bluuebunny/crossref_metadata_2025 huggingface dataset:
Paradoxical Effects of Alcohol Information on Alcohol Outcome Expectancies
Authors: Krank Marvin D. , Ames Susan L. , Grenard Jerry L. , Schoenfeld Tara , Stacy Alan W.
Published: May 2010

Background:  Cognitive associations with alcohol predict both current and future use in youth and young adults. Much cognitive and social cognitive research suggests that exposure to information may have unconscious influences on thinking and behavior. The present study assessed the impact of information statements on the accessibility of alcohol outcome expectancies.

Methods:  The 2 studies reported here investigated the effects of exposure to alcohol statements typical of informational approaches to prevention on the accessibility of alcohol outcome expectancies. High school and university students were presented with information statements about the effects of alcohol and other commercial products. The alcohol statements were taken from expectancy questionnaires. Some of these statements were presented as facts and others as myths. The retention of detailed information about these statements was manipulated by (i) divided attention versus focused attention or (ii) immediate versus delayed testing. Accessibility of personal alcohol outcome expectancies was subsequently measured using an open‐ended question about the expected effects of alcohol.

Results:  Participants reported more alcohol outcomes seen during the information task as personal expectations about the effects of alcohol use than similar unseen items. Paradoxically, myth statements were also more likely to be reported as expectancies than unseen items in all conditions. Additionally, myth statements were generated less often than fact statements only under the condition of immediate testing with strong content processing instructions.

Conclusions:  These observations are consistent with findings from cognitive research where familiarity in the absence of explicit memory can have an unconscious influence on performance. In particular, the exposure to these items in an informational format increases accessibility of the seen items even when the participants were told that they were myths. The findings have implications for the development of effective prevention materials.
Inflexible and Indifferent Alcohol Drinking in Male Mice
Authors: Lesscher Heidi M. B. , Van Kerkhof Linda W. M. , Vanderschuren Louk J. M. J.
Published: May 2010

Background:  Alcoholism is characterized by compulsive alcohol intake, but this critical feature of alcoholism is seldom captured in preclinical studies. Here, we evaluated whether alcohol‐preferring C57BL/6J mice develop compulsive alcohol drinking patterns, using adulteration of the alcohol solution with quinine, in a limited access choice paradigm. We assessed 2 independent aspects of compulsive drinking: (i) inflexible alcohol intake by testing whether mice would drink bitter alcohol solutions if this was their only source of alcohol and (ii) indifferent drinking by comparing intake of aversive and nonaversive alcohol solutions.

Methods:  Male C57BL/6J mice consumed alcohol for 2 or 8 consecutive weeks. The alcohol solution was then adulterated with graded quinine concentrations, and the effect on alcohol intake was determined.

Results:  C57BL/6J mice rapidly developed compulsive alcohol drinking patterns. Adulteration of the alcohol solution with an aversive quinine concentration failed to reduce intake, indicative of inflexible drinking behavior, after only 2 weeks of alcohol experience, although quinine adulteration did suppress the acquisition of alcohol drinking in naïve mice. After 8 weeks of alcohol consumption, the mice also became indifferent to quinine. They consumed an aversive, quinine‐containing alcohol solution, despite the simultaneous availability of an unadulterated alcohol solution. Prolonged alcohol ingestion did not alter the sensitivity to the bitter taste of quinine itself.

Conclusion:  These findings demonstrate the staged occurrence in mice of 2 distinct behavioral characteristics of alcoholism, i.e., inflexible and indifferent alcohol drinking.
Polymorphisms of Alcohol Dehydrogenase‐1B and Aldehyde Dehydrogenase‐2 and the Blood and Salivary Ethanol and Acetaldehyde Concentrations of Japanese Alcoholic Men
Authors: Yokoyama Akira , Tsutsumi Eri , Imazeki Hiromi , Suwa Yoshihide , Nakamura Chizu , Yokoyama Tetsuji
Published: May 2010

Background:  The effects of genetic polymorphism of aldehyde dehydrogenase‐2 (ALDH2) on alcohol metabolism are striking in nonalcoholics, and the effects of genetic polymorphism of alcohol dehydrogenase‐1B (ADH1B) are modest at most, whereas genetic polymorphisms of both strongly affect the susceptibility to alcoholism and upper aerodigestive tract (UADT) cancer of drinkers.

Methods:  We evaluated associations between ADH1B/ADH1C/ALDH2 genotypes and the blood and salivary ethanol and acetaldehyde levels of 168 Japanese alcoholic men who came to our hospital for the first time in the morning and had been drinking until the day before.

Results:  The ethanol levels in their blood and saliva were similar, but the acetaldehyde levels in their saliva were much higher than in their blood, probably because of acetaldehyde production by oral bacteria. Blood and salivary ethanol and acetaldehyde levels were both significantly higher in the subjects with the less active ADH1B*1/*1 genotype than in the ADH1B*2 carriers, but none of the levels differed according to ALDH2 genotype. Significant linkage disequilibrium was detected between the ADH1B and ADH1C genotypes, but ADH1C genotype did not affect the blood or salivary ethanol or acetaldehyde levels. High blood acetaldehyde levels were found even in the active ALDH2*1/*1 alcoholics, which were comparable with the levels of the inactive heterozygous ALDH2*1/*2 alcoholics with less active ADH1B*1/*1. The slope of the increase in blood acetaldehyde level as the blood ethanol level increased was significantly steeper in alcoholics with inactive heterozygous ALDH2*1/*2 plus ADH1B*2 allele than with any other genotype combinations, but the slopes of the increase in salivary acetaldehyde level as the salivary ethanol level increased did not differ between the groups of subjects with any combinations of ALDH2 and ADH1B genotypes.

