bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential subtypes of diabetic older adults diagnosed with Alzheimer's disease
Authors: Sakurai Takashi , Kawashima Shuji , Satake Shosuke , Miura Hisayuki , Tokuda Haruhiko , Toba Kenji
Published: March 2014

Aim

The clinical management of diabetic elderly patients with Alzheimer's disease (AD) is hindered by several difficulties. The present study aimed to clarify the clinical characteristics and pathophysiological properties of AD in diabetic older adults.

Methods

A total of 91 patients with type 2 diabetes mellitus and 161 non‐diabetic individuals who were diagnosed with AD were recruited. Diabetic patients were classified into two groups with glycated hemoglobin (HbA1c) <7.0% or ≥7.0%. The demographics, cognition, daily‐life function, metabolic changes, treatment, and behavioral and psychological symptoms of dementia (BPSD), as well as brain pathophysiology, were compared among the three groups.

Results

Patients with higher HbA1c had increased diabetic vascular complications and impaired activities of daily living with decreased levels of serum high‐molecular‐weight adiponectin and 25‐hydroxyvitamin D. Although cognitive status was similar among the three groups, BPSD, including apathy, overeating and excessive daytime sleeping appeared to be increased in the patients with HbA1c ≥7.0%. The frequency of apolipoprotein E4 carriers and of posterior cerebral hypoperfusion (AD‐pattern) on single‐photon emission computed tomography in poorly controlled diabetic subjects was similar to that in non‐diabetic AD patients, whereas diabetic patients with HbA1c <7.0% included fewer apolipoprotein E4 carriers and fewer patients with an AD pattern on single‐photon emission computed tomography.

Conclusion

Subtypes of older diabetic patients with AD were identified based on clinical features and brain pathophysiology. Physical and psychological complications of dementia are prevalent in patients with higher HbA1c. It seems likely that difficulties in the management of diabetes with AD are due not only to non‐adherence to diabetes treatment, but also several symptoms and pathophysiological characteristics of dementia. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 62–70.
Nutritional management of older adults with cognitive decline and dementia
Authors: Ogawa Sumito
Published: March 2014

Age‐related cognitive decline is a main predictor of disability among elderly people, and with the continued expansion of the aging population and the increase in life expectancy, the prevalence of mild cognitive impairment and dementia represented by Alzheimer's disease (AD), which is a multifactorial neurodegenerative disorder of older adults, have increased. Recent epidemiological and observational studies suggest a relationship exists between lifestyle factors, including nutrition and diet, and cognitive function in aging adults. It is also suggested that malnutrition and nutrient deficiencies are associated with cognitive decline in patients with dementia. There are a variety of nutritional factors, including nutritional status and dietary patterns, that might be associated with cognitive function, and specific micronutrients and dietary components have been suggested to have an association with cognitive function as well. Based on these findings and evidence, evaluation of nutritional state, as well as nutritional intervention, might be able to play a role in the management and prevention of dementia. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 17–22.
Early detection of dementia in the community under a community‐based integrated care system
Authors: Maki Yohko , Yamaguchi Haruyasu
Published: March 2014

Early detection of dementia is recommended in the stages from mild cognitive impairment to early dementia, excluding the asymptomatic stage. The advantages of early detection for patients and their caregivers include early receipt of pharmacological and non‐pharmacological therapies, and early access to appropriate agencies and/or support networks. The disadvantages include psychological damage related to anxiety and depression, and risk of stigmatization and/or social exclusion. The possibility of false positive diagnoses is also problematic. For detection of dementia, various screening tests and questionnaires have been developed. However, none of these techniques are sensitive and specific enough to avoid false positives. Thus, these screening tools are recommended for assessment of the severity of functional decline after sufficient information has been gathered to suspect dementia. In terms of social services, early detection might delay institutionalization. However, implementation of early detection would add a heavy burden on social resources, especially human resources. For effective implementation of early diagnosis and management of dementia, measures are required to improve social and human resources, including the following: improvement of the diagnostic abilities of general practitioners, improvement of necessary care and support systems after diagnosis, and organizing volunteers to support local communities. Under a community‐based integrated care system, each community will create a “tailored” system that meets the health needs, health status and values of the community. Promoting social participation and community involvement of the residents should be one of the key strategies to address the shortage of human resources. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 2–10.
Association of grip strength and related indices with independence of activities of daily living in older adults, investigated by a newly‐developed grip strength measuring device
Authors: Matsui Yasumoto , Fujita Remi , Harada Atsushi , Sakurai Takashi , Nemoto Tetsuya , Noda Nobuo , Toba Kenji
Published: March 2014

Aim

To investigate the association of grip strength and activities of daily living independence in older adults, using a newly‐developed grip strength measuring device.

Methods

Patients who visited the clinic for memory disorders at the National Center for Geriatrics and Gerontology (142 men and 205 women, mean age 74.8 ± 8.8 years) were included in the present study. Their strength during gripping performance is described in detail, and following the indices were calculated: maximum strength (MS), response time (RT), time to MS, time to reach turning point (TP), strength at TP, inclination from start to TP, time from TP to reach MS, inclination from TP to MS and ratio of strength (TP/MS). Barthel Index (BI), total scores and scores of each subclass were used for evaluating activities of daily living independence. MS was compared between the independent and dependent groups. Correlations, using partial Pearson's coefficient adjusted for age, and Mini‐Mental State Examination total score were analyzed between indices and BI by sex, side, and age groups.

