bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Choices and Clinical Outcomes in Octogenarians and Nonagenarians with Iron‐Deficiency Anemia in the Netherlands
Authors: Hamaker Marije E. , Acampo Tessa , Remijn Jasper A. , van Tuyl Sebastiaan A.C. , Pronk Apollo , van der Zaag Edwin S. , Paling Heleen A. , Smorenburg Carolien H. , de Rooij Sophia E. , van Munster Barbara C. 
Published: March 2013

ObjectivesTo evaluate current clinical practice for octogenarians with iron‐deficiency anemia (IDA) by assessing referral patterns, diagnostic choices, clinical consequences of omission of endoscopy, and risks and benefits of IDA‐related surgery.DesignChart review.SettingA regional hospital‐based laboratory in the Netherlands between January 2008 and December 2010.ParticipantsAll individuals aged 80 and older with newly ascertained IDA.MeasurementsIDA was defined as a hemoglobin level of 11.1 g/dL or less and a ferritin level of 25 μg/L or less.ResultsFour hundred seventy‐one participants were newly diagnosed with IDA during the study period (median age 85.4), 276 of whom (59%) did not undergo any diagnostic procedures for IDA. A cause of anemia was identified during the initial examination in 50% of the 205 investigated participants, including nine (4%) upper and 37 (18%) lower gastrointestinal malignancies. Another 24 malignancies were identified during follow‐up, of which 16 were in the gastrointestinal tract, primarily in participants for whom the initial diagnostic examination was limited or omitted. Perioperative mortality was 15% in individuals with colon cancer. Median survival for participants with colon cancer was 2.2 years, and the survival benefit of surgery over supportive care was not apparent until 1.3 years after ascertainment of IDA.ConclusionThe omission of endoscopy for IDA and the omission of surgery for colon cancer occur frequently in octogenarians and seem appropriate in the presence of significant comorbidity and in cases in which there is limited life expectancy. Further research is needed to determine which baseline factors should guide decision‐making to optimize treatment outcomes and quality of life.
Pain as a Risk Factor for Disability or Death
Authors: Andrews James S. , Cenzer Irena Stijacic , Yelin Edward , Covinsky Kenneth E. 
Published: March 2013

ObjectivesTo determine whether pain predicts future activity of daily living (ADL) disability or death in individuals aged 60 and older.DesignProspective cohort study.SettingThe 1998 to 2008 Health and Retirement Study (HRS), a nationally representative study of older community‐living individuals.ParticipantsTwelve thousand six hundred thirty‐one participants in the 1998 HRS aged 60 and older who did not need help in any ADL.MeasurementsParticipants reporting that they had moderate or severe pain most of the time were defined as having significant pain. The primary outcome was time to development of ADL disability or death over 10 yrs, assessed at five successive 2‐year intervals. ADL disability was defined as needing help performing any ADL: bathing, dressing, transferring, toileting, eating, or walking across a room. A discrete hazards survival model was used to examine the relationship between pain and incident disability over each 2‐year interval using only participants who started the interval with no ADL disability. Several potential confounders were adjusted for at the start of each interval: demographic factors, seven chronic health conditions, and functional limitations (ADL difficulty and difficulty with five measures of mobility).ResultsAt baseline, 2,283 (18%) participants had significant pain. Participants with pain were more likely (all P < .001) to be female (65% vs 54%), have ADL difficulty (e.g., transferring 12% vs 2%, toileting 11% vs 2%), have difficulty walking several blocks (60% vs 21%), and have difficulty climbing one flight of stairs (40% vs 12%). Over 10 years, participants with pain were more likely to develop ADL disability or death (58% vs 43%, unadjusted hazard ratio (HR) = 1.67, 95% confidence interval (CI) = 1.57–1.79), although after adjustment for confounders, participants with pain were not at greater risk for ADL disability or death (HR = 0.98, 95% CI = 0.91–1.07). Adjustment for functional status almost entirely explained the difference between the unadjusted and adjusted results.ConclusionAlthough there are strong cross‐sectional relationships between pain and functional limitations, individuals with pain are not at higher risk of subsequent disability or death after accounting for functional limitations. Like many geriatric syndromes, pain and disability may represent interrelated phenomena that occur simultaneously and require unified treatment paradigms.
Short‐term body weight fluctuations in older well‐hydrated hospitalised patients
Authors: Vivanti A. , Yu L. , Palmer M. , Dakin L. , Sun J. , Campbell K. 
Published: March 2013

