bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proximate and ultimate causes of signal diversity in the electric fishGymnotus
Authors: Crampton W. G. R. , Rodríguez-Cattáneo A. , Lovejoy N. R. , Caputi A. A. 
Published: June 2013

SummaryA complete understanding of animal signal evolution necessitates analyses of both the proximate (e.g. anatomical and physiological) mechanisms of signal generation and reception, and the ultimate (i.e. evolutionary) mechanisms underlying adaptation and diversification. Here we summarize the results of a synthetic study of electric diversity in the species-rich neotropical electric fish genus Gymnotus. Our study integrates two research directions. The first examines the proximate causes of diversity in the electric organ discharge (EOD) – which is the carrier of both the communication and electrolocation signal of electric fishes – via descriptions of the intrinsic properties of electrocytes, electrocyte innervation, electric organ anatomy and the neural coordination of the discharge (among other parameters). The second seeks to understand the ultimate causes of signal diversity – via a continent-wide survey of species diversity, species-level phylogenetic reconstructions and field-recorded head-to-tail EOD (ht-EOD) waveforms (a common procedure for characterizing the communication component of electric fish EODs). At the proximate level, a comparative morpho-functional survey of electric organ anatomy and the electromotive force pattern of the EOD for 11 species (representing most major clades) revealed four distinct groups of species, each corresponding to a discrete area of the phylogeny of the genus and to a distinct type of ht-EOD waveform. At the ultimate level, our analyses (which emphasize the ht-EOD) allowed us to conclude that selective forces from the abiotic environment have had minimal impact on the communication component of the EOD. In contrast, selective forces of a biotic nature – imposed by electroreceptive predators, reproductive interference from heterospecific congeners, and sexual selection – may be important sources of diversifying selection on Gymnotus signals.
Mirabegron: β3-Adrenergic Receptor Agonist for the Treatment of Overactive Bladder
Authors: Bridgeman Mary Barna , Friia Nicholas J , Taft Christina , Shah Milisha 
Published: June 2013

OBJECTIVE To review the place in therapy of mirabegron, a new oral β3-adrenergic receptor agonist, for the treatment of overactive bladder (OAB). DATA SOURCES A literature search of MEDLINE and MEDLINE In-Process & Other Non-Indexed Citations Databases (1996-April 2013) was conducted using the key words mirabegron, receptor, adrenergic, beta-3; adrenergic beta-3 receptor; beta-3 receptor, and overactive bladder; urinary bladder; overactive. All published articles regarding mirabegron were included. References of selected articles, data from poster presentations, and abstract publications were additionally reviewed. STUDY SELECTION AND DATA EXTRACTION Available English-language data from reviews, abstracts, presentations, and clinical trials of mirabegron in humans were reviewed; relevant clinical data were selected and included. DATA SYNTHESIS Mirabegron is the newest option for treatment of OAB with symptoms of urge incontinence. As a β3-receptor agonist, it reduces bladder muscle contractions. In two 12-week, randomized, double-blind, placebo-controlled Phase 3 studies, mirabegron significantly reduced the number of incontinence episodes per 24 hours from baseline (−1.47, −1.63, and −1.13; p < 0.05; and −1.57, −1.46, and −1.17; p < 0.05; all values for mirabegron 50 mg, 100 mg, and placebo). Micturitions per 24 hours were also reduced from baseline (−1.66, −1.75, and −1.05; p < 0.05; and −1.93, −1.77, and −1.34; p < 0.05; all values for mirabegron 50 mg, 100 mg, and placebo). A 12-month trial found mirabegron to have a safety and efficacy profile similar to that of tolterodine. CONCLUSIONS Treatment of OAB initially includes lifestyle and nonpharmacologic intervention; for patients with persistent symptoms despite these treatments, drug therapy represents a next-step approach for symptom control. Mirabegron alleviates symptoms of OAB while having a mechanism of action that provides an alternative for patients who are intolerant of or who have contraindications to anticholinergic agents. The place in therapy of mirabegron relative to anticholinergics in the treatment of urge incontinence has not yet been established.
Reintroduction of Clozapine After Perforation of the Large Intestine—A Case Report and Review of the Literature
Authors: Ikai Saeko , Suzuki Takefumi , Uchida Hiroyuki , Mimura Masaru , Fujii Yasuo 
Published: June 2013

