bluuebunny/crossref_metadata_2025 huggingface dataset:
The Mini‐Mental State Examination, Clinical Factors, and Motor Vehicle Crash Risk
Authors: Joseph Philip G. , O'Donnell Martin J , Teo Koon K. , Gao Peggy , Anderson Craig , Probstfield Jeffrey L. , Bosch Jackie , Khatib Rasha , Yusuf Salim
Published: July 2014

Objectives

To examine the association between Mini‐Mental State Examination (MMSE) score and motor vehicle crash (MVC) risk in a large cohort of community‐dwelling participants with cardiovascular disease (CVD) or diabetes mellitus.

Design

Prospective observational study.

Setting

Participants enrolled in the Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial and Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease clinical trial, which included individuals aged 55 and older with CVD or diabetes mellitus.

Participants

Totally 17,538 frequent drivers (defined as driving at least once per week) who had completed a baseline MMSE.

Measurements

Involvement in a MVC as the driver.

Results

Baseline MMSE score was divided into four categories: 30, 27–29, 24–26, and < 24. The median MMSE score was 29 (interquartile range 27–30), and 726 (4.1%) has a MMSE score of less than 24 at baseline. After a mean follow‐up of 4.5 years, 1,068 (6.1%) participants were drivers in a MVC. Lower scores were not associated with future MVCs (MMSE score 29–27, hazard ratio (HR) = 1.06, 95% confidence interval (CI) = 0.93–1.22); MMSE score 26–24, HR = 0.96, 95% CI = 0.78–1.19; MMSE score <24, HR = 0.72, 95% CI = 0.50–1.05) on multivariable analysis. A MVC within the previous 2 years (HR = 2.68, 95% CI = 2.29–3.13) was the strongest predictor of future MVCs. Other clinical factors associated with greater MVC risk were depression, falls within the previous year, sleep apnea, and lower baseline systolic blood pressure.

Conclusion

In a population of frequent drivers, the MMSE does not predict MVCs. Other clinical factors have a stronger association with MVC risk.
Contribution of Noncommunicable Diseases to Medical Admissions of Elderly Adults in Africa: A Prospective, Cross‐Sectional Study in Nigeria, Sudan, and Tanzania
Authors: Akinyemi Rufus O. , Izzeldin Isameldin M. H. , Dotchin Catherine , Gray William K. , Adeniji Olaleye , Seidi Osheik A. , Mwakisambwe Josephine J. , Mhina Carl J. , Mutesi Florence , Msechu Helen Z. , Mteta Kien A. , Ahmed Mayada A. M. , Hamid Shahd H. M. , Abuelgasim Nazik A. A. , Mohamed Sumia A. A. , Mohamed Ashraf Y. O. , Adesina Fidelis , Hamzat Mohammed , Olunuga Taiwo , Maro Venance P. , Walker Richard
Published: July 2014

Objectives

To describe the nature of geriatric medical admissions to teaching hospitals in three countries in Africa (Nigeria, Sudan, Tanzania) and compare them with data from the United Kingdom.

Design

Cross‐sectional cohort study.

Setting

Federal Medical Centre, Idi‐Aba, Abeokuta, Nigeria; Soba University Hospital, Khartoum, Sudan; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; and North Tyneside General Hospital, North Shields, United Kingdom.

Participants

All people aged 60 and older urgently medically admitted from March 1 to August 31, 2012.

Measurements

Data were collected regarding age, sex, date of admission, length of stay, diagnoses, medication, date of discharge or death, and discharge destination.

Results

In Africa, noncommunicable diseases (NCDs) accounted for 81.0% (n = 708) of admissions (n = 874), and tuberculosis, malaria, and the human immunodeficiency virus and acquired immunodeficiency syndrome accounted for 4.6% (n = 40). Cerebrovascular accident (n = 224, 25.6%) was the most common reason for admission, followed by cardiac or circulatory dysfunction (n = 150, 17.2%). Rates of hypertension were remarkably similar in the United Kingdom (45.8%) and Africa (40.2%).

Conclusions

In the elderly population, the predicted increased burden of NCDs on health services in Africa appears to have occurred. Greater awareness and some reallocation of resources toward NCDs may be required if the burden of such diseases is to be reduced.
Delirium Recognition by Family: European Portuguese Validation Study of the Family Confusion Assessment Method
Authors: Martins Sónia , Conceição Filipe , Paiva José A. , Simões Mário R. , Fernandes Lia
Published: July 2014

Objectives

To present the validation study of the European Portuguese version of the Family Confusion Assessment Method (FAM‐CAM) and to assess the level of psychological distress in families and caregivers of elderly hospitalized adults with delirium.

Design

Validation study.

Setting

Intermediate care unit of the Intensive Medicine Service of the São João Hospital Center, Porto, Portugal.

Participants

Families and caregivers of elderly hospitalized adults (≥48 hours). Inclusion criteria were sufficient knowledge about the individual to enable reporting on his or her mental and physical abilities and staying at the individual's bedside daily during hospitalization. Families and caregivers younger than 18 and those who did not speak Portuguese were excluded.

Measurements

A trained researcher translated the FAM‐CAM according to International Society For Pharmacoeconomics and Outcomes Research guidelines. All individuals were assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM‐IV‐TR) (reference standard) and the Confusion Assessment Method (CAM). A trained researcher administered the FAM‐CAM to families and caregivers. The level of family‐perceived distress was evaluated on a numerical rating scale from 0 to 4.