Conclusions:  The ADH1B/ALDH2 genotype affected the blood and salivary ethanol and acetaldehyde levels of nonabstinent alcoholics in a different manner from nonalcoholics, and clear effects of ADH1B genotype and less clear effects of ALDH2 were observed in the alcoholics. Alterations in alcohol metabolism as a result of alcoholism may modify the gene effects, and these findings provide some clues in regard to associations between the genotypes and the risks of alcoholism and UADT cancer.
Chronic Ethanol Disrupts Circadian Photic Entrainment and Daily Locomotor Activity in the Mouse
Authors: Brager Allison J. , Ruby Christina L. , Prosser Rebecca A. , Glass J. David
Published: May 2010

Background: Chronic ethanol abuse is associated with disrupted circadian rhythms and sleep. Ethanol administration impairs circadian clock phase‐resetting, suggesting a mode for the disruptive effect of alcohol abuse on circadian timing. Here, we extend previous studies to explore the effects of chronic forced ethanol on photic phase‐resetting, photic entrainment, and daily locomotor activity patterns in C57BL/6J mice.

Methods: First, microdialysis was used to characterize the circadian patterns of ethanol uptake in the suprachiasmatic (SCN) circadian clock and correlate this with systemic ethanol levels and episodic drinking of 10 or 15% ethanol. Second, the effects of chronic forced ethanol drinking and withdrawal on photic phase‐delays of the circadian activity rhythm were assessed. Third, the effects of chronic ethanol drinking on entrainment to a weak photic zeitgeber (1 minute of 25 lux intensity light per day) were assessed. This method was used to minimize any masking actions of light that could mask ethanol effects on clock entrainment.

Results: Peak ethanol levels in the SCN and periphery occurred during the dark phase and coincided with the time when light normally induces phase‐delays in mice. These delays were dose‐dependently inhibited by chronic ethanol and its withdrawal. Chronic ethanol did not impede re‐entrainment to a shifted light cycle but affected entrainment under the weak photic zeitgeber and disrupted the daily pattern of locomotor activity.

Conclusions: These results confirm that chronic ethanol consumption and withdrawal markedly impair circadian clock photic phase‐resetting. Ethanol also disturbs the temporal structure of nighttime locomotor activity and photic entrainment. Collectively, these results suggest a direct action of ethanol on the SCN clock.
Bedside‐to‐Bench Conference: Research Agenda for Idiopathic Fatigue and Aging
Authors: Alexander Neil B. , Taffet George E. , Horne Frances McFarland , Eldadah Basil A. , Ferrucci Luigi , Nayfield Susan , Studenski Stephanie
Published: May 2010

The American Geriatrics Society, with support from the National Institute on Aging and the John A. Hartford Foundation, held its fifth Bedside‐to‐Bench research conference, “Idiopathic Fatigue and Aging,” to provide participants with opportunities to learn about cutting‐edge research developments, draft recommendations for future research, and network with colleagues and leaders in the field.

Fatigue is a symptom that older persons, especially by those with chronic diseases, frequently experience. Definitions and prevalence of fatigue may vary across studies, across diseases, and even between investigators and patients. The focus of this review is on physical fatigue, recognizing that there are other related domains of fatigue (such as cognitive fatigue).

Many definitions of fatigue involve a sensation of “low” energy, suggesting that fatigue could be a disorder of energy balance. Poor energy utilization efficiency has not been considered in previous studies but is likely to be one of the most important determinants of fatigue in older individuals. Relationships between activity level, capacity for activity, a tolerable rate of activity, and a tolerable fatigue threshold or ceiling underlie a notion of fatiguability. Mechanisms probably contributing to fatigue in older adults include decline in mitochondrial function, alterations in brain neurotransmitters, oxidative stress, and inflammation. The relationships between muscle function and fatigue are complex. A number of diseases (such as cancer) are known to cause fatigue and may serve as models for how underlying impaired physiological processes contribute to fatigue, particularly those in which energy utilization may be an important factor. A further understanding of fatigue will require two key strategies: to develop and refine fatigue definitions and measurement tools and to explore underlying mechanisms using animal and human models.
Sleep Quality in Residents of Assisted Living Facilities: Effect on Quality of Life, Functional Status, and Depression
Authors: Martin Jennifer L. , Fiorentino Lavinia , Jouldjian Stella , Josephson Karen R. , Alessi Cathy A.
Published: May 2010

OBJECTIVES: To describe sleep patterns in older adults living in assisted living facilities (ALFs) and to explore the relationship between sleep disturbance and quality of life, functional status, and depression over 6 months of follow‐up.

DESIGN: Prospective, observational cohort study.

SETTING: Eighteen ALFs in the Los Angeles area.

PARTICIPANTS: One hundred twenty‐one ALF residents aged 65 and older (mean age 85.3, 86% female, 88% non‐Hispanic white).

MEASUREMENTS:

Data were collected at baseline and 3 and 6 months after enrollment. Data collected were demographics, physical and cognitive functioning, depression, quality of life, comorbidities, medications, and subjective (i.e., questionnaires) and objective (i.e., 3 days and nights of wrist actigraphy) measures of sleep.

RESULTS: Sixty‐five percent of participants reported clinically significant sleep disturbance on the Pittsburgh Sleep Quality Index, and objective wrist actigraphy confirmed poor sleep quality. In regression analyses including sleep variables and other predictors, more self‐reported sleep disturbance at baseline was associated with worse health‐related quality of life (Medical Outcomes Study 12‐item Short Form Survey Mental Component Summary score) and worse depressive symptoms five‐item Geriatric Depression Scale at follow‐up. Worse nighttime sleep (according to actigraphy) at baseline was associated with worse activities of daily living functioning and more depressive symptoms at follow‐up.

