bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic accuracy and efficacy of color Doppler mapping for tubal patency
Authors: Demir Berfu , Kocak Muberra , Beydilli Gulay , Kaplan Metin , Gelisen Orhan , Haberal Ali
Published: March 2011

Aim:  To evaluate the diagnostic accuracy of color Doppler mapping for tubal patency, comparing its results with those of hysterosalpingography (HSG) and laparoscopy.

Material and Methods:  A prospective clinical study was conducted in 36 subfertile women who were offered laparoscopy after HSG evaluation. All infertile couples were evaluated with basic infertility procedures. After HSG assessment, laparoscopy was offered when evidence of either unilateral or bilateral tubal obstruction was observed. One day before the operation, transvaginal ultrasound scanning of the pelvis and color Doppler mapping were performed. The findings of sonography, HSG and laparoscopy were compared.

Results:  Sixty‐four of 72 fallopian tubes were evaluated and four patients were excluded from the analysis because of technical difficulties. The sensitivity of color Doppler mapping for detecting tubal patency was 76.2% with a specificity of 81.4%. The positive and negative predictive values were 66.7% and 87.5%, respectively. The concordance rate was 79.7%. The false positivity rate for color Doppler mapping and HSG were observed as 19% and 35%, respectively.

Conclusion:  Color Doppler mapping as an adjunct to an abnormal HSG may decrease the need for laparoscopic intervention for the diagnosis of tubal disorders.
Comparison of success rate of nifedipine, progesterone, and bed rest for inhibiting uterine contraction in threatened preterm labor
Authors: Chawanpaiboon Saifon , Pimol Kanjana , Sirisomboon Ratre
Published: March 2011

Aim:  To compare the success rates and gestational ages at delivery of nifedipine, proluton depot administration as a tocolytic agent and bed rest groups to pregnant women with threatened preterm labor.

Material and Methods:  A total of 150 pregnant women with threatened preterm labor between 28 and 35 weeks of gestation were enrolled in the study. All women underwent contraction inhibition randomly sorted into three groups. The first and second groups were inhibited with nifedipine and proluton depot, respectively. The third group was admitted for bed rest.

Results:  Nifedipine, proluton depot and bed rest can be used to inhibit contraction in threatened preterm labor. However, when time‐to‐event test was used, nifedipine took the shortest time for contraction inhibition with statistical significance.

Conclusion:  Nifedipine, proluton depot and bed rest can be used successfully to inhibit contraction in threatened preterm labor. However, nifedipine took the shortest time to inhibit uterine contraction in threatened preterm labor.
Decreased fetal movement prompts investigation of prenatal/neonatal nemaline myopathy: The possible merit of fetal movement count
Authors: Kuwata Tomoyuki , Matsubara Shigeki , Ohkusa Takashi , Yada Yukari , Suzuki Mitsuaki
Published: March 2011

We highlight the merit of fetal movement count to identify a fetus with neuromuscular disorder: nemaline myopathy. A 38‐year‐old 1‐para woman not in a consanguineous marriage had decreased fetal movement. This, together with increased amniotic fluid volume, led us to perform detailed ultrasound examinations, which revealed stretch contracture of the knee joints, leading us to suspect fetal neuromuscular disorders. At 382/7, she gave birth vaginally to a 2444 g female infant. Her respiration was very weak, requiring respiratory support. Contractures of the upper/lower extremity joints and club feet were observed. All skeletal muscles were hypotonic. Biopsized muscle cells showed nemaline bodies, confirming the diagnosis of nemaline myopathy. Fetal movement count may contribute to the identification of fetal neuromuscular diseases, such as nemaline myopathy.
Sonographic measurement of cervical length and risk of preterm delivery
Authors: Demirci Oya , Ünal Ayşegül , Demirci Elif , Sözen Hamdullah , Akdemir Yeşim , Boybek Esra , Ertekin Aktuğ
Published: March 2011

Aim:  To study the relationship between cervical lengths measured by ultrasound and risk of preterm delivery.

Material & Methods:  We examined 209 women with singleton pregnancies. The inclusion criteria were women who presented with regular and painful contractions (≥2 contractions at intervals of 10 min for at least 1 h). Transvaginal scan was performed to measure the cervical length. The clinical management of the women, including hospitalization and administration of tocolytics, was determined by the attending obstetricians, who were blinded about cervical length. The primary outcome was delivery within 7 days of presentation.

Results:  Delivery within 7 days of presentation occurred in 19/209 (9%) of pregnancies who were presenting with regular and painful uterine contraction at 31 weeks of gestation, and this was inversely related to cervical length. Logistic regression analysis demonstrated that cervical length and history of abortion remain as significant contributors to predicting delivery within 7 days. Of the patients who presented with threatened preterm labor, 117 (56%) received tocolytics, and 92 (44%) did not. In the group with a cervical length of <15 mm, delivery within 7 days occurred in 15/21 (71.4%) who were treated with tocolytics and 2/5 (40%) that were managed expectantly.

