bluuebunny/crossref_metadata_2025 huggingface dataset:
United Kingdom Myeloma Forum (UKMF) position statement on the use of bendamustine in myeloma
Authors: Pratt G. , Bowcock S. , Lai M. , Bell S. , Bird J. , D'Sa S. , Cavenagh J. , Cook G. , Morgan G. , Owen R. , Snowden J.A. , Yong K. , Davies F.
Published: April 2013

Bendamustine is a unique bifunctional alkylating agent with promising activity in myeloma. Despite the increasing number of studies demonstrating its efficacy in both the upfront and relapse settings, including patients with renal insufficiency, the optimal use of bendamustine, in terms of dosage, schedule and combination with other agents, has yet to be defined. It is currently licensed for use as frontline treatment with prednisolone for patients with myeloma who are unsuitable for transplantation and who are contraindicated for thalidomide and bortezomib. Studies in relapsed/refractory patients are currently ongoing with other combinations. Given the increasing data to date, the UK Myeloma Forum believes that bendamustine with steroids alone or in combination with a novel agent could be considered for patients with multiply relapsed myeloma. This document provides guidance for the use of bendamustine for patients with myeloma until the results of definitive studies are available.
Understanding e‐Government portal use in rural India: role of demographic and personality characteristics
Authors: Venkatesh Viswanath , Sykes Tracy Ann , Venkatraman Srinivasan
Published: April 2013

Electronic government (e‐Government) is one of the most important ways to bridge the digital divide in developing countries. We develop a model of e‐Government portal use. We use various individual characteristics, namely demographics and personality, as predictors of e‐Government portal use. Specifically, our predictors were (1) gender, age, income and education; (2) the Big Five personality characteristics, i.e. extraversion, neuroticism, conscientiousness, agreeableness and openness to experience; and (3) personal innovativeness with information technology. We conducted a field study in a village in India. We collected data from over 300 heads of household. We found support for our model, with most variables being significant and explaining 40% of the variance in e‐Government portal use.
The senses as direct theoreticians in practice
Authors: Dawkins Ashley , Loftus Alex
Published: April 2013

The senses are relationally produced through, in part, the everyday activities of making urban space. This reciprocal relationship suggests new ways of exploring the conditions of possibility for an urban politics. In seeking to chart such possibilities, we turn to the twofold understanding of aesthetics found within Marx’s critique of political economy, using this as a lens through which to learn from the practices of insurgent artists and anarchitects as they perform ‘relational urban interventions’ in the cities of London and New York. Just as Marx railed against the anaesthetising tendencies of capitalist society, and saw within communism the possibilities for the liberation of the senses and the freeing of creative activity, so relational urban interventions develop a twofold aesthetic model. Nevertheless, recent scholarly attempts to consider the political life of sensation and to theorise the relationship between space and politics have been filtered through a post‐Althusserian lens that is less attentive to emergent possibilities within critical spatial practice. Taking a different tack, we call for a philosophy of praxis that builds on an understanding of relational sensuousness and a Marxist aesthetics in order to prise open the conditions of possibility for an urban politics.
Pain and Associated Substance Use among Opioid Dependent Individuals Seeking Office‐Based Treatment with Buprenorphine–Naloxone: A Needs Assessment Study
Authors: Barry Declan T. , Savant Jonathan D. , Beitel Mark , Cutter Christopher J. , Moore Brent A. , Schottenfeld Richard S. , Fiellin David A.
Published: April 2013

Background and Objectives

A paucity of studies has examined the pain experiences of opioid dependent individuals seeking office‐based buprenorphine‐naloxone treatment (BNT). We set out to examine, among those seeking BNT: (a) the prevalence of pain types (i.e., recent pain, chronic pain), (b) the characteristics of pain (intensity, frequency, duration, interference, location, and genesis), and (c) substance use to alleviate pain.

Method

We surveyed 244 consecutive individuals seeking office‐based BNT for opioid dependence about physical pain and associated substance use.

Results

Thirty‐six percent of respondents reported chronic pain (CP) (i.e., pain lasting at least 3 months) and 36% reported “some pain” (SP) (i.e., past week pain not meeting the threshold for CP). In comparison to SP respondents, those with CP were, on average, older; reported greater current pain intensity, pain frequency, typical pain duration, typical pain intensity, and typical pain interference; were more likely to report shoulder or pelvis and less likely to report stomach or arms as their most bothersome pain location; and were more likely to report accident or nerve damage and less likely to report opioid withdrawal as the genesis of their pain. Both pain subgroups reported similarly high rates of past‐week substance use to alleviate pain.

Conclusions and Scientific Significance

The high rates of pain and self‐reported substance use to manage pain suggest the importance of assessing and addressing pain in BNT patients. (Am J Addict 2013; 22:212–217)
Association between Craving and Attention Deficit/Hyperactivity Disorder Symptoms among Patients with Alcohol Use Disorders
Authors: Seitz Andrea , Wapp Manuela , Burren Yuliya , Stutz Sonja , Schläfli Katrin , Moggi Franz
Published: April 2013

Background/Aim

Adult Alcohol Use Disorders (AUD) patients with Attention Deficit/Hyperactivity Disorder (ADHD) symptoms may suffer more from craving than patients who only have AUD. However, craving may be even more strongly related to withdrawal and psychiatric symptoms; therefore, the association between craving and ADHD may be misinterpreted. The purpose of this study is to examine the association between craving and ADHD symptoms among AUD patients in more detail.