Results

The sample included 40 families and caregivers (58% adult children). According to the DSM‐IV‐TR, 20% of individuals had delirium. The FAM‐CAM had moderate sensitivity (75%) and good specificity (91%) when assessed against the DSM‐IV‐TR and better sensitivity (86%) and specificity (91%) than the CAM. Fifty‐seven percent of families and caregivers classified delirium as an extremely distressing experience.

Conclusion

These preliminary results suggest that FAM‐CAM is a sensitive screening tool for family detection of delirium in elderly hospitalized adults. The high level of psychological distress found corroborated previous studies. Future studies with larger samples will be needed for further validation and to allow the analysis of other psychometric properties.
A Simplified Model to Include Dynamic Product‐User Interaction in the Eco‐Design Process
Authors: Serna‐Mansoux Livier , Popoff Alexandre , Millet Dominique
Published: July 2014

For many modern products, the use phase is intensive and poses a serious environmental impact because of the energy and resources consumed. This could be resolved by optimizing the product's environmental impact by improving the understanding of the users’ relationship with it. In this work, we propose a model that can be used to include the use phase and the eco‐oriented strategies in the environmental impact assessment of a product. This model takes into account the changing nature of the interactions between the user and the product over time. An indicator designated mitigation rate is introduced to help model this change. It acknowledges the loss in performance of eco‐oriented strategies over time. This work presents the methodology to understand, model, and select among different eco‐oriented strategies with different time frames. A case study is also presented, where four alternative models considering different eco‐oriented strategies are shown and compared.
Paternal Influences on Offspring Development: Behavioural and Epigenetic Pathways
Authors: Braun K. , Champagne F. A.
Published: July 2014

Although mammalian parent–offspring interactions during early life are primarily through the mother, there is increasing evidence for the impact of fathers on offspring development. A critical issue concerns the pathways through which this paternal influence is achieved. In the present review, we highlight the literature suggesting several of these routes of paternal effects in mammals. First, similar to mothers, fathers can influence offspring development through the direct care of offspring, as has been observed in biparental species. Second, there is growing evidence that, even in the absence of contact with offspring, fathers can transmit environmentally‐induced effects (i.e. behavioural, neurobiological and metabolic phenotypes induced by stress, nutrition and toxins) to offspring and it has been speculated that these effects are achieved through inherited epigenetic variation within the patriline. Third, fathers may also impact the quality of mother–infant interactions and thus achieve an indirect influence on offspring. Importantly, these pathways of paternal influence are not mutually exclusive but rather serve as an illustration of the complex mechanisms through which parental influence is achieved. These influences may serve to transmit traits across generations, thus leading to a transgenerational transmission of neurobiological and behavioural phenotypes.
GOVERNMENT SIZE AND GROWTH: A SURVEY AND INTERPRETATION OF THE EVIDENCE – A COMMENT
Authors: Colombier Carsten
Published: July 2014

In contrast to the commonly held view, Bergh and Henrekson (2011) conclude that a consensus has almost been reached on the thesis that government size is negatively correlated with economic growth in developed countries. They underpin this by claiming that the only study in the survey to deviate from this consensus view, i.e. Colombier (2009), was rebutted by Bergh and Öhrn (2011). This comment shows that the claim by Bergh and Henrekson (2011) cannot be upheld because the analysis by Bergh and Öhrn (2011) is based on a flawed dataset. The re‐estimation of Colombier's (2009) regressions with time‐fixed effect does not reject his main findings. Moreover, it is demonstrated that recent empirical evidence on the growth impact of government size in rich countries is not as unanimous as the survey by Bergh and Henrekson (2011) suggests. Thus, the claim that a consensus view has been reached is premature.
Heart failure and Alzheimer′s disease
Authors: Cermakova P. , Eriksdotter M. , Lund L. H. , Winblad B. , Religa P. , Religa D.
Published: July 2014

It has recently been proposed that heart failure is a risk factor for Alzheimer′s disease. Decreased cerebral blood flow and neurohormonal activation due to heart failure may contribute to the dysfunction of the neurovascular unit and cause an energy crisis in neurons. This leads to the impaired clearance of amyloid beta and hyperphosphorylation of tau protein, resulting in the formation of amyloid beta plaques and neurofibrillary tangles. In this article, we will summarize the current understanding of the relationship between heart failure and Alzheimer′s disease based on epidemiological studies, brain imaging research, pathological findings and the use of animal models. The importance of atherosclerosis, myocardial infarction, atrial fibrillation, blood pressure and valve disease as well as the effect of relevant medications will be discussed.
THE GREAT RECESSION AND NONMETROPOLITAN AMERICA
Authors: Rickman Dan S. , Guettabi Mouhcine
Published: July 2014

The influence of the housing market on U.S. business cycle dynamics during the previous decade has been well documented. Yet, little if anything is known about how nonmetropolitan areas fared. This study examines the association of regional housing market bubbles with relative nonmetropolitan economic performance during the business cycle phases of the decade. Among the primary findings, the study establishes the association of natural amenity attractiveness with nonmetropolitan housing market bubbles and growth during the expansion phase. During the Great Recession, industry composition best explained the pattern of employment declines and natural population growth differences best explained the variation of population growth, with amenity attractiveness waning in importance.
Information Distribution, Utilization, and Decisions by New Product Development Teams
Authors: Zhang Haisu , Basadur Timothy M. , Schmidt Jeffrey B.
Published: July 2014

