bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Arthritis in Middle Age on Older‐Age Functioning
Authors: Covinsky Kenneth E. , Lindquist Karla , Dunlop Dorothy D. , Gill Thomas M. , Yelin Edward 
Published: December 2009

OBJECTIVES: To examine whether symptomatic arthritis in middle age predicts the earlier onset of functional difficulties (difficulty with activities of daily living (ADLs) and walking) that are associated with loss of independence in older persons.DESIGN: Prospective longitudinal study.SETTING: The Health and Retirement Study, a nationally representative sample of persons aged 50 to 62 at baseline who were followed for 10 years.PARTICIPANTS: Seven thousand five hundred forty‐three subjects with no difficulty in mobility or ADL function at baseline.MEASUREMENTS: Arthritis was measured at baseline according to self‐report. The primary outcome was time to persistent difficulty in one of five ADLs or mobility (walking several blocks or up a flight of stairs). Difficulty with ADLs or mobility was assessed according to subject interview every 2 years. Analyses were adjusted for other comorbid conditions, body mass index, exercise, and demographic characteristics.RESULTS: Twenty‐nine percent of subjects reported arthritis at baseline. Subjects with arthritis were more likely to develop persistent difficulty in mobility or ADL function over 10 years of follow‐up (34% vs 18%, adjusted hazard ratio (HR)=1.63, 95% confidence interval (CI)=1.43–1.86). When each component of the primary outcome was assessed separately, arthritis was also associated with persistent difficulty in mobility (30% vs 16%, adjusted HR=1.55, 95% CI=1.41–1.71) and persistent difficulty in ADL function (13% vs 5%, adjusted HR=1.85, 95% CI=1.58–2.16).CONCLUSION: Middle‐aged persons who report a history of arthritis are more likely to develop mobility and ADL difficulties as they enter old age. This finding highlights the need to develop interventions and treatments that take a life‐course approach to preventing the disabling effect of arthritis.
Hearing Handicap Predicts the Development of Depressive Symptoms After 3 Years in Older Community‐Dwelling Japanese
Authors: Saito Hideyuki , Nishiwaki Yuji , Michikawa Takehiro , Kikuchi Yuriko , Mizutari Kunio , Takebayashi Toru , Ogawa Kaoru 
Published: December 2009

OBJECTIVES: To examine the association between hearing handicap and depressive symptoms in older community‐dwelling Japanese.DESIGN: Community‐based cohort study.SETTING: Kurabuchi Town, Gunma Prefecture, Japan.PARTICIPANTS: Five hundred eighty residents (261 men, 319 women) aged 65 and older without depressive symptoms.MEASUREMENTS: In a baseline examination performed in 2005/06, participants answered the 10‐item screening version of the Hearing Handicap Inventory for Elderly (HHIE‐S). They were divided into two groups according to their scores: a group with no hearing handicap (HHIE‐S scores of ≤8) and a hearing handicap group (HHIE‐S scores of ≥10). The Geriatric Depression Scale was used to identify depressive symptoms in face‐to‐face home visit interviews conducted in 2008, and the association between hearing handicap and depressive symptoms was assessed using logistic regression.RESULTS: The incidence of depressive symptoms was 19.6% in the group with a hearing handicap and 8.0% in the group without a hearing handicap. When compared with the subjects without hearing handicap, subjects with a hearing handicap had a multiadjusted odds ratio of depressive symptoms of 2.45 (95% confidence interval=1.26–4.77). The association remained significant even when hearing impairment measured with pure‐tone audiometry was added to the multiadjusted model.CONCLUSION: A hearing handicap can predict future depressive symptoms in older community‐dwelling people.
Training Nursing Staff to Recognize Depression in Home Healthcare
Authors: Brown Ellen L. , Raue Patrick J. , Roos Bernard A. , Sheeran Thomas , Bruce Martha L. 
Published: December 2009