Methods

In a multisite study, 385 patients with and without ADHD symptoms who were attending treatment for alcohol dependence were compared in terms of craving, withdrawal, and psychiatric symptoms. The contribution of ADHD symptoms to craving was estimated in a hierarchical regression analysis by controlling for psychiatric and withdrawal symptoms.

Results

Patients with probable adult ADHD showed higher craving, more withdrawal and psychiatric symptoms, and rated withdrawal symptoms as more severe than did patients without ADHD symptoms. In the regression model, only about 3% of variance in alcohol craving was explained by ADHD symptomatology, whereas 23% of the variance was explained when withdrawal and psychiatric symptoms were added to the model.

Conclusions

Alcohol craving is likely related to withdrawal and psychiatric symptoms more strongly than to ADHD symptoms. (Am J Addict 2013; 22:292–296)
Characteristics of Outpatients in an Addictions Clinic for Co‐occurring Disorders
Authors: Malat Jan , Turner Nigel E.
Published: April 2013

Background and Objectives

To examine characteristics of treatment‐seeking outpatients from a clinic for co‐occurring disorders within an urban psychiatric hospital.

Methods

Patients (n = 131) completed six self‐report scales including the Brief Symptom Inventory and Toronto Alexithymia Scale.

Results

The most common substance use disorders were: alcohol (62%), tobacco (50%), cannabis (22%), cocaine/stimulants (18%). The most common psychiatric disorders were: mood (65%), psychotic (24%) and anxiety disorders (24%). Many of the scales correlated with the global psychiatric severity score. Patients with mood disorders had superior interpersonal functioning global scores and reported reduced drug use and reduced advice seeking. Patients with psychotic disorders had higher global psychiatric severity scores and reported higher advice seeking.

Conclusions and Scientific Significance

This preliminary study indicates that among a heterogeneous sample of patients with co‐occurring disorders the more symptomatic patients may present with a wider range of impairments along with some specific differences based on psychiatric diagnosis. (Am J Addict 2013; 22:297–301)
An Observation of Lower Rates of Drug Use over Time in Community Syringe Exchangers
Authors: Kidorf Michael , King Van L. , Peirce Jessica , Kolodner Ken , Brooner Robert K.
Published: April 2013

Background and Objectives

The present study evaluated changes in rates of self‐reported heroin and cocaine use in opioid‐dependent individuals newly registered to a syringe exchange program (SEP), and examined the effects of recovery‐oriented longitudinal variables (i.e., substance abuse treatment, self‐help group participation, employment) on changes in drug use.

Methods

Study participants (n = 240) were opioid‐dependent and drawn from a larger study evaluating strategies to improve treatment‐seeking. Mixed model analyses were used to evaluate changes in rates of heroin and cocaine use, and longitudinal correlates of change in these substances, over a one‐year period.

Results

Results showed reductions in days of heroin and cocaine use over time, and that participation in recovery‐oriented activities was strongly associated with greater changes in drug use.

Conclusions and Scientific Significance

These results suggest SEPs can play a vital role in facilitating reductions in drug use through motivating participation in treatment and other recovery‐oriented activities. (Am J Addict 2013; 22:271–276)
Buprenorphine + Naloxone in the Treatment of Opioid Dependence during Pregnancy—Initial Patient Care and Outcome Data
Authors: Debelak Kimber , Morrone William R. , O'Grady Kevin E. , Jones Hendrée E.
Published: April 2013

Background and Objectives

Research has indicated that the buprenorphine‐mono product yields maternal outcomes similar to methadone and a less severe neonatal abstinence syndrome. However, maternal and neonatal outcomes following buprenorphine + naloxone exposure during pregnancy have not been documented.

Methods

Retrospective chart review identified 10 opioid‐dependent pregnant women treated with the buprenorphine + naloxone film product between January, 2010‐June, 2011. Seven maternal outcome measures – weight gain, fetal presentation at delivery, Cesarean delivery, analgesia during delivery, urine drug screening results at delivery, number of days of maternal hospital stay, and began breastfeeding following delivery—and eleven neonatal outcome measures—gestational age at delivery, 1‐ and 5‐minute Apgar scores, head circumference, length, and weight at birth, treated for neonatal abstinence syndrome (NAS), total amount of morphine sulfate needed to treat NAS, length of hospital stay for NAS treatment, and length of hospital stay—were extracted from medical records.

Results

Maternal findings were unremarkable, and comparable with what might be found following treatment with the buprenorphine‐mono product. Neonates were full‐term with normal birth parameters. Four neonates were treated for NAS, and number of days treated for NAS and number of hospital days were in line with values reported for the buprenorphine‐mono product.

Conclusions

Findings suggest no obvious significant adverse maternal or neonatal outcomes related to the use of buprenorphine + naloxone for the treatment of opioid dependence during pregnancy.

Scientific Significance

These initial findings underscore the need for future research to systematically examine the relative safety and effectiveness of buprenorphine + naloxone for mother, fetus, and child. (Am J Addict 2013; 22:252–254)
The Role of Drinking Severity on Sex Risk Behavior and HIV Exposure among Illicit Drug Users
Authors: Scherer Michael , Trenz Rebecca , Harrell Paul , Mauro Pia , Latimer William
Published: April 2013

Objectives

The current study examined how drinking severity among injection and non‐injection drug users is associated with sex risk behaviors and risk of HIV exposure.

