bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of high and low risk HPV types by cytological status: a population based study from Italy
Authors: Giorgi Rossi Paolo , Chini Francesco , Bisanzi Simonetta , Burroni Elena , Carillo Giuseppe , Lattanzi Amedeo , Angeloni Claudio , Scalisi Aurora , Macis Rosalba , Pini Maria T , Capparucci Paola , Guasticchi Gabriella , Carozzi Francesca M ,   the Prevalence Italian Working Group.HPV
Published: March 2013

Abstract

Background
HPV type distribution by cytological status represents useful information to predict the impact of mass vaccination on screening programs.

Methods
women aged from 25 to 64 who attended cervical cancer screening in five different Italian regions were tested for HPV infection with Hybrid Capture II (HCII) low and high risk probes. Women repeating Pap-test upon unsatisfactory or positive results, or as a post-treatment and post-colposcopy follow-up analysis, were excluded from our study. High risk (HR) HPV positive samples were typed using GP5+/GP6+ primed PCR, followed by Reverse Line Blot for 18 high/intermediate risk HPV types, while low risk (LR) HPV positive samples were tested with type specific primers for HPV6 and HPV11.

Results
3410 women had a valid HCII and Pap-test. The prevalence of HR and LR infections was 7.0% and 3.6%, 29.1% and 13.7%, 68.1% and 31.9%, 60.0% and 0.0%, 65.0% and 12.0%, for negative, ASC-US, L-SIL, ASC-H and H-SIL cytology, respectively. The fraction of ASC-US+ cytology due to HPV 16 and 18 ranged from 11.2 (HPV 16/18 alone) to 15.4% (including HPV 16/18 in co-infection with other virus strains), and that due to HPV 6 and 11 ranged from 0.2% (HPV 6/11 alone) to 0.7% (including HPV 6/11 in co-infection with other LR virus strains).

Conclusions
mass vaccination with bivalent or quadrivalent HPV vaccine would modestly impact on prevalence of abnormal Pap-test in screening.
A real-time PCR assay with improved specificity for detection and discrimination of all clinically relevant Bordetella species by the presence and distribution of three Insertion Sequence elements
Authors: Roorda Lieuwe , Buitenwerf Johannes , Ossewaarde Jacobus M , van der Zee Anneke 
Published: March 2013

Abstract

Background
In Dutch laboratories molecular detection of B. pertussis and B. parapertussis is commonly based on insertion sequences IS 481 and IS 1001, respectively. Both IS elements are more widely spread among Bordetella species. Both Bordetella
holmesii, and B. bronchiseptica can harbour IS 481. Also, IS 1001 is found among B. bronchiseptica. IS 481, and IS 1001 based PCR thus lacks specificity when used for detection of specific Bordetella spp.

Findings
We designed a PCR based on IS 1002, another IS element that is present among Bordetella species, and exploited it as a template in combination with PCR for IS 481, and IS 1001. In combining the PCRs for IS 481, IS 1001, and IS 1002, and including an inhibition control, we were able to detect and discriminate all clinically relevant Bordetella species.

Conclusions
We developed an improved PCR method for specific detection of B. pertussis, B. parapertussis, B. holmesii, and B. bronchiseptica.
The efficacy of incretin therapy in patients with type 2 diabetes undergoing hemodialysis
Authors: Terawaki Yuichi , Nomiyama Takashi , Akehi Yuko , Takenoshita Hiromasa , Nagaishi Ryoko , Tsutsumi Yoko , Murase Kunitaka , Nagasako Hisahiro , Hamanoue Nobuya , Sugimoto Kaoru , Takada Ayako , Ito Kenji , Abe Yasuhiro , Sasatomi Yoshie , Ogahara Satoru , Nakashima Hitoshi , Saito Takao , Yanase Toshihiko 
Published: March 2013

Abstract

Background
Although incretin therapy is clinically available in patients with type 2 diabetes undergoing hemodialysis, no study has yet examined whether incretin therapy is capable of maintaining glycemic control in this group of patients when switched from insulin therapy. In this study, we examined the efficacy of incretin therapy in patients with insulin-treated type 2 diabetes undergoing hemodialysis.

