bluuebunny/crossref_metadata_2025 huggingface dataset:
Aquaporin‐4 autoantibody: a neurogenic cause of anorexia and weight loss
Authors: FUNG EVA LAI‐WAH , TSUNG LILIAN LI‐YAN , DALE RUSSELL C
Published: December 2011

Neuromyelitis optica (NMO) is a severe inflammatory demyelinating disease often associated with a highly specific autoantibody, aquaporin‐4 antibody. Although the classic syndrome involves the optic nerves and spinal cord, aquaporin‐4 antibody has been important in defining the true spectrum of NMO, which now includes brain lesions in areas of high aquaporin‐4 expression. Brainstem involvement, specifically area postrema involvement in the medulla, has been associated with intractable vomiting in some patients with NMO. We describe a 14‐year‐old female with positive aquaporin‐4 antibody whose clinical course was dominated by severe anorexia with associated weight loss (from 68‐41kg; body mass index 25.2–15.6). Magnetic resonance imaging showed lesions in the medulla, pons, and thalami. Although she had asymptomatic radiological longitudinally extensive transverse myelitis, she never had symptoms or signs referable to the spinal cord or the optic nerves. We propose that anorexia and weight loss should be considered part of the NMO spectrum, probably related to area postrema involvement.
Age‐related sexual plumage dimorphism and badge framing in the European Robin Erithacus rubecula
Authors: JOVANI ROGER , AVILÉS JESÚS M. , RODRÍGUEZ‐SÁNCHEZ FRANCISCO
Published: December 2011

Male and female European Robins Erithacus rubecula display their red breasts in year‐round territorial contests. Despite the clear signalling role of the red breast, little is known about its sexual dimorphism or trends in size when Robins age. We studied these patterns in resident and migrant Robins in a Mediterranean population. Both male and female first‐year Robins had smaller red breasts than second‐year individuals. Females, but not males, showed a reduction in badge area after the second year of life, leading to sexual dimorphism in red breast area in the oldest Robins. The grey fringe around the red breast showed a steady increase in width in males when ageing, but not in females, also leading to sexual dimorphism in this trait among oldest Robins. The contrast between the red breast and its surrounding grey fringe was higher than that between the breast and the back at both high and low environmental light intensities. This suggests that the grey fringe could function as a frame to highlight the perimeter of the red breast, and that the Robin’s plumage is equally suited to display in open areas and forest understoreys. Our study suggests that the extent of the red breast and its grey frame could confer information about the age and sex of the birds, and thus be used as a signal in territorial contests and mating decisions.
Overnight foraging trips by chick‐rearing Nazca Boobies Sula granti and the risk of attack by predatory fish
Authors: ZAVALAGA CARLOS B. , EMSLIE STEVEN D. , ESTELA FELIPE A. , MÜLLER MARTINA S. , DELL’OMO GIACOMO , ANDERSON DAVID J.
Published: December 2011

Most tropical booby species complete breeding foraging trips within daylight hours, thus avoiding nights at sea. Nazca Boobies Sula granti are unusual in this respect, frequently spending one or more nights away from the nest. We used GPS dataloggers, time‐depth recorders, and changes in body weight to characterize foraging trips and to evaluate potential influences on the decisions of 64 adult Nazca Boobies to spend a night at sea, or to return to their chicks on Isla Española, Galápagos, in daylight hours. The tagged birds foraged east of Isla Española, undertaking both single‐day (2–15 h, 67% of trips) and overnight trips (28 h–7.2 days, 33%), and executing 1–19 foraging plunge‐dives per single‐day trip. Birds might forage longer if they are in nutritional stress when they depart, but body weight at departure was not correlated with trip length. Birds might be expected to return from longer trips with more prey for young, but they returned from single‐day and overnight trips with similar body weights, consistent with previous indications that Nazca Boobies forage until accumulating a target value of prey weight. Birds with a lower dive frequency during the first 5 h of a trip were more likely to spend the night at sea, suggesting that they might choose to spend the night at sea if prey capture success was low. At night, birds almost never dived and spent most of their time resting on the water’s surface (11.8–12.1 h, > 99% of the time between civil sunset and civil dawn). Thus, the night is an unproductive time spent among subsurface predators under low illumination. The birds’ webbed feet provided evidence of this risk: 24% of birds were missing > 25% of their foot tissue, probably due to attacks by predatory fish, and the amount of foot tissue lost increased with age, consistent with a cumulative risk across the lifespan. In contrast, other tropical boobies (Blue‐footed Sula nebouxii and Brown Boobies Sula leucogaster), which do not spend the night on the water, showed no such damage. These results suggest that chick‐rearing Nazca Boobies accept nocturnal predation risk on occasions of low prey encounter during a foraging trip’s first day.
Prevalence, Predictors, and Patient Outcomes Associated with Physician Co‐management: Findings from the Los Angeles Women's Health Study
Authors: Rose Danielle E. , Tisnado Diana M. , Tao May L. , Malin Jennifer L. , Adams John L. , Ganz Patricia A. , Kahn Katherine L.
Published: December 2011

Background

Physician co‐management, representing joint participation in the planning, decision‐making, and delivery of care, is often cited in association with coordination of care. Yet little is known about how physicians manage tasks and how their management style impacts patient outcomes.

