bluuebunny/crossref_metadata_2025 huggingface dataset:
The Emotional Eye: Red Sclera as a Uniquely Human Cue of Emotion
Authors: Provine Robert R. , Nave‐Blodgett Jessica , Cabrera Marcello O.
Published: August 2013

The sclera, the eye's tough white outer layer, provides the ground necessary for the display of its own color and that of the overlying membrane, the conjunctiva. This study evaluated the sclera as a cue of emotion by contrasting the ratings of 38 subjects for the level of anger, fear, sadness, disgust, happiness, or surprise of normal (untinted) eye images with copies of those images that were reddened by digital editing. Subjects rated individuals with reddened sclera as having more anger, fear, disgust, and sadness, and less happiness than those with normal, untinted sclera. Surprise was the only emotion unaffected by scleral redness. Humans, but not other primates, have evolved the white sclera necessary to display the blood flow in the overlying conjunctiva that produces the redness associated with certain emotional states.
Effect of Mating Activity and Dominance Rank on Male Masturbation Among Free‐Ranging Male Rhesus Macaques
Authors: Dubuc Constance , Coyne Sean P. , Maestripieri Dario
Published: August 2013

The adaptive function of male masturbation is still poorly understood, despite its high prevalence in humans and other animals. In non‐human primates, male masturbation is most frequent among anthropoid monkeys and apes living in multimale–multifemale groups with a promiscuous mating system. In these species, male masturbation may be a non‐functional by‐product of high sexual arousal or be adaptive by providing advantages in terms of sperm competition or by decreasing the risk of sexually transmitted infections. We investigated the possible functional significance of male masturbation using behavioral data collected on 21 free‐ranging male rhesus macaques (Macaca mulatta) at the peak of the mating season. We found some evidence that masturbation is linked to low mating opportunities: regardless of rank, males were most likely to be observed masturbating on days in which they were not observed mating, and lower‐ranking males mated less and tended to masturbate more frequently than higher‐ranking males. These results echo the findings obtained for two other species of macaques, but contrast those obtained in red colobus monkeys (Procolobus badius) and Cape ground squirrels (Xerus inauris). Interestingly, however, male masturbation events ended with ejaculation in only 15% of the observed masturbation time, suggesting that new hypotheses are needed to explain masturbation in this species. More studies are needed to establish whether male masturbation is adaptive and whether it serves similar or different functions in different sexually promiscuous species.
Midge (Chironomidae, Chaoboridae, Ceratopogonidae) assemblages and their relationship with biological and physicochemical variables in shallow, polymictic lakes
Authors: Wazbinski Kristin E. , Quinlan Roberto
Published: August 2013

We explored the relationship of aquatic midge assemblages with physicochemical and biological environmental gradients to assess which variables may govern the distribution of midge larvae in 47 shallow, polymictic lakes across New Jersey and New York State (NJ/NY) in the United States of America.

Subfossil taxa collected from surficial sediments (0–1 cm sediment depth), comprising 50 taxa from 47 lakes, were analysed in conjunction with environmental variables using multivariate statistical techniques.

Alkalinity, maximum depth, surface area, total phosphorus and pH were identified as significant and ecologically relevant variables that explained the most variation in the midge assemblage across NJ/NY. Lake trophic state was the main driver for midge distributions in NJ/NY lakes. Biological gradients, such as per cent macrophyte cover or algal productivity (as chlorophyll a concentration), did not explain a significant portion of the variation in midge community composition. The addition of chaoborid larvae to ordinations strengthened the relationship between midge community structure and bottom oxygen concentration in NJ/NY lakes.

Our results confirm that complex species–environment relationships in shallow, polymictic lakes create challenges for assessing midge assemblages along a particular environmental gradient, independently of other environmental conditions. However, it may still be possible to develop palaeolimnological inference models using midge remains to assess general historical patterns of disturbance for NJ/NY and other polymictic lakes, provided it is understood that midge‐based inferences integrate some covariation in changes along several environmental gradients.
Squeezing the most out of existing literature: a systematic re‐analysis of published evidence on ecological responses to altered flows
Authors: Angus Webb J. , Miller Kimberly A. , King Elise L. , de Little Siobhan C. , Stewardson Michael J. , Zimmerman Julie K. H. , LeRoy Poff N.
Published: August 2013

Human‐induced changes in river flow regimes are ubiquitous worldwide. Although numerous case studies have identified negative ecological impacts of changes in different aspects of flow regimes (e.g. magnitude, timing), there have been few attempts to systematically review this literature to derive general relationships regarding ecological responses to changes in flow regimes.

Systematic literature reviews can inform science and management in ecologically complex systems not amenable to experimentation. However, such analysis of existing literature is often limited by inconsistent study design and data reporting. To attempt to overcome these difficulties, we used the recently developed Eco Evidence method and software to analyse 165 studies of ecological responses to changes in river flow regimes.

Eco Evidence provides a rule set and standardised list of terms to assist reviewers to interpret consistently the results of disparate studies. The companion software assists with the synthesis of this information to reach transparent and repeatable conclusions regarding cause–effect hypotheses of ecological responses to environmental drivers.

