bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of post‐kidney transplant parathyroidectomy on allograft function
Authors: Parikh Samir , Nagaraja Haikady , Agarwal Anil , Samavedi Srinivas , Von Visger Jon , Nori Uday , Andreoni Kenneth , Pesavento Todd , Singh Neeraj
Published: March 2013

Background

The impact of parathyroidectomy on allograft function in kidney transplant patients is unclear.

Methods

We conducted a retrospective, observational study of all kidney transplant recipients from 1988 to 2008 who underwent parathyroidectomy for uncontrolled hyperparathyroidism (n = 32). Post‐parathyroidectomy, changes in estimated glomerular filtration rate (eGFR) and graft loss were recorded. Cross‐sectional associations at baseline between eGFR and serum calcium, phosphate, and parathyroid hormone (PTH), and associations between their changes within subjects during the first two months post‐parathyroidectomy were assessed.

Results

Post‐parathyroidectomy, the mean eGFR declined from 51.19 mL/min/1.73 m2 at parathyroidectomy to 44.78 mL/min/1.73 m2 at two months (p < 0.0001). Subsequently, graft function improved, and by 12 months, mean eGFR recovered to 49.76 mL/min/1.73 m2 (p = 0.035). Decrease in serum PTH was accompanied by a decrease in eGFR (p = 0.0127) in the first two months post‐parathyroidectomy. Patients whose eGFR declined by ≥20% (group 1) in the first two months post‐parathyroidectomy were distinguished from the patients whose eGFR declined by <20% (group 2). The two groups were similar except that group 1 had a higher baseline mean serum PTH compared with group 2, although not significant (1046.7 ± 1034.2 vs. 476.6 ± 444.9, p = 0.14). In group 1, eGFR declined at an average rate of 32% (p < 0.0001) during the first month post‐parathyroidectomy compared with 7% (p = 0.1399) in group 2, and the difference between these two groups was significant (p = 0.0003). The graft function recovered in both groups by one yr. During median follow‐up of 66.00 ± 49.45 months, 6 (18%) patients lost their graft with a mean time to graft loss from parathyroidectomy of 37.2 ± 21.6 months. The causes of graft loss were rejection (n = 2), pyelonephritis (n = 1) and chronic allograft nephropathy (n = 3). No graft loss occurred during the first‐year post‐surgery.

Conclusion

Parathyroidectomy may lead to transient kidney allograft dysfunction with eventual recovery of graft function by 12 months post‐parathyroidectomy. Higher level of serum PTH pre‐parathyoidectomy is associated with a more profound decrease in eGFR post‐parathyroidectomy.
Expression of CK7, Cam 5.2 and Ber‐Ep4 in cutaneous squamous cell carcinoma
Authors: Clarke Loren E. , Conway Andrea B. , Warner Nicole M. , Barnwell Patricia N. , Sceppa Jennifer , Helm Klaus F.
Published: March 2013

Background

Cytokeratin 7 (CK7) and Cam 5.2 are often used to differentiate extramammary Paget's disease (EPD) from squamous cell carcinoma (SCC) in situ because they are generally considered to be expressed in the former but not in the latter. However, we have encountered CK7+ and Cam 5.2+ SCCs.

Methods

We evaluated CK7, Cam 5.2 and Ber‐Ep4 expression in SCC and EPD.

Results

We found significant CK7 and Cam 5.2 positivity in SCCs, particularly in those with a pagetoid pattern. Only one case expressed Ber‐Ep4.

Conclusions

We conclude that CK7 and Cam 5.2 expression may occur in SCC. A panel including Ber‐Ep4 is advisable for immunohistochemical differentiation of EPD from SCC.
Exposing Mammon: Devotion to Money in a Market Society
Authors: Goodchild Philip
Published: March 2013

Abstract:  The recent financial crisis has exposed the extent to which the contemporary global economy is driven by credit. Yet credit is the obverse of debt, and where overspending threatens instability through an increasing debt spiral, austerity measures also threaten instability through reducing growth, also leading to an increasing debt spiral. Humanity is increasingly exposed to the force of money, which is created as debt with a given expiration date. Yet to place our credit or faith in the power of debt itself is to place faith in a world of shadows, in estimations of the value of things as perceived by others or market prices. Redemption from debt involves a restoration of our capacity to judge intrinsic values rather than mere prices.
Variability of glucose‐lowering effect as a limiting factor in optimizing basal insulin therapy: a review
Authors: Vora J. , Heise T.
Published: March 2013

Lowering blood glucose with insulin therapy towards beneficial target levels while also avoiding hypoglycaemia is a challenging task. An important confounding factor, which might be under‐appreciated in this scenario, is that of variable glucose readings causing difficulties with dose adjustment. Furthermore, this glucose variability is, to some extent, a reflection of variability in the glucose‐lowering action of the insulin therapy itself. Not only is glucose variability a major confounding factor in disease management but it is possibly also of direct prognostic consequence and is increasingly recognized as an informative measurement in diabetes management. The scope for insulin‐induced glucose variability is particularly great with basal insulins because of their prolonged absorption from high‐dose depots. Pharmacodynamic (PD) variability manifests as both fluctuations in the level of glucose‐lowering effect over time, and as inconsistencies in the response from one injection to another. Well‐controlled pharmacokinetic (PK)/PDstudies using repeated isoglycaemic clamp methodology clearly how that many injected basal insulin products have high variable absorption with correspondingly variable action. Incomplete resuspension and precipitation appear to be important issues with regard to unpredictability in this action, while an inadequate duration of action relative to the dosing interval results in a fluctuating action profile. There are some ultra–long‐acting basal insulins with novel protraction mechanisms currently in clinical development for which clamp studies show markedly improvedPK/PDprofiles.
Cold atmospheric plasma, a new strategy to induce senescence in melanoma cells
Authors: Arndt Stephanie , Wacker Eva , Li Yang‐Fang , Shimizu Tetsuji , Thomas Hubertus M. , Morfill Gregor E. , Karrer Sigrid , Zimmermann Julia L. , Bosserhoff Anja‐Katrin
Published: March 2013