OBJECTIVE To report on a patient who was successfully rechallenged with clozapine after perforation of the large intestine and pulmonary embolism postoperatively, and provide a literature review on clozapine rechallenge. CASE SUMMARY A 46-year-old Japanese man with treatment-resistant schizophrenia developed constipation and slight abdominal discomfort while taking clozapine 275 mg/day. He developed appendicitis, leading to perforation of the large intestine. During the postsurgery period, a partial embolism of the pulmonary artery was revealed. The patient's constipation was relieved when clozapine was discontinued, but other antipsychotics failed to control his delusions well. After thorough discussion, it was decided to rechallenge with clozapine. The low dose of clozapine 200 mg/day was tolerable for his delusion, and his constipation was managed with laxatives and exercises until 8 months after the accident. DISCUSSION Clozapine is a gold standard medication in treatment-resistant schizophrenia but is associated with various adverse effects, some of which are life-threatening. Reintroduction of clozapine after severe adverse drug effects when other medications are not effective almost always poses a clinical dilemma for mental health professionals. A PubMed search (to January 25, 2013) using the key words clozapine and rechallenge found 50 articles. There were only sporadic positive case reports regarding the rechallenge after clozapine-related serious gastrointestinal problems. CONCLUSIONS From the currently available evidence, most psychiatrists appear to avoid reintroduction of clozapine. However, the evidence is too weak to draw a definitive conclusion about reintroduction of this drug. Reintroduction of clozapine after initial adverse effects in patients with treatment-resistant schizophrenia may warrant case-by-case judgment, but needs to be further investigated.
Functional Range of Creatinine Clearance for Renal Drug Dosing: A Practical Solution to the Controversy of Which Weight to Use in the Cockcroft-Gault Equation
Authors: Brown Daniel L , Masselink Andrew J , Lalla Christina D 
Published: June 2013

OBJECTIVE To describe a practical solution for addressing body weight when using the Cockcroft-Gault equation to determine drug dosing. DATA SOURCES A literature search was conducted using PubMed MEDLINE (1980-April 2013) using creatinine clearance, Cockcroft and Gault, Cockcroft-Gault, body weight, and obesity as search terms. Reference citations from publications reviewed were included. STUDY SELECTION AND DATA EXTRACTION All English-language articles identified by the search were reviewed. Studies comparing the accuracy and bias of the Cockcroft-Gault equation using a variety of body weight designations in adult populations were included in the analysis. DATA SYNTHESIS Study results indicated that, for obese patients, ideal body weight (IBW) underestimates creatinine clearance (CrCl) and total body weight (TBW) overestimates CrCl. Some studies suggest that adjusted body weight with a factor of 0.4 is most accurate, while others suggest the use of lean body weight. These studies have failed to produce a definitive resolution to the controversy. Despite many well-designed studies, the Cockcroft-Gault body weight controversy remains unresolved and uncertainty continues to exist as to which form of weight should be used in the equation. A different perspective is warranted. Since renal dosing guidelines are generally based on ranges of CrCl, applying a CrCl range to describe a patient's renal function might be more practical than relying on a specific CrCl value. Ultimately, CrCl-based drug dosing involves the use of an imperfect mathematical approximation, which is then applied as precisely as possible to the benefit versus risk analysis for a specific patient. CONCLUSIONS We propose the use of a CrCl range for drug dosing purposes, with the lower boundary defined by using IBW in the Cockcroft-Gault equation and the upper boundary by using TBW.
Pathophysiological Implications of Fibroblast Growth Factor-23 and Klotho and Their Potential Role as Clinical Biomarkers
Authors: Donate-Correa Javier , Muros de Fuentes Mercedes , Mora-Fernández Carmen , Navarro-González Juan F 
Published: June 2013

Abstract

BACKGROUND
Fibroblast growth factor-23 (FGF-23) and Klotho constitute the main regulatory system of phosphorus homeostasis. Beyond this physiological role, there is growing evidence suggesting that this system has relevant pathophysiological implications in different clinical processes.

CONTENT
In this review we discuss the pathophysiological implications of the FGF-23/Klotho system and the potential utility that measurements of its components may have as clinical biomarkers in different clinical settings, such as progression of chronic kidney disease, acute renal failure, and secondary hyperparathyroidism, as well as vascular dysfunction, atherosclerosis, and cardiovascular morbidity and mortality. We outline and discuss the current commercially available assays for determination of FGF-23 and Klotho and the assay limitations that must be overcome to translate these biomarkers into reliable indicators in clinical practice.

