bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of Tree Regeneration in Fern‐dominated Forest Understories After Reduction of Deer Browsing
Authors: De La Cretaz Avril L. , Kelty Matthew J. 
Published: March 2003

AbstractDennstaedtia punctilobula(hay‐scented fern) can act as a native invasive species in forests in eastern North America where prolonged deer browsing occurs in stands with partially open overstory canopies. Ferns dominate the understory with a 60‐cm tall canopy, with little regeneration of native tree species. It has been hypothesized that, once established, ferns may continue to inhibit tree regeneration after deer browsing has been reduced. To test this hypothesis, we documented the pattern of recovery of the tree seedling understory in plantations ofPinus strobus(white pine) andPinus resinosa(red pine) on the Quabbin Reservation watershed protection forest in central Massachusetts, where after 40 years of intensive deer browsing the deer herd was rapidly reduced through controlled hunting. Dense fern understories occur on nearly 4,000 ha of the predominantly oak–pine forest. Three years after deer herd reduction, stands with the highest density fern cover (77% of plots with>90% cover) had significantly fewer seedlings at least 30 cm in height, compared with stands with lower fern density, and those seedlings consisted almost entirely ofBetula lenta(black birch) and white pine. Height growth analysis showed that black birch and white pine grew above the height of the fern canopy in 3 and 6 years, respectively. In contrast, two common species,Fraxinus americana(white ash) andQuercus rubra(red oak), grew beneath the dense fern cover for 5 years with height growth less than 5 cm/yr after the first year. A study of spring phenology indicated that the ability of black birch to grow through the fern canopy might have been due to its early leaf development in spring before the fern canopy was formed, in contrast to oak and ash with delayed leaf development. Thus, the ferns showed differential interference among species with seedling development after reduction of deer browse.
THE USE OF INTERFERENCE REFLECTION CONTRAST IN THE EXAMINATION OF DIATOM VALVES
Authors: Siver Peter A. , Hinsch Jan 
Published: March 2003

Even though scanning electron microscopy (SEM) is now needed to identify some species of diatoms, the majority of identifications and quantification of these organisms in ecological works is accomplished with a light microscope, using transmitted light optical methods. In this paper we demonstrate the use of interference reflection contrast (incident light) for the examination of diatoms, a method that significantly improves the resolution of structural detail, and therefore, identification of diatom taxa with light microscopy. Using incident light we were routinely able to distinguish between structures that were close to the theoretical limit of resolution for visible light, and that were not resolvable with such standard transmitted light techniques as phase contrast and differential interference contrast (DIC). Light microscopes with epi‐illumination light paths can be easily and inexpensively outfitted to use this simple technique. Abbreviations: DIC, differential interference contrast; IRC, interference reflection contrast; LM, light microscopy
Accumulation of Triacylglycerols in Haematococcus Pluvialis is Correlated with that of Astaxanthin Esters
Authors: Zhekisheva M. , Boussiba S. , Khozin‐Goldberg I. , Zarka A. , Cohen Z. 
Published: March 2003

AbstractThe chlorophyte Haematococcus pluvialis accumulates large quantities of astaxanthin under stress conditions. Under either nitrogen starvation or high light, the proportion of each picogram of astaxanthin was accompanied by that of 5 or 3–4 pg of fatty acids, respectively. In both cases, the newly formed fatty acids, consisted mostly of oleic (up to 34% of fatty acids in comparison to 13% in the control), palmitic and linoleic acids, were deposited mostly in triacylglycerols. Furthermore, the enhanced production of oleic acid was linearly correlated with that of astaxanthin. Astaxanthin which is mostly monoesterified, is deposited in globules made of triacylglycerols. We suggest that the production of tailor‐made oleic acid‐rich triacylglycerols on the one hand and the esterification of astaxanthin on the other hand, enable the oil globules to maintain the high content of astaxanthin esters.
The Relationship Between Blood Pressure and Mortality in the Oldest Old
Authors: Satish Shiva , Freeman Daniel H. , Ray Laura , Goodwin James S. 
Published: March 2003