OBJECTIVES: To describe the implementation and acceptability of the TRaining In the Assessment of Depression (TRIAD) intervention, which has been tested in a randomized trial. The primary aim of TRIAD is to improve the ability of homecare nurses to detect depression in medically ill, older adult homecare patients.DESIGN: Description of the important components of TRIAD, its implementation, and evaluation results from nurse surveys.SETTING: Three certified home healthcare agencies in Westchester County, New York.PARTICIPANTS: Thirty‐six homecare nurses.INTERVENTION: Participants randomly assigned to TRIAD (n=17) were provided with the opportunity to observe and practice patient interviewing. The approach focused on clinically meaningful identification of the two “gateway” symptoms of depression and is consistent with the newly revised Medicare mandatory Outcome and Assessment Information Set (OASIS‐C). Control group participants (n=19) received no training beyond that which agencies may have provided routinely.MEASUREMENTS: Baseline and 1‐year nurse confidence in depression detection, and postintervention acceptability ratings of the TRIAD intervention.RESULTS: Participants randomized to the TRIAD intervention reported a statistically significant increase in confidence in assessing for depression mood (P<.001), whereas the usual care group's confidence remained unchanged (P=.34) 1 year later.CONCLUSION: An educational program designed to improve depression detection by giving nurses the skills and confidence to integrate depression assessment into the context of routine care can be successfully implemented with homecare agency support. The authors discuss the intervention in terms of OASIS‐C and the “real world” realities of intervention implementation.
Effect of a Statewide Fall Prevention Program on Incidence of Femoral Fractures in Residents of Long‐Term Care Facilities
Authors: Rapp Kilian , Lamb Sarah E. , Erhardt‐Beer Luzia , Lindemann Ulrich , Rissmann Ulrich , Klenk Jochen , Becker Clemens 
Published: December 2009

OBJECTIVES: To evaluate the effect of a statewide dissemination of a modified evidence‐based fall prevention program on incidence of femoral fractures in nursing homes.DESIGN: Observational study of a staged implementation of a successful fall prevention program.SETTING: One thousand three hundred fifty‐nine nursing homes in two federal states in the south of Germany.PARTICIPANTS: Nine thousand seventy‐seven residents in the intervention homes and 43,583 residents in control homes from the same and a different federal state.INTERVENTION: Staff education on fall prevention, advice on environmental adaptations, and progressive strength and balance training over at least 1 year.MEASUREMENTS: Incident femoral fractures.RESULTS: One thousand five hundred eighteen femoral fractures occurred in the total study population during the intervention period. The crude incidence rate of femoral fractures was 39.5/1,000 person‐years in residents from the intervention homes and 40.9 and 39.7/1,000 person‐years in residents from two sets of control homes. In a multivariate model, there was no evidence of an effect of the fall prevention program on incidence of femoral fracture when compared with control homes from the same federal state (adjusted hazard ratio (AHR)=0.96, 95% confidence interval (CI)=0.83–1.11) or from a different federal state (AHR=1.00, 95% CI=0.86–1.16).CONCLUSION: The statewide dissemination of a multifactorial fall prevention program did not appear to reduce the burden of femoral fractures in residents of nursing homes.
Evaluating maturation and genetic modification of human dendritic cells in a new polyolefin cell culture bag system
Authors: Macke Lars , Garritsen Henk S.P. , Meyring Wilhelm , Hannig Horst , Pägelow Ute , Wörmann Bernhard , Piechaczek Christoph , Geffers Robert , Rohde Manfred , Lindenmaier Werner , Dittmar Kurt E.J. 
Published: December 2009