SUMMARY
In addition to its physiological role, the FGF-23/Klotho system appears to provide important information regarding the pathophysiology of several clinical conditions. Although there has been increasing study of the components of this new biological system and their potential use as clinical biomarkers, the ultimate value of this system in clinical practice will not be known until remaining assay limitations can be overcome and adequately designed studies have been conducted to demonstrate its clinical utility.
Copeptin, a Surrogate Marker for Arginine Vasopressin, Is Associated With Cardiovascular and All-Cause Mortality in Patients With Type 2 Diabetes (ZODIAC-31)
Authors: Riphagen Ineke J. , Boertien Wendy E. , Alkhalaf Alaa , Kleefstra Nanne , Gansevoort Ron T. , Groenier Klaas H. , van Hateren Kornelis J.J. , Struck Joachim , Navis Gerjan , Bilo Henk J.G. , Bakker Stephan J.L. 
Published: June 2013

OBJECTIVE
Copeptin, a surrogate marker for arginine vasopressin, has been associated with cardiovascular (CV) events and mortality in patients with type 2 diabetes complicated by end-stage renal disease or acute myocardial infarction. For stable outpatients, these associations are unknown. Our aim was to investigate whether copeptin is associated with CV and all-cause mortality in patients with type 2 diabetes treated in primary care.

RESEARCH DESIGN AND METHODS
Patients with type 2 diabetes participating in the observational Zwolle Outpatient Diabetes Project Integrating Available Care (ZODIAC) study were included. Cox regression analyses with age as time scale were used to assess the relationship of baseline copeptin with CV and all-cause mortality.

RESULTS
We included 1,195 patients (age 67 ± 12 years, 44% male). Median baseline copeptin concentration was 5.4 (interquartile range [IQR] 3.1–9.6) pmol/L. After a median follow-up of 5.9 (IQR 3.2–10.1) years, 345 patients died (29%), with 148 CV deaths (12%). Log2 copeptin was associated with CV (hazard ratio 1.17 [95% CI 0.99–1.39]; P = 0.068) and all-cause mortality (1.22 [1.09–1.36]; P = 0.001) after adjustment for age, sex, BMI, smoking, systolic blood pressure, total cholesterol to HDL ratio, duration of diabetes, HbA1c, treatment with ACE inhibitors and angiotensin receptor blockers, history of CV diseases, log serum creatinine, and log albumin to creatinine ratio; however, copeptin did not substantially improve risk prediction for CV (integrated discrimination improvement 0.14% [IQR −0.27 to 0.55%]) and all-cause mortality (0.77% [0.17–1.37%]) beyond currently used clinical markers.

CONCLUSIONS
We found copeptin to be associated with CV and all-cause mortality in patients with type 2 diabetes treated in primary care. Intervention studies should show whether the high CV risk in type 2 diabetes can be reduced by suppression of vasopressin, for example by reducing salt intake.
Aldosterone, C-Reactive Protein, and Plasma B-Type Natriuretic Peptide Are Associated With the Development of Metabolic Syndrome and Longitudinal Changes in Metabolic Syndrome Components
Authors: Musani Solomon K. , Vasan Ramachandran S. , Bidulescu Aurelian , Liu Jiankang , Xanthakis Vanessa , Sims Mario , Gawalapu Ravi K. , Samdarshi Tandaw E. , Steffes Michael , Taylor Herman A. , Fox Ervin R. 
Published: June 2013

OBJECTIVE
Several pathomechanisms are implicated in the pathogenesis of metabolic syndrome (MetS), most of which have not been investigated in African Americans (AAs). We examined the contribution of a selected panel of biomarkers to the development of MetS in Jackson Heart Study (JHS) participants in this investigation.

RESEARCH DESIGN AND METHODS
We evaluated 3,019 JHS participants (mean age, 54 years; 64% women) with measurements for seven biomarkers representing inflammation (high-sensitivity C-reactive protein [CRP]), adiposity (leptin), natriuretic pathway (B-natriuretic peptide [BNP]), adrenal pathway (cortisol and aldosterone), and endothelial function (endothelin and homocysteine). We related the biomarker panel to the development of MetS on follow-up and to longitudinal changes in MetS components.