CONCLUSIONS: Sleep disturbance is common in older ALF residents, and poor sleep is associated with declining functional status and quality of life and greater depression over 6 months of follow‐up. Studies are needed to determine whether improving sleep in ALF residents will result in improvements in these outcomes. Well‐established treatments should be adapted for use in ALFs and systematically evaluated in future research.
Glycemia and Levels of Cerebrospinal Fluid Amyloid and Tau in Patients Attending a Memory Clinic
Authors: Exalto Lieza G. , van der Flier Wiesje M. , Scheltens Phillip , Biessels Geert Jan
Published: May 2010

OBJECTIVES: To determine the association between markers of glycemia and cerebrospinal fluid (CSF) amyloid β 1–42 (Aβ42) and tau levels in patients attending a memory clinic.

DESIGN: Cross‐sectional study.

SETTING: Memory clinic.

PARTICIPANTS: Two hundred forty‐five consecutive patients attending a memory clinic. Clinical diagnoses were subjective cognitive complaints (n=91), mild cognitive impairment (n=62), Alzheimer's disease (n=58), and other dementia (n=34). Twenty‐one patients had diabetes mellitus.

MEASUREMENTS: Glycosylated hemoglobin (HbA1c); fasting blood glucose levels; and CSF levels of Aβ42, total tau, and p‐tau 181.

RESULTS: In regression analyses across the whole study sample adjusted for age, sex, and diagnostic group, there was no relationship between HbA1c or fasting glucose and CSF tau, p‐tau 182, or Aβ42 levels. Stratification for diabetes mellitus did not change the results.

CONCLUSION: These observations do not support the hypothesis that the association between dysglycemia and impaired cognitive functioning is mediated through aberrant amyloid or tau metabolism.
The 4Cs (Crash History, Family Concerns, Clinical Condition, and Cognitive Functions): A Screening Tool for the Evaluation of the At‐Risk Driver
Authors: O'Connor Margaret G. , Kapust Lissa R. , Lin Bixuan , Hollis Ann M. , Jones Richard N.
Published: May 2010

OBJECTIVES: To evaluate the effectiveness of crash history, family concerns, clinical condition, and cognitive function (the 4Cs, an interview‐based screening tool for health providers working with older drivers) in identifying at‐risk older drivers.

DESIGN: Retrospective cohort study.

SETTING: Clinical driving evaluation program at a teaching hospital in the United States.

PARTICIPANTS: One hundred sixty patients who completed comprehensive driving evaluations between 2003 and 2009.

MEASUREMENTS: Medical record information was used to identify component and total 4Cs scores. Other measurements included the Trail Making Test, the Mini‐Mental State Examination, and brake reaction time. The outcome variable was performance on a 45‐minute road test.

RESULTS: Fifty participants passed the road test, 67 failed, and 43 demonstrated marginal driving skills. The relationship between 4Cs scores and road test outcome was statistically significant (P<.001). The domains most strongly associated with road test outcome were cognitive function (P<.001) and family concerns (P=.01). Scores of 9 or greater‐on the 4Cs identified 84% of participants who were at risk for poor road test performance.

CONCLUSION: The 4Cs, an interview based screening tool, may be a useful marker to identify at‐risk older drivers.
Measuring Falls Events in Acute Hospitals—A Comparison of Three Reporting Methods to Identify Missing Data in the Hospital Reporting System
Authors: Hill Anne‐Marie , Hoffmann Tammy , Hill Keith , Oliver David , Beer Christopher , McPhail Steven , Brauer Sandra , Haines Terry P.
Published: May 2010

OBJECTIVES: To compare three different methods of falls reporting and examine the characteristics of the data missing from the hospital incident reporting system.

DESIGN: Fourteen‐month prospective observational study nested within a randomized controlled trial.

SETTING: Rehabilitation, stroke, medical, surgical, and orthopedic wards in Perth and Brisbane, Australia.

PARTICIPANTS: Fallers (n=153) who were part of a larger trial (1,206 participants, mean age 75.1±11.0).

MEASUREMENTS: Three falls events reporting measures: participants' self‐report of fall events, fall events reported in participants' case notes, and falls events reported through the hospital reporting systems.

RESULTS: The three reporting systems identified 245 falls events in total. Participants' case notes captured 226 (92.2%) falls events, hospital incident reporting systems captured 185 (75.5%) falls events, and participant self‐report captured 147 (60.2%) falls events. Falls events were significantly less likely to be recorded in hospital reporting systems when a participant sustained a subsequent fall, (P=.01) or when the fall occurred in the morning shift (P=.01) or afternoon shift (P=.01).

CONCLUSION: Falls data missing from hospital incident report systems are not missing completely at random and therefore will introduce bias in some analyses if the factor investigated is related to whether the data is missing. Multimodal approaches to collecting falls data are preferable to relying on a single source alone.
Sex Disparities in Self‐Reported Physical Functioning: True Differences, Reporting Bias, or Incomplete Adjustment for Confounding?
Authors: Louie Grant H. , Ward Michael M.
Published: May 2010

OBJECTIVES: To determine whether sex disparities in self‐reported physical functioning remain after adjusting for potential confounding factors and to assess associations for possible reporting bias.

DESIGN: Cross‐sectional survey.

SETTING: U.S. population of noninstitutionalized older adults.

PARTICIPANTS: Women and men aged 60 and older (N=5,396) who participated in the Third National Health and Nutrition Examination Survey.

MEASUREMENTS: Degree of self‐reported limitation in 11 physical functions.