BACKGROUND: Dendritic cells (DCs) are applied worldwide in several clinical studies of immune therapy of malignancies, autoimmune diseases, and transplantations. Most legislative bodies are demanding high standards for cultivation and transduction of cells. Closed‐cell cultivating systems like cell culture bags would simplify and greatly improve the ability to reach these cultivation standards. We investigated if a new polyolefin cell culture bag enables maturation and adenoviral modification of human DCs in a closed system and compare the results with standard polystyrene flasks.STUDY DESIGN AND METHODS: Mononuclear cells were isolated from HLA‐A*0201–positive blood donors by leukapheresis. A commercially available separation system (CliniMACS, Miltenyi Biotec) was used to isolate monocytes by positive selection using CD14‐specific immunomagnetic beads. The essentially homogenous starting cell population was cultivated in the presence of granulocyte‐macrophage–colony‐stimulating factor and interleukin‐4 in a closed‐bag system in parallel to the standard flask cultivation system. Genetic modification was performed on Day 4. After induction of maturation on Day 5, mature DCs could be harvested and cryopreserved on Day 7. During the cultivation period comparative quality control was performed using flow cytometry, gene expression profiling, and functional assays.RESULTS: Both flasks and bags generated mature genetically modified DCs in similar yields. Surface membrane markers, expression profiles, and functional testing results were comparable. The use of a closed‐bag system facilitated clinical applicability of genetically modified DCs.CONCLUSIONS: The polyolefin bag–based culture system yields DCs qualitatively and quantitatively comparable to the standard flask preparation. All steps including cryopreservation can be performed in a closed system facilitating standardized, safe, and reproducible preparation of therapeutic cells.
Considerations on the use of adjunct red blood cell exchange transfusion in the treatment of severe Plasmodium falciparum malaria
Authors: Shelat Suresh G. , Lott Jason P. , Braga Matthew S. 
Published: December 2009

BACKGROUND: Travelers returning to the United States from malaria‐endemic areas are at increased risk of a potentially fatal infection from Plasmodium falciparum, which requires prompt and aggressive treatment.STUDY DESIGN AND METHODS: Described is a case of a 7‐year‐old boy who was infected by P. falciparum while in Africa and developed features of severe infection, including hyperparasitemia, altered neurologic status, and malarial hepatitis.RESULTS: A single automated erythrocytapheresis procedure reduced parasitemia from 14% to less than 1%. Along with intravenous quinidine, this reduced parasite level was maintained throughout the hospitalization and the patient recovered.CONCLUSION: Exchange transfusion (ET) is an effective adjunct therapy to reduce the parasite load in cases of severe P. falciparum malaria. When performed in certain defined settings, the benefits can outweigh the risks of the procedure. Discussed are the medical and technical considerations on the use of adjunctive ET for severe P. falciparum infection and a review of the literature of the use of adjunct ET in the treatment of severe P. falciparum malaria.
A dual antiglobulin test for the detection of weak or nonagglutinating immunoglobulin M warm autoantibodies
Authors: Bartolmäs Thilo , Salama Abdulgabar 
Published: December 2009

BACKGROUND: Immunoglobulin (Ig)M warm autoantibodies (AABs) usually cause severe autoimmune hemolytic anemia (AIHA) and, in some cases, red blood cell (RBC)‐bound IgM cannot be detected. We describe a simple dual antiglobulin test (DDAT) for diagnosing such cases.STUDY DESIGN AND METHODS: A patient with erroneously suspected cold agglutinin syndrome was investigated. The direct antiglobulin test (DAT) was performed using standard techniques and dual (two stages) antiglobulin reagents (IgG rabbit anti‐human IgM, IgG goat anti‐rabbit IgG).RESULTS: A cold agglutinin syndrome was diagnosed initially, as the patient's serum was reactive with RBCs at a temperature of 28°C or less, and the DAT was strongly positive with anti‐C3d. Six months later, the patient was reexamined at this hospital due to progressive hemolysis. His RBCs were found to be coated with IgM warm AABs that only became detectable using a DDAT, and his serum contained only a weak cold agglutinin. The hemolysis remained refractory to treatment with prednisolone and also prednisolone plus azathioprine, but gradually improved after treatment with prednisolone plus cyclophosphamide.CONCLUSION: Weak or nonagglutinating RBC‐bound IgM warm antibodies can be identified by the presented DDAT.
MANAGING EDUCATIONAL TRANSFORMATION IN THE GLOBALIZED WORLD: A DEWEYAN PERSPECTIVE
Authors: Striano Maura 
Published: December 2009

In the globalization scenarios we currently face, educational systems are challenged by different and sometimes competing pressures and requests. These call for a deep transformation of the organization, role, and social function of educational systems. Within this context, the very concept of education has come to be understood in different ways, which sometimes distort its moral and social value. In this essay, Maura Striano contends that from a Deweyan perspective, educational transformation must be seen as strictly connected to social change, and education should be understood as a process that facilitates and supports social growth and development. In order to be effective and fruitful, Striano suggests, this transformation must occur from the inside of educational systems and can only be brought about by reflective and inquiry‐based inner processes if it is to have a sound moral and social impact within the changing framework of the globalized world.
That education shares in the confusion of transition, and in the demand for reorganization, is a source of encouragement and not of despair. It proves how integrally the school is bound up with the entire movement of modern life. —John Dewey, The Educational Situation
Mammalian Densities in a Neotropical Wetland Subject to Extreme Climatic Events
Authors: Desbiez Arnaud Léonard Jean , Bodmer Richard Ernest , Tomas Walfrido Moraes 
Published: December 2009

