bluuebunny/crossref_metadata_2025 huggingface dataset:
SES differences in language processing skill and vocabulary are evident at 18 months
Authors: Fernald Anne , Marchman Virginia A. , Weisleder Adriana
Published: December 2012

This research revealed both similarities and striking differences in early language proficiency among infants from a broad range of advantaged and disadvantaged families. English‐learning infants (n = 48) were followed longitudinally from 18 to 24 months, using real‐time measures of spoken language processing. The first goal was to track developmental changes in processing efficiency in relation to vocabulary learning in this diverse sample. The second goal was to examine differences in these crucial aspects of early language development in relation to family socioeconomic status (SES). The most important findings were that significant disparities in vocabulary and language processing efficiency were already evident at 18 months between infants from higher‐ and lower‐SES families, and by 24 months there was a 6‐month gap between SES groups in processing skills critical to language development.
Aortic Distensibility and Aortic Intima‐Media Thickness in Patients without Clinical Manifestation of Atherosclerotic Cardiovascular Disease
Authors: Elbasan Zafer , Şahin Durmuş Yıldıray , Gür Mustafa , Kalkan Gülhan Yüksel , Yıldız Ali , Kaya Zekeriya , Kıvrak Ali , Gözübüyük Gökhan , Özdoğru Ibrahim , Çaylı Murat
Published: December 2012

Background: There is growing evidence that aortic distensibility (AD) is a subclinical marker of early atherosclerosis. Aortic intima‐media thickness (IMT) was an earlier marker than carotid IMT of preclinical atherosclerosis. In this study, we aimed to assess the relationship between thoracic aortic IMT and AD. Methods: We studied 192 patients (mean age: 45.5 ± 8.4 years) who underwent transesophageal echocardiography (TEE) for various indications. Four different grades were determined according to IMT of thoracic aorta (Grade 1 < 1 mm; 1 mm ≤ Grade 2 < 3 mm; 3 mm ≤ Grade 3 < 5 mm; 5 mm ≤ Grade 4). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements in all patients. High sensitive C‐reactive protein (hsCRP) and other biochemical markers were measured using an automated chemistry analyzer. Results: TEE evaluation characterized thoracic aortic intimal morphology as grade 1 in 71 patients (37%), grade 2 in 57 patients (29.7%), grade 3 in 34 patients (17.7%), and grade 4 in 30 (15.6%) patients. The lowest AD level was observed in grade 4 group compared with grade 1 and grade 2 groups (P < 0.001, P = 0.009, respectively). AD level of grade 3 group was lower than grade 1 and grade 2 group (P < 0.001, P = 0.021, respectively). In multiple linear regression analysis, AD was independently associated with age (β = −0.138, P = 0.029), hsCRP (β = −0.209, P = 0.001), and aortic IMT (β = −0.432, P < 0.001). Conclusion: AD is independently associated with age, thoracic aortic IMT, and hsCRP. Impaired elasticity index of the aorta might be an independent predictor for the severity of thoracic atherosclerosis.
Serendipitous Discovery of a Right Coronary Artery to Right Pulmonary Artery Fistula by Transesophageal Echocardiogram
Authors: Wayangankar Siddharth A. , Payne Joshua , Po Sunny , Sivaram Chittur A.
Published: December 2012

Mini‐Abstract

Although computed tomography, magnetic resonance angiography, and catheter‐based angiography have been preferred for diagnosis and management of coronary artery fistulae (CAF), transesophageal echocardiogram (TEE) may play an important supplementary role in diagnosis and management of patients, where use of the afore‐mentioned modalities is limited (renal dysfunction, pacemaker, severe anaphylaxis to contrast agents). We present an imaging vignette depicting a serendipitous discovery of right CAF draining into right pulmonary artery via TEE.
Circumferential Type A Aortic Dissection and Intimal Intussusception of the Aorta Causing Severe Aortic Regurgitation and Obstruction of the Left Main Coronary Artery
Authors: Yang Eric H. , Kwon Murray H. , Mahajan Aman , Child John S. , Tobis Jonathan M. , Manthripragada Gopi , Silverstein Cheri A. , Shamsa Kamran
Published: December 2012

Mini‐Abstract

Circumferential dissection of the ascending aorta is a rare subtype of Type A aortic dissection which involves the entire intimal layer of the aorta which can cause a variety of devastating sequelae, given its propensity to involve the aortic valve and coronary arteries. Echocardiography is essential in making the diagnosis and visualize its involvement of the cardiovascular system, as invasive aortography can be limited in visualization of this unusual variant of aortic dissection. We present a patient who suffered a circumferential dissection of the ascending aorta which also caused severe aortic regurgitation and ischemia from left main coronary artery obstruction.
Diastolic Abnormalities in Normal Phenotype Hypertrophic Cardiomyopathy Gene Carriers: A Study Using Speckle Tracking Echocardiography
Authors: Kauer Floris , van Dalen Bas M. , Michels Michelle , Soliman Osama I. I. , Vletter Wim B. , van Slegtenhorst Marjon , ten Cate Folkert J. , Geleijnse Marcel L.
Published: December 2012

Background

Tissue Doppler imaging (TDI) of the mitral annulus has been proposed as an alternative for the identification of hypertrophic cardiomyopathy (HCM) genetically affected subjects without left ventricular hypertrophy (G+/LVH−). Unfortunately, conflicting results have been described in the literature, potentially caused by the angle‐dependency of TDI. This study sought to assess abnormalities in mitral annular velocities in G+/LVH− subjects as detected by speckle tracking echocardiography (STE).