Over the past few years, the application of cold atmospheric plasma (CAP) in medicine has developed into an innovative field of research of rapidly growing importance. One promising new medical application of CAP is cancer treatment. Different studies revealed that CAP may potentially affect the cell cycle and cause cell apoptosis or necrosis in tumor cells dependent on the CAP device and doses. In this study, we used a novel hand‐held and battery‐operated CAP device utilizing the Surface Micro Discharge (SMD) technology for plasma production in air and consequently analysed dose‐dependent CAP treatment effects on melanoma cells. After 2 min of CAP treatment, we observed irreversible cell inactivation. Phospho‐H2AX immunofluorescence staining and Flow cytometric analysis demonstrated that 2 min of CAP treatment induces DNA damage, promotes induction of Sub‐G1 phase and strongly increases apoptosis. Further, protein array technology revealed induction of pro‐apoptotic events like p53 and Rad17 phosphorylation of Cytochrome c release and activation of Caspase‐3. Interestingly, using lower CAP doses with 1 min of treatment, almost no apoptosis was observed but long‐term inhibition of proliferation. H3K9 immunofluorescence, SA‐ß‐Gal staining and p21 expression revealed that especially these low CAP doses induce senescence in melanoma cells. In summary, we observed differences in induction of apoptosis or senescence of tumor cells in respond to different CAP doses using a new CAP device. The mechanism of senescence with regard to plasma therapy was so far not described previously and is of great importance for therapeutic application of CAP.
Studies of Jak/STAT3 expression and signalling in psoriasis identifies STAT3‐Ser727 phosphorylation as a modulator of transcriptional activity
Authors: Andrés Rosa M. , Hald Anne , Johansen Claus , Kragballe Knud , Iversen Lars
Published: March 2013

Jak/Tyk proteins have recently aroused as possible therapeutic targets for the treatment of psoriasis. In psoriasis, these proteins signal through STAT molecules including STAT3, and STAT3 expression and activation has been shown augmented in psoriatic lesions. Here, we characterized the expression of Jak/Tyk proteins in lesional compared with non‐lesional psoriatic skin. Jak1, Jak2 mRNA and protein and Tyk2 mRNA appeared to be downregulated, whereas Jak3 mRNA expression was increased. Moreover, STAT3 expression and activation was examined in psoriasis. STAT3 is activated at two phosphorylation sites: Tyr705 and Ser727. Both phosphorylation sites were phosphorylated in lesional psoriatic skin. The activation of STAT3 by Jak/Tyk proteins was studied in cultured normal human keratinocytes. Tyr705 phosphorylation was induced by IL‐6 and IL‐20 in a Jak2‐dependent manner, and moreover, phosphorylation of Tyr705 produced a strong increase in STAT3 transcriptional activity. TNFα, 12‐O‐Tetradecanoylphorbol 13‐acetate (TPA) and UVB irradiation induced Ser727 phosphorylation of STAT3 in an ERK1/2‐ and p38 MAPK‐dependent manner, which resulted in a modulatory effect on STAT3 transcriptional activity. Our results demonstrate how different signalling pathways can integrate and lead to regulation of STAT3 transcriptional activity.
Attitudes Toward Task‐Based Language Learning: A Study of College Korean Language Learners
Authors: Ooyoung Pyun Danielle
Published: March 2013

This study explores second/foreign language (L2) learners' attitudes toward task‐based language learning (TBLL) and how these attitudes relate to selected learner variables, namely anxiety, integrated motivation, instrumental motivation, and self‐efficacy. Ninety‐one college students of Korean as a foreign language, who received task‐based language instruction, participated in this questionnaire study. Data were analyzed using both descriptive and inferential statistics. A correlation analysis between variables indicated that students' attitudes toward TBLL were positively associated with self‐efficacy and integrative motivation while they were negatively associated with anxiety. A multiple regression analysis further revealed that only one variable, self‐efficacy, was the significant predictor of learners' attitudes toward TBLL.
Light saturated RuBP oxygenation by Rubisco is a robust predictor of light inhibition of respiration in Triticum aestivum L
Authors: Griffin K. L. , Turnbull M. H.
Published: March 2013

