bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of family care infrastructure for demented elderly in inner cities and regional areas in Japan
Authors: SHINAGAWA Shunichiro , YATABE Yusuke , HASHIMOTO Mamoru , NAKAYAMA Kazuhiko , IKEDA Manabu 
Published: September 2012

AbstractBackground:  Family members' observations of daily life are important for the diagnosis and treatment of dementia. However, elderly people are increasingly living alone, and family structures tend to differ between inner‐city areas and regional areas. We aimed to compare the family caregiving infrastructure of demented elderly visiting a memory clinic.Methods:  Subjects were consecutive outpatients with dementia at the memory clinic at a university hospital in two different areas. We compared subjects' demographic data, residency status, housemates and companion status at the time of their initial visit.Results:  Patients in the inner‐city area (n= 99) had more education and higher Mini‐Mental State Examination scores than those in the regional area (n= 172). In both areas, the highest proportion of patients lived with their spouse. In the inner city, patients' housemates were either their spouse (34%) or their child (13%); 22% lived alone. In regional areas, patients lived with their spouse only (39%) or in their child's household (23%); 14% lived alone. At their initial consultation, inner‐city patients were accompanied by a family member other than their spouse (49%), a spouse (27%), or they were alone (7%). In the regional area, patients' companions were their spouse (35%) or their spouse and other family members (18%); patients rarely arrived alone. Regression analysis showed that education, diagnosis, housemate state (child only), and companion state (alone) significantly influenced the living area.Conclusion:  Our results suggest family caregiving infrastructure of demented elderly differ between the two areas. This may reflect changes in social structure and increased awareness regarding dementia in inner‐city areas.
Living alone is associated with depression among the elderly in a rural community in Japan
Authors: FUKUNAGA Ryuta , ABE Yasuhisa , NAKAGAWA Youichi , KOYAMA Asuka , FUJISE Noboru , IKEDA Manabu 
Published: September 2012

AbstractAim:  This study aimed to investigate factors associated with depression in a sample of elderly Japanese individuals in a rural community and to examine differences among factors associated with individuals living alone or living with others.Methods:  Using a population‐based sample from rural Japan, we assessed a total of 1552 participants aged 65 years or older by mailing a survey and evaluating responses based on the Geriatric Depression Scale. Factors associated with depression were also examined.Results:  We received 964 valid responses. Depressed subjects comprised 20.5% of the sample. Living alone was significantly related to depression. In individuals living alone, depression was associated with loss of appetite, suicidal ideation, financial strain, and worries in life. However, multiple linear regression analyses revealed that the influence of living alone was negated by having a good social support system.Conclusion:  These findings confirm that living alone is an important factor in depression among the elderly in a rural part of Japan. Results also confirm what others have found in Western cultures: high levels of social support, awareness of receiving social support, and willingness to receive assistance may reduce the risk of depression.
Classification of delusions in Alzheimer's disease and their neural correlates
Authors: NOMURA Keiko , KAZUI Hiroaki , WADA Tamiki , SUGIYAMA Hiromichi , YAMAMOTO Daisuke , YOSHIYAMA Kenji , SHIMOSEGAWA Eku , HATAZAWA Jun , TAKEDA Masatoshi 
Published: September 2012

