bluuebunny/crossref_metadata_2025 huggingface dataset:
Materials for primary tooth pulp treatment: the present and the future
Authors: Chen Jung‐Wei , Jorden Monserrat
Published: November 2012

Many materials have been used for pulp treatment in primary teeth, but not many of them are extensively supported in the dental literature. In recent years, new materials have been introduced along with new procedures, and these will be reviewed in this article. Many of these new materials have shown promising results in the short run but can only be thoroughly evaluated after longer use and more extensive applications. There is clearly a need for long‐term studies to identify the best materials for pulp treatment of primary teeth.
Are keloid and hypertrophic scar different forms of the same disorder? A fibroproliferative skin disorder hypothesis based on keloid findings
Authors: Huang Chenyu , Akaishi Satoshi , Hyakusoku Hiko , Ogawa Rei
Published: November 2012

Hypertrophic scars (HSs) and keloids are commonly seen as two different diseases by both clinicians and pathologists. However, as supported by histological evidence showing they share increased numbers of fibroblasts and accumulate collagen products, HS and keloid might be different forms of the same pathological entity, rather than separate conditions. To test this hypothesis, keloids from patients who underwent scar excisions (n = 20) in Nippon Medical School from 2005 to 2010 were examined histologically. The proportion and distribution of cellular and matrix collagen components were evaluated at the centre and periphery of each sample. In keloid samples, coexistence of hyalinised collagen, which is the most important pathognomonic characteristic of a keloid and dermal nodules that are considered to be characteristic of HS, was found. Moreover, hyalinised fibres appeared to initiate from the corner of the dermal nodules. Key features of inflammation such as microvessels, fibroblasts and inflammatory cells all decreased gradually from the periphery to the centre of keloids, indicative of reduced inflammation in the centre. Thus, we hypothesise that HS and keloid can be considered as successive stages of the same fibroproliferative skin disorder, with differing degrees of inflammation that might be affected by genetic predisposition.
Biological effects of short‐term salmon oil administration, using distinct salmon oil sources in healthy dogs
Authors: Hesta M. , Verbrugghe2 A. , Gulbrandsen K. E. , Christophe A. , Zentek J. , Hellweg P. , Janssens G. P. J.
Published: November 2012

OBJECTIVES

To assess the short‐term effects of feeding distinct salmon oil sources in healthy dogs.

METHODS

A diet containing chicken fat as major fat source was fed to 17 dogs for 14 days. For the next 14 days, dogs received one of two diets, both with 1% of chicken fat exchanged for 1% salmon oil; Norwegian or Scottish salmon oil, harvested using a distinct procedure. Finally, all dogs were fed chicken fat again for 14 days.

RESULTS

Salmon oil increased serum phospholipid total n‐3 polyunsaturated fatty acids, eicosapentaenoic and docosahexaenoic acid and decreased total n‐6 polyunsaturated fatty acids and n‐6:n‐3. The phospholipid fatty acid profile returned to initial values within 2 weeks of discontinuing salmon oil administration. Blood coagulation, acute phase response and plasma immunoglobulin concentrations were not affected by salmon oil and no differences were detected for the measured indices between the two salmon oils.

CLINICAL SIGNIFICANCE

Low‐dose salmon oil administration alters serum phospholipid fatty acid profile within 2 weeks, but without affecting selected immunologic and coagulation indices. Salmon oil sources from different sources and harvested using a distinct procedure did not induce different effects, most probably because of their similar fatty acid profiles.
The Role of Angiotensin II Receptor Blockers in the Treatment of Heart Failure Patients
Authors: Theal Michael , Demers Catherine , McKelvie Robert S.
Published: November 2012

Evidence from large, randomized, controlled clinical trials supports the use of angiotensin‐converting enzyme (ACE) inhibitors, β blockers, and spironolactone to reduce mortality and morbidity. Despite these effective therapies, event rates related to heart failure remain high. Although ACE inhibitors reduce angiotensin II production, they do not fully suppress the increased angiotensin II production in heart failure. Angiotensin II receptor blockers (ARBs) directly block the effect of angiotensin II, derived from any source, at the receptor level and have the potential to be as effective or even more effective than ACE inhibitors. The results of a number of clinical studies have demonstrated ARBs are effective and well tolerated. However, no studies have demonstrated a convincing decrease in mortality with ARB use, although a decrease has been observed for heart failure hospitalization. The results from further studies are awaited to clarify the role of ARBs in the treatment of heart failure.
Cardiogenic Shock: A Summary of the Randomized SHOCK Trial
Authors: Menon Venu , Fincke Rupert
Published: November 2012