Objectives

To describe physician practice style using breast cancer as a model. We characterize correlates and predictors of physician practice style for 10 clinical tasks, and then test for associations between physician practice style and patient ratings of care.

Methods

We queried 347 breast cancer physicians identified by a population‐based cohort of women with incident breast cancer regarding care using a clinical vignette about a hypothetical 65‐year‐old diabetic woman with incident breast cancer. To test the association between physician practice style and patient outcomes, we linked medical oncologists’ responses to patient ratings of care (physician n = 111; patient n = 411).

Results

After adjusting for physician and practice setting characteristics, physician practice style varied by physician specialty, practice setting, financial incentives, and barriers to referrals. Patients with medical oncologists who co‐managed tasks had higher patient ratings of care.

Conclusion

Physician practice style for breast cancer is influenced by provider and practice setting characteristics, and it is an important predictor of patient ratings. We identify physician and practice setting factors associated with physician practice style and found associations between physician co‐management and patient outcomes (e.g., patient ratings of care).
Family Doctor Responses to Changes in Incentives for Influenza Immunization under the U.K. Quality and Outcomes Framework Pay‐for‐Performance Scheme
Authors: Kontopantelis Evangelos , Doran Tim , Gravelle Hugh , Goudie Rosalind , Siciliani Luigi , Sutton Matt
Published: December 2011

Objective

To analyze the effect of setting higher targets, in a primary care pay‐for‐performance scheme, on rates of influenza immunization and exception reporting.

Study Setting

The U.K. Quality and Outcomes Framework links financial rewards for family practices to four separate influenza immunization rates for patients with coronary heart disease (CHD), chronic obstructive pulmonary disease, diabetes, and stroke. There is no additional payment for immunization rates above an upper threshold. Patients for whom immunization would be inappropriate can be excepted from the practice for the calculation of the practice immunization rate.

Data

Practice‐level information on immunizations and exceptions extracted from electronic records of all practices in England 2004/05 to 2009/10 (n = 8,212–8,403).

Study Design

Longitudinal random effect multilevel linear regressions comparing changes in practice immunization and exception rates for the four chronic conditions before and after the increase in the upper threshold immunization rate for CHD patients in 2006/07.

Principal Findings

The 5 percent increase in the upper payment threshold for CHD was associated with increases in the proportion of immunized CHD patients (0.41 percent, CI: 0.25–0.56 percent), and exception was reported (0.26 percent, CI: 0.12–0.40 percent).

Conclusions

Making quality targets more demanding can not only lead to improvement in quality of care but can also have other consequences.
The Effect of Community Uninsurance Rates on Access to Health Care
Authors: Sabik Lindsay M.
Published: December 2011

Objective

To investigate the effect of local uninsurance rates on access to health care for the uninsured and insured and improve on recent studies by controlling for time‐invariant differences across markets.

Data Sources

Individual‐level data from the 1996 and 2003 Community Tracking Study, and market‐level data from other sources, including the Area Resource File and the Bureau of Primary Healthcare.

Study Design

Market‐level fixed effects models estimate the effect of changes in uninsurance rates within markets on access to care, measured by whether individuals report forgoing necessary care. Instrumental variables models are also estimated.

Principal Findings

Increases in the rate of uninsurance are associated with poorer access to necessary care among the uninsured. In contrast with recent evidence, increases in uninsurance had no effect on access to care among the insured. Instrumental variables results are similar, although not statistically significant.

Conclusions

Changes in rates of insurance coverage are likely to affect access to care for both previously and continuously uninsured. In contrast with earlier studies, there is no evidence of spillover effects on the insured, suggesting that such policy changes may have little effect on access for those who are already insured.
A Longitudinal Analysis of the Lifetime Cost of Dementia
Authors: Yang Zhou , Zhang Kun , Lin Pei‐Jung , Clevenger Carolyn , Atherly Adam
Published: December 2011

Objective

Estimate the lifetime cost of dementia to Medicare and Medicaid.

Data Source

1997–2005 Medicare Current Beneficiary Survey.

Study Design

A multistage analysis was conducted to first predict the probability of developing dementia by age and then predict the annual Medicare/Medicaid expenditures conditional on dementia status. A cohort‐based simulation was conducted to estimate the lifetime cost of dementia.

Principal Findings

The average lifetime cost of dementia per patient for Medicare is approximately $12,000 (2005 dollars) and for Medicaid about $11,000. Dementia onset at older age leads to shorter duration and lower lifetime cost. Increased educational level leads to longer longevity, more dementia cases per cohort, but shorter duration, and lower lifetime cost per patient, which could offset the cost increase induced by more dementia cases. Increased body mass index leads to more dementia cases per cohort and higher lifetime cost per patient.