AbstractBackground:  Previous findings on neural correlates of delusion in Alzheimer's disease (AD) have been inconsistent because of methodological issues, such as treating multiple delusions as a single entity. In this retrospective study, we classified AD delusions and investigated their neural correlates by using single‐photon emission computed tomography data.Methods:  We selected AD patients with delusions from our consecutive outpatients from 2004 to 2010. In this study, eight types of delusions were evaluated with Neuropsychiatric Inventory and classified by factor analysis. Twenty‐five of the patients also had single‐photon emission computed tomography data, which we used to assess the relationships between cerebral regions of hypoperfusion and hyperperfusion and each classified delusion. The relations were assessed using Statistical Parametric Mapping with normalization to the white matter cerebral blood flow.Results:  The delusions were classified into three factors. Factor 1 consisted of a belief that his/her house is not his/her home, phantom boarder symptom, delusion of abandonment, and belief that one's spouse or others are not who they claim to be. Factor 1 was related to hypoperfusion in the right temporal pole and hyperperfusion in the medial frontal and precentral regions. Factor 2 consisted of delusion relating to the television and delusion of persecution. Factor 2 was related to hypoperfusion in the precuneus and hyperperfusion in the insula and thalamus. Factor 3 consisted of delusion of abandonment and delusional jealousy. Factor 3 was related to hypoperfusion in the right inferior temporal and frontal regions and hyperperfusion in the middle frontal gyrus, insula and posterior cingulate gyrus. Delusion of theft was not included in any factors, and it was related to hypoperfusion in the bilateral thalami and left posterior cingulate gyrus and hyperperfusion in the left inferior frontal regions and anterior cingulate gyrus.Conclusions:  Delusions in AD were classifiable, and each classified delusion was related to different neural networks.
One‐Year Results of the CRISTAL Trial, a Randomized Comparison of Cypher Sirolimus‐Eluting Coronary Stents versus Balloon Angioplasty for Restenosis of Drug‐Eluting Stents
Authors: CHEVALIER BERNARD , MOULICHON ROBERT , TEIGER EMMANUEL , BRUNEL PHILIPPE , METZGER JEAN‐PHILIPPE , PANSIERI MICHEL , CARRIE DIDIER , STOLL HANS‐PETER , WITTEBOLS KRISTEL , SPAULDING CHRISTIAN , FAJADET JEAN ,   FOR THE CRISTAL INVESTIGATORS
Published: September 2012

Objectives:
We compared the efficacy of the Cypher Select™ (Cordis Corporation, Bridgewater, NJ, USA) sirolimus‐eluting stent (SES) versus balloon angioplasty (BA) in in‐stent restenosis (ISR) of Taxus™ or Taxus Liberté™ paclitaxel‐eluting stents (PES; Boston Scientific, Natick, MA, USA) or Cypher/Cypher Select SES.
Background:
Optimal treatment strategies have not been identified for drug‐eluting stent (DES) ISR.
Methods:
Patients with a native coronary artery SES or PES ISR were randomized to SES or BA. In addition, a control group included BMS ISR treated with SES. Angiographic control was performed at 12 months.
Results:
281 patients were enrolled. Significant differences favoring SES over BA were noted in immediate and net gain (1.39 ± 0.51 vs. 0.97 ± 0.54 mm, P < 0.0001 and 1.07 ± 0.69 vs. 0.49 ± 0.67 mm, P < 0.0001), 12‐month mean luminal diameter (MLD; 2.14 ± 0.62 vs. 1.71 ± 0.55 mm, P < 0.0001) and percent diameter stenosis (%DS; 21 ± 19.24 vs. 29.82 ± 18.47, P = 0.001). There was no significant difference at 12 months between SES and BA in the primary end‐point late lumen loss (LLL; 0.37 ± 0.57 vs.0.41 ± 0.63, P = 0.73) and in in‐stent binary restenosis (11.1% vs. 14%, P = 0.59). Target‐lesion revascularization (TLR) was numerically lower in patients treated with SES (5.9% vs. 13.1%, P = 0.097). There was no difference according to the initial DES. In contrast, significantly higher immediate and net gains and MLD were noted in the BMS control group treated by SES.
Conclusions:
In this angiographic randomized trial comparing SES and BA in SES or PES restenosis, 12 month MLD, immediate and net gain, and %DS favored SES whereas no difference was noted in LLL.
Condensed Abstract
Optimal treatment strategies have not been identified for sirolimus‐ (SES) or paclitaxel‐eluting stent (PES) in‐stent restenosis (ISR). We randomized patients with a native coronary artery SES or PES ISR to SES or BA. In addition, a control group included BMS ISR treated with SES. There was no difference in the primary end‐point, late lumen loss (LLL) at 12 months between the SES and BA groups. However, follow‐up MLD and immediate and net gain favored SES. (J Interven Cardiol 2012;25:586–595)
The Longitudinal Association of Marital Confidence, Time Spent Together, and Marital Satisfaction
Authors: Johnson Matthew D. , Anderson Jared R. 
Published: September 2012