Plant respiratory metabolism is complicated by the fact that the rate of non‐photorespiratory mitochondrial CO2 release in the light (Rlight) may be lower than the rate of leaf respiration in the dark (Rdark). A body of work on this topic implies a linkage between light inhibition of respiration and photorespiration, although the direction of effect and underlying mechanisms remain uncertain. In this study we used a variety of short‐ and long‐term environmental manipulations to explicitly manipulate the rate of photorespiration (νo) and quantify the effect on the inhibition of mitochondrial respiration in the light (Rlight:Rdark). We address the following three questions: (i) will the Rlight:Rdark ratio increase or decrease with high CO2 or low O2 and at low temperatures; (ii) does νo correlate with Rlight:Rdark, and if so, in what way; (iii) will suppression of respiration by light (the ‘Kok effect’) be seen to the same extent in Zea mays, a C4 plant, and in Triticum aestivum, a C3 plant? We found that Rlight:Rdark decreased under conditions that suppressed νo in wheat, and this resulted in a positive relationship between Rlight:Rdark and νo. Inhibition of respiration by light in C4 maize did not respond to environmental treatment, and the fixed Rlight:Rdark (0.46–0.72) was consistent with the wheat response, assuming a νo approaching zero. The most likely mechanism to explain this finding is that Rlight increases (or the inhibition of respiration by light decreases) when there is an increase in photorespiration and thus an increase in the demand for TCA cycle substrates associated with the recovery of photorespiratory cycle intermediates in the peroxisome. This work is significant because it combines a comparison of C3 and C4 metabolism with a range of environmental treatments to independently suppress νo.
A comparative study of aluminium and nutrient concentrations in mistletoes on aluminium‐accumulating and non‐accumulating hosts
Authors: Scalon M. C. , Haridasan M. , Franco A. C.
Published: March 2013

Mistletoes offer a unique model to study interactions amongAl and nutrients in vascular plants, because they grow and reproduce on hosts with distinctAl uptake strategies. We investigatedAl distribution and nutrient relations of mistletoes onAl‐accumulating and non‐accumulating hosts. We hypothesised that mistletoes would exhibit similar leaf nutrient and Al concentrations as their host plants, but a strong compartmentalisation ofAl when growing onAl‐accumulators. We measured concentrations ofN,P,K,Ca,Mg,Cu,Fe,Mn,Zn in leaves andAl in leaves, seeds and branches ofPhthirusa ovataandPsittacanthus robustusinfectingMiconia albicans,an Al‐accumulator, andPh. ovatainfectingByrsonima verbascifolia, a non‐Al‐accumulator. High leaf concentrations of Al inPh. ovataonly occurred while parasitizing theAl‐accumulating host; there was no accumulation in branches or seeds. InP. robustus, large concentrations ofAl were found in leaves, branches and seeds. Mistletoe seed viability and leaf nutrient concentrations were not affected byAl accumulation. Passive uptake ofAl,Ca,Mg,Mn andCu in mistletoes was evidenced by significant correlations between mistletoes and host leaf concentrations, but not ofN,PandK.Al was retranslocated to different plant organs inP. robustus, whereas it was mostly restricted to leaves inPh. ovata. We suggest that Al might have some specific function inP. robustus, which only parasitizes Al‐accumulator hosts, while the host generalistPh. ovatacan be considered a facultativeAl‐accumulator.
Is Multiculturalism Bad for Social Cohesion and Redistribution?
Authors: Levrau François , Loobuyck Patrick
Published: March 2013

Multiculturalism as an official policy strategy has recently come in for significant criticism in a number of Western European countries. A key criticism is that multicultural policies undermine redistribution policies, since they would erode the social cohesion upon which redistribution measures are built. However, empirical research does not univocally confirm this critique. This article explains why this is the case. The first argument is called the integration‐recognition paradox. Policies that focus on recognising minority groups may lead to a greater social acceptance of those minorities, and in turn may lead to their feeling more appreciated as participants in society. In a second argument, the authors discuss how multicultural policies could easily be combined with policies that invest in national unity and social cohesion.
SecondWorldWar spending and local economic activity inUScounties, 1939–58
Authors: Fishback Price , Cullen Joseph A.
Published: March 2013

Studies of the development of local economies often point to large‐scaleSecondWorldWar military spending as a source of economic growth, even though spending declined sharply after demobilization. We examine the relationship between war spending per capita and the changes in economic activity inUScounties between 1939 before the war and a period several years after the war. In the longer term counties receiving more war spending per capita during the war experienced greater population growth, but growth in per capita measures of economic activity showed little relationship with per capita war spending.
Long‐Term Maintenance of Arytenoid Cartilage Abduction and Stability During Exercise After Laryngoplasty in 33 Horses
Authors: Barnett Timothy P. , O'Leary John Mark , Parkin Timothy D.H. , Dixon Padraic M. , Barakzai Safia Z.
Published: March 2013

Objectives

To (1) assess long‐term maintenance of arytenoid cartilage abduction (ACA) after laryngoplasty (LP); and (2) correlate the residual grade of ACA and postoperative abductory loss with arytenoid cartilage stability (ACS) during exercise.

Study Design

Case series.

Animals

Horses re‐examined after laryngoplasty (n = 33).

Methods

Of 89 LP horses (2005–2010), 33 had historic ACA data available and upper airway endoscopy at rest and during over‐ground exercise (mean, 33 months; range, 4–71 months) after surgery. ACA grade at 1 and 6 weeks postoperatively were correlated to long‐term ACA grade. Effects of long‐term ACA grade and magnitude of postoperative abductory loss on ACS during exercise were investigated.

Results

Median ACA grade at 1 week (n = 33) was 2, reducing to grade 3 by week 6 (n = 16). Grade 3 abduction was maintained in the long‐term. Correlation between ACA at 1 week and the long‐term was poor (ρ = .43,P = .1), but there was good correlation between week 6 and long‐term (ρ = .89,P < .001). Arytenoid cartilage instability was observed during exercise in 7/33 of horses, and not significantly associated with the ACA grade (P = .50), or the number of grades of ACA lost (P = .64).