We compared our results to those of a recent, informal systematic review of the same studies, which is proving extremely influential. Stronger conclusions are reached when evidence is weighted, classified and combined according to the rules in Eco Evidence. Compared to the original review, we reached informative conclusions for a larger number of flow–response hypotheses, found that hypotheses for which the most evidence was available returned inconsistent results, addressed hypotheses at levels of conceptual resolution relevant to management and identified where insufficient evidence exists to reach a conclusion.

Analyses conducted at several levels of conceptual resolution found strong support for many hypotheses regarding ecological impacts. We found a consistent sensitivity to changes in flow regime for both fish and riparian vegetation across a variety of performance metrics. While macroinvertebrate responses varied among performance metrics (e.g. abundance was negatively affected by increases or decreases in flows, diversity was only negatively affected by flow decreases, and assemblage structure was affected by neither), they were largely consistent within these metrics.

We thus conclude that the Eco Evidence approach allowed us to extract more knowledge from the data set than was possible in the original review. Eco Evidence can improve synthesis of the burgeoning ecological literature and improve our general understanding in ecology. Amid widespread calls for ‘evidence‐based’ environmental management, this powerful tool provides managers with a means of using research to help inform complex environmental decision‐making.
Total submission of pelvic lymphadenectomy tissues removed during radical prostatectomy for prostate cancer increases lymph node yield and detection of micrometastases
Authors: Perry‐Keene Joanna , Ferguson Peter , Samaratunga Hemamali , Nacey John N , Delahunt Brett
Published: August 2013

Aims

The detection of lymph node metastases has prognostic and therapeutic implications for patients undergoing radical prostatectomy for prostate cancer. Macroscopic identification of pelvic lymph nodes in surgical lymphadenectomy specimens can be difficult, with a potential for incomplete submission of lymph nodes for microscopic examination. This study was undertaken to determine whether complete sampling of lymphadenectomy specimens would improve the detection of metastatic disease in patients undergoing radical prostatectomy.

Methods and results

We examined 109 pelvic lymphadenectomies accompanying radical prostatectomy specimens to assess the benefit of complete submission of the lymph node packets to detect extra lymph nodes and metastatic disease. We found that blocking the residual tissue, after all palpable lymph nodes had been identified, increased the mean number of lymph nodes from 3.8 to 10.8, with an average of 0.84 macroscopically undetectable nodes being recovered per block submitted. Metastatic prostate cancer was identified in eight cases, one of which had cancer in an impalpable lymph node only.

Conclusions

Submission of all pelvic lymphadenectomy tissue for histological examination improves the yield of lymph nodes and the detection of metastatic prostate cancer.
Ulcerative colitis or Crohn's disease? Pitfalls and problems
Authors: Feakins Roger M
Published: August 2013

The interpretation of colorectal biopsies taken for the initial diagnosis of chronic idiopathic inflammatory bowel disease (IBD) is challenging. Subclassification of IBD as ulcerative colitis (UC) or Crohn's disease, which may be particularly difficult, is the subject of this review. Biopsies taken at first presentation are emphasised, partly because their features have not been modified by time or treatment. Aspects of longstanding disease and of resections are also mentioned. The first part of the review comprises background considerations and a summary of histological features that are discriminant, according to published evidence, between UC and Crohn's disease in initial biopsies. Pitfalls and problems associated with making the distinction between UC and Crohn's disease are then discussed. These include: mimics of IBD; inadequate clinical details; unreliable microscopic features; absence of histological changes in early IBD; discontinuity in UC; cryptolytic granulomas; differences between paediatric and adult UC; reliance on ileal and oesophagogastroduodenal histology; and atypical features in IBD resections. Avoidance by pathologists of known pitfalls should increase the likelihood of accurate and confident subclassification of IBD, which is important for optimum medical and surgical management.
Differences in RRM1 protein expression between diagnostic biopsies and resection specimens, and changes during carboplatin and paclitaxel treatment, in non‐small‐cell lung cancer
Authors: Jakobsen Jan N , Santoni‐Rugiu Eric , Sørensen Jens B
Published: August 2013

Aims

It is of interest whether expression of potentially predictive biomarkers changes during chemotherapy, for accurate evaluation after first‐line chemotherapy. This study aimed to evaluate changes in RRM1 expression during chemotherapy.

Materials and methods

RRM1 immunohistochemistry was performed on tumour samples from a total of 118 NSCLC patients with stage T1‐4N0‐2M0 disease. Samples were included from 65 patients treated with paclitaxel and carboplatin before surgery [neoadjuvant chemotherapy (NAC) group], and 53 patients who had undergone surgery but not chemotherapy [operation (OP) group].

Results

Discordant RRM1 expression (low versus high) was observed in 32% and 43% of paired diagnostic and subsequent resection specimens in the OP group and NAC group, respectively (P = 0.913). Ten (33%) and 12 (23%) tumours in the NAC group and the OP group, respectively, had increased RRM1 expression in the resection specimens (P = 0.289), and 12 (40%) and 19 (36%) tumours had decreased expression (P = 0.707). Eleven (50%) lymph node metastases had higher RRM1 expression following chemotherapy, and two (7%) had decreased expression.

