bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of Psychopharmacological Medication Prescribing and Mortality in Medicare Beneficiaries in Nursing Homes
Authors: Wei Yu‐Jung , Simoni‐Wastila Linda , Zuckerman Ilene H. , Huang Ting‐Ying J. , Brandt Nicole , Moyo Patience , Lucas Judith A.
Published: July 2014

Objectives

To examine the influence of quality measures of psychopharmacological medication (PPM) prescribing on all‐cause mortality in a Medicare long‐stay nursing home (NH) population.

Design

Longitudinal.

Setting

2007–09 Medicare data linked to Minimum Data Set 2.0 files.

Participants

Four new‐user cohorts of residents initiating antipsychotic (n = 13,105), antidepressant (n = 14,251), anxiolytic and sedative–hypnotic (n = 10,789), and any PPM (n = 14,568) medication.

Measurements

Three measures of PPM prescribing quality were assessed monthly with a 6‐month look‐back: evidence of appropriate indication, dose (modified standardized daily dose (mSDD); below (<1), at (1), and above (>1) recommended geriatric dose), and duration of therapy (DOT; ≤30, 31–60, 61–90, 91–180 days from medication initiation). Complementary log–log models with quality measures as time‐dependent variables were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality.

Results

Appropriate use of antidepressants, anxiolytics and sedative–hypnotics, and any PPMs, as evidenced by appropriate indications, was significantly associated with lower mortality risk (HRantidepressants = 0.81, 95% CI = 0.76–0.86; HRanxiolytics and sedative–hypnotics = 0.81, 0.75–0.88; HRPPM = 0.89, 0.83–0.95). Antipsychotic and anxiolytic and sedative–hypnotic users with a mSDD of less than 1 had lower mortality risk than those with a mSDD greater than 1, whereas a protective effect was observed in antidepressant users with a mSDD greater than 1. In all four cohorts, those with a DOT of 91 to 180 days had lower mortality than those with a DOT of 1 month or less; the lower risk of mortality was detected after antipsychotic use for 31 days or longer.

Conclusion

Optimal PPM prescribing quality, as measured by indication and duration, is associated with low mortality. The benefit related to drug dosage varied by therapeutic class. When prescribing PPMs to NH residents, providers should consider not only drug choice, but also dose and duration of prescribed regimens.
Comorbidity in Dementia: Update of an Ongoing Autopsy Study
Authors: Magaki Shino , Yong William H. , Khanlou Negar , Tung Spencer , Vinters Harry V.
Published: July 2014

Objectives

To examine systemic and central nervous system (CNS) comorbidities of individuals with dementia evaluated during general autopsy.

Design

Retrospective cohort study.

Setting

A large tertiary academic medical center in Los Angeles, California.

Participants

Individuals with clinically and neuropathologically diagnosed dementia who received complete autopsies (n = 86) and individuals with dementia who received partial (brain only) autopsies (n = 132).

Measurements

Information on cause of death and systemic and CNS comorbidities was obtained from autopsy reports and clinical information as available from the medical records. Findings were tabulated with respect to type of dementia, semiquantitative assessment of the severity of cerebral amyloid angiopathy, semiquantitative assessment of the severity of cerebrovascular disease, and evidence of ischemic damage in the brain.

Results

Of 218 subjects with dementia, 175 (80.3%) had Alzheimer's disease alone or in combination with other lesions that might contribute to cognitive impairment, such as cerebrovascular disease and diffuse Lewy body disease (DLBD), 14 (6.4%) had frontotemporal dementia, and seven (3.2%) had isolated DLBD. The most common cause of death in participants with dementia was pneumonia (n = 57, 66.3%), followed by cardiovascular disease (n = 14, 16.3%). Eighteen subjects (20.9%) had lung disease, and 16 (18.6%) had evidence of an old or recent myocardial infarction. Clinically undiagnosed neoplasms included colonic adenocarcinoma, metastatic pulmonary neuroendocrine carcinoma, meningioma, and Schwannoma.

Conclusion

Significant comorbidities were discovered at autopsy in individuals with dementia. Understanding the causes of death and associated comorbidities in individuals with various subtypes of dementia is important in the assessment of end‐of‐life care in these individuals.
Fatigue and quality of life in women treated for various types of gynaecological cancers: a cross‐sectional study
Authors: Sekse Ragnhild Johanne Tveit , Hufthammer Karl Ove , Vika Margrethe Elin
Published: July 2014

Aims and objectives

To examine the prevalence of cancer‐related fatigue in women treated for various types of gynaecological cancers and, for these cancers, to assess fatigue in relation to distress, health‐related quality of life, demography and treatment characteristics.

Background

Advances in treatment of cancer have improved the likelihood of survival. Consequently, there are a growing number of patients who become survivors after cancer and who face side effects even years after treatment. One of the most frequently reported side effects across all types and stages of the disease is cancer‐related fatigue.

Design

A descriptive cross‐sectional study.

Methods

One hundred and twenty women treated for gynaecological cancers who were participants in an intervention study were included. Fatigue, psychological distress, health‐related QoL and demographics were assessed by questionnaires. Disease and treatment characteristics were extracted from medical records.

Results

Cancer‐related fatigue was reported in 53% of the women treated for gynaecological cancers, with a higher proportion in the group of cervical cancer, followed by ovarian cancer. Younger participants reported fatigue more frequently than older participants. When adjusting for age, the type of cancer a woman experiences was shown to have little impact on her risk of experiencing fatigue. The participants with fatigue reported higher levels of anxiety and depression than participants without fatigue. There was a relationship between fatigue and quality of life as measured by SF‐36 domains.

