bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rhetoric and argumentation: how clinical practice guidelines think
Authors: Fuller Jonathan 
Published: May 2013

AbstractIntroductionClinical practice guidelines (CPGs) are an important source of justification for clinical decisions in modern evidence‐based practice. Yet, we have given little attention to how they argue their evidence. In particular, how do CPGs argue for treatment with long‐term medications that are increasingly prescribed to older patients?Approach and rationaleI selected six disease‐specific guidelines recommending treatment with five of the medication classes most commonly prescribed for seniors in Ontario, Canada. I considered the stated aims of these CPGs and the techniques employed towards those aims. Finally, I reconstructed and logically analysed the arguments supporting recommendations for pharmacotherapy.AnalysisThe primary function of CPGs is rhetorical, or persuasive, and their means of persuasion include both a display of their credibility and their argumentation. Arguments supporting pharmacotherapy recommendations for the target population follow a common inductive pattern: statistical generalization from randomized controlled trial (RCT) and meta‐analysis evidence. Two of the CPGs also argue their treatment recommendations for older patients in this style, while three fail to justify pharmacotherapy specifically for the older population.DiscussionThe arguments analysed lack the auxiliary assumptions that would warrant making a generalization about the clinical effectiveness of medications for the older population. Guidelines reason using simple induction, while ignoring important inferential gaps. Future guidelines should aspire to be well‐reasoned rather than simply evidence‐based; argue from a plurality of evidence; be wary of hasty inductions; appropriately limit the scope of their recommendations; and avoid making law‐like, prescriptive generalizations.
A short note on probability in clinical medicine
Authors: Upshur Ross E. G. 
Published: May 2013

AbstractProbability claims are ubiquitous in clinical medicine, yet exactly how clinical events relate to interpretations of probability has been not been well explored. This brief essay examines the major interpretations of probability and how these interpretations may account for the probabilistic nature of clinical events. It is argued that there are significant problems with the unquestioned application of interpretation of probability to clinical events. The essay concludes by suggesting other avenues to understand uncertainty in clinical medicine.
Addiction: lifestyle choice or medical diagnosis?
Authors: Nutt David 
Published: May 2013

AbstractThe concept of addiction is under threat from the current UK government's attempt to define it as a lifestyle choice rather than an illness. This overturns the previous government's rational policy on drug treatment and is both dishonest and damaging. It is dishonest because addiction fulfils all the criteria for an illness. It is damaging because proven treatments for many addictions exist and the failure to optimize these means that more patients will die, get blood‐borne viruses, and encourage others into drug use. In this paper, I detail these issues and suggest ways to avoid irreparable damage to the current care provisions that are proving effective.
The depressed patient in a biological world: on philosophical and diagnostic strategies
Authors: Korf Jakob , Bosker Fokko 
Published: May 2013

AbstractRationale, aims and objectiveWe questioned: what kind of relationships between mental and neurobiological levels of complexity is or could become useful in the psychiatric practice? The concept of mind and associated mood states defended here is that they are physically emergent, subjective, qualitative, unified features of the brain. We compared our neurobiological assessment also to psychoanalytical practice (first person's perspective).ArgumentApplied to recent work on major depressive disorder (MDD), our ideas are among other supported by clinical and experimental studies on sleep deprivation, deep brain stimulation and epidemiological assessments of time‐to‐recovery.Clinical implicationsWe suggest that depression is a transient state of the brain, that is mutually exclusive to the state of pleasure (in the Freudian context), rather than a disorder or disease with a characteristic time course (like many reversible somatic diseases). MDD can best be described with stochastic transition models, which is discussed in the context of a presumed brain serotonin dysfunction in depression. Our ideas invite a reconsideration of some concepts underlying current diagnostic and therapeutic approaches in the clinical practice.
TheEBM ArgumentHygieneCampaign
Authors: Cramer Peter 
Published: May 2013