Using three waves of dyadic data collected at 18‐month intervals from a community‐based sample of 610 newly married heterosexual couples (1 220 individuals), we examined the relationship between marital confidence, time spent together, and marital satisfaction using a modified actor‐partner interdependence model. Results indicate that after controlling for marital satisfaction and time spent together at Time 1, marital confidence around the time of marriage was associated with marital satisfaction approximately 3 years later. In addition, marital confidence was associated with how much time husbands and wives spent together at Time 2, which was related to marital satisfaction at Time 3. Tests of the mediating paths from marital confidence to marital satisfaction trended toward significance. The results suggest the importance of assessing for relationship confidence when working with couples in the early stages of their relationship.
A Randomized Controlled Trial of a Comprehensive Migraine Intervention Prior to Discharge From an Emergency Department
Authors: Friedman Benjamin W. , Solorzano Clemencia , Norton Jennifer , Adewumni Victoria , Campbell Caron M. , Esses David , Bijur Polly E. , Solomon Seymour , Lipton Richard B. , John Gallagher E. 
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1151–1157 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  Patients who use an emergency department (ED) for acute migraine headaches have higher migraine disability scores, lower socioeconomic status, and are unlikely to have used a migraine‐specific medication prior to presentation to the ED. The objective was to determine if a comprehensive migraine intervention, delivered just prior to ED discharge, could improve migraine impact scores 1 month after the ED visit.Methods:  This was a randomized controlled trial of a comprehensive migraine intervention versus typical care among patients who presented to an ED for management of acute migraine. At the time of discharge, for patients randomized to comprehensive care, the research team reinforced their diagnosis, shared a migraine education presentation from the National Library of Medicine, provided them with six tablets of sumatriptan 100 mg and 14 tablets of naproxen 500 mg, and if they wished, provided them with an expedited free appointment to the institution’s headache clinic. Patients randomized to typical care received the care their attending emergency physicians (EPs) felt was appropriate. The primary outcome was a between‐group comparison of the Headache Impact Test (HIT‐6) score, a validated headache assessment instrument, 1 month after ED discharge. Secondary outcomes included an assessment of satisfaction with headache care and use of migraine‐specific medication within that 1‐month period.Results:  Over a 19‐month period, 50 migraine patients were enrolled. One‐month follow‐up was successfully obtained in 92% of patients. Baseline characteristics were comparable. One‐month HIT‐6 scores in the two groups were nearly identical (59 vs. 56, 95% confidence interval [CI] for difference of 3 = −5 to 11), as was dissatisfaction with overall headache care (17% vs. 18%, 95% CI for difference of 1% = −22% to 24%). Patients randomized to the comprehensive intervention were more likely to be using triptans or migraine‐specific therapy (43% vs. 0%, 95% CI for difference of 43% = 20 to 63%) 1 month later.Conclusions:  A comprehensive migraine intervention, when compared to typical care, did not improve HIT‐6 scores (a validated measure of the effect of migraine on one’s daily life) 1 month after ED discharge. Future work is needed to define a migraine intervention that is practical and useful in an ED, where many underserved patients, of necessity, present for care.
Chemical Characterization of Automotive Polyurethane Foam Using Solid‐Phase Microextraction and Gas Chromatography–Mass Spectrometry
Authors: Parsons Norah S. , Lam Michael H. W. , Hamilton Sheilah E. 
Published: September 2012

AbstractSolid‐phase microextraction (SPME) coupled with gas chromatography–mass spectrometry (GC‐MS) was used in this study to identify volatile organic compounds (VOCs) emitted from heated automotive polyurethane (PU) foam collected from 17 different automobiles located in Yuen Long, HK SAR. The samples (0.05 g each) underwent incubation inside 5‐mL glass vials for 30 min, and the VOCs were then collected from the headspace with a polydimethylsiloxane fiber by insertion for 30 min. The VOCs were then qualitatively identified by GC‐MS analysis and were mostly found to be saturated hydrocarbons. However, differences were noted from car to car in the retention time range of 10–23 min. The VOCs collected during this segment of retention time from the PU foams ranged from antioxidants, food preservatives, pesticides, plasticizers, flame retardants to antiseptic agents. The results obtained from this study therefore highlight the usefulness of SPME/GC‐MS as a form of chemical characterization in the analysis of PU foams in forensic casework.
Sonic Hedgehog Is Neuroprotective in the Cavernous Nerve with Crush Injury
Authors: Angeloni Nicholas , Bond Christopher W. , Harrington Daniel , Stupp Samuel , Podlasek Carol A. 
Published: September 2012

ABSTRACT

Introduction
The cavernous nerve (CN) is commonly injured during prostatectomy, resulting in erectile dysfunction (ED). Although peripheral nerves have a limited ability to regenerate, a return of function typically does not occur due to irreversible down stream morphological changes in the penis that result from CN injury. We have shown in previous studies that sonic hedgehog (SHH) is critical for CN regeneration and improves erectile function after crush injury.