Typically, organizations use new product development processes composed of activities followed by decision points, where projects are continued or abandoned. A decision maker likely possesses some common information also held by other decision makers and some unique information (that only she/he possesses). If a team relies mainly on overlapping, or common, information, decisions may suffer, but if they share and utilize information originally possessed by a subset of individual members, better decisions can be made. In this paper, the authors designed and conducted four studies to examine the effects of information distribution and utilization on new product team decision‐making. In study 1, the findings show that team members tend to use information possessed by everyone (i.e., common information) but neglect critical information possessed only by one of them (i.e., unique information). This common information bias results in suboptimal new product continuation decisions. In study 2, the interplay between the common information bias and team commitment to theNPDproject favored by unique information is examined. The results show that although commitment influences new product development team decisions, the common information bias is stronger. Study 3 was conducted to rule out an alternative explanation for the effect of information distribution—the perception of information importance. In study 4, the focal hypotheses were re‐tested using a different sample to add confidence in the findings.
Interaction between amino acids on the performances of individually housed piglets
Authors: Millet S. , Aluwé M. , Ampe B. , De Campeneere S.
Published: July 2014

Dietary branched‐chain amino acid and tryptophan concentrations have been associated with effects on daily feed intake; this study is an extension of that research. We evaluated eight dietary treatments in a Latin square cross‐over design with 32 female piglets during 8 weeks (9.9 ± 0.6 kg to 44.9 ± 2.9 kg, mean ± SD). Treatments differed in dietary standardized ileal digestible leucine (10.8 and 21.3 g/kg), valine (7.0 and 7.8 g/kg), isoleucine (6.0 or 7.3 g/kg) and tryptophan (2.0 and 2.5 g/kg) content. A longitudinal model was fitted with the level of valine, leucine, isoleucine, tryptophan and the interactions leucine × tryptophan, valine × leucine, isoleucine × tryptophan as fixed effects. Increasing the dietary leucine content decreased feed intake (−169 g/day) and daily gain (−168 g/day) of the pigs and impaired the feed conversion ratio (+0.49 g/g) (p < 0.01 for all parameters). Adding valine to the high leucine diet counteracted the feed intake reduction partially, while effects on daily gain and feed conversion ratio were largely counteracted by adding extra valine. The positive effect on feed conversion ratio diminished over time (p = 0.001 for age × valine). Adding extra tryptophan to the high leucine diet tended to negatively affect daily gain (p = 0.081) and feed conversion ratio (p = 0.074). Adding extra dietary isoleucine together with extra valine did not further counteract the negative effects of excess dietary leucine. The present results confirmed that, with excess leucine, extra valine benefits performance. Further adding extra tryptophan or isoleucine did not improve performances.
Quantitative analysis of classical and new putative periodontal pathogens in subgingival biofilm: a case–control study
Authors: Al‐hebshi N. N. , Al‐Alimi A. , Taiyeb‐Ali T. , Jaafar N.
Published: July 2014

Background and Objectives

A number of species/phylotypes have been newly implicated as putative periopathogens. The objective of this study was to explore associations among classical and new pathogens in subgingival biofilm and to assess their relative importance to chronic periodontitis.

Material and Methods

Pooled subgingival biofilm samples were obtained from 40 patients with chronic periodontitis and 40 healthy controls. Taqman q‐PCR assays were used to determine the absolute and relative counts of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Parvimonas micra, Filifactor alocis, oral Synergistetes and oral TM7s. Microbial associations were assessed using cluster analysis. Different statistical models were used to explore associations between microbial parameters and periodontitis.

Results

The median log and relative counts were lowest for TM7s (4.4 and 0.0016%, respectively) and highest for oral Synergistetes (7.2 and 1.4%, respectively). Oral Synergistetes clustered strongly with the red complex, particularly T. forsythia (100% rescaled similarity). All species/phylotypes except TM7s were significantly associated with periodontitis (Mann–Whitney test; p ≤ 0.005). However, P. gingivalis and F. alocis lost association after adjusting for confounders (ordinal regression). In receiving operator characteristic curve analysis, the log counts of oral Synergistetes were the best markers of periodontitis (82.5% sensitivity and specificity), followed by those of T. forsythia, P. micra and T. denticola. In prediction analysis, however, P. micra was the only microbial predictor of periodontal parameters.

Conclusions

Oral Synergistetes are presented here as new members of the red complex, with relative importance to periodontitis exceeding that of the classical members. P. micra is shown as an important periodontal pathogen warranting more attention.
Interferon–ribavirin therapy induces serum antibodies determining ‘rods and rings’ pattern in hepatitis C patients
Authors: Novembrino Cristina , Aghemo Alessio , Ferraris Fusarini Chiara , Maiavacca Rita , Matinato Caterina , Lunghi Giovanna , Torresani Erminio , Ronchi Mariangela , Garlaschi Maria Cristina , Ramondetta Miriam , Colombo Massimo
Published: July 2014

