bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Features of Malabsorptive Disorders, Small-Bowel Diseases, and Bacterial Overgrowth Syndromes
Authors: Oxentenko Amy S. 
Published: August 2014

Abstract
Malabsorption (defect in absorption of nutrients) and maldigestion (defect in hydrolysis of nutrients) both imply disordered physiologic mechanisms in the gastrointestinal system. Malabsorption and maldigestion of nutritional substrates can occur in multiple phases: the luminal phase, the mucosal phase, and the delivery phase. Small-bowel diseases include celiac disease, Whipple disease, tropical sprue, eosinophilic gastroenteritis, intestinal lymphangiectasia, and amyloidosis. Normally, the small-bowel flora contains a relatively small number of bacteria, with a predominance of gram-positive organisms. In contrast, the colonic flora has a significantly higher concentration of bacteria, which are largely gram-negative and anaerobic organisms. When there is stasis, altered motility, or loss of protective defenses in the proximal intestinal tract, bacteria that are more representative of colonic flora can overgrow in the small bowel and result in a syndrome of diarrhea and nutritional deficiencies known as small intestinal bacterial overgrowth.
Nonvariceal Gastrointestinal Tract Bleeding
Authors: Alexander Jeffrey A. 
Published: August 2014

Abstract
Upper gastrointestinal tract bleeding (“UGI bleeding”) constitutes 75% to 80% of all cases of acute gastrointestinal tract bleeding. The incidence has decreased, but the mortality rate from acute UGI bleeding, ranging from 3% to 10%, has not changed appreciably in the past 50 years. This lack of change in mortality rate likely is related to the increased age of patients who present with UGI bleeding and the increase in associated comorbid conditions. Peptic ulcers are the most common source of UGI bleeding, accounting for about 40% of cases. Other major causes are gastric erosions, bleeding varices, and Mallory-Weiss tears. The use of aspirin or nonsteroidal anti-inflammatory drugs is prevalent in 45% to 60% of all cases of acute bleeding. Moreover, the risk of UGI bleeding is increased in patients who take as few as one “baby aspirin” per day.
Cholestatic Liver Disease
Authors: Talwalkar Jayant A. 
Published: August 2014

Abstract
Cholestatic liver disease in adults without biliary obstruction encompasses a broad differential diagnosis. Drug-induced cholestasis may be the most common explanation for cholestasis in these patients. Primary biliary cirrhosis is the most common cholestatic liver disease in adults. Primary sclerosing cholangitis is about half as common as primary biliary cirrhosis. Other cholestatic conditions in adults include antimitochondrial antibody (AMA)-negative primary biliary cirrhosis, human immunodeficiency virus (HIV)-related cholangiopathy, and miscellaneous conditions.
Autoimmune Hepatitis
Authors: Watt Kymberly D. , Czaja Albert J. 
Published: August 2014

Abstract
Autoimmune hepatitis is a self-perpetuating inflammation of the liver of unknown cause that is associated with autoantibodies, hypergammaglobulinemia, and interface hepatitis seen on histologic examination. Autoimmune hepatitis afflicts 100,000 to 200,000 persons in the United States annually and accounts for 5.9% of liver transplants performed in the United States. The cause of autoimmune hepatitis is unknown. Multiple agents have been implicated as triggers of the disease, including certain viruses (hepatitis A, hepatitis B, hepatitis C, Epstein-Barr, herpes simplex, and measles viruses) and drugs (diclofenac, isoniazid, ?-methyldopa, minocycline, nitrofurantoin, atorvastatin, and propylthiouracil; recently, infliximab and adalimumab have been implicated). Hepatitis A virus infection and minocycline have been implicated most often worldwide. Most cases have no identifiable trigger.
Peptic Ulcer Disease
Authors: Hansel Stephanie L. 
Published: August 2014