Conclusion

Net cost of dementia is lower than the estimates from cross‐sectional studies. Promoting healthy lifestyle to reverse the obesity epidemic is a short‐term priority to confront the epidemic of dementia in the near future. Promoting higher education among the younger generation is a long‐term priority to mitigate the effect of population aging on the dementia epidemic in the distant future.
Pollen and Macro‐Fossil Assemblages in Disturbed Urban Wetlands on South Vancouver Island Reveal Recent Invasion of Reed Canarygrass (Phalaris arundinacea) and Guide Restoration
Authors: Townsend Lise , Hebda Richard J.
Published: December 2011

Paleoecological analyses and historical information were used to characterize pre‐disturbance conditions in Swan Lake wetland of suburban Victoria, Vancouver Island, British Columbia, to provide a reference for restoration and management. Highly invasive reed canarygrass (Phalaris arundinacea) dominates Swan Lake wetlands and inhibits restoration. Grass pollen presumably produced by Phalaris predominates only in the top 5 cm (south site) to 35 cm (north site) of sediment cores. Below these levels assemblages are variously dominated by taxa including Salix, Alnus, Lysichiton, Cyperaceae, and Rosaceae. Pollen grains of agricultural disturbance indicators, such as plantain, liguliflorate Asteraceae, and cereals occur to depths of 35 cm. The results strongly suggest that Phalaris communities arose in historical times following agricultural disturbance and have no pre‐European equivalent. Pollen assemblages below the Phalaris zone, corroborated by historical documentary references, show diverse original wetland types. Disturbance and crop species pollen indicators may be useful indicators of intensity and depth of disturbance. Pre‐agricultural plant communities are a guide for restoration, provided that ecologically limiting factors are managed.
The streptomycin mouse model for Salmonella diarrhea: functional analysis of the microbiota, the pathogen’s virulence factors, and the host’s mucosal immune response
Authors: Kaiser Patrick , Diard Médéric , Stecher Bärbel , Hardt Wolf‐Dietrich
Published: December 2011

Summary:  The mammalian intestine is colonized by a dense microbial community, the microbiota. Homeostatic and symbiotic interactions facilitate the peaceful co‐existence between the microbiota and the host, and inhibit colonization by most incoming pathogens (‘colonization resistance’). However, if pathogenic intruders overcome colonization resistance, a fierce, innate inflammatory defense can be mounted within hours, the adaptive arm of the immune system is initiated, and the pathogen is fought back. The molecular nature of the homeostatic interactions, the pathogen’s ability to overcome colonization resistance, and the triggering of native and adaptive mucosal immune responses are still poorly understood. To study these mechanisms, the streptomycin mouse model for Salmonella diarrhea is of great value. Here, we review how S. Typhimurium triggers mucosal immune responses by active (virulence factor elicited) and passive (MyD88‐dependent) mechanisms and introduce the S. Typhimurium mutants available for focusing on either response. Interestingly, mucosal defense turns out to be a double‐edged sword, limiting pathogen burdens in the gut tissue but enhancing pathogen growth in the gut lumen. This model allows not only studying the molecular pathogenesis of Salmonella diarrhea but also is ideally suited for analyzing innate defenses, microbe handling by mucosal phagocytes, adaptive secretory immunoglobulin A responses, probing microbiota function, and homeostatic microbiota–host interactions. Finally, we discuss the general need for defined assay conditions when using animal models for enteric infections and the central importance of littermate controls.
Development and evolution of RORγt+ cells in a microbe’s world
Authors: Eberl Gérard
Published: December 2011

Summary:  The nuclear hormone receptor retinoid‐related orphan receptor γt (RORγt) induces a pro‐inflammatory program in lymphoid cells, culminating in the expression of interleukin‐6 (IL‐6), IL‐17, IL‐22, granulocyte‐macrophage colony‐stimulating factor, and tumor necrosis factor. During ontogeny, the first type of cells expressing RORγt are lymphoid tissue inducer cells, a type of innate lymphoid cell (ILC) generated in mammalian fetuses to induce the development of lymph nodes and Peyer’s patches. After birth, RORγt+ ILCs and RORγt+ T cells are involved in the defense of epithelial surfaces against extracellular microbes and play an important role in the intestinal homeostasis with symbiotic microbiota. The development and evolution of RORγt+ cells is intimately associated with the construction of a stable host–microbe interface.
Immune modulation during latent herpesvirus infection
Authors: White Douglas W. , Suzanne Beard R. , Barton Erik S.
Published: December 2011

Summary:  Nearly all human beings, by the time they reach adolescence, are infected with multiple herpesviruses. At any given time, this family of viruses accounts for 35–40 billion human infections worldwide, making herpesviruses among the most prevalent pathogens known to exist. Compared to most other viruses, herpesviruses are also unique in that infection lasts the life of the host. Remarkably, despite their prevalence and persistence, little is known about how these viruses interact with their hosts, especially during the clinically asymptomatic phase of infection referred to as latency. This review explores data in human and animal systems that reveal the ability of latent herpesviruses to modulate the immune response to self and environmental antigens. From the perspective of the host, there are both potentially detrimental and surprisingly beneficial effects of this lifelong interaction. The realization that latent herpesvirus infection modulates immune responses in asymptomatic hosts forces us to reconsider what constitutes a ‘normal’ immune system in a healthy individual.
Adapting to environmental stresses: the role of the microbiota in controlling innate immunity and behavioral responses
Authors: Fagundes Caio T. , Amaral Flávio A. , Teixeira Antônio L. , Souza Danielle G. , Teixeira Mauro M.
Published: December 2011