Results

MS was significantly higher in the independent group. MS and RT were significantly related with BI total and certain subclasses in both hands, TP/MS was significantly related in the right hand of either sex, and strength at TP was significantly related in both hands in women and in the left hand in men. Time to reach TP was particularly correlated in both hands and time from TP to reach MS in the right hand, in men. The correlation of indices varied by sex, hand side and age group, especially in men aged in their 70s, and in women aged less than 70 years and women aged in their 80s.

Conclusion

MS was shown to be useful, but some of the newly defined indices, such as RT, strength at TP, and elements regarding before and after TP until reaching MS, were also suggested to be useful. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 77–86.
Lipoprotein‐associated phospholipase A2 and cardiovascular disease risk in HIV infection
Authors: Ross Eckard A , Longenecker CT , Jiang Y , Debanne SM , Labbato D , Storer N , McComsey GA
Published: March 2014

Objectives

HIV‐infected patients on antiretroviral therapy (ART) have an increased cardiovascular disease (CVD) risk as a result of heightened inflammation and immune activation, despite at times having normal lipids and few traditional risk factors. Biomarkers are needed to identify such patients before a clinical event. Lipoprotein‐associated phospholipase A2 (Lp‐PLA2) predicts CVD events in the general population. This study investigated the relationship between Lp‐PLA2 and markers of CVD risk, systemic inflammation, immune activation, and coagulation in HIV infection.

Methods

One hundred subjects on stable ART with normal fasting low‐density lipoprotein (LDL) cholesterol were enrolled in the study. Plasma Lp‐PLA2 concentrations were measured by enzyme‐linked immunosorbent assay (ELISA; > 200 ng/mL was considered high CVD risk). Subclinical atherosclerosis, endothelial function, inflammation, immune activation and fasting lipids were also evaluated.

Results

The median age of the patients was 47 years and 77% were male. Median (range) Lp‐PLA2 was 209 (71–402) ng/mL. Fifty‐seven per cent of patients had Lp‐PLA2 concentrations > 200 ng/mL. Lp‐PLA2 was positively correlated with soluble markers of inflammation or immune activation (tumour necrosis factor receptor‐II, intercellular and vascular cellular adhesion molecules, and CD14; all R = 0.3; P < 0.01), and negatively correlated with coagulation markers (D‐dimer and fibrinogen; both R = −0.2; P < 0.04). Lp‐PLA2 was not correlated with lipids, coronary artery calcium score, or flow‐mediated vasodilation, but trended towards a significant correlation with carotid intima‐media thickness (R = 0.2; P = 0.05).

Conclusions

In this population with stable ART and normal LDL cholesterol, Lp‐PLA2 was in the high CVD risk category in the majority of subjects. Lp‐PLA2 appears to be associated with inflammation/immune activation, but also with anti‐thrombotic effects. Lp‐PLA2 may represent a valuable early biomarker of CVD risk in HIV infection before subclinical atherosclerosis can be detected.
Effects of sugar‐free chewing gum sweetened with xylitol or maltitol on the development of gingivitis and plaque: a randomized clinical trial
Authors: Keukenmeester RS , Slot DE , Rosema NAM , Van Loveren C , Van der Weijden GA
Published: March 2014

Objective

The objective of this study was to test the effect of sugar‐free chewing gum sweetened with xylitol or maltitol compared to the use of a gum base or no gum on gingivitis and plaque scores under both brushing and non‐brushing circumstances.

Methods

The design of the study was a four‐group, double‐blinded, randomized controlled study with a 3‐week duration. In each group, the participants did not brush the teeth in the lower jaw designated to develop experimental gingivitis, while maintaining normal oral hygiene procedures in the upper jaw. After professional dental prophylaxis, the participants were allocated into one of four groups (xylitol, maltitol, gum base or no gum). Chewing gum was used five times a day for 10 min.

Results

220 participants completed the study and provided evaluable data. The increase in bleeding on marginal probing (BOMP) and plaque scores (PS) in the non‐brushed (lower) jaw with experimental gingivitis was significant in all groups (P < 0.001). As compared to the gum base, the increase in BOMP in the xylitol and maltitol group was significantly lower. In the brushed upper jaw, no significant changes for BOMP were observed from the baseline to the end point of the study, and there were no significant differences in BOMP and PS between the groups.

Conclusion

In circumstances where regular brushing is performed, no effect of chewing gum was observed on bleeding and plaque scores. In the absence of brushing, chewing xylitol or maltitol gum provided a significant inhibitory effect on gingivitis scores compared to chewing gum base. The difference when compared to the group not using gum was not significant.
Strategies for improving antibiotic use in Qatar: a survey of pharmacists' perceptions and experiences
Authors: Pawluk Shane , Black Emily , El-Awaisi Alla
Published: March 2014

Objectives

The objectives of this study were to identify antimicrobial stewardship activities in Qatar, identify pharmacist involvement in activities and summarize perceived barriers for implementation of antimicrobial stewardship programs (ASPs).

Methods

A cross-sectional survey was developed based on study objectives and completed by pharmacists in Qatar.

Key findings

Most hospital settings have implemented components of ASP. Lack of infectious disease specialists and training of healthcare providers was the most common barrier to implementation or expansion of ASP identified in the hospital and community settings respectively.

