset or early‐onset orbital frontal cortex (areas 11/13) lesions in rhesus monkeys
Authors: Bachevalier Jocelyne , Machado Christopher J. , Kazama Andy
Published: December 2011

The orbital frontal cortex (OFC) has been implicated in a number of psychiatric disorders, including depression, anxiety, phobia, and obsessive‐compulsive disorder. Thus, a better understanding of its functions will likely provide critical information to understand the specific behavioral and cognitive processes affected in these human disorders. In recent years, a growing number of studies have provided evidence for anatomical and functional differentiation within the OFC. Here we discuss the effects of selective OFC (areas 11/13) lesions on social behavior, emotional regulation, and behavioral adaptation. Damage to these specific OFC subfields in adult monkeys resulted in profound changes in the flexible modulation of responses guided by reward value that could explain the poor fear regulation and disturbed social interactions observed in the same animals. A similar pattern of results was found when the OFC lesions were done in infancy. Thus, in monkeys, self‐regulation abilities mediated by OFC areas 11/13 emerge from midinfancy through adolescence.
Neuronal signals for reward risk in frontal cortex
Authors: Schultz Wolfram , O’Neill Martin , Tobler Philippe N. , Kobayashi Shunsuke
Published: December 2011

Rewards can be viewed as probability distributions of reward values. Besides expected (mean) value, a key parameter of such distributions is variance (or standard deviation), which constitutes a measure of risk. Single neurons in orbitofrontal cortex signal risk mostly separately from value. Comparable risk signals in human frontal cortex reflect risk attitudes of individual participants. Subjective outcome value constitutes the primary economic decision variable. The terms risk avoidance and risk taking suggest that risk affects subjective outcome value, a basic tenet of economic decision theories. Correspondingly, risk reduces neuronal value signals in frontal cortex of human risk avoiders and enhances value signals in risk takers. Behavioral contrast effects and reference‐dependent valuation demonstrate flexible reward valuation. As a potential correlate, value signals in orbitofrontal neurons adjust reward discrimination to variance (risk). These neurophysiological mechanisms of reward risk on economic decisions inform and validate theories of economic decision making under uncertainty.
The orbitofrontal cortex, predicted value, and choice
Authors: Balleine Bernard W. , Leung Beatrice K. , Ostlund Sean B.
Published: December 2011

Considerable evidence suggests that choice between goal‐directed actions depends on two incentive processes encoding the reward value of the goal or outcome and the predicted value of an action based on outcome‐related stimuli. Although incentive theories generally assume that these processes are mediated by a common associative mechanism, a number of recent findings suggest that they are dissociable; the reward value of an action is derived from consummatory experience with the outcome itself, whereas the predicted value of an action is based on the presence of outcome‐associated stimuli from which estimates of the likelihood of an outcome are derived. Importantly, the orbitofrontal cortex (OFC) in rodents appears to mediate the effect of outcome‐related stimuli on choice; OFC lesions disrupt the influence of Pavlovian stimuli on choice in tests of outcome‐specific Pavlovian‐instrumental transfer. However, the influence of outcome‐related stimuli on choice involves a larger circuit including the OFC, the ventral striatum, and the amygdala. How these structures interact, however, is not yet fully understood and is an important question for future research.