RESULTS
There were 278 (22.9%) of 1,215 participants without MetS at baseline who had development of new-onset MetS at follow-up. The incidence of MetS was significantly associated with serum aldosterone (P = 0.004), CRP (P = 0.03), and BNP (P for trend = 0.005). The multivariable-adjusted odds ratios (95% CI) per SD increment of log biomarker were as follows: 1.25 (1.07–1.45) for aldosterone, 1.20 (1.02–1.43) for CRP, and 1.54 (1.07–2.23) and 1.91 (1.31–2.80) for low and high BNP quartiles, respectively. Aldosterone was positively associated with change in all MetS risk components, except low HDL cholesterol and waist circumference. CRP concentration was significantly and directly associated with change in systolic blood pressure (SBP) and waist circumference but inversely associated with HDL cholesterol. For BNP, we observed a U-shape relation with SBP and triglycerides.

CONCLUSIONS
Our analysis confirms that, in AAs, higher circulating aldosterone and CRP concentrations predict incident MetS. The nonlinear U-shape relation of BNP with MetS and its components has not been reported before and thus warrants replication.
Applying Current Screening Tools for Gestational Diabetes Mellitus to a European Population: Is It Time for Change?
Authors: Avalos Gloria E. , Owens Lisa A. , Dunne Fidelma ,   for the ATLANTIC DIP Collaborators
Published: June 2013

OBJECTIVE
The optimal screening regimen for gestational diabetes mellitus (GDM) remains controversial. Risk factors used in selective screening guidelines vary. Given that universal screening is not currently adopted in our European population, we aimed to evaluate which selective screening strategies were most applicable.

RESEARCH DESIGN AND METHODS
Between 2007 and 2009, 5,500 women were universally screened for GDM, and a GDM prevalence of 12.4% using International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria was established. We retrospectively applied selective screening guidelines to this cohort.

RESULTS
When we applied National Institute for Health and Clinical Excellence (NICE), Irish, and American Diabetes Association (ADA) guidelines, 54% (2,576), 58% (2,801), and 76% (3,656) of women, respectively, had at least one risk factor for GDM and would have undergone testing. However, when NICE, Irish, and ADA guidelines were applied, 20% (120), 16% (101), and 5% (31) of women, respectively, had no risk factor and would have gone undiagnosed. Using a BMI ≥30 kg/m2 for screening has a specificity of 81% with moderate sensitivity at 48%. Reducing the BMI to ≥25 kg/m2 (ADA) increases the sensitivity to 80% with a specificity of 44%. Women with no risk factors diagnosed with GDM on universal screening had more adverse pregnancy outcomes than those with normal glucose tolerance.

CONCLUSIONS
This analysis provides a strong argument for universal screening. However, if selective screening were adopted, the ADA guidelines would result in the highest rate of diagnosis and the lowest number of missed cases.
The Importance of Waist Circumference and BMI for Mortality Risk in Diabetic Adults
Authors: Katzmarzyk Peter T. , Hu Gang , Cefalu William T. , Mire Emily , Bouchard Claude 
Published: June 2013

OBJECTIVE
We aimed to determine the associations of waist circumference (WC) and BMI with all-cause mortality among patients with diabetes.

RESEARCH DESIGN AND METHODS
The sample included 847 white and 553 African American patients (18–69 years of age) with diabetes. Height, weight, and WC were measured, and the BMI (kg/m2) was calculated. Cox regression was used to analyze the associations of BMI and WC with mortality, adjusting for age, sex, race, examination year, smoking status, alcohol consumption, and physical activity. Hazard ratios (HRs) are expressed per standard deviation of each independent variable.

RESULTS
A total of 86 deaths occurred during 6.7 years of follow-up. After adjustment for covariates, WC (HR 1.40 [95% CI 1.14–1.72]) and BMI (1.29 [1.04–1.61]) demonstrated significant relationships with mortality.