Method

The study is a secondary analysis of an investigation of risk factors among drug users in Baltimore known as the NEURO‐HIV epidemiologic study. Participants (N = 557) completed an interview, self‐reported 30‐day alcohol use, lifetime injection and non‐injection drug use, and provided blood samples to screen for HIV. Participants were grouped into one of three drinking severity conditions: abstinent (no reported alcohol use in prior 30 days), moderate alcohol use (≤30 drinks for females, or ≤60 drinks for males), or problematic alcohol use (>30 drinks for females, or >60 drinks for males). Drinking severity groups were significantly different on lifetime injection drug use, heroin injection, snorting/sniffing cocaine, and smoking crack.

Results

Logistic regression analyses found problematic alcohol users to be more likely than alcohol abstainers to inject drugs before or during sex (AOR = 5.78; 95% CI = 2.07–16.10), and more likely than moderate alcohol users to use alcohol before/during sex (AOR = 4.96; 95% CI = 2.09–11.81), inject drugs before/during sex (AOR = 2.96; 95% CI = 1.29–6.80), and to be HIV+ among Black participants (AOR = 2.72; 95% CI = 1.14–6.49).

Conclusions

These results outline the necessity for research and clinical intervention among this population to reduce sex risk behaviors and potential HIV exposure, while highlighting the need to examine drinking severity as a predictor of sex risk behaviors. (Am J Addict 2013; 22:239–245)
Posttraumatic Stress Disorder and Cannabis Use Characteristics among Military Veterans with Cannabis Dependence
Authors: Boden Matthew Tyler , Babson Kimberly A. , Vujanovic Anka A. , Short Nicole A. , Bonn‐Miller Marcel O.
Published: April 2013

Background and Objectives

The present study is the first to explore links between PTSD and cannabis use characteristics immediately prior to a cannabis quit attempt, including motives, use problems, withdrawal, and craving.

Methods

Measures of PTSD diagnosis, symptom severity, and cannabis use characteristics were administered to a sample of cannabis dependent military veterans (n = 94). Hypotheses were tested with a series of analyses of variance and covariance and hierarchical multiple regressions with Bonferroni corrections. Analyses were conducted with and without adjusting for variance shared with substance use (cannabis, alcohol, tobacco) in the previous 90 days, and co‐occurring mood, anxiety, and substance use diagnoses.

Results and Conclusions

Compared to participants without PTSD, participants with PTSD reported significantly increased: (a) use of cannabis to cope, (b) severity of cannabis withdrawal, and (c) experiences of craving related to compulsivity, emotionality, and anticipation, with findings regarding coping and craving remaining significant after adjusting for covariates. Among the total sample, PTSD symptom severity was positively associated with (a) use of cannabis to cope, (b) cannabis use problems, (c) severity of cannabis withdrawal, and (d) experiences of craving related to compulsivity and emotionality, with findings regarding withdrawal and emotion‐related craving remaining significant after adjusting for covariates. Thus, links between PTSD and using cannabis to cope, severity of cannabis withdrawal, and especially craving appear robust across measures of PTSD and analytical method.

Scientific Significance

The results of this study provide support for models that posit a pernicious feedback loop between PTSD symptomatology and cannabis use. (Am J Addict 2013; 22:277–284)
Urban–Rural Differentials: A Spatial Analysis of Alabama Students' Recent Alcohol Use and Marijuana Use
Authors: Lo Celia C. , Weber Joe , Cheng Tyrone C.
Published: April 2013

Background and Objectives

This study of Alabama public school students sought urban‐rural differences in social and spatial mechanisms connecting structural factors to recent use of alcohol and marijuana.

Methods

Its dataset comprised a state‐sponsored 2002 need‐assessment survey of Alabama students; Alabama education department data; U. S. Census data; and alcohol‐outlet locations listed by Alabama's Alcoholic Beverage Control Board. It measured structural‐disadvantage factors (population disadvantages, community instability, alcohol‐outlet density), social‐organization factors (protective role of community, protective role of school), and recent‐use factors. Using Geographic Information Systems (GIS), it generated maps of school catchment areas (SCAs)—the units of analysis for the study—that outline spatial patterns (across areas deemedurbanorrural) of students' recent use of alcohol and marijuana.

Results

In the final sample of 370 SCAs, significant urban‐versus‐rural differences were observed for certain structural factors and in how these factors were associated with substance use. These differences aside, spatial analysis weighing the SCAs' particular geographic characteristics suggested location's importance, showing that a school playing a strong protective role significantly reduced not just its own students' recent substance use, but that of students in neighboring SCAs as well.

Conclusions and Scientific Significance

The findings show students' recent use of alcohol and marijuana are associated with characteristics of the environment. (Am J Addict 2013; 22:188–196)
Sexual Sensation Seeking, Co‐occurring Sex and Alcohol Use, and Sexual Risk Behavior among Adolescents in Treatment for Substance Use Problems
Authors: Oshri Assaf , Tubman Jonathan G. , Morgan‐Lopez Antonio A. , Saavedra Lissette M. , Csizmadia Annamaria
Published: April 2013

Objective

This study evaluated relations between sexual sensation seeking, co‐occurring sex and alcohol use, and sexual risk behaviors (eg, unprotected intercourse and multiple sex partners) among adolescents receiving treatment for substance abuse problems.