Methods
Ten type 2 diabetic patients undergoing hemodialysis received daily 0.3 mg liraglutide, 50 mg vildagliptin, and 6.25 mg alogliptin switched from insulin therapy on both the day of hemodialysis and the non-hemodialysis day. Blood glucose level was monitored by continuous glucose monitoring. After blood glucose control by insulin, patients were treated with three types of incretin therapy in a randomized crossover manner, with continuous glucose monitoring performed for each treatment.

Results
During treatment with incretin therapies, severe hyperglycemia and ketosis were not observed in any patients. Maximum blood glucose and mean blood glucose on the day of hemodialysis were significantly lower after treatment with liraglutide compared with treatment with alogliptin (p < 0.05), but not with vildagliptin. The standard deviation value, a marker of glucose fluctuation, on the non-hemodialysis day was significantly lower after treatment with liraglutide compared with treatment with insulin and alogliptin (p < 0.05), but not with vildagliptin. Furthermore, the duration of hyperglycemia was significantly shorter after treatment with liraglutide on both the hemodialysis and non-hemodialysis days compared with treatment with alogliptin (p < 0.05), but not with vildagliptin.

Conclusions
The data presented here suggest that patients with type 2 diabetes undergoing hemodialysis and insulin therapy could be treated with incretin therapy in some cases.
Highly diverse chromoviruses of Beta vulgaris are classified by chromodomains and chromosomal integration
Authors: Weber Beatrice , Heitkam Tony , Holtgräwe Daniela , Weisshaar Bernd , Minoche André E , Dohm Juliane C , Himmelbauer Heinz , Schmidt Thomas 
Published: March 2013

Abstract

Background
Chromoviruses are one of the three genera of Ty3-gypsy long terminal repeat (LTR) retrotransposons, and are present in high copy numbers in plant genomes. They are widely distributed within the plant kingdom, with representatives even in lower plants such as green and red algae. Their hallmark is the presence of a chromodomain at the C-terminus of the integrase. The chromodomain exhibits structural characteristics similar to proteins of the heterochromatin protein 1 (HP1) family, which mediate the binding of each chromovirus type to specific histone variants. A specific integration via the chromodomain has been shown for only a few chromoviruses. However, a detailed study of different chromoviral clades populating a single plant genome has not yet been carried out.

Results
We conducted a comprehensive survey of chromoviruses within the Beta vulgaris (sugar beet) genome, and found a highly diverse chromovirus population, with significant differences in element size, primarily caused by their flanking LTRs. In total, we identified and annotated full-length members of 16 families belonging to the four plant chromoviral clades: CRM, Tekay, Reina, and Galadriel. The families within each clade are structurally highly conserved; in particular, the position of the chromodomain coding region relative to the polypurine tract is clade-specific. Two distinct groups of chromodomains were identified. The group II chromodomain was present in three chromoviral clades, whereas families of the CRM clade contained a more divergent motif. Physical mapping using representatives of all four clades identified a clade-specific integration pattern. For some chromoviral families, we detected the presence of expressed sequence tags, indicating transcriptional activity.

Conclusions
We present a detailed study of chromoviruses, belonging to the four major clades, which populate a single plant genome. Our results illustrate the diversity and family structure of B. vulgaris chromoviruses, and emphasize the role of chromodomains in the targeted integration of these viruses. We suggest that the diverse sets of plant chromoviruses with their different localization patterns might help to facilitate plant-genome organization in a structural and functional manner.
Lack of clinically evident signs of organ failure affects ED treatment of patients with severe sepsis
Authors: Kakebeeke Dirkjan , Vis Alice , de Deckere Ernie RJT , Sandel Maro H , de Groot Bas 
Published: February 2013

Abstract

Background
It is not known whether lack of recognition of organ failure explains the low compliance with the “Surviving Sepsis Campaign” (SSC) guidelines. We evaluated whether compliance was higher in emergency department (ED) sepsis patients with clinically recognizable signs of organ failure compared to patients with only laboratory signs of organ failure.

Methods
Three hundred twenty-three ED patients with severe sepsis and septic shock were prospectively included. Multivariable binary logistic regression was used to assess if clinical and biochemical signs of organ failure were associated with compliance to a SSC-based resuscitation bundle. In addition, two-way analysis of variance was used to investigate the relation between the predisposition, infection, response and organ failure (PIRO) score (3 groups: 1–7, 8–14, 15–24) as a measure of illness severity and time to antibiotics with disposition to ward or ICU as effect modifier.