Cardiogenic shock is the most common cause of death for patients hospitalized with acute myocardial infarction. The Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial randomly assigned 302 patients with predominant left ventricular failure following an acute myocardial infarction to a strategy of emergency revascularization or initial medical stabilization. Emergency revascularization by either coronary artery bypass grafting or angioplasty was required within 6 hours of randomization. Patients assigned to initial medical stabilization could undergo delayed revascularization at a minimum of 54 hours post‐randomization. The primary end point of the study was 30‐day all‐cause mortality. Overall survival at 30 days did not differ significantly between the emergency revascularization and initial medical stabilization groups (53% vs. 44%; p=0.109). However, at the 6‐ and 12‐month follow‐up, there was a significant survival benefit with early revascularization (50% vs. 37%; p=0.027 and 47% vs. 34%; p=0.025, respectively). The benefit appeared to be greatest for those less than 75 years of age, with 20 lives saved at 6 months per 100 patients treated. According to the results of the SHOCK trial, the American College of Cardiology/American Heart Association guidelines for myocardial infarction now recommend emergency revascularization for patients younger than 75 years with cardiogenic shock.
Dental findings and special care in patients with Angelman syndrome: a report of three cases
Authors: de Queiroz Alexandra Mussolino , de Siqueira Melara Talitha , Fernandes Ferreira Paula Dariana , Lucisano Marília Pacífico , De Rossi Andiara , Nelson‐Filho Paulo , Bezerra Silva Raquel Assed
Published: November 2012

Angelman syndrome (AS) is a neurogenetic disorder, characterized by intellectual disability, movement or balance disorders, specific abnormal behaviors, and severe speech and language limitations. Due to its low incidence and the nonspecifity of developmental problems in newborns and young children, AS is not easily identified by clinical pediatricians. The aim of this paper is to present three cases of AS, reporting the orofacial characteristics and requisite dental care in these patients. Interestingly, this investigation found that certain typical features of mouth breathing syndrome, such as long and narrow faces, open mouth, shortened upper lip, lowered mandible position, shadows under the eyes (infraorbital cyanosis), muscular hypotonia, and enlarged and anteriorized tongue, were present in the three studied AS patients.
Physical and Emotional Well‐Being: Court Performance Measures for Children and Youth in Foster Care
Authors: Sydow Nora E. , Flango Victor E.
Published: November 2012

Given that courts have the responsibility to ensure the state is providing proper care to children in its custody, courts need to consider whether those children over whom they have jurisdiction are receiving a quality education and are physically and emotionally healthy. Court well‐being measures were not developed when the safety, permanency, timeliness, and due process measures were established. However, there have been recent efforts to address this void. This article describes the newly developed set of well‐being measures for courts to track success in improving well‐being outcomes in the areas of physical health, mental health, maintaining permanent relationships, transition to adulthood, and enhanced family capacity to provide for their children's needs.
Transferring Pre‐Teens to Adult Criminal Courts: Searching for a Justification
Authors: Ruddell Rick , Mays G. Larry
Published: November 2012

This research examined the demographic and offense‐related characteristics of 1,488 children who were 12 years of age or younger when transferred by juvenile court judges to criminal courts in the United States from 1985 to 2009. Juvenile court statistics show a twofold increase in the number of these children transferred between 2005 and 2009, compared to the five‐year era between 1985 and 1989. Examination of the data revealed that the major offense that precipitated most of these transfers was a nonviolent act. Given these facts, a number of key questions emerged from this study: (1) Are these transfers desirable given the potential lifelong consequences of a criminal conviction for these youngsters; (2) Do these practices accomplish a legitimate crime control function; and (3) Are these transfers just and fair given the developmental status of these children?
Global Justice: Between Leviathan and Cosmopolis
Authors: Maffettone Sebastiano
Published: November 2012

A comprehensive ideal of global justice is not yet theoretically justifiable: nonetheless, it does not deserve the scepticism :(commonly expressed by) many statists express towards it. To create a kind of continuity between global justice –‘Cosmopolis’– and interstate justice –‘Leviathan’– a third, ‘Liberal’ option is proposed. The statist argument is presented through a discussion of Thomas Nagel’s position on global justice. The cosmopolitan argument is presented through a discussion of Amartya Sen’s overall vision of justice. The liberal view, modeled on Rawls’ political philosophy, “proposes” that the right cannot consist in a mere realization of the good. Liberals that respect the ‘priority of right’ believe that morality has to be different from politics. By bypassing institutionalism through moralism, cosmopolitans contradict the priority of the right. Contrary to cosmopolitans, the author maintains that the only moral source of global justice compatible with the priority of the right consists in a duty to protect life in case of ‘urgency’. This duty is not purely humanitarian – as statists would have it – and captures the ethical appeal of cosmopolitanism.

Policy Implications

 The core problem of global justice is the lack of basic rights to security and subsistence. As such, obligations derived from the duty of justice based on urgency are binding.

 The duty of justice can be interpreted through the positions of statism or cosmopolitanism.

 The distinction between cosmopolitanism and statism is not only interesting from the point of view of political philosophy but also has a significant tradition within the context of international law and the interpretation of its main sources. While the UN Charter has a generally statist approach, (starting with) Article 2 (that strongly defends) the territorial integrity of states is strongly depended the discipline compromising humanitarian law as introduced in and human rights is largely inspired by cosmopolitanism.