AbstractBackgroundThe usual daily weight fluctuations of well‐hydrated older hospitalised people have not been documented internationally. To date, dehydration assessments based on a short‐term body weight change defined as >2% have been drawn from healthy population data. The present pilot study aimed to describe usual body weight fluctuation at the same time of day over a 3‐day time frame in well‐hydrated older hospitalised adults.MethodsAn observational study of non‐acute inpatients (n = 10) admitted to a Geriatric and Rehabilitation Unit, aged ≥60 years, assessed as well‐hydrated, mobile, non‐amputee and without conditions that influenced fluid status, was conducted. Participants were weighed hourly over a 9‐h period for 3 days. Food and fluid intake, clothing items added or removed, and urine and faecal output were recorded.ResultsWeight fluctuation for each participant [mean (SD) 80.2 (4.2) years; male 60.0%, n = 10] over 3 days ranged from 1.1% to 3.6%. Over 3 days, 40.0% (4/10) of participants had weight fluctuations of >2% and 20% (2/10) had weight fluctuations of >3%. Time of weigh‐in accounted for 99.8% of the variation in weight fluctuation (P < 0.05), with the lowest fluctuations observed when weights were compared at the same time each day (≤0.4 kg).ConclusionsWeights recorded at the same time daily had the greatest accuracy. Given that the range 1.1–3.6% was within normal weight fluctuations for well‐hydrated older hospitalised participants, the weight change indicative of dehydration remains to be established in this setting but appears greater than conventionally used figures.
Evaluation of seasonality on total water intake, water loss and water balance in the general population in Greece
Authors: Malisova O. , Bountziouka V. , Panagiotakos D. Β. , Zampelas A. , Kapsokefalou M. 
Published: March 2013

AbstractBackgroundWater balance is achieved when water intake from solid and fluid foods and drinking water meets water losses, mainly in sweat, urine and faeces. Seasonality, particularly in Mediterranean countries that have a hot summer, may affect water loss and consequently water balance. Water balance has not been estimated before on a population level and the effect of seasonality has not been evaluated. The present study aimed to compare water balance, intake and loss in summer and winter in a sample of the general population in Greece.MethodsThe Water Balance Questionnaire (WBQ) was used to evaluate water balance, estimating water intake and loss in summer (n = 480) and in winter (n = 412) on a stratified sample of the general population in Athens, Greece.ResultsIn winter, mean (SD) water balance was −63 (1478) mL/day−1, mean (SD)water intake was 2892 (987) mL/day−1 and mean (quartile range) water loss was 2637 (1810–3922) mL/day−1. In summer, mean (SD) water balance was −58 (2150) mL/day−1, mean (SD) water intake was 3875 (1373) mL/day−1 and mean (quartile range) water loss was 3635 (2365–5258) mL/day−1. Water balance did not differ between summer and winter (P = 0.96); however, the data distribution was different; in summer, approximately 8% more participants were falling in the low and high water balance categories. Differences in water intake from different sources were identified (P < 0.05).ConclusionsWater balance in summer and winter was not different. However, water intake and loss were approximately 40% higher in summer than in winter. More people were falling in the low and high water balance categories in summer when comparing the distribution on water balance in winter.
Effect of dietary protein on post‐prandial glucose in patients with type 1 diabetes
Authors: Borie‐Swinburne C. , Sola‐Gazagnes A. , Gonfroy‐Leymarie C. , Boillot J. , Boitard C. , Larger E. 
Published: March 2013