Method

The ethnically diverse sample included 394 adolescents recruited from outpatient treatment (280 males; Mage = 16.33 years, SDage = 1.15). Structural equation modeling (SEM) was used to test direct and indirect paths between sexual sensation seeking and sexual risk behaviors via the frequency of co‐occurring sex and alcohol use. Conditional indirect effects by gender were also tested.

Results

Analyses identified significant direct and indirect effects from sexual sensation seeking to sexual risk behaviors via co‐occurring sex and alcohol. The path from co‐occurring sex and alcohol use to unprotected intercourse was significantly stronger among adolescent girls, suggesting a mediation effect moderated by gender. The path from sexual sensation seeking to past year number of partners via co‐occurring sex and alcohol was stronger among adolescent boys. However, this gender path difference was not statistically significant.

Conclusions

Selected prevention efforts are needed to promote HIV risk reduction among adolescents in substance abuse treatment. The documented conditional indirect effect for unprotected intercourse suggests that HIV prevention programs should pay special attention to gender‐specific patterns of alcohol use and sexual risk behavior when tailoring program content. (Am J Addict 2013;XX:000–000)
Parasites as prey in aquatic food webs: implications for predator infection and parasite transmission
Authors: Thieltges David W. , Amundsen Per‐Arne , Hechinger Ryan F. , Johnson Pieter T. J. , Lafferty Kevin D. , Mouritsen Kim N. , Preston Daniel L. , Reise Karsten , Zander C. Dieter , Poulin Robert
Published: April 2013

While the recent inclusion of parasites into food‐web studies has highlighted the role of parasites as consumers, there is accumulating evidence that parasites can also serve as prey for predators. Here we investigated empirical patterns of predation on parasites and their relationships with parasite transmission in eight topological food webs representing marine and freshwater ecosystems. Within each food web, we examined links in the typical predator–prey sub web as well as the predator–parasite sub web, i.e. the quadrant of the food web indicating which predators eat parasites. Most predator– parasite links represented ‘concomitant predation’ (consumption and death of a parasite along with the prey/host; 58–72%), followed by ‘trophic transmission’ (predator feeds on infected prey and becomes infected; 8–32%) and predation on free‐living parasite life‐cycle stages (4–30%). Parasite life‐cycle stages had, on average, between 4.2 and 14.2 predators. Among the food webs, as predator richness increased, the number of links exploited by trophically transmitted parasites increased at about the same rate as did the number of links where these stages serve as prey. On the whole, our analyses suggest that predation on parasites has important consequences for both predators and parasites, and food web structure. Because our analysis is solely based on topological webs, determining the strength of these interactions is a promising avenue for future research.
Food‐web aggregation, methodological and functional issues
Authors: Gauzens Benoît , Legendre Stéphane , Lazzaro Xavier , Lacroix Gérard
Published: April 2013

Trophic species in food webs are often aggregated into fewer groups, using theoretical and empirical approaches, either for modelling tractability or because of the lack of data resolution. Heterogeneities in the resolution of food webs used in the literature have led to question their use to establish general topological rules. Despite an increasing number of studies relating topology to ecosystem functioning, we still have no idea on how species’ aggregation affects our perception of network functionalities. Therefore, we re‐examined the conclusions drawn from an experimental manipulation relating top‐predator foraging behaviour and biomass to food‐web topology (Lazzaro et al. 2009) by aggregating a 74‐species network according to different criteria (taxonomy, trophic similarity, size, expertise). We found that initial significant effects and functional properties were preserved over a large portion of the aggregation gradient (2/3) despite strong variations in the topological descriptor values along the gradient. Aggregation tended to produce more type II errors (false positive) than type I errors, advocating that most effects in aggregated networks are not methodological artefacts. Aggregation by taxonomy, trophic similarity and expertise better preserved functional properties (down to 38, 30 and 17 nodes, respectively) than aggregation by size (down to 40 nodes). Our results suggest that it is possible to relate the structure of aggregated networks to ecosystem properties provided that the methodological approaches are standardized and the level of lumping does not a exceed a reasonable threshold.
Pompeii, Tombs and Drinking Habits: Archaeology Counts
Authors: Baxter Mike
Published: April 2013

Pompeii and statistics? Iron age tombs and correspondence analysis? It comes as a surprise to many that there are any applications at all of statistics and mathematics in archaeology. But as Mike Baxter explains, counting what you find can give new insights into the past.
Invalid Inversion
Authors: Senn Stephen
Published: April 2013

Stephen Senn warns us that some things work backwards, but others do not.
Ion Microprobe Determination of Hydrogen Concentration and Isotopic ratio in Extraterrestrial Metallic Alloys
Authors: Defouilloy Céline , Duhamel Rémi , Robert François
Published: April 2013

The isotopic ratio of hydrogen was measured in an iron meteorite and terrestrial native iron using an IMS 3f ion microprobe. The extraterrestrial D/H ratio (93 ± 9 × 10−6) was close to the terrestrial value (105 ± 6 × 10−6), and both samples had low H concentrations (7 ± 4 and 33 ± 11 ng g−1 for the iron meteorite and the terrestrial sample, respectively). Experiments on artificially D‐enriched samples showed that the measured hydrogen signal is a combination of indigenous H and terrestrial atmospheric contamination. This contamination comes from the isotope exchange reaction between water adsorbed on the sample surface and atmospheric water, and would be continuously added to the indigenous H in the ion crater by the adsorbed water sinking into the crater during sputtering. Experiments showed that this contamination represents up to 20% of the signal but was within the uncertainty of the measured D/H ratio.
The metabolic inter‐relationships between changes in waist circumference, triglycerides, insulin sensitivity and small, dense low‐density lipoprotein particles with acute weight loss in clinically obese children and adolescents
Authors: Hobkirk J. P. , King R. F. , Davies I. , Harman N. , Gately P. , Pemberton P. , Smith A. , Barth J. H. , Carroll S.
Published: April 2013

What is already known about this subject

Small, dense LDL is highly atherogenic and the prevalence is higher in obesity.