Summary:  Mammals are subject to colonization by an astronomical number of mutualistic and commensal microorganisms on their environmental exposed surfaces. These mutualistic species build up a complex community, called the indigenous microbiota, which aid their hosts in several physiological activities. In this review, we show that the transition between a non‐colonized and a colonized state is associated with modification on the pattern of host inflammatory and behavioral responsiveness. There is a shift from innate anti‐inflammatory cytokine production to efficient release of proinflammatory mediators and rapid mobilization of leukocytes upon infection or other stimuli. In addition, host responses to hypernociceptive and stressful stimuli are modulated by indigenous microbiota, partly due to the altered pattern of innate and acquired immune responsiveness of the non‐colonized host. These altered responses ultimately lead to significant alteration in host behavior to environmental threats. Therefore, host colonization by indigenous microbiota modifies the way the host perceives and reacts to environmental stimuli, improving resilience of the entire host–microorganism consortium to environmental stresses.
The effects of commensal microbiota on immune cell subsets and inflammatory responses
Authors: Chinen Takatoshi , Rudensky Alexander Y
Published: December 2011

Summary:  Billions of years of coevolution shaped the mutually beneficial relationships between metazoans and symbiotic commensal microorganisms. Commensal microorganisms profoundly affect the physiology of the host and provide the host with survival advantages in several ways, while they could also trigger pathogenic immune responses and threaten the well‐being of the host. Recent advances in DNA sequencing technology enabled the analysis of commensal microbiota, and improvements in the techniques of culturing gut‐resident microorganisms and of rearing gnotobiotic rodents have made it possible to assess the effect of individual component of microbial communities on host physiology. In this review, we discuss the current understanding of the interactions of commensal microbiota with the host immune system.
Melatonin pharmacokinetics following two different oral surge‐sustained release doses in older adults
Authors: Gooneratne Nalaka S. , Edwards Alena Y. Z. , Zhou Chen , Cuellar Norma , Grandner Michael A. , Barrett Jeffrey S.
Published: December 2011

Abstract:  Melatonin is increasingly used for the treatment of sleep disorders. Surge‐sustained formulations consisting of combined immediate release and controlled release dosing may mimic the endogenous melatonin physiologic profile. However, relatively little is known about the pharmacokinetic properties of low‐dose (<0.5 mg) and high‐dose (>2 mg) melatonin in a combined immediate release/controlled release dose, especially in older adults who may also exhibit altered melatonin disposition. To assess this, we conducted a randomized, double‐blind, placebo‐controlled study of low‐dose (0.4 mg) and high‐dose (4.0 mg) melatonin (25% immediate release + 75% controlled release) in 27 older adults with insomnia complaints and low endogenous melatonin levels to determine whether melatonin pharmacokinetic properties differ between these two doses. The time to maximum level (1.3 hrs versus 1.5 hrs), elimination half‐life (1.8 hrs versus 2.1 hrs), and apparent total clearance (379 L/hr versus 478 L/hr) did not differ significantly between the low‐ and high‐dose arms, respectively. The maximum concentration was 405 ± 93 pg/mL for the low‐dose arm and 3999 ± 700 pg/mL for the high‐dose arm, both of which are substantially higher than physiologic melatonin levels for this age group. In addition, subjects in the high‐dose arm maintained melatonin levels >50 pg/mL for an average of 10 hrs, which could result in elevated melatonin levels beyond the typical sleep period. Renal and liver function parameters remained stable after 6 wks of treatment. The linear pharmacokinetic behavior of melatonin observed in the elderly can form the basis for future studies exploring a wider range of dosing scenarios to establish exposure–response relationships for melatonin‐mediated sleep outcomes.
HTR2A gene polymorphisms and Inward and Outward Personal Meaning Organisations
Authors: Nardi Bernardo , Piva Francesco , Turchi Chiara , Giulietti Matteo , Castellucci Gianni , Arimatea Emidio , Rocchetti David , Rocchetti Gianfranco , Principato Giovanni , Tagliabracci Adriano , Bellantuono Cesario
Published: December 2011

Nardi B, Piva F, Turchi C, Giulietti M, Castellucci G, Arimatea E, Rocchetti D, Rocchetti G, Principato G, Tagliabracci A, Bellantuono C. HTR2A gene polymorphisms and Inward and Outward Personal Meaning Organisations.

Objective:Caregiver behaviours and emotional expressions may induce development of two basic categories of constructing identity and of regulating cognitive and emotional processes: an Inward or an Outward Personal Meaning Organisation (PMO). Inwards read environmental signals through their internal activations. Their emotions are more distinct, and reciprocity is more based on physical distance (protection, loneliness). Outwards read internal activations through the environment. Their emotions are more blurred, and reciprocity is more based on a semantic sight of relations (approval, rules).

It has recently been shown that PMO development may also have physiological and genetic bases. In a functional magnetic resonance imaging (fMRI) study, Inward and Outward subjects showed different amygdala activation patterns and an association with the SLC6A4 serotonin transporter gene 5-HTTLPR polymorphism.

Methods:In this work, 149 healthy subjects were examined with respect to Inward and Outward PMOs. We explored the association with 10 serotonin receptor 2A (HTR2A) gene single nucleotide polymorphisms (SNPs) selected by bioinformatics methods.

Results:An intronic SNP (rs55948462) was found to be significantly associated with an Inward and an Outward PMOs development. However, after statistical adjustments, these results did not remain significant.