A cytoplasmic antigen associated to inosine‐5'‐monophosphatedehydrogenase 2 eliciting specific antibodies (antirods and rings, RR) has been identified in patients with chronic hepatitis C who were exposed to pegylated interferon (PI) and ribavirin (RBV). The significance of anti‐RR in these patients merits to be investigated. Sera from 88 chronic hepatitis C virus (HCV)‐infected patients undergoing PI‐RBV therapy were analysed for the presence of RR pattern by indirect immunofluorescence on HEp‐2 substrate (Inova Diagnostics, San Diego, CA, USA). Anti‐RR antibodies developed de novo in 32 patients independently of any demographic and virological feature, but with a significant association with cumulative exposure to PI‐RBV (P = 0.0089; chi‐square test). RR pattern was significantly more frequent in relapsers than in patients achieving sustained virological response (56% vs 30%; P = 0.0282, chi‐square test). Anti‐RR titre ranged from 1:80 to 1:1280, but significantly declined following treatment cessation. Anti‐RR develop de novo in a substantial proportion of patients exposed to PI‐RBV in relation to the duration of treatment exposure. Further investigations are necessary to unravel the mechanisms leading to the formation of these autoantibodies.
Antifibrotic effects of luteolin on hepatic stellate cells and liver fibrosis by targeting AKT/mTOR/p70S6K and TGFβ/Smad signalling pathways
Authors: Li Jie , Li Xingxia , Xu Weiheng , Wang Shaozhan , Hu Zhenlin , Zhang Qing , Deng Xing , Wang Jing , Zhang Junping , Guo Cheng
Published: July 2014

Background & Aims

Luteolin has been reported to exert antifibrogenic effects in CCl4‐induced hepatic fibrosis in mice. However, limited information is available on the cellular and molecular events responsible for this effect. This study focused on the action of luteolin on hepatic stellate cells (HSCs) and the relevant signalling molecules and pathways as well as the antifibrotic efficacy in multiple models of fibrosis.

Methods

The in vitro effect of luteolin on rat HSCs and HSC‐T6 cells was assessed using proliferation assays, invasion chamber, quantitative real‐time PCR analysis and Western blotting. The in vivo effect of luteolin on progression of fibrosis was assessed in three experimental rat models induced by CCl4, dimethylnitrosamine (DMN) and bile duct ligation (BDL).

Results

Luteolin inhibited proliferation, migration, collagen synthesis as well as expression of fibrosis‐related genes in the activated HSCs and HSC‐T6 cells stimulated with or without transforming growth factor‐β1(TGFβ1) or platelet‐derived growth factor (PDGF). Luteolin induced HSC apoptosis associated with the increased caspase 3 activity and p53 expression, and induced G1 arrest with the decreased expression of bcl‐2, Cyclin E and p‐Cdk‐2. Moreover, luteolin significantly inhibited PDGF and TGFβ1‐simulated phosphorylation of AKT and Smad pathway. In vivo study showed that luteolin administration markedly alleviated hepatic fibrosis along with reduced elevations of alanine aminotransferase and aspartate aminotransferase. HSCs were found to undergo apoptosis and decreased expression of p‐Smad2 and p‐AKT in luteolin‐treated animals.

Conclusions

This study demonstrates that luteolin prevents the progression of liver fibrosis through multiple mechanisms and indicates that luteolin has potential for effective treatment of liver fibrosis.
Primary sclerosing cholangitis increases the risk for pancreatitis after endoscopic retrograde cholangiopancreatography
Authors: von Seth Erik , Arnelo Urban , Enochsson Lars , Bergquist Annika
Published: July 2014

Background & Aims

Patients with primary sclerosing cholangitis (PSC) have an increased risk for adverse events following endoscopic retrograde cholangiopancreatography (ERCP), mainly caused by bacterial cholangitis. The risk of pancreatitis is less examined. Therefore, our aim was to study adverse events following ERCP and to evaluate if PSC is a risk factor for pancreatitis.

Methods

Data were collected through a Swedish nationwide quality registry comprising fifty‐one Swedish ERCP centres. The final study cohort consisted of 8932 adults who had undergone ERCP from 1 January 2007 to 31 December 2009. A total of 141 patients had PSC. Variables of importance for adverse events were entered into a multivariate logistic regression model for risk factor analysis.

Results

The following adverse events were increased in PSC as compared with non‐PSC patients: overall (18.4% vs. 7.3%), pancreatitis (7.8% vs. 3.2%, P = 0.002), cholangitis (7.1% vs. 2.1%, P < 0.001) and per‐operative extravasation of contrast (5.7% vs. 0.7%, P < 0.001). PSC was shown to be an independent risk factor for all of these adverse events: pancreatitis, OR 2.02 (95% CI, 1.04–3.92), cholangitis, OR 2.88 (95% CI, 1.47–5.65), and extravasation of contrast, OR 5.84 (95% CI, 2.24–15.23).

Conclusion

The rate of adverse events overall following ERCP in PSC is 18% and PEP occurs in 8%. PSC is an independent risk factor for PEP and the risk is doubled. These findings underline the importance of a careful selection of PSC patients eligible for ERCP as well as a need for high competence of the treating team.
Monetary Policy at the Zero Lower Bound and After: A Reassessment of Quantitative Easing and Critique of the Federal Reserve's Proposed Exit Strategy
Authors: Palley Thomas I.
Published: July 2014

This paper analyses quantitative easing, focusing on its implicit fiscal dimension. It distinguishes between ‘weak’ and ‘strong’ zero lower bound traps. A strong trap corresponds to the liquidity trap. In a weak trap QE is expansionary but subject to diminishing returns. QE implicitly transfers income streams to the fiscal authority, generating fiscal drag that can eventually render QE contractionary. Proposals to exit QE by paying interest on reserves to check inflationary pressures is contradicted because paying interest constitutes an implicit tax cut. Instead, the paper suggests implementing asset based reserve requirements that deactivate liquidity by requiring banks hold increased reserves.
Diplomatic Interactions and Negotiations
Authors: Faizullaev Alisher
Published: July 2014