RESULTS: In unadjusted models, women reported more limitations than men in 10 of 11 tasks. In multivariate ordinal logistic regression models that included adjustment for age, race or ethnicity, education level, comorbidities, smoking, hemoglobin, serum albumin, knee pain, body mass index, skeletal muscle index, and physical performance tests, women reported more limitations only in lifting or carrying 10 pounds (adjusted odds ratio=2.03, 95% confidence interval=1.45–2.84). There was no evidence of systematic reporting differences between men and women for limitations in lifting or carrying 10 pounds relative to the degree of limitation predicted by the model.

CONCLUSION: Older women have similar degrees of self‐reported limitation in physical functioning as older men of the same age, health, and physical abilities.
Survey of Geriatricians on the Effect of Fecal Incontinence on Nursing Home Referral
Authors: Grover Madhusudan , Busby‐Whitehead Jan , Palmer, RN Mary H. , Heymen Steve , Palsson Olafur S. , Goode Patricia S. , Turner Marsha , Whitehead William E.
Published: May 2010

OBJECTIVES: Determine the effect of fecal incontinence (FI) on healthcare providers' decisions to refer patients for nursing home (NH) placement.

DESIGN: Survey.

SETTING: Questionnaires were e‐mailed to participants' homes or offices. Participants could also volunteer at the 2008 American Geriatric Society annual meeting in Washington, DC.

PARTICIPANTS: Two thousand randomly selected physician members and all 181 nurse practitioner members of the American Geriatrics Society were surveyed.

MEASUREMENTS: The survey presented a clinical scenario of a 70‐year‐old woman ready for discharge from a hospital and asked about the likelihood of making a NH referral if the patient had no incontinence, urinary incontinence (UI) alone, or FI. Subsequent questions modified the clinical situation to include other conditions that might affect the decision to refer. A second survey of respondents to Survey 1 addressed possible moderators of the decision to refer (e.g., family caregiver presence, diarrhea or constipation, other physical or psychiatric limitations). Significance of differences in the relative risk (RR) for NH referral was tested using the chi‐square test.

RESULTS: Seven hundred sixteen members (24.7% response rate) completed the first survey, and 686 of the 716 (96%) completed the second. FI increased the likelihood of NH referral (RR=4.71, P<.001) more than UI did (RR=1.90, P<.001). Mobility restrictions, cognitive decline, and multiple chronic illnesses increased the likelihood of NH referral more than FI alone (P<.001 for each), but in all scenarios, adding FI further increased the likelihood of referral (P<.001). Having family caregivers willing to help with toileting attenuated the likelihood of referral.

CONCLUSION: FI increases the probability that geriatricians will refer to a NH. More‐aggressive outpatient treatment of FI might delay or prevent NH referral, improve quality of life, and reduce healthcare costs.
An Internet‐Based Communication Network for Information Transfer During Patient Transitions from Skilled Nursing Facility to the Emergency Department
Authors: Hustey Fredric M. , Palmer Robert M.
Published: May 2010

OBJECTIVES: To determine whether the implementation of an Internet‐based communication system improves the amount of essential information conveyed between a skilled nursing facility (SNF) and the emergency department (ED) during patient care transitions.

DESIGN: Interventional; before and after.

SETTING: ED of an urban teaching hospital with approximately 55,000 visits per year and a 55‐bed subacute free‐standing rehabilitation facility (the SNF).

PARTICIPANTS: All patients transferred from the SNF to the ED over 16 months.

INTERVENTION: An Internet‐based communication network with SNF–ED transfer form for communication during patient care transitions.

MEASUREMENTS: Nine elements of patient information assessed before and after intervention through chart review. Secondary outcomes: changes in efficiency of information transfer and staff satisfaction.

RESULTS: Two hundred thirty‐four of 237 preintervention and all 276 postintervention care transitions were reviewed. The Internet communication network was used in 78 (26%) of all care transitions, peaking at 40% by the end of the study. There was more critical patient information (1.85 vs 4.29 of 9 elements; P<.001) contained within fewer pages of transfer documents (24.47 vs 5.15; P<.001) after the intervention. Staff satisfaction with communication was higher among ED physicians after the intervention.

CONCLUSION: The use of an Internet‐based system increased the amount of information communicated during SNF–ED care transitions and significantly reduced the number of pages in which this information was contained.
Randomized Trial of a Delirium Abatement Program for Postacute Skilled Nursing Facilities
Authors: Marcantonio Edward R. , Bergmann Margaret A. , Kiely Dan K. , Orav E. John , Jones Richard N.
Published: May 2010

OBJECTIVES: To determine whether a delirium abatement program (DAP) can shorten duration of delirium in new admissions to postacute care (PAC).

DESIGN: Cluster randomized controlled trial.

SETTING: Eight skilled nursing facilities specializing in PAC within a single metropolitan region.

PARTICIPANTS: Four hundred fifty‐seven participants with delirium at PAC admission.

INTERVENTION: The DAP consisted of four steps: assessment for delirium within 5 days of PAC admission, assessment and correction of common reversible causes of delirium, prevention of complications of delirium, and restoration of function.

MEASUREMENTS: Trained researchers screened eligible patients. Those with delirium defined according to the Confusion Assessment Method were eligible for participation using proxy consent. Regardless of location, researchers blind to intervention status re‐assessed participants for delirium 2 weeks and 1 month after enrollment.

RESULTS: Nurses at DAP sites detected delirium in 41% of participants, versus 12% in usual care sites (P<.001), and completed DAP documentation in most participants in whom delirium was detected, but the DAP intervention had no effect on delirium persistence based on two measurements at 2 weeks (DAP 68% vs usual care 66%) and 1 month (DAP 60% vs usual care 51%) (adjusted P≥.20). Adjusting for baseline differences between DAP and usual care participants and restricting analysis to DAP participants in whom delirium was detected did not alter the results.