Conclusion:We did not find associations between considered SNPs and Inward/Outward PMOs. However, the role of HTR2A polymorphisms was not considered in this study and that of the other serotonin-related genes should be valued.
Grass litter is a natural seed trap in long‐term undisturbed grassland
Authors: Ruprecht Eszter , Szabó Anna
Published: December 2011

Questions

Litter quantity in grasslands is highly affected by disturbance regime and influences seed recruitment of constituent species through different mechanisms. Does litter act as a mechanical barrier to burial of freshly shed seeds, and does seed morphology affect this? How is the fate and mobility of seeds affected by litter compared to that of seeds in the seed bank?

Location

Transylvanian Lowland, Romania.

Methods

We analysed the seed content of litter and underlying soil collected from six dry grassland sites having different disturbance histories, ranging from sites that are currently grazed to those that have been long abandoned. We related seed content of litter to the litter quantity, seed morphology and the seed content of soil, and the estimated seed production of the above‐ground vegetation.

Results

Grass litter represented a natural trap for seeds; we identified significant quantities of seeds of a large number of species (37) within litter samples, and there was a mass effect in the seed trapping by litter – higher litter quantities trapped more seeds. As a long‐term consequence, we expected that seed bank stores would be gradually depleted in abandoned grassland due to the elimination of seeds by litter, but this was not the case. The higher seed production of the above‐ground vegetation in undisturbed sites very probably compensated for seed losses through litter. Seeds retained in the litter were larger, more rounded and had appendages than those in soil. Especially for seeds meeting any of these criteria, litter represents a hazardous medium, since the seeds may fail or have delayed germination.

Conclusions

The role of litter as a seed trap is more relevant in grasslands that have not been disturbed for a long time, where litter seed entrapment can exert a selective pressure on certain species, and thus drive community assembly in grasslands.
Comparisons of complementary feeding indicators and associated factors in children aged 6–23 months across five South Asian countries
Authors: Senarath Upul , Agho Kingsley E. , Akram Dur‐e‐Samin , Godakandage Sanjeeva S.P. , Hazir Tabish , Jayawickrama Hiranya , Joshi Nira , Kabir Iqbal , Khanam Mansura , Patel Archana , Pusdekar Yamini , Roy Swapan K. , Siriwardena Indika , Tiwari Kalpana , Dibley Michael J.
Published: December 2011

Improving infant and young child feeding practices will help South Asian countries achieve the Millennium Development Goal of reducing child mortality. This paper aims to compare key indicators of complementary feeding and their determinants in children aged 6–23 months across five South Asian countries – Bangladesh, India, Nepal, Pakistan and Sri Lanka. The latest Demographic and Health Survey and National Family Health Survey India data were used. The analyses were confined to last‐born children aged 6–23 months – 1728 in Bangladesh, 15 028 in India, 1428 in Nepal, 2106 in Sri Lanka and 443 infants aged 6–8 months in Pakistan. Introduction of solid, semi‐solid or soft foods, minimum dietary diversity, minimum meal frequency and minimum acceptable diet, and their significant determinants were compared across the countries. Minimum dietary diversity among children aged 6–23 months ranged from 15% in India to 71% in Sri Lanka, with Nepal (34%) and Bangladesh (42%) in between. Minimum acceptable diet among breastfed children was 9% in India, 32% in Nepal, 40% in Bangladesh and 68% in Sri Lanka. The most consistent determinants of inappropriate complementary feeding practices across all countries were the lack of maternal education and lower household wealth. Limited exposure to media, inadequate antenatal care and lack of post‐natal contacts by health workers were among predictors of inappropriate feeding. Overall, complementary feeding practices among children aged 6–23 months need improvement in all South Asian countries. More intensive interventions are necessary targeting the groups with sup‐optimal practices, while programmes that cover entire populations are being continued.
Complementary feeding practices in South Asia: analyses of recent national survey data by the South Asia Infant Feeding Research Network
Authors: Senarath Upul , Dibley Michael J.
Published: December 2011

South Asian region has the highest global burden of child undernutrition, with almost 41% of children stunted, 16% wasted and 33% underweight. Improved feeding of children less than 2 years of age is particularly important because they experience rapid growth and development, and are vulnerable to illnesses such as acute respiratory infections and diarrhoeal diseases. The present supplement aimed to describe complementary feeding practices in five South Asian countries – Bangladesh, India, Nepal, Pakistan and Sri Lanka – using the new and updated global complementary feeding indicators and to identify determinants of inappropriate complementary feeding practices. The South Asia Infant Feeding Research Network held a series of workshops to study and discuss the operational guidelines for the new complementary feeding indicators in consultation with regional and international experts. The latest Demographic and Health Surveys for Bangladesh, Nepal, Pakistan and Sri Lanka, and the National Family Health Survey of India were used as data sources. Four key indicators were calculated: introduction of solid, semisolid or soft foods in 6–8 months aged, minimum dietary diversity, minimum meal frequency and minimum acceptable diet in 6–23‐month‐aged children. Univariate and multivariate logistic regression analyses were performed to identify determinants of poor complementary feeding practices. The papers in this supplement present results of these analyses for each individual country and a comparison between countries. The results have important implications for policies, programmes and research on infant and young child feeding in the region, especially for targeting groups at high risk for suboptimal practices.
Determinants of inappropriate complementary feeding practices in young children in Sri Lanka: secondary data analysis of Demographic and Health Survey 2006–2007
Authors: Senarath Upul , Godakandage Sanjeeva S. P. , Jayawickrama Hiranya , Siriwardena Indika , Dibley Michael J.
Published: December 2011