 Taking the middle ground between statism and cosmopolitanism into account, based on Rawls’ central idea of the ‘priority of right’, global politics requires more demanding norms than those dictated by humanitarianism. However, global politics of a less demanding type than the ones recommended by a cosmopolitan egalitarian approach.
A Justice‐Based Regime for Foreign Investment Protection and the Counsel of the Osgoode Hall Statement
Authors: Sornarajah Muthucumaraswamy
Published: November 2012

Developments in international investment arbitration have expanded the scope of investment protection well beyond the intention of states making investment treaties, to the detriment of developing states and their peoples. These developments take place on the basis of the trickle‐down theory that wealth enhancement will benefit everyone. Rather, such wealth enhancement has made the rich richer and the poor poorer. The restoration of the law based on normative values, requires the taking of measures described in the Osgoode Hall Public Statement on the International Investment Regime. This article describes the measures advocated by the Statement in their policy context.
International Finance and Human Rights: Scope for a Mutually Beneficial Relationship
Authors: Dowell‐Jones Mary
Published: November 2012

Despite the devastating social consequences of the ongoing financial crisis, human rights law has been virtually invisible in debates on reforming the governance of international finance. While human rights lawyers tend to lack grounding in the basics of finance, financiers tend to be too engrossed in quantitative methodologies to see the value of a more qualitative, human rights focus. This gap could potentially be bridged by using human rights‐based analysis to enrich our understanding of the dynamics of tail risk. A human rights‐based understanding of institutional power dynamics and social aspects of risk could help shed light on the way the inherited social and institutional architecture of different states shapes the dynamics of risk in global financial markets.
Reshaping Global Governance: The Case of the Right to Food
Authors: De Schutter Olivier
Published: November 2012

The realization of human rights requires the establishment of an enabling environment at the international level, through improvements to global governance. In the area of the right to food, the reform of the Committee on World Food Security in Rome provides a concrete example of how such a transformation can be imagined.
WTO Non‐Violation or Situation Complaints: A Remedy for Extraterritorial Effects on the Human Right to an Adequate Standard of Living
Authors: Herwig Alexia
Published: November 2012

Economic globalization has created the possibility that human rights can be infringed abroad. The WTO, an engine of economic globalization, has remained surprisingly immune from human rights‐related complaints. I argue that its non‐violation or situation complaint, by invoking impediments to the attainment of treaty objectives, could provide for redress when WTO members interfere with the right to an adequate standard of living and the continuous improvement of living conditions abroad through trade in goods. The non‐violation and situation complaints reflect the shared but differentiated responsibility of WTO members for the human right to an adequate standard of living.
Human Rights Norms for a Globalized World: The Maastricht Principles on Extraterritorial Obligations of States in the area of Economic, Social and Cultural Rights
Authors: Salomon Margot E. , Seiderman Ian
Published: November 2012

The Maastricht Principles on Extraterritorial Obligations of States in the area of Economic, Social and Cultural Rights were adopted on 28 September 2011 by leading experts in international law and human rights. The Maastricht Principles enunciate the parameters within which extraterritorial obligations must be discharged. Economic globalization fosters an accountability gap and has made evident an imbalance between the scope of influence of states and the way in which their legal responsibility is defined. Still, the extraterritorial dimensions of economic and social rights have been approached by courts and human rights expert bodies in a largely ad hoc fashion. By authoritatively bringing together the requirements of international human rights law in this fast‐evolving area, the Principles should contribute to reconciling the human rights duties of states with globalization.
Adolescent varicocoele management controversies
Authors: Serefoglu E. C. , Saitz T. R. , La Nasa J. A. , Hellstrom W. J.
Published: November 2012

Varicocoele is defined as excessive dilatation of the pampiniform venous plexus of the spermatic cord. Varicocoele frequently appears during early puberty and is recognized to be the most common surgically correctable cause of male infertility. However, the actual incidence in adolescents, pathophysiology and the association with male factor infertility all remain somewhat controversial. The most accurate diagnostic technique for identifying young men who will benefit from surgical treatment has yet to be established. Observations of testicular asymmetry and deteriorating semen quality helped establish current guidelines and recommendations for surgical treatment. Further studies, comparing observation with surgical intervention, are needed to refine the current indications for varicocoele repair in the adolescent male.
Longitudinal Relationships Between Pain and Stress Problems in the General Population: Predicting Trajectories From Cognitive Behavioral Variables
Authors: Boersma Katja , MacDonald Shane , Linton Steven J.
Published: November 2012

Lately, cognitive behavioral models have put forth that the co‐occurrence of pain and stress might be explained by mutually maintaining psychological mechanisms such as catastrophizing and avoidance. This study aimed to map the interrelationship between pain, stress, catastrophizing, cognitive, and behavioral avoidance across time. A general population sample (n = 551) was followed from baseline to 3‐month and 1‐year follow‐up. The results revealed subgroups with stress and pain in combination as well as in isolation. The subgroups were highly stable across time, and catastrophizing, cognitive, and behavioral avoidance were related to the development of symptoms. The results support that shared, but also specific cognitive and behavioral, processes may maintain and drive the development of pain and stress problems.
From the mountains to the sea: phylogeography and cryptic diversity within the mountain mullet, Agonostomus monticola (Teleostei: Mugilidae)
Authors: McMahan Caleb D. , Davis Matthew P. , Domínguez‐Domínguez Omar , García‐de‐León Francisco J. , Doadrio Ignacio , Piller Kyle R.
Published: November 2012