This article examines the role of state actors, organization agencies, and individual agents in diplomatic interactions and negotiations. States as diplomatic actors, organizations as diplomatic agencies, and individuals as diplomatic agents enter into complex and interdependent relationships. Proposing a three‐level analysis of interstate interactions and diplomatic negotiations, I argue that no diplomatic negotiation happens without interactions between parties at the state, organizational, and individual levels. The agency–structure paradigm provides a conceptual framework for understanding behavioral and structural properties of international interactions and their influence on diplomatic negotiations. Diplomatic negotiation employs specific forms of interaction, using a distinct language, protocol norms, symbols, ceremonies, and rituals. The state's “self” (as a social conception of its identity, values, and interests) affects the process of diplomatic negotiation. By managing, organizing, and improving international interactions at the actor, agency, and agent levels, negotiating parties can advance the process and effectiveness of diplomatic negotiation.
Orofacial functional impairments among patients following stroke: a systematic review
Authors: Dai R , Lam O LT , Lo E CM , Li L SW , Wen Y , McGrath C
Published: July 2014

Objectives

The objective of this study was to review orofacial functional impairments among patients following stroke, including objective and subjective assessment.

Methods

A structured search strategy was applied to three electronic databases (Pubmed, Embase, and Web of Science) to identify effective papers. Relevant data regarding subjects, method, outcomes, and key findings were extracted from the effective papers and the results were summarized.

Results

The initial search yielded 5227 papers, and 18 effective papers (Kappa: 0.971) were in accordance with the inclusion criteria. The patients with stroke consistently showed a decreased lip force, salivary flow rate, and chewing performance compared with the healthy controls. Due to equivocal results gained from the effective papers, the qualitative assessments regarding whether there was any change in masticatory force on the affected side and oral health‐related quality of life were inconclusive.

Conclusions

Existing evidence highlights a number of compromised orofacial functions experienced by patients following stroke. These impairments appear to be sustained, with spontaneous recovery unlikely to occur. While rehabilitative approaches may have the potential to improve orofacial function and quality of life following stroke, there is currently a lack of evidence‐based interventions available to inform the development of comprehensive rehabilitation protocols.
Arrhythmia Risk Assessment Using Heart Rate Variability Parameters in Patients with Frequent Ventricular Ectopic Beats without Structural Heart Disease
Authors: BARUTÇU AHMET , TEMIZ AHMET , BEKLER ADEM , ALTUN BURAK , KIRILMAZ BAHADIR , AKSU FEYZA ULUSOY , KÜÇÜK UĞUR , GAZI EMINE
Published: July 2014

Background

Ventricular ectopic beats (VEBs) are usually considered a benign condition that can be managed with conservative measures. Heart rate variability (HRV), which is one of the most important methods for assessing autonomic activity, is a noninvasive, quantitative method of analyzing autonomic effects on the heart. We aimed to investigate the risk of arrhythmia in patients with VEBs and without cardiovascular disease by using HRV parameters.

Methods

Patients with frequent VEBs (more than 30 times in 1 hour, according to the Lown classification) were identified. Identified patients were evaluated by 24‐hour ECG recording. Our study included 43 patients with frequent VEBs and 43 controls.

Results

General characteristics of the study population were similar. The LF (low frequency)/HF (high frequency) ratio was significantly higher in the frequent VEBs group than in the control group (P < 0.001). The rate of paroxysmal atrial fibrillation (PAF) was higher in the frequent VEB group than in the control group (P = 0.003). The number of VEBs was correlated with LF/HF ratio and PAF (r = 0.339, P = 0.001 and r = 0.294, P = 0.006, respectively).

Conclusions

Our study showed that the sympathetic nervous system is dominant in young patients with VEBs and without significant comorbidities. There is a higher risk of atrial fibrillation in patients with VEBs and they should be monitored closely for atrial fibrillation.
Changing from a traditional psychodynamic treatment programme to mentalization‐based treatment for patients with borderline personality disorder – Does it make a difference?
Authors: Kvarstein Elfrida H. , Pedersen Geir , Urnes Øyvind , Hummelen Benjamin , Wilberg Theresa , Karterud Sigmund
Published: July 2014

Objectives

Few studies outside United Kingdom have documented effects of mentalization‐based treatment (MBT) for patients with borderline personality disorder (BPD). This study aimed to investigate outcomes for BPD patients treated in an MBT programme in a Norwegian specialist treatment unit and compare benefits of the implemented MBT with the unit's former psychodynamic treatment programme.

Design

A naturalistic, longitudinal, comparison of treatment effects for BPD patients before and after transition to MBT.

Methods

The sample consisted of 345 BPD patients treated in the period 1993–2013. Before 2008, patients were admitted to a psychodynamic treatment programme (n = 281), after 2008 patients received MBT (n = 64). Symptom distress, interpersonal problems, and global functioning were assessed repeatedly throughout the treatment. Suicidal/self‐harming acts, hospital admissions, medication, and occupational status were assessed at the start and end of treatment. Therapists' competence and adherence to MBT was rated and found satisfactory. The statistical method for longitudinal analyses was mixed models.