OBJECTIVES: To explore the relationship between systolic and diastolic blood pressure and risk of 6‐year, all‐cause mortality in men and women age 65 to 84 versus those 85 and older.DESIGN: A population‐based longitudinal study.SETTING: This study was conducted at four different sites: East Boston, Massachusetts; New Haven, Connecticut; two rural counties in Iowa; and Piedmont, North Carolina.PARTICIPANTS: 12,802 community‐dwelling persons age 65 and older.MEASUREMENTS: Baseline measurements collected include demographics, self‐reported chronic medical conditions, blood pressure measurements, medications, health habits, and hospitalizations.RESULTS: Unadjusted actuarial survival analyses show that men age 65 to 84 years with systolic blood pressure <130 mmHg have significantly lower mortality compared with those with systolic blood pressure ≥180 mmHg (P < .0001). In contrast, men 85 and older with systolic blood pressure ≥180 mmHg have significantly lower mortality compared with those with systolic blood pressure <130 mmHg (P < .0001). In Cox proportional hazards analyses controlling for other predictors of survival, the hazard of death associated with each 10‐mmHg increase in systolic blood pressure is positively associated among men age 65 to 84 years and negatively associated among men age 85 and older (Hazard ratio and 95% confidence interval (CI): 1.04 (1.01, 1.07) for younger men vs 0.92 (0.86, 0.99) for older men). Among women age 65 to 84, the hazard of death significantly increased with increase in systolic blood pressure (P < .0001), while there was no relationship between level of systolic blood pressure and survival in women 85 and older. Both men 65 to 84 years old and those 85 and older showed a negative relationship between diastolic blood pressure and all‐cause mortality (Hazard ratio 0.93, 95% CI (0.88–0.97) for men age 65–84 years, and Hazard ratio 0.90, 95% CI 0.80–1.02 for men 85 and older).CONCLUSION: In men age 85 and older, higher systolic blood pressure is associated with better survival.
Medical Comorbidity and Rehabilitation Efficiency in Geriatric Inpatients
Authors: Patrick Louise , Knoefel Frank , Gaskowski Peter , Rexroth Daniel 
Published: March 2003

OBJECTIVES: To measure and describe medical comorbidity in geriatric rehabilitation patients and investigate its relationship to rehabilitation efficiency.DESIGN: Prospective, multivariate, within‐subject design.SETTING: The Geriatric Rehabilitation inpatient unit of the SCO Health Service in Ottawa, Canada.MEASUREMENTS: The rehabilitation efficiency ratio, based on gains in functional status achieved with rehabilitation treatment, and the length of stay were computed for all patients. Values were regressed on the scores of the Cumulative Illness Rating Scale (CIRS), the Mini‐Mental State Examination, and the Geriatric Depression Scale to establish predictive power.RESULTS: The findings suggest that geriatric rehabilitation patients experience considerable medical comorbidity. Sixty percent of patients had impairments across six of the 13 dimensions of the CIRS, whereas 36% of patients had impairments across 11 of the 13 dimensions. In addition, medical comorbidity was negatively related to rehabilitation efficiency. This relationship was significant even after controlling for age, cognitive status, depressive symptoms, and functional independence status at admission.CONCLUSION: Medical comorbidity was a significant predictor of rehabilitation efficiency in geriatric patients. Comorbidity scores> 5 were prognostic of poorer rehabilitation outcomes and can serve as an empirical guide in estimating a patient's suitability for rehabilitation. Medical comorbidity predicted both the overall functional change achieved with rehabilitation (Functional Independence Measure gains) and the rate at with which those gains were reached (rehabilitation efficiency ratio).
The Appropriateness of Drug Use in an Older Nondemented and Demented Population
Authors: Giron Maria Stella T. , Wang Hui‐Xin , Bernsten Cecilia , Thorslund Mats , Winblad Bengt , Fastbom Johan 
Published: March 2003