Aim

The mountain mullet, Agonostomus monticola, is a diadromous fish widespread throughout Middle America, occurring in rivers along the Atlantic and Pacific slopes, as well as in the West Indies. Based on the disjunct distribution of this species, it has been hypothesized that this fish may represent more than one taxon. The purpose of this study was to conduct a robust phylogeographical analysis of A. monticola across its range, using mitochondrial and nuclear markers. We aimed to investigate the potential for cryptic diversity and the time‐scale of divergence in an effort to elucidate biogeographical episodes within Middle America in relation to the evolutionary history of Agonostomus monticola.

Location

North and Middle America, including the West Indies.

Methods

Mitochondrial and nuclear sequence data (cyt b, S7‐1) from individuals throughout the range of the species were analysed phylogenetically using maximum‐likelihood methodology. The oldest known fossil mullet was used as a calibration to investigate divergence times for clades within A. monticola.

Results

Results indicate four distinct lineages within the known range of A. monticola that largely correspond to oceanic basins (Caribbean, Gulf of Mexico, Pacific‐A, Pacific‐B). Divergence time estimates indicate early to mid‐Miocene divergences for all four A. monticola clades, with Oligocene to Miocene divergences of internal nodes.

Main conclusions

These findings are congruent with geological hypotheses regarding movement of the Chortís block, as well as recent studies on the age of beginning emergence of the Panama Arc.
Dispersal and vicariance of Hoplias malabaricus (Bloch, 1794) (Teleostei, Erythrinidae) populations of the Brazilian continental margin
Authors: Pereira Tiago L. , Santos Udson , Schaefer Carlos E. , Souza Gisele O. , Paiva Samuel R. , Malabarba Luiz R. , Schmidt Eduardo E. , Dergam Jorge A.
Published: November 2012

Aim

The aim of this study was to test the hypothesis that the Brazilian coastal populations of Hoplias malabaricus were subject to the same geomorphological and palaeohydrological factors that resulted in endemic fish regions, by characterizing the mitochondrial DNA, nuclear sequences and cytogenetic data of these populations.

Location

Seventeen coastal basins in north‐eastern, eastern and south‐eastern Brazil, plus the São Francisco Basin.

Methods

Forty‐two specimens were analysed. Mitochondrial ATP synthase 6 (ATPase‐6) and nuclear recombination activating gene 2 (RAG2) gene sequences were used for Bayesian inference and maximum parsimony analyses. Molecular models were selected using MrModeltest.

Results

Molecular analyses indicated four haplogroups (Northeastern, Eastern A, Eastern B and Southeastern) for ATPase‐6 and three clades for RAG2. All topologies were congruent with Hoplias malabaricus diploid numbers, with most regions of proposed endemism and coastal geomorphological units.

Main conclusions

Deep genetic divergence between the Northeastern and the other haplogroups was interpreted as evidence of the vicariant effect of the Abrolhos Formation, which effectively isolates 2n = 40 and 2n = 42 coastal populations. To the south, the Cabo Frio Magmatic Lineament also isolates the Eastern and Southeastern 2n = 42 populations. In the Northeastern haplogroup, stream piracy was probably involved in chronologically varied dispersal events between coastal and continental basins. All haplogroups also included haplotypes that dispersed in recent times. Results show an older vicariant pattern and recent dispersal events congruent with the occurrence of temporary connections along the coast caused by eustatic sea level variations and the occurrence of stream piracy involving either continental or coastal basins, and suggest these processes contributed to the current distribution patterns of Brazilian coastal freshwater fish.
Excessive gingival display: treatment by a modified lip repositioning technique
Authors: Silva Cléverson O. , Ribeiro‐Júnior Noé V. , Campos Thiago V. S. , Rodrigues Jefferson G. , Tatakis Dimitris N.
Published: November 2012

Aim

The objective of this prospective study was to investigate outcomes of a lip repositioning technique for the treatment of excessive gingival display.

Materials and Methods

Thirteen consecutively treated patients with excessive gingival display were treated with a modified lip repositioning technique. Treatment consisted of the removal of two strips of mucosa, bilaterally to the maxillary labial frenum and coronal repositioning of the new mucosal margin. The clinical dimensions of gingival display, upper lip and vermillion length were measured at baseline, 3 and 6 months post‐operatively. Subjects completed surveys to evaluate satisfaction with outcomes.

Results

The baseline gingival display of 5.8 ± 2.1 mm significantly decreased to 1.4 ± 1.0 mm at 3 months (p < 0.0001) and was maintained until 6 months (1.3 ± 1.6 mm). The reduction in gingival display strongly correlated to the combined change in upper lip and vermillion length (r2 = 0.60, p = 0.0018). Subjects were satisfied with their smile after surgery and would likely choose to undergo the procedure again (92%). The worst part of undergoing the procedure was the discomfort or the inability to move the lip during the early healing (69%).