Weight loss lowers the prevalence of small, dense LDL.

What this study adds

The important role of TG in lowering LDL peak particle density and the proportion of small, dense LDL particles.

Waist or insulin resistance were not predictive of these important changes in LDL characteristics.

Objective

Small, dense low‐density lipoprotein (LDL) particles are highly atherogenic and strongly associated with obesity‐related dyslipidemia. The metabolic inter‐relationships between weight loss induced changes in waist circumference, triglycerides, insulin sensitivity and small‐dense LDL particles in clinically obese children and adolescents have not been studied.

Methods

Seventy‐five clinically obese boys and girls (standardized body mass index 3.07 ± 0.59, aged 8–18 years) were recruited. Anthropometric, body composition and cardiometabolic risk factors were measured pre‐ and post‐weight loss.

Results

There were highly significant reductions in anthropometric, body composition and cardiometabolic risk factors. Triglyceride change was positively correlated with LDL peak particle density and percentage LDL pattern B changes (relative abundance of small, dense LDL particles). Multiple regression analyses showed that changes in triglyceride concentration accounted for between 24 and 18% of the variance in LDL peak particle density and percentage LDL pattern B change, respectively. Changes in waist circumference and insulin sensitivity did not predict these changes in LDL characteristics.

Conclusion

Acute and highly significant weight loss significantly decreased LDL peak particle density and percentage LDL pattern B. The change in triglycerides was a strong predictor of LDL peak particle density and percentage LDL pattern B change.
Enhanced and Long‐Lived Near‐Infrared Luminescence of Er3+ Ions in Lead Borate Glass‐Ceramics Containing PbWO4 Nanocrystals
Authors: Pisarski Wojciech A. , Pisarska Joanna , Czopek Izabela , Goryczka Tomasz , Lisiecki Radosław , Ryba‐Romanowski Witold
Published: April 2013

Lead tungstate PbWO4 nanocrystals in transparent lead borate glass‐ceramics containing Er3+ ions were fabricated. Luminescence spectra at about 1530 nm due to main 4I13/2–4I15/2 laser transition of Er3+ ions were examined for glass samples before and after heat treatment. Near‐infrared luminescence of Er3+ ions in glass‐ceramics is enhanced and long‐lived in comparison to precursor glasses. It suggests that the Er3+ ions are partially incorporated into PbWO4 crystalline phase.
Quadriceps Strength, Quadriceps Power, and Gait Speed in Older U.S. Adults with Diabetes Mellitus: Results from the National Health and Nutrition Examination Survey, 1999–2002
Authors: Kalyani Rita Rastogi , Tra Yolande , Yeh Hsin‐Chieh , Egan Josephine M. , Ferrucci Luigi , Brancati Frederick L.
Published: April 2013

Objectives

To examine the independent association between diabetes mellitus (and its duration and severity) and quadriceps strength, quadriceps power, and gait speed in a national population of older adults.

Design

Cross‐sectional nationally representative survey.

Setting

United States.

Participants

Two thousand five hundred seventy‐three adults aged 50 and older in the National Health and Nutrition Examination Survey 1999–2002 who had assessment of quadriceps strength.

Methods

Diabetes mellitus was ascertained according to questionnaire. Measurement of isokinetic knee extensor (quadriceps) strength was performed at 60º/s. Gait speed was assessed using a 20‐foot walk test. Multiple linear regression analyses were used to assess the association between diabetes mellitus status and outcomes, adjusting for potential confounders or mediators.

Results

Older U.S. adults with diabetes mellitus had significantly slower gait speed (0.96 ± 0.02 m/s) than those without (1.08 ± 0.01 m/s; P < .001). After adjusting for demographic characteristics, weight, and height, diabetes mellitus was also associated with significantly lower quadriceps strength (−4.6 ± 1.9 Nm; P = .02) and power (−4.9 ± 2.0 W; P = .02) and slower gait speed (−0.05 ± 0.02 m/s; P = .002). Associations remained significant after adjusting for physical activity and C‐reactive protein. After accounting for comorbidities (cardiovascular disease, peripheral neuropathy, amputation, cancer, arthritis, fracture, chronic obstructive pulmonary disease), diabetes mellitus was independently associated only with gait speed (−0.04 ± 0.02 m/s; P = .02). Diabetes mellitus duration in men and women was negatively associated with age‐adjusted quadriceps strength (−5.7 and −3.5 Nm/decade of diabetes mellitus, respectively) and power (−6.1 and −3.8 W/decade of diabetes mellitus, respectively) (all P ≤ .001, no significant interactions according to sex). Glycosylated hemoglobin was not associated with outcomes after accounting for body weight.

