bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the boundary of a specialist service for adults with intellectual disabilities using a Delphi study: a quantification of stakeholder participation
Authors: Hempe Eva‐Maria , Morrison Cecily , Holland Anthony 
Published: July 2013

AbstractBackgroundThere are arguments that a specialist service for adults with intellectual disabilities is needed to address the health inequalities that this group experiences. The boundary of such a specialist service however is unclear, and definition is difficult, given the varying experiences of the multiple stakeholder groups.ObjectivesThe study reported here quantitatively investigates divergence in stakeholders’ views of what constitutes a good specialist service for people with intellectual disabilities. It is the first step of a larger project that aims to investigate the purpose, function and design of such a specialist service. The results are intended to support policy and service development.Study designA Delphi study was carried out to elicit the requirements of this new specialist service from stakeholder groups. It consisted of three panels (carers, frontline health professionals, researchers and policymakers) and had three rounds. The quantification of stakeholder participation covers the number of unique ideas per panel, the value of these ideas as determined by the other panels and the level of agreement within and between panels.FindingsThere is some overlap of ideas about of what should constitute this specialist service, but both carers and frontline health professionals contributed unique ideas. Many of these were valued by the researchers and policymakers. Interestingly, carers generated more ideas regarding how to deliver services than what services to deliver. Regarding whether ideas are considered appropriate, the variation both within and between groups is small. On the other hand, the feasibility of solutions is much more contested, with large variations among carers.ConclusionsThis study provides a quantified representation of the diversity of ideas among stakeholder groups regarding where the boundary of a specialist service for adults with learning disabilities should sit. The results can be used as a starting point for the design process. The study also offers one way to measure the impact of participation for those interested in participation as a mechanism for service improvement.
The circadian clock is functional in eosinophils and mast cells
Authors: Baumann Anja , Gönnenwein Simone , Bischoff Stephan C. , Sherman Hadas , Chapnik Nava , Froy Oren , Lorentz Axel 
Published: July 2013

SummaryAllergic diseases are frequently exacerbated between midnight and early morning, suggesting a role for the biological clock. Mast cells (MC) and eosinophils are the main effector cells of allergic diseases and some MC‐specific or eosinophil‐specific markers, such as tryptase or eosinophil cationic protein, exhibit circadian variation. Here, we analysed whether the circadian clock is functional in mouse and human eosinophils and MC. Mouse jejunal MC and polymorphonuclear cells from peripheral blood (PMNC) were isolated around the circadian cycle. Human eosinophils were purified from peripheral blood of non‐allergic and allergic subjects. Human MC were purified from intestinal tissue. We found a rhythmic expression of the clock genes mPer1, mPer2, mClock and mBmal1 and eosinophil‐specific genes mEcp, mEpo and mMbp in murine PMNC. We also found circadian variations for hPer1, hPer2, hBmal1, hClock, hEdn and hEcp mRNA and eosinophil cationic protein (ECP) in human eosinophils of both healthy and allergic people. Clock genes mPer1, mPer2, mClock and mBmal1 and MC‐specific genes mMcpt‐5, mMcpt‐7, mc‐kit and mFcεRI α‐chain and protein levels of mMCPT5 and mc‐Kit showed robust oscillation in mouse jejunum. Human intestinal MC expressed hPer1, hPer2 and hBmal1 as well as hTryptase and hFcεRI α‐chain, in a circadian manner. We found that pre‐stored histamine and de novo synthesized cysteinyl leukotrienes, were released in a circadian manner by MC following IgE‐mediated activation. In summary, the biological clock controls MC and eosinophils leading to circadian expression and release of their mediators and, hence it might be involved in the pathophysiology of allergy.
Quantification and comparison of psychiatric distress in African patients with albinism and vitiligo: a 5‐year prospective study
Authors: Ajose F.O.A. , Parker R.A. , Merrall E.L.C. , Adewuya A.O. , Zachariah M.P. 
Published: July 2013