Conclusion

Treatment of excessive gingival display by means of a modified lip repositioning technique results in high level of patient satisfaction and predictable outcomes that are stable in the short term.
Efficacy of language intervention in the early years
Authors: Fricke Silke , Bowyer‐Crane Claudine , Haley Allyson J. , Hulme Charles , Snowling Margaret J.
Published: November 2012

Background:  Oral language skills in the preschool and early school years are critical to educational success and provide the foundations for the later development of reading comprehension.

Methods:  In a randomized controlled trial, 180 children from 15 UK nursery schools (n = 12 from each setting; Mage = 4;0) were randomly allocated to receive a 30‐week oral language intervention or to a waiting control group. Children in the intervention group received 30 weeks of oral language intervention, beginning in nursery (preschool), in three group sessions per week, continuing with daily sessions on transition to Reception class (pre‐Year 1). The intervention was delivered by nursery staff and teaching assistants trained and supported by the research team. Following screening, children were assessed preintervention, following completion of the intervention and after a 6‐month delay.

Results:  Children in the intervention group showed significantly better performance on measures of oral language and spoken narrative skills than children in the waiting control group immediately after the 30 week intervention and after a 6 month delay. Gains in word‐level literacy skills were weaker, though clear improvements were observed on measures of phonological awareness. Importantly, improvements in oral language skills generalized to a standardized measure of reading comprehension at maintenance test.

Conclusions:  Early intervention for children with oral language difficulties is effective and can successfully support the skills, which underpin reading comprehension.
Children born through reproductive donation: a longitudinal study of psychological adjustment
Authors: Golombok Susan , Blake Lucy , Casey Polly , Roman Gabriela , Jadva Vasanti
Published: November 2012

Background:  Parenting and children’s adjustment were examined in 30 surrogacy families, 31 egg donation families, 35 donor insemination families, and 53 natural conception families.

Methods: Parenting was assessed at age 3 by a standardized interview designed to assess quality of parenting and by questionnaire measures of anxiety, depression, and marital quality. Children’s adjustment was assessed at ages 3, 7, and 10 using the Strengths and Difficulties Questionnaire (SDQ).

Results:  Although children born through reproductive donation obtained SDQ scores within the normal range, surrogacy children showed higher levels of adjustment difficulties at age 7 than children conceived by gamete donation. Mothers who had kept their child’s origins secret showed elevated levels of distress. However, maternal distress had a more negative impact on children who were aware of their origins.

Conclusions:  The absence of a gestational connection to the mother may be more problematic for children than the absence of a genetic link.
Efficacy and safety evaluation of an innovative CO2 laser/radiofrequency device in dermatology
Authors: Campolmi P. , Bonan P. , Cannarozzo G. , Bruscino N. , Moretti S.
Published: November 2012

Background  CO2 laser has not only become the most widely used laser in dermatological surgical practice, but it has also proved to be highly effective in treating aesthetic imperfections.

Objective  To examine the efficacy and safety of a novel fractional CO2 laser combined with a radiofrequency device in different dermatological, surgical and aesthetic fields.

Methods  A total of 79 patients were treated in our Outpatient Service with a novel fractional CO2 laser combined with a bipolar radiofrequency device for a maximum of 5 months. Group A consisted of 39 patients with lesions requiring complete excision, whereas Group B consisted of 40 subjects seeking to enhance aesthetic facial imperfections. The results were assessed by three ‘blind’ investigators using photographs and clinical observations; in addition, the patients had to give their own subjective assessment of the results.

Results  At the 6‐month follow‐up, the lesions of the Group A patients had been completely removed, except for one case of a large sebaceous nevus on the scalp. All the Group B patients showed global improvement in skin tightening, removal of fine lines and rhytides and correction of dilated pores and hyperpigmentation, with no significant side‐effects and short downtimes.

Conclusion  This kind of laser meets the needs of the majority of dermatologists requiring a unique, versatile tool to remove cutaneous lesions and at the same time, safely and effectively treat skin imperfections.
Faithful females receive more help: the extent of male parental care during incubation in relation to extra‐pair paternity in songbirds
Authors: Matysioková B. , Remeš V.
Published: November 2012

Parental care provided by males occurs in a diverse array of animals and there are large differences among species in its extent compared with female care. However, social and ecological factors responsible for interspecific differences in male's share of parental duties remain unclear. Genetic fidelity of females has been long considered important. Theory predicts that females should receive more help from their mates in raising the offspring in species with high genetic fidelity. Using avian incubation behaviour as a model system, we confirmed this prediction. The extent of male's help during incubation increased with decreasing rate of extra‐pair paternity across species (22 species of socially monogamous songbirds from 13 families; male's share of incubation ranged from 6% to 58%), even after accounting for covariates, biases in species selection and intraspecific variability. Moreover, this result was not sensitive to two different phylogenies and branch length estimates. We suggest that our findings support the notion, backed by theory, that genetic fidelity is an important factor in the evolution of male parental care. We offer several behavioural scenarios for the coevolution between male's share of parental duties and the genetic mating system.
Phenotypic landscapes: phenological patterns in wild and cultivated barley
Authors: Hübner S. , Bdolach E. , Ein‐Gedy S. , Schmid K. J. , Korol A. , Fridman E.
Published: November 2012