Conclusions

The substantial discordance between paired samples emphasizes the need for sufficient tumour tissue in biopsies when RRM1 expression is evaluated. No change in RRM1 expression was observed in primary tumours, but expression seemed to be higher in N2 lymph node metastases following chemotherapy. Tumour heterogeneity and potential post‐chemotherapy changes should be considered when RRM1 expression is evaluated.
Conductivity Studies of Silver‐, Potassium‐, and Magnesium‐Doped Hydroxyapatite
Authors: Singh Brajendra , Kumar Samayendra , Basu Bikramjit , Gupta Rajeev
Published: August 2013

We report the electrical transport properties of silver‐, potassium‐, and magnesium‐doped hydroxyapatites (HAs). While Ag+ or K+ doping to HA enhances the conductivity, Mg+2 doping lowers the conductivity when compared with undoped HA. The mechanism behind the observed differences in ionic conductivity has been discussed using the analysis of high‐temperature frequency‐dependent conductivity data, Cole–Cole plots of impedance data as well as on the basis of the frequency dependence of the imaginary part (M″) of the complex electric modulus. The fmax of modulus M″ decreased in silver‐ and potassium‐doped samples in comparison with the undoped HA.
Mechanical Properties of Phosphate Glass Optical Fibers
Authors: Sglavo Vincenzo M. , Mura Emanuele , Milanese Daniel , Lousteau Joris
Published: August 2013

In this work, step‐index 40/125 μm diameter optical fibers produced from two slightly different lithium phosphate glasses were subjected to mechanical characterization. Tensile tests were carried out on fibers with gage length from 10 to 150 mm, allowing for the determination of the failure stress (ranging from ≈200 to 400 MPa) and the elastic modulus (60 GPa). Some tests were also performed with the fiber “immersed” in water; an important subcritical crack growth effect was pointed out, and a fatigue susceptibility parameter (n) equal to 11.4 was determined. The analysis of fracture mirror allows an estimated fracture toughness equal to 0.5 MPa m0.5.
Seasonal influenza vaccine effectiveness among children, 2010–2012
Authors: Fu Chuanxi , He Qing , Li Zhaotian , Xu Jianxiong , Li Yongqian , Lu Jianyun , Li Kuibiao , Yang Qiongying , Dong Zhiqiang , Liu Xiangyi , Wen Sijun , Hu Wensui , Zhang Danfeng , Lv Jiayun , Zhu Wei , Wang Ming
Published: August 2013

Background

The annual differences in the seasonal influenza vaccine and the circulating strains make it necessary to assess influenza vaccine effectiveness (VE) yearly. We assessed the effectiveness of the trivalent inactivated influenza vaccine for the 2010–2011 and 2011–2012 influenza seasons among children in Guangzhou, China.

Methods

We conducted a 1:2 matched case–control study based on date of birth (±7 days), gender, and area of residence. The influenza cases from surveillance sites in Guangzhou were laboratory‐confirmed during the 2010–2012 seasons. The controls were randomly selected from children aged 6–59 months in the Children's Expanded Programmed Immunization Administrative Computerized System. The influenza vaccination information for both cases and controls was retrieved from this system.

Results

We analyzed the vaccination information for 1255 influenza cases and 2510 matched controls in 2 influenza seasons in Guangzhou, China. We found that the VE for vaccination during the 2010–2011 and 2011–2012 seasons of virus circulation was 73·2% (95% confidence interval (CI), 52·2–85·0%) and 52·9% (95% CI, 42·1–61·7%), respectively. The VE decreased from 68·9% (95% CI, 57·5–77·2%) in the period between January and March to 48·4% (95% CI, 33·8–59·7%) in the period between April and June.

Conclusions

This post‐licensing study of VE found moderate protection against influenza for vaccinated children aged 6–59 months. Although the influenza vaccine strains for the 2010–2011 and the 2011–2012 seasons were the same, our study indicated that annual vaccination is recommended even for those who received the vaccine during the previous season.
Respiratory viral infections and effects of meteorological parameters and air pollution in adults with respiratory symptoms admitted to the emergency room
Authors: Silva Denise R. , Viana Vinícius P. , Müller Alice M. , Livi Fernando P. , Dalcin Paulo de Tarso R.
Published: August 2013

Background

Respiratory viral infections (RVIs) are the most common causes of respiratory infections. The prevalence of respiratory viruses in adults is underestimated. Meteorological variations and air pollution are likely to play a role in these infections.

Objectives

The objectives of this study were to determine the number of emergency visits for influenza‐like illness (ILI) and severe acute respiratory infection (SARI) and to evaluate the association between ILI/SARI, RVI prevalence, and meteorological factors/air pollution, in the city of Porto Alegre, Brazil, from November 2008 to October 2010.

Methods

Eleven thousand nine hundred and fifty‐three hospitalizations (adults and children) for respiratory symptoms were correlated with meteorological parameters and air pollutants. In a subset of adults, nasopharyngeal aspirates were collected and analyzed through IFI test. The data were analyzed using time‐series analysis.