AbstractBackgroundVitiligo and Albinism are two disorders of pigmentation that make the affected African highly visible and strikingly different from their peers. Both pose considerable management challenges, attract significant stigma and profound impairment of quality of life.Objective and MethodsTo determine and compare psychiatric distress in vitiligo and albinism using the Hospital Anxiety and Depression Scale (HADS). Participants were 87 albinos and 102 vitiligo adult patients seen at an urban tertiary hospital in Nigeria between 2004 and 2009.ResultsPrevalence of psycho morbidity was 59% (60/102) in vitiligo compared with 26% (23/87) in the albinos. The mean anxiety score was estimated to be 2.55 points lower for albino patients (95% CI: 1.47 to 3.64), and the mean depression score 2.76 points lower (95% CI: 1.84 to 3.68), after adjustment for age, sex and marital status. However, significant differences were not observed when comparing the vitiligo patients with the subset of albino patients with skin cancer. Older patients had significantly higher anxiety and depression scores. Females had significantly higher anxiety scores (but not depression scores) compared to males. Genital involvement in vitiligo was significantly associated with anxiety but not depression.ConclusionsWe found that the African with vitiligo suffers significantly higher psychiatric distress than the African albino on average. Clinical evaluation of these patients would be incomplete without assessment of their psycho morbidity. There is need for increased focus on cancer prevention strategies in the African albino.
Phase equilibria for graphitic metapelite including solution of CO2 in melt and cordierite: implications for dehydration, partial melting and graphite precipitation
Authors: Chu X. , Ague J. J. 
Published: July 2013

AbstractWhen graphite is present, carbon‐bearing species dissolve in the C‐O‐H fluid and lower the activity of water (). Accordingly, metamorphic reactions that involve water, namely dehydration and partial melting reactions, adjust their P–T positions to accommodate the change of . In this modelling study, pseudosections are calculated for graphite‐bearing systems that are either closed or that progressively lose fluid and/or melt. The diagrams incorporate a new model of CO2 solubility in felsic melts that we derived to be compatible with a recently published melt model. As the result of the lowered in the carbon‐bearing systems, the temperature displacements of the solidus can be as large as 50 °C at low pressures in cordierite‐bearing zones (<4 kbar), but are smaller than 15 °C at mid‐pressure P–T conditions (4–9 kbar). In the supersolidus region, the phase relations among silicate minerals + melt are very close to those in carbon‐free systems. The fluid CO2 content increases as temperature increases in the supersolidus assemblages. The CO2‐rich fluid can be stable in granulite facies conditions in an oxidized system. In graphitic systems, melt and/or cordierite dominate the CO2 budget of high‐grade rocks. During cooling, the fluid that exsolves from such crystalizing melt is CO2‐rich. In addition to the phase relations, the pseudosections presented in this study enable researchers to quantitatively investigate the evolution of phase modes, including graphite, along specific metamorphic P–T paths. At low pressures in the cordierite stability field, graphite is predicted to precipitate as the pressure increases or temperature decreases in the subsolidus assemblages, or temperature increases in the region of melt + fluid coexistence. On the other hand, the graphite abundance remains nearly constant along the mid‐pressure P–T series, but the graphite mode in the supersolidus region may increase due to residual enrichment if the melt is extracted. The modelling results show that metamorphic processes in closed systems lead to only small changes in graphite mode (a few tenths of a per cent). This strongly suggests that open‐system behaviours are required for large amounts of graphite deposition, including fluid infiltration and mixing or residual enrichment processes in high‐grade rocks. In addition to P–T pseudosections, P/T–XO diagrams (XO = O/(H + O) in the fluid) illustrate the thermodynamic features of internal buffering from another perspective, and explore the dependence of phase relations on the externally imposed redox state. If the system is equilibrated with CO2 or CH4‐rich infiltrating fluid, the temperature displacements of metamorphic reactions can be larger than 50 °C, compared with carbon‐free systems.
Rapid Oestrogenic Regulation of Social and Nonsocial Learning
Authors: Ervin K. S. J. , Phan A. , Gabor C. S. , Choleris E. 
Published: July 2013