Phenotypic variation in natural populations is the outcome of the joint effects of environmentally induced adaptations and neutral processes on the genetic architecture of quantitative traits. In this study, we examined the role of adaptation in shaping wild barley phenotypic variation along different environmental gradients. Detailed phenotyping of 164 wild barley (Hordeum spontaneum) accessions from Israel (of the Barley1K collection) and 18 cultivated barley (H. vulgare) varieties was conducted in common garden field trials. Cluster analysis based on phenotypic data indicated that wild barley in this region can be differentiated into three ecotypes in accordance with their ecogeographical distribution: north, coast and desert. Population differentiation (QST) for each trait was estimated using a hierarchical Bayesian model and compared to neutral differentiation (FST) based on 42 microsatellite markers. This analysis indicated that the three clusters diverged in morphological but not in reproductive characteristics. To address the issue of phenotypic variation along environmental gradients, climatic and soil gradients were compared with each of the measured traits given the geographical distance between sampling sites using a partial Mantel test. Flowering time and plant growth were found to be differentially correlated with climatic and soil characteristic gradients, respectively. The H. vulgare varieties were superior to the H. spontaneum accessions in yield components, yet resembled the Mediterranean types in vegetative characteristics and flowering time, which may indicate the geographical origin of domesticated barley.
Presepsis Depressive Symptoms Are Associated with Incident Cognitive Impairment in Survivors of Severe Sepsis: A Prospective Cohort Study of Older Americans
Authors: Davydow Dimitry S. , Hough Catherine L. , Langa Kenneth M. , Iwashyna Theodore J.
Published: November 2012

Objectives

To test the hypothesis that presepsis depressive symptoms are associated with risk of new cognitive impairment in survivors of severe sepsis.

Design

Prospective longitudinal cohort study.

Setting

Population‐based cohort of older U.S. adults interviewed as part of the Health and Retirement Study (1998–2006).

Participants

Four hundred forty‐seven individuals with normal presepsis cognition who survived 540 hospitalizations for severe sepsis and completed at least one follow‐up interview.

Measurements

Severe sepsis was identified using a validated algorithm in Medicare claims. Depressive symptoms were assessed prospectively using a modified version of the Center for Epidemiologic Studies Depression Scale. Cognitive function was assessed using versions of the Telephone Interview for Cognitive Status (TICS). Logistic regression with robust standard errors was used to examine associations between substantial depressive symptoms at any interview before sepsis and incident cognitive impairment (mild or moderate to severe cognitive impairment) at any interview after sepsis.

Results

The prevalence of substantial depressive symptoms in participants with normal cognition before sepsis was 38% (95% confidence interval (CI) = 34–42%). After severe sepsis, 18% (95% CI = 15–20%) of survivors had incident cognitive impairment. In unadjusted analyses, presepsis substantial depressive symptoms were associated with postsepsis incident cognitive impairment (odds ratio (OR) = 2.56, 95% CI = 1.53–4.27). After adjustment for demographics, health‐risk behaviors, clinical characteristics of the sepsis episode, and presepsis TICS scores, substantial presepsis depressive symptoms remained the strongest factor associated with postsepsis incident cognitive impairment (OR = 2.58, 95% CI = 1.45–4.59).

Conclusion

Substantial presepsis depressive symptoms are independently associated with incident postsepsis cognitive impairment. Depressed older adults may be particularly at risk of developing cognitive impairment after a serious medical illness.
Depressive Symptoms After Hospitalization in Older Adults: Function and Mortality Outcomes
Authors: Pierluissi Edgar , Mehta Kala M. , Kirby Katharine A. , Boscardin W. John , Fortinsky Richard H. , Palmer Robert M. , Landefeld C. Seth
Published: November 2012

Objectives

To determine the relationship between depressive symptoms after hospitalization and survival and functional outcomes.

Design

Secondary analysis of a prospective cohort study.

Setting

General medical service of two urban, teaching hospitals in Ohio.

Participants

Hospitalized individuals aged 70 and older.

Measurements

Ten depressive symptoms, instrumental activities of daily living (IADLs), and basic activities of daily living (ADLs) were measured at hospital discharge and 1, 3, 6, and 12 months later. Participant‐specific changes in depressive symptoms (slopes) were determined using all data points. Four groups were also defined according to number of depressive symptoms (≤3 symptoms, low; 4–10 symptoms, high) at discharge and follow‐up: low–low, low–high, high–low, and high–high. Mortality was measured 3, 6, and 12 months after hospital discharge.

Results

Participant‐specific discharge depressive symptoms and change in depressive symptoms over time (slopes) were associated (P < .05) with functional and mortality outcomes. At 1 year, more participants in the low–low depressive symptom group (49%) were alive and independent in IADLs and ADLs than in the low–high group (37%, P = .02), and more participants in the high–low group (39%) were alive and independent in IADLs and ADLs than in the high–high group (19%, P < .001).