ABSTRACTEffective management and conservation of an ecosystem requires information on species assemblages as well as reliable estimates of population sizes to plan, implement and evaluate management strategies. The Brazilian Pantanal is one of the world's largest freshwater wetlands and considered a priority landscape for wildlife conservation. It is subject to pluri‐annual extreme dry and wet periods, which cause extreme flood and drought events, which strongly affect wildlife. Using the line‐transect method, this study examined the distribution of densities and metabolic biomass of medium‐ to large‐sized nonvolant mammals in forest, cerrado and floodplain landscapes, in an area with low anthropogenic influence, in the central area of the Brazilian Pantanal during a prolonged drought. Comparisons with a previous survey conducted during years of average rainfall in part of the study area suggest that population fluctuations of certain species are closely associated with water due to the drought. Results from this study showed that mammal assemblages varied between landscapes. Forested landscapes have the highest densities of mammals and are the most important in terms of relative energy consumption. In addition, at the time of the study, frugivores were found to have higher energy consumption than browser/grazers across the three landscapes; most fruits are produced in forested areas stressing their importance. By converting forested landscapes into grasslands, the intensification of ranching practices seriously threatens biodiversity and ecological processes in the region.
What is New in Protectionism? Consumers, Cranks, and Captives
Authors: Kerr William A. 
Published: December 2009

The most contentious international trade issues currently arise not from traditional producer requests for protection, but as a result of consumers and other economic agents asking governments to erect trade barriers. The economic model that underpins multilateral trade policy—as manifest in World Trade Organization (WTO) agreements—only predicts that firms will lobby for protection, with no provisions for how governments faced with requests for protection from other groups can respond. Consequently, governments have been forced to defend the imposition of trade barriers using spurious justifications; the WTO dispute mechanism has largely dismissed these justifications, and consumers (and others) feel disenfranchised. The result has been a loss of credibility for the WTO and sometimes its demonization. The WTO needs to change but a new economic model must also be developed to deal with a broader spectrum of protectionist interests.À l'heure actuelle, les questions de commerce international les plus litigieuses ne sont pas alimentées par des producteurs traditionnels qui demandent des mesures protectionnistes, mais plutôt par des consommateurs et d'autres agents économiques qui demandent que les États érigent des barrières commerciales. Le modèle économique à la base de la politique commerciale multilatérale – manifeste dans les accords de l'Organisation mondiale du commerce (OMC) – prévoit seulement que les entreprises exerceront des pressions protectionnistes, sans disposition sur la réaction possible des États qui sont confrontés à des demandes de protectionnisme provenant d'autres groupes. En conséquence, les États ont été forcés de défendre l'imposition de barrières commerciales en utilisant de fausses justifications. Le mécanisme de règlement des différends de l'OMC a en grande partie rejeté ces justifications, et les consommateurs (et autres agents économiques) se sentent privés de leurs droits. L'OMC a ainsi perdu de sa crédibilité et est parfois diabolisée. L'OMC doit être revue, mais il faut également élaborer un nouveau modèle économique pour tenir compte d'un large éventail d'intérêts protectionnistes.
Design of Nano‐Laminated Coatings to Control Bioavailability of Lipophilic Food Components
Authors: McClements David Julian 
Published: December 2009