Conclusion

Pharmacists report some components of ASP have been implemented; however, barriers must be overcome to further expand ASPs.
Association between developmental defects of enamel and early childhood caries: a cross‐sectional study
Authors: Corrêa‐Faria Patrícia , Paixão‐Gonçalves Suzane , Paiva Saul Martins , Pordeus Isabela Almeida , Marques Leandro Silva , Ramos‐Jorge Maria Letícia
Published: March 2014

Background

The determination of risk factors for early childhood caries (ECC) is important to the implementation of preventive and restorative measures. However, few studies have addressed the association between ECC and developmental defects of enamel (DDE).

Aims

To investigate the association between DDE and ECC, controlling for socioeconomic factors and the presence of dental plaque.

Design

A cross‐sectional study was carried out with 387 children aged two to 5 years during the National Immunisation Day held in 2010 in Diamantina, Brazil. Data were collected through clinical examinations and interviews with parents/guardians addressing socioeconomic indicators. Statistical analysis involved the chi‐squared test and Poisson regression.

Results

The prevalence of DDE and ECC was 33.9% and 43.3%, respectively. Children with DDE had a greater prevalence rate of ECC (PR: 1.325; 95% CI: 1.093–1.607). Early childhood caries was more prevalent among children with unsatisfactory oral hygiene (PR: 2.933; 95% CI: 2.22–3.86), those who resided in rural areas (PR: 1.267; 95% CI: 1.03–1.55) and those from families with a lower monthly household income (PR: 1.501; 95% CI: 1.06–2.12).

Conclusions

The presence of ECC was associated with the occurrence of DDE in the primary dentition. Place of residence and monthly household income (socioeconomic indicators) and oral hygiene (behavioural factor) exerted an influence on the occurrence of ECC.
Another Determinant of Household Leverage: Evidence from Japan's Mortgage Loan Data
Authors: Nagano Mamoru , Yeom Dong‐Ho
Published: March 2014

We investigate determinants of household leverage in Japan, which did not experience the sharp rise in real estate prices and dramatic securitized mortgage market developments in the 2000s, and prove that these determinants are not universal. We employ household sample data collected during 2001–2010 by the Japan Housing Finance Agency and the Nikkei NEEDs Radar Financial Survey, totaling to 28,561 samples. We find that the degree of household interest rate risk preference, which proxies the household constitutional and behavioral factors including risk tolerance, positively relates to the household debt to income ratio. Further, as regards residential mortgage loans, these interest rate risk‐preferring households buy higher‐priced houses relative to their income, hold fewer financial assets, and tend to be headed by young males. We also find similarities between household mortgage debt determinants in Japan and the United States: the degree of regional bank market competition and the state of bank management soundness influence the aggressiveness of the residential mortgage loan business.
Long‐run Effects of Minimum Trading Unit Reductions on Stock Prices
Authors: Isaka Naoto
Published: March 2014

We examine empirically the long‐run effects of reductions in minimum trading units (MTU) on stock prices in Japan from October 2001 to May 2008. When firms reduce their MTU, the number of individual shareholders tends to increase significantly for several years. We estimate buy‐and‐hold abnormal returns and find that positive stock returns are observed not only for the period between the announcement day and the actual date of MTU decreases, but also for a period of several years following MTU reductions. In addition, we measure stock price reactions to the release of public information before and after MTU reductions and find that stock prices react less to the release of positive information and more to the release of negative information after the MTU reductions. These findings, together with evidence of the change in the short and long positions of investors after the MTU reductions, indicate that individual investors face short‐sales constraints.
Is No News Good News?: The Streaming News Effect on Investor Behavior Surrounding Analyst Stock Revision Announcement
Authors: Azuma Takahiro , Okada Katsuhiko , Hamuro Yukinobu
Published: March 2014

We investigate media influence on stock returns that are revised by sell‐side analysts. Our main findings are twofold. First, post‐announcement returns depend on whether the stock is covered by the media. Media‐covered stocks demonstrate weaker post‐announcement returns than their non‐media‐covered counterparts. Second, for media‐covered event samples, we create a sentiment proxy using a unique news word count method and investigate whether pre‐event sentiment affects post‐event returns. Our results indicate that pre‐event sentiment dictates short‐run investor behavior and affects the post‐announcement return in a significant manner.
Melatonin in testes of infertile men: evidence for anti‐proliferative and anti‐oxidant effects on local macrophage and mast cell populations
Authors: Rossi S. P. , Windschuettl S. , Matzkin M. E. , Terradas C. , Ponzio R. , Puigdomenech E. , Levalle O. , Calandra R. S. , Mayerhofer A. , Frungieri M. B.
Published: March 2014