Results

Influenza‐like illness and SARI were diagnosed in 3698 (30·9%) and 2063 (17·7%) patients, respectively. Thirty‐seven (9·0%) samples were positive by IFI and 93 of 410 (22·7%) were IFI and/or PCR positive. In a multivariate logistic regression model, IFI positivity was statistically associated with absolute humidity, use of air conditioning, and presence of mold in home. Sunshine duration was significantly associated with the frequency of ILI cases. For SARI cases, the variables mean temperature, sunshine duration, relative humidity, and mean concentration of pollutants were singnificant.

Conclusions

At least 22% of infections in adult patients admitted to ER with respiratory complaints were caused by RVI. The correlations among meteorological variables, air pollution, ILI/SARI cases, and respiratory viruses demonstrated the relevance of climate factors as significant underlying contributors to the prevalence of RVI.
Spectral Properties of Pr3+‐Doped Transparent‐Glass‐Ceramic Containing Ca5(PO4)3F Nanocrystals
Authors: Huang Jianhua , Zhang Sinian , Chen Yujing , Gong Xinghong , Lin Yanfu , Luo Zundu , Huang Yidong
Published: August 2013

A Pr3+‐doped transparent oxyfluoride glass‐ceramic containing Ca5(PO4)3F nanocrystals was prepared by melt quenching and subsequent thermal treatment. The crystallization phase and morphology of the Ca5(PO4)3F nanocrystals were investigated by X‐ray diffraction and transmission electron microscope, respectively. The volume fraction of the Ca5(PO4)3F nanocrystals in the glass‐ceramic is about 10% and the fraction of Pr3+ ions incorporated into the Ca5(PO4)3F nanocrystals is about 22%. The peak absorption cross sections at 435 and 574 nm increase up to 128% and 132% after crystallization, respectively. The peak stimulated emission cross sections of the 3P0→3H4 blue laser channel and 3P0→3F2 red laser channel for the glass‐ceramic are 4.95 × 10−20 and 29.8 × 10−20 cm2, respectively. The spectral properties indicate that the glass‐ceramic is a potential visible laser material.
Transformational leadership and safety performance among nurses: the mediating role of knowledge‐related job characteristics
Authors: Lievens Ilse , Vlerick Peter
Published: August 2013

Aims

To report the impact of transformational leadership on two dimensions of nurses' safety performance (i.e. safety compliance and safety participation) and to study the mediating role of knowledge‐related job characteristics in this relationship.

Background

Safety performance refers to the behaviours that employees exhibit to adhere to safety guidelines and to promote health and safety at their workplace. Nurses' safety performance is a major challenge for healthcare settings, urging the need to identify the key determinants and psychological mechanisms that influence it.

Design

A cross‐sectional survey study.

Methods

The study was carried out in September 2010 in a large Belgian hospital. We used self‐administered questionnaires; 152 nurses participated. The hypotheses were tested using hierarchical regression analyses.

Results/Findings

In line with our first hypothesis, the results show that transformational leadership exerted a significant positive impact on both dimensions of nurses' safety performance. This positive relation was mediated by knowledge‐related job characteristics, supporting our second hypothesis.

Conclusion

Head nurses' transformational leadership can enhance nurses' compliance with and participation in safety. Furthermore, transformational head nurses are able to influence the perception that their nurses have about the kind and amount of knowledge in their job, which can also lead to increases in both dimensions of nurses' safety performance. This study therefore demonstrates the key impact that transformational head nurses have, both directly and indirectly, on the safety performance of their nurses.
The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients
Authors: Hartgerink J.M. , Cramm J.M. , Bakker T.J.E.M. , van Eijsden A.M. , Mackenbach J.P. , Nieboer A.P.
Published: August 2013

Aim

To identify predictors of relational coordination among professionals delivering care to older patients.

Background

Relational coordination is known to enhance quality of care in hospitals. The underlying mechanisms, however, remain poorly understood.

Design

This cross‐sectional study was part of a larger evaluation study examining the opportunity to prevent loss of function in older patients due to hospitalization in the Netherlands.

Methods

This study was performed in spring 2010 among team members delivering care to older hospitalized patients (192 respondents; 44% response rate) in one hospital. Relational coordination was measured by the Relational Coordination survey; team climate by the Team Climate Inventory and questions were asked about participation in multidisciplinary team meetings and disciplines represented in these meetings. To account for the hierarchical structure, a multilevel analysis was performed.

Results

Correlation analysis revealed a positive relationship among being female, being a nurse and relational coordination; medical specialists showed a negative relationship. The number of disciplines represented during multidisciplinary team meetings and team climate were positively related with relational coordination. The multilevel analysis showed a positive relationship between the number of disciplines represented during multidisciplinary team meetings and team climate with relational coordination.

Conclusions

The enhancement of team climate and attendance of diverse professionals during multidisciplinary team meetings are expected to improve relational coordination. Furthermore, this study underscores the importance of enhancing relational coordination between medical specialists and other professionals.
Genealogy as a critical toolbox: deconstructing the professional identity of nurses
Authors: Miró‐Bonet Margalida , Bover‐Bover Andreu , Moreno‐Mulet Cristina , Miró‐Bonet Rosa , Zaforteza‐Lallemand Concha
Published: August 2013

Aim

To discuss the Foucauldian concept of genealogy as a framework for understanding and transforming nurses' professional identity.