Methods

The study population consisted of 23 consecutive genotyped family members without major or minor criteria for the diagnosis of HCM (mean age 37 ± 13 years, 9 men) and 23 healthy volunteers (age 38 ± 12 years, 12 men) who prospectively underwent STE.

Results

There were no significant differences in global peak systolic annular velocity (7.4 ± 1.2 vs. 7.1 ± 1.0 cm/sec) and early diastolic annular velocity (10.2 ± 2.5 vs. 11.3 ± 2.2 cm/sec) between G+/LVH− and control subjects. Global peak late diastolic annular velocity was higher in G+/LVH− subjects (8.1 ± 1.7 vs. 5.7 ± 1.1 cm/sec, P < 0.001). Regionally, this difference was seen in all 6 studied LV walls.

Conclusions

This STE study confirms our previous TDI observations on increased peak late diastolic annular velocities in G+/LVH− subjects. Because of the complete overlap in early diastolic annular velocities this parameter cannot be used in the genotypes we studied to differentiate genotype (+) from genotype (−) individuals.
Viewpoint: The ENIGMAS Trial – When Should We Treat Patients with Moderate Aortic Stenosis?
Authors: Mischie Alexandru Nicolae , Andrei Catalina Liliana , Sinescu Crina
Published: December 2012

Aortic stenosis (AS) is the most frequent valvular heart disease encountered in our daily practice. Although there are clear guidelines for severe AS management, cardiologists often have few treatment options for patients with moderate AS; however, there is higher mortality in this patient subgroup versus an age‐matched population. The authors reviewed all of the studies on moderate AS, summarized the factors that increase disease progression and discussed an ideal trial design to prospectively evaluate AS progression factors using modern cardiology tools such as strain and magnetic resonance imaging.
Collapse of Aortic Tube Graft during Systole
Authors: Barbieri John S. , Weiss Richard L.
Published: December 2012

Mini‐Abstract

We present a case of a 61‐year‐old man with a history of an ascending aortic aneurysm repair who was found to have prosthetic valve endocarditis. On transthoracic and transesophageal echocardiography, we show a devastating complication of prosthetic valve endocarditis: valve dehiscence with paravalvular flow compressing the tube graft during systole and distal dehiscence of the graft as blood from outside the graft reenters the native aorta. These echocardiographic images highlight the virulent nature of prosthetic valve endocarditis and the value of echocardiography in the diagnosis and management of prosthetic valve endocarditis.
Functional expression, purification and reconstitution of the recombinant phosphate transporter Pho89 of Saccharomyces cerevisiae
Authors: Sengottaiyan Palanivelu , Ruiz‐Pavón Lorena , Persson Bengt L.
Published: December 2012

The Saccharomyces cerevisiae high‐affinity phosphate transporter Pho89 is a member of the inorganic phosphate (Pi) transporter (PiT) family, and shares significant homology with the type III Na+/Pi symporters, hPit1 and hPit2. Currently, detailed biochemical and biophysical analyses of Pho89 to better understand its transport mechanisms are limited, owing to the lack of purified Pho89 in an active form. In the present study, we expressed functional Pho89 in the cell membrane of Pichia pastoris, solubilized it in Triton X‐100 and foscholine‐12, and purified it by immobilized nickel affinity chromatography combined with size exclusion chromatography. The protein eluted as an oligomer on the gel filtration column, and SDS/PAGE followed by western blotting analysis revealed that the protein appeared as bands of approximately 63, 140 and 520 kDa, corresponding to the monomeric, dimeric and oligomeric masses of the protein, respectively. Proteoliposomes containing purified and reconstituted Pho89 showed Na+‐dependent Pi transport activity driven by an artificially imposed electrochemical Na+ gradient. This implies that Pho89 operates as a symporter. Moreover, its activity is sensitive to the Na+ ionophore monensin. To our knowledge, this study represents the first report on the functional reconstitution of a Pi‐coupled PiT family member.

Structured digital abstract

Pho89 and Pho89 bind by molecular sieving (View interaction)

Pho89 and Pho89 bind by comigration in gel electrophoresis (View interaction)

Pho89 and Pho89 bind by molecular sieving (View interaction)

Pho89 and Pho89 bind by comigration in gel electrophoresis (View interaction)
Mixed-methods research in pharmacy practice: basics and beyond (part 1)
Authors: Hadi Muhammad Abdul , Alldred David Phillip , Closs S José , Briggs Michelle
Published: December 2012

This is the first of two papers which explore the use of mixed-methods research in pharmacy practice. In an era of evidence-based medicine and policy, high-quality research evidence is essential for the development of effective pharmacist-led services. Over the past decade, the use of mixed-methods research has become increasingly common in healthcare, although to date its use has been relatively limited in pharmacy practice research. In this article, the basic concepts of mixed-methods research including its definition, typologies and advantages in relation to pharmacy practice research are discussed. Mixed-methods research brings together qualitative and quantitative methodologies within a single study to answer or understand a research problem. There are a number of mixed-methods designs available, but the selection of an appropriate design must always be dictated by the research question. Importantly, mixed-methods research should not be seen as a ‘tool’ to collect qualitative and quantitative data, rather there should be some degree of ‘integration’ between the two data sets. If conducted appropriately, mixed-methods research has the potential to generate quality research evidence by combining strengths and overcoming the respective limitations of qualitative and quantitative methodologies.
Sozialschutz und Krankheitsprävention in Entwicklungsländern: Der gesundheitliche Nutzen von Renten‐ und Krankenversicherung
Authors: Lloyd‐Sherlock Peter , Minicuci Nadia , Beard John , Chatterji Somnath
Published: December 2012