Conclusions

Limited abductory loss occurs after 6 weeks postoperatively. Resting ACA grade was not a useful predictor of ACS during exercise.
Improved Co‐Firing of Ferrite and Dielectric Tape Based on Master Sintering Curve Predictions and Shrinkage Mismatch Calculations
Authors: Brandt Björn , Naghib‐zadeh Hamid , Rabe Torsten
Published: March 2013

Co‐firing of low temperature co‐fired ceramics (LTCC) and functional ceramics like ferrites is a promising approach to increase the level of integration in future microsystems, and to create new applications for LTCC technology. Besides the development of compatible material combinations, the configuration of the sintering process is an important issue for successful co‐firing. A method is presented to derive the linear shrinkage mismatch of a material combination based on density data calculated from the master sintering curves (MSCs) of the individual materials. The influence of the firing profile on the constraint in the combined multilayer can be anticipated using this method. To investigate and improve the co‐firing of ferrite and dielectric tape, the shrinkage mismatch with respect to heating rate was studied. A significant reduction of shrinkage mismatch was found for increased heating rates. The calculated results are verified by lateral shrinkage measurements on combined laminates.
Crystal Structure and Microwave Dielectric Properties of LiRE9(SiO4)6O2 Ceramics (RE = La,Pr,Nd,Sm,Eu,Gd, and Er)
Authors: Manu Kurusaroor Mana , Karthik Chinnathambi , Leu Lii‐Cherng , Lazar Kokken Anlin , Ubic Rick , Sebastian Mailadil Thomas
Published: March 2013

The crystal structure and microwave dielectric properties of apatite‐type LiRE9(SiO4)6O2 ceramics (RE = La, Pr, Nd, Sm, Eu, Gd, and Er) have been investigated. The densification of lithium apatites has been greatly improved with the addition of 1 wt% LiF. Selected area electron diffraction and X‐ray diffraction (XRD) Rietveld analysis confirm that these compounds belong to the P63/m (No. 176) space group with hexagonal crystal symmetry. The porosity‐corrected relative permittivity was found to decrease with decreasing ionic polarizability of RE3+ ions. Relationships between the structural parameters and microwave dielectric properties have been examined. The observed variation in the quality factor of LiRE9(SiO4)6O2 + 1 wt% LiF ceramics (RE = La, Pr, and Nd) was correlated with average cation covalency (%). The temperature coefficient of resonant frequency was found to depend on the bond valence sum of cations. LiEr9(SiO4)6O2 + 1 wt% LiF ceramics showed good microwave dielectric properties with εr = 12.8, Qu × f = 13000 GHz and τf = +17 ppm/°C. All the compositions showed low coefficient of thermal expansion with thermal conductivity in the range 1.3–2.8 W (m K)−1.
Concurrent and prospective effects of psychopathic traits on affective and cognitive empathy in a community sample of late adolescents
Authors: Brouns Bart H. J. , de Wied Minet Annette , Keijsers Loes , Branje Susan , van Goozen Stephanie H. M. , Meeus Wim H. J.
Published: March 2013

Background

A deficit in affective rather than cognitive empathy is thought to be central to psychopathic traits. However, empirical evidence for empathy deficits in adolescents with psychopathic traits is limited. We investigated the concurrent and prospective effects of psychopathic traits on affective and cognitive trait empathy in late adolescence.

Methods

A community sample of 107 males and 126 females who were approximately 16‐year olds at Time 1 participated in four annual waves. Sex‐specific classes of adolescents' psychopathic traits were created using Latent Class Analyses. Subsequently, we investigated class differences in level and development of empathy.

Results

For both sexes, Latent Class Analyses produced two classes: one class with low and one with moderate levels of psychopathic traits. Consistent with our hypothesis, for both sexes, adolescents with moderate levels of psychopathic traits reported lower mean levels of affective empathy than adolescents with low levels of psychopathic traits. In addition, female adolescents with moderate psychopathic traits reported lower mean levels of cognitive empathy. Male adolescents showed a trend in this direction. No differences between classes were found in development of empathy, which increased over years.

Conclusions

This is the first study to show that male and female adolescents with higher levels of psychopathic traits have lower levels of affective empathy not only concurrently but also prospectively over a 3‐year period. Females additionally showed a similar pattern on cognitive empathy. In this community sample, developmental results suggest that adolescents with higher levels of psychopathic traits have relative rather than absolute empathy deficits.
Practitioner Review: The effectiveness of solution focused brief therapy with children and families: a systematic and critical evaluation of the literature from 1990–2010
Authors: Bond Caroline , Woods Kevin , Humphrey Neil , Symes Wendy , Green Lorraine
Published: March 2013

Background and scope

Solution focused brief therapy (SFBT) is a strengths‐based therapeutic approach, emphasizing the resources that people possess and how these can be applied to a positive change process. The current study provides a systematic review of the SFBT evidence base and a critical evaluation of the use and application of SFBT in clinical practice with children and families.

Methods

Between 21 December 2010 and 12 May 2011 forty‐four database searches (including, PsychInfo, ISI Web of Knowledge, ASSIA, British Education Index, Medline and Scopus), web searches and consultation with experts in the field were used to identify reports of SFBT studies published between 1990 and 2010. Studies were then screened according to trialled qualitative and quantitative assessment frameworks and reported according to the PRISMA guidelines.

Results

A total of 38 studies were included in the review. Of these, 9 applied SFBT to internalizing child behaviour problems, 3 applied SFBT to both internalizing and externalizing child behaviour problems, 15 applied the approach to externalizing child behaviour problems and 9 evaluated the application of SFBT in relation to a range of other issues.