CONCLUSION: Detection of delirium improved at the DAP sites, but the DAP had no effect on the persistence of delirium. This effectiveness trial demonstrated that a nurse‐led DAP intervention was not effective in typical PAC facilities.
Neuropsychological Predictors of Driving Errors in Older Adults
Authors: Dawson Jeffrey D. , Uc Ergun Y. , Anderson Steven W. , Johnson Amy M. , Rizzo Matthew
Published: May 2010

OBJECTIVES: To identify neuropsychological factors associated with driving errors in older adults.

DESIGN: Cross‐sectional observational study.

SETTING: Neuropsychological assessment laboratory and an instrumented vehicle on a 35‐mile route on urban and rural roads.

PARTICIPANTS: One hundred eleven older adult drivers (aged 65–89; mean age 72.3) and 80 middle‐aged drivers (aged 40–64; mean age 57.2).

MEASUREMENTS: Explanatory variables included age, neuropsychological measures (cognitive, visual, and motor), and a composite cognitive score (COGSTAT). The outcome variable was the safety error count, as classified according to video review using a standardized taxonomy.

RESULTS: Older drivers committed an average of 35.8 ± 12.8 safety errors per drive, compared with an average of 27.8 ± 9.8 for middle‐aged drivers (P<.001). For older drivers, there was an increase of 2.6 errors per drive observed for each 5‐year age increase (P=.03). After adjustment for age, education, and sex, COGSTAT was a significant predictor of safety errors in older drivers (P=.005), with an approximately 10% increase in safety errors observed for a 10% decrease in cognitive function. Individual significant predictors of more safety errors in older drivers included poorer scores on the Complex Figure Test—Copy, the Complex Figure Test—Recall, Block Design, Near Visual Acuity, and the Grooved Pegboard task.

CONCLUSION: Driving errors in older adults tend to increase, even in the absence of neurological diagnoses. Age‐related decline in cognitive abilities, vision, and motor skills can explain some of this increase. Changes in visuospatial and visuomotor abilities appear to be particularly associated with unsafe driving in old age.
Are All Commonly Prescribed Antipsychotics Associated with Greater Mortality in Elderly Male Veterans with Dementia?
Authors: Rossom Rebecca C. , Rector Thomas S. , Lederle Frank A. , Dysken Maurice W.
Published: May 2010

OBJECTIVES: To estimate mortality risk associated with individual commonly prescribed antipsychotics.

DESIGN: Five‐year retrospective study.

SETTING: Veterans national healthcare data.

PARTICIPANTS: Predominantly male, aged 65 and older, with a diagnosis of dementia and no other indication for an antipsychotic. Subjects who received an antipsychotic were compared with randomly selected controls who did not. Exposed and control cohorts were matched according to their date of dementia diagnosis and time elapsed from diagnosis to the start of antipsychotic therapy.

MEASUREMENTS: Mortality during incident antipsychotic use.

RESULTS: Cohorts who were exposed to haloperidol (n=2,217), olanzapine (n=3,384), quetiapine (n=4,277), or risperidone (n=8,249) had more comorbidities than their control cohorts. During the first 30 days, there was a significant increase in mortality in subgroups prescribed a daily dose of haloperidol greater than 1 mg (hazard ratio (HR)=3.2, 95% confidence interval (CI)=2.2–4.5, P<.001), olanzapine greater than 2.5 mg (HR=1.5, 95% CI=1.1–2.0, P=.01), or risperidone greater than 1 mg (HR=1.6, 95% CI=1.1–2.2, P=.01) adjusted for demographic characteristics, comorbidities, and medication history using Cox regression analyses. Greater mortality was not seen when a daily dose of quetiapine greater than 50 mg (HR=1.2, 95% CI=0.7–1.8, P=.50) was prescribed, and there was no greater mortality associated with a dose less than 50 mg (HR=0.7, 95% CI=0.5–1.0, P=.03). No antipsychotic was associated with greater mortality after the first 30 days.

CONCLUSION: Commonly prescribed doses of haloperidol, olanzapine, and risperidone, but not quetiapine, were associated with a short‐term increase in mortality. Further investigations are warranted to identify patient characteristics and antipsychotic dosage regimens that are not associated with a greater risk of mortality in elderly patients with dementia.
Emergency department blood transfusion predicts early massive transfusion and early blood component requirement
Authors: Nunez Timothy C. , Dutton William D. , May Addison K. , Holcomb John B. , Young Pampee P. , Cotton Bryan A.
Published: May 2010

BACKGROUND: The purpose of this study was to evaluate the ability of uncrossmatched transfusions in the emergency department (ED) to predict early (<6 hr) massive transfusion (MT) of red blood cells (RBCs) and blood components.

STUDY DESIGN AND METHODS: All patients admitted to a Level 1 trauma center between July 2005 and June 2007 who received any transfusions and were transported directly from the scene of injury were included. Early MT was defined as the need for 10 U or more or RBCs in the first 6 hours. Early MT plasma was defined as 6 U or more of plasma in the first 6 hours. Early MT platelets (PLTs) were defined as two or more apheresis transfusions in the first 6 hours. Univariate and multivariate analyses were performed.