Auszug

In diesem Artikel beurteilen wir die Wirksamkeit von Rentenbereitstellung und Krankenversicherung für die Krankheitsprävention bei älteren Menschen in Entwicklungsländern. Wir behaupten, dass in den Sozialschutzagenden bis vor kurzem der Prävention von Gesundheitsrisiken zu wenig Aufmerksamkeit gewidmet und stattdessen das Schwergewicht auf die Verringerung der Einkommensarmut durch Geldtransfers gelegt worden ist. Im vorliegenden Beitrag wird gezeigt, dass wenige zuverlässige Beweise vorliegen, aus denen sich ableiten ließe, dass die Bereitstellung von Rentenleistungen für ältere Menschen deren Gesundheitszustand verbessert, und dass dieses Ergebnis daher von den Entscheidungsträgern nicht als gesichert vorausgesetzt werden sollte. Wir befassen uns anschließend damit, wie die Einbeziehung älterer Menschen in Krankenversicherungssysteme deren Gesundheit beeinflusst und gehen konkret auf die Ergebnisse bei Bluthochdruck ein. Unter Bezugnahme auf die erst seit kurzem verfügbaren Daten von der Weltgesundheitsorganisation für Ghana, Mexiko und Südafrika wird gezeigt, dass sich ältere Menschen, die über eine Krankenversicherung verfügen, Gesundheitsproblemen wie Bluthochdruck mit geringfügig grösserer Wahrscheinlichkeit bewusst sind, und dass sie diese höchstwahrscheinlich unter Kontrolle haben. Dessen ungeachtet wird die überwiegende Mehrheit älterer Menschen mit Bluthochdruck — ob versichert oder nicht versichert — nicht wirksam behandelt. Es zeigt sich, dass die hauptsächlichen Hindernisse zur Behandlung vorallem mit dem Bewusstsein und Leistungsangebot zu tun haben und weniger mit den Finanzen. Folglich hängt die Fähigkeit von Renten‐ oder Krankenversicherungen, zu besseren Gesundheitsergebnissen älterer Menschen in solchen Ländern wie auch in ländlichen Gebieten beizutragen, stark von der Gesundheitserziehung, von medizinischen Untersuchungen und einem geeigneten Leistungsangebot ab. Diese Interventionen sollten als ein integraler Bestandteil von Standard‐Sozialschutzstrategien betrachtet werden und nicht in Ergänzung zu diesen. In der Praxis werden jedoch Sozialschutz und Gesundheitsförderung weiterhin als fast vollständig separate Bereiche behandelt, und müssen daher als substanzielle institutionelle Hindernisse zur Entwicklung kombinierter Interventionen angesehen werden.
Soziale Unsicherheit besser verhindern
Authors: Sinfield Adrian
Published: December 2012

Auszug

Starke Programme der sozialen Sicherheit, die kollektive und individuelle Sicherheit fördern, können einen wichtigen Beitrag dazu leisten, soziale Unsicherheit zu verhindern: Sie fungieren als eingebaute automatische Stabilisatoren mit sozialem, politischem und wirtschaftlichem Nutzen für die Gesamtgesellschaft. Im Gegensatz dazu haben schwächere Systeme de facto eine eingebaute destabilisierende Wirkung. In vielen Ländern hat die Art und Weise, wie Systeme der sozialen Sicherheit dazu beitragen, soziale und wirtschaftliche Unsicherheit zu verhindern, an Wirkung eingebüßt. Wir untersuchen hier die Gründe für die relative Vernachlässigung des Präventionsgedankens sowie die Veränderungen, die in den Systemen der sozialen Sicherheit ganz konkret zu einer Schwächung der präventiven Elemente geführt haben. Der strukturelle Kontext, innerhalb dessen Handlungskonzepte zur sozialen Sicherheit umgesetzt werden müssen, und insbesondere die Qualität und die Quantität von Beschäftigung sowie die Interaktion mit anderen Programmen öffentlicher Stellen haben natürlich einen großen Einfluss auf ihre Fähigkeit, präventiv zu wirken. Dennoch können Systeme viel erreichen, wenn sie die Aufmerksamkeit stärker auf die Notwendigkeit richten, Unsicherheit zu verhindern. Um eine Debatte über diese Thematik anzuregen und die Rolle der Prävention ins Zentrum zu rücken, werden Vorschläge zur Stärkung des Präventivbeitrags in Programmen der sozialen Sicherheit unterbreitet.
Acute bacterial septic vasculopathy
Authors: Delgado‐Jiménez Yolanda , Fraga Javier , Requena Celia , Requena Luis , Aragües Maximiliano , Fernandez Herrera Jesus , Diez Amaro Garcia
Published: December 2012

Objectives  The frequency and clinicopathologic characteristics of cutaneous lesions in sepsis are not well known. This study aimed to analyze cutaneous lesions in bacterial septic vasculopathy.

Methods  The study population comprised 32 patients with bacterial sepsis, cutaneous lesions, and skin biopsy‐proven septic vasculopathy. The clinical and histologic characteristics of the lesions were analyzed. Findings in non‐immunosuppressed patients (NISPs) and immunosuppressed patients (ISPs) were compared.