Abstract
A peptic ulcer is a persistent 5 mm or larger break in the gastrointestinal mucosa of the stomach or duodenum that penetrates through the muscularis mucosa. At endoscopy, an ulcer should be readily apparent with perceivable depth. Smaller and more shallow mucosal breaks represent erosions. Most ulcers are due to infection with Helicobacter pylori or the administration of nonsteroidal anti-inflammatory drugs. The term peptic ulcer disease refers to ulceration that depends in part on the acid and peptic (pepsins) activity of gastric juice. Gastric malignancy is an example of ulceration that may occur in the absence of acid and peptic activity. Most peptic ulcer disease involves the stomach or duodenal bulb. Epidemiology, pathophysiology, diagnosis, testing, and treatment are discussed.
Preservation of Blueschist-facies Minerals along a Shear Zone by Coupled Metasomatism and Fast-flowing CO2-bearing Fluids
Authors: Kleine Barbara I. , Skelton Alasdair D. L. , Huet Benjamin , Pitcairn Iain K. 
Published: August 2014

AbstractTwo types of blue halo (types I and II) composed of blueschist-facies minerals are centered around a brittle, normal shear zone in greenschist-facies rocks on the island of Syros, Aegean Sea, Greece. The shear zone is steeply dipping and cuts a near-horizontal layer of greenschist-facies rocks (albite + epidote + actinolite + chlorite + quartz). Type I and II blue haloes are 0·3 m and c. 1 m wide respectively, and are seen on both sides of the shear zone. The inner type I haloes are composed of nearly pure glaucophane schist and were formed by metasomatic addition of Na2O and SiO2, and to a lesser extent of K2O and large ion lithophile elements (LILE), coupled with loss of CaO, Al2O3 and MnO. The outer type II haloes consist of a carbonated blueschist-facies assemblage (glaucophane + calcite + phengite + epidote + garnet + quartz). These experienced only slight metasomatic changes (i.e. addition of K2O and LILE), which cannot alone explain halo formation. We present petrological, geochemical and thermodynamic evidence that this assemblage was preserved at greenschist-facies conditions because XCO2 was elevated by flow of a CO2-bearing fluid along the shear zone, which was approximately contemporaneous with greenschist-facies hydration in the surrounding rocks. We further note that the flux of CO2-bearing fluid along the shear zone was rapid with respect to the fluid flux in the surrounding rocks. Mass-balance calculations reveal that the fluid flux within the shear zone was at least 100–2000 times greater than the fluid flux within the surrounding rocks. Mineral textures show greenschist-facies minerals replacing blueschist minerals in the type II haloes, supporting our interpretation that the blueschist-facies minerals were preserved during greenschist-facies retrogression. A simplified P–T vs XCO2 pseudosection confirms that preservation of carbonated blueschist can occur at greenschist-facies conditions in the presence of a CO2-bearing fluid.
Lack of Nephrotoxicity by 6% Hydroxyethyl Starch 130/0.4 during Hip Arthroplasty
Authors: Kancir Anne Sophie Pinholt , Pleckaitiene Lina , Hansen Torben Bæk , Ekeløf Niels Peter , Pedersen Erling Bjerregaard 
Published: August 2014

Abstract

Background:
Hydroxyethyl starch (HES) is commonly used as plasma expander during surgery but may be nephrotoxic as seen in studies in patients with sepsis. The authors hypothesized that the possible nephrotoxicity of 6% HES 130/0.4 could be revealed by measurements of urinary excretion of neutrophil gelatinase–associated lipocalin (u-NGAL) in patients with normal renal function during hip arthroplasty.

Methods:
In this randomized, double-blinded, placebo-controlled study, 40 patients referred for hip arthroplasty received either 6% HES 130/0.4 or isotonic saline 0.9%; 7.5 ml/kg during the first hour of surgery and 5 ml/kg during the following hours; 38 patients completed the study. U-NGAL, urine albumin, blood pressure, and plasma concentrations of creatinine, renin, NGAL, albumin, angiotensin-II, and aldosterone were measured before, during, and after surgery. U-NGAL was defined as primary outcome.

Results:
There were no significant differences in U-NGAL (mean difference and 95% CI), plasma creatinine, and urine albumin during the study. U-NGAL and urine albumin increased significantly in both groups the morning after surgery but was normalized at follow-up after 10 to 12 days. Mean arterial pressure was significantly higher during the recovery period in the HES group compared with that in the control group (91 [13] and 83 [6] mmHg, mean [SD], P < 0.03). Plasma renin and angiotensin-II were nonsignificantly different in both groups, whereas plasma aldosterone was significantly lower in the HES group. Plasma albumin was reduced in both groups, but to a significantly lower level in the HES group.