Melatonin acting through the hypothalamus and pituitary regulates testicular function. In addition, direct actions of melatonin at the testicular level have been recently suggested. We have described that melatonin inhibits androgen production in hamster Leydig cells via melatonin subtype 1a (mel1a) receptors and the local corticotrophin‐releasing hormone (CRH) system. The initial events of the melatonin/CRH signalling pathway have also been established. Melatonin and all components of the melatonergic/CRH system were also detected in Leydig cells of infertile men. This study attempted to search for additional targets of melatonin in the human testis, and to investigate the effects of melatonin on proliferation and the oxidative state in these novel target cells. To this aim, evaluation of human testicular biopsies of patients suffering from hypospermatogenesis or Sertoli cell only syndrome and cell culture studies were performed. Melatonergic receptors were found in macrophages (MACs) and mast cells (MCs) of the human testis. In biopsies of patients suffering idiopathic infertility, melatonin testicular concentrations were negatively correlated with MAC number per mm2 and TNFα, IL1β and COX2 expression, but positively correlated with the expression of the anti‐oxidant enzymes SOD1, peroxiredoxin 1 and catalase. Melatonin inhibited proliferation and the expression of pro‐inflammatory cytokines and cyclooxygenase 2 (COX2) in both the human non‐testicular THP‐1 MAC cell line and primary cell cultures of hamster testicular MACs. In the human HMC‐1 MC line, melatonin increased the expression of anti‐oxidant enzymes and decreased reactive oxygen species (ROS) generation. The results reveal new testicular targets of melatonin and describe anti‐proliferative and anti‐inflammatory effects of this hormone on testicular MACs. Furthermore, melatonin might provide protective effects against oxidative stress in testicular MCs.
Risk of Atrial Fibrillation After Atrial Flutter Ablation: Impact of AF History, Gender, and Antiarrhythmic Drug Medication
Authors: BREMBILLA‐PERROT BÉATRICE , GIRERD NICOLAS , SELLAL JEAN MARC , OLIVIER ARNAUD , MANENTI VLADIMIR , VILLEMIN THIBAUT , BEURRIER DANIEL , DE CHILLOU CHRISTIAN , LOUIS PIERRE , SELTON OLIVIER , DE LA CHAISE ARNAUD TERRIER
Published: March 2014

Antiarrhythmic Drug and Ablation of Atrial Flutter

Introduction

Atrial fibrillation (AF) and flutter (AFL) are frequently associated. We assessed the frequency and identified the predictors of AF occurrence after AFL ablation.

Methods and Results

A total of 1,121 patients referred for AFL ablation were followed for a mean duration of 2.1 ± 2.7 years. Antiarrhythmic drugs were stopped after ablation in patients with no AF prior to ablation, or continued otherwise. A total of 356 patients (31.7%) had a history of AF prior to AFL ablation. Patients with AF prior to ablation were more likely to be females (OR = 1.35, CI = 1.00–1.83, P = 0.05). After ablation, 260 (23.2%) patients experienced AF. In the multivariable model, AF prior to ablation (OR = 1.90, CI = 1.42–2.54, P < 0.001) and female gender (OR = 1.77, CI = 1.29–2.42, P < 0.001) were associated with a higher risk of AF after ablation. In patients without prior AF, class I antiarrhythmics and amiodarone prior to AFL ablation were independently associated with higher risk of AF after ablation (OR = 2.11, CI = 1.15–3.88, P = 0.02 and OR = 1.60, CI = 1.08–2.36, P = 0.02, respectively). In patients who experienced AF after ablation, 201/260 (77.3%) had a CHA2DS2‐VASc ≥1. Two patients with AF prior to ablation had a stroke during the follow‐up whereas none of the patients without AF prior to ablation had a stroke.

Conclusions

AF occurrence after AFL ablation is frequent (>20%), especially in patients with a history of AF, in female patients, and in patients treated with class I antiarrythmics/amiodarone prior to AFL. Since most patients who experience AF after AFL ablation have a CHA2DS2‐VASc ≥1, the decision to stop anticoagulants after ablation should be considered on an individual basis.
Feasibility of Implementation of a “Simplified, No‐X‐Ray, No‐Lead Apron, Two‐Catheter Approach” for Ablation of Supraventricular Arrhythmias in Children and Adults
Authors: STEC SEBASTIAN , ŚLEDŹ JANUSZ , MAZIJ MARIUSZ , RAŚ MAŁGORZATA , LUDWIK BARTOSZ , CHRABĄSZCZ MICHAŁ , ŚLEDŹ ARKADIUSZ , BANASIK MAŁGORZATA , BZYMEK MAGDALENA , MŁYNARCZYK KRZYSZTOF , DEUTSCH KAROL , LABUS MICHAŁ , ŚPIKOWSKI JERZY , SZYDŁOWSKI LESŁAW
Published: March 2014

Simplified, No‐X‐Ray Catheter Ablation of SVT

Introduction

Although the “near‐zero‐X‐Ray” or “No‐X‐Ray” catheter ablation (CA) approach has been reported for treatment of various arrhythmias, few prospective studies have strictly used “No‐X‐Ray,” simplified 2‐catheter approaches for CA in patients with supraventricular tachycardia (SVT). We assessed the feasibility of a minimally invasive, nonfluoroscopic (MINI) CA approach in such patients.

Methods

Data were obtained from a prospective multicenter CA registry of patients with regular SVTs. After femoral access, 2 catheters were used to create simple, 3D electroanatomic maps and to perform electrophysiologic studies. Medical staff did not use lead aprons after the first 10 MINI CA cases.

Results

A total of 188 patients (age, 45 ± 21 years; 17% <19 years; 55% women) referred for the No‐X‐Ray approach were included. They were compared to 714 consecutive patients referred for a simplified approach using X‐rays (age, 52 ± 18 years; 7% <19 years; 55% women). There were 9 protocol exceptions that necessitated the use of X‐rays. Ultimately, 179/188 patients underwent the procedure without fluoroscopy, with an acute success rate of 98%. The procedure times (63 ± 26 vs. 63 ± 29 minutes, P > 0.05), major complications (0% vs. 0%, P > 0.05) and acute (98% vs. 98%, P > 0.05) and long‐term (93% vs. 94%, P > 0.05) success rates were similar in the “No‐X‐Ray” and control groups.