Results  Nine of 32 patients were immunosuppressed. The foci of sepsis were variable; in 17 patients, the focus was not identified. Although Neisseria meningitidis was the most common causal agent, several microorganisms were identified. Cutaneous manifestations were an early event in 90.6% of patients. The most common skin signs were purpuric lesions and petechiae. Overall mortality was 28.1%; 65.5% of patients survived without sequelae. Skin biopsies showed thrombi in 100% of cases. Other common findings were inflammatory infiltrate, blood extravasation, and epidermal involvement. Bacteria within the vascular wall were seen in 21.9% of cases and fibrinoid necrosis in 25%. A comparison of ISPs with NISPs disclosed that meningococcemia was more common in the latter group, and the presence of pustules was more common in the former. Histopathology testing revealed that fibrinoid necrosis and bacterial invasion of the vessel wall were more common in ISPs than in NISPs.

Conclusions  Several microorganisms can cause septic vasculopathy. Clinical presentation is variable and does not depend on the microorganism or the pathogenic mechanism. Histopathologically, septic vasculopathy is a thrombo‐occlusive vasculopathy with variable morphology. Cutaneous lesions are an early event and allow for rapid diagnosis.
Signaling pathways targeted by curcumin in acute and chronic injury: burns and photo‐damaged skin
Authors: Heng Madalene C. Y.
Published: December 2012

Phosphorylase kinase (PhK) is a unique enzyme in which the spatial arrangements of the specificity determinants can be manipulated to allow the enzyme to recognize substrates of different specificities. In this way, PhK is capable of transferring high energy phosphate bonds from ATP to serine/threonine and tyrosine moieties in serine/threonine kinases and tyrosine kinases, thus playing a key role in the activation of multiple signaling pathways. Phosphorylase kinase is released within five minutes following injury and is responsible for activating inflammatory pathways in injury‐activated scarring following burns. In photo‐damaged skin, PhK plays an important role in promoting photocarcinogenesis through activation of NF‐kB‐dependent signaling pathways with inhibition of apoptosis of photo‐damaged cells, thus promoting the survival of precancerous cells and allowing for subsequent tumor transformation. Curcumin, the active ingredient in the spice, turmeric, is a selective and non‐competitive PhK inhibitor. By inhibition of PhK, curcumin targets multiple PhK‐dependent pathways, with salutary effects on a number of skin diseases induced by injury. In this paper, we show that curcumin gel produces rapid healing of burns, with little or no residual scarring. Curcumin gel is also beneficial in the repair of photo‐damaged skin, including pigmentary changes, solar elastosis, thinning of the skin with telangiectasia (actinic poikiloderma), and premalignant lesions such as actinic keratoses, dysplastic nevi, and advanced solar lentigines, but the repair process takes many months.
Cytomegalovirus infection and ganciclovir resistance caused by UL97 mutations in pediatric transplant recipients
Authors: Kim Y.‐J. , Boeckh M. , Cook L. , Stempel H. , Jerome K.R. , Boucek R. , Burroughs L. , Englund J.A.
Published: December 2012

Background

Cytomegalovirus (CMV) infection may cause serious disease after hematopoietic cell transplantation (HCT) and solid organ transplantation (SOT), but few reports describe ganciclovir (GCV) resistance in pediatric patients.

Objectives

This study was performed to describe the clinical impact of CMV infection with UL97 mutation in pediatric transplant recipients.

Methods

Quantitative surveillance data for CMV infection in pediatric patients between October 2001 and February 2007 at the University of Washington were analyzed. Testing for UL97 mutation was performed in selected patients with prolonged CMV viremia despite therapy. Data associated with the detection of UL97 mutations were reviewed.

Results

CMV was detected in 89 pediatric transplant recipients. Among these, 39 had undergone HCT and 50 SOT (12 heart, 22 kidney, 15 liver, and 1 bilateral lung transplants). CMV with at least one UL97 sequence variation was detected in 5 patients: 4 HCT recipients (4/39, 10%) and 1 heart transplant recipient (1/50, 2%). All 5 pediatric patients were CMV seropositive before transplantation. Underlying conditions included chronic myelogenous leukemia, primary immunodeficiency disorders, and hypoplastic left heart syndrome. One known GCV drug‐resistant mutation was detected in 2 HCT recipients (A594V). Three strain variants with mutations considered to have no significant impact on UL97 function (H469Y, N510S, and D605E) were detected. Two of these 5 patients died, 1 because of uncontrolled CMV infection and 1 with other complications.

Conclusions

UL97 drug‐resistant mutations occur in pediatric transplant recipients with CMV viremia and can cause serious disease. Screening for mutations conferring resistance to CMV antivirals should be considered for patients with persistent viremia during therapy and the sequences of UL97 mutations evaluated.
A study of student participation and nonparticipation in prelecture electronic surveys
Authors: Tong Vincent C. H. , Chow Danny S. L.
Published: December 2012

Student nonparticipation in electronic surveys represents a challenge to educators as it may impact significantly on the implementation or evaluation of the associated teaching activities. We here study the student evaluation of a pedagogical project consisting of prelecture online polling followed by linked revision lectures. This investigation involves studying the responses from 43 undergraduate students following a course in accounting at a British university. With regard to the students' views on the use of prelecture polling, our study shows that there are no statistically significant differences between those who did not participate in the online polling and those who did. Both groups of students were generally positive about the use of (1) polling results in structuring the revision lecture, (2) online survey in helping them prepare for the examination and (3) online polling as a teaching platform in other courses. Our findings therefore suggest that prelecture electronic surveys can help engage students with follow‐up lectures, including those who did not participate in the prelecture survey.
Negotiating Multiple Identities, Constructing Western‐Muslim Selves in the Netherlands and the United States
Authors: Ozyurt Saba
Published: December 2012