AbstractThe campaign promotingevidence‐basedmedicine (EBM) shares similarities withJosephLister's 19th century campaign promoting surgical antisepsis. Both target medical practitioners as their primary clients, and both appeal to these clients in the manner of a public health programme, arguing that their standards are authoritative and relevant, that the clients fail to meet them, and that this failure is a problem that requires the clients to change. Both promote hygienic solutions to the problems that they identify, the problem of microbial pathogens in the case ofLister, and the process of clinical decision making in the case ofEBM. Hygienic solutions aim to operationalize standards as case‐independent procedures that can be performed as habits, and seek to identify instruments of purification against sources of contamination.EBM's solution is hygienic because it characterizes clinical decision‐making behaviour as a source of contamination and because it promotes a general procedure designed to correct it. Comparing theEBMcampaign toLister's helps to explain why some clinicians have had trouble trying to implementEBMas a decision‐making procedure in particular cases.EBMpromotes a hygienic solution, but unlikeLister, does not confront a well‐defined, empirically grounded problem. Some of the difficulties withEBMstem from a mismatch between its hygienic solution and the complexity and case‐dependency of clinical decision making.
Chemical Composition and in vitro Antimicrobial Activities of Mentha pulegium Leaves Extracts against Foodborne Pathogens
Authors: Ghazghazi Hanene , Chedia Aouadhi , Weslati Moufida , Trakhna Faten , Houssine Sebei , Abderrazak Maaroufi , Brahim Hasnaoui 
Published: May 2013

AbstractThe chemical composition and the biological activities of Mentha pulegium leaves extracts were evaluated. The main components of M. pulegium EO were menthone (41.7%), cis‐isopulegone (31.71%) and isomenthone (15.03%). The methanol extract of M. pulegium was rich in phenols and flavonoids. The EO showed much better antioxidant activity than the methanol extract against the DPPH and ABTS radicals scavenging. The EO showed strong antibacterial and antifungal activities against 10 tested microorganisms (Escherichia coli, Salmonella typhimurium, Staphylococcus aureus, Pseudomonas aeruginosa, Aeromonas hydrophila, Listeria monocytogenes, Bacillus cereus, Aspergillus niger, Aspergillus flavus, Candida albicans) tested whereas the methanol extract almost remained inactive. The IZ diameters and minimal inhibitrice concentration values for tested microorganisms were in the range of 15–30 mm and 0.05–0.8% (v/v), respectively. Future studies should focus on to determine the usage ability of M. pulegium EO in foods as natural preservative in effective dose.Practical ApplicationsThe replacement of synthetic additives by natural active compounds fosters research on the screening of medicinal plants as sources of new antioxidants. Moreover, such compounds can be used for extension of product shelf life by inhibiting the growth of foodborne spoilage bacteria. This study focused on the evaluation of biological activities of M. pulegium EO because of its application in food industries as a reasonably safe agent.Thus, this species might be a good candidate for further investigation in developing new antioxidants, as well as preservatives in food against the well‐known causal agents of foodborne diseases and food spoilage, particularly E. coli, S. typhimurium, L. monocytogenes, P. aeruginosa and S. aureus.
Diverticulitis in the young is not more aggressive than in the elderly, but it tends to recur more often: Systematic review and meta‐analysis
Authors: Katz Lior H , Guy Daniel D , Lahat Adi , Gafter‐Gvili Anat , Bar‐Meir Simon 
Published: May 2013

AbstractBackground and AimFor years, the natural course of diverticulitis in the young has been debatable in terms of its severity and recurrence rate, and no consensus has been reached regarding its treatment and timing of surgery. Thus, the study aims to evaluate by meta‐analysis the natural course of acute diverticulitis in the young.MethodsData were obtained from electronic databases and manual search of studies comparing the course of diverticulitis in young versus elderly patients. The age cut‐off was selected to be 40–50 years, and only studies using computed tomography as the sole modality for diagnosis were included. Primary outcomes were surgery during hospitalization and disease recurrence. Relative risks (RRs) with 95% confidence intervals (CIs) are reported.ResultsOne thousand eighty publications were found, 12 of which were included. The total number of patients was 4982. Most young patients were males (RR 1.70, 95% CI 1.31–2.21), without tendency toward a more complicated disease at admission (RR 0.95, 95% CI 0.46–1.97). While there was no significant difference in the rate of surgery during hospitalization (RR 0.69, 95% CI 0.46–1.06), young patients underwent more elective surgeries (RR 2.39, 95% CI 1.82–3.15). No mortality was recorded among young patients. The disease recurrence rate was significantly higher than that of elderly patients (RR 1.70, 95% CI 1.31–2.21); however, no study specified the mean follow‐up period for each group.ConclusionsThe course of diverticulitis in the young is not more severe than that in elderly patients; however, the disease tends to recur more often. Therefore, while choosing a therapeutic regimen, factors other than age should also be considered.
Hepatic steatosis and severity‐related factors in obese children
Authors: Navarro‐Jarabo Jose Maria , Ubiña‐Aznar Esther , Tapia‐Ceballos Leopoldo , Ortiz‐Cuevas Carmen , Pérez‐Aísa M Angeles , Rivas‐Ruiz Francisco , Andrade Raul J , Perea‐Milla Emilio 
Published: May 2013