OBJECTIVE: To assess the extent of inappropriateness of drug use in an older nondemented and demented population. DESIGN: Descriptive analysis based on data from a sample of older subjects age 81 years and older. Data were collected from the second follow‐up conducted in 1994–1996. SETTING: A population‐based study of the Kungsholmen project in Stockholm, Sweden. PARTICIPANTS: Drug information was obtained from 681 subjects with a mean age of 86.9 years. The subjects were predominantly women (78%). Thirteen percent resided in institutions and 27.6% were diagnosed with dementia. MEASUREMENTS: Dementia diagnosis based on DSM III‐R. Criteria for inappropriateness of drug use: use of drugs with potent anticholinergic properties, drug duplication, potential drug‐drug and drug‐disease interactions, and inappropriate drug dosage. RESULTS: The mean number of drugs used was 4.6: 4.5 drugs for nondemented and 4.8 for demented subjects. Nondemented subjects more commonly used cardiovascular‐system drugs and demented subjects used nervous‐system drugs. Demented subjects were more commonly exposed to drug duplication and to drugs with potent anticholinergic properties, both involving the use of psychotropic drugs. Nondemented subjects were more commonly exposed to potential drug‐disease interactions, mostly with the use of cardiovascular drugs. The most common drug combination leading to a potential interaction was the use of digoxin with furosemide, occurring more frequently among nondemented subjects. The most common drug‐disease interaction was the use of beta‐blockers and calcium antagonists in subjects with congestive heart failure. The doses of drugs taken by both nondemented and demented subjects were mostly lower than the defined daily dose. CONCLUSION: There was substantial exposure to presumptive inappropriateness of drug use in this very old nondemented and demented population. The exposure of demented subjects to psychotropic drugs and nondemented subjects to cardiovascular drugs reflect the high frequency of prescribing these drugs in this population.
Screening for Depression in Patients in Long‐Term Care Facilities: A Randomized Controlled Trial of Physician Response
Authors: Soon Judith A. , Levine Marc 
Published: March 2003

OBJECTIVES: To determine the effect of a screening protocol using the Geriatric Depression Scale (GDS) on the frequency of primary care physicians' decisions to prescribe drug therapy or refer long‐term care patients with possible depression to mental health care.DESIGN: Case‐finding phase, followed by a randomized controlled trial of the effect of a physician‐targeted intervention on antidepressant prescribing or referral to mental health services.SETTING: Twenty‐two nonacademic long‐term care facilities.PARTICIPANTS: One hundred three of 1,602 patients aged 65 and older who met criteria for cognitive function and untreated symptoms of depression.INTERVENTION: The 77 physicians of these patients were randomized as clusters into an early notification (experimental) or a delayed notification (control) group.MEASUREMENTS: Frequency of physician response (mental health consult or antidepressant therapy) at 4 and 8 weeks from notification, physician follow‐up, and factors associated with physician response.RESULTS: Frequency of physician response in the early group (25%) was greater than in the delayed group (2%) (P < .005) 4 weeks from baseline. Physician response rate when the groups were combined was 36% (95% confidence interval (CI) = 26%–46%) 8 weeks from notification. Overall, there was evidence of physician action after letters of notification in 69% (95% CI = 60%–78%) of cases. Univariate logistic regression suggested that physicians' decisions were primarily associated with physician‐related characteristics.CONCLUSIONS: Screening of long‐term care patients for depression can increase the frequency of treatment or referral by primary care physicians.
Attitudes Toward Working on Interdisciplinary Healthcare Teams: A Comparison by Discipline
Authors: Leipzig Rosanne M. , Hyer Kathryn , Ek Kirsten , Wallenstein Sylvan , Vezina Maria L. , Fairchild Susan , Cassel Christine K. , Howe Judith L. 
Published: March 2003

Interdisciplinary teams are important in providing care for older patients, but interdisciplinary teamwork is rarely a teaching focus, and little is known about trainees' attitudes towards it. To determine the attitudes of second‐year post‐graduate (PGY‐2) internal medicine or family practice residents, advanced practice nursing (NP), and masters‐level social work (MSW) students toward the value and efficiency of interdisciplinary teamwork and the physician's role on the team, a baseline survey was administered to 591 Geriatrics Interdisciplinary Team Training participants at eight U.S. academic medical centers from January 1997 to July 1999.Most students in each profession agreed that the interdisciplinary team approach benefits patients and is a productive use of time, but PGY‐2s consistently rated their agreement lower than NP or MSW students. Interprofessional differences were greatest for beliefs about the physician's role; 73% of PGY‐2s but only 44% to 47% of MSW and NP trainees agreed that a team's primary purpose was to assist physicians in achieving treatment goals for patients. Approximately 80% of PGY‐2s but only 35% to 40% of MSW or NP trainees agreed that physicians have the right to alter patient care plans developed by the team. Although students from all three disciplines were positively inclined toward medical interdisciplinary teamwork, medical residents were the least so. Exposure to interdisciplinary teamwork may need to occur at an earlier point in medical training than residency. The question of who is ultimately responsible for the decisions of the team may be an “Achilles heel,” interfering with shared decision‐making.
Validity of Divided Attention Tasks In Predicting Falls in Older Individuals: A Preliminary Study
Authors: Verghese Joe , Buschke Herman , Viola Lisa , Katz Mindy , Hall Charles , Kuslansky Gail , Lipton Richard 
Published: March 2003