CONCLUSIONS
The results indicate that maintaining a healthy WC and BMI are both important for individuals living with diabetes.
Effect of socio-demographic characteristics on the prevalence of anemia among school going adolescent girls in Lucknow district, India
Authors: Sachan Beena , Idris MZ , Singh Ashutosh 
Published: June 2013

Anemia is a serious public health concern in most developing countries and the prevalence of anemia is quite high among adolescent girls. A cross-sectional descriptive study was carried out among school going adolescent girls in urban as well as rural schools of the Lucknow district, Uttar Pradesh, India from October 2008 to September 2009 with the objectives of studying the prevalence of anemia and the various socio-demographic characteristics in relation to anemia. Multistage random sampling was used to select the requisite number of girls. A total of 847 school going adolescent girls between 10-19 years of age were interviewed. Information regarding their socio-demographic characteristics was collected and the girls were also examined for presence or absence of pallor for anemia. Statistical analyses were done using percentage, Chi-square test, and odds ratio. The prevalence of anemia was found to be 55.6% and 57.9% in urban and rural school going adolescent girls respectively and significant association of anemia was observed with religion, caste and socio-economic status (p value<0.05). There is need to develop strategies for intensive adult education, nutrition education and dietary supplementation including anemia prophylaxis.South East Asia J Public Health | Jan-June 2012 | Vol 2 Issue 1 | 8-12 DOI: http://dx.doi.org/10.3329/seajph.v2i1.15254
Utilization of ASHA services under NRHM in relation to maternal health in rural Lucknow, India
Authors: Singh Manish K , Singh JV , Kumari Rema , Ahmad Naim , Khanna Anish 
Published: June 2013

To address poor utilization of maternal and child health services by the rural community, the National Rural Health Mission (NRHM) was launched in 2005 in India. Under NRHM, ASHA (Accredited Social Health Activist) was identified as an effective link between the government and poor pregnant women. The aim of the present study was to examine the utilization of ASHA services under NRHM in relation to maternal health by the Recently Delivered Women (RDW) in the study area. A cross-sectional study was conducted at PHC Sarojini Nagar, Lucknow and its rural field areas. A sample of 350 RDW, chosen by simple random sampling, were interviewed at bedside by a preformed schedule and then were followed up after six weeks. Antenatal registration was reported by 97% RDW of which 73% registered early. About 53% RDW had three or more antenatal care visits. Two dose Tetanus Toxoid coverage was 92.9%. Receipt and consumption of iron and folic acid was low. ASHA was the major facilitator for higher utilization of antenatal care services, except for Iron and Folic Acid receipt/consumption. Low utilization of postnatal care (21.5% RDW had at least one postnatal check-up) is a matter of concern. Knowledge and awareness of ASHA on importance of postnatal care needs to be enhanced via hands on training by specialists and regular orientation programs. Better and intense advocacy in the community regarding importance of availing services of ASHA in relation to maternal health needs to be addressed.South East Asia J Public Health | Jan-June 2012 | Vol 2 Issue 1 | 24-27 DOI: http://dx.doi.org/10.3329/seajph.v2i1.15261
Perception regarding reproductive health among adolescents of rural Sindh, Pakistan
Authors: Shahid Anjum , Pirzada Abdul Ghaffar , Memon Ashfaque Ahmed 
Published: June 2013

Adolescence, the second decade of life, is a period in which an individual undergoes major physical and psychological changes. Adolescence is a period when health problems that have serious immediate consequences can occur or when problem behaviours that could have serious adverse effects on health in the future are initiated. This study examines the knowledge and perception regarding reproductive health and opinion toward reproductive health education among adolescents of rural Sindh, Pakistan. Study was conducted in 2008- 2009 on a total number of 369 adolescent males (209) and females (160) studying in colleges of Kambar Shadadkot, rural Sindh. This descriptive study using cluster sampling technique was conducted in randomly selected eight intermediate colleges of boys and girls. After informed consent and ensuring confidentiality, an anonymous quantitative questionnaire was completed to ascertain the knowledge of adolescents. Main outcome measures were adolescents knowledge of reproductive health concepts, pregnancy and contraceptive methods and knowledge in relation to sexually transmitted diseases (STDs) and HIV/AIDS. Analysis of data revealed that a sizable proportion of adolescents had low knowledge regarding reproductive health issues and had misconception regarding reproductive physiology, STDs and condoms. Teacher was the focal source of information and 63% male and 43 % female respondents desired a need for RH education. More than half of participants had no knowledge on STDs and HIV/AIDS and its spread and a small percentage had awareness regarding contraceptive methods, about condom use and its protective coverage against STDs and pregnancy. Strong efforts are needed to augment awareness among rural adolescents and education could serve the purpose. Gender-based ethnically amenable sex education curriculum should be introduced in educational institutions.South East Asia J Public Health | Jan-June 2012 | Vol 2 Issue 1 | 39-45 DOI: http://dx.doi.org/10.3329/seajph.v2i1.15264