RESULTS: A total of 485 patients (34%) received ED transfusions (ED RBC+) and 956 (66%) did not receive ED transfusions (ED RBC–). ED RBC+ patients were younger, were more likely to be male, and arrived with more severe injuries. Multivariate regression identified ED transfusion of uncrossmatched RBC as an independent predictor of requiring early MT of RBCs (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.36‐7.59; p = 0.001), plasma (OR, 2.7; 95% CI, 1.66‐4.39; p < 0.001), and PLTs (OR, 1.9; 95% CI, 1.08‐3.41; p = 0.025).

CONCLUSION: Patients receiving uncrossmatched RBCs in the ED are more than three times more likely to receive early MT of RBCs. Additionally, patients transfused with ED RBCs are more likely to receive 6 units or more of plasma and two or more apheresis PLT transfusions. Given these findings, ED transfusion of uncrossmatched RBCs should be considered a potential trigger for activation of an institution's MT protocol.
Information and Incentives Inside the Firm: Evidence from Loan Officer Rotation
Authors: HERTZBERG ANDREW , LIBERTI JOSE MARIA , PARAVISINI DANIEL
Published: May 2010

We present evidence that reassigning tasks among agents can alleviate moral hazard in communication. A rotation policy that routinely reassigns loan officers to borrowers of a commercial bank affects the officers' reporting behavior. When an officer anticipates rotation, reports are more accurate and contain more bad news about the borrower's repayment prospects. As a result, the rotation policy makes bank lending decisions more sensitive to officer reports. The threat of rotation improves communication because self‐reporting bad news has a smaller negative effect on an officer's career prospects than bad news exposed by a successor.
Preparation of Reticulated MAX‐Phase Support with Morphology‐Controllable Nanostructured Ceria Coating for Gas Exhaust Catalyst Devices
Authors: Sun Ziqi , Liang Ying , Li Meishuan , Zhou Yanchun
Published: May 2010

Reticulated porous Ti3AlC2 ceramic, a member of the MAX‐phase family (Mn+1AXn phases, where M is an early transition metal, A is an A‐group element, and X is carbon and/or nitrogen), was prepared from the highly dispersed aqueous suspension by a replica template method. Through a cathodic electrogeneration method, nanocrystalline catalytic CeO2 coatings were deposited on the conductive porous Ti3AlC2 supports. By adjusting the pH value and cathodic deposition current, coatings exhibiting nanocellar, nanosheets‐like, or bubble‐free morphologies can be obtained. This work expects to introduce a novel practically feasible material system and a catalytic coating preparation technique for gas exhaust catalyst devices.
Nanostructures from Zirconium Diboride and Alumina Ceramics
Authors: Baldridge Tyson , Gupta Mool C. , Sun Chen‐Nan
Published: May 2010

In this paper, we describe the observation of nanostructure formation under microwave processing of zirconium diboride powder with aluminum oxide. These nanostructures appear to be formed from arcing resulting from a microwave‐induced electric field across conductive ZrB2 particles. Microwave heating allows process times <1 min. The arcing rapidly heated the ZrB2 and nearby alumina creating nanotubes and nanorods. The morphology of these nanostructures was characterized using scanning and transmission electron microscopy (TEM), showing ∼100 nm tube wall thicknesses with widths up to a few micrometer and lengths to 40 μm. Energy‐dispersive X‐ray spectroscopy showed the composition of the nanotubes included aluminum, oxygen, zirconium, and boron. Fast Fourier transform's of the TEM images provided characterization of the lattice parameters. Morphology, composition and crystallography resemble both single‐crystal aluminum borate and boron‐mullite nanotubes. The produced nanostructures could be used to reinforce high‐temperature materials, improve the durability of metal surfaces or as needles for intracellular drug delivery.
Fabrication of Structural Leucite Glass–Ceramics from Potassium‐Based Geopolymer Precursors
Authors: Xie Ning , Bell Jonathan. L. , Kriven Waltraud M.
Published: May 2010

Leucite glass–ceramics were fabricated by cold isostatically pressing K2O·Al2O3·4SiO2·11H2O geopolymer powders into pellets followed by firing at 950°–1200°C, every 50°C in air. Leucite formation was observed in specimens heat treated to ≥1000°C. The relative density, Vickers hardness, fracture toughness, and biaxial flexural strength of sintered samples ranged approximately 96%–98%, 767–865 kg/mm2, 0.94–2.36 MPa·m1/2, and 90–140 MPa, respectively. The toughness and biaxial flexure strength increased with the firing temperature, while the density and hardness were relatively constant. Scanning electron microscopic and transmission electron microscopic analysis revealed that the sintered geopolymer formed leucite crystals and a compositionally variable glassy phase. Samples heated to 1200°C attained the highest biaxial flexure strength and toughness. This higher strength is believed to arise from an optimum in density, leucite content, and crystal size distribution.
Permanent Ge Coordination Change Induced by Pressure in La2O3–B2O3–GeO2 Glass
Authors: Coussa‐Simon Camille , Martinet Christine , De Ligny Dominique , Deschamps Thierry , Trapananti Angela , Champagnon Bernard
Published: May 2010

In this study, we report the results of an in situ X‐ray absorption spectroscopy investigation of the La2O3–B2O3–GeO2 (LBG) glass compressed in a diamond anvil cell until 17 GPa at ambient temperature. A pressure‐induced coordination change of germanium from fourfold to sixfold is shown here. The analysis of Ge K‐edge X‐ray absorption near‐edge structure spectra supports a model of mixing of fourfold and sixfold coordinated Ge sites during the compression/decompression cycle. This transformation proves to be irreversible: about 25% of sixfold coordinated Ge still exists at ambient pressure. This phenomenon underlines a polymorphism property of the LBG glass, whose origin lies in the complexity of composition.
Fine‐Grained Transparent Spinel Windows by the Processing of Different Nanopowders
Authors: Krell Andreas , Hutzler Thomas , Klimke Jens , Potthoff Annegret
Published: May 2010