This article evaluates the psychological processes, discursive practices, and sociopolitical mechanisms underlying the identity reconstruction of Muslim immigrant women in the United States and the Netherlands. Specifically, it focuses on the ways in which Muslim immigrant women who are embedded in both Islamic and Western cultures negotiate their traditional and modern identities and self‐representations and construct a coherent self‐narrative about their bicultural existence as “Western‐Muslim.” The qualitative evidence presented here expands existing theoretical and empirical discussions on biculturalism and acculturation by demonstrating the ways in which contextual factors define the negotiation repertoire that is available to bicultural individuals. The findings of this article also call into question some of the earlier findings on cultural conflict hypothesis, because it shows that successful negotiation of bicultural identities depends not so much on whether the individual perceives these identities and cultures to be compatible with each other, but rather on the availability of a coherent self‐narrative of belonging to both cultural worlds.
Multicriteria decision analysis for sustainable data centers location
Authors: Covas Miguel T. , Silva Carlos A. , Dias Luis C.
Published: December 2012

Data centers (DCs) are complex organizational and technical infrastructures that assure the performance and reliability of modern information and communication systems. The high installation and operations costs of DCs and the stringent requirements regarding reliability and safety require close attention to the location of this type of facility. This paper proposes a multicriteria decision analysis (MCDA) approach for identifying the most interesting locations to install sustainable DCs, taking into account technical, social, economic, and environmental dimensions. For each of these main dimensions, the evaluation was formulated as a multicriteria sorting problem. These problems were analyzed using the outranking MCDA method ELECTRE TRI through the IRIS software, allowing for uncertainty about the criteria weights. The results are summarized in a graphical form, without attempting to reduce such incommensurable dimensions to a single value.
One‐stage, simultaneous skin grafting with artificial dermis and basic fibroblast growth factor successfully improves elasticity with maturation of scar formation
Authors: Hamuy Rodrigo , Kinoshita Naoshi , Yoshimoto Hiroshi , Hayashida Kenji , Houbara Seiji , Nakashima Masahiro , Suzuki Keiji , Mitsutake Norisato , Mussazhanova Zhanna , Kashiyama Kazuya , Hirano Akiyoshi , Akita Sadanori
Published: December 2012

The efficacy of one‐stage artificial dermis and skin grafting was tested in a nude rat model. Reconstruction with artificial dermis is usually a two‐stage procedure with 2‐ to 3‐week intermission. If one‐stage use of artificial dermis and split‐thickness skin grafting are effective, the overall burden on patients and the medical cost will markedly decrease. The graft take rate, contraction rate, tissue elasticity, histology, morphometric analysis of the dermal thickness, fibroblast counting, immunohistochemistry of α‐smooth muscle actin, matrix metalloproteinase‐2, CD31, and F4/80, as well as gelatin zymography, real‐time reverse transcriptase polymerase chain reaction for matrix metalloproteinase‐2, and electron microscopy, were investigated from day 3 to 3 months postoperatively. The graft take rate was good overall in one‐stage artificial dermis and skin grafting groups up to 3 weeks, and the contraction rate was greater in the two‐staged artificial dermis and skin grafting group than in the skin grafting alone or one stage of artificial dermis and skin grafting groups. Split‐thickness skin grafting with artificial dermis and basic fibroblast growth factor at a concentration of 1 μg/cm2 showed significantly greater elasticity by Cutometer, and the dermal thickness was significantly thinner, fibroblast counting was significantly greater, and the α‐smooth muscle actin expression level was more notable with a more mature blood supply in the dermis and more organized dermal fibrils by electron microscopy at 3 weeks. Thus, one‐stage artificial dermis and split‐thickness skin grafting with basic fibroblast growth factor show a high graft take rate and better tissue elasticity determined by Cutometer analysis, maturity of the dermis, and increased fibroblast number and blood supply compared to a standard two‐stage reconstruction.
Earnings and income inequality in the EU during the crisis
Authors: DE BEER Paul
Published: December 2012

The author examines the impact of the economic crisis on employment, earnings, inequality and poverty in the EU, focusing on Denmark, Germany, Slovakia, Spain and the United Kingdom during the period 2008–10. After reviewing the literature, he analyses recent trends, finding that during this stage of the crisis real wages reacted countercyclically in most countries, thus diverging from the pattern observed in previous recessions. He finds considerable cross‐national variation in the severity and direction of changes in terms of inequality and poverty rates. However, he argues that inequality may widen because of the potential regressive effects of the announced austerity programmes.
Immigration stabilizes a population of threatened cavity‐nesting raptors despite possibility of nest box imprinting
Authors: Brown Jessi L. , Collopy Michael W.
Published: December 2012