Conclusion

The findings underscore the importance of screening for fatigue, patient education and symptom management. This should be included in a standard procedure during treatment and follow‐up. Both somatic and psychological aspects of fatigue should be emphasised.

Relevance to clinical practice

The findings imply the need for health personnel to have focus on fatigue during the entire cancer trajectory of women after gynaecological cancers, as well as the need for screening, information, guidance and symptom management.
Steroid plus antiviral treatment for Bell's palsy
Authors: Kang H. M. , Jung S. Y. , Byun J. Y. , Park M. S. , Yeo S. G.
Published: July 2014

Objectives

The effectiveness of antiviral agents for the treatment of Bell's palsy is uncertain. We evaluated whether a steroid with an antiviral agent (S + A group) provided better recovery outcomes than a steroid alone (S group) in patients with Bell's palsy.

Subjects and design

A total of 1342 patients diagnosed with Bell's palsy who visited the Kyung Hee Medical Center in Seoul, Korea, from 2002 to 2012 were included in this study. Patients in the S + A group were treated with prednisolone and antiviral agents (n = 569) and those in the S group with prednisolone alone (n = 773). Outcomes were measured using the House–Brackmann (HB) scale according to age, initial disease severity, electroneurography (ENoG) findings and underlying comorbidities.

Results

The rate of recovery (HB grades I and II) with initially severe Bell's palsy (HB grades V and VI) was higher in the S + A than in the S group (P = 0.001). However, the rates of recovery were similar with initially moderate palsy (HB grades II–IV) (P = 0.502). In patients classified according to age and ENoG‐determined severity of palsy, the overall recovery rate was higher in the S + A than in the S group, but the differences were not statistically significant (P > 0.05 for both). The recovery rate without diabetes mellitus (DM) and hypertension (HTN) was higher in the S + A group than in the S group (P = 0.031). But in the patients with HTN and DM, the difference in recovery rates between the S + A and S groups was not statistically significant (P = 0.805).

Conclusions

Treatment with a steroid plus antiviral agent resulted in significantly higher recovery rates than steroid therapy alone in patients with initially severe Bell's palsy and without either HTN or DM, and a nonsignificant trend towards higher recovery rates in all patients with Bell's palsy in this study. Antiviral agents may therefore help in the treatment of Bell's palsy.
Psychopathy and the DSM
Authors: Crego Cristina , Widiger Thomas A.
Published: July 2014

Psychopathy is one of the more well‐established personality disorders. However, its relationship with the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) has been controversial. The purpose of this article is to trace and discuss the history of this relationship from the very first edition of the DSM to the current fifth edition. Emphasized in particular is the problematic relationship of DSM antisocial personality disorder with the diagnosis of psychopathy by Cleckley (1941, 1976) and the Psychopathy Checklist‐ Revised (Hare, 2003), as well as with the more recently developed models of psychopathy by Lilienfeld and Widows (2005), Lynam et al. (2011), and Patrick, Fowles, and Krueger (2009).
PROPERTY LEFT BEHIND: AN UNINTENDED CONSEQUENCE OF A NO CHILD LEFT BEHIND “FAILING” SCHOOL DESIGNATION
Authors: Bogin Alexander , Nguyen‐Hoang Phuong
Published: July 2014

Under the No Child Left Behind Act (NCLB), schools receiving Title I funding that fail to meet adequate academic performance targets for two consecutive years are deemed “failing.” This broadly defined, but often misunderstood designation has exerted a negative and unintended effect on low‐income neighborhoods—the same neighborhoods NCLB was originally intended to help. Specifically, we find that “failing” designations significantly decrease home prices. This property value response is observed even after controlling for a myriad of traditional test score measures and school‐level student demographics. Additional analyses suggest that this home price effect is largely due to strong perceptions of poor school quality or social stigma surrounding a “failing” designation.
Presence and content of kynurenic acid in animal feed
Authors: Turski M. P. , Zgrajka W. , Siwicki A. K. , Paluszkiewicz P.
Published: July 2014

Kynurenic acid (KYNA) was found to be an antagonist of iontropic glutamate receptors and alpha7 nicotinic acetylcholine receptors. Furthermore, it was documented thatKYNAis an agonist ofG‐protein coupledGPR35 receptors which are mainly present in the gastrointestinal tract. It was also found thatKYNAis present in the gastrointestinal tract and that its concentration gradually increases along it. The origin ofKYNAin the gastrointestinal tract is not known. Both might be synthesized from tryptophan in it or absorbed from food and other dietary products. Therefore, the aim of the study was to investigate the concentration ofKYNAin animal feed. The results indicate that the highest concentration ofKYNAwas found in animal feeds intended for livestock. The lower amount ofKYNAwas detected in animal feeds for fish. Interestingly, the lowest amount ofKYNAwas found in dog and cat feeds. Furthermore, an analysis ofKYNAcontent in animal food ingredients was conducted. The concentration ofKYNAfound in one of the ingredients – rapeseed meal – was several times higher in comparison to animal feeds studied. The content ofKYNAin the remaining feed ingredients tested was significantly lower. This is the first report on the concentration ofKYNAin animal feeds. There is a need for further detailed analysis leading to establishing a set of guidelines for animal feeding.
Genetic diversity and haplotype distribution of Pachymeniopsis gargiuli sp. nov. and P. lanceolata (Halymeniales, Rhodophyta) in Korea, with notes on their non‐native distributions
Authors: Kim Su Yeon , Manghisi Antonio , Morabito Marina , Yang Eun Chan , Yoon Hwan Su , Miller Kathy Ann , Boo Sung Min
Published: July 2014