Conclusions

Although much of the literature has methodological weaknesses, existing research does provide tentative support for the use of SFBT, particularly in relation to internalizing and externalizing child behaviour problems. SFBT appears particularly effective as an early intervention when presenting problems are not severe. Further well‐controlled outcome studies are needed. Studies included in the review highlight promising avenues for further research.
Diagnostic transitions from childhood to adolescence to early adulthood
Authors: Copeland William E. , Adair Carol E. , Smetanin Paul , Stiff David , Briante Carla , Colman Ian , Fergusson David , Horwood John , Poulton Richie , Jane Costello E. , Angold Adrian
Published: March 2013

Background

Quantifying diagnostic transitions across development is needed to estimate the long‐term burden of mental illness. This study estimated patterns of diagnostic transitions from childhood to adolescence and from adolescence to early adulthood.

Methods

Patterns of diagnostic transitions were estimated using data from three prospective, longitudinal studies involving close to 20,000 observations of 3,722 participants followed across multiple developmental periods covering ages 9–30. Common DSM psychiatric disorders were assessed in childhood (ages 9–12; two samples), adolescence (ages 13–18; three samples), and early adulthood (ages 19 to age 32; three samples) with structured psychiatric interviews and questionnaires.

Results

Having a disorder at an early period was associated with at least a threefold increase in odds for having a disorder at a later period. Homotypic and heterotypic transitions were observed for every disorder category. The strongest evidence of continuity was seen for behavioral disorders (particularly ADHD) with less evidence for emotional disorders such as depression and anxiety. Limited evidence was found in adjusted models for behavioral disorders predicting later emotional disorders. Adult substance disorders were preceded by behavioral disorders, but not anxiety or depression.

Conclusions

Having a disorder in childhood or adolescence is a potent risk factor for a range of psychiatric problems later in development. These findings provide further support for prevention and early life intervention efforts and suggest that treatment at younger ages, while justified in its own right, may also have potential to reduce the risk for disorders later in development.
Improving a Measure of Mobility‐Related Fatigue (The Mobility‐Tiredness Scale) by Establishing Item Intensity
Authors: Fieo Robert A. , Mortensen Erik L. , Rantanen Taina , Avlund Kirsten
Published: March 2013

Objectives

To improve the construct validity of self‐reported fatigue by establishing a formal hierarchy of scale items and to determine whether such a hierarchy could be maintained across time (aged 75–80), sex, and nationality.

Design

Cohort study.

Setting

Two Nordic urban locations: Jyväskylä, Finland, and Glostrup, Denmark.

Participants

Baseline (1989/90) consisted of a random sample of citizens of Finland or Denmark born in 1914 (n = 837). At 5‐year follow‐up, excluding those lost to follow‐up and with baseline disability resulted in a sample of n = 690.

Measurements

The Mobility‐Tiredness (Mob‐T) Scale is a six‐item scale that requires subjects to self‐report on whether they become tired performing mobility‐related tasks. Employing item response theory, an attempt was made to enhance construct validity by confirming a hierarchy of mobility‐related fatigue.

Results

A formal hierarchy of fatigue tasks, maintained across time, was established using the revised Mob‐T Scale. At age 75, the scalability statistics were a homogeneity coefficient (H) of 0.80, of 3.9% and an HT value of 0.66. The corresponding figures at age 80 were 0.75, 6.9% and 0.59. The property of invariant item ordering was maintained across subgroups based on sex and nationality.

Conclusion

Establishing a formal hierarchy at age 75 allowed which tasks were most debilitating to be identified more clearly and the individual's “distance” from these tasks to be gauged. Because it was possible to confirm that the item hierarchy was maintained across time (aged 75–80), researchers or clinicians can be more confident that performance over time is the result of real change and has less to do with measurement error.
Refining Physician Quality Indicators for Screening Mammography in Older Women: Distinguishing Appropriate Use from Overuse
Authors: Tan Alai , Kuo Yong‐Fang , Elting Linda S. , Goodwin James S.
Published: March 2013

Objectives

To assess the feasibility of refining physician quality indicators of screening mammography use based on patient life expectancy.

Design

Retrospective population‐based cohort study.

Setting

Texas.

Participants

Three thousand five hundred ninety‐five usual care providers (UCPs) with at least 10 female patients aged 67 and older on January 1, 2008, with an estimated life expectancy of 7 years or more (222,584 women) and at least 10 women with an estimated life expectancy of less than 7 years (90,903 women), based on age and comorbidity.

Measurements

Screening mammography use in 2008–09 by each provider in each population.

Results

The average adjusted mammography screening rates for UCPs were 31.1% for women with a life expectancy of less than 7 years and 55.2% for women with a life expectancy of 7 years or longer. For women with limited life expectancy, 3.7% of UCPs had significantly lower and 9.2% had significantly higher than average adjusted mammography screening rates. For women with longer life expectancy, 16.7% of UCPs had significantly lower and 19.7% had significantly higher than average rates. UCP adjusted screening rates were stable over time (2006–07 vs 2008–09, correlation coefficient (r) = 0.65, P < .001). There was a strong correlation between UCP screening rates for their female patients with a life expectancy of less than 7 years and 7 years or longer (r = 0.67, P < .001). Most physician characteristics associated with higher screening rates (e.g., being female and foreign trained) in women with longer life expectancy were also associated with higher screening rates in women with limited life expectancy.