Background

The professional identity of nurses has primarily been defined by personal and interpersonal attributes and by the intradisciplinary dimensions of nursing, leading to its conceptualization as a universal, monolithic phenomenon. The Foucauldian genealogical perspective offers a critical lens to examine what constitutes this professional identity; Spanish nursing offers a historical case study of an active effort to impose an identity that fits the monolithic ideal.

Data sources

Five of the 33 professional conduct manuals for nurses' training published from 1956–1976 during the Franco dictatorship in Spain and six interviews with nursing instructors or students at the time were analysed using a theoretical framework drawn from Foucault's writing.

Discussion

Foucault's genealogical framework considers practices of normalization and resistance as a means of understanding knowledge continuities and discontinuities, clarifying practices that constitute nurses' professional identity in a particular way in specific contexts and analysing the implications of this theoretical frame.

Implications for nursing

The genealogy concept offers valuable tools to determine how professional identities are constituted, questions assumptions about the profession and its professionals and envisions alternative approaches. This theoretical approach helps both scholars and practitioners understand, question and transform their practices as needed.

Conclusion

The genealogical approach prioritizes analysis of the phenomenon over its description and challenges many unknown, forgotten, excluded and/or unquestioned aspects of identity from a position of diversity and complexity.
Learning in a mobile age: an investigation of student motivation
Authors: Ciampa K.
Published: August 2013

The purpose of this single‐case study was to explore the lived experiences of a grade 6 teacher and students who used tablets as part of their classroom instruction. Malone and Lepper's taxonomy of intrinsic motivations for learning is used as a framework for examining whether and how this particular theory of motivation applies equally well for mobile learning. This study reports on the grade 6 teacher's and students' perceptions regarding the motivational affordances of using these mobile devices for learning. The findings are consistent with those of Malone and Lepper that motivation can be enhanced through challenge, curiosity, control, recognition, competition and cooperation. This model is helpful in informing our understanding of the motivating features of using mobile devices for learning and how mobile technologies can be used to enhance learners' motivation.
Cardiac Channelopathies Associated with Infantile Fatal Ventricular Arrhythmias: From the Cradle to the Bench
Authors: KATO KOICHI , MAKIYAMA TAKERU , WU JIE , DING WEI‐GUANG , KIMURA HIROMI , NAIKI NOBU , OHNO SEIKO , ITOH HIDEKI , NAKANISHI TOSHIO , MATSUURA HIROSHI , HORIE MINORU
Published: August 2013

Channelopathies in Infantile Arrhythmias

Background

Fatal ventricular arrhythmias in the early period of life have been associated with cardiac channelopathies for decades, and postmortem analyses in SIDS victims have provided evidence of this association. However, the prevalence and functional properties of cardiac ion channel mutations in infantile fatal arrhythmia cases are not clear.

Methods and Results

Seven infants with potentially lethal arrhythmias at age < 1 year (5 males, age of onset 44.1 ± 72.1 days) were genetically analyzed for KCNQ1, KCNH2, KCNE1–5, KCNJ2, SCN5A, GJA5, and CALM1 by using denaturing high‐performance liquid chromatography and direct sequencing. Whole‐cell currents of wildtype and mutant channels were recorded and analyzed in Chinese hamster ovary cells transfected with SCN5A and KCNH2 cDNA. In 5 of 7 patients, we identified 4 mutations (p.N1774D, p.T290fsX53, p.F1486del and p.N406K) in SCN5A, and 1 mutation (p.G628D) in KCNH2. N1774D, F1486del, and N406K in SCN5A displayed tetrodotoxin‐sensitive persistent late Na+ currents. By contrast, SCN5A‐T290fsX53 was nonfunctional. KCNH2‐G628D exhibited loss of channel function.

Conclusion

Genetic screening of 7 patients was used to demonstrate the high prevalence of cardiac channelopathies. Functional assays revealed both gain and loss of channel function in SCN5A mutations, as well as loss of function associated with the KCNH2 mutation.
Midlife Hypertensive Status and Cognitive Function 20 Years Later: The Southall and Brent Revisited Study
Authors: Taylor Clare , Tillin Therese , Chaturvedi Nish , Dewey Michael , Ferri Cleusa P. , Hughes Alun , Prince Martin , Richards Marcus , Shah Ajit , Stewart Robert
Published: August 2013

Objectives

To investigate long‐term prospective associations between a range of measurements of hypertensive status in midlife and cognitive impairment 20 years later.

Design

Cohort study.

Setting

Two areas (Southall and Brent) of northwest London.

Participants

Survey samples of a multiethnic population (European, African Caribbean, South Asian) aged 40 to 67 were followed up 20 years later.

Measurements

Comprehensive cardiovascular assessments were performed at baseline, including measurements of resting blood pressure (BP) and, in a subsample, ambulatory BP. At follow‐up, a battery of cognitive assessments was administered, and a composite outcome was derived, with impairment defined as the lowest 10% within each ethnic group. Logistic regression models were used to investigate associations with prior measures of hypertensive status.

Results

In 1,484 participants at follow‐up, cognitive impairment showed significant U‐shaped associations with baseline diastolic BP (DBP) and mean arterial pressure (MAP; strongest for those aged ≥50 at baseline), independent of a range of covariates, but no associations were found with systolic BP or pulse pressure. Cognitive impairment was also associated with antihypertensive medication use and higher evening ambulatory DBP at baseline. No substantial differences in strengths of association were found between ethnic groups.