Results

BPD patients in MBT and in the former psychodynamic treatment programme had comparable baseline severity and impairments of functioning. BPD patients in MBT had a remarkably low drop‐out rate (2%), significantly lower than the former treatment. Improvements of symptom distress, interpersonal, global and occupational functioning were significantly greater for MBT patients. Large reductions in suicidal/self‐harming acts, hospital admissions, and use of medication were evident in the course of both treatments.

Conclusions

The study confirms the effectiveness of MBT for BPD patients and indicates greater clinical benefits than in traditional psychodynamic treatment programmes.

Practitioner points

MBT is an effective treatment for patients with BPD.

MBT can successfully be implemented in therapeutic settings outside United Kingdom and may be more beneficial than psychodynamic treatment programmes for BPD patients.
A Teenage Girl with Green Hair
Authors: Schwartz Richard H. , Yasin Shima K. , Yoo Jinny K.
Published: July 2014

An adolescent girl with blond hair, her family, and classmates noted that her hair was progressively turning green. Initially the green color was thought to be secondary to chlorine from the local swimming pool. This was not the real cause. The chlorotrichosis was actually caused by an excessive amount of dissolved copper from copper pipes in the home plumbing system. Copper had leached from the plumbing and accumulated in the pipes because the rented house had been vacant for many months. Risk factors for chlorotrichosis include light‐colored hair, copper plumbing, long periods when the water was not thoroughly flushed out of the copper pipes, and frequent shampooing.
Expression Pattern of Vascular Endothelial Growth Factor in Canine Folliculogenesis and its Effect on the Growth and Development of Follicles after Ovarian Organ Culture
Authors: Abdel‐Ghani MA , Shimizu T , Suzuki H
Published: July 2014

Contents

In this study, the expressions of VEGF in dog follicles were detected by immunohistochemistry and the effects of VEGF treatment on the primordial to primary follicle transition and on subsequent follicle progression were examined using a dog ovary organ culture system. The frozen‐thawed canine ovarian follicles within slices of ovarian cortical tissue were cultured for 7 and 14 days in presence or absence of VEGF. After culture, the ovaries were fixed, sectioned, stained and counted for morphologic analysis. The results showed that VEGF was expressed in the theca cells of antral follicles and in the granulosa cells nearest the oocyte in preantral follicle but not in granulosa cells of primordial and primary follicles; however, the VEGF protein was expressed in CL. After in vitro culture, VEGF caused a decrease in the number of primordial follicles and concomitant increase in the number of primary follicles that showed growth initiation and reached the secondary and preantral stages of development after 7 and 14 days. Follicular viability was also improved in the presence of VEGF after 7 and 14 days in culture. In conclusion, treatment with VEGF was found to promote the activation of primordial follicle development that could provide an alternative approach to stimulate early follicle development in dogs.
A Computational Framework for Prime Implicants Identification in Noncoherent Dynamic Systems
Authors: Maio Francesco Di , Baronchelli Samuele , Zio Enrico
Published: July 2014

Dynamic reliability methods aim at complementing the capability of traditional static approaches (e.g., event trees [ETs] and fault trees [FTs]) by accounting for the system dynamic behavior and its interactions with the system state transition process. For this, the system dynamics is here described by a time‐dependent model that includes the dependencies with the stochastic transition events. In this article, we present a novel computational framework for dynamic reliability analysis whose objectives are i) accounting for discrete stochastic transition events and ii) identifying the prime implicants (PIs) of the dynamic system. The framework entails adopting a multiple‐valued logic (MVL) to consider stochastic transitions at discretized times. Then, PIs are originally identified by a differential evolution (DE) algorithm that looks for the optimal MVL solution of a covering problem formulated for MVL accident scenarios. For testing the feasibility of the framework, a dynamic noncoherent system composed of five components that can fail at discretized times has been analyzed, showing the applicability of the framework to practical cases.
Intra‐industry Trade Liberalization and the Environment
Authors: Benarroch Michael , Gaisford James
Published: July 2014

This paper examines how trade liberalization affects national and global pollution in a multi‐country model incorporating monopolistic competition and intra‐industry trade as well as inter‐industry trade. Each country produces skill‐intensive differentiated goods and labor‐intensive goods. Pollution is a by‐product of production but pollution abatement can be undertaken. Regardless of country characteristics, if the differentiated‐good sector is sufficiently cleaner (dirtier) then, without any change in environmental taxes, a multilateral reduction in import protection accorded to the differentiated good or to both goods typically leads to a decline (rise) in pollution in all countries. Pollution havens tend not to arise.
Assessing Policy Design and Interpretation: An Institutions‐Based Analysis in the Context of Aquaculture in Florida and Virginia, United States
Authors: Siddiki Saba
Published: July 2014

Recently in the field of policy studies, there has been a renewed interest in research that connects policy design with broader governance outcomes. As opposed to past studies of policy design that have characterized policies along broad categories of variables, however, recent studies have sought to systematically assess the language of public policies and resultant outcomes. This paper contributes to the existing and emerging literature on policy design by coupling a content analysis of polices governing the aquaculture industry in two U.S. states and interviews with aquaculture community members to understand policy design and perceptions of policy legitimacy, coerciveness, and enforcement.
Prediction of Patient-Reported Outcome Measures Via Multivariate Ordered Probit Models
Authors: Conigliani Caterina , Manca Andrea , Tancredi Andrea
Published: July 2014