Aims
Examine a new direction, to determine if SHH is neuroprotective to the pelvic ganglia (PG)/CN after crush injury. A secondary focus is to examine if SHH signaling decreases with age in the PG/CN.

Methods
Sprague–Dawley rats underwent bilateral CN crush and SHH and glial fibrillary acidic protein were quantified by western analysis of the PG/CN (N = 6 rats at each time point) at 1, 2, 4, 7, and 14 days, and the apoptotic index was measured in the penis. SHH was quantified by western in the PG/CN with blockade of anterograde transport (N = 4 rats) in comparison to mouse IgG (N = 4 rats). If SHH is neuroprotective was examined at 4 (N = 14 rats) and 7 days (N = 16 rats) of treatment after CN crush. SHH protein was quantified in aging (P200-300, N = 5 rats) PG/CN in comparison to normal adult (P115-120, N = 3 rats) PG/CN.

Main Outcome Measures
SHH pathway was examined in PG via immunohistochemistry, in situ, western, and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL).

Results
SHH is neuroprotective in the PG/CN with injury. SHH localization in the PG/CN suggests SHH interaction in neuronal/glial signaling. SHH protein is significantly decreased in the PG/CN after crush injury and in the aged PG/CN. Signals from the PG are required to maintain SHH in the CN.

Conclusions
There is a window of opportunity immediately after nerve insult in which manipulation of SHH signaling in the nerve microenvironment can affect long-term regeneration outcome.
Initial experience on the urogenital outcomes after robotic rectal cancer surgery
Authors: Leung Alex L.H. , Chan Wai‐Hong , Cheung Hester Y.S. , Lui Gilbert K.L. , Fung James T.K. , Li Michael K.W. 
Published: September 2012

AimDespite improvement in surgical approach and technology, total mesorectal excision for low rectal cancer has been associated with significant postoperative sexual and urinary dysfunction. We hypothesize that robot‐assisted laparoscopic total mesorectal excision can achieve maintenance of such functions by its more assured pelvic splanchnic nerve preservation.Patients and MethodsWe prospectively assessed the preoperative and postoperative sexual and urinary function of male patients who received robot‐assisted laparoscopic total mesorectal excision for rectal cancer since May 2009. The International Prostatic Symptom Score (IPSS) and International Index of Erectile Function (IIEF‐5) were employed for the assessment. The baseline and the 3‐month postoperative assessments of sexual and urinary function were analyzed and compared.ResultsIn a 34‐month period, 33 male patients underwent robotic‐assisted rectal surgery. Their median age was 64 years (range: 33–84). Twenty‐six patients underwent sphincter‐saving total mesorectal excision, and four patients underwent neoadjuvant chemo‐irradiation. At 3 months' postoperative, one patient (3 per cent) still failed to produce spontaneous voiding. He was treated by long‐term Foley catheterization. The mean baseline and 3 months' postoperative IPSS scores were 4 and 4.1, respectively. There was no significant difference in IPSS score after operation. Fifteen patients (45.5 per cent) were sexually active before their operation. The mean baseline and 3 months' postoperative IIEF‐5 scores were 20 and 9.4, respectively. There was no significant difference in the IIEF‐5 score before and after the operation. Overall, there was a trend towards worsening erectile function after surgery.ConclusionPreliminary data from this study suggest that the robot‐assisted technique does not confer additional benefits in the preservation of urogenital function when compared to conventional laparoscopic technique. Further large‐scale studies are warranted to validate the role of the robot‐assisted technique in rectal cancer surgery.
Trends in training for nutritionists and dietitians in the Caribbean
Authors: THOMPSON Patricia Y. ,   on behalf of Caribbean Association of Nutritionists and Dietitians (CANDi)
Published: September 2012