Conclusion

Providers with high mammography screening rates for women with longer life expectancy also tend to screen women with limited life expectancy. Quality indicators for screening practice can be improved by distinguishing appropriate use from overuse based on patient life expectancy.
A Qualitative Evaluation of a Telemedicine‐Enhanced Emergency Care Program for Older Adults
Authors: Shah Manish N. , Morris Dylan , Jones Courtney M. C. , Gillespie Suzanne M. , Nelson Dallas L. , McConnochie Kenneth M. , Dozier Ann
Published: March 2013

Objectives

To document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine‐enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators.

Design

Qualitative study.

Setting

A primary care geriatric medicine practice.

Participants

Stakeholders associated with telemedicine visits: patients, family caregivers, telemedicine dispatcher, certified telemedicine assistants, telemedicine providers, and SLC staff.

Measurements

Between June and August 2011, telemedicine encounters were observed, and field notes were recorded. After each telemedicine visit, all participants were interviewed using a semistructured guide. Discrete statements from interviews and field notes were coded and arranged into themes. Concordance or discordance in field notes and stakeholder responses were grouped for analysis.

Results

After 10 telemedicine visits and 34 interviews from 21 unique participants, redundancy was achieved. Participants and their families overwhelmingly reported satisfaction with their care, remarking particularly on the convenience, speed, and completeness of the evaluation. Participants reported some unmet expectations regarding provider presence at home and visit length. Providers thought telemedicine made them more efficient overall and improved diagnostic certainty but considered in‐person visits to be superior. All stakeholders, including patients, noted inadequate telemedicine technician training, leading to low confidence levels and performance difficulties. Participants, providers, and telemedicine technicians cited problems with the reliability, weight, and size of the equipment as serious challenges, decreasing their satisfaction and increasing their frustration.

Conclusion

Telemedicine‐enhanced emergency care is an acceptable method of providing emergency care to older adults in SLCs. Stakeholders report a number of advantages. Training and technology barriers require particular attention.
Body Mass Index, Change in Body Mass Index, and Survival in Old and Very Old Persons
Authors: Dahl Anna K. , Fauth Elizabeth B. , Ernsth‐Bravell Marie , Hassing Linda B. , Ram Nilam , Gerstof Denis
Published: March 2013

Objectives

To examine how body mass index (BMI) and change in BMI are associated with mortality in old (70–79) and very old (≥80) individuals.

Design

Pooled data from three multidisciplinary prospective population‐based studies: OCTO‐twin, Gender, and NONA.

Setting

Sweden.

Participants

Eight hundred eighty‐two individuals aged 70 to 95.

Measurements

BMI was calculated from measured height and weight as kg/m2. Information about survival status and time of death was obtained from the Swedish Civil Registration System.

Results

Mortality hazard was 20% lower for the overweight group than the normal–underweight group (relative risk (RR) = 0.80, P = .011), and the mortality hazard for the obese group did not differ significantly from that of the normal–underweight group (RR = 0.93, P = .603), independent of age, education, and multimorbidity. Furthermore, mortality hazard was 65% higher for the BMI loss group than for the BMI stable group (RR = 1.65, P < .001) and 53% higher for the BMI gain group than for the BMI stable group (RR = 1.53, P = .001). Age moderated the BMI change differences. That is, the higher mortality risks associated with BMI loss and gain were less severe in very old age.

Conclusion

Old persons who were overweight had a lower mortality risk than old persons who were of normal weight, even after controlling for weight change and multimorbidity. Persons who increased or decreased in BMI had a greater mortality risk than those who had a stable BMI, particularly those aged 70 to 79. This study lends further support to the belief that the World Health Organization guidelines for BMI are overly restrictive in old age.
A new scenario of the evolutionary derivation of the mammalian diaphragm from shoulder muscles
Authors: Hirasawa Tatsuya , Kuratani Shigeru
Published: March 2013

The evolutionary origin of the diaphragm remains unclear, due to the lack of a comparable structure in other extant taxa. However, recent researches into the developmental mechanism of this structure have yielded new insights into its origin. Here we summarize current understanding regarding the development of the diaphragm, and present a possible scenario for the evolutionary acquisition of this uniquely mammalian structure. Recent developmental analyses indicate that the diaphragm and forelimb muscles are derived from a shared cell population during embryonic development. Therefore, the embryonic positions of forelimb muscle progenitors, which correspond to the position of the brachial plexus, likely played an important role in the evolution of the diaphragm. We surveyed the literature to reexamine the position of the brachial plexus among living amniotes and confirmed that the cervico‐thoracic transition in ribs reflects the brachial plexus position. Using this osteological correlate, we concluded that the anterior borders of the brachial plexuses in the stem synapsids were positioned at the level of the fourth spinal nerve, suggesting that the forelimb buds were laid in close proximity of the infrahyoid muscles. The topology of the phrenic and suprascapular nerves of mammals is similar to that of subscapular and supracoracoid nerves, respectively, of the other amniotes, suggesting that the diaphragm evolved from a muscle positioned medial to the pectoral girdle (cf. subscapular muscle). We hypothesize that the diaphragm was acquired in two steps: first, forelimb muscle cells were incorporated into tissues to form a primitive diaphragm in the stem synapsid grade, and second, the diaphragm in cynodonts became entrapped in the region controlled by pulmonary development.
A Person‐Centered Examination of Adolescent Religiosity Using Latent Class Analysis
Authors: Pearce Lisa D. , Foster E. Michael , Hardie Jessica Halliday
Published: March 2013