Conclusion:
The study showed no evidence of a harmful effect of intraoperative infusion of 6% HES 130/0.4 on renal function in patients during hip arthroplasty.
To vaccinate or not to vaccinate: lessons learned from an experimental mass vaccination of free‐ranging dog populations
Authors: Belsare A. V. , Gompper M. E. 
Published: August 2014

AbstractDomestic animal populations have the potential to act as reservoirs for multi‐host pathogens, which may be transmitted to native species and cause population declines or extirpations. Domestic dogs are known reservoirs for several multi‐host pathogens that may be transmitted to native carnivores. Mass vaccination of dogs has been suggested as a tool for mitigating the disease threat to sympatric carnivores. To determine the extent to which such mass vaccination programs are practicable and appropriate for large, free‐ranging dog populations, a vaccination experiment was undertaken in six villages adjoining the Great Indian Bustard Wildlife Sanctuary in central India. Dogs from three villages were vaccinated against rabies virus, canine adenovirus (CAV), canine parvovirus (CPV) and canine distemper virus (CDV) (treatment dogs), while those from three other villages were only vaccinated against rabies virus (control dogs). Immunoglobulin G (IgG) antibody titers against CAV, CPV and CDV in control and treatment dogs were determined on four occasions during the study. When first examined, a large proportion of the initially unvaccinated adult dogs in both the control and treatment group were IgG antibody positive, indicating prior natural exposure. Dogs recovering from natural infection because of CAV, CPV and CDV develop a lifelong immunity and are thus protected against these pathogens. For each of the three viruses, background antibody seroprevalence rates were generally > 72%. Furthermore, several unvaccinated adult dogs acquired protection against these pathogens during the study. Vaccination failed to increase the proportion of adult dogs with IgG antibodies against CAV, CPV or CDV in the treatment group compared with the control group, as much of the effort was put into vaccinating dogs that were already antibody positive. In such situations, vaccination of adult dogs against these enzootic viral pathogens seems unnecessary, and would escalate the cost‐benefit ratio of dog disease control programs.
Daily torpor and hibernation in birds and mammals
Authors: Ruf Thomas , Geiser Fritz 
Published: August 2014

ABSTRACTMany birds and mammals drastically reduce their energy expenditure during times of cold exposure, food shortage, or drought, by temporarily abandoning euthermia, i.e. the maintenance of high body temperatures. Traditionally, two different types of heterothermy, i.e. hypometabolic states associated with low body temperature (torpor), have been distinguished: daily torpor, which lasts less than 24 h and is accompanied by continued foraging, versus hibernation, with torpor bouts lasting consecutive days to several weeks in animals that usually do not forage but rely on energy stores, either food caches or body energy reserves. This classification of torpor types has been challenged, suggesting that these phenotypes may merely represent extremes in a continuum of traits. Here, we investigate whether variables of torpor in 214 species (43 birds and 171 mammals) form a continuum or a bimodal distribution. We use Gaussian‐mixture cluster analysis as well as phylogenetically informed regressions to quantitatively assess the distinction between hibernation and daily torpor and to evaluate the impact of body mass and geographical distribution of species on torpor traits. Cluster analysis clearly confirmed the classical distinction between daily torpor and hibernation. Overall, heterothermic endotherms tend to be small; hibernators are significantly heavier than daily heterotherms and also are distributed at higher average latitudes (∼35°) than daily heterotherms (∼25°). Variables of torpor for an average 30 g heterotherm differed significantly between daily heterotherms and hibernators. Average maximum torpor bout duration was >30‐fold longer, and mean torpor bout duration >25‐fold longer in hibernators. Mean minimum body temperature differed by ∼13°C, and the mean minimum torpor metabolic rate was ∼35% of the basal metabolic rate (BMR) in daily heterotherms but only 6% of BMR in hibernators. Consequently, our analysis strongly supports the view that hibernators and daily heterotherms are functionally distinct groups that probably have been subject to disruptive selection. Arguably, the primary physiological difference between daily torpor and hibernation, which leads to a variety of derived further distinct characteristics, is the temporal control of entry into and arousal from torpor, which is governed by the circadian clock in daily heterotherms, but apparently not in hibernators.
Influence of noninjecting and injecting drug use on mortality, retention in the cohort, and antiretroviral therapy, in participants in the Swiss HIV Cohort Study
Authors: Weber R , Huber M , Battegay M , Stähelin C , Castro Batanjer E , Calmy A , Bregenzer A , Bernasconi E , Schoeni‐Affolter F , Ledergerber B ,   Swiss HIV Cohort Study
Published: August 2014