Inappropriate complementary feeding increases risk of undernutrition, illness and mortality in infants and children. This paper aimed to determine the factors associated with inappropriate complementary feeding practices in Sri Lanka. The Sri Lanka Demographic and Health Survey 2006–2007 used a stratified two‐stage cluster sample of ever‐married women 15–49 years, and included details about foods given to children aged 6–23 months during the last 24 h. The new World Health Organization indicators for infant and young child feeding (IYCF) – (introduction of solid/semi‐solid or soft foods; minimum dietary diversity; minimum meal frequency; and minimum acceptable diet) were calculated for 2106 children aged 6–23 months. These indicators were examined against explanatory variables with multivariate analyses to identify factors associated with inappropriate practices.

Eighty‐four per cent of infants aged 6–8 months were introduced to complementary food. The proportion of infants aged 6–8 months who consumed eggs (7.5%), fruits and vegetables other than those rich in vitamin A (29.6%) and flesh foods (35.2%) was low. Of children aged 6–23 months, minimum dietary diversity was 71%, minimum meal frequency 88% and minimum acceptable diet 68%. Children who lived in tea estate sector had a lower dietary diversity and minimum acceptable diet than children in urban and rural areas. Other determinants of not receiving a diverse or acceptable diet were lower maternal education, shorter maternal height, lower wealth index, lack of postnatal visits, unsatisfactory exposure to media and acute respiratory infections. In conclusion, complementary feeding indicators were adequate except in the 6–11 months age group. Subgroups with inappropriate feeding practices should be the focus of IYCF promotion programs.
An exploration of empathy and correlates among Taiwanese nurses
Authors: KUO Jen‐Che , CHENG Jung‐Feng , CHEN Yu‐Lan , LIVNEH Hanoch , TSAI Tzung‐Yi
Published: December 2011

Aim:  Empathy is essential to optimal health care. The empathy of nurses, who make up the front line in patient care, merits particular attention. However, information on empathy among nurses is still limited. This study aimed to examine the nurses' empathy and correlates in Taiwan.

Methods:  The study used a cross‐sectional correlational design with a convenience sampling method to recruit full‐time nurses from a hospital in southern Taiwan between May and November of 2010. A structured questionnaire was used to gather data on respondents' demographic and job characteristics and included a Chinese version of the Jefferson Scale of Empathy. Descriptive statistics, t‐tests, Pearson correlations, analysis of variance, and stepwise linear regression were used for analysis.

Results:  Of a total of 740 questionnaires that were distributed, 675 valid copies were returned, for a response rate of 91.2%. After the exclusion of 15 cases because of missing data, 660 participants were included for data analysis. The mean empathy score for entire participants was 110.66. Those who received empathy‐related training, worked on a psychiatric ward, had children, and had more years of nursing work experience demonstrated significantly higher empathy scores. These four variables accounted for 22.0% of the variance in empathy among participants.

Conclusions:  Our findings may help hospital administrators better understand the empathy level of nurses, and can serve as a reference in the design of appropriate in‐service training to improve empathy among nurses.
The Effects of the 2004 Tsunami on a Coastal Aquifer in Sri Lanka
Authors: Vithanage Meththika , Engesgaard Peter , Villholth Karen G. , Jensen Karsten H.
Published: December 2011

On December 26, 2004, the earthquake off the southern coast of Sumatra in the Indian Ocean generated far‐reaching tsunami waves, resulting in severe disruption of the coastal aquifers in many countries of the region. The objective of this study was to examine the impact of the tsunami on groundwater in coastal areas. Field investigations on the east coast of Sri Lanka were carried out along a transect located perpendicular to the coastline on a 2.4 km wide sand stretch bounded by the sea and a lagoon. Measurements of groundwater table elevation and electrical conductivity (EC) of the groundwater were carried out monthly from October 2005 to August 2007. The aquifer system and tsunami saltwater intrusion were modeled using the variable‐density flow and solute transport code HST3D to understand the tsunami plume behavior and estimate the aquifer recovery time. EC values reduced as a result of the monsoonal rainfall following the tsunami with a decline in reduction rate during the dry season. The upper part of the saturated zone (down to 2.5 m) returned to freshwater conditions (EC < 1000 µS/cm) 1 to 1.5 years after the tsunami, according to field observations. On the basis of model simulations, it may take more than 15 years for the entire aquifer (down to 28 m) to recover completely, although the top 6 m of the aquifer may become fresh in about 5 years.
Synthesis of Potent Dishevelled PDZ Domain Inhibitors Guided by Virtual Screening and NMR Studies
Authors: Shan Jufang , Zhang Xinxin , Bao Ju , Cassell Robert , Zheng Jie J.
Published: December 2011