Conclusion

Older U.S. adults with diabetes mellitus have lower quadriceps strength and quadriceps power that is related to the presence of comorbidities and walk slower than those without diabetes mellitus. Future studies should investigate the relationship between hyperglycemia and subsequent declines in leg muscle function.
Depressive Symptomatology as a Risk Factor for Falls in Older People: Systematic Review and Meta‐Analysis
Authors: Kvelde Tasha , McVeigh Catherine , Toson Barbara , Greenaway Mark , Lord Stephen R. , Delbaere Kim , Close Jacqueline C.T.
Published: April 2013

Objectives

To conduct a systematic literature review and meta‐analysis to evaluate studies that have addressed depressive symptoms as a risk factor for falls in older people.

Design

Systematic review with meta‐analysis.

Setting

Community and residential care.

Participants

Individuals aged 60 and older.

Measurements

Depressive symptoms, incidence of falls.

Results

Twenty‐five prospective studies with a total of 21,455 participants met inclusion criteria for the systematic review. Twenty studies met criteria for the meta‐analyses. Recruitment of participants was conducted randomly or by approaching groups with identified healthcare needs. Eleven measures were used to assess depressive symptoms, and length of follow‐up for falls ranged from 90 days to 8 years. Reporting of antidepressant use was variable across studies. The pooled effect of 14 studies reporting odds ratios (ORs) indicated that a higher level of depressive symptoms at baseline resulted in a greater likelihood of falling during follow‐up (OR = 1.46, 95% confidence interval (CI) = 1.27–1.67, P < .001, I2 = 77.2%). In six studies reporting relative risks (RRs) or hazard ratios, a higher level of depressive symptoms at baseline resulted in a greater likelihood of falling during follow‐up (RR = 1.52, 95% CI = 1.19–1.84, P < .001). There was no difference between community samples and those with identified healthcare needs with respect to depressive symptoms being a risk factor for falls.

Conclusion

Depressive symptoms were found to be consistently associated with falls in older people, despite the use of different measures of depressive symptoms and falls and varying length of follow‐up and statistical methods. Clinicians should consider management of depression when implementing fall prevention initiatives, and further research on factors mediating depressive symptoms and fall risk in older people is needed.
Effect of Aging on Stimulated Salivary Flow in Adults
Authors: Smith Christina H. , Boland Briony , Daureeawoo Youshan , Donaldson Elaine , Small Kathryn , Tuomainen Jyrki
Published: April 2013

The literature on the effect of age on saliva production, which has implications for health, quality of life, differential diagnosis, and case management, remains inconclusive. Physiological changes, motor and sensory, are frequently reported with increasing age. It was hypothesized that there would be a change in saliva production with older age. Whole stimulated saliva was collected by asking participants to chew gauze for 1 minute and then comparing the weight of saliva produced according to age and sex. Data were collected in activity centers for older adults, workplaces, universities, and participants' homes. Five hundred forty healthy individuals (aged 20–97) in three age groups (young = 20–30; middle‐aged = 40–50; older ≥70) participated (90 men and 90 women in each group). A decrement in saliva production was identified for age in that the young and older participants and the middle‐aged and older participants differed significantly from each other, but no difference was found between the young and middle‐aged participants. The main effect of sex was not significant, nor was the interaction of age and sex. The results have implications for research and clinical work, including the differential diagnosis and subsequent management of salivary flow impairment due to age or underlying medical diagnosis or treatment. The assessment tool is easily administered and inexpensive and lends itself to use in many different clinical and research settings by different professionals.
Effects of Depression Diagnosis and Antidepressant Treatment on Mortality in Medicare Beneficiaries with Chronic Obstructive Pulmonary Disease
Authors: Qian Jingjing , Simoni‐Wastila Linda , Langenberg Patricia , Rattinger Gail B. , Zuckerman Ilene H. , Lehmann Susan , Terrin Michael
Published: April 2013

Objectives

To estimate the effects of depression diagnosis and antidepressant treatment on 2‐year all‐cause mortality in Medicare beneficiaries with chronic obstructive pulmonary disease (COPD) and determine whether Social Security Disability Insurance (SSDI) eligibility modifies these relationships.

Design

Retrospective cohort study.

Setting

A 5% random sample of Medicare beneficiaries aged 65 and older in stand‐alone Part D plans in 2006 to 2008.

Participants

Beneficiaries diagnosed with COPD and continuously enrolled in Medicare Parts A, B, and D (N = 75,699).

Measurements

Depression diagnosis was assessed at baseline (2006). Evidence of antidepressant treatment was measured across time. Covariates included baseline characteristics, comorbidities, and disease severity. Survival analyses using Cox proportional hazards models estimated 2‐year mortality associated with depression diagnosis or antidepressant treatment (in beneficiaries with depression). Interaction terms of SSDI eligibility with baseline depression and time‐dependent antidepressant treatment were tested.

Results

More than one‐fifth (21.6%) of beneficiaries with COPD had a depression diagnosis at baseline, and 82.1% of those received antidepressants. Nearly one‐sixth (16.3%) of the sample were SSDI eligible. Baseline depression heightened risk of death (hazard ratio = 1.13, 95% confidence interval = 1.09–1.18) in beneficiaries who were not eligible for SSDI. In beneficiaries with depression, the association between antidepressant treatment and lower mortality was different according to SSDI eligibility status.