Conclusion:  Women with threatened preterm labor and a cervical length of <15 mm at presentation are at high risk of delivering preterm within 7 days. Sonographic measurement of cervical length helps to avoid over‐diagnosis of preterm labor.
Seven principles in the regulation of adult neurogenesis
Authors: Kempermann Gerd
Published: March 2011

Seven key elements describing the regulation of adult neurogenesis are proposed. (i) A distinction must be made between regulation and ‘control’ at the transcriptional level in order to appreciate the hierarchy of regulatory factors. (ii) The regulatory hierarchy comprises conceptual levels from behaviour to genes. Consequently, ‘regulation’ of neurogenesis can be confounded by confusing rather than integrating factors, levels and concepts. The immense spectrum of neurogenic regulators reflects the sensitivity of adult neurogenesis to many different types of stimuli, and provides a means of abstraction. (iii) Age per se does not seem to play a constant role in the modulation of this process, as the dramatic ‘age‐related’ changes in adult neurogenesis only take place early in life. (iv) The regulatory hierarchy at any given time‐point is corresponded by the directionality and sequential interdependence of different regulatory factors in the course of development. Regulation goes from non‐specific to specific, and the following steps build on regulation at the previous ones. (v) This complexity is reflected at the genetic level in that adult neurogenesis is highly heritable and highly polygenic with single factors explaining little of the variance. (vi) As regulation is additive, there is an element of self‐reinforcement in the regulation of adult neurogenesis, allowing the formation of regulatory reserves for situations of functional demand. (vii) The complexity of regulation makes adult neurogenesis sensitive to pathological disturbance at various levels, suggesting that different molecular events might result in similar and shared behavioural or functional phenotypes originating in the dentate gyrus.
Restrictions in time and space – new insights into generation of specific neuronal subtypes in the adult mammalian brain
Authors: Weinandy Franziska , Ninkovic Jovica , Götz Magdalena
Published: March 2011

Key questions in regard to neuronal repair strategies are which cells are best suited to regenerate specific neuronal subtypes and how much of a neuronal circuit needs to persist in order to allow its functional repair. Here we discuss recent findings in the field of adult neurogenesis, which shed new light on these questions. Neural stem cells in the adult brain generate very distinct types of neurons depending on their regional and temporal specification. Moreover, distinct brain regions differ in the mode of neuron addition in adult neurogenesis, suggesting that different brain circuits may be able to cope differently with the incorporation of new neurons. These new insights are then considered in regard to the choice of cells with the appropriate region‐specific identity for repair strategies.
Epigenetic regulation of neurogenesis in the adult mammalian brain
Authors: Sun Jiaqi , Sun Jiawei , Ming Guo‐li , Song Hongjun
Published: March 2011

Epigenetic regulation represents a fundamental mechanism to maintain cell‐type‐specific gene expression during development and serves as an essential mediator to interface the extrinsic environment and the intrinsic genetic programme. Adult neurogenesis occurs in discrete regions of the adult mammalian brain and is known to be tightly regulated by various physiological, pathological and pharmacological stimuli. Emerging evidence suggests that various epigenetic mechanisms play important roles in fine‐tuning and coordinating gene expression during adult neurogenesis. Here we review recent progress in our understanding of various epigenetic mechanisms, including DNA methylation, histone modifications and non‐coding RNAs, as well as cross‐talk among these mechanisms, in regulating different aspects of adult mammalian neurogenesis.
A new chapter in the field of memory: adult hippocampal neurogenesis
Authors: Koehl Muriel , Abrous Djoher N.
Published: March 2011

Understanding the cellular mechanisms underlying learning and memory is a major challenge in neurobiology. Structural and functional changes occurring in the hippocampus such as synaptic remodeling and long‐term potentiation are key signatures of long‐term memory processes. The discovery of a de novo hippocampal production of neurons in the adult brain has been a breakthrough in the field of plasticity and memory, introducing a new actor that could sustain memory processes. Here we will review our current knowledge on the role of these adult new neurons in memory. In particular we will provide evidence showing that they are required for learning and memory and that an alteration in their production rate or maturation leads to memory impairments. Through a thorough survey of the literature, we will also acknowledge that there are many controversies regarding the specific role played by newborn neurons. The emerging picture is that they are involved in the establishment of spatiotemporal relationships among multiple environmental cues for the flexible use of the acquired information. Indeed, newborn neurons have been found to be required for separating events based on their spatial and temporal characteristics, a process that preserves the uniqueness of a memory representation. Thus, adult‐born neurons are required for allocentric space representation, for long‐term memory retention and for flexible inferential memory expression. Finally, we will conclude by highlighting directions for future research, emphasizing that the exact participation of newborn neurons in memory processes will not be approached without considering the hippocampal network in general.
Neurogenesis and affective disorders
Authors: Samuels Benjamin A. , Hen René
Published: March 2011

The neurogenesis hypothesis of depression was originally formed upon the demonstration that stress impacts levels of adult neurogenesis in the hippocampus. Since then much work has established that newborn neurons in the dentate gyrus are required for mediating some of the beneficial effects of antidepressant treatment. Recent studies combining behavioral, molecular and electrophysiological approaches have attempted to make sense of the role young neurons play in modulating mood by demonstrating a potential role in regulating the circuitry in the brain that underlies depression. Here we discuss the work that led to the neurogenesis hypothesis of depression, and the subsequent studies that have sought to test this hypothesis. We also discuss different animal models of depression that have been used to test the role of neurogenesis in mediating the antidepressant response.
Modeling new neuron function: a history of using computational neuroscience to study adult neurogenesis
Authors: Aimone James B. , Gage Fred H.
Published: March 2011