Dishevelled (Dvl) PDZ domains transduce Wnt signals from the membrane‐bound receptor Frizzled to the downstream. As abnormal Wnt signaling has been implicated in tumorigenesis, the Dvl PDZ domain is a potential target for small‐molecule inhibitors that block Wnt signaling at the Dvl level. We expanded our in silico search to examine the chemical space near previously developed PDZ binders and identified nine additional compounds bind to the Dvl PDZ. We then performed a quantitative structure‐activity relationship (QSAR) analysis of these compounds and combined these results with structural studies of the PDZ domain in complex with the compounds to design and synthesize a group of new, further optimized compounds. Two rounds of synthesis and testing yielded a total of six compounds that have greatly improved binding affinity to the Dvl PDZ domain and most potent ones competitively displace Dapper peptide from the PDZ domain. In addition to providing more potent Dvl PDZ domain inhibitors, this study demonstrates that virtual screening and structural studies can be powerful tools in guiding the chemical synthesis hit‐to‐lead optimization stage during the drug discovery process.
Intermediate‐conductance Ca2+‐activated potassium and volume‐sensitive chloride channels in endothelial progenitor cells from rat bone marrow mononuclear cells
Authors: Xu X. , Xia J. , Yang X. , Huang X. , Gao D. , Zhou J. , Lian J. , Zhou J.
Published: December 2011

Aim

Bone marrow endothelial progenitor cells (BMEPCs) are believed to be a promising cell source for regenerative medicine; however, their electrophysiology properties have not been fully clarified, which is important to the clinical application of BMEPCs. The current study was designed to determine the transmembrane ion currents and mRNA expression levels of related ion channel subunits in rat BMEPCs.

Methods

Bone marrow mononuclear cells were isolated by density gradient separation and cultured in EPC medium. The transmembrane ion currents were determined using whole‐cell patch‐voltage clamp technique, and the levels of mRNA and protein expressions of functional ionic channels were measured using RT‐PCR and western immunoblot analysis.

Results

We observed two types of ionic currents in undifferentiated rat BMEPCs. One was Ca2+‐activated potassium current (Ikca), which was seen in approx. 90% of cells when 1 μm Ca2+ was employed in pipette solution, and it was predominantly inhibited by intermediate‐conductance Ikca inhibitor clotrimazole. The other one was volume‐sensitive chloride current (Icl), which was detected in 85.7% of cells when BMEPCs were subjected to K+‐free hypotonic extracellular solution, whose currents could be inhibited by 5‐nitro‐2‐(3‐phenylpropylamino) benzoic acid (NPPB). The corresponding ion channel genes and proteins, KCNN4 for Ikca and Clcn3 for Icl, were confirmed by RT‐PCR and western immunoblot analysis of BMEPCs.

Conclusion

Our results demonstrated for the first time that rat BMEPCs expressed intermediate‐conductance Ca2+‐activated potassium currents and volume‐sensitive chloride currents, and corresponding genes and proteins of these two channels are KCNN4 and Clcn3 respectively.
Corticosteroid‐associated avascular necrosis: dose relationships and early diagnosis
Authors: Aaron Roy K. , Voisinet Anne , Racine Jennifer , Ali Yousaf , Feller Edward R.
Published: December 2011

Corticosteroids are the most common etiological factor in nontraumatic avascular necrosis (AVN) of bone, accounting for about 10% of arthroplasties performed annually in the United States. Evidence is conflicting on the relative importance of peak dose, daily dose, or cumulative dose, and most likely all three represent “high dose” corticosteroid administration and play a role in AVN. The etiology may be multifactorial with corticosteroids superimposed on genetic or pathological predispositions. Joint preservation depends upon early diagnosis and treatment before fracture of the subchondral trabeculae and joint incongruity. Early intervention depends upon identifying at‐risk patients and quantifying their risk by understanding clinical and pathophysiological contributions to that risk. Our data and that of others suggest that a screening MRI of at‐risk populations will permit detection of AVN at a prefracture stage when preservation of the joint is possible.
How are osteoclasts induced to resorb bone?
Authors: Chambers T.J. , Fuller K.
Published: December 2011

Although much is known about how osteoclasts are formed, we know little about how they are activated, or how they recognize bone as the substrate appropriate for resorption. Bone mineral is considered to be essential to this recognition process, but a “mineral receptor” has never been identified. Recently, we found that resorptive behavior, as judged by the formation of ruffled borders and actin rings, occurs on ordinary tissue culture substrates if they are first coated with vitronectin. Similarly, vitronectin‐coated substrates induce osteoclasts to secrete tartrate‐resistant acid phosphatase and to form podosome belts, and to make resorption trails in the protein that coat the substrate. The same applies to bone mineral, which only induces resorptive behavior if coated with vitronectin. In contrast, fibronectin has none of these effects, despite inducing adhesion and spreading. It appears that osteoclasts recognize bone as the substrate appropriate for resorption through the high affinity of vitronectin‐receptor ligands for bone mineral.
Recent progress in understanding molecular mechanisms of cartilage degeneration during osteoarthritis
Authors: Wang Meina , Shen Jie , Jin Hongting , Im Hee‐Jeong , Sandy John , Chen Di
Published: December 2011