Conclusion

Social Security Disability Insurance eligibility modifies the effects of depression and antidepressant treatment on mortality in Medicare beneficiaries with COPD. These data suggest that clinicians should identify and treat depression in individuals with COPD, but further studies are needed to determine the effect of these interventions.
Unregulated and unsafe: The impact of motorcycle trauma on Queensland children
Authors: Pym Aaron J , Wallis Belinda A , Franklin Richard C , Kimble Roy M
Published: April 2013

Aim

To describe paediatric (0–15 years) motorcycle incidents in Queensland, inform safety policy and identify opportunities to improve data in this area.

Method

Population‐based study of motorcycle‐related child (0–15 years) trauma, resulting in fatality or hospital admission beyond 24 h to any Queensland public hospital (2007–2009). Data compiled by Statewide Trauma Network and Commission for Children and Young People and Child Guardian.

Results

Ten child fatalities were recorded (child death rate = 0.36/100 000 population 0–15 years). All were male and primary riders of their motorcycle. Nine fatalities were related to head injury; of these, five wore inadequate head protection. The coroner identified rider factors as contributory (speed, age or substance abuse) in seven cases. Motorcycle‐related incidents were the second most common mechanism recorded after bicycles, comprising 6.8% of 9141 paediatric trauma cases (619 motorcycle‐related incidents; 1225 injuries; admission rate = 22.2/100 000 population 0–15 years). Compared with the all‐trauma population, patients were older (median age = 13 vs. 10 years) and more frequently male (85% vs. 67%). Average admission was 4.4 days (head injuries = 7.0 days; burns = 5.8 days). Most children incurred >1 injury (mean = 2.01 injuries) with fractures (45%) and open wounds (17%) most common. As a proportion of all diagnoses, most injuries were to lower limb (44%), upper limb (26%) or head and neck (16%).

Conclusions

These data emphasise the need for children to use full protective equipment, especially helmets. Children are not currently protected by legislation mandating safety standards. Regulating rider age and safety standards (protective equipment, training and vehicle maintenance) may reduce the rate and severity of injury.
Use of urinalysis as a screening tool for asymptomatic infants
Authors: Bereket Gamze , Bozdogan Gunseli , Saribeyoglu Ebru , Arapoglu Mujde , Serteser Mustafa , Celiker Alpay
Published: April 2013

Aim

The utility of screening urinalysis in asymptomatic children has been questioned based on studies done in school‐age children or adolescents. The American Academy of Pediatrics (AAP) recommended to abandon this screening in 2007 but many paediatricians perform it at some point during childhood. Thus, we aimed to investigate usefulness of screening urinalysis during infancy.

Methods

We retrospectively reviewed results of screening urinalysis done in infants at 6–18 months of age who had regular care since birth at our centre. Infants with an ICD‐10 (International Classification of Diseases, Tenth Revision) diagnostic code for routine child health exam (Z00.1) and a urinalysis requested with this code on the same date were included.

Results

A total of 683 infants met the inclusion criteria. 44 (6%) had an abnormal urinalysis. The most common abnormality (n = 39, 5,7%) was pyuria. Of these 39 babies, 5 had a repeat urinalysis only, 18 had a repeat urinalysis with urine culture, and 16 had a urine culture alone. Six patients had positive culture results and were given antibiotic treatment. All six babies who received treatment had normal ultrasound and two patients had a voiding cystourethrography, which were also normal. The other abnormalities (n = 5) detected were microscopic hematuria and proteinuria. Repeat urinalyses of these patients were normal.

Conclusion

Screening urinalysis results were abnormal in 6% of the babies, but in 86% of those, abnormalities were transient. Only <1% had positive culture results. These data add to the evidence that screening urinalysis during infancy is unjustified supporting the AAP 2007 recommendations.
Heterogeneity of internal tandem duplications in the c‐kit of dogs with multiple mast cell tumours
Authors: Amagai Y. , Tanaka A. , Matsuda A. , Jung K. , Oida K. , Nishikawa S. , Jang H. , Matsuda H.
Published: April 2013

Mast cell tumours are one of the most common neoplasms in dogs. Mutations in the proto‐oncogene c‐kit, especially internal tandem duplications of exon 11, are considered to play a crucial role in mast cell tumourigenesis. In this report, two cases that suffered from multiple mast cell tumours containing an internal tandem duplication in the primary lesion but not in the secondary lesions are described. This finding indicates the existence of heterogenous c‐kit gene mutations in each site of multiple mast cell tumours. Additionally, these results raise the possibility that the contribution of internal tandem duplications in the malignant transformation of mast cells is quite limited. It is proposed that, for clinicians, genetic analysis of several regions of multiple mast cell tumours is necessary for predicting prognosis and tumour response to KIT inhibitors.
Bilateral medial displacement of the biceps tendon of origin: repair using polypropylene mesh and staples
Authors: Barnes D. M.
Published: April 2013

A three‐year‐old male greyhound was presented with acute onset right forelimb lameness because of medial displacement of the biceps tendon of origin. Ultrasonographic examination confirmed the diagnosis, and a concomitant partial tear of the medial glenohumeral ligament was detected during arthroscopy. To stabilise the biceps tendon, polypropylene mesh was fixed across the intertubercular groove to replace the torn transverse humeral retinaculum. Recovery was uneventful and lameness resolved. Fifteen months later, the dog was presented with medial displacement of the biceps tendon of origin of the left shoulder, and was treated successfully using the same technique.
Continuous‐time autoregressive moving average processes in discrete time: representation and embeddability
Authors: Thornton Michael A. , Chambers Marcus J.
Published: April 2013