AbstractBackground and AimObesity is an important health‐care problem in developed countries. It is considered a multisystemic disease, but it may also affect the liver, thus provoking non‐alcoholic fatty liver disease. This disease has been less extensively studied among children than among adults. We propose to analyze the prevalence of hepatic steatosis among a pediatric population within an area in southern Europe besides the variables associated with its development and severity.MethodsCross‐sectional study carried out on a population of children aged 6–14 years inclusive, using abdominal ultrasound as a method to determine the presence and severity of hepatic steatosis; in addition, anthropometric and blood‐tested parameters were examined to determine which of these were associated with steatosis.ResultsOne hundred forty‐four children were analyzed, 84 male (58.3%). Steatosis was detected in 50 children (34.7%; 95% confidence interval [CI]: 26.0–42.0%). In six of these cases (12%), elevated aminotransferase levels were recorded. Factors found to be associated with steatosis were body mass index ≥ 99th percentile (odds ratio [OR] 3.58, 95% CI 1.16–15.6) and the level of alanine aminotransferase (ALT) (OR 1.08, 95% CI 1.03–1.13), while its severity was associated with ALT (OR 1.17, 95% CI 1.09–1.28). A level of ALT < 23.5 UI/dL predicted lack of severe steatosis with an area under receiver operating characteristic curve of 0.805 (95% CI 0.683–0.927).ConclusionsNon‐alcoholic fatty liver disease is common in the obese pediatric population in our geographical area. High levels of ALT are associated with severe steatosis, although having ALT above the normal range is not common. Also, the lack of severity of steatosis can be predicted in a subgroup of children with obesity.
Gilbert's syndrome and the risk of death: A population‐based cohort study
Authors: Horsfall Laura J. , Nazareth Irwin , Pereira Stephen P. , Petersen Irene 
Published: May 2013

AbstractBackground and AimsGilbert's syndrome is a common familial hyperbilirubinemia that may reduce the risk of various age‐related diseases because of the antioxidant properties of bilirubin. We conducted a large cohort study using The Health Improvement Network primary care database and compared all‐cause mortality rates in those with and without Gilbert's syndrome.MethodsMortality rates in patients with a diagnosis of Gilbert's syndrome and raised bilirubin level (n = 4266) were compared with those of patients with similar characteristics but with normal bilirubin levels (n = 21 968). Multivariate Poisson regression was also used to estimate adjusted mortality rate ratios.ResultsDuring the 350 000 PYs of follow up across the Gilbert's and comparison cohorts, there were 1174 deaths. Mortality rates were 24/10 000 PYs in the Gilbert's cohort versus 50/10 000 PYs in the comparison cohort. Mortality rates were around half in patients with Gilbert's syndrome after accounting for sociodemographics and general health indicators (adjusted mortality rate ratio: 0.5 [95% confidence interval; 0.4–0.7; P < 0.001]).ConclusionsMortality rates observed for people with Gilbert's syndrome in the general population are almost half those of people without evidence of Gilbert's syndrome.
Delay of second‐line eradication therapy for Helicobacter pylori can increase eradication failure
Authors: Nishizawa Toshihiro , Suzuki Hidekazu , Takahashi Masahiko , Suzuki Masayuki , Hibi Toshifumi 
Published: May 2013