Conclusions

Implementation of a strict “No‐X‐Ray, simplified 2‐catheter” CA approach is safe and effective in majority of the patients with SVT. This modified approach for SVTs should be prospectively validated in a multicenter study.
Keratinocyte growth factor‐2 intratracheal instillation significantly attenuates ventilator‐induced lung injury in rats
Authors: Bi Jing , Tong Lin , Zhu Xiaodan , Yang Dong , Bai Chunxue , Song Yuanlin , She Jun
Published: March 2014

Preservation or restoration of normal alveolar epithelial barrier function is crucial for pulmonary oedema resolution. Keratinocyte growth factor‐2 (KGF‐2), a potent epithelial cell mitogen, may have a role in preventing ventilator‐induced lung injury (VILI), which occurs frequently in mechanically ventilated patients. The aim of the study was to test the role of KGF‐2 in VILI in rats. Forty healthy adult male Sprague‐Dawley rats were randomly allocated into four groups, where rats in Groups HVZP (high‐volume zero positive end‐expiratory pressure) and HVZP+KGF‐2 were given intratracheally equal PBS and 5 mg/kg KGF‐2 72 hrs before 4 hrs HVZP ventilation (20 ml/kg), respectively, while PBS and KGF‐2 were administered in the same manner in Groups Control and KGF‐2, which underwent tracheotomy only with spontaneous breathing. Inflammatory cytokines (tumour necrosis factor‐α, macrophage inflammatory protein 2), neutrophil and total protein levels in bronchoalveolar lavage fluid and surfactant protein mRNA expression in lung tissue were detected; the number of alveolar type II cells, lung water content and lung morphology were also evaluated. The results indicate that pre‐treatment with KGF‐2 showed dramatic improvement in lung oedema and inflammation compared with HVZP alone, together with increased surfactant protein mRNA and alveolar type II cells. Our results suggest that KGF‐2 might be considered a promising prevention for human VILI or other acute lung injury diseases.
The influence of treatment on the development of leishmaniasis recidiva cutis: a 17‐year case–control study in Midwestern Brazil
Authors: Gomes C.M. , Cesetti M.V. , de Morais O.O. , Mendes M.S.T. , Roselino A.M. , Sampaio R.N.R.
Published: March 2014

Background

The recurrence of American cutaneous leishmaniasis (ACL) in patients experiencing a long‐term cure is often called leishmaniasis recidiva cutis (LRC). LRC is considered an unusual form of ACL.

Objective

This study aims to estimate the incidence of LRC in ACL patients evaluated at a tertiary dermatologic centre in Midwestern Brazil. We also aim to evaluate the association between various treatment regimens and the development of LRC using multivariate analysis in a case–control study.

Methods

We performed a 17‐year epidemiological study using data from patients treated at our dermatologic centre from July 1994 to December 2011. A retrospective analysis was then performed to estimate risk and protective factors related to clinical presentation. We also assessed the influence of treatment regimens in the development of LRC.

Results

The incidence of LRC among ACL patients was 1.34%. The analysis included 105 patients; 82 patients (78%) were in the control group, and 23 patients (22%) were in the LRC case group. The data analysis indicated that the standard treatment N‐methylglucamine antimoniate (N‐MA) reduced the development of LRC in bivariate (odds ratio (OR) = 0.34; 95% CI = 0.13–0.91) and multivariate analyses (OR = 0.16; 95% CI = 0.03–0.86; P = 0.03). However, no differences in LRC incidence were observed when the standard treatment N‐MA and alternative drugs, such as pentamidine and amphotericin B, were considered (OR = 0.47; 95% CI = 0.16–1.35)

Conclusion

We conclude that the standard treatment N‐MA, as proposed by the Brazilian Ministry of Health, is effective in the prevention of LRC. Although other drugs have shown promising results in LRC, more scientific evidence is needed to assess their efficacy compared with N‐MA.
Association between parasite load and orange, but not blue, male nuptial colouration in Etheostoma caeruleum
Authors: Ciccotto P. J. , Dresser D. J. , Mendelson T. C.
Published: March 2014

The hypothesis that males possessing more vivid nuptial colouration are of better quality with regard to individual measures of health such as parasite infection was investigated by taking spectral measurements of orange and blue bars in the nuptial males of a sexually dichromatic stream fish rainbow darter Etheostoma caeruleum to determine if male colouration in this species varied with parasite load in the form of black spot disease. The yellow chroma of orange bars, i.e. the relative contribution of wavelengths in the range of 550–625 nm to total brightness, was the only spectral measurement significantly associated with parasite counts. These results are discussed in the context of sexual selection and the potential of orange bars in E. caeruleum to serve as honest indicators of quality to potential mates.
Combined Effect of Xylanase, Ascorbic and Citric Acid in Regulating the Quality of Bread Made From Organically Grown Spelt Cultivars
Authors: Filipčev Bojana , Šimurina Olivera , Bodroža‐Solarov Marija
Published: March 2014

The present study was aimed at improving bread‐making performance of two spelt cultivars from organic production differing in dough rheological properties. For this purpose, a small composite design was employed to study the combined effect of xylanase (XYL), ascorbic (ASC) and citric (CIT) acid on bread characteristics and, finally, to optimize their doses. In both cultivars, XYL exerted improving effects on specific volume and crumb firmness. In stronger spelt cultivar, there was a significant ASC/XYL synergistic effect on improving loaf volume and crumb properties. CIT showed crumb softening effect in both cultivars and increased crumb resilience (weaker spelt being more sensitive). Optimized formulation contained (in mg/kg): 50 ASC/90 CIT/60 XYL for stronger and 20 ASC/10 CIT/120 XYL for weaker spelt cultivar. The optimized formulations allowed substantial increases in specific volume (by 45%) and crumb resilience (30%) for stronger and crumb softening (36%) for weaker spelt cultivar.