Conclusion

Low and high DBP and MAP were associated with cognitive impairment 20 years later. Higher evening DBP on ambulatory monitoring was also associated with greater risk.
People's Attitudes, Beliefs, and Experiences Regarding Polypharmacy and Willingness to Deprescribe
Authors: Reeve Emily , Wiese Michael D. , Hendrix Ivanka , Roberts Michael S. , Shakib Sepehr
Published: August 2013

Objectives

To capture people's attitudes, beliefs, and experiences regarding the number of medications they are taking and their feelings about stopping medications.

Design

Administration of a validated questionnaire.

Setting

Multidisciplinary ambulatory consulting service at the Royal Adelaide Hospital.

Participants

Participants were individuals aged 18 and older (median 71.5) taking at least one regular prescription medication; 100 participants completed all items of the questionnaire, 65 of whom were aged 65 and older.

Measurements

Participants were administered the 15‐item Patients' Attitudes Towards Deprescribing (PATD) questionnaire.

Results

Participants were taking an average of 10 different prescription and nonprescription (including complementary), regular and as‐needed medications. More than 60% felt that they were taking a “large number” of medications, and 92% stated that they would be willing to stop one or more of their current medications if possible. Number of regular medications, age, and number of medical conditions were not found to be correlated with willingness to stop a medication. The findings were similar in older and younger participants.

Conclusion

This study has shown that a cohort of mostly older adults were largely accepting of a trial of cessation of medication(s) that their prescriber deemed to be no longer required. Because few factors were associated with willingness to cease medications, all patients should be individually evaluated for deprescribing.
Operationalization of Frailty Using Eight Commonly Used Scales and Comparison of Their Ability to Predict All‐Cause Mortality
Authors: Theou Olga , Brothers Thomas D. , Mitnitski Arnold , Rockwood Kenneth
Published: August 2013

Objectives

To operationalize frailty using eight scales and to compare their content validity, feasibility, prevalence estimates of frailty, and ability to predict all‐cause mortality.

Design

Secondary analysis of the Survey of Health, Ageing and Retirement in Europe (SHARE).

Setting

Eleven European countries.

Participants

Individuals aged 50 to 104 (mean age 65.3 ± 10.5, 54.8% female, N = 27,527).

Measurements

Frailty was operationalized using SHARE data based on the Groningen Frailty Indicator, the Tilburg Frailty Indicator, a 70‐item Frailty Index (FI), a 44‐item FI based on a Comprehensive Geriatric Assessment (FI‐CGA), the Clinical Frailty Scale, frailty phenotype (weighted and unweighted versions), the Edmonton Frail Scale, and the FRAIL scale.

Results

All scales had fewer than 6% of cases with at least one missing item, except the SHARE‐frailty phenotype (11.1%) and the SHARE‐Tilburg (12.2%). In the SHARE‐Groningen, SHARE‐Tilburg, SHARE‐frailty phenotype, and SHARE‐FRAIL scales, death rates were 3 to 5 times as high in excluded cases as in included ones. Frailty prevalence estimates ranged from 6% (SHARE‐FRAIL) to 44% (SHARE‐Groningen). All scales categorized 2.4% of participants as frail. Of unweighted scales, the SHARE‐FI and SHARE‐Edmonton scales most accurately predicted mortality at 2 (SHARE‐FI area under the receiver operating characteristic curve (AUC) = 0.77, 95% confidence interval (CI) = 0.75–0.79); SHARE‐Edmonton AUC = 0.76, 95% CI = 0.74–0.79) and 5 (both AUC = 0.75, 95% CI = 0.74–0.77) years. The continuous score of the weighted SHARE‐frailty phenotype (AUC = 0.77, 95% CI = 0.75–0.78) predicted 5‐year mortality better than the unweighted SHARE‐frailty phenotype (AUC = 0.70, 95% CI = 0.68–0.71), but the categorical score of the weighted SHARE‐frailty phenotype did not (AUC = 0.70, 95% CI = 0.68–0.72).

Conclusion

Substantive differences exist between scales in their content validity, feasibility, and ability to predict all‐cause mortality. These frailty scales capture related but distinct groups. Weighting items in frailty scales can improve their predictive ability, but the trade‐off between specificity, predictive power, and generalizability requires additional evaluation.
Multidimensional Team‐Based Intervention Using Musical Cues to Reduce Odds of Facility‐Acquired Pressure Ulcers in Long‐Term Care: A Paired Randomized Intervention Study
Authors: Yap Tracey L. , Kennerly Susan M. , Simmons Mark R. , Buncher Charles R. , Miller Elaine , Kim Jay , Yap Winston Y.
Published: August 2013

Objectives

To test the effectiveness of a pressure ulcer (PU) prevention intervention featuring musical cues to remind all long‐term care (LTC) staff (nursing and ancillary) to help every resident move or reposition every 2 hours.

Design

Twelve‐month paired‐facility two‐arm (with one‐arm crossover) randomized intervention trial.