This article explores techniques to derive the exact discrete‐time representation for data generated by a continuous‐time autoregressive moving average (ARMA) process, augmenting existing methods with a stochastic integration‐by‐parts formula. The continuous‐time ARMA(2, 1) system is considered in detail, and a mapping from the parameters of a univariate discrete‐time ARMA(2, 1) process to a univariate continuous‐time ARMA(2, 1) process observed at discrete intervals is derived. This is used to derive conditions for the embeddability of such processes.
Hepatitis B virus surface protein mutations clustered mainly in CTL immune epitopes in chronic carriers: results of an Iranian nationwide study
Authors: Khedive A. , Norouzi M. , Ramezani F. , Karimzadeh H. , Alavian S. M. , Malekzadeh R. , Montazeri G. , Nejatizadeh A. , Ziaee M. , Abedi F. , Ataei B. , Yaran M. , Sayad B. , Somi M. H. , Sarizadeh G. , Sanei‐Moghaddam I. , Mansour‐Ghanaei F. , Rafatpanah H. , Pourhosseingholi M. A. , Keyvani H. , Kalantari E. , Saberifiroozi M. , Judaki M. A. , Ghamari S. , Daram M. , Mahabadi M. , Fazeli Z. , Goodarzi Z. , Poortahmasebi V. , Jazayeri S. M.
Published: April 2013

Mutations within the coding region of hepatitis B surface antigen (HBsAg) have been found naturally in chronic carriers. To characterize the mutations of HBsAg from Iranian chronic carriers who were vaccine and/or medication naive. The surface genes from 360 patients were amplified and directly sequenced. The distribution of amino acid substitutions was classified according to different immune epitopes of the surface protein. All isolates belonged to genotype D. 222 (61.6%) of 360 patients contained at least one amino acid substitution. 404 (74.5%) of 542 amino acid changes occurred in different immune epitopes of HBsAg, of which 112 (27.7%) in 32 residues of B‐cell epitopes (62 in the ‘a’ determinant); 111 (27.4%) in 32 residues of T helper; and 197 (48.7%) in 32 residues inside cytotoxic T lymphocyte (CTL) epitopes. One Th (186–197) and two CTL (28–51 and 206–215) epitopes were found to be hotspot motifs for the occurrence of 213 (52.7%) substitutions. 20 stop codons were identified in different epitopes. There was a significant association between amino acid substitutions and anti‐HBe seropositivity; however, the correlation between such changes with viral load and ALT levels was not significant. In chronic hepatitis B virus(HBV) carriers, positive selection in particular outside the ‘a’ determinant appeared to exert influence on the surface proteins. These changes could be immune escape mutations naturally occurring due to the host immune surveillance especially at the T‐cell level.
Regression of liver fibrosis is progressive after sustained virological response to HCV therapy in patients with hepatitis C and HIV coinfection
Authors: Casado J. L. , Quereda C. , Moreno A. , Pérez‐Elías M. J. , Martí‐Belda P. , Moreno S.
Published: April 2013

There are few data about the long‐term histological outcome of HIV‐/HCV‐coinfected patients after therapy with interferon and ribavirin. We performed an observational study of 216 patients who received therapy against HCV and who had at least three successive transient elastographies (TE) during the follow‐up. The primary endpoint was confirmed fibrosis regression, defined as a reduction of at least 1 point in Metavir fibrosis score, confirmed and without worsening in successive TE. At baseline, 23% had fibrosis stage 4 or cirrhosis. Overall, 82 (38%) achieved sustained virological response (SVR), without differences in baseline fibrosis or time of follow‐up. Confirmed fibrosis regression was observed in 55% of patients, higher for SVR (71% vs 44%; P < 0.01), and the likelihood of achieving fibrosis regression at 3, 5 and 7 years was 0.17, 0.51 and 0.67, respectively, for SVR patients, in comparison with 0.02, 0.23 and 0.41 for no SVR patients (P < 0.01, log‐rank test at any time point). Progressive regression, defined as continuous improvement in successive TE, was observed in 62% of patients with advanced liver fibrosis or cirrhosis who achieved SVR. In a Cox regression model, only SVR (HR, 4.01; 95% CI, 2.33–7.57; P < 0.01) and a younger age (HR, 1.14; 95% CI, 1.05–1.25; P < 0.01; per year) were associated with fibrosis regression. This study confirms that the rate of liver fibrosis regression increases during the follow‐up after SVR to interferon therapy in HIV‐/HCV‐coinfected patients.
The nature and nurture of human infant hand preference
Authors: Fagard Jacqueline
Published: April 2013

This paper reviews the earliest documented manual and postural asymmetries, in the fetus and during the first months of life. I attempt to analyze which genetic and/or environmental factors are likely to trigger each one, as well as its consequences for the other ones. I conclude that right‐handedness is prevalent in all cultures because an intrinsic tendency toward right‐handedness has many occasions to be reinforced, from the uterine to the perinatal environment and from the familial to the cultural environment. Finally, the combination of potential genetic factors—direct (motoric) or indirect (postural)—with varied biological and cultural environmental influences over various periods during development may explain the high variability of handedness in typical populations (as long as hand preference is not equated with the hand used for writing).