The assessment of patient-reported outcome measures (PROMs) is of central importance in many areas of research and public policy. Unfortunately, it is quite common for clinical studies to employ different PROMs, thus limiting the comparability of the evidence base that they contribute to. This issue is exacerbated by the fact that some national agencies are now explicit about which PROMs must be used to generate evidence in support of claims for reimbursement. The National Institute for Health and Care Excellence for England and Wales, for instance, has identified in EuroQoL-5D, EQ-5D, the PROM of choice, while accepting the use of a ‘mapping’ approach to predict EQ-5D from other PROMs when EQ-5D data have not been collected. Here we consider the problem of directly predicting EQ-5D responses from ‘Short form 12', while recognizing both the likely dependence between the five dimensions of the EQ-5D responses at the patient level, and the fact that the levels of each health dimension are naturally ordered. We carry out the analysis within a Bayesian framework. We also address the key problem of choosing an appropriate summary measure of agreement between predicted and actual results when analysing PROMs, with particular attention devoted to scoring rules.
Joint Modelling of Goals and Bookings in Association Football
Authors: Titman A. C. , Costain D. A. , Ridall P. G. , Gregory K.
Published: July 2014

A multivariate counting process formulation is developed for the quantification of association football event interdependences which permits dynamic prediction as events unfold. We model data from English Premier League and Championship games from the 2009–2010 and 2010–2011 football seasons and assess predictive capacity by using a model-based betting strategy, applied prospectively to available live spread betting prices. Both the scoreline and the bookings status were predictive of match outcome. In particular, the award of a red card led to increased goal rates for the non-penalized team and the home team scoring rate decreased once they were ahead. Overall the betting strategy profited with gains made in the bookings markets.
HIV‐related stigma in the dental setting: a qualitative study
Authors: Patel Natisha , Furin Jennifer J. , Willenberg Danae J. , Apollon Chirouze Nicole J. , Vernon Lance T.
Published: July 2014

Purpose

To explore the experiences and expectations of HIV‐related stigma in dental settings.

Methods

This was a cross‐sectional study of 60 HIV+ adult volunteers. We conducted audio‐recorded interviews; responses to four open‐ended questions were analyzed qualitatively for theme and content.

Results

Twenty‐seven participants (45%) reported ever having anticipated being judged, stigmatized or treated with disrespect in a dental setting due to HIV status. Thematic response categories included concerns about: (i) receiving humane and respectful treatment, (ii) being judged or stereotyped and (iii) giving HIV to the dentist. Regarding hesitancy to visit the dentist, subjects equally endorsed fear of the dentist (35%) and concerns about confidentiality and receiving humane treatment (35%).

Conclusion

HIV+ individuals encounter many fears and concerns related to dental care; fear of the dentist and concerns about confidentiality and receiving humane treatment appear to be central issues. Dental providers should be aware of and better manage these issues.
A specific Toll‐like receptor profile on T lymphocytes and values of monocytes correlate with bacterial, fungal, and cytomegalovirus infections in the early period of allogeneic stem cell transplantation
Authors: Skert C. , Fogli M. , Garrafa E. , Perucca S. , Fiorentini S. , Cancelli V. , Turra A. , Ribolla R. , Filì C. , Malagola M. , Bergonzi C. , Cattina F. , Bernardi S. , Caruso A. , Di Palma A. , Russo D.
Published: July 2014

Background

Bacterial, fungal, and viral infections often affect non‐relapse mortality after allogeneic stem cell transplantation (alloSCT). Recovery from infections depends on a balanced integration between innate and adaptive immune responses. In this complex interplay, a key role is played by Toll‐like receptors (TLRs), which are sensors of pathogen‐associated molecular patterns. To our knowledge, no previous study deals with both expression and function of all human TLRs together, in relation to infections in the setting of alloSCT.

Methods

We prospectively evaluated 9 TLRs by flow cytometry on T lymphocytes and monocytes of 35 patients in relation to infectious events from day +30 to day +120. Tumor necrois factor‐alpha, interleukin‐4, interferon‐gamma, and monocyte chemoattractant protein‐1 induction upon TLR activation was assessed by enzyme‐linked immunosorbent assay on cell supernatants.

Results

In multivariate Cox regression analysis, levels of TLR‐9 expression on T lymphocytes (P = 0.01) and values of natural killer cells (P = 0.01) correlated negatively with bacterial infections, whereas cytomegalovirus (CMV) infection resulted as a positive predictor. We observed a trend for negative correlation between TLR‐7 levels on T lymphocytes and fungal infections (P = 0.07). Values of monocytes were negatively associated with CMV infection (P = 0.03), whereas levels of TLR‐5 on T lymphocytes were positive predictors (P = 0.01). Age (P = 0.03) and bacterial infections (P = 0.006) negatively influenced overall survival. Monocyte values were positive predictors of survival (P = 0.003).

Conclusions

Bacterial, fungal, and CMV infections were associated with a different expression of some TLRs on T lymphocytes. The protective role of TLR‐7 and TLR‐9 seemed dominant over other TLRs involved in recognizing fungi and bacteria. We also observed an atypical involvement of TLR‐5 in CMV infection. The dominant and atypical role of some TLRs could depend on their pleiotropic functions and the changing inflammatory environment of transplanted patients. A specific TLR profile and an adequate count of monocytes could improve survival, promoting an effective control of infections, and balanced immune responses. If our findings will be confirmed by further studies, these immunological variables could be useful as parameters to predict susceptibility to infections.
Monoclonal anti‐A activity against the FORS1 (Forssman) antigen
Authors: Barr Katie , Korchagina Elena , Popova Inna , Bovin Nicolai , Henry Stephen
Published: July 2014

Background

The FORS blood group system (originally recognized as the Apae phenotype) was discovered by sporadic activity against polyclonal anti‐A reagents and activity against the lectin Helix pomatia. The extent of monoclonal anti‐A reagent activity against the FORS1 antigen is serologically and immunochemically incomplete.