Adult neurogenesis is a sophisticated biological process whose function has remained a mystery to neuroscience researchers. To address this question, a number of unique modeling studies have explored the computational implications of adding new neurons to the adult dentate gyrus. Models of neurogenesis fall into two broad categories: abstract models that explore the function of new neurons in simple networks, and biologically based models that investigate the role of new neurons in networks based on the anatomy of the hippocampus. In this review, we summarize the strategies and results of these different modeling approaches, and we discuss their conclusions and limitations in the face of new biological findings.
Neurogenesis in humans
Authors: Curtis Maurice A. , Kam Monica , Faull Richard L. M.
Published: March 2011

Since 1944 increasing evidence has been emerging that the adult human brain harbours progenitor cells with the potential to produce neuroblasts. However, it was not until 1998 that this fact was confirmed in the adult human brain. With the purpose of human neurogenesis being hotly debated, many research groups have focussed on the effect of neurodegenerative diseases in the brain to determine the strength of the endogenous regenerative response. Although most of the human studies have focussed on the hippocampus, there is a groundswell of evidence that there is greater plasticity in the subventricular zone and in the ventriculo‐olfactory neurogenic system. In this review, we present the evidence for increased or decreased plasticity and neurogenesis in different diseases and with different drug treatments in the adult human brain. Whilst there is a paucity of studies on human neurogenesis, there are sufficient to draw some conclusions about the potential of plasticity in the human brain.
Comparative analysis of various prognostic nodal factors, adjuvant chemotherapy and survival among stage III colon cancer patients over 65 years: an analysis using Surveillance, Epidemiology and End Results (SEER)‐Medicare data
Authors: Hanna N. N. , Onukwugha E. , Choti M. A. , Davidoff A. J. , Zuckerman I. H. , Hsu V. D. , Mullins C. D.
Published: March 2011

Aim  The prognostic effects of chemotherapy and various lymph node measures [positive nodes, total node count and the positive lymph node ratio (PLNR)] have been established. It is unknown whether the cancer‐specific survival benefit of chemotherapy differs across these nodal prognostic categories.

Method  This retrospective analysis of linked Surveillance, Epidemiology and End Results (SEER) data and Medicare data (SEER‐Medicare)included patients ≥ 65 years of age with a diagnosis of stage III colon cancer between 1997 and 2002. We grouped patients according to the number of positive nodes (N1 and N2), total node count (≥ 12 and < 12 total nodes) and PLNR (below the 75th percentile and at least at the 75th percentile of the PLNR). The end point was colon cancer‐specific mortality.

Results  Fifty‐one per cent (3701) of the 7263 patients received adjuvant therapy during the time period 1997–2002. The mean (standard deviation) number of total nodes examined was 13 (9) and the number of positive nodes identified was 3 (3). Patients with N2 disease, < 12 total nodes examined and a high PLNR had a worse survival at 2, 3 and 5 years following colectomy. Utilization of chemotherapy demonstrated a colon cancer‐specific survival benefit (hazard ratio at median follow up = 0.7; P < 0.001) that was consistent and statistically significant across the three nodal prognostic categories examined.

Conclusion  The benefit of chemotherapy did not vary based on N stage, total node count or PLNR. The results favour a broad‐based approach towards increasing the chemotherapy treatment rates in stage III patients of ≥ 65 years of age, rather than an approach that targets clinical subgroups.
Time‐intensity curve parameters in colorectal tumours measured using double contrast‐enhanced ultrasound: correlations with tumour angiogenesis
Authors: Zhuang H. , Yang Z‐G. , Chen H‐J. , Peng Y‐L. , Li L.
Published: March 2011

Aim  The aim of the study was to assess the correlation between time‐intensity curve (TIC) parameters and colorectal tumour angiogenesis using double contrast‐enhanced ultrasound (DCEUS), in which an intraluminal contrast agent was used in combination with an intravascular contrast agent.

Method  Thirty nine patients with colorectal tumours were examined preoperatively. During hydrocolonal examination with the intraluminal contrast agent, an intravascular contrast agent, SonoVue, was used to perform the DCEUS. The parameter arrival time (AT), time to peak (TTP), peak intensity (PI) and area under the curve (AUC) were measured. Postoperative specimens were assessed for microvessel density (MVD) and vascular endothelial growth factor (VEGF). The correlation between TIC parameters and the expression of VEGF or MVD was studied.

Results  The mean values of AT, TTP, PI and AUC of the colorectal tumours were 14.32 ± 11.36 s, 30.61 ± 18.65 s, 20.38 ± 17.45 dB and 221.10 ± 156.09 dB.s, respectively. Both AUC and MVD were significantly higher in colorectal adenocarcinomas than in adenomas (all P < 0.05). A positive linear correlation was found between the AUC and MVD in colorectal tumours (r = 0.686, P = 0.0019). No correlation was found between VEGF and any TIC parameter.

Conclusion  DCEUS is a valuable method for evaluating angiogenesis in colorectal tumours in vivo. The AUC has a positive linear correlation with MVD and could form a new index for assessing angiogenesis and the biological behaviour of colorectal tumours.
Pouchitis may increase the risk of dysplasia after restorative proctocolectomy in patients with ulcerative colitis.
Authors: Banasiewicz T. , Marciniak R. , Paszkowski J. , Krokowicz P. , Kaczmarek E. , Walkowiak J. , Szmeja J. , Majewski P. , Drews M.
Published: March 2011

Aim  Dysplasia of the pouch mucosa after restorative proctocolectomy is rare. The aim of this study was to establish whether there is a correlation between pouchitis and dysplasia.