The red alga Pachymeniopsis lanceolata, formerly known as Grateloupia lanceolata, is a component of the native algal flora of northeast Asia and has been introduced to European and North American waters. It has been confused with a cryptic species collected from Korea and Italy. Our analyses of rbcL, cox3 and ITS from P. lanceolata and this cryptic species has revealed two distinct entities, forming a clade, which were clearly separated from its congeners and positioned with other Asian species. Here, we describe the cryptic species as P. gargiuli sp. nov., a species that differs from others by molecular sequence and subtle anatomical characters. We hypothesize that P. gargiuli may have been recently dispersed by anthropogenic vectors, possibly at or near the same time as was P. lanceolata. Our cox3 data set revealed that one haplotype of P. gargiuli, shared between Korea and Italy, and two haplotypes of P. lanceolata, commonly occurring in Korea and USA, are invasive haplotypes. This is the first report of the utility of the mitochondrial coding cox3 sequences in red algae.
Phylogeny ofNorthAmericanTolypella(Charophyceae,Charophyta) based on plastidDNAsequences with a description ofTolypella ramosissimasp. nov.
Authors: Pérez William , Hall John D. , McCourt Richard M. , Karol Kenneth G.
Published: July 2014

Characeae (Charophyceae,Charophyta) contains two tribes with six genera: tribeChareae with four genera and tribeNitelleae, which includesTolypellaandNitella. This paper uses molecular and morphological data to elucidate the phylogeny ofTolypellaspecies inNorthAmerica. In the most comprehensive taxonomic treatment ofCharaceae, 16Tolypellaspecies worldwide were subsumed into two species,T. intricataandT. nidifica, in two sections,RothiaandTolypellarespectively. It was further suggested thatTolypellamight be a derived group withinNitella. In this investigation into species diversity and relationships inNorthAmericanTolypella, sequence data from the plastid genesatpB,psbC, andrbcL were assembled for a broad range of charophycean and land plant taxa. Molecular data were used in conjunction with morphology to test monophyly of the genus and species within it. Phylogenetic analyses of the sequence data showed thatCharaceae is monophyletic but thatNitelleae is paraphyletic withTolypellasister to a monophyleticNitella+Chareae. The results also supported the monophyly ofTolypellaand the sectionsRothiaandTolypella. Morphologically defined species were supported as clades with little or noDNAsequence differences. In addition, molecular data revealed several lineages and a new species (T. ramosissimasp. nov.), which suggests greater species diversity inTolypellathan previously recognized.
Therapeutic Potential of Adipose-Derived Stem Cells-Based Micro-Tissues in a Rat Model of Postprostatectomy Erectile Dysfunction
Authors: Xu Yongde , Guan Ruili , Lei Hongen , Li Huixi , Wang Lin , Gao Zhezhu , Song Weidong , Xin Zhongcheng
Published: July 2014

Introduction

Stem cells (SCs) show significant benefits in the treatment of postprostatectomy erectile dysfunction (ED). However, the low retention rate of the traditional single-cell strategy at the injection sites limits its therapeutic potential.

Aim

This study aims to investigate the feasibility and mechanism of adipose-derived stem cells (ADSCs)-based micro-tissues (MTs) in the treatment of ED in a rat model of bilateral cavernous nerves (CNs) injury.

Methods

ADSCs labeled with 5-ethynyl-2-deoxyuridine (EdU) were used to generate MTs with hanging drop method. 10 Sprague-Dawley (SD) rats underwent sham surgery and intracavernous (IC) injection of phosphate buffer solution (PBS) (the sham group). Another 70 rats underwent bilateral CN crush and were then treated with PBS (n = 10, the crush group), dissociated ADSCs (n = 30, the ADSCs group), and MTs (n = 30, the MTs group), respectively. At day 1, 3, 7, 14 (n = 5), and 28 (n = 10) postsurgery, specimens were harvested for histology. At day 28, 10 rats in each group were examined for erectile function before tissue harvest.

Main Outcome Measures

Light microscopy of the dynamic aggregation of the MT, immunohistologic examination of the MTs, the retention and distribution of EdU + ADSCs in the corpus cavernosum (CC), and the penis histological analyses of collagen content, Western blot of functional proteins in MTs, intracavernous pressure recording on CN electrostimulation.

Results

Three-day-old MTs became stable and expressed nerve growth factor, vascular endothelial growth factor, C-X-C chemokine receptor type 4, Wnt5a, and collagen IV. More EdU + ADSCs retained in the CC in the MTs group than that in the ADSCs group. IC injection of MTs resulted in significant restoration of the erectile function and histopathological changes compared with the ADSCs group.