Nest box provisioning is a common management tool intended to increase population size or stability of threatened birds, but its effectiveness is rarely assessed. The provisioning of nest boxes may lead to unexpected results if nest type imprinting prevents naïve adult birds from immigrating into the nest box population, or limiting the ability of juveniles reared in nest boxes to emigrate to areas with only natural nesting substrates. We analyzed the population trends from 2008 to 2010 of southeastern American kestrels Falco sparverius paulus associated with a network of nest boxes in north‐central Florida, USA, with Bayesian integrated population models (IPMs) that simultaneously considered mark–recapture data sets, fledgling production, and population surveys. We evaluated the demography of the nest box population by comparing population growth rates, apparent survival probabilities, and recapture probabilities between an IPM that explicitly modeled immigration and one that did not. Overall population growth rates suggested that the population was stable, and that immigration was apparently important in maintaining this stability, with approximately 0.3 and 0.5 female immigrants per resident female kestrel each year. Explicitly modeling immigration resulted in lower estimates of juvenile kestrel apparent survival probability, suggesting that a large proportion of locally produced juveniles emigrated rather than recruited locally. We concluded that neither preference for natural cavities nor imprinting on artificial nest boxes appeared to prevent immigration from maintaining the stability of the local population. Natal habitat preference imprinting on nest sites may occur to some degree, but it did not preclude the adoption of nest boxes by most breeding kestrels. We also found additional indications that many juvenile kestrels fledged from nest boxes emigrated to the surrounding natural areas.
Aquatic insects in a sea of desert: population genetic structure is shaped by limited dispersal in a naturally fragmented landscape
Authors: Phillipsen Ivan C. , Lytle David A.
Published: December 2012

Habitat requirements and landscape features can exert strong influences on the population structure of organisms. For aquatic organisms in particular, hydrologic requirements can dictate the extent of available habitat, and thus the degree of genetic connectivity among populations. We used a landscape genetics approach to evaluate hypotheses regarding the influence of landscape features on connectivity among populations of the giant water bug Abedus herberti (Hemiptera: Belostomatidae). Abedus herberti is restricted to naturally‐fragmented, perennial stream habitats in arid regions of North America. This species is exceptional because it is flightless at all life stages. Thus, we hypothesized a high degree of population genetic structure in A. herberti due to hydrologic constraints on habitat and low dispersal ability of the organism. A total of 617 individuals were sampled from 20 populations across southeastern Arizona, USA and genotyped at 10 microsatellite loci. We used a Bayesian clustering method to delineate genetic groups among populations. To determine which of six landscape variables (representing hypotheses of landscape‐level connectivity) has the strongest association with genetic connectivity in A. herberti, we used information‐theoretic model selection. Strong population structure was evident among A. herberti populations, even at small spatial scales. At a larger scale, A. herberti populations were hierarchically structured across the study region, with groups of related populations generally occurring in the same mountain range, rather than in the same major watershed. Surprisingly, stream network connectivity was not important for explaining among‐population patterns. Only the Curvature landscape variable was identified as having an association with genetic connectivity in A. herberti. The Curvature variable hypothesizes that gene flow tends to occur where local topography is concave, such as within stream drainages and dry gullies. Thus, our results suggest that population connectivity may depend on the shape of local overland topography rather than direct connectivity within stream drainage networks.
Risk Factors for Recurrence of Immunoglobulin A Nephropathy After Renal Transplantation: Single Center Study
Authors: Sato Keitaro , Ishida Hideki , Uchida Keiko , Nitta Kosaku , Tanabe Kazunari
Published: December 2012

We investigated the risk factors for recurrence of IgA nephropathy after kidney transplantation. Of the 184 recipients of allografts for end‐stage renal disease caused by primary IgA nephropathy at our institution and affiliated hospitals between 1990 and 2005, 70 developed recurrent IgA nephropathy (group 1), while the remaining 114 did not develop recurrent IgA nephropathy (group 2). The diagnosis of recurrent IgA nephropathy was based on case and/or protocol renal biopsies. We examined the risk factors for recurrence of IgA nephropathy by comparing the two groups. In addition, we also investigated the risk factors for graft loss in the patients with recurrent IgA nephropathy. The recipient's age at transplantation was significantly younger in group 1 than in group 2 (33.4 ± 10.4 vs. 36.7 ± 10.7, P = 0.037). No significant influence of the immunosuppressive regimens used was observed on the likelihood of recurrence of IgA nephropathy. In the analysis of the risk factors for graft loss, the mean age of the donor was significantly higher in the patient group with graft loss (59.1 ± 9.5 vs. 53.9 ± 9.0, P = 0.033), and the serum creatinine level at one year after surgery was also significantly higher in the patient group with graft loss (1.62 ± 0.52 vs. 1.34 ± 0.34, P = 0.022). Recipients with recurrent IgA nephropathy after transplantation, especially younger patients, need to be followed up carefully.
Cause‐Specific Excess Mortality Among Dialysis Patients: Comparison With the General Population in Japan
Authors: Wakasugi Minako , Kazama Junichiro James , Yamamoto Suguru , Kawamura Kazuko , Narita Ichiei
Published: December 2012