Empirical studies of religion's role in society, especially those focused on individuals and analyzing survey data, conceptualize and measure religiosity as ranging from low to high on a single measure or a summary index of multiple measures. Other concepts, such as “lived religion,” “believing without belonging,” or “fuzzy fidelity” emphasize what scholars have noted for decades: humans are rarely consistently low, medium, or high across dimensions of religiosity including institutional involvement, private practice, salience, or belief. A method with great promise for identifying population patterns in how individuals combine types and levels of belief, practice, and personal religious salience is latent class analysis. In this article, we use data from the first wave of the National Study of Youth and Religion's telephone survey to discuss how to select indicators of religiosity in an informed manner, as well as the implications of the number and types of indicators used for model fit. We identify five latent classes of religiosity among adolescents in the United States and their sociodemographic correlates. Our findings highlight the value of a person‐centered approach to understanding how religion is lived by American adolescents.
The Longevity Effects of Religious and Nonreligious Participation: A Meta‐Analysis and Meta‐Regression
Authors: Shor Eran , Roelfs David J.
Published: March 2013

Scholars have long argued that the reduced mortality risk associated with frequent participation in religious services derives from two sources: social participation and religious belief efficacy. In contrast, the reduced mortality risk associated with participation in nonreligious groups is thought to derive solely from the social participation component. This study tests the religious efficacy hypothesis by comparing the effects of religious participation with nonreligious participation using meta‐analyses of 312 mortality risk estimates from 74 publications (providing data on more than 300,000 persons). We found no significant difference between the mean hazard ratio (HR) for low religious participation (HR, 1.32; 95% CI, 1.24–1.41) and the mean HR for low nonreligious participation (HR, 1.25; 95% CI, 1.17–1.33). These findings suggest that the positive health effects of religious participation may largely be attributed to the social participation component, rather than to the religious component of the act.
Negotiating Religious Differences: The Strategies of Interfaith Chaplains in Healthcare
Authors: Cadge Wendy , Sigalow Emily
Published: March 2013

Chaplains in healthcare increasingly work in interfaith roles with patients and families from a range of religious and spiritual backgrounds. Some move with ease between their own religious backgrounds and those of the individuals with whom they work. Others encounter tensions as their status as a person of faith comes into conflict with their status as an interfaith chaplain. We explore the two main strategies—neutralizing and code‐switching—chaplains at one large academic medical center use when working with patients and families whose religious and spiritual backgrounds are different from their own. Through training in clinical pastoral education and experiences on the job, chaplains learn to neutralize (use a broad language of spirituality that emphasizes commonalities rather than differences) and to code‐switch (use the languages, rituals, and practices of the people with whom they work). To the extent that the strategies evident here are present among chaplains in a broader range of institutional settings, they suggest a kind of spiritual secularism or broad approach to meaning makings that may be facilitated by interfaith chaplains in a range of settings.
Ca2+/S100 proteins regulate HCV virus NS5A–FKBP8/FKBP38 interaction and HCV virus RNA replication
Authors: Tani Joji , Shimamoto Seiko , Mori Kyoko , Kato Nobuyuki , Moriishi Kohji , Matsuura Yoshiharu , Tokumitsu Hiroshi , Tsuchiya Mitsumasa , Fujimoto Tomohito , Kato Kiyohito , Miyoshi Hisaaki , Masaki Tsutomu , Kobayashi Ryoji
Published: March 2013

Background & Aim

FKBP8/FKBP38 is a unique FK506‐binding protein with a C‐terminal membrane anchor and localizes at the outer membranes of mitochondria and the endoplasmic reticulum. Similar to some immunophilins, such as FKBP51, FKBP52 and Cyclophilin 40, FKBP8/FKBP38 contain a putative Calmodulin‐binding domain and a tetratricopeptide‐repeat (TPR) domain for the binding of Hsp90. Both Hsp90 and the non‐structural protein 5A (NS5A) of the hepatitis C virus (HCV) interact specifically with FKBP8/FKBP38 through its TPR domain, and the ternary complex formation plays a critical role in HCV RNA replication. The goal of this study is to evaluate that the host factor inhibits the ternary complex formation and the replication of HCV in vitro and in vivo.

Methods

S100 proteins, FKBP38, FKBP8, HCV NS5A, Hsp90, and calmodulin were expressed in E.coli and purified. In vitro binding studies were performed by GST pull‐down, S‐tag pull‐down and surface plasmon resonance analyses. The effect of S100 proteins on HCV replication was analysed by Western blotting using an HCV NS3 antibody following transfection of S100 proteins into the HCV replicon harbouring cell line (sO cells).

Results

In vitro binding studies showed that S100A1, S100A2, S100A6, S100B and S100P directly interacted with FKBP8/FKBP38 in a Ca2+‐dependent manner and inhibited the FKBP8/FKBP38–Hsp90 and FKBP8/FKBP38–NS5A interactions. Furthermore, overexpression of S100A1, S100A2 and S100A6 in sO cells resulted in the efficient inhibition of HCV replication.

Conclusion

The association of the S100 proteins with FKBP8/FKBP38 provides a novel Ca2+‐dependent regulatory role in HCV replication through the NS5A–host protein interaction.
IL‐6 cooperates with peroxisome proliferator‐activated receptor‐α‐ligands to induce liver fatty acid binding protein (LFABP) up‐regulation
Authors: Vida Margarita , Serrano Antonia , Romero‐Cuevas Miguel , Pavón Francisco J. , González‐Rodriguez Águeda , Gavito Ana L. , Cuesta Antonio L. , Valverde Ángela M. , Rodríguez de Fonseca Fernando , Baixeras Elena
Published: March 2013

Background

LFABP plays a critical role in the uptake and intracellular transport of fatty acids (FA) and other peroxisome proliferator‐activated receptor alpha (PPARα) ligands. PPARα activation by PPARα ligands bound to LFABP results in gene expression of FA oxidation enzymes and de novo LFABP. The cytokine IL‐6 is involved in regulating liver lipid oxidation.