OBJECTIVES: Although cognitive impairment is known to be a major risk factor for falls in older individuals, the role of cognitive tests in predicting falls has not been established. Limited attentional resources may increase the risk for falls in older individuals. We examined the reliability and validity of divided attention tasks, walking while talking (WWT), in predicting falls.DESIGN: A prospective cohort study of 12‐months' duration.SETTING: Community‐based longitudinal aging study, the Einstein Aging Study.PARTICIPANTS: Sixty nondemented community‐living subjects, aged 65 to 98 (mean age ± standard deviation = 79.6 ± 6.3).MEASUREMENTS: Simple and complex versions of the WWT task in addition to standard balance and cognitive assessments. The primary outcome was cumulative incidence of falls at 12 months.RESULTS: Thirteen subjects fell over the 12 months, four of whom had major injuries. The WWT task had good interrater reliability (r = 0.602, P < .001). Poor performance on simple (odds ratio (OR) = 7.02, 95% confidence interval (CI) = 1.7–29.4) and complex WWT tasks (OR = 13.7, 95% CI = 2.3–83.6) was highly predictive of falls. The simple task had a sensitivity of 46% and specificity of 89%. For the complex task, sensitivity was 39%, and specificity was 96%.CONCLUSIONS: The WWT is a reliable and valid test to identify older individuals at high risk for falls. Future studies with larger sample sizes and in different settings are needed to confirm the findings of this study.
Use of Artificial Networks in Clinical Trials: A Pilot Study to Predict Responsiveness to Donepezil in Alzheimer's Disease
Authors: Mecocci Patrizia , Grossi Enzo , Buscema Massimo , Intraligi Marco , Savarè Rita , Rinaldi Patrizia , Cherubini Antonio , Senin Umberto 
Published: March 2003

OBJECTIVES: To evaluate the accuracy of artificial neural networks compared with discriminant analysis in classifying positive and negative response to the cholinesterase inhibitor donepezil in a group of Alzheimer's disease (AD) patients.DESIGN: Convenience sample.SETTING: Patients with mild to moderate AD consecutively admitted to a geriatric day hospital and treated with donepezil 5 mg/day.PARTICIPANTS: Sixty‐one older patients of both sexes with AD.MEASUREMENTS: Accuracy in detecting subjects sensitive (responders) or not (nonresponders) to 3‐month therapy with ANNs. The criterion standard for evaluation of efficacy was the scores of Alzheimer's Disease Assessment Scale—Cognitive portion and Clinician's Interview Based Impression of Change—plus scales.RESULTS: ANNs were more effective in discriminating between responders and nonresponders than other advanced statistical methods, particularly linear discriminant analysis. The total accuracy in predicting the outcome was 92.59%.CONCLUSIONS: ANNs appear to be a useful tool in detecting patient responsiveness to pharmacological treatment in AD.
Management of Nonmalignant Pain in Home‐Dwelling Older People: A Population‐Based Survey
Authors: Pitkala Kaisu H. , Strandberg Timo E. , Tilvis Reijo S. 
Published: March 2003

OBJECTIVES: To investigate use of prescribed analgesic drugs in relation to experience of joint or back pain in a home‐dwelling older population, to study changes in the use of analgesic drugs over 10 years, and to investigate concomitant use of protective gastrointestinal drugs with prescribed analgesic drugs in 1999.DESIGN: Cross‐sectional mailed surveys 10 years apart.SETTING: Helsinki, Finland.PARTICIPANTS: Random samples of older birth cohorts born in 1904, 1909, and 1914 in 1989 (n = 644) , and of three separate cohorts born in 1914, 1919, and 1924 in 1999 (n = 3,000).MEASUREMENTS: Use of various types of analgesic and protective gastrointestinal drugs, prescribed and over the counter. Experience of joint and back pain that interferes with daily functioning.RESULTS: The response rate of home‐dwelling older people was 83% in 1989 and 81% in 1999. Although the use of analgesic drugs as self‐treatment increased from 28.5% to 41.4% during the 10 years, in 1999, only 35.5% to 38.2% of those suffering joint or back pain that impaired daily functioning had been prescribed an analgesic drug for regular use. Of those using prescribed medication, 57.5% were on nonsteroidal antiinflammatory drugs (NSAIDs), 20.9% acetaminophen, and 18.5% weak opiates. Only one‐fifth of those individuals taking NSAIDs were on a concomitant gastroprotective drug.CONCLUSIONS: Pain is markedly undertreated in community‐dwelling older people, which may have serious implications for their well‐being and functioning. Although we noted a tendency for safety in the use of prescribed analgesic drugs, a significant effort must sill be made to implement evidence‐based practice. Self‐treatment of pain has increased in 1 decade, which may reduce the overall safety of analgesic drug use among older people.
Comparative analysis of six different white cell‐reduction filters for packed red cells
Authors: Bontadini A. , Fruet F. , Tazzari P.L. , Lollini P.‐L. , Conte R. 
Published: March 2003