AbstractBackground and AimThe interval between first‐line Helicobacter pylori eradication treatment and second‐line treatment may be critical to the second‐line therapeutic effect. We attempted to assess the association between the second‐line eradication rates and the treatment interval.MethodsData of patients, who were administered the second‐line H. pylori eradication regimen at Tokyo Medical Center between 2008 and 2012, were reviewed.ResultsOf the 148 patients enrolled, one patient dropped out. The eradication rates were 88.6% (intention‐to‐treat [ITT]) and 89.3% (per‐protocol [PP]) for early eradication group (eradication interval < 180 days, patients number 132) and 68.8% (ITT and PP) for delayed eradication group (eradication interval ≥ 180 days, patients number 16). The eradication rate in the delayed eradication group was significantly lower than in the early eradication group (P = 0.027 [ITT] and 0.021 [PP]). The eradication interval in the subjects showing eradication failure (124.0 ± 96.8 days, patients number 19) was significantly longer than those showing successful eradication (85.8 ± 56.9 days, patients number 128, P = 0.008).ConclusionOur results suggest that the delay of second‐line treatment should be avoided.
Influences of swallowing volume and viscosity on regulation of levator veli palatini muscle activity during swallowing
Authors: Okuno K. , Tachimura T. , Sakai T. 
Published: May 2013

SummaryThis study examined the aspect of the regulation of velum movement in the transition from the oral to pharyngeal phases of swallowing in relation to changes in the swallowing volume and viscosity by means of measurment of levator veli palatini muscle activity. The subjects were nine normal adults, ranging in age from 24 to 30 years. The swallowing volume was set at 1/4, 1/2 and 1 volume of the optimum volume of green tea for swallowing determined in each subject, and the viscosity was adjusted to 0, 2·0 and 4·6 Pa·s by mixing with thickener. Nine test foods were prepared in total. The electromyographic activity of the levator veli palatini muscle was monitored using bipolar hooked wire electrodes. The levator veli palatini muscle activity was defined as the integrated electromyographic wave. The mean in swallowing each test food was determined in each subject. The levator veli palatini muscle activity increased with the swallowing volume for all subjects (P < 0·05) and decreased inversely with the viscosity for six subjects (P < 0·05), but no change with the increase in the viscosity was noted for three subjects. This study clarified the aspect of the regulation of velar movement with regard to the involvement of the levator veli palatini muscle in swallowing activity with changes in the swallowing volume and viscosity.
Effect of Zinc on the Development of Brown Spot in Rice
Authors: Moreira Wiler R. , Rodrigues Fabrício Avila , Duarte Henrique Silva Silveira 
Published: May 2013

AbstractBrown spot, caused by the fungus Bipolaris oryzae, is one of the most destructive diseases of rice. This study investigated the effect of zinc rates on the development of brown spot in rice. Rice plants (cv. ‘Metica‐1′) were grown in hydroponic culture amended with Zn rates (applied as ZnSO4.7H2O) of 0, 0.5, 1, 2 and 4 μm and inoculated with B. oryzae. The foliar concentration of Zn was determined. Leaf samples were assessed for disease severity, and then, area under brown spot progress curve (AUBSPC) was calculated. The relationship between Zn concentrations on leaf tissues and the rates of this micronutrient was best described by a positive linear regression model, while the relationship between the Zn rates and the AUBSPC was best described with a positive quadratic regression model. The correlation between Zn concentrations on leaf tissues and AUBSPC was positive and significant (r = 0.68, P < 0.05). The results from this study showed that high foliar concentration of Zn was associated with increasing rice susceptibility to brown spot.
Melatonin inhibits cholangiocarcinoma and reduces liver injury in Opisthorchis viverrini‐infected and N‐nitrosodimethylamine‐treated hamsters
Authors: Laothong Umawadee , Pinlaor Porntip , Boonsiri Patcharee , Pairojkul Chawalit , Priprem Aroonsri , Johns Nutjaree Pratheepawanit , Charoensuk Lakhanawan , Intuyod Kitti , Pinlaor Somchai 
Published: May 2013