Conclusion

Number of depressive symptoms and change in number of depressive symptoms during the year after discharge were associated with functional and mortality outcomes in hospitalized older adults. Fewer participants with persistently high or increasing depressive symptoms after hospitalization were alive and functionally independent 1 year later than participants with decreasing or persistently low symptoms, respectively.
Effectiveness of Acute Geriatric Unit Care Using Acute Care for Elders Components: A Systematic Review and Meta‐Analysis
Authors: Fox Mary T. , Persaud Malini , Maimets Ilo , O'Brien Kelly , Brooks Dina , Tregunno Deborah , Schraa Ellen
Published: November 2012

Objectives

To compare the effectiveness of acute geriatric unit care, based on all or part of the Acute Care for Elders (ACE) model and introduced in the acute phase of illness or injury, with that of usual care.

Design

Systematic review and meta‐analysis of 13 randomized controlled and quasi‐experimental trials with parallel comparison groups retrieved from multiple sources.

Setting

Acute care geriatric and nongeriatric hospital units.

Participants

Acutely ill or injured adults (N = 6,839) with an average age of 81.

Interventions

Acute geriatric unit care characterized by one or more ACE components: patient‐centered care, frequent medical review, early rehabilitation, early discharge planning, prepared environment.

Measurements

Falls, pressure ulcers, delirium, functional decline at discharge from baseline 2‐week prehospital and hospital admission statuses, length of hospital stay, discharge destination (home or nursing home), mortality, costs, and hospital readmissions.

Results

Acute geriatric unit care was associated with fewer falls (risk ratio (RR) = 0.51, 95% confidence interval (CI) = 0.29–0.88), less delirium (RR = 0.73, 95% CI = 0.61–0.88), less functional decline at discharge from baseline 2‐week prehospital admission status (RR = 0.87, 95% CI = 0.78–0.97), shorter length of hospital stay (weighted mean difference (WMD) = −0.61, 95% CI = −1.16 to −0.05), fewer discharges to a nursing home (RR = 0.82, 95% CI = 0.68–0.99), lower costs (WMD = −$245.80, 95% CI = −$446.23 to −$45.38), and more discharges to home (RR = 1.05, 95% CI = 1.01–1.10). A nonsignificant trend toward fewer pressure ulcers was observed. No differences were found in functional decline between baseline hospital admission status and discharge, mortality, or hospital readmissions.

Conclusion

Acute geriatric unit care, based on all or part of the ACE model and introduced during the acute phase of older adults' illness or injury, improves patient‐ and system‐level outcomes.
Resistance and Balance Training Improves Functional Capacity in Very Old Participants Attending Cardiac Rehabilitation After Coronary Bypass Surgery
Authors: Busch John C. , Lillou Dorothea , Wittig Godehard , Bartsch Petra , Willemsen Detlev , Oldridge Neil , Bjarnason‐Wehrens Birna
Published: November 2012

Objectives

To compare the efficacy of intensive functional exercise training with that of usual cardiac rehabilitation (CR) in very old adults soon after coronary bypass surgery (CABG).

Design

Randomized controlled trial.

Setting

In‐hospital CR.

Participants

Individuals aged 75 and older (n = 173, mean 78.5 ± 3.2) participated in inpatient CR, which started soon after surgery (13.1 ± 5.3 days) and lasted for a mean of 20.4 ± 3.2 days.

Intervention

Participants were randomly assigned to an inpatient CR intervention group (IG; n = 84) or a control group (CG; n = 89). All participants participated in the inpatient CR program. In addition, IG participants participated in resistance training and special balance training (5 d/wk).

Measurements

Six‐minute walk test, cardiopulmonary exercise testing, Timed‐Up‐and‐Go Test (TUG), and a maximal isometric strength test were used to access functional capacity and the MacNew questionnaire to evaluate health‐related quality of life (HRQL).

Results

There were significant improvements (P < .001) in all measured variables over the duration of CR. Improvements in functional capacity were significantly greater in the IG than the CG for 6‐minute walk distance (6‐MWD) (IG Δ 67.3 ± 49.0 m vs CG Δ 41.9 ± 51.7 m; P = .003), TUG time (IG Δ −2.4 ± 2.2 seconds vs CG Δ −1.2 ± 3.4 seconds; P = .005), and relative workload (IG Δ 0.19 ± 0.21 W/kg vs CG Δ 0.13 ± 0.11 W/kg; P = .03).

Conclusion

There were significant improvements in all measured variables in very old adults participating in CR soon after CABG. With additional functional exercise training, participants randomized to IG improved significantly more than those randomized to CG on 6‐MWD, TUG time, and relative workload.
Aspirin Use After Diagnosis Improves Survival in Older Adults with Colon Cancer: A Retrospective Cohort Study
Authors: Reimers Marlies S. , Bastiaannet Esther , van Herk‐Sukel Myrthe P. P. , Lemmens Valery E. P. , van den Broek Colette B. M. , van de Velde Cornelis J. H. , de Craen Anton J. M. , Liefers Gerrit Jan
Published: November 2012

Objectives

To assess survival in relation to aspirin use after diagnosis in older adults with colon cancer.