Conclusion

IC-injected MTs resulted in a better restoration of erectile function than traditional single-cell strategy. The underlying mechanisms of recovery appear to involve enhanced cellular retention in the penis and upregulation of some paracrine factors.
Mirtazapine treatment ceased the progression of progressive multifocal leukoencephalopathy associated with systemic sarcoidosis
Authors: Matsudaira Takashi , Araki Kunihiko , Oishi Wataru , Sugiura Akira , Miura Katsutoshi , Nakamichi Kazuo , Saijo Masayuki , Obi Tomokazu
Published: July 2014

Progressive multifocal leukoencephalopathy occurs almost exclusively in immunosuppressed individuals. Mirtazapine, a 5‐hydroxytryptamine‐2A antagonist, has been used empirically against progressive multifocal leukoencephalopathy. A 60‐year‐old man who was diagnosed with sarcoidosis at 20 years‐of‐age and had not taken immunosuppressive therapies developed dysarthria, left hemiparesis and dressing apraxia. Cranial ?uid‐attenuated inversion‐recovery magnetic resonance imaging showed hyperintense areas in the right frontal and temporoparietal white matter. The initial diagnosis was neurosarcoidosis, based on non‐caseating granuloma in a lymph node biopsy. Immunosuppressive therapy was initiated; however, this aggravated his neurological symptoms. Immunohistochemistry of the brain biopsy showed John Cunningham virus infected large ballooned oligodendrocytes, leading to a diagnosis of progressive multifocal leukoencephalopathy. Treatment with mirtazapine improved the neurological symptoms, and the magnetic resonance imaging abnormality did not progress. We stress the diagnostic difficulties of distinguishing progressive multifocal leukoencephalopathy from neurosarcoidosis, and suggest that mirtazapine treatment is effective against progressive multifocal leukoencephalopathy associated with sarcoidosis.
Neurotransmitter levels in basal ganglia during levodopa and deep brain stimulation treatment in Parkinson's disease
Authors: Zsigmond Peter , Nord Maria , Kullman Anita , Diczfalusy Elin , Wårdell Karin , Dizdar Nil
Published: July 2014

Background

The mechanism by which deep brain stimulation of the nucleus subthalamicus improves Parkinson's disease symptoms remains unclear. In a previous perioperative study, we showed that there might be alterations of neurotransmitter levels in the globus pallidum interna during deep brain stimulation of the nucleus subthalamicus.

Aim

In this study, we examined whether deep brain stimulation of the nucleus subthalamicus and levodopa infusion interact and affect the levels of neurotransmitters.

Methods

Five patients with advanced Parkinson's disease took part in the study. During subthalamic nucleus surgery, microdialysis catheters were inserted bilaterally in the globus pallidum interna and unilaterally in the right putamen. A study protocol was set up and was followed for 3 days. Levodopa infusion with and without concomitant bilateral deep brain stimulation of the nucleus subthalamicus was also carried out.

Results

The putaminal dopamine levels increased during deep brain stimulation of the nucleus subthalamicus. In addition, an increase of gamma amino buturic acid concentrations in the globus pallidum interna during deep brain stimulation of the nucleus subthalamicus and during levodopa infusion was found.

Conclusions

These findings provide evidence that the subthalamic nucleus has a direct action on the substantia nigra pars compacta, and that deep brain stimulation of the nucleus subthalamicus might indirectly release putaminal dopamine. There is also evidence that deep brain stimulation of the nucleus subthalamicus interferes with levodopa therapy resulting in higher levels of levodopa in the brain, explaining why it is possible to decrease levodopa medication after deep brain stimulation surgery.
Deep brain stimulation and intracerebral infection: A case report and review of the literature
Authors: Zsigmond Peter , Göransson Nathanael
Published: July 2014

Deep brain stimulation is a well‐established surgical treatment for patients with movement disorders. Adverse events, such as hardware infections, are well known, but intracerebral infections are extremely rare, and can develop both shortly after surgery and after several months. We present one case of intracerebral infection after deep brain stimulation surgery, and a short review of the literature.
Nurses' Empowerment Scale for ICU patients' families: an instrument development study
Authors: Li Hong , Liu Ya‐Lan , Qiu Li , Chen Qiao‐Ling , Wu Jing‐Bing , Chen Li‐Li , Li Na
Published: July 2014

Background

Family members provide essential support for ICU patients, contributing to their mental and physical recovery. Empowering ICU patients' families may help them overcome inadequacies and meet their own and patients' acknowledged needs. Nursing should understand and address patients' families' empowerment status.

Aims and objectives

To develop a tool, the Nurses' Empowerment Scale for Intensive Care Unit (ICU) Patients' Families (NESIPF), to help ICU nursing staff assess the empowerment status of patients' families.

Design

Four‐phase instrument development study.

Methods

A 19‐item instrument was initially generated based on literature review and interviews with family members of ICU patients. The Delphi research method was applied to gain expert opinion and consensus via rounds of questionnaires. A panel of 27 experts experienced in critical care medicine, nursing and psychology participated in two Delphi rounds and their input helped formulate an 18‐item pretest instrument. Families of 20 patients were recruited to examine instrument readability. After a 2‐week interval, another 20 patients' families were recruited to examine test‐retest reliability. Two hundred questionnaires were then administered and analysed to examine the instrument's construct validity, criterion‐related validity and internal consistency.

Results

Expert authority coefficients of two Delphi rounds reached 0·89 and 0·91. Kendall' W coefficients of 0·113 (P < 0·001) in round 1 and 0·220 (P < 0·001) in round 2 indicated slight to fair agreement among experts. Content validity index (CVI) reached 1·0 for 12 items; the CVI for item 13 was <0·7 so it was excluded. Cronbach's α coefficient was 0·92, indicating acceptable internal consistency reliability. The coefficient of internal consistency of each dimension was 0·717–0·921. The Pearson correlation coefficient >0·9 (P < 0·05) showed an acceptable test‐retest reliability.