Method  A group of 276 patients treated for ulcerative colitis by restorative proctocolectomy between 1984 and 2009 was analysed. The presence or absence of pouchitis and dysplasia within the pouch was evaluated.

Results  Inflammation was diagnosed in 66 (23.9%) patients, low‐grade dysplasia in five (1.8%), high‐grade dysplasia in three (1.1%), and cancer in one patient (0.4%). The prevalence of low‐grade dysplasia was significantly higher in patients with inflammation than in those without (P < 0.04). High‐grade dysplasia was significantly more frequent in pouchitis than in non‐inflamed pouches (P < 0.01). Logistic regression analysis suggested that the occurrence of mucosal inflammation increased the risk of low grade dysplasia.

Conclusion  Patients with chronic pouchitis are at risk of dysplasia and require surveillance of the pouch.
Anorectal function evaluation and predictive factors for faecal incontinence in 600 patients
Authors: Lam T. J. , Kuik D. J. , Felt‐Bersma R. J. F.
Published: March 2011

Aim  Anorectal function was assessed in patients with and without faecal incontinence (FI) . Risk factors predictive for FI were determined.

Method  Between 2003 and 2009, all consecutive patients referred were assessed by questionnaire, anorectal manometry and anal endosonography. Predictive factors were identified and used to develop a statistical model to predict FI.

Results  Of 600 patients (519 women), 285 (48%) were faecally incontinent. In comparison with continent women, incontinent women (mean Vaizey score 15.4), were older, had more liquid stools, more deliveries, more urinary incontinence, lower anal pressures, shorter sphincter length, smaller rectal capacity and more sphincter defects. Incontinent men (mean Vaizey score 15.3) were older and had lower anal pressures. Incontinent and continent patients showed an overlap in test results. Predictors in women were age, stool consistency, anal pressures, rectal capacity, and internal and external sphincter defects. The area under the ROC‐curve was 0.84 (P < 0.001; 95% confidence interval, 0.80–0.87). Using a cut off point of 0.4, FI was predicted with sensitivity, specificity, positive and negative predictive values of 86%, 68%, 74% and 82%, respectively. The model was studied in five women with a temporary stoma and was accurate in predicting FI after stoma closure.

Conclusion  Incontinent patients have lower pressures, smaller rectal capacity and more sphincter defects than controls, but show a large overlap. Our model shows a relatively high sensitivity and negative predictive value for predicting FI in women. The model seems promising in the patients studied with a temporary stoma.
Perceived challenges and priorities in co‐morbidity management of older patients with Type 2 diabetes
Authors: Beverly E. A. , Wray L. A. , Chiu C. J. , Weinger K.
Published: March 2011

Diabet. Med. 28, 781–784 (2011)

Aims  To explore older patients’ perceived impact of chronic co‐morbid conditions on Type 2 diabetes self‐management.

Methods  We used purposive sampling to select 32 mentally alert community‐dwelling adults, aged 60 years or older, diagnosed with Type 2 diabetes and at least one other chronic health condition to participate in focus groups. We summarized the discussions following each focus group and identified codes to describe the overarching themes.

Results  We conducted eight 90‐min focus groups, each consisting of two to six patients. Three themes emerged. (i) Diabetes complications as a motivator: managing co‐morbid conditions made health an important focal point in the lives of older patients. Most patients acknowledged the positive effect complications had on their diabetes self‐management by motivating them to pay greater attention to their diabetes to diminish the progression of these complications. (ii) Prioritizing health conditions: patients reported prioritizing health conditions and selectively attending to the management of those conditions based on perceived severity or importance. Further, many patients perceived some conditions as more serious than others and admitted to prioritizing another health condition over their diabetes. (iii) Emotional impact of co‐morbidity management: patients described feeling frustrated, confused, and overwhelmed in response to conflicting treatment recommendations, particularly for diet, physical activity and medication regimens.

Conclusions  Complications and co‐morbidities may have differential impacts on the diabetes self‐management of older patients. Addressing the perceived impact of co‐morbidity on diabetes self‐management may improve patients’ outcomes; however, the most effective method of utilizing this information in clinical practice needs to be examined.
The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes
Authors: Corrado F. , D’Anna R. , Di Vieste G. , Giordano D. , Pintaudi B. , Santamaria A. , Di Benedetto A.
Published: March 2011

Diabet. Med. 28, 972–975 (2011)

Aim  To test the hypothesis that myoinositol supplementation will improve insulin sensitivity as measured by markers of insulin resistance such as homeostasis model assessment of insulin resistance and adiponectin in women with gestational diabetes.

Methods  The trial was carried out in diet‐treated patients with gestational diabetes diagnosed in our department between April 2008 and September 2009. Subjects were randomly assigned to receive either myoinositol supplementation (4 g daily) plus folic acid (400 μg daily)—the study group—or folic acid only (400 μg daily)—the control group. Both groups received the same diet prescription. Homeostasis model assessment of insulin resistance and adiponectin were assayed while fasting at the time of the diagnostic oral glucose tolerance test and after 8 weeks of treatment.