Background: The reduction of white cells in blood components before transfusion by filters with at least 3 log10 depletion may prevent adverse transfusion reactions such as HLA alloimmunization, febrile reactions, transmitted infections, and immunomodulation. A new generation of filters with 4 log10 depletion is now available.Study Design and Methods: The aim of this study is to compare the efficiency of white cell reduction by six commercial filters for packed red cells with 3 and 4 log10 depletion (claimed by manufacturers). The analysis of white cell concentration in the white cell‐reduced units was performed by flow cytometry and with a Nageotte chamber.Results: The last generation of filters (BPF4, RC400, R01 Plus) show mean residual white cell numbers of 0.18 ± 0.14, 0.26 ± 0.21, and 0.25 ± 0.15 × 106, respectively, by flow cytometric analysis and 0.05 ± 0.04, 0.18 ± 0.15, and 0.38 ± 0.23 × 106, respectively, by Nageotte chamber evaluation. The 3 log10 depletion filters (R01, Leucostop‐4LT‐ mono, R200) have mean residual white cell numbers of 1.41 ± 0.92, 2.4 ± 1.99, and 1.05 ± 0.64 × 106, respectively, by flow cytometric analysis and 3.56 ± 1.7, 1.67 ± 1.3, and 3.21 ± 4.1 × 106, respectively, by Nageotte chamber evaluation. The data show that the BPF4, RC400, and R01 Plus filters are likely to be more efficient by 1 log10 reduction than the R01, Leucostop‐4LT‐mono, and R200 filters.Conclusion: The most recent generation of filters is able to deplete white cells from packed red cells by 4 log10; in particular, with one of the filters, the residual WBC content was less than 0.5 × 106 per unit in all experiments, while two other filters reached that level in 9 of 10 experiments.
Blood group A immunodeterminants on human red cells differ in biologic activity and sensitivity to alpha‐N‐acetylgalactosaminidase
Authors: Hoskins L.C. , Larson G. , Naff G.B. 
Published: March 2003

BACKGROUND: Epitopes of blood group A antigen can be enzymatically cleaved from red cells (RBCs), but the extent of cleavage required for normal survival in allogeneic blood transfusion recipients is unknown. Therefore, the cleavage rates were studied for A antigen epitope binding of 1) complement‐activating anti‐A, 2) Dolichos biflorus anti‐ A, lectin, and 3) hemagglutinating anti‐A during incubation with a purified alpha‐N‐acetylgalactosaminidase, E.C. 3.2.1.49 (alpha‐ GalNAc'ase).STUDY DESIGN AND METHODS: Suspensions of group A RBCs were incubated with alpha‐GalNAc'ase. Cells were removed at intervals, washed, and tested for loss of binding by monoclonal, polyclonal, and complement‐activating anti‐A, D. biflorus anti‐A1 lectin, and Ulex europaeus anti‐H lectin.RESULTS: A epitopes binding D. biflorus lectin were highly susceptible to alpha‐GalNAc'ase; simultaneously with their loss, binding with U. europaeus lectin emerged. Loss of complement‐ mediated hemolysis was slower. A epitopes binding hemagglutinating anti‐ A were most resistant. Cleavage of A epitopes from membrane glycosphingolipids with short oligosaccharide chains was similarly resistant. Rates of cleavage from A1 and A2 RBCs were similar.CONCLUSION: RBC epitopes of blood group A differ in susceptibility to cleavage and biologic reactivity, which suggests that subsets mediating important biologic functions exist on functionally and topographically distinct membrane glycoconjugates.