Results
One hundred twenty-five of 323 included sepsis patients with new-onset organ failure were admitted to the ICU, and in all these patients the SSC resuscitation bundle was started. Respiratory difficulty, hypotension and altered mental status as clinically recognizable signs of organ failure were independent predictors of 100% compliance and not illness severity per se. Corrected ORs (95% CI) were 3.38 (1.08–10.64), 2.37 (1.07–5.23) and 4.18 (1.92–9.09), respectively. Septic ED patients with clinically evident organ failure were more often admitted to the ICU compared to a ward (125 ICU admissions, P < 0.05), which was associated with shorter time to antibiotics [ward: 127 (113–141) min; ICU 94 (80–108) min (P = 0.005)].

Conclusions
The presence of clinically evident compared to biochemical signs of organ failure was associated with increased compliance with a SSC-based resuscitation bundle and admission to the ICU, suggesting that recognition of severe sepsis is an important barrier for successful implementation of quality improvement programs for septic patients. In septic ED patients admitted to the ICU, the time to antibiotics was shorter compared to patients admitted to a normal ward.
The labour supply effects of a partial cash-out of in-kind transfers to single mothers
Authors: Bingley Paul , Walker Ian 
Published: March 2013

Abstract

Abstract
We estimate a model of labour supply and participation in multiple cash and in-kind welfare programmes. The modeling exploits a reform that affected U.K. single mothers. In-work cash entitlements increased under this reform but eligibility to in-kind child nutrition programmes was lost for some households. When we allow for differences in the costs associated with each welfare programme we find that in-work cash and in-work in-kind transfers both have large positive labour supply effects. There is, however, a utility loss from programme participation which is estimated to be larger for the cash programme than for the child nutrition programmes. Our findings imply that the partial cash out of the in-kind transfers reduced labour supply and suggest that there may be a place in policy portfolios for in-kind programmes despite their “inefficiency”.

JEL Codes
C31, C35, D12, J22
Evaluation of the novel folate receptor ligand [18F]fluoro-PEG-folate for macrophage targeting in a rat model of arthritis
Authors: Gent Yoony YJ , Weijers Karin , Molthoff Carla FM , Windhorst Albert D , Huisman Marc C , Smith Desirée EC , Kularatne Sumith A , Jansen Gerrit , Low Philip S , Lammertsma Adriaan A , van der Laken Conny J 
Published: March 2013

Abstract
Introduction
Detection of (subclinical) synovitis is relevant for both early diagnosis and monitoring of therapy of rheumatoid arthritis (RA). Previously, the potential of imaging (sub)clinical arthritis was demonstrated by targeting the translocator protein in activated macrophages using (R)-[11C]PK11195 and positron emission tomography (PET). Images, however, also showed significant peri-articular background activity. The folate receptor (FR)-β is a potential alternative target for imaging activated macrophages. Therefore, the PET tracer [18F]fluoro-PEG-folate was synthesized and evaluated in both in vitro and ex vivo studies using a methylated BSA induced arthritis model.

Methods
[18F]fluoro-PEG-folate was synthesized in a two-step procedure. Relative binding affinities of non-radioactive fluoro-PEG-folate, folic acid and naturally circulating 5-methyltetrahydrofolate (5-Me-THF) to FR were determined using KB cells with high expression of FR. Both in vivo [18F]fluoro-PEG-folate PET and ex vivo tissue distribution studies were performed in arthritic and normal rats and results were compared with those of the established macrophage tracer (R)-[11C]PK11195.

Results
[18F]fluoro-PEG-folate was synthesized with a purity >97%, a yield of 300 to 1,700 MBq and a specific activity between 40 and 70 GBq/µmol. Relative in vitro binding affinity for FR of F-PEG-folate was 1.8-fold lower than that of folic acid, but 3-fold higher than that of 5-Me-THF . In the rat model, [18F]fluoro-PEG-folate uptake in arthritic knees was increased compared with both contralateral knees and knees of normal rats. Uptake in arthritic knees could be blocked by an excess of glucosamine-folate, consistent with [18F]fluoro-PEG-folate being specifically bound to FR. Arthritic knee-to-bone and arthritic knee-to-blood ratios of [18F]fluoro-PEG-folate were increased compared with those of (R)-[11C]PK11195. Reduction of 5-Me-THF levels in rat plasma to those mimicking human levels increased absolute [18F]fluoro-PEG-folate uptake in arthritic joints, but without improving target-to-background ratios.