Despite significant therapeutic advances, mortality of dialysis patients remains unacceptably high. The aim of this study is to compare mortality and its causes in dialysis patients with those in the general Japanese population. We used data for 2008 and 2009 from the Japanese Society for Dialysis Therapy registry and a national Vital Statistics survey. Cardiovascular mortality was defined as death attributed to heart failure, cerebrovascular disorders, myocardial infarction, hyperkalemia/sudden death, and pulmonary thromboembolism. Non‐cardiovascular mortality was defined as death attributed to infection, malignancies, cachexia/uremia, chronic hepatitis/cirrhosis, ileus, bleeding, suicide/refusal of treatment, and miscellaneous. We calculated standardized mortality ratios and age‐adjusted mortality differences between dialysis patients and the general population for all‐cause, cardiovascular versus non‐cardiovascular, and cause‐specific mortality. During the 2‐year study period, there were 2 284 272 and 51 432 deaths out of 126 million people and 273 237 dialysis patients, respectively. The standardized mortality ratio for all‐cause mortality was 4.6 (95% confidence interval, 4.6–4.7) for the dialysis patients compared to the general population. Age‐adjusted mortality differences for cardiovascular and non‐cardiovascular disease were 33.1 and 30.0 per 1000 person‐years, respectively. The standardized mortality rate ratios were significant for all cause‐specific mortality rates except accidental death. Our study revealed that excess mortality in dialysis patients compared to the general population in Japan is large, and differs according to age and cause of death. Cause‐specific mortality studies should be planned to improve life expectancies of dialysis patients.
Diagnostic Procedures in Ischaemic Stroke Patients with Dementia. A Population-Based Study
Authors: Béjot Yannick , Jacquin Agnès , Troisgros Odile , Rouaud Olivier , Aboa-Eboulé Corine , Hervieu Marie , Osseby Guy-Victor , Giroud Maurice
Published: December 2012

Background

Dementia is a frequent condition in stroke patients.

Aims

To investigate the effect of dementia on access to diagnostic procedures in ischaemic stroke patients.

Methods

All cases of ischaemic stroke from 2006 to 2010 were identified from the population-based Stroke Registry of Dijon, France. Patients' characteristics were recorded, as was the use of brain computed tomography scans, brain magnetic resonance imaging, electrocardiogram, echocardiography, and Doppler ultrasonography of the cervical arteries. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Logistic regression models were used to evaluate the associations between dementia and the use of the diagnostic procedures.

Results

Of the 907 patients recorded, 104 were excluded because of death and inability to test cognition. Among the remaining 803 patients, 149 (18·5%) had dementia. Almost all of the patients underwent a brain computed tomography scan and an electrocardiogram during their stay. In contrast, the use of both Doppler ultrasonography of the cervical arteries (79·2% versus 90·2%, P < 0·001), echocardiography (32·9% versus 43·6%, P = 0·02), and brain magnetic resonance imaging (21·5% versus 34·4%, P < 0·001) were significantly lower in stroke patients with dementia than in those without. In multivariate logistic regression, dementia was associated with a lower use of both Doppler ultrasonography (odds ratio = 0·49; 95% confidence interval: 0·29–0·81, P = 0·005), echocardiography (odds ratio = 0·57; 95% confidence interval: 0·37–0·89, P = 0·012), brain magnetic resonance imaging (odds ratio = 0·55; 95% confidence interval: 0·34–0·89, P = 0·015), and a comprehensive assessment (odds ratio = 0·62; 95% confidence interval: 0·40–0·96, P = 0·033).

Conclusion

Demented patients were less likely to undergo diagnostic procedures after ischaemic stroke. Further studies are needed to determine whether this lower utilization could account for the reported excess in recurrent events in these patients.
A Critical Review of Early Supported Discharge for Stroke Patients: From Evidence to Implementation into Practice
Authors: Mas Miquel Àngel , Inzitari Marco
Published: December 2012

After an acute stroke, a multidimensional approach based on multidisciplinary work and rehabilitation is required in order to promote functional independence and social reinsertion and to maintain medical stability. These activities are usually developed in the hospital setting as a continuum of the acute phase, but hospitalization is resource consuming and resources are limited. Early Support Discharge strategies base postacute care and rehabilitation at home after an early discharge planning and represent possible alternatives to conventional hospitalization. Recent evidence suggests that Early Supported Discharge might be superior to hospitalization from both the clinical-functional and the economic viewpoints. Moreover, home-based rehabilitation might potentiate important determinants of effectiveness, such as patient's motivation and goal-directed rehabilitation. However, hitherto produced evidence and recommendations show a number of limitations related to the organization models, the inclusion/exclusion criteria, and the questionable applicability of results to any healthcare setting worldwide. In this article, we critically review different methodological and organizational aspects of the available studies. For example in the definition of the target population, based mainly on residual disability and medical stability, we suggest that other relevant aspects, such as premorbid functional status, cognitive function, and previous institutionalization, should be better defined. Focusing on the outcomes, we suggest that, besides strong outcomes such as global functioning, surrogate outcomes, such as physical function, could help to refine the specific interventions. Finally, considering that the majority of studies were conducted in northern Europe, further studies are needed to test the implementation of Early Supported Discharge in different regions.
Aspergillus bronchitis without significant immunocompromise
Authors: Chrdle Ales , Mustakim Sahlawati , Bright‐Thomas Rowland J. , Baxter Caroline G. , Felton Timothy , Denning David W.
Published: December 2012

Aspergillus bronchitis is poorly understood and described. We extracted clinical data from more than 400 referred patients with persistent chest symptoms who did not fulfill criteria for allergic, chronic, or invasive aspergillosis. Symptomatic patients with a positive culture or real‐time PCR for Aspergillus spp. were reviewed. Seventeen patients fulfilled the selected criteria. Fourteen were women, with a mean age of 57 years (range 39–76). Sixteen of the patients had productive cough, eight had voluminous tenacious sputum, and seven had recurrent chest infections. Eight patients had Medical Research Council dyspnea scores of 4–5; 12 had bronchiectasis; and 13 patients grew A. fumigatus, 3 A. niger, and 1 A. terreus. Twelve of the 17 patients (71%) had elevated Aspergillus IgG (47–137 mg/L, mean 89.2) and 5 (29%) had elevated Aspergillus precipitins. Six of 12 (50%) had a major response to antifungal therapy and five of 12 (42%) patients relapsed, requiring long‐term therapy. Aspergillus bronchitis is a discrete clinical entity in patients with structural lung disease but who are not significantly immunocompromised. It is distinct from asymptomatic fungal colonization and other forms of aspergillosis, and may respond to antifungal therapy.
The cell biology of the innate immune response to Aspergillus fumigatus
Authors: Mansour Michael K. , Tam Jenny M. , Vyas Jatin M.
Published: December 2012