ObjectivesWe studied the influence of noninjecting and injecting drug use on mortality, dropout rate, and the course of antiretroviral therapy (ART), in the Swiss HIV Cohort Study (SHCS).MethodsCohort participants, registered prior to April 2007 and with at least one drug use questionnaire completed until May 2013, were categorized according to their self‐reported drug use behaviour. The probabilities of death and dropout were separately analysed using multivariable competing risks proportional hazards regression models with mutual correction for the other endpoint. Furthermore, we describe the influence of drug use on the course of ART.ResultsA total of 6529 participants (including 31% women) were followed during 31 215 person‐years; 5.1% participants died; 10.5% were lost to follow‐up. Among persons with homosexual or heterosexual HIV transmission, noninjecting drug use was associated with higher all‐cause mortality [subhazard rate (SHR) 1.73; 95% confidence interval (CI) 1.07–2.83], compared with no drug use. Also, mortality was increased among former injecting drug users (IDUs) who reported noninjecting drug use (SHR 2.34; 95% CI 1.49–3.69). Noninjecting drug use was associated with higher dropout rates. The mean proportion of time with suppressed viral replication was 82.2% in all participants, irrespective of ART status, and 91.2% in those on ART. Drug use lowered adherence, and increased rates of ART change and ART interruptions. Virological failure on ART was more frequent in participants who reported concomitant drug injections while on opiate substitution, and in current IDUs, but not among noninjecting drug users.ConclusionsNoninjecting drug use and injecting drug use are modifiable risks for death, and they lower retention in a cohort and complicate ART.
Staff's person‐centredness in dementia care in relation to job characteristics and job‐related well‐being: a cross‐sectional survey in nursing homes
Authors: Willemse Bernadette M. , De Jonge Jan , Smit Dieneke , Visser Quirijn , Depla Marja F.I.A. , Pot Anne Margriet 
Published: August 2014

AbstractAimTo explore the role of nursing staff's person‐centredness caring for people with dementia in relation to their work environment and job‐related well‐being.BackgroundGiven the development towards person‐centred care and labour force issues, research has recently focused on the effect of person‐centredness on nursing staff's well‐being. Findings from occupational stress research suggest that employees' personal characteristics, such as person‐centredness, can moderate the impact particular job characteristics have on their job‐related well‐being.DesignCross‐sectional survey.MethodsA national survey was conducted among healthcare staff (n = 1147) in 136 living arrangements for people with dementia in the Netherlands (2008–2009). Hierarchical regression analyses were used.ResultsPerson‐centredness moderates the relationship between coworker support and three outcomes of job‐related well‐being and between supervisor support and two of these outcomes. For highly person‐centred nursing staff, coworker support was found to have a weaker impact and supervisor support to have a stronger impact on their job‐related well‐being. In addition, direct effects showed that person‐centredness was weakly associated with more job satisfaction, more emotional exhaustion and more strongly with more personal accomplishment.ConclusionNursing staff's person‐centredness does play a modest role in relation to job characteristics and job‐related well‐being. Findings indicate that person‐centredness is not only beneficial to residents with dementia as found earlier, but also for nursing staff themselves; specifically, in case nursing staff members feel supported by their supervisor. Since a more person‐centred workforce feels more competent, further implementation of person‐centred care might have a positive impact on the attractiveness of the profession.
Participant Comprehension of Research for Which They Volunteer: A Systematic Review
Authors: Montalvo Wanda , Larson Elaine 
Published: August 2014