Setting

Ten midwestern U.S. LTC facilities. Four treatment facilities received intervention during Months 1 to 12, four comparison facilities received intervention during Months 7 to 12, and two pseudo‐control facilities received no intervention.

Participants

LTC facility residents (N = 1,928).

Intervention

All facility staff received in‐person education, video, and handouts, and visiting family members received informational pamphlets on PU prevention and an intervention featuring musical cues. Nurse‐led multidisciplinary staff teams presented the cues as prompts for staff and family to reposition residents or remind them to move. Musical selections (with and without lyrics) customized to facility preferences were played daily over the facility intercom or public address system every 2 hours for the 12‐hour daytime period.

Measurements

Primary outcome measure was the frequency of new facility‐acquired PUs divided by the total number of facility Minimum Data Set (MDS) resident assessments conducted during the study period.

Results

Odds of a new PU were lower in intervention facilities (P = .08) for MDS 2.0 assessments and were significantly lower (P = .05) for MDS 3.0. Mean odds ratios suggested intervention facility residents were 45% less likely than comparison facility residents to develop a new PU.

Conclusion

Customized musical cues that prompt multidisciplinary staff teams to encourage or enable movement of all residents hold promise for reducing facility‐acquired PUs in LTC settings.
Plasma Membrane Protein Ubiquitylation and Degradation as Determinants of Positional Growth in Plants
Authors: Korbei Barbara , Luschnig Christian
Published: August 2013

Being sessile organisms, plants evolved an unparalleled plasticity in their post‐embryonic development, allowing them to adapt and fine‐tune their vital parameters to an ever‐changing environment. Crosstalk between plants and their environment requires tight regulation of information exchange at the plasma membrane (PM). Plasma membrane proteins mediate such communication, by sensing variations in nutrient availability, external cues as well as by controlled solute transport across the membrane border. Localization and steady‐state levels are essential for PM protein function and ongoing research identifiedcis‐ andtrans‐acting determinants, involved in control of plant PM protein localization and turnover. In this overview, we summarize recent progress in our understanding of plant PM protein sorting and degradation via ubiquitylation, a post‐translational and reversible modification of proteins. We highlight characterized components of the machinery involved in sorting of ubiquitylated PM proteins and discuss consequences of protein ubiquitylation on fate of selected PM proteins. Specifically, we focus on the role of ubiquitylation and PM protein degradation in the regulation of polar auxin transport (PAT). We combine this regulatory circuit with further aspects of PM protein sorting control, to address the interplay of events that might control PAT and polarized growth in higher plants.

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Christian Luschnig

(Corresponding author)
The Family Context of Relational Aggression in “Difficult to Treat” Female Juvenile Offenders
Authors: Taylor Erin K. , Borduin Charles M.
Published: August 2013

Female juvenile offenders often engage in socially aggressive behaviors that make them more difficult to treat than male juvenile offenders. This social (i.e., relational) aggression may be developed or maintained through transactions with family members. To investigate this issue, we measured relational aggression in the family interactions of 140 adolescents divided by gender and offender status into four equal‐sized groups (female juvenile offenders, male juvenile offenders, female nonoffenders, and male nonoffenders). Adolescents and caregivers completed a family discussion task, and raters coded relationally aggressive behaviors at the dyadic level. Results showed that female juvenile offenders and their mothers directed more relational aggression toward each other than did mother–adolescent dyads in the other groups. Implications of these results for treatment and research are discussed.
The Dark Side of Political Society: Patronage and the Reproduction of Social Inequality
Authors: Martin Nicolas
Published: August 2013

Development optimists in South Asia have argued that electoral politics and the reduced role of villages as centres of economic activity have largely put an end to exploitation by dominant castes. Although the political arrangements that have emerged out of these changes fall short of the idealized standards of civil society, various commentators have argued that they nevertheless benefit subordinate classes. Partha Chatterjee even argues that the ad hoc and extra‐legal nature of these political arrangements – which he terms ‘political society’ – actually serve popular enfranchisement better than the law‐bound activities of civil society, which he sees as captive to capital. On the basis of village ethnography from the Pakistani Punjab, I argue that political society is in fact integral to processes that dispossess people of their rights and to the reproduction of elite power. The paper illustrates how it is not the cold rationality of the state and the rule of law that disenfranchise subordinate classes, but their absence.
Long‐term effects of metformin on endothelial function in type 2 diabetes: a randomized controlled trial
Authors: de Jager J. , Kooy A. , Schalkwijk C. , van der Kolk J. , Lehert P. , Bets D. , Wulffelé M. G. , Donker A. J. , Stehouwer C. D. A.
Published: August 2013

Objectives

We investigated whether metformin can improve endothelial function and decrease inflammatory activity, and thereby decrease the risk of atherothrombotic disease.

Subjects and design

A randomized, placebo‐controlled trial with a follow‐up period of 4.3 years set in the outpatient clinics of three nonacademic hospitals (Hoogeveen, Meppel and Coevorden Hospitals, the Netherlands). A total of 390 patients with type 2 diabetes treated with insulin were included. Either metformin 850 mg or placebo (one to three times daily) was added to insulin therapy. Urinary albumin excretion and plasma levels of von Willebrand factor (vWf), soluble vascular adhesion molecule‐1 (sVCAM‐1), soluble E‐selectin (sE‐selectin), tissue‐type plasminogen activator (t‐PA), plasminogen activator inhibitor‐1 (PAI‐1), C‐reactive protein (CRP) and soluble intercellular adhesion molecule‐1 (sICAM‐1) were measured at baseline and after 4, 17, 30, 43 and 52 months.