Conclusions
The novel PET tracer [18F]fluoro-PEG-folate, designed to target FR on activated macrophages provided improved contrast in a rat model of arthritis compared with the accepted macrophage tracer (R)-[11C]PK11195. These results warrant further exploration of [18F]fluoro-PEG-folate as a putative PET tracer for imaging (sub)clinical arthritis in RA patients.
Cultural factors and sexual dysfunction in clinical practice
Authors: Bhavsar Vishal , Bhugra Dinesh 
Published: March 2013

SummaryAttitudes to sex and the perceived role of sexual activity are very strongly influenced by cultural values. Culturally determined gender roles influence relationships between different-sex partners, and cultural values affect attitudes towards sexual variation. Cultures define what is deviant and from where help is sought. Through differing patterns of child-rearing, cultures also affect individuals' cognitive development, world views and explanatory models of emotional distress. It is critical that clinicians are aware of the role of culture in defining sexual dysfunction and how cultural factors can be used in initiating treatment as well as in therapeutic engagement and alliance. Although epidemiological data on prevalence of sexual dysfunction across cultures are scanty, it is likely that prevalences vary, as will pathways into care and patterns of help-seeking. In this article we discuss the potential impact of culture on sexual dysfunction, and issues that clinicians, whether in specialist or in general services, need to be aware of in assessing and treating patients who present with sexual dysfunction.
Clinical dashboard: use in older adult mental health wards
Authors: Daley Kate , Richardson Jonathan , James Ian , Chambers Annette , Corbett David 
Published: March 2013

Aims and methodTo explore the experiences and attitudes of mental health professionals working in acute elderly care to a new clinical dashboard system. Metrics were identified from the Royal College of Psychiatrists' Accreditation for Inpatient Mental Health Services – Older People (AIMS-OP); these were tracked from baseline to 6 months. A questionnaire was developed and distributed across the three clinical areas involved in the clinical dashboard mental health pilot.ResultsStaff completed the questionnaire 3 months after the initial implementation. At this point the benefits of the introduction of the dashboard were suggested as: improved access to information, increased communication and information-sharing, increased staff awareness, and data quality.Clinical implicationsThe introduction of the clinical dashboard in older adult mental health services allowed for better data availability and resulted in better data quality.
Functional Plasticity of the Human Infant β-Cell Exocytotic Phenotype
Authors: Fox Jocelyn E. Manning , Seeberger Karen , Dai Xiao Qing , Lyon James , Spigelman Aliya F. , Kolic Jelena , Hajmrle Catherine , Joseph Jamie W. , Kin Tatsuya , Shapiro A.M. James , Korbutt Gregory , MacDonald Patrick E. 
Published: March 2013

Abstract
Our understanding of adult human β-cells is advancing, but we know little about the function and plasticity of β-cells from infants. We therefore characterized islets and single islet cells from human infants after isolation and culture. Although islet morphology in pancreas biopsies was similar to that in adults, infant islets after isolation and 24–48 hours of culture had less insulin staining, content, and secretion. The cultured infant islets expressed pancreatic and duodenal homeobox 1 and several (Glut1, Cav1.3, Kir6.2) but not all (syntaxin 1A and synaptosomal-associated protein 25) markers of functional islets, suggesting a loss of secretory phenotype in culture. The activity of key ion channels was maintained in isolated infant β-cells, whereas exocytosis was much lower than in adults. We examined whether a functional exocytotic phenotype could be reestablished under conditions thought to promote β-cell differentiation. After a 24- to 28-day expansion and maturation protocol, we found preservation of endocrine markers and hormone expression, an increased proportion of insulin-positive cells, elevated expression of syntaxin 1A and synaptosomal-associated protein 25, and restoration of exocytosis to levels comparable with that in adult β-cells. Thus, human infant islets are prone to loss of their exocytotic phenotype in culture but amenable to experimental approaches aimed at promoting expansion and functional maturation. Control of exocytotic protein expression may be an important mechanism underlying the plasticity of the secretory machinery, an increased understanding of which may lead to improved regenerative approaches to treat diabetes.
Evaluation of a mobile clinical pathology laboratory developed for the home care of pediatric patients following transplantation of peripheral blood precursor cells
Authors: Facco Fabio , Agazzi Alessia , Manfredini Luca , Dallorso Sandro , Melioli Giovanni 
Published: February 2013

Abstract

Background: A mobile clinical pathology laboratory (MoLab) was designed, outfitted and evaluated to improve the turnaround time (TAT) of laboratory tests performed in patients who receive follow-up care at home.