Conclusions

The instrument has acceptable reliability and validity and can assess the empowerment status of families of critically ill patients.

Relevance to clinical practice

Knowledge of families' empowerment status may help to address their psychological needs and their ability to provide family support.
Report on Third International Intensive Aftercare Conference in Norrköping, Sweden
Authors: Jones Christina , Bäckman Carl , Egerod Ingrid , Gibb Peter , Nydahl Peter , Storli Sissel
Published: July 2014

The third international conference on intensive care unit (ICU) diaries and intensive aftercare took place in Norrköping, Sweden, on 28 November 2013. The conference was organized by Carl Bäckman and colleagues, Vrinnevi Hospital and NOFI, and represented by Sissell Storli. More than 100 clinicians from across Europe and the USA attended the conference.
Continuous flow using an entrainer and t‐piece vs drawover apparatus for inhalational induction of anesthesia in children
Authors: Chikumbanje Singatiya , Bell Graham T. , Kapatuka Kenneth , Pollach Gregor
Published: July 2014

Background

Inhalational induction in children is easiest to perform with the Ayres t‐piece & bag (Mapleson F). Drawover anesthesia systems may be used but have not been studied. The aim of this study was to examine the quality of induction of anesthesia in children comparing a continuous flow system using the Farman entrainer and the pediatric t‐piece, to a pediatric drawover system.

Methods

We conducted a randomized controlled trial in accordance with departmental and institutional standards with 60 subjects who received inhalational induction using either apparatus.

Results

There was no evidence of a difference in the median Sp02 between the two methods (P = 0.626) neither was there a difference between the method of induction regarding abdominal distension (P = 0.348) or restraint (P = 0.186). Induction time using the pediatric drawover apparatus 240 (range 115–605) seconds was significantly greater than the Farman entrainer/t‐piece 146 (range 65–535) seconds (P < 0.05).

Conclusions

We consider that this difference is unlikely to be clinically significant in many cases; however, the increased speed using the entrainer and t‐piece may sometimes confer an advantage.
Peroxisomal APX knockdown triggers antioxidant mechanisms favourable for coping with high photorespiratory H2O2 induced by CAT deficiency in rice
Authors: SOUSA RACHEL H. V. , CARVALHO FABRICIO E. L. , RIBEIRO CAROL W. , PASSAIA GISELE , CUNHA JULIANA R. , LIMA‐MELO YUGO , MARGIS‐PINHEIRO MÁRCIA , SILVEIRA JOAQUIM A. G.
Published: July 2014

The physiological role of peroxisomal ascorbate peroxidases (pAPX) is unknown; therefore, we utilized pAPX4 knockdown rice and catalase (CAT) inhibition to assess its role in CAT compensation under high photorespiration. pAPX4 knockdown induced co‐suppression in the expression of pAPX3. The rice mutants exhibited metabolic changes such as lower CAT and glycolate oxidase (GO) activities and reduced glyoxylate content; however, APX activity was not altered. CAT inhibition triggered different changes in the expression of CAT, APX and glutathione peroxidase (GPX) isoforms between non‐transformed (NT) and silenced plants. These responses were associated with alterations in APX, GPX and GO activities, suggesting redox homeostasis differences. The glutathione oxidation‐reduction states were modulated differently in mutants, and the ascorbate redox state was greatly affected in both genotypes. The pAPX suffered less oxidative stress and photosystem II (PSII) damage and displayed higher photosynthesis than the NT plants. The improved acclimation exhibited by the pAPX plants was indicated by lower H2O2 accumulation, which was associated with lower GO activity and glyoxylate content. The suppression of both pAPXs and/or its downstream metabolic and molecular effects may trigger favourable antioxidant and compensatory mechanisms to cope with CAT deficiency. This physiological acclimation may involve signalling by peroxisomal H2O2, which minimized the photorespiration.
High‐dose chemotherapy with autologous stem cell rescue for treatment of retinoblastoma: Report of five cases
Authors: Caselli Désirée , Tamburini Angela , La Torre Agostino , Pollazzi Liliana , Tintori Veronica , Bambi Franco , Caputo Roberto , Aricò Maurizio
Published: July 2014

RB is a primarily pediatric cancer arising from the retina, initiated by biallelic loss of the RB1 gene. We report five children with bilateral RB (n = 3), extra‐ocular disseminated RB, or disseminated relapsed RB, who were treated with tandem high‐dose chemotherapy and autologous stem cell rescue. All patients received at least 2.2 × 106/kg CD34+ (median, 3.9 × 106/kg) cells. The preparative regimen for course 1 was carboplatin, thiotepa, etoposide, and for course 2, CM and melphalan. ANC of at least 0.5 × 109/L occurred at a median of 11 days (range, 10–12) and 15 days (range, 12–16) after the first and second procedure, respectively. Platelet engraftment occurred at a median of 13 days (range, 12–17) and 15 days (range, 14–22) after the first and second procedure, respectively. All of the five patients treated remain alive and disease free at the last follow‐up time, ranging between 21 and 44 months after completion of autologous transplant. Additional therapy was required in one patient, in whom enucleation had to be performed because of early disease relapse, refractory to local therapy. Intensification of chemotherapy with repeated high‐dose chemotherapy and autologous rescue appears an acceptable choice in selected cases with bilateral or extra‐ocular disease, either recurrent or refractory.
Translation of Obesity Practice Guidelines: Interprofessional Perspectives Regarding the Impact of Public Health Nurse System‐Level Intervention
Authors: Monsen Karen A. , Attleson Ingrid S. , Erickson Kristin J. , Neely Claire , Oftedahl Gary , Thorson Diane R.
Published: July 2014

Objective

The purpose of the study was to investigate the perceptions of administrators and clinicians regarding a public health facilitated collaborative supporting the translation into practice of the Institute for Clinical Systems Improvement (ICSI) Adult Obesity Guideline.