AbstractBackgroundIn flexible insulin therapy, determination of the prandial insulin dose only takes into account the carbohydrate content of the evening meal, and not the protein content. Protein can, however, contribute to gluconeogenesis. We compared the glycaemic effect of a standard evening meal with that of a test evening meal enriched in protein.MethodsThe present study was conducted in 28 C‐peptide negative patients with type 1 diabetes. Two evening meals that were similar in content, except that one was enriched by the addition of 300 g of 0%‐fat fromage frais, were taken on two consecutive days. Insulin doses were maintained exactly the same before both evening meals. Patients were monitored with a continuous glucose‐monitoring device.ResultsPatients ate similar quantities at both evening meals, except for protein (21.5 g more at the test evening meal). The preprandial insulin dose was 0.96 (0.4) U per 10 g carbohydrates. After correction for differences of interstitial glucose at the start of the evening meals, both interstitial and capillary glucose levels were similar after both evening meals, except for the late‐post‐prandial interstitial glucose level.ConclusionsWe found no effect of dietary protein on post‐prandial‐, overnight‐ or late‐night glucose levels in patients with type 1 diabetes. This confirms that dietary proteins need not be included in the calculation of prandial insulin dose.
Business‐to‐Business Information Technology User Practices at End of Life in the United Kingdom, Germany, and France
Authors: Peagam Richard , McIntyre Kirstie , Basson Lauren , France Chris 
Published: March 2013

SummaryBusiness‐to‐business (B2B) electronics account for a significant volume of the electrical and electronic equipment (EEE) put on the market. Very little B2B waste electrical and electronic equipment (WEEE) is reported as collected in the European Union (EU) in compliance with the WEEE Directive, which uses the policy principle of extended producer responsibility (EPR) to ensure that WEEE is managed correctly. This presents a barrier to parties looking for access to the waste. Company practice dictates the channels into which B2B WEEE flows following primary use. This article presents a study that engaged with company actors directly to get a better understanding of business information technology (IT) EEE asset management. Data were collected to determine the barriers current practice could present to the collection of B2B IT EEE at end of life and the implications of these for the development of policies and strategies for EPR. A questionnaire was developed and data were gathered from organizations in three EU countries—the United Kingdom, Germany, and France—stratified by size. Some notable findings were that there are several routes by which end‐of‐life B2B WEEE can flow. The recycling and refurbishment of B2B IT units at end of use was shown to be commonplace, but it is likely that these units enter streams where they are not reported. The actors disposing of their units did not have information on the management or disposition of these streams. It is concluded that to achieve the goals of EPR for B2B IT WEEE, the networks and the operational practices of these streams need to be better understood when developing strategies and policies.
Exhumation of oceanic eclogites: thermodynamic constraints on pressure, temperature, bulk composition and density
Authors: Chen Y. , Ye K. , Wu T. F. , Guo S. 
Published: March 2013

AbstractThe exhumation mechanism of high‐pressure (HP) and ultrahigh‐pressure (UHP) eclogites formed by the subduction of oceanic crust (hereafter referred to as oceanic eclogites) is one of the primary uncertainties associated with the subduction factory. The phase relations and densities of eclogites with MORB compositions are modelled using thermodynamic calculations over a P–T range of 1–4 GPa and 400–800 °C, respectively, in the NCKFMASHTO (Na2O–CaO–K2O–FeO–MgO–Al2O3–SiO2–H2O–TiO2–Fe2O3) system. Our modelling suggests that the mineral assemblages, mineral proportions and density of oceanic crust subducted along a cold P–T path are quite different from those of crust subducted along a warm P–T path, and that the density of oceanic eclogites is largely controlled by the stability of low‐density hydrous minerals, such as lawsonite, chlorite, glaucophane and talc. Along a cold subduction P–T path with a geotherm of ~6 °C km−1, lawsonite is always present at 1.1 to >4.0 GPa, and chlorite, glaucophane and talc can be stable at pressures of up to 2.3, 2.6 and 3.6 GPa respectively. Along such a P–T path, the density of subducted oceanic crust is always lower than that of the surrounding mantle at depths shallower than 110–120 km (< 3.3–3.6 GPa). However, along a warm subduction P–T path with a geotherm of ~10 °C km−1, the P–T path is outside the stability field of lawsonite, and the hydrous minerals of chlorite, epidote and amphibole break down completely into dry dense minerals at relatively lower pressures of 1.5, 1.85 and 1.9 GPa respectively. Along such a warm subduction P–T path, the subducted oceanic crust becomes denser than the surrounding mantle at depths >60 km (>1.8 GPa). Oceanic eclogites with high H2O content, oxygen fugacity, bulk‐rock XMg [ = MgO/(MgO + FeO)], XAl [ = Al2O3/(Al2O3 + MgO + FeO)] and low XCa [ = CaO/(CaO + MgO + FeO + Na2O)] are likely suitable for exhumation, which is consistent with the bulk‐rock compositions of the natural oceanic eclogites on the Earth's surface. On the basis of natural observations and our calculations, it is suggested that beyond depths around 110–120 km oceanic eclogites are not light enough and/or there are no blueschists to compensate the negative buoyancy of the oceanic crust, therefore explaining the lack of oceanic eclogites returned from ultradeep mantle (>120 km) to the Earth's surface. The exhumed light–cold–hydrous oceanic eclogites may have decoupled from the top part of the sinking slab at shallow depths in the forearc region and are exhumed inside the serpentinized subduction channel, whereas the dense–hot–dry eclogites may be retained in the sinking slab and recycled into deeper mantle.
Preservation of subduction‐related prograde deformation in lawsonite pseudomorph‐bearing rocks
Authors: Philippon M. , Gueydan F. , Pitra P. , Brun J‐P. 
Published: March 2013