Results  There were 69 evaluable patients, 24 in the study group and 45 in the control group. Fasting glucose and insulin, and consequently homeostasis model assessment of insulin resistance, decreased in both groups (50% in the study group vs. 29% in the control group), but the decline in the study group was significantly greater than that in the control group (P = 0.0001). Adiponectin increased in the myoinositol group while it decreased in the control group (P = 0.009).

Conclusion  Myoinositol improves insulin resistance in patients with gestational diabetes.
Cognitive function in 6‐ to 12‐year‐old offspring of women with Type 1 diabetes
Authors: Temple R. C. , Hardiman M. , Pellegrini M. , Horrocks L. , Martinez‐Cengotitabengoa M.‐T.
Published: March 2011

Diabet. Med. 28, 845–848 (2011)

Aims  Maternal diabetes is a recognized risk factor for congenital malformation, perinatal morbidity and obesity in later childhood. The aim of this study is to assess the impact of maternal diabetes on cognitive function in offspring.

Methods  Participants were 6‐ to 12‐year‐old offspring of women with Type 1 diabetes. All women received their antenatal care and delivered at one university hospital. HbA1c was monitored monthly throughout pregnancy and cognitive function was assessed using the Wechsler Intelligence Scale for Children, version 4.

Results  We present results in 40 offspring. There was no difference in overall full‐scale IQ compared with UK normative data. However, working memory was poorer than other parts of the Wechsler Intelligence Scale for Children version 4 test and significantly lower compared with UK normative data [8.4 (2.2) vs. 10.1 (3.2), P < 0.01]. We found no correlation between measurement of digit span or HbA1c at any stage during pregnancy (r = –0.225 to 0.002), gestational age at delivery (r = –0.178) or infant birthweight ratio (r = –0.176). There was no relationship between working memory score and maternal hypoglycaemia episodes or maternal duration of diabetes. Comparing infants born before (n = 9) or after 37 weeks’ gestation, digit span was non‐significantly lower [7.9 (1.8) vs. 8.6 (2.4)].

Discussion  These results suggest offspring of women with Type 1 diabetes have normal overall cognitive function but poorer working memory. We have been unable to identify specific risk factors. Further larger studies are required to increase the understanding of this memory defect and identify any modifiable risk factors.
Glycaemic control is positively associated with prevalent fractures but not with bone mineral density in patients with Type 1 diabetes
Authors: Neumann T. , Sämann A. , Lodes S. , Kästner B. , Franke S. , Kiehntopf M. , Hemmelmann C. , Lehmann T. , Müller U. A. , Hein G. , Wolf G.
Published: March 2011

Diabet. Med. 28, 872–875 (2011)

Aim  There are conflicting data regarding the risk of osteoporosis in patients with Type 1 diabetes. We investigated an association between diabetes, bone mineral density and prevalent fractures.

Methods  A single‐centre, cross‐sectional study of men and pre‐menopausal women with Type 1 diabetes (n = 128) and a matched control group (n = 77) was conducted. The primary outcome measure was bone mineral density and secondary measures were markers of bone metabolism and prevalent fractures.

Results  Hip and total body bone mineral densities were significantly lower in women with diabetes compared with control subjects. In men, no difference in bone mineral density was found. A multivariate regression analysis in women with diabetes revealed higher BMI as the strongest predictor of higher total hip, femoral neck and total body bone mineral density, whereas previous fractures were inversely associated with total hip bone mineral density and C‐terminal telopeptide of type I collagen with total body bone mineral density. Poor long‐term glycaemic control was not associated with low bone mineral density. Fracture frequency was higher in patients with diabetes compared with control subjects (1.64 vs. 0.62 per 100 patient‐years; P < 0.05). In a multivariable model, long‐term HbA1c control was associated with increased clinical fracture prevalence (OR 1.92; 95% CI 1.09–2.75) in those with diabetes.

Conclusions  Type 1 diabetes contributes to low bone mineral density in women. Previous fractures and low BMI were strong predictors of impaired bone mineral density and should therefore be considered in risk estimation. Fractures are more frequent in Type 1 diabetes. Long‐term hyperglycaemia may account for impaired bone strength, independently from bone mineral density.
Islet autoantibodies can discriminate maturity‐onset diabetes of the young (MODY) from Type 1 diabetes
Authors: McDonald T. J. , Colclough K. , Brown R. , Shields B. , Shepherd M. , Bingley P. , Williams A. , Hattersley A. T. , Ellard Sian
Published: March 2011

Diabet. Med. 28, 1028–1033 (2011)

Aim  Maturity‐onset diabetes of the young is a monogenic form of familial, young‐onset diabetes. It is rare (∼1% diabetes) and may be misdiagnosed as Type 1 diabetes and inappropriately treated with insulin. Type 1 diabetes is characterized by the presence of islet autoantibodies, including glutamate decarboxylase (GAD) and islet antigen‐2 (IA‐2) antibodies. The prevalence of islet autoantibodies is unknown in maturity‐onset diabetes of the young and may have the potential to differentiate this form of diabetes from Type 1 diabetes. The aim of this study was to determine the prevalence of GAD and IA‐2 antibodies in patients with maturity‐onset diabetes of the young and Type 1 diabetes.