AbstractPurposeEvidence indicates that research participants often do not fully understand the studies for which they have volunteered. The aim of this systematic review was to examine the relationship between the process of obtaining informed consent for research and participant comprehension and satisfaction with the research.DesignSystematic review of published research on informed consent and participant comprehension of research for which they volunteer using the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) Statement as a guide.MethodsPubMed, Cumulative Index for Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trails, and Cochrane Database of Systematic Reviews were used to search the literature for studies meeting the following inclusion criteria: (a) published between January 1, 2006, and December 31, 2013, (b) interventional or descriptive quantitative design, (c) published in a peer‐reviewed journal, (d) written in English, and (e) assessed participant comprehension or satisfaction with the research process. Studies were assessed for quality using seven indicators: sampling method, use of controls or comparison groups, response rate, description of intervention, description of outcome, statistical method, and health literacy assessment.FindingsOf 176 studies identified, 27 met inclusion criteria: 13 (48%) were randomized interventional designs and 14 (52%) were descriptive. Three categories of studies included projects assessing (a) enhanced consent process or form, (b) multimedia methods, and (c) education to improve participant understanding. Most (78%) used investigator‐developed tools to assess participant comprehension, did not assess participant health literacy (74%), or did not assess the readability level of the consent form (89%). Researchers found participants lacked basic understanding of research elements: randomization, placebo, risks, and therapeutic misconception.ConclusionsFindings indicate (a) inconsistent assessment of participant reading or health literacy level, (b) measurement variation associated with use of nonstandardized tools, and (c) continued therapeutic misconception and lack of understanding among research participants of randomization, placebo, benefit, and risk. While the Agency for Healthcare and Quality and National Quality Forum have published informed consent and authorization toolkits, previously published validated tools are underutilized.Clinical RelevanceInformed consent requires the assessment of health literacy, reading level, and comprehension of research participants using validated assessment tools and methods.
Formula food‐reducing diets: A new evidence‐based addition to the weight management tool box
Authors: Leeds A. R. 
Published: August 2014

AbstractThe changing pattern of obesity‐related disease has created a need for a greater range of weight management options for the increasing number of people for whom weight loss and maintenance cannot be addressed by conventional dietary methods.Formula diet weight loss programmes [very low‐calorie diets (VLCDs) (400–800 kcal/day) and low‐calorie diets (LCDs) (800–1200 kcal/day)] can deliver weight loss at rates of 1–2 kg/week. This rate of weight loss can result in 10–20 kg weight loss in 8–12 weeks. Many health benefits associated with weight reduction seem to require between 10 and 20 kg weight loss. Formula diet programmes can result in weight loss, reduction of liver volume and reduction of visceral fat before bariatric surgery; weight loss before knee joint replacement surgery has also been shown. The benefit of pre‐operative weight loss is still under investigation and such practices before bariatric surgery are variable in surgical units across the UK.Weight loss with formula diet in obesity‐associated conditions where inflammation is an important component, such as osteoarthritis and psoriasis, has been demonstrated. Maintenance of about 10% of initial bodyweight loss, with symptom improvement in elderly obese people with knee osteoarthritis, has been shown over a period of 4 years. In obese people with psoriasis, weight loss with skin improvement has been maintained for 1 year.Clinical trials are currently underway to examine the merits of an initial weight loss with formula diet in pre‐diabetes, in early type 2 diabetes and in insulin‐treated type 2 diabetes.Rapid initial weight loss can result in rapid symptom improvement, such as reduced joint pain in osteoarthritis, improved sleep quality in obstructive sleep apnoea, reduced shortness of breath on exertion, reduced peripheral oedema and rapid improvement in metabolic control in diabetes, all changes that are highly motivating and conducive towards compliance.There is also some evidence for improved vitamin D status and maintained bone health in elderly obese people with osteoarthritis but more research is needed.Rapid initial weight loss was feared to be followed by rapid weight regain. However, provided initial weight loss is delivered in parallel with an intense education programme about nutrition, cooking, shopping and lifestyle for long‐term maintenance; and where long‐term support is provided, subsequent weight maintenance after VLCDs and LCDs has been shown to be possible. A recent literature review identified high‐protein diets, obesity drugs and partial use of formula meal replacements as methods which can result in statistically significantly greater weight maintenance after initial weight loss with VLCDs or LCDs.Anxiety about serious adverse side effects seems to be unfounded although users need to be aware of both minor and more serious, though very infrequent, adverse events, such as gallstones and gallbladder disease.