AbstractLawsonite pseudomorphs are used to identify and distinguish the kinematic records of subduction and exhumation in blueschist‐facies rocks from Syros (Cyclades; Greece). Lawsonite is a hydrous mineral that crystallizes at high‐pressure and low‐temperature conditions. During decompression, lawsonite is typically pseudomorphed by an aggregate dominated by epidote and paragonite. Such aggregates are easily deformable and if deformation occurs after the lawsonite breakdown, the pseudomorphs are difficult to distinguish from the matrix. The preservation of the lawsonite crystal shape, despite complete retrogression, indicates therefore that the host blueschist rock has not been affected by penetrative deformation during exhumation, thus providing indication of strain‐free conditions. Therefore, tracking the lawsonite growth and destabilization along the P–T path followed by the rocks during a subduction/exhumation cycle provides information about the subduction/exhumation‐related deformation. Using microstructural observations and P–T pseudosections calculated with thermocalc, it is inferred that top‐to‐the‐south sense of shear preserved in lawsonite pseudomorph‐bearing blueschists on Syros occurred during the prograde metamorphic path within the lawsonite stability field, and is therefore associated with subduction. On the contrary, the deformation with a top‐to‐the‐north sense of shear is observed in surrounding rocks, where lawsonite pseudomorphs are deformed or apparently lacking. This deformation occurred after the lawsonite breakdown during exhumation. At the regional scale, exhumation‐related deformation is heterogeneous, allowing the preservation of lawsonite pseudomorphs in significant volumes of blueschists of the central and southern Cyclades. It is argued that such successive shearing deformation events with opposite senses more likely correspond to an exhumation process driven by slab rollback, in which subduction and exhumation are not synchronous.
Structural kinematics, metamorphic P–T profiles and zircon geochronology across the Greater Himalayan Crystalline Complex in south‐central Tibet: implication for a revised channel flow
Authors: Wang J. M. , Zhang J. J. , Wang X. X. 
Published: March 2013

AbstractA specific question about the Himalayas is whether the orogeny grew by distributed extrusion or discrete thrusting. To place firm constraints on tectonic models for the orogeny, kinematic, thermobarometric and geochronological investigations have been undertaken across the Greater Himalayan Crystalline Complex (GHC) in the Nyalam region, south‐central Tibet. The GHC in this section is divided into the lower, upper and uppermost GHC, with kinematically top‐to‐the‐south, alternating with top‐to‐the‐north shear senses. A new thrust named the Nyalam thrust is recognized between the lower and upper GHC, with a 3 kbar pressure reversion, top‐to‐the‐south thrust sense, and was active after the exhumation of the GHC. Peak temperature reached ∼749 °C in the cordierite zone, and decreased southwards to 633–667 °C in the kyanite and sillimanite‐muscovite zones, and northwards to greenschist facies at the top of the South Tibetan Detachment System (STDS). Pressure at peak temperature reached a maximum value in the kyanite zone of 9.0–12.6 kbar and decreased northwards to ∼4.1 kbar in the cordierite zone. Zircon U‐Pb ages of a sillimanite migmatite and an undeformed leucogranite dyke cutting the mylonitized rocks in the STDS reveal a long‐lived partial melting of the GHC, which initiated at 39.7–34 Ma and ceased at 14.1 Ma. Synthesizing the obtained and collected results, a revised channel flow model is proposed by considering the effect of heat advection and convection by melt and magma migration. Our new model suggests that distributed processes like channel flow dominated during the growth of the Himalayan orogen, while discrete thrusting occurred in a later period as a secondary process.
On semiautomatic estimation of surface area
Authors: DVOŘÁK J. , JENSEN E.B.V. 
Published: March 2013