Design and Sample

This qualitative study was conducted with 10 health care organizations participating in a voluntary, interprofessional obesity management collaborative. A purposive sample of 39 participants included two to three clinicians and an administrator from each organization. Interview analysis focused on how the intervention affected participants and their practices.

Results

Four themes described participant experiences of obesity guideline translation: (1) a shift from powerlessness to positive motivation, (2) heightened awareness coupled with improved capacity to respond, (3) personal ownership and use of creativity, and (4) a sense of the importance of increased interprofessional collaboration.

Conclusions

The investigation of interprofessional perspectives illuminates the feelings and perceptions of clinician and administrator participants regarding obesity practice guideline translation. These themes suggest that positive motivation, improved capacity, personal creative ownership, and interprofessional collaboration may be conducive to successful evidence‐based obesity guideline implementation. Further research is needed to evaluate these findings relative to translating the ICSI obesity guideline and other guidelines into practice in diverse clinical settings.
Meta‐Analysis of Lost Ecosystem Attributes in Urban Streams and the Effectiveness of Out‐of‐Channel Management Practices
Authors: Smucker Nathan J. , Detenbeck Naomi E.
Published: July 2014

Urban development is a leading cause of stream impairment that reduces biodiversity and negatively affects ecosystem processes and habitat. Out‐of‐stream restoration practices, such as stormwater ponds, created wetlands, and restored riparian vegetation, are increasingly implemented as management strategies to mitigate impacts. However, uncertainty exists regarding how effectively they improve downstream ecosystems because monitoring is uncommon and results are typically reported on a case‐by‐case basis. We conducted a meta‐analysis of literature and used response ratios to quantify how downstream ecosystems change in response to watershed development and to out‐of‐stream restoration. Biodiversity in unrestored urban streams was 47% less than that in reference streams, and ecological communities, habitat, and rates of nutrient cycling were negatively affected as well. Mean measures of ecosystem attributes in restored streams were significantly greater than, and 156% of, those in unrestored urban streams. Measures of biodiversity in restored streams were 132% of those in unrestored urban streams, and indices of biotic condition, community structure, and nutrient cycling significantly improved. However, ecosystem attributes and biodiversity at restored sites were significantly less than, and only 60% and 45% of, those in reference streams, respectively. Out‐of‐stream management practices improved ecological conditions in urban streams but still failed to restore reference stream conditions. Despite statistically significant improvements, assessing restoration success remains difficult due to few comparisons to reference sites or to clearly defined targets. These findings can inform future monitoring, management, and development strategies and highlight the need for preventative actions in a watershed context.
Should Smaller Countries Be More Protectionist? The Diversification Motive for Tariffs
Authors: Gaisford James , Ivus Olena
Published: July 2014

This paper examines the diversification motive for tariffs under trade‐related uncertainty when there is incomplete international and domestic risk sharing. In the context of a two‐country Ricardian continuum‐of‐sectors model with shocks to foreign technologies or preferences, tariffs allow a country to mitigate external risk by diversifying across sectors. Given sufficiently high risk and risk aversion, the optimality of tariffs depends primarily on a country's ability to diversify, rather than its market power, such that small countries gain most.
Donor Altruism and the Transfer Paradox in an Overlapping Generations Model
Authors: Hamada Kojun , Yanagihara Mitsuyoshi
Published: July 2014

This paper examines the transfer problem between two countries when a donor exhibits altruistic utility toward a recipient in a one‐sector overlapping generations model. We demonstrate that if the donor has a larger marginal propensity to save than the recipient, the donor's altruism never contributes to donor enrichment irrespective of the degree of the donor's altruism. Donor enrichment occurs only if the donor has a smaller marginal propensity to save and a sufficiently high level of altruism. These findings imply that the altruism of a donor toward a recipient does not necessarily explain the motivation to voluntarily provide a transfer.
Estimating the Health Benefit of Reducing Indoor Air Pollution in a Randomized Environmental Intervention
Authors: Peng Roger D. , Butz Arlene M. , Hackstadt Amber J. , Williams D'Ann L. , Diette Gregory B. , Breysse Patrick N. , Matsui Elizabeth C.
Published: July 2014

Recent intervention studies targeted at reducing indoor air pollution have demonstrated both the ability to improve respiratory health outcomes and to reduce particulate matter (PM) levels in the home. However, these studies generally do not address whether it is the reduction in PM levels specifically that improves respiratory health. We apply the method of principal stratification to data from a randomized air cleaner intervention designed to reduce indoor PM in homes of children with asthma. We estimate the health benefit of the intervention among study subjects who would experience a substantial reduction in PM in response to the intervention. For those subjects we find an increase in symptom-free days that is almost three times as large as the overall intention-to-treat effect. We also explore the presence of treatment effects among those subjects whose PM levels would not respond to the air cleaner. This analysis demonstrates the usefulness of principal stratification for environmental intervention trials and its potential for much broader application in this area.
Facies analysis of a Pliocene river‐dominated deltaic succession (Siena Basin, Italy): Implications for the formation and infilling of terminal distributary channels
Authors: Martini Ivan , Sandrelli Fabio
Published: July 2014