The development of invasive aspergillosis is a feared complication for immunocompromised patients. Despite the use of antifungal agents with excellent bioactivity, the morbidity and mortality rates for invasive aspergillosis remain unacceptably high. Defects within the innate immune response portend the highest risk for patients, but detailed knowledge of molecular pathways in neutrophils and macrophages in response to this fungal pathogen is lacking. Phagocytosis of fungal spores is a key step that places the pathogen into a phagosome, a membrane‐delimited compartment that undergoes maturation and ultimately delivers antigenic material to the class II MHC pathway. We review the role of Toll‐like receptor 9 (TLR9) in phagosome maturation of Aspergillus fumigates–containing phagosomes. Advanced imaging modalities and the development of fungal‐like particles are promising tools that will aid in the dissection of the molecular mechanism to fungal immunity.
Regional flood frequency analysis forSouthwestPeninsularMalaysia byLQ‐moments
Authors: Shabri A. , Jemain A.A.
Published: December 2012

A regional flood frequency analysis based on theL‐moments procedure has been applied successfully for modelling floods. In this study, we propose an alternative regional frequency analysis by usingLQ‐moments. Annual maximum stream flow data observed at 12 sites inSouthwestPeninsularMalaysia are investigated. Three probability distributions, the generalised extreme value (GEV), generalisedPareto (GPA) and generalised logistic (GLO) distributions, were derived and used to develop the regional frequency analysis procedure. The moment ratio diagram andZ‐test were developed usingLQ‐moments to determine the best fitting distribution. A comparative study was performed betweenLQ‐moments andL‐moments for the study area. Analyses showed that theGLOandGEVdistributions were suitable for a homogeneous region based onL‐moments andLQ‐moments. The robustness of the designated regional frequency distributions was further investigated by assessing the relative root mean square error (RRMSE) and regional average relative bias (RBIAS) byMonteCarlo.
Functional Prognosis of Dizziness in Older Adults in Primary Care: A Prospective Cohort Study
Authors: Dros Jacquelien , Maarsingh Otto R. , Beem Leo , van der Horst Henriëtte E. , Riet Gerben ter , Schellevis François G. , van Weert Henk C. P. M.
Published: December 2012

Objectives

To investigate the 6‐month functional prognosis of dizziness in older adults in primary care, to identify important predictors of dizziness‐related impairment, and to construct a score to assist risk prediction.

Design

Prospective cohort study with 6‐month follow‐up.

Setting

Twenty‐four primary care practices in the Netherlands.

Participants

Four hundred seventeen older adults (mean age 78.5, range 65–95, 74% female) presenting consecutively to primary care with dizziness.

Measurements

Tests, including history and physical and additional examination, previously selected by an international expert panel and based on an earlier systematic review, were performed. The main outcome measure was 6‐month dizziness‐related impairment score measured using the Dizziness Handicap Inventory.

Results

Follow‐up was complete for 92% of participants. Although 61% of participants experienced less impairment at 6 months, 130 participants (34%) showed persistent dizziness‐related impairment. Factors most predictive of dizziness‐related impairment at 6 months were onset of dizziness at least 6 months before inclusion, standing still as a dizziness‐provoking circumstance, trouble with walking or (almost) falling (associated symptom), polypharmacy, absence of diabetes mellitus, presence of anxiety or depressive disorder, and impaired functional mobility. A score was constructed using these predictors to estimate the functional prognosis of dizziness at 6 months.

Conclusion

A score based on the presence of easily obtainable clinical information facilitates identification of older adults in primary care with poor functional prognosis of their dizziness without exactly knowing the cause(s) of their dizziness. Clinical management might be most effective by treating factors that can be influenced, such as polypharmacy, anxiety and depression, and functional mobility.
Factors associated with the calibration of a food frequency questionnaire for the Bambuí Project, Brazil
Authors: Lopes A. C. S. , Caiaffa W. T. , Sichieri R. , Mingoti S. A. , Lima‐Costa M. F.
Published: December 2012

Background

The present study aimed to calibrate a food frequency questionnaire (FFQ) using one 24‐h recall (R24) associated with foodstuff replicas.

Methods

Calibration was performed by linear regression. Of a probability sample of 150 individuals (>18 years) of the town of Bambui, 98 completed the study.

Results

The mean age of the participants was 43.8 years and 63.3% were women. The calibration of the FFQ included sex for the estimation of iron, protein and zinc; and an interaction between sex and R24 was significant for vitamin A and cholesterol models. Age contributed to the vitamin C, polyunsaturated fatty acids, proteins and zinc models, and an interaction between age and R24 was significant for protein and zinc.

Conclusions

Calibration coefficients and many interactions in linear regression models revealed important differences between dietary methods, indicating the complexity encountered when combining two methodologies for estimating food intake.