Design

Subgroup analysis of a previously published cohort and retrospective study.

Setting

Individuals registered in the Eindhoven Cancer Registry (ECR) between 1998 and 2007, linked to prescriptions of low‐dose aspirin (80 mg) registered in a community pharmacy database.

Participants

Five hundred thirty‐six individuals aged 70 and older diagnosed with colon cancer with or without aspirin use after diagnosis.

Measurements

Survival was analyzed with user status as a time‐dependent covariate. Multivariate Poisson regression survival models were used to study the effect of aspirin on overall survival.

Results

One hundred seven participants (20.0%) started aspirin after being diagnosed with colon cancer; 429 (80.0%) were not prescribed aspirin. Three hundred thirty‐nine participants (63.2%) had died by the end of follow‐up. Aspirin use after diagnosis was associated with longer overall survival (rate ratio (RR) = 0.51, 95% confidence interval (CI) = 0.38–0.70, P < .001). Multivariate proportional hazards regression analysis revealed that aspirin use was associated with longer overall survival (adjusted RR = 0.59, 95% CI = 0.44–0.81, P = .001).

Conclusion

Aspirin use after the diagnosis of colon cancer in older adults was associated with longer survival. Low‐dose aspirin could be used as an effective adjuvant therapy in older adults with colon cancer.
Global, 3‐dimensional approach to natural rejuvenation: part 1 – recommendations for volume restoration and the periocular area
Authors: Raspaldo Hervé , Gassia Véronique , Niforos François‐Rene , Michaud Thierry
Published: November 2012

Background

New techniques and products have lead to a global approach for the treatment of signs of aging. However, there is little published literature on the procedures involved in this approach and currently no validated recommendations exist.

Objectives

To provide a detailed, practical guide to midfacial volume restoration and rejuvenation of the periocular area based on expert consensus recommendations.

Methods

The expert committee took into account both volumetric and dynamic aspects of treatment, as well as benefits of treatment combinations, for example, combining OnabotulinumtoxinA with hyaluronic acid (HA) fillers and volumizers. An aging severity scale was established for each area, together with recommendations of appropriate products, doses, site, depth, and injection techniques, as well as rules to be respected.

Results

The expert group concluded that volume restoration of the midface is the first essential step in the global approach because treatment for this area has the most significant positive impact. Firstly, it is important to restore the malar contour, as malar volume anchors the structure of the midface. Secondly, an assessment of the effects of malar enhancement on the appearance of the nasolabial folds and the nasojugal fold (tear trough) should be conducted because these aging signs may be decreased by malar enhancement. Finally, treatment for the nasolabial folds and periorbital area with HA should be performed when needed.

Conclusions

Practical guidance is provided for midfacial volume restoration and rejuvenation of the periocular area based on validated expert consensus recommendations. This will help esthetic facial physicians to achieve optimum outcomes.
Stability, transdermal penetration, and cutaneous effects of ascorbic acid and its derivatives
Authors: Stamford Nicholas P J
Published: November 2012

Topically applied antioxidants exert their benefits by offering protection from damaging free radicals and over‐the‐counter cosmeceuticals incorporating antioxidants are among the most popular anti‐aging products available. One potent antioxidant of particular note, vitamin C, has been extensively utilized because it possesses a variety of other cutaneous benefits including photoprotection from UV A & B, neocollagenesis, inhibition of melanogenesis and improvement of a variety of inflammatory skin disorders. However, the instability of this water‐soluble vitamin, together with difficulties associated with its topical delivery, has presented issues for the formulation chemist. This article reviews the scientific data and clinical studies that underpin the stability, percutaneous absorption, and cutaneous effects of vitamin C together with its commonly utilized, commercially available derivatives.
Use of a neuromuscular electrical stimulation device for facial muscle toning: a randomized, controlled trial
Authors: Kavanagh Suzane , Newell John , Hennessy Michael , Sadick Neil
Published: November 2012

Background

Age‐related loss of muscle mass contributes to aging of the human face.

Aims

To evaluate the effects of a neuromuscular electrical stimulation (NMES) device on facial muscle tone and signs of facial aging in healthy women.

Patients/Methods

One hundred and eight healthy women (mean age 43.7, range 32 to 58–45 years) participated in this randomized, controlled, partially blinded study. Participants were randomized to 12 weeks' treatment with theNMESfacial device (20 min/day, 5 days/week) or to a nonintervention control group. Participants could not alter fitness, diet or facial care routines during the study. Assessments included psychometric evaluations of facial appearance and assessor‐blinded ultrasound measurements of the thickness of the zygomatic major muscle.

Results

Mean muscle thickness increasedvs. baseline in theNMESgroup (18.6%) but not the control group. Between‐group differences were significant at 6 and 12 weeks (P = 0.05 andP = 0.0001).NMESusers reported subjective improvements in facial attributes. The control group did not. In an overall evaluation, ≥80% ofNMESusers reported improved firmness, tone and liftvs. <5% of the control group (P < 0.001).

Conclusions

A 12‐week course of facialNMESwas associated with increased thickness of the zygomatic major muscle and subjective improvements in facial attributes.