The study investigated the deagglomeration of spinel nanopowders (MgO·nAl2O3, n≈1) from different syntheses in correlation with their resulting performance on green processing and sintering. Transmission results are addressed as a means of evaluating the degree of last pore elimination. As a result, clear transparent components with a thickness of up to 20 mm and lateral dimensions up to about 240 mm were manufactured equally successfully from spinel powders with lower specific surface areas (13–15 m2/g↔120 nm particle size) or from nanopowders (25–35 m2/g↔55 nm particle size) if the different performance of these powders was balanced by differently accommodated processing and sintering. However, without additives only the 55 nm starting powders enabled the preparation of microstructures with a grain size of 270 nm and a maximum transmittance at sintering temperatures <1300°C. On the other hand, a better optical homogeneity was achieved for materials fabricated from the 120 nm powder.
In Situ Time‐Resolved X‐Ray Diffraction of Tobermorite Formation Process Under Autoclave Condition
Authors: Kikuma Jun , Tsunashima Masamichi , Ishikawa Tetsuji , Matsuno Shin‐Ya , Ogawa Akihiro , Matsui Kunio , Sato Masugu
Published: May 2010

Hydrothermal formation reaction of tobermorite has been investigated by in situ X‐ray diffraction (XRD) using high‐energy X‐rays from a synchrotron radiation source in combination with a newly developed autoclave cell and a photon‐counting pixel array detector. XRD measurements were conducted in a temperature range of 100°–190°C throughout 7.5 h of reaction time with a time interval of 4.25 min under a saturated steam pressure. Two samples using different types of cements were compared: high early strength Portland cement and ordinary Portland cement. In both cases, noncrystalline calcium silicate hydrate (C–S–H), hydroxylellestadite (HE), and katoite were clearly observed as intermediate materials. A possible mechanism that the consumption of noncrystalline C–S–H and HE as precursors of tobermorite occurs sequentially rather than simultaneously has been suggested. Four tobermorite peaks corresponding to different reflections started to be detected at the same timing, suggesting tobermorite is formed without any preference for a particular crystal axis at the beginning. A decrease in the Bragg spacing of the basal reflection during the reaction was observed, implying the increase of periodicity along the c‐axis.
Ferroelectric and Impedance Behavior of La‐ and Ti‐Codoped BiFeO3 Thin Films
Authors: Wu Jiagang , Wang John
Published: May 2010

To study the effects of La and Ti cosubstitutions on ferroelectric and impedance behavior of BiFeO3, (Bi0.90La0.10)FeO3, Bi(Fe0.95Ti0.05)O3, and (Bi0.90La0.10)(Fe0.95Ti0.05)O3 thin films were deposited on LaNiO3‐buffered Pt/TiO2/SiO2/Si(100) substrates by off‐axis radio frequency sputtering. The (Bi0.90La0.10)(Fe0.95Ti0.05)O3 thin film exhibits an Ohmic conduction behavior in the range of the electric field investigated, and its leakage current at high electric fields is greatly suppressed. The Curie temperature of (Bi0.90La0.10)(Fe0.95Ti0.05)O3 decreases to ∼690°C due to La and Ti cosubstitutions, and a direct band gap of 2.88 eV is identified for the (Bi0.90La0.10)(Fe0.95Ti0.05)O3 thin film, demonstrating the increase of a direct band gap with La and Ti codoping. A high remanent polarization (2Pr∼102.6 μc/cm2 and 2Ec∼538.0 kV/cm) as confirmed by positive up negative down was obtained for the (Bi0.90La0.10)(Fe0.95Ti0.05)O3 thin film at room temperature because of the great inhibition of the leakage current density at high electric fields. The La and Ti cosubstitutions also improve the fatigue behavior of BiFeO3 thin film. Impedance analyses at different temperatures and frequencies show that the La‐ and Ti‐codoped BFO thin film exhibits rather different dielectric relaxation and conduction mechanism as compared with those of the undoped and La‐ or Ti‐doped BFO thin films, where oxygen vacancies appear to be involved in the dielectric relaxation and conduction processes of these thin films.
Diameter‐Dependent Photocatalytic Activity of Electrospun TiO2 Nanofiber
Authors: Li Heping , Zhang Wei , Li Bin , Pan Wei
Published: May 2010

TiO2 nanofibers with controllable diameters have been successfully fabricated by a facile electrospinning method. Their crystal structure and morphology features were monitored by X‐ray diffraction and scanning electron microscopy. The photocatalytic activity of TiO2 nanofibers was evaluated by the photodecomposition of rhodamine B aqueous solution. It was found that the diameter of the nanofibers, controlled by changing the tetrabutyl titanate content in the precursor solution, plays an important role on the photocatalytic activity of TiO2 nanofibers. There is an optimal value of diameter on the photocatalytic activity of TiO2 nanofibers, which increases with the increasing of fiber diameter up to about 200 nm and then decreases. The mechanism may relate to the dynamics of electron/hole recombination on surface sites.
Gesturing Saves Cognitive Resources When Talking About Nonpresent Objects
Authors: Ping Raedy , Goldin‐Meadow Susan
Published: May 2010