Practical Applications

Spelt wheat is an important cereal in organic cultivation and spelt products are highly demanded by health‐conscious customers. Most commonly, spelt is processed into flour and further into bread. Technologically, spelt is impaired in comparison to common bread wheat, although high diversity exists in bread‐making potential within cultivars. In practice, it is not rare that spelt bread‐making results in production of unappealing, small bread loaves with dense, crumbly structure. Considering the much higher price of spelt bread, low quality of loaves may diminish its valorization in spite of its unique nutritional and health properties. This work presents that by combining improvers based on enzyme (xylanase), ascorbic and citric acid, which are permitted in organic foods, it is possible to substantially improve spelt bread volume and crumb properties.
“Don't Get Weak in Your Compassion”: Bereaved Next of Kin's Suggestions for Improving End‐of‐Life Care in Veterans Affairs Medical Centers
Authors: Riggs Jennifer S. , Woodby Lesa L. , Burgio Kathryn L. , Amos Bailey F. , Williams Beverly R.
Published: March 2014

Objectives

To analyze bereaved next of kin's suggestions for improving end‐of‐life (EOL) care in Veterans Affairs (VA) Medical Centers (VAMCs).

Design

Qualitative.

Setting

This study was part of a larger study testing the effectiveness of a multimodal intervention strategy to improve processes of EOL care in six southeast U.S. VAMCs (Best Practices for End‐of‐Life Care for Our Nation's Veterans—BEACON Trial).

Participants

Bereaved next of kin (n = 78) of veterans who died between 2005 and 2010.

Measurements

Data addressing praise, criticism, and recommendations for enhancing EOL care were abstracted from semistructured interviews of next of kin and aggregated into a code labeled “Suggestions.” Content analysis proceeded iteratively through data review, comparison, and negotiation of emergent themes and integration of all coauthors' insights and interpretations into the evolving interpretive scheme.

Results

Next of kin provided examples that resonated with their conceptions of quality EOL care. They also described distressing situations and perceptions of deficits in care. Major themes derived were compassionate care, good communication, support for family visits and privacy, and the need for death preparation and postdeath guidance. The fifth theme, unique to this study, was the salience of the relationship between the veterans and their families and the VA and the expectations this engendered in terms of dignity and honor.

Conclusion

Interventions that support staff's ability to convey compassion, communicate information to families and other staff, listen to patients and families, prepare families for the individual's death, and provide consistent, coordinated information regarding after‐death activities may optimize EOL hospital care for veterans.
Knowledge and Skill Retention of a Mobile Phone Data Collection Protocol in Rural Liberia
Authors: Munro Michelle L. , Lori Jody R. , Boyd Carol J. , Andreatta Pamela
Published: March 2014

Introduction

With a large number of births occurring outside the formal health system, it is difficult to determine the number of pregnant women in rural regions of Liberia. The exponential growth of mobile phone use in developing countries provides a potential avenue for data collection on maternal and child health in such rural, remote regions.

Methods

A pre‐, post‐, and one‐year posttest design was used to collect data on knowledge and skill retention for 7 essential items required for mobile phone use among traditional birth attendants (TBAs) trained in a short message service (SMS) texting data collection protocol (N = 99) in rural Liberia.

Results

Sixty‐three participants (63.6% retention) completed the one‐year posttest and displayed evidence of statistically significant knowledge and skill retention in 6 of the 7 tasks (P < .005), including the ability to: 1) turn on the phone, 2) use the mobile phone to make a call, 3) recognize that they have coverage, 4) recognize that the mobile phone is charged, 5) create a SMS text message without help, and 6) send a SMS text message without help. The TBAs continued to have difficulty with more complex tasks such as adding minutes to a phone.

Discussion

The mobile phone data‐collection protocol proved feasible with TBAs demonstrating knowledge retention in a one‐year posttest; however, clinical significance needs further investigation. The protocol increased communication and collaboration among TBAs, certified midwives, and clinic staff.
Sex Differences in Expression of Oestrogen Receptor α but not Androgen Receptor mRNAs in the Foetal Lamb Brain
Authors: Reddy R. C. , Estill C. T. , Meaker M. , Stormshak F. , Roselli C. E.
Published: March 2014