Methods  We measured plasma GAD and IA‐2 antibodies in 508 patients with the most common forms of maturity‐onset diabetes of the young (GCK: n = 227; HNF1A: n = 229; HNF4A: n = 52) and 98 patients with newly diagnosed Type 1 diabetes (diagnosed < 6 months). Autoantibodies were considered positive if ≥ 99th centile of 500 adult control subjects.

Results  GAD and/or IA‐2 antibodies were present in 80/98 (82%) patients with Type 1 diabetes and 5/508 (< 1%) patients with maturity‐onset diabetes of the young. In the cohort with Type 1 diabetes, both GAD and IA‐2 antibodies were detected in 37.8% of patients, GAD only in 24.5% and IA‐2 only in 19.4%. All five patients with maturity‐onset diabetes of the young with detectable antibodies had GAD antibodies and none had detectable IA‐2 antibodies.

Conclusion  The prevalence of GAD and IA‐2 antibodies in maturity‐onset diabetes of the young is the same as in control subjects (< 1%). The finding of islet autoantibodies, especially IA‐2 antibodies, makes the diagnosis of maturity‐onset diabetes of the young very unlikely and genetic testing should only be performed if other clinical characteristics strongly suggest this form of diabetes rather than Type 1 diabetes. This supports routine islet autoantibody testing before proceeding to more expensive molecular genetic testing.
Trends in Type 1 diabetes incidence in the UK in 0‐ to 14‐year‐olds and in 15‐ to 34‐year‐olds, 1991–2008
Authors: Imkampe A.‐K. , Gulliford M. C.
Published: March 2011

Diabet. Med. 28, 811–814 (2011)

Aim  To describe Type 1 diabetes incidence trends in the UK between 1991 and 2008 in children aged 0–14 years and in young adults aged 15–34 years.

Methods  Data from the UK General Practice Research Database were analysed, including 3002 individuals (1565 aged 0–14 years and 1437 aged 15–34 years) newly diagnosed with Type 1 diabetes. Poisson regression was used to model annual incidence increases and seasonality effects.

Results  Type 1 diabetes incidence increased from 11 to 24/100 000 person‐years in boys and from 15 to 20/100 000 person‐years in girls. In adults, the incidence rate increased from 13 to 20/100 000 person‐years (men) and from 7 to 10/100 000 person‐years (women). Annual incidence increases tended to be greater in children (4.1%, 95% CI 3.0–5.2%) compared with 15‐ to 34‐year‐olds (2.8%, 95% CI 1.6–3.9%). There was evidence of higher incidence rates during autumn and winter in children, but not in adults.

Conclusions  A continuing increase in Type 1 diabetes incidence was shown that was greater in children than in young adults. Seasonal variation was observed in children only.
Depressed youth: treatment outcome and changes in family functioning in individual and family therapy
Authors: Garoff Finn Ferdinand , Heinonen Kati , Pesonen Anu‐Katriina , Almqvist Fredrik
Published: March 2011

This study explores the role of family functioning in therapeutic change in focused individual psychodynamic psychotherapy (FIPP) and time‐limited systems integrative family therapy (SIFT) for depressed children and adolescents. After a screening process, 72 participants aged 8 to 15 were randomized to either FIPP or time‐limited SIFT. Assessments took place prior to, at the end of, and 6 months after treatment. Families in both SIFT and FIPP showed a small but significant and sustained improvement in family functioning by the end of treatment in both mothers' self‐reports and family therapists' assessments. Better family functioning at baseline in mothers' self‐reports and improved family functioning during SIFT, as assessed by family therapists, predicted a sustained decrease in self‐reported depressive symptoms. Results indicated that time‐limited SIFT may be more effective with younger children and in patients without a diagnosis of double depression than adolescents.
Global Imbalances, Under‐consumption and Over‐borrowing: The State of the World Economy and Future Policies
Authors: Cripps Francis , Izurieta Alex , Singh Ajit
Published: March 2011

This contribution addresses the question of whether growth convergence can be sustained in the global economy without compromising welfare and without causing major crises. It employs a simplified stock‐flow analytical framework to examine the proposition that the pace and pattern of global growth is conditioned by ‘under‐consumption’ in some regions of the world and ‘over‐borrowing’ in other regions. A baseline projection using the Cambridge‐Alphametrics model (CAM) illustrates consequences of resumed global imbalances after the 2008–2009 crisis. An alternative scenario exemplifies the case in which China and India shift towards internal income redistribution and domestic demand‐orientated policies and suggests that this will not be sufficient to correct global imbalances or induce improved growth rates in other developing regions. Finally a more ambitious development perspective is simulated. Such a scenario requires internationally‐coordinated policy efforts, with a greater role for governments in the management of demand, income distribution and environmental sustainability, as well as measures to reduce instability of exchange rate and commodity markets.
A test of stress theory: relief workers in refugee camps
Authors: Soliman Hussein H. , Gillespie David F.
Published: March 2011

The purpose of this paper is to apply a stress model drawn from the literature to the relief and social service workers who have been active in refugee camps for a prolonged period of time. Working in difficult environments, social service workers deliver essential services to refugee populations around the world. A model of four work‐stress determinants—tasks, management, appreciation and collaboration—was tested on 274 social workers in five regions of the Middle East (Jordan, Lebanon and Syria, as well as the occupied Palestinian territories of the Gaza Strip and the West Bank). Statistical fit indices were adequate but two relationships were statistically insignificant. The collaboration variable was dropped to create a modified model with tasks indirectly and management and appreciation directly affecting work‐related stress. The five direct relationships and two indirect relationships of this modified model are consistent with stress theory, and all relationships—direct and indirect—are statistically significant.
Free Health Clinics, Resistance and the Entanglement of Christianity and Commodified Health Care Delivery
Authors: Hossler Peter
Published: March 2011