AbstractThe human liver fluke Opisthorchis viverrini infection and N‐nitrosodimethylamine (NDMA) administration induce cholangiocarcinoma (CCA) and liver injury in hamsters. Melatonin protects against liver injury and reduces the alteration of mitochondrial structure, mitochondrial membrane potential, and mitochondrial pro‐ and anti‐apoptotic pathways in various cancer types. To investigate the chemopreventive effect of melatonin on CCA genesis and liver injury, hamsters were treated with a combination of O. viverrini infection and NDMA concurrently administered with melatonin (10 mg/kg and 50 mg/kg) for 120 days. Melatonin treatment at 50 mg/kg caused a significant reduction in liver/body weight ratios and decreased tumor volumes leading to an increase in the survival of animals. In the tumorous tissues, the high‐dose melatonin reduced DNA fragmentation and mitochondrial apoptosis by inducing anti‐apoptotic protein (Bcl‐2) in the mitochondrial fraction and down‐regulating cytochrome c, pro‐apoptotic protein (Bax), and caspase‐3 in tumor cytosol. Moreover, a high‐dose melatonin treatment significantly increased mitochondrial antioxidant enzymes and prevented mitochondrial ultrastructure changes in the tumor. Overall, melatonin has potent chemopreventive effects in inhibiting CCA genesis and also reduces liver injury in hamster CCA, which, in part, might involve in the suppression of CCA by reducing tumor mitochondria alteration.
Effects of elevated pCO2 on the metabolism of a temperate rhodolith Lithothamnion corallioides grown under different temperatures
Authors: Noisette Fanny , Duong Gwendoline , Six Christophe , Davoult Dominique , Martin Sophie 
Published: May 2013

Coralline algae are considered among the most sensitive species to near future ocean acidification. We tested the effects of elevated pCO2 on the metabolism of the free‐living coralline alga Lithothamnion corallioides (“maerl”) and the interactions with changes in temperature. Specimens were collected in North Brittany (France) and grown for 3 months at pCO2 of 380 (ambient pCO2), 550, 750, and 1000 μatm (elevated pCO2) and at successive temperatures of 10°C (ambient temperature in winter), 16°C (ambient temperature in summer), and 19°C (ambient temperature in summer +3°C). At each temperature, gross primary production, respiration (oxygen flux), and calcification (alkalinity flux) rates were assessed in the light and dark. Pigments were determined by HPLC. Chl a, carotene, and zeaxanthin were the three major pigments found in L. corallioides thalli. Elevated pCO2 did not affect pigment content while temperature slightly decreased zeaxanthin and carotene content at 10°C. Gross production was not affected by temperature but was significantly affected by pCO2 with an increase between 380 and 550 μatm. Light, dark, and diel (24 h) calcification rates strongly decreased with increasing pCO2 regardless of the temperature. Although elevated pCO2 only slightly affected gross production in L. corallioides, diel net calcification was reduced by up to 80% under the 1,000 μatm treatment. Our findings suggested that near future levels of CO2 will have profound consequences for carbon and carbonate budgets in rhodolith beds and for the sustainability of these habitats.
Interspecific differentiation and gene flow between two desert poplars inferred from six vacuolar Na+/H+ exchanger loci
Authors: GUO Yu‐Peng , GUO Qiu‐Hong , WANG Juan , YAN Yan , WANG Gai‐Ni , LU Zhi‐Qiang , WU Yu‐Xia 
Published: May 2013

AbstractPopulus euphratica Olivier and P. pruinosa Schrenk are known for their tolerance to highly saline and arid habitats, and overlapping distribution. We examined interspecific differentiation and gene flow between these two species at six loci that encode vacuolar Na+/H+ exchanger genes. Interspecific divergence varied greatly between sampled loci and could collectively delimit the two species well. Simulations based on the isolation–migration model suggested gene flow primarily from P. euphratica into P. pruinosa. This asymmetrical gene flow may be related to the adaptive survival of the introgressed individuals. Our findings suggest that these species may have diverged in the presence of gene flow and that local adaptation may have played an important role in maintaining the distinct species lineages by restricting gene flow between them. Our results together indicate that interspecific divergence and gene flow differ greatly between members of the same gene family, possibly due to differential subfunctionalization and/or neofunctionalization during ongoing speciation of these two poplar species.