Gonadal steroid hormones play important roles during critical periods of development to organise brain structures that control sexually dimorphic neuroendocrine responses and behaviours. Specific receptors for androgens and oestrogens must be expressed at appropriate times during development to mediate these processes. The present study was performed to test for sex differences in the relative expression of oestrogen receptor (ER)α and androgen receptor (AR) mRNA during the window of time in gestation that is critical for behavioural masculinisation and differentiation of the ovine sexually dimorphic nucleus (oSDN) in the sheep. In addition, we examined whether ERα and AR mRNA expression is localised within the nascent oSDN and could be involved in its development. Using the quantitative real‐time polymerase chain reaction, we found that females expressed more ERα mRNA than males in medial preoptic area and medial basal hypothalamus during the mid‐gestational critical period for brain sexual differentiation. No sex differences were found for AR mRNA in any tissue examined or for ERα in amygdala and frontal cortex. Using radioactive in situ hybridisation, we found that the distributions of ERα and AR mRNA overlapped with aromatase mRNA, which delineates the boundaries of the developing oSDN and identifies this nucleus as a target for both androgens and oestrogens. These data demonstrate that the transcriptional machinery for synthesising gonadal steroid receptors is functional in the foetal lamb brain during the critical period for sexual differentiation and suggest that possible mechanisms for establishing dimorphisms controlled by gonadal steroids may exist at the level of steroid hormone receptor expression.
Risk Detection and Self‐Protection Among Homeless Youth
Authors: Bender Kimberly , Thompson Sanna , Ferguson Kristin , Yoder Jamie , DePrince Anne
Published: March 2014

Utilizing qualitative interviews with a large sample of 145 homeless youth seeking services at homeless youth service agencies from across three U.S. cities (Los Angeles, Denver, and Austin), this study sought to explore youths' perspectives on ways in which they detect risk and protect themselves on the streets. Results indicated that youth use a combination of internal cues (affective responses) and external cues (reading people) to detect danger, although many times danger was described as undetectable. Certain contexts, includes those that were unfamiliar, difficult to escape, or involved drugs were described as most dangerous. In response to these dangers, youth employed self‐protection strategies such as carrying weapons, banding together with trusted others, isolating, or seeking programing to leave the streets.
Bidirectional Associations Between Self‐Regulation and Parenting Styles in Early Adolescence
Authors: Moilanen Kristin L. , Rasmussen Katie E. , Padilla‐Walker Laura M.
Published: March 2014

The goal of this study was to explore bidirectional associations between teens' self‐regulation and maternal and paternal parenting styles (i.e., authoritative, authoritarian, and permissive‐indulgent) over one year. As part of an ongoing longitudinal study, 489 teens ages 11–16 (51% female, 70% European American, 69% in two‐parent households) and their parents completed questionnaires on two occasions. Analyses revealed high temporal stability of parenting and self‐regulation over time. No cross‐lagged effects emerged in either authoritative parenting model. Bidirectional effects were observed in the maternal authoritarian parenting model only. Child effects on parenting were revealed in both permissive‐indulgent parenting models. The interpretation of these findings and their implications for future research are delineated in the discussion.
Changes in state policies related to oral health in the United States, 2002‐2009
Authors: Mandal Mahua , Edelstein Burton L. , Ma Sai , Minkovitz Cynthia S.
Published: March 2014

Objectives

Examining state policies in oral health, including changes over time, helps inform the degree to which states fulfill public health dentistry functions and deliver essential services. This study examines changes in state policies affecting oral health in the United States between 2002 and 2009.

Methods

We reviewed 43 oral health policies in three domains (public dental insurance; workforce capacity; and infrastructure, programs, and surveillance). Data sources included federal, state, and private foundation reports and databases. Fifteen of 43 policies had data available for both time points and were analyzed. We examined national and regional changes over time using McNemar's test and Wilcoxon matched pairs signed ranks test.

Results

Between 2002 and 2009, the number of states offering Medicaid reimbursement to nondental professionals increased, more states had 12‐month continuous coverage in CHIP, income eligibility for children on Medicaid expanded, and the number of licensed dentists per 10,000 population per state increased. However, the percent of public and private state health expenditures going toward dental services declined. Though nationally no other state policies significantly changed, the proportion of population on public water system with fluoridated water increased in Western states, and administration of needs assessments or oral health surveys decreased in the Northeast.

Conclusion

Efforts are needed to systematically track the status of state policies to promote the public's oral health. Further research can determine if changes in state policies have led to improvements in the provision of oral health services and oral health status and reductions in disparities.
Does Rurality Influence Treatment Decisions in Early Stage Laryngeal Cancer?
Authors: Mackley Heath B. , Teslova Tatiana , Camacho Fabian , Short Pamela F. , Anderson Roger T.
Published: March 2014

Purpose

The mortality rate of laryngeal cancer has been trending downward with the use of more effective surgical, radiation, and systemic therapies. Although the best treatment for this disease is not entirely clear, there is a growing consensus on the value of primary radiotherapy as an organ preservation strategy. This study examines urban‐rural differences in the use of radiotherapy as the primary treatment for early stage laryngeal cancer in Pennsylvania.

Experimental Design

The sample was drawn from the Pennsylvania tumor registry, which lists 2,437 laryngeal cancer patients diagnosed from 2001 to 2005. We selected 1,705 adults with early stage squamous cell carcinoma of the larynx for our analysis. Demographic data and tumor characteristics were included as control variables in multivariate analyses. Rurality was assigned by ZIP code of patient residence.

Results

Controlling for demographic and clinical factors, rural patients were less likely than urban patients to receive radiotherapy as the primary treatment modality for early stage larynx cancer (OR 0.740, 95% CI 0.577‐0.949, P = .0087). No other associations between rural status and treatment choice were statistically significant.