Results

Metformin significantly reduced levels of vWF, sVCAM‐1, t‐PA, PAI‐1, CRP and sICAM‐1, which, except for CRP, remained significant after adjustment for baseline differences in age, sex, smoking and severity of previous cardiovascular (CV) disease. No effects on urinary albumin excretion or sE‐selectin were observed. The improvements in vWf and sVCAM‐1 statistically explained about 34% of the reduction in the risk of CV morbidity and mortality associated with metformin treatment in this study.

Conclusions

Metformin is associated with improvement in some (vWF and sVCAM‐1) but not all markers of endothelial function, which may explain why it is associated with a decreased risk of CV disease in type 2 diabetes.
A comparative study of the Osstell™ versus the Osstell Mentor™ to evaluate implant stability in human cadaver mandibles
Authors: Snijders R. S. , van Wijk A. J. , Lindeboom J. A.
Published: August 2013

The aim of this study was to assess the primary stability of dental implants by resonance frequency analysis (RFA) using the Osstell™ and Osstell Mentor™ devices and to investigate the reproducibility and comparability of the results obtained with these devices. Twenty‐four Straumann implants (Straumann AG, Basel, Switzerland) were placed in the anterior mandible of 12 fresh edentulous human cadaver mandibles. The implant stability quotients (ISQs) were measured with the Osstell™ and Osstell Mentor™ when implants were inserted at 50% of their length and following their complete insertion. The Osstell™ device measured lower scores compared with the Osstell Mentor™. This was significant for the full position (mean difference = 9·9), t (11) = 7·4, P < 0·001 and for the halfway position (mean difference = 5·9), t (11) = 2·41, P = 0·03. In con‐clusion, the Osstell™ produced relatively lower ISQ scores than the Osstell Mentor™.
Lateral occlusion schemes in natural and minimally restored permanent dentition: a systematic review
Authors: Abduo J. , Tennant M. , McGeachie J.
Published: August 2013

Clinicians commonly encounter the dilemma of which lateral occlusion schemes is most suitable for a specific patient. The aim of this review is to evaluate the prevalence of the lateral occlusion schemes that exist naturally. An electronic search was completed through PubMed (MEDLINE), Google Scholar and Cochrane Library. The search was confined to peer‐reviewed studies published in English, up to April 2013. The literature search was supplemented by manual searching through the bibliography lists of the selected studies. The initial search retrieved a total of 575 studies. After applying the selection criteria, only 12 studies were suitable for inclusion. The Critical Appraisal Skills Programme (CASP) tools were utilised to appraise the quality of the studies. The prevalence of canine‐guided, group function and balanced occlusions was reported. Overall, there was a clear variability between the studies. The prevalence of the lateral occlusion schemes appears to be influenced by the following factors: (i) the magnitude of excursion, (ii) an individual's age and (iii) the static occlusal relationship. During complete excursion, the canine‐guided occlusion tends to be more frequently observed. After partial excursion, the most prevalent lateral occlusion schemes was group function occlusion. With ageing, the prevalence of canine‐guided occlusion tends to be reduced and the prevalence of group function occlusion is increased. Dentition that is closer to Class II occlusion exhibits mainly canine‐guided occlusion, while for Class III occlusion, group function occlusion is more prevalent. The studies revealed no relationship between the lateral occlusion schemes and TMD development.
Dental service mix among working‐age adults in the United States, 1999 and 2009
Authors: Manski Richard J. , Macek Mark D. , Brown Erwin , Carper Kelly V. , Cohen Leonard A. , Vargas Clemencia
Published: August 2013

Objective

In the United States, health‐care costs are increasing while state and federal budgets contract. In order to establish a baseline and provide data for alternative oral health workforce models, this report describes the types of dental procedures received by US working‐age adults in 2009 and looks at trends since 1999.

Methods

Data for this analysis came from the 1999 and 2009 Medical Expenditure Panel Surveys. The primary outcome variable represented the types of dental procedures undergone during a dental visit in the preceding year. Descriptive variables included dental insurance coverage and income. Analysis was restricted to adults aged 21‐64 years.

Results

In 2009, diagnostic and preventive procedures accounted for >75 percent of all dental services received by working‐age adults. Those with public insurance and those who were uninsured, as well as those with lower income, were less likely to receive these services than their peers. Between 1999 and 2009, small but statistically significant increases in the proportion of preventive and diagnostic procedures received occurred in the nation. The likelihood that a preventive service would be received during a visit also increased during this period, while the probability that a restorative procedure would be undergone went down.

Conclusions

Preventive‐type procedures represented the vast majority of dental services received by working‐age adults in 2009. Between 1999 and 2009, receipt of preventive‐type procedures generally increased while receipt of surgical‐type procedures decreased. These findings emphasize the health‐promoting role of the dental team and provide a baseline for the measurement of future trends.