The recent recognition and description of terminal distributary channels in ancient delta‐front deposits have led to important progress when it comes to understanding: delta construction processes; the plan‐view shapes of both modern and ancient river‐dominated deltas; and sediment dispersal within deltas. Deltaic deposits fed by terminal distributary channels can be observed in the extensive outcrops (approximately up to 300 m wide and 50 to 70 m thick) in the central sector of the Pliocene Siena Basin in Tuscany, Italy. Stratigraphic constraints indicate that the deposition occurred in relatively shallow marine settings, was not affected by tidal effects and was influenced only locally by wave action. As a consequence, these rock exposures provide an opportunity to investigate the facies assemblage of an ancient delta complex, which was built up almost exclusively as the result of river‐related processes. The studied deltaic succession is composed of vertically stacked parasequence‐like units, which are invariably characterized by the lack of coarse‐grained distributary channel deposits at the top and an extensive network of terminal distributary channels that controlled the deltaic deposition. These deposits were interpreted previously as deep‐water turbidites. This study provides new elements for the correct distinction between hyperpycnal‐dominated delta fronts and basinal turbidite deposits. The terminal distributary channel facies documented in this study are more complex than those investigated in previous research. The channels are often passively filled during abandonment phases, and not just due to the aggradation and lateral/upstream migration of mouth bars, as classically proposed. Moreover, the frequent occurrence of mudstone beds just above the basal channel scours may be indicative of an abandonment phase after the channel incision, and before its infilling, with subsequent implications for the formational and infilling mechanisms of terminal distributary channels. Furthermore, the channel fills are often the result of alternating depositional and erosional phases, leading to a complex stratigraphic arrangement.
New insights into geochemical behaviour in ancient marine carbonates (Upper Jurassic Ammonitico Rosso): Novel proxies for interpreting sea‐level dynamics and palaeoceanography
Authors: Coimbra Rute , Immenhauser Adrian , Olóriz Federico , Rodríguez‐Galiano Víctor , Chica‐Olmo Mario
Published: July 2014

Elemental concentrations in Phanerozoic sea water are known to fluctuate both in time and space. With regard to carbonates precipitated from marine fluids, elemental concentrations in the carbonate crystal lattice are affected by a complex array of equilibrium and non‐equilibrium as well as post‐depositional alteration processes. To assess the potential of carbonate elemental chemostratigraphy, seven Upper Jurassic sections were investigated along a proximal to distal transect across the south‐east Iberian palaeomargin. The aim was to explore stratigraphic and spatial variations in calcium, strontium, magnesium, iron and manganese elemental abundances. The epicontinental geochemical record is influenced by the combination of continental runoff and a significant diagenetic overprint. In contrast, the epioceanic geochemical record agrees with reconstructed open marine sea water values, reflecting a moderate degree of syn‐depositional to early marine pore water diagenesis. Establishing a fair degree of preservation of matrix micrite, a thorough statistical approach was applied and elemental associations tested for their environmental significance. Principal component and hierarchical cluster analyses revealed a persistent relation between carbonate magnesium, iron and strontium abundances. Processes related to early diagenetic nodulation in Ammonitico Rosso facies most probably account for the incorporation of these elements in the calcium carbonate lattice. The clear decoupling of carbonate manganese abundance with respect to the remaining elements is documented and related to high sea floor spreading rates and hydrothermal activity during the Late Jurassic. The investigation of potential time‐fluctuation of geochemical patterns was approached through variogram computation. The observed temporal behaviour is most likely to be forced by relative sea‐level dynamics, reflecting Late Jurassic palaeoceanographic conditions and potential planetary interactions. The data obtained in this study highlight the utility of elemental data from carbonate matrix micrites as geochemical proxies for studying the influence of remote trigger factors.
Soil degradation in environmentally sensitive areas driven by urbanization: an example from Southeast Europe
Authors: Salvati L. , Karamesouti M. , Kosmas K.
Published: July 2014

Rapid urbanization together with policy ineffectiveness in controlling urban growth is often associated to soil and land degradation in both the developing and developed world. The present study analyses the relationship between urban expansion and soil degradation in an arid Mediterranean region (Attica, Greece) where the compact settlement pattern has been replaced by low‐density urban development. The study area is one of the most densely populated areas in the Mediterranean basin that has experienced an impressive growth in population during the last 60 yr. Low‐density, dispersed urban settlements developed during the last decade (2000–2010) occupy primarily land at medium‐low soil quality. However, the overall quality conditions of vegetation, climate and soil assessed by our study shows that urban expansion consumed high‐quality land previously classified as non‐vulnerable to desertification. By contrast, compact urban settlements have consumed land of intermediate or even high soil quality, but experience poor climatic and vegetation conditions that are classified as highly vulnerable to desertification. Regional planning should incorporate multi‐dimensional indicators of soil, climate and vegetation quality to evaluate the environmental impact of urban expansion.
Cerebral trypanosomiasis in a renal transplant recipient
Authors: Cicora F. , Escurra V. , Bibolini J. , Petroni J. , González I. , Roberti J.
Published: July 2014