Methods: Full blood counts (FBCs), basic clinical biochemistry tests on blood and urine, and basic coagulation and blood gases were measured using bench-top laboratory analyzers to perform point-of-care tests in a mobile setting. The quality of the results was evaluated on the instruments both while the vehicle was at rest and following movement during the course of routine activity.

Results: The equivalence of the values produced by the point-of-care testing (POCT) and central laboratory (CL) measurement procedures was demonstrated and remained stable after movement in city traffic. The TATs ranged from a few minutes for FBCs to <20 min for extended clinical biochemistry tests.

Conclusions: During the first 6 months of activity, the MoLab assured the provision of laboratory results for home care patients in a matter of minutes. This approach not only allowed for real-time modifications in therapy but also reduced the number of second visits by the home care medical team. Point-of-care tests performed on the MoLab were significantly more expensive than the same tests performed in the CL. However, the savings in patient hospitalization expenses and the reduced costs resulting from fewer second daily visits completely offset the costs of using the MoLab during the first 6-month pilot phase.
Budd-Chiari syndrome following vaginal delivery in a patient with Crohn’s disease: a case report and review of the literature
Authors: Aygun Banu Kumbak , Pinar Gulser Goktolga , Sahin Levent , Ozkan Zehra Sema , Poyraz Ahmet Kursad , Aygun Cem 
Published: February 2013

Abstract

Introduction: The association of Budd-Chiari syndrome (BCS), Crohn’s disease (CD) and pregnancy is extremely rare. The successful medical treatment of BCS in the postpartum period in a woman with CD is presented.

Case report: A 28-year-old woman with CD presented with fever of 42°C and gross abdominal distention 2 days following delivery. On sonographic examination, massive ascites and hepatosplenomegaly were noted. Color Doppler ultrasonography and contrast-enhanced computed tomography revealed a thrombus in the suprahepatic inferior vena cava causing significant luminal obstruction. She was diagnosed with BCS. Medical treatment with spironolactone, furosemide, imipenem, metronidazole, and enoxaparin improved the clinical picture.

Conclusion: In a pregnant woman with CD, extreme thromboembolic events such as BCS might occur. If diagnosed early and treated in the acute phase, prognosis is fair.
Systematic Update of Computerized Physician Order Entry Order Sets to Improve Quality of Care: A Case Study
Authors: Leu Michael G. , Morelli Sheryl A. , Chung Oi-Yan , Radford Shanon 
Published: March 2013

BACKGROUND AND OBJECTIVES:
Seattle Children’s Hospital was one of the early adopters of computerized physician order entry. As part of our 2003 go-live, order sets were created opportunistically by using an ad hoc development process. A pilot study revealed that this ad hoc development process resulted in order sets that were neither internally nor externally consistent. We sought to update order sets by using software development techniques, to try and improve consistency and also to review clinical content so that they could be updated to current evidence and consensus-based best practice. We also sought to identify and categorize errors found in the original order sets.

METHODS:
This is a case study of a new order set development process that: (1) assigned order set ownership; (2) created and applied standards for how orders should appear and be organized within order sets; (3) supported multidisciplinary review and update; and (4) enforced submitting completed specifications before order set build. We extracted order sets into Microsoft Word specifications, updated content by using the Track Changes function, and then updated our Clinical Information System. Changes were reviewed and organized according to themes.

RESULTS:
We created standard order formats for 98 orders; 191 order sets were standardized. Multidisciplinary review identified medication issues in 37% of order sets (used in 47.6% of inpatient admissions).

CONCLUSIONS:
This case study demonstrates that it is not sufficient to simply implement computerized physician order entry. Clinical decision supports should be subject to rigorous development processes to ensure both clinical appropriateness and correctness.