Conclusions

Relatively fewer rural patients with larynx cancer are treated primarily with radiation therapy. Further investigations to describe this interaction more thoroughly, and to see if this observation is found in larger population data sets, are warranted.
Canine T‐Zone Lymphoma: Unique Immunophenotypic Features, Outcome, and Population Characteristics
Authors: Seelig D.M. , Avery P. , Webb T. , Yoshimoto J. , Bromberek J. , Ehrhart E.J. , Avery A.C.
Published: March 2014

Background

Canine T‐cell lymphoma (TCL) is clinically and histologically heterogeneous with some forms, such as T‐zone lymphoma (TZL), having an indolent course. Immunophenotyping is an important tool in the classification of TCL in people, and can be equally useful in dogs.

Hypothesis/Objectives

We hypothesized that loss of expression of the CD45 antigen is a specific diagnostic feature of TZL.

Animals

Twenty dogs with concurrent histology and immunophenotyping by flow cytometry were studied in depth. An additional 494 dogs diagnosed by immunophenotyping were used to characterize the population of dogs with this disease.

Methods

Lymph node biopsies from 35 dogs with TCL were classified by 2 pathologists using WHO criteria. Twenty lymph nodes were from dogs with CD45− TCL and 15 were from CD45+ TCL. The pathologists were blinded to the flow cytometry findings. Outcome information was sought for the 20 dogs with CD45− lymphoma, and population characteristics of the additional 494 dogs were described.

Results

All 20 CD45− cases were classified as TZL. The 15 CD45+ cases were classified as aggressive TCL and are described in an accompanying paper. TZL cases had a median survival of 637 days. Examination of 494 additional dogs diagnosed with TZL by immunophenotyping demonstrated that 40% of cases are in Golden Retrievers, are diagnosed at a median age of 10 years, and the majority have lymphadenopathy and lymphocytosis.

Conclusions

TZL has unique immunophenotypic features that can be used for diagnosis.
Rodent population dynamics affect seedling recruitment in alpine habitats
Authors: Nystuen Kristin O. , Evju Marianne , Rusch Graciela M. , Graae Bente J. , Eide Nina E.
Published: March 2014

Questions

How do rodents with cyclic population dynamics affect seedling recruitment in alpine habitats? Does disturbance from rodents have larger implications on seedling recruitment in some plant communities than in others?

Location

Snowbeds and sheltered heaths in the low‐alpine zone in areas of Børgefjell and Dovrefjell, Norway.

Methods

We recorded seedling emergence, rodent activity and cover of mosses, lichens, litter and bare ground in 270 plots in snowbeds and sheltered heaths in a rodent population peak year and in the following low‐density year.

Results

Seedling recruitment was positively correlated with disturbances from lemmings and voles in both years. More seedlings emerged in the low‐density year than in the year of the population peak. Snowbeds had higher seedling recruitment than the sheltered heaths, but both habitats were equally affected by disturbances from rodents.

Conclusions

Rodent activity created gaps and increased seedling emergence in these alpine plant communities, particularly in the year after the rodent peak, both in snowbeds and sheltered heath habitats. Our study therefore suggests that regeneration patterns in alpine vegetation are tightly linked to the population cycles of lemmings and voles, which peak in density at 3‐ to 5‐yr intervals.
Gap ecology in the Florida scrubby flatwoods: effects of time‐since‐fire, gap area, gap aggregation and microhabitat on gap species diversity
Authors: Dee Justin R. , Menges Eric S.
Published: March 2014

Questions

The ecology of landscape gaps is important for the maintenance of species diversity in a variety of plant ecosystems. In the scrubby flatwoods community type of the pyrogenic Florida scrub, we aimed to identify the relationship between time‐since‐fire, gap area, quality (microhabitat) and aggregation (structural connectivity) with neighbouring gaps on gap species diversity and occupancy.

Location

Archbold Biological Station (ABS), Lake Wales Ridge, south‐central Florida, USA.

Methods

We measured species diversity, gap area, aggregation and microhabitat (percentage bare sand) in 120 gaps divided evenly amongst 1, 2, 4, 8, 16 and 26 yrs since fire in the scrubby flatwoods of ABS (typical fire return interval of 5–20 yrs) throughout the summer of 2011.

Results

Gap area and aggregation were significantly highest in the first 4 yrs after fire, but decreased and remained fairly constant at longer times‐since‐fire. Percentage bare sand gradually decreased with time‐since‐fire until a strong decline at the 26‐yr mark, where litter cover was significantly higher than all previous years. Gap area strongly and positively predicted species richness (total and herb spp.) and total species diversity (H'). Bare sand content was positively correlated with the richness of species that are obligate seeders post‐fire. Gap aggregation was generally a poor predictor of diversity components, although it positively influenced the occurrence of Stipulicida setacea, a seeder species that occasionally resprouts after fire. Overall, species richness and diversity peaked at intermediate times‐since‐fire, probably because long‐unburned gaps were too small and inundated with litter to sustain higher richness of herbs and obligate seeders.

Conclusion

In a prior gap ecology study, in neighbouring more xeric rosemary scrub, gaps were larger, more persistent and had higher bare sand cover, resulting in higher levels of total species richness and diversity for decades longer after fire than gaps in this study. In both these types of Florida scrub, the threat of fire suppression and its adverse effects on gap area and microhabitat may be detrimental for several endemic species that depend on gaps.