Osteoarthritis (OA) is a highly prevalent disease affecting more than 20% of American adults. Predispositions include joint injury, heredity, obesity, and aging. Biomechanical alterations are commonly involved. However, the molecular mechanisms of this disease are complex, and there is currently no effective disease‐modifying treatment. The initiation and progression of OA subtypes is a complex process that at the molecular level probably involves many cell types, signaling pathways, and changes in extracellular matrix. Ex vivo studies with tissue derived from OA patients and in vivo studies with mutant mice have suggested that pathways involving receptor ligands such as TGF‐β1, WNT3a, and Indian hedgehog; signaling molecules such as Smads, β‐catenin, and HIF‐2a; and peptidases such as MMP13 and ADAMTS4/5 are probably involved to some degree. This review focuses on molecular mechanisms of OA development related to recent findings.
Tunku Abdul Rahman, Charisma, and the Nationalist Movement in Malaya, 1952–1957
Authors: Fernando Joseph M.
Published: December 2011

This article examines the role and importance of charisma in Tunku Abdul Rahman's leadership of the nationalist movement in Malaya in the 1950s. A Cambridge University‐educated prince from the northern state of Kedah, the Tunku turned a disparate group of communal political parties into a potent nationalist movement, the Alliance Party, which secured independence from Britain within five years of its formation. Previous studies have focused largely on his political leadership of the movement and have not examined the element of the Tunku's charisma in the nationalists' campaign. This article examines the political charisma of this leader in the context of recent theories of charisma. Historical evidence indicates that his personal appeal or charisma significantly influenced support for the Tunku's leadership of the nationalist movement, and, at a certain stage, he had almost a cult following. Some of the Tunku's strategies and actions were highly risky and even bordered on the irrational; yet, they were fully embraced by his supporters. The phenomenon of charisma is useful in attempting to understand political galvanisation, such as that instigated by the Tunku, in a way that other theories of political mobilisation (such as legal‐rational or traditional leadership) cannot. Drawing on a wide range of primary sources such as the Alliance Party documents and records of the Colonial Office, this article explores the Tunku's charisma as an explanatory factor in the rise of the nationalist movement in Malaya in the 1950s.
Multi‐Ethnic Parties in Bosnia‐Herzegovina: Naša Stranka and the Paradoxes of Postethnic Politics
Authors: Touquet Heleen
Published: December 2011

To what extent is political mobilisation across ethnic boundaries possible in states with highly ethnicised state structures? This article explores the opportunities and obstacles that activists in Bosnia‐Herzegovina meet when they seek to develop integrative discourses as a basis for political action. The first part of the article focuses on the role of multi‐ethnic parties in deeply divided societies. The second part develops alternative ideas on the obstacles facing multi‐ethnic parties in Bosnia, focusing on the case of Naša Stranka, a political party that was established by civil society actors. There are two conclusions to be drawn. First, despite the centrifugal nationalisms that seem to dominate the top political level, there are civil society actors in Bosnia who engage in integrative political mobilisation. Second, these actors face difficulties that go beyond the often‐cited problem of the tendency of the constitutional state structure to reify ethnic identities.
The Emergence of a New Form of Mexican Nationalism in San Antonio, Texas
Authors: Rangel‐Ortiz Luis Xavier
Published: December 2011

This article explores the role played by a growing community of Mexican national entrepreneurs who are crafting a new form of Mexican nationalism in San Antonio, Texas. This population of Mexican business people is growing in size and influence in the city. The experiences of Mexican entrepreneurs differ from understood forms of Mexican immigration and acculturation to the United States. They differ from previous waves of affluent groups of political and religious Mexican refugees that flourished in San Antonio from 1908 through the 1940s. The integration and cultural adaptation experiences of Mexican entrepreneurs represent a new form of Mexican nationalism that engages both Mexican and American nationalisms in a bidirectional acculturation process. Blending attitudes, values, beliefs, and behaviours of both countries represent a new form of Mexican and American culture emerging in San Antonio at the beginning of the twenty‐first century. To better understand the experiences and dynamics of these business people, this study builds on Pierre Bourdieu's principles of capital and power.
Unilateral Optic Disc Swelling : Differential Diagnosis and Evaluation
Authors: GOLNIK K
Published: December 2011

Abstract not provided
In vitro techniques for assessing differentiation and functionality of human pluripotent stem cell ‐derived RPE cells
Authors: JUUTI‐UUSITALO K
Published: December 2011

Human embryonic stem cells (hESC) and induced pluripotent stem cells (iPSC) serve an unlimited source of cells capable of differentiating retinal pigment epithelial cells. These cells may be used in in vitro drug testing and in cell transplantation therapies. Small population of pluripotent hESCs and iPSCs spontaneously differentiate to RPE cells. At present most differentiation methods are based on this rather inefficient method. Maturation of RPE cells from pluripotent stem cells occurs via multiple developmental phases. In those phases cells express genes and proteins that are characteristic to neuroectodermal, optic vesicle, optic cup and in the end mature RPE cells. Differentiation and maturation process of RPEs is slow, taking several weeks. However, attempts to improve the yield and the rate of maturation with biological and chemical supplements are ongoing in the laboratories around the world. The differentiation potency and maturation status is dependent on the cell line and the culture environment, furthermore hESC and iPSC derived RPE cells are also capable to trans‐differentiatiate. In addition to the basic cell and molecular biological characterizations it is vitally important to assess the differentiation and maturation status of acquired cells with functional tests. In this lecture methods to derive RPE cells from hESC and iPSC as well as functional test to assess functionality of acquired cells will be addressed.