Study Design and Methods

In the absence of natural FORS1‐positive red blood cells (RBCs), kodecytes were created with synthetic disaccharide and pentasaccharide Forssman function‐spacer‐lipid (FSL) constructs, Fsdi‐kodecytes, and FORS1‐kodecytes, respectively. FSL constructs were also applied to solid surfaces and used in solid‐phase enzyme immunoassays. A range of characterized monoclonal anti‐A and anti‐B reagents were then serologically and immunochemically characterized against these Forssman antigens. Polyclonal human anti‐A, anti‐B, the lectin H. pomatia serologic reagents; and canine RBCs were used as serologic controls.

Results

None of 19 different monoclonal anti‐A reagents were able to detect the pentasaccharide Forssman on FORS1‐kodecytes, while three reagents were able to detect disaccharide Forssman on Fsdi‐kodecytes. Most anti‐A reagents were immunochemically reactive with both the di‐ and the pentasaccharide Forssman antigens in the solid‐phase assays. Historic polyclonal human anti‐A and the lectin H. pomatia reacted strongly with the FORS1‐kodecytes, correlating with the discovery of the Apae phenotype and supporting the use of FORS1‐kodecytes as FORS1 surrogates.

Conclusions

Monoclonal anti‐A reagents, despite showing reactivity against the FORS1 antigen in solid‐phase assays are unlikely to cause the agglutination of FORS1 antigen–positive RBCs.
Effects of interruptions of controlled‐rate freezing on the viability of umbilical cord blood stem cells
Authors: Yang Hongyou , Pidgorna Alla , Loutfy Mona R. , Shuen Paul
Published: July 2014

Background

An optimal cooling rate is critical for cryopreserving cord blood stem cells, so it is generally achieved by using controlled‐rate freezers (CRFs). The cooling rate can be interrupted by many factors during cooling; therefore, a proper response to the interruption in cryopreservation is crucial to prevent the loss of valuable cells.

Study Design and Methods

Cord blood samples (n = 6) containing 10% dimethyl sulfoxide were cooled from 4 to −80°C using a CRF. At different temperatures during cooling, cells were transferred either to liquid nitrogen vapor phase (LNVP) directly or a −80°C mechanical freezer where they were stored for 18.1 ± 0.6 hours before transferring to LNVP. The cells were stored in LNVP for 127 ± 48.1 hours before postthaw recovery, viability, and survival of total nucleated cells and/or CD45+ cells, CD34+ cells, and colony‐forming unit–granulocyte‐macrophage (CFU‐GM) were assessed.

Results

For all types of postthaw evaluations, there were no significant differences when cells were transferred to a −80°C freezer before LNVP, regardless of the temperature at which cooling was interrupted. In contrast, there were significant differences when cells were transferred to LNVP directly, but the differences were determined by the type of assays and how viability was calculated.

Conclusions

Cord blood samples can be transferred to a −80°C freezer anytime during controlled‐rate cooling, but should only be transferred to LNVP when the samples have been cooled to −40°C or lower. Percent postthaw survival of CFU‐GM should be routinely assessed when controlled‐rate cooling is interrupted.
Product Heterogeneity and Cost Allocations in Contingent Trade Protection
Authors: Kelly Brian D.
Published: July 2014

The WTO allows members to impose contingent protection, including anti‐dumping duties, within agreed constraints. Anti‐dumping proceedings typically name a single captioned product but include large numbers of individual products within that caption. The inclusion of multiple products creates a variety of issues for both anti‐dumping and other contingent protection measures, issues that have been prominent in national actions and WTO dispute settlements, but have been largely ignored in research. This work focuses on the most important such area, the allocation of costs among products in anti‐dumping proceedings. We develop a comprehensive economic analysis for cost allocation issues, and couple it with the accounting tools that must be used for its implementation, to derive the first‐best allocation methods for anti‐dumping purposes. These results have direct relevance in other contingent trade contexts, such as injury determinations and subsidy pass‐through analysis.
Of mice and men: olfactory neuroblastoma among animals and humans
Authors: Lubojemska A. , Borejko M. , Czapiewski P. , Dziadziuszko R. , Biernat W.
Published: July 2014

Olfactory neuroblastoma (ONB) is a rare tumour of nasal cavity and paranasal sinuses that arises from the olfactory neuroepithelium and has unpredictable clinical course. As the sense of smell is phylogenetically one of the first senses and olfactory neuroepithelium is evolutionary conserved with striking similarities among different species, we performed an extensive analysis of the literature in order to evaluate the similarities and differences between animals and humans on the clinical, morphological, immunohistochemical, ultrastructural and molecular level. Our analysis revealed that ONB was reported mainly in mammals and showed striking similarities to human ONB. These observations provide rationale for introduction of therapy modalities used in humans into the veterinary medicine. Animal models of neuroblastoma should be considered for the preclinical studies evaluating novel therapies for ONB.