Abstract:  Free clinics are an important part of the US health care safety net and their numbers are rising. This article offers a critical analysis of the politics of free health clinics in Milwaukee, Wisconsin. It uses the geographies of resistance literature to assess free clinics as a response to the neoliberalization of health care delivery. It underlines the multiple political spaces free clinics occupy as a result of the entanglements of a diverse range of identities and practices within the clinic space. In Milwaukee, the primary entanglement occurs between the progressive Christian identity inspiring the practices of the free clinic's volunteers and the commodified identity of the corporate non‐profit health care systems that dominate health care delivery in the city. This research suggests that understanding the transition from oppositional identities, such as progressive Christianity, to resistance is an important next step in constructing more robust responses to neoliberal capitalism and other exploitive social relations.
Glory as an Ethical Idea
Authors: Chappell Timothy
Published: March 2011

There is a gap between what we think and what we think we think about ethics. This gap appears when elements of our ethical reflection and our moral theories contradict each other. It also appears when something that is important in our ethical reflection is sidelined in our moral theories. The gap appears in both ways with the ethical ideaglory. The present exploration of this idea is a case study of how far actual ethical reflection diverges from moral theory. This divergence tells against moral theory, and in favour of less constricted and more flexible modes of ethical reflection.
The Cost of Being Mother's Ideal Child: The Role of Internalization in the Development of Perfectionism and Depression
Authors: Tong Ying , Lam Shui‐fong
Published: March 2011

The study investigated how children's willingness to internalize mothers' values affected the associations between mothers' performance goals for their children and the development of children's perfectionism and depression. The participants were 59 Hong Kong fifth graders and their mothers. The results showed that internalization, as a child factor, moderated the association between mothers' performance goals for their children and children's self‐oriented perfectionism, but not socially prescribed perfectionism. Children's internalization also moderated the association between mothers' performance goals for their children and children's depression. Among the children who were more willing to internalize their mothers' values, their mothers' performance goals for them were correlated positively with their self‐oriented perfectionism, but negatively with their depression. Paradoxically, internalization appeared to be a risk and also a protective factor in the psychological well‐being of children.
Contextual Variations in Ethnic Group Differences in Educational Attainments
Authors: Plewis Ian
Published: March 2011

The primary school population in England is becoming ethnically more diverse and differences in educational attainments between ethnic groups continue to be of interest. The paper applies multilevel modelling to an administrative database—the national pupil database—to assess the extent of these differences. It shows that the national picture hides considerable heterogeneity both within and between schools and that the models for attainment are complex. The analyses highlight the relative educational success of Chinese pupils and a cause for concern about the attainments of black Caribbean boys. The paper’s most important message is that conclusions about ethnic group differences in attainments need to be related to individual, family, school and cognitive contexts. Methodological issues about model specification and the categorization of ethnic groups are discussed.
The Impact of Uncertainty and Strategy on the Perceived Usefulness of Fixed and Flexible Budgets
Authors: Ekholm Bo‐Göran , Wallin Jan
Published: March 2011

Abstract:  It has been claimed that the traditional annual budget is a dysfunctional management instrument and that flexible budgets, such as rolling budgets, should be used instead. However, empirical research has produced conflicting results. The results of the present study indicate that environmental uncertainty has a significant negative association with the perceived usefulness of traditional annual budgets, whereas there is no indication of a significant association with flexible budgets. By contrast, there is a significant positive association between accentuation of strategy and appreciation of both types of budget. There is also evidence of a positive association between the perceived usefulness of traditional annual budgets and the perceived usefulness of flexible budgets, supporting prior findings that these budgets are seen more as complements than rivals.
The Market's Reaction to Unexpected Earnings Thresholds
Authors: Herrmann Don , Hope Ole‐Kristian , Payne Jeff L. , Thomas Wayne B.
Published: March 2011

Abstract:  We examine differences in quarterly earnings announcement returns as a function of meeting or missing each of three earnings thresholds – reporting a profit, reporting an increase in earnings, and meeting analysts’ forecasts. In contrast to prior research, the research design identifies the incremental market reaction to the profit and earnings increase thresholds, after controlling for the effect of meeting or missing analysts’ forecasts. Using this methodology, we find little evidence of incremental threshold effects beyond meeting analyst forecasts. In other words, zero earnings and a zero change in earnings do not appear to be ‘special’ points that elicit a differential response by investors. Our results are robust to including a number of control variables and alternative tests. The fact that we find little evidence to support market‐related incentives to manage earnings at the profit and earnings increase thresholds suggests either that managers have other incentives to manage earnings at these thresholds or that managers perceive market rewards and penalties when none exist.
Capital Allocation and Timely Accounting Recognition of Economic Losses
Authors: Bushman Robert M. , Piotroski Joseph D. , Smith Abbie J.
Published: March 2011