AbstractAim:  Because of its small size, the case study of the Caribbean region could be instructive in how a diversified profession would strengthen professional growth. This paper aims to describe the historical trends and efforts at restructuring the profession of nutrition and dietetics in the Caribbean to illustrate the processes followed and the progression of training.Methods:  Data were collected from members of the Caribbean Association of Nutritionists and Dietitians by two sets of emailed questionnaires. This was followed by a face‐to‐face workshop consultation one year later, and with subsequent small group discussions to achieve consensus.Results:  Initial responses revealed 17 pathways to qualification depending on country where trained and the main focus of the curricula. Responses to the second questionnaire detailed post‐didactic training expressed as internship, practicum, supervised practice and/or research. These responses were rationalised in subsequent discussions and consensus reached on relevant professional titles and qualifications.Conclusion:  Professional advancement in the future will come from promoting greater diversity of the nutrition and dietetics profession. Graduates with diverse backgrounds are better able in a limited job market, to create niches for themselves in various sectors in addition to health and government. Of necessity is to create a clear image of our unique identity and to minimise confusion with varied professional titles and qualifications. Developing generic training programmes allowed for more effective positioning of our capabilities to potential users of our services and to facilitate free movement of professionals throughout the region.
Experimentalism in theEU: Common ground and persistent differences
Authors: Sabel Charles F. , Zeitlin Jonathan 
Published: September 2012

AbstractOur central claim in this rejoinder is that experimentalist forms of organization in making regulatory rules, organizing social services, and articulating constitutional norms arise and diffuse as the problem that the actors and the state face shifts from ignorance to uncertainty. We argue that this has consequences for forms of accountability and for the conception and organization of democracy and constitutionalism. TheEU, founded by diverse states in a period of continuing uncertainty, intensified by growing interdependence, proves to be a natural laboratory for observing urgent efforts to adjust to this new situation, and the symposium focuses on developments there. The symposium has brought us to see that there is more common ground in these debates than prior exchanges may have suggested. We therefore emphasize convergence on large points, while underscoring and, we hope, clarifying persistent differences, with the aim of encouraging the joint exploration of them already underway, in part explicitly, in part implicitly.
Reflections on experimentalist governance
Authors: Fossum John Erik 
Published: September 2012

AbstractThis article critically engages with Sabel and Zeitlin's important notion of experimentalist governance (EG). It is cast as a “recursive process of provisional goal‐setting and revision based on learning from the comparison of alternative approaches to advancing them in different contexts.” This is a useful heuristic device to capture policymaking and implementation in complex, dynamic, and highly diverse political entities. This article discusses the micro‐foundations underpinningEG, how it relates to hierarchical modes of governing, and how well it captures the distinctive traits of theEU. It also discussesEGfrom a democratic perspective. In democratic termsEGis understood as a form of direct deliberative polyarchy. This article notes that the question ofEG's contribution to democratization cannot, however, be adequately addressed unless we pay more systematic attention to representation and representative democracy.
Disease recurrence plays a minor role as a cause for retransplantation after living‐donor liver transplantation for primary biliary cirrhosis: A multicenter study in Japan
Authors: Egawa Hiroto , Nakanuma Yasuni , Maehara Yoshihiko , Uemoto Shinji , Eguchi Susumu , Sato Yoshinobu , Shirabe Ken , Takatsuki Mitsuhisa , Mori Akira , Yamamoto Masakazu , Tsubouchi Hirohito 
Published: September 2012

AimTo clarify the role of disease recurrence as a cause of graft loss after living‐donor liver transplantation (LDLT) for primary biliary cirrhosis (PBC), we investigated explant grafts, as well as the native liver and liver biopsy specimens, of patients who underwent retransplantation.MethodsOf 516 patients who underwent LDLT for PBC and were registered in the Japanese Liver Transplant Registry, nine patients (1.7%) underwent retransplantation.ResultsSeven patients undergoing retransplantation later than 6 months after primary liver transplantation (LT) were enrolled. All seven patients were female, with ages ranging from 34–57 years, and Model for End‐Stage Liver Disease scores ranging 10–28. The right lobe was used as graft in one and the left lobe in six. The initial immunosuppression regimen was tacrolimus in six and cyclosporin in one. The period between the primary LT and retransplantation ranged 11–120 months, with a median of 36 months. Three patients survived and four patients died due to poor graft functions or complications after retransplantation. The primary causes of primary graft loss revealed by histological examination of the explant livers were chronic rejection in three, portal thrombus and/or steatohepatitis in three and outflow block in one. PBC recurrence was observed in 3 and the stage was mild in all.ConclusionPBC recurrence has a small impact as a cause of graft loss after LDLT.