SummaryIn this paper, we propose a semiautomatic procedure for estimation of particle surface area. It uses automatic segmentation of the boundaries of the particle sections and applies different estimators depending on whether the segmentation was judged by a supervising expert to be satisfactory. If the segmentation is correct the estimate is computed automatically, otherwise the expert performs the necessary measurements manually. In case of convex particles we suggest to base the semiautomatic estimation on the so‐called flower estimator, a new local stereological estimator of particle surface area. For convex particles, the estimator is equal to four times the area of the support set (flower set) of the particle transect. We study the statistical properties of the flower estimator and compare its performance to that of two discretizations of the flower estimator, namely the pivotal estimator and the surfactor. For ellipsoidal particles, it is shown that the flower estimator is equal to the pivotal estimator based on support function measurements along four perpendicular rays. This result makes the pivotal estimator a powerful approximation to the flower estimator. In a simulation study of prolate and oblate ellipsoidal particles, the surfactor also performs well for particles which are not extremely elongated. In particular, the surfactor is not very much affected by the singularity in the surfactor formula or by possible inaccuracies in the necessary angle measurements. We also assess the performance of the semiautomatic procedure in a study of somatostatin positive inhibitory interneurons from mice hippocampi. Only 35% of the cells needed to be analysed manually and an important decrease in workload was obtained by using the semiautomatic approach.
Temperature measurement in the microscopic regime: a comparison between fluorescence lifetime‐ and intensity‐based methods
Authors: PAVIOLO C. , CLAYTON A.H.A. , MCARTHUR S.L. , STODDART P.R. 
Published: March 2013

SummaryThermally sensitive fluorescent indicators have been proposed to monitor temperature changes in microfluidic systems, mainly based on fluorescence intensity or lifetime. However, measuring temperature in a structured environment, such as biological tissue, presents additional challenges due to the chemical and structural complexity. Here, we investigate the potential for resolving temperature distributions within the volume of a single cell. Rhodamine B (RhB) dye was employed as a temperature indicator to compare fluorescence intensity‐ and lifetime‐based techniques. The relationship between the fluorescence lifetime and temperature was found to be highly dependent on the biological environment. The intensity‐based method allowed the temperature distribution to be mapped with partial success within the volume of a single cell. Under ideal circumstances, the temperature can be mapped pixel by pixel with a resolution better than ±0.3°C within the cell cytoplasm, but this accuracy was reduced to ±1.8°C by environmental variations. These results suggest that the fluorophore should be encapsulated and immobilized in the biological tissue in order to reduce the influence of environmental factors on temperature measurements at the cellular level.
Challenges in developing novel therapies for peripheral neuropathies: a summary of The Foundation for Peripheral Neuropathy Scientific Symposium 2012
Authors: Höke Ahmet , Simpson David M. , Freeman Roy 
Published: March 2013

AbstractOn March 14–16, 2012, The Foundation for Peripheral Neuropathy organized a scientific meeting that brought together basic and clinical scientists studying peripheral neuropathies and mechanisms of axonal degeneration and representatives from the drug industry, National Institutes of Health, and Federal Drug Administration. This meeting summary covers the main discussion points laid out by the participants that hamper development of novel therapies for peripheral neuropathies and neuropathic pain. In each section of the meeting, the discussion was led by a keynote talk and was followed by a panel of discussants that were asked to bring two key questions in their areas of research. With audience participation, this format led to a lively discussion that pointed out the deficiencies in both animal modeling of human diseases and issues in clinical trial design unique to the peripheral neuropathies and neuropathic pain.