Chagas disease is a lifelong, systemic, parasitic infection caused by the protozoan Trypanosoma cruzi. The main form of disease transmission is vector borne, but vertical transmission, such as by organ transplantation from a chronically infected donor, is also possible. The brain tumor‐like form can occur years after infection and has been described in patients with acquired immunodeficiency syndrome, and in a very few cases in transplant recipients. We describe the case of a kidney transplant patient who was human immunodeficiency virus negative and infected with T. cruzi, and developed cerebral trypanosomiasis that was successfully treated with benznidazole at 7 mg/kg/day for 60 days. The risk of Chagas disease transmission should not be underestimated in renal transplant patients, even in non‐endemic areas. Chagas disease can present as a tumor‐like brain lesion, very difficult to differentiate from other opportunistic infectious or neoplastic processes. Frequent monitoring for T. cruzi infection is essential to promptly implement treatment, which, in our patient, proved to be effective and safe.
Multiple Domains of Tetanus Toxin Direct Entry into Primary Neurons
Authors: Blum Faith C. , Tepp William H. , Johnson Eric A. , Barbieri Joseph T.
Published: July 2014

Tetanus toxin elicits spastic paralysis by cleaving VAMP‐2 to inhibit neurotransmitter release in inhibitory neurons of the central nervous system. As the retrograde transport of tetanus neurotoxin (TeNT) from endosomes has been described, the initial steps that define how TeNT initiates trafficking to the retrograde system are undefined. This study examines TeNT entry into primary cultured cortical neurons by total internal reflection fluorescence (TIRF) microscopy. The initial association of TeNT with the plasma membrane was dependent upon ganglioside binding, but segregated from synaptophysin1 (Syp1), a synaptic vesicle (SV) protein. TeNT entry was unaffected by membrane depolarization and independent of SV cycling, whereas entry of the receptor‐binding domain of TeNT (HCR/T) was stimulated by membrane depolarization and inhibited by blocking SV cycling. Measurement of the incidence of colocalization showed that TeNT segregated from Syp1, whereas HCR/T colocalized with Syp1. These studies show that while the HCR defines the initial association of TeNT with the cell membrane, regions outside the HCR define how TeNT enters neurons independent of SV cycling. This provides a basis for the unique entry of botulinum toxin and tetanus toxin into neurons.
Supply Chains, Global Financial Shocks and Firm Behaviour towards Liquidity Needs
Authors: Jinjarak Yothin
Published: July 2014

Driven by the increasingly important role of supply chains in global production, this paper studies empirical association between global credit‐market shocks and firm behaviour towards liquidity needs across countries and industries. Focusing on the adjustment of working‐capital financing, we find two pieces of supporting evidence from international firm‐level panel data covering the period 2002:I–2012:IV. First, for industries where specific investment in the input supplier–customer relationship is large, firms are more exposed to credit‐market shocks. We find that measures of global credit‐market shocks are negatively associated with trade receivables, trade payables and inventories, conditional on the level of contract intensity in the industries where firms operate. Second, firms in emerging markets are more vulnerable to
credit‐market shocks than are firms in developed countries. We are also able to verify the economic significance of sales growth, operating cash flows, cash stock and firm size in the overall adjustment. Our findings highlight the importance of balance‐sheet contagion along supply chains during the 2007–09 global financial crisis.
An ex vivo evaluation of efficacy of refrigerated canine plasma
Authors: Grochowsky Adam R. , Rozanski Elizabeth A. , de Laforcade Armelle M. , Sharp Claire R. , Meola Dawn M. , Schavone Jessica J. , Brooks Majory B.
Published: July 2014

Objectives

To determine thawing times of fresh frozen plasma (FFP), and to evaluate the activity of hemostatic proteins (coagulation factors V, VII, VIII, IX, X, and fibrinogen), clotting times (prothrombin time and activated partial thromboplastin time), and sterility of canine plasma stored refrigerated.

Design

Prospective laboratory‐based study.

Setting

Veterinary teaching hospital blood bank.

Interventions

Phase 1: Six units of canine FFP were retrieved from the blood bank and thawed individually in a warm water bath. Time for thaw was recorded in minutes and reported as mean ± SD. Phase 2: One unit of fresh whole blood was collected from 9 dogs and processed routinely. Resulting plasma was divided into 2 aliquots, 1 stored as refrigerated plasma (RP) and 1 as frozen plasma. Samples from the RP were taken at 0, 1, 5, 7, and 14 days and from the FFP at days 0 and 14 for determination of clotting factor activity (V, VII, VIII, IX, and X and fibrinogen) and clotting times. Coagulation factors and clotting times were analyzed using a mixed effects linear model for ANOVA, comparing changes over time as well as differences between groups. For all comparisons, a P value of <0.05 was considered significant. Batch bacterial aerobic and anaerobic cultures of the RP samples were submitted on days 7 and 14 and from the frozen plasma on day 14.

Measurements and Main results

Time to thaw for FFP units was 34.7 ± 1.38 minutes. Refrigerated storage resulted in significant decreases in the activity of all clotting factors and a subsequent prolongation in clotting times. However, no values were outside of the reference interval. All bacterial cultures yielded no growth.

Conclusions

Refrigerated storage results in only minor loss of coagulation factor activity in canine plasma. The use of RP, therefore, may be a viable option in high‐volume veterinary hospitals for rapid correction of coagulopathy in critical care patients.