Abstract:  This paper explores direct relations between corporate investment behavior and the timeliness of accounting recognition of economic losses (TLR) reflected in a country's accounting regime. We explicitly investigate the extent to which TLR influences investment decisions of firm managers. Given the asymmetric emphasis on negative outcomes inherent in TLR, we hypothesize that TLR will most strongly influence investment behavior when managers face deteriorating investment environments. We conjecture that TLR will have an asymmetric impact on investment behavior whereby TLR impacts firms’ investment decisions in the face of declining investment opportunities, but not in the face of increasing in investment opportunities. Using firm‐level investment decisions spanning twenty five countries, we find that investment responses to declining opportunities increases with TLR, while we find no evidence that TLR influences the sensitivity of investment to increasing investment opportunities. Our results are robust to alternative estimates of TLR, alternative estimates of investment responses to changing investment opportunities, and to controls for important country‐level, industry‐level, and firm‐level variables that may impact firms’ investment decisions.
Minor neurological dysfunction and IQ in 9‐year‐old children born at term
Authors: KIKKERT HEDWIG K , DE JONG CORINA , HADDERS‐ALGRA MIJNA
Published: March 2011

Aim  The aim of this study was to examine the relationship between the severity and type of minor neurological dysfunction (MND) and IQ in 9‐year‐old children born at term.

Method  Three hundred and forty‐one children (177 males, 164 females; mean age 9y, SD 3mo, range 8y 10mo–9y 7mo) who were born at term were neurologically assessed according to Touwen. Children with perinatal risk or with a congenital disorder were excluded. Special attention was paid to the severity and type of MND. Eight domains of dysfunction were distinguished, including fine manipulative ability and coordination. On the basis of the number of dysfunctional domains, the severity of dysfunction was expressed as simple MND (sMND) or complex MND (cMND). Verbal, Performance, and Full‐scale IQ (FSIQ) were assessed with the Wechsler Abbreviated Scale of Intelligence. Univariate and multivariate statistical analyses were performed.

Results  Neurologically normal children had higher IQ scores than those with sMND and cMND (mean FSIQ 104 [95% confidence interval (CI) 102–106] to 100 [95% CI 97–102] and 95 [95% CI 91–98] respectively). Multivariate statistics confirmed that the IQ scores of children with sMND and cMND did not differ. Fine manipulative disability and coordination problems were associated with lower IQ scores but other dysfunctions were not.

Interpretation  The type of MND rather than the severity is associated with lower IQ in children born at term.
Tropisetron and paracetamol association in post‐operative patients
Authors: Pickering Gisèle , Faure Michael , Commun Fabienne , de Boissy Elisabeth Carrier , Roche Ghislaine , Mom Thierry , Simen Estelle , Dubray Claude , Eschalier Alain , Gilain Laurent
Published: March 2011

Studies in animals and in healthy volunteers have demonstrated the central serotonergic analgesic mechanism of action of paracetamol involving the inhibition of this analgesia by tropisetron, a 5‐HT3 antagonist. This randomized, double‐blind, controlled study aims at studying this interaction in post‐operative patients after ear surgery. Thirty‐six patients are included in two parallel groups with intravenous paracetamol (1 g) and either tropisetron (T, 5 mg/mL) or placebo (c, NaCl 0.9%) administered at the end of surgery. Numerical pain evaluations are performed every 30 min, six times after awakening. The difference between the sums of numerical scales of both groups [9 ± 10 (T) vs. 6 ± 7 (c)] is not significant, but the tropisetron group displays higher pain scores despite additional rescue analgesia. The limits of this trial call for a much larger study to investigate further this pharmacodynamic interaction.
Comparison of the approaches to non‐febrile neutropenia developing in children with acute lymphoblastic leukemia
Authors: Paksu Muhammet Sukru , Paksu Sule , Akbalik Mehtap , Ozyurek Emel , Duru Feride , Albayrak Davut , Fisgin Tunc
Published: March 2011

The objectives of this study was to investigate of the influences of high‐dose (20 mg/kg/day) methyl prednisolone (HDMP) and granulocyte colony stimulating factor (G‐CSF) in shortening the duration of chemotherapy‐induced neutropenia encountered in children with ALL receiving maintenance therapy. Sixty‐four non‐febrile neutropenic attacks developed in 29 patients with ALL receiving St Jude XIII maintenance protocol were evaluated retrospectively. The patients were clinically followed up without drugs for shortening the duration of neutropenia in 21 (32.8%) attacs, while HDMP and G‐CSF were administered in 26 (40.6%) and 17 (26.6%) attacks, respectively. After the detection of neutropenia, restoration of neutrophil counts at 2nd or 4th days to the levels that allow resuming the chemotherapy were considered as success. While second day and overall success rates in patients administered HDMP and G‐CSF were significantly higher than the patients who were observed clinically. Both second day and overall neutrophil counts were significantly higher in patients administered G‐CSF than the other groups. Methyl prednisolone and G‐CSF treatments were well‐tolerated by the patients. The cost‐per neutropenic attack was significantly higher in G‐CSF group than of the HDMP group. Especially in patients experiencing frequent neutropenic attacks and hence interruptions of the therapy, one of the myelopoiesis induction therapies can be used to shorten the duration of neutropenia. For this indication short‐course HDMP therapy can be considered as an alternative to G‐CSF in this patients due to its relatively low cost, amenability to outpatient administration, and well‐tolerability by children.