ABSTRACT:  There is currently a lack of effective delivery systems to encapsulate, protect, and release bioactive lipophilic components, such as ω‐3 fatty acids, conjugated linoleic acid, tributyrin, vitamins, antioxidants, carotenoids, and phytosterols, which is holding back the development of functional foods designed to combat diseases such as coronary heart disease, diabetes, hypertension, and cancer. Delivery systems consisting of lipid droplets encapsulated by nano‐laminated biopolymer coatings have great potential for use in the food industry for the encapsulation, protection, and release of bioactive lipids.This article reviews the potential impact of the physicochemical characteristics of nano‐laminated biopolymer coatings on the bioavailability of encapsulated lipids. The effects of layer thickness, composition, electrical charge, permeability, and environmental responsiveness on digestion, release, and absorption of lipophilic components are highlighted. The possibility of designing nano‐laminated biopolymer coatings to increase, decrease, or control the bioavailability of encapsulated lipids is shown. Data generated from in vitro digestion models and animal feeding studies are presented. This knowledge could be used by the food industry to produce functional foods designed to improve human health and wellness.
Alkylpyrazines and Other Volatiles in Cocoa Liquors at pH 5 to 8, by Selected Ion Flow Tube‐Mass Spectrometry (SIFT‐MS)
Authors: Huang Yang , Barringer Sheryl A. 
Published: December 2009

ABSTRACT:  Cocoa beans were alkalized before or after roasting and made into cocoa liquor before analyzing by SIFT‐MS. In both alkalized‐before‐roasting and alkalized‐after‐roasting samples, there were significantly higher concentrations of alkylpyrazines for the samples with pH above 7 than pH below 7. At pH 8, the concentrations of 2,3‐, 2,5‐, and 2,6‐dimethylpyrazine (DMP), 2,3,5‐trimethylpyrazine (TrMP), 2,3,5,6‐tetramethylpyrazine (TMP), and 2,3‐diethyl‐5‐methylpyrazine (EMP) in the samples alkalized‐before‐roasting were higher than those in the samples alkalized‐after‐roasting. Volatiles increased under conditions that promoted the Maillard reaction. The partition coefficient was not significantly affected by pH from 5.2 to 8. The ratios of TrMP/DMP and DMP/TMP increased while the ratio of TMP/TrMP decreased as the pH increased. The concentrations of Strecker aldehydes and other volatiles followed a similar pattern as that of the alkylpyrazines. High pH favors the production of alkylpyrazines and Strecker aldehydes.Practical Applications: Cocoa beans alkalized‐before‐roasting had higher levels of many important chocolate aroma volatiles than those alkalized‐after‐roasting. Thus, alkalizing before roasting should produce a stronger cocoa aroma. The higher the pH, the higher the concentrations of these important volatiles. There was little change in volatile concentration at acid pH. Above pH 7, volatile levels increased rapidly with increasing pH. To maintain the recommended ratio of tetramethylpyrazine to trimethylpyrazine, a longer roasting time or higher temperature is needed for cocoa liquor with a pH below 6.5, while a shorter roasting time or lower temperature is needed for cocoa liquor with a pH above 7.
Vertical Stiffnesses of Preloaded Linear Guideway Type Ball Bearings Incorporating the Flexibility of the Carriage and Rail
Authors: Ohta Hiroyuki , Tanaka Keisuke 
Published: December 2009

Abstract
This article deals with the vertical stiffnesses of preloaded linear guideway type ball bearings (linear bearings) incorporating the flexibility of the carriage and rail. First the vertical stiffnesses of light and medium preloaded linear bearings were measured, as well as the outward carriage deformations in the width direction. Compared with the stiffnesses calculated by the conventional rigid model (assuming the carriage and rail are rigid, except for the contact points with the balls), the measured stiffnesses were about 40% less. In preloaded linear bearings under a vertical load, the side faces of the carriage deformed outward. The deformations were minimal at the top, increased toward the bottom, and had a tendency to be greater under either a larger preload or a smaller vertical load. The measured stiffnesses and outward carriage deformations cannot be explained using the conventional rigid model. To overcome these problems with the conventional rigid model, a flexible model (taking into account the flexibility of the carriage and rail) is presented in this article. The flexible model deformations were estimated through finite element (FE) analysis. The Hertzian contacts between the balls and the carriage or rail also were considered. With relative errors of 9–21%, the calculated stiffnesses using the flexible model more closely matched the measured stiffnesses. Also, the calculated outward carriage deformations matched the measured deformations well. Clearly, there is a better match between the calculated results of the flexible model and the measurements than with the conventional rigid model.