Aims

To study the ability of IL‐6 to modulate the expression of the LFABP in hepatocytes. Methods: HepG2 and mouse primary hepatocytes were used to test LFABP mRNA and protein expression after IL‐6 and PPARα‐ligand treatments. Mice lacking IL‐6 and wild‐type C57Bl/6 were subjected to a fasting/re‐feeding cycle to monitor hepatic LFABP mRNA kinetics after food intake.

Results

In hepatocyte cultures, IL‐6 treatment stimulated a LFABP mRNA sustained expression. Combined treatment of IL‐6 plus PPARα ligands further enhanced LFABP gene and protein expression. In contrast, pretreatment with the PPARα‐antagonist GW‐6471 prevented the up‐regulation of LFABP mRNA induced by IL‐6 in the late phase of LFABP kinetics. Furthermore, the up‐regulation of LFABP mRNA observed in the liver of wild‐type mice 8 h after re‐feeding was absent in mice lacking IL‐6.

Conclusions

IL‐6 induces LFABP kinetics in hepatocytes and is partially dependent on PPARα. The maximum increase in LFABP expression occurs when the stimulation with IL‐6 and PPARα‐ligands takes place simultaneously. The in vivo results indicate a postprandial regulation of LFABP that correlates with the presence of IL‐6. These effects may have important implications in the postprandial increase in FA uptake and intracellular trafficking in the liver.
Thermal adaptation and acclimation of ectotherms from differing aquatic climates
Authors: Narum Shawn R. , Campbell Nathan R. , Meyer Kevin A. , Miller Michael R. , Hardy Ronald W.
Published: March 2013

To elucidate the mechanisms of thermal adaptation and acclimation in ectothermic aquatic organisms from differing climates, we used a common‐garden experiment for thermal stress to investigate the heat shock response of redband trout (Oncorhynchus mykiss gairdneri) from desert and montane populations. Evidence for adaptation was observed as expression of heat shock genes in fish from the desert population was more similar to control (unstressed) fish and significantly different (P ≤ 0.05) from those from the montane population, while F1 crosses were intermediate. High induction of heat shock proteins (Hsps) in the montane strain appeared to improve short‐term survival during first exposure to high water temperatures, but high physiological costs of Hsp production may have led to lower long‐term survival. In contrast, the desert strain had significantly lower heat shock response than the montane fish and F1 crosses, suggesting that these desert fish have evolved alternative mechanisms to deal with thermal stress that provide better balance of physiological costs. Genomewide tests of greater than 10 000 SNPs found multipleSNPs that were significantly associated with survival under thermal stress, including Hsp47 which consistently appeared as a strong candidate gene for adaption to desert climates. CandidateSNPs identified in this study are prime targets to screen more broadly across this species' range to predict the potential for adaptation under scenarios of climate change. These results demonstrate that aquatic species can evolve adaptive responses to thermal stress and provide insight for understanding how climate change may impact ectotherms.
Chaperone‐mediated autophagy components are upregulated in sporadic inclusion‐body myositis muscle fibres
Authors: Cacciottolo M. , Nogalska A. , D'Agostino C. , Engel W. K. , Askanas V.
Published: March 2013

Aims

Sporadic inclusion‐body myositis (s‐IBM) is an age‐associated degenerative muscle disease. Characteristic features are muscle‐fibre vacuolization and intramuscle‐fibre accumulations of multiprotein aggregates, which may result from the demonstrated impairments of the 26S proteasome and autophagy. Chaperone‐mediated autophagy (CMA) is a selective form of lysosomal degradation targeting proteins carrying the KFERQ motif. Lysosome‐associated membrane protein type 2A (LAMP2A) and the heat‐shock cognate protein 70 (Hsc70) constitute specific CMA components. Neither CMA components nor CMA activity has been studied in normal or disease human muscle, to our knowledge.

Methods

We studied CMA components by immunocytochemistry, immunoblots, real‐time PCR and immunoprecipitation in: (a) 16 s‐IBM, nine aged‐matched normal and nine disease control muscle biopsies; and (b) cultured human muscle fibres (CHMFs) with experimentally inhibited activities of either the 26S proteasome or autophagy.

Results

Compared with age‐matched controls, in s‐IBM muscle, LAMP2A and Hsc70 were on a given transverse section accumulated as aggregates in approximately 5% of muscle fibres, where they (a) colocalized with each other and α‐synuclein (α‐syn), a CMA‐targeted protein; and (b) were bound to each other and to α‐syn by immunoprecipitation. By immunoblots, LAMP2A was increased sevenfold P < 0.001 and Hsc70 2.6‐fold P < 0.05. LAMP2A mRNA was increased 4.4‐fold P < 0.001 and Hsc70 mRNA 1.9‐fold P < 0.05. In CHMFs inhibition of either the 26S proteasome or autophagy induced CMA, evidenced by a significant increase of both LAMP2A and Hsc70.

Conclusions

Our study demonstrates, for the first time, up‐regulation of CMA components in s‐IBM muscle, and it provides further evidence that altered protein degradation is likely an important pathogenic aspect in s‐IBM.