In numerous experimental contexts, gesturing has been shown to lighten a speaker’s cognitive load. However, in all of these experimental paradigms, the gestures have been directed to items in the “here‐and‐now.” This study attempts to generalize gesture’s ability to lighten cognitive load. We demonstrate here that gesturing continues to confer cognitive benefits when speakers talk about objects that are not present, and therefore cannot be directly indexed by gesture. These findings suggest that gesturing confers its benefits by more than simply tying abstract speech to the objects directly visible in the environment. Moreover, we show that the cognitive benefit conferred by gesturing is greater when novice learners produce gestures that add to the information expressed in speech than when they produce gestures that convey the same information as speech, suggesting that it is gesture’s meaningfulness that gives it the ability to affect working memory load.
A Computational Account of the Development of the Generalization of Shape Information
Authors: Doumas Leonidas A. A. , Hummel John E.
Published: May 2010

Abecassis, Sera, Yonas, and Schwade (2001)showed that young children represent shapes more metrically, and perhaps more holistically, than do older children and adults. How does a child transition from representing objects and events as undifferentiated wholes to representing them explicitly in terms of their attributes? According to RBC (Recognition‐by‐Components theory;Biederman, 1987), objects are represented as collections of categorical geometric parts (“geons”) in particular categorical spatial relations. We propose that the transition from holistic to more categorical visual shape processing is a function of the development of geon‐like representations via a process of progressive intersection discovery. We present an account of this transition in terms of DORA (Doumas, Hummel, & Sandhofer, 2008), a model of the discovery of relational concepts. We demonstrate that DORA can learn representations of single geons by comparing objects composed of multiple geons. In addition, as DORA is learning it follows the same performance trajectory as children, originally generalizing shape more metrically/holistically and eventually generalizing categorically.
Curiouser and Curiouser: Montgomery McFate's Strange Interpretation of the Relationship between Anthropology and Counterinsurgency
Authors: Sluka Jeffrey A.
Published: May 2010

In 2005, in an article in Military Review titled “Anthropology and Counterinsurgency: The Strange Story of their Curious Relationship,” Dr. Montgomery McFate launched a serious academic assault on the anthropological tradition of noninvolvement in mission‐related military and counterinsurgency research. Dr. McFate was then instrumental in the establishment of the Human Terrain System in 2006, which has “embedded” social scientists with front‐line army units in Iraq and Afghanistan. This has caused great concern among anthropologists and renewed interest in the professional ethics of the discipline. This article critically reviews McFate's accounting of the relationship between anthropology and counterinsurgency and argues that it is her particular reading of history of that relationship that is curious and strange. Viewed in its proper historical context, and illustrated with the example of the politics and ethics of my research on community support for the Irish Republican Army and Irish National Liberation Army in Northern Ireland, the antipathetic relationship that had evolved was perfectly appropriate, ethical, and in no sense “curious” or “strange.” This article critiques McFate's article as a fundamentally flawed revisionist history intended to legitimate and facilitate the active involvement of anthropologists with the US military in the “war on terrorism” in Iraq, Afghanistan, and beyond.
Correlation between immature platelet fraction and reticulated platelets. Usefulness in the etiology diagnosis of thrombocytopenia
Authors: Pons Issac , Monteagudo Manuel , Lucchetti Gianni , Muñoz Luz , Perea Granada , Colomina Isabel , Guiu Joaquim , Obiols Joaquima
Published: May 2010

Background:  Reticulated platelets (RP) are a surrogate marker for megakaryocytic activity, but the limitation of this determination is the lack of standardization of methodology. The determination of the immature platelet fraction (IPF) is performed in a simple, automated, and reproducible way between laboratories. We analyzed the correlation between IPF and RP, and usefulness of IPF in patients with thrombocytopenia.

Methods:  RP were determined by flow cytometry using double staining with thiazole orange and CD61 PerCP®. IPF was performed with Sysmex XE2100 analyzer. We used a control group with normal platelets, and thrombocytopenic patients were classified into three groups: Group 1. Central thrombocytopenia, Group 2. Thrombocytopenia as a result of enhanced peripheral platelet destruction, and Group 3. Peripheral non‐immune thrombocytopenia by abnormal distribution.

Results:  Fourteen controls and 66 patients were analyzed. Group 1: 25 patients, they had mean and confidence interval 95% (95% CI) for IPF 8.67% (6.49–10.46%) and RP 4.08% (2.86–5.30%). Group 2: 20 patients, they had mean and 95%CI for IPF 16.80% (12.20–21.39%) and RP 16.14% (9.89–22.40%). Group 3: 21 patients, they had mean and 95% CI for IPF 9.04% (6.95–11.14%) and RP 5.23% (3.41–7.05%). The overall Pearson linear correlation between IPF and RP was r: 0.65. There were statistically significant differences in values of IPF and RP between Group 2 and the other two groups (P < 0.01).

Conclusion:  There is a good correlation between IPF and RP mainly in thrombocytopenia by peripheral destruction. Determination of IPF is an easy technique in their implementation, standardized and reproducible, so it could be a useful screening technique in patients with thrombocytopenia.
Organ transplantation and skin cancer: basic problems and new perspectives
Authors: Hofbauer Günther F.L. , Bavinck Jan Nico Bouwes , Euvrard Sylvie
Published: May 2010

Please cite this paper as: Organ transplantation and skin cancer: basic problems and new perspectives. Experimental Dermatology 2010; 19: 473–483.

Abstract:  Solid organ transplant and subsequent graft survival have increased worldwide, while immunosuppression has prevented rejection with increasing success. Side effects of cutaneous infection and neoplasm, however, affect the majority of solid organ transplant recipients (OTRs). Squamous cell carcinoma of the skin (SCC) is the most common neoplasm overall following organ transplant with a risk that is 60–100 times greater than for the immunocompetent population. This review focuses on questions of ongoing debate about SCC formation in OTRs such as viral carcinogenesis, systemic photoprotection, photosensitization by drugs, the impact of immunosuppressive drugs and inflammation as a driver of carcinogenesis.