Much research on oestrogens has focused on their long‐term action, exerting behavioural effects within hours to days through gene transcription. Oestrogens also affect behaviour on a much shorter time scale. These rapid effects are assumed to occur through cell signalling and can elicit a behavioural effect as early as 15 min after treatment. These effects on behaviour have primarily been explored through the action of oestradiol at three well‐known oestrogen receptors (ERs): ERα, ERβ and the more recently described G protein‐coupled ER1 (GPER1). The rapid effects of oestradiol and ER agonists have been tested on both social and nonsocial learning paradigms. Social learning refers to a paradigm in which an animal acquires information and modifies its behaviour based on observation of another animal, commonly studied using the social transmission of food preferences paradigm. When administered shortly before testing, oestradiol rapidly improves social learning on this task, although no ER agonist has definitive, comparable improving effects. Some evidence points to GPER1, whereas ERα impairs, and ERβ activation has no effect on social learning. Conversely, ERα and GPER1 play a larger role than ERβ in the rapid improving effect of oestrogens on nonsocial learning, including social and object recognition. In addition, when administered immediately post‐acquisition, oestrogens also rapidly improve memory consolidation in a variety of learning paradigms: object recognition, object placement, inhibitory avoidance and the Morris water maze, indicating that oestradiol affects the consolidation of multiple types of memory. Evidence suggests that these improvements are the result of oestrogens acting in the dorsal hippocampus where selective activation of all three ERs shows rapid improving effects on spatial learning comparable to oestradiol. However, the hippocampus is not necessary for rapid oestradiol improvements on social recognition. Although acute treatment with oestradiol enhances learning and memory on various social and nonsocial learning paradigms, the specific ERs play different roles in each type of learning. Future research should aim to further determine the roles of ERs with respect to the enhancing effects of oestradiol on learning and memory, and also determine where in the brain oestradiol acts to affect social and nonsocial learning.
Spinal muscular atrophy: a motor neuron disorder or a multi‐organ disease?
Authors: Shababi Monir , Lorson Christian L. , Rudnik‐Schöneborn Sabine S. 
Published: July 2013

AbstractSpinal muscular atrophy (SMA) is an autosomal recessive disorder that is the leading genetic cause of infantile death. SMA is characterized by loss of motor neurons in the ventral horn of the spinal cord, leading to weakness and muscle atrophy. SMA occurs as a result of homozygous deletion or mutations in Survival Motor Neuron‐1 (SMN1). Loss of SMN1 leads to a dramatic reduction in SMN protein, which is essential for motor neuron survival. SMA disease severity ranges from extremely severe to a relatively mild adult onset form of proximal muscle atrophy. Severe SMA patients typically die mostly within months or a few years as a consequence of respiratory insufficiency and bulbar paralysis. SMA is widely known as a motor neuron disease; however, there are numerous clinical reports indicating the involvement of additional peripheral organs contributing to the complete picture of the disease in severe cases. In this review, we have compiled clinical and experimental reports that demonstrate the association between the loss of SMN and peripheral organ deficiency and malfunction. Whether defective peripheral organs are a consequence of neuronal damage/muscle atrophy or a direct result of SMN loss will be discussed.
Role of osteopontin in differential diagnosis of ovarian tumors
Authors: Moszynski Rafal , Szubert Sebastian , Szpurek Dariusz , Michalak Slawomir , Sajdak Stefan 
Published: July 2013

AbstractAimThe aim of this study was to evaluate the role of the serum osteopontin (OPN) level as a biomarker for discriminating between malignant and benign ovarian tumors. Furthermore, comparisons with the diagnostic usefulness of the other tests were performed.MethodsThe study included 114 consecutive women with ovarian tumors (82 benign and 32 malignant) who were referred to our division.ResultsA cut‐off level of 28.0 ng/mL for OPN showed a sensitivity of 71.87% and a specificity of 89.02%. The area under the receiver–operator curve (ROC) was 0.812. There were no differences in diagnostic utility between OPN and the other studied tests. OPN levels were lower in patients with endometriotic ovarian cysts than in those with other benign ovarian tumors (14.00 vs 19.50 ng/mL; P = 0.018). The difference between the median OPN level in patients with endometriotic cysts (14.0 ng/mL) and those with malignant tumors (40.85 ng/mL) was also statistically significant (P < 0.0001). The calculated OPN/CA‐125 ratio was significantly different between patients with endometriotic cysts (median, 0.36; range, 0.05–2.89) and those with other benign tumors (median, 1.25; range, 0.05–5.70) (P = 0.0002). There was also a statistically significant difference in the median OPN/CA‐125 ratio between patients with endometrial cysts (median, 0.36; range, 0.05–2.89) and those with malignant tumors (median, 0.12; range, 0.01–3.39) (P = 0.004).ConclusionThe diagnostic utility of OPN is similar to that of ultrasonographic evaluation and CA‐125 level assessment. Thus, OPN may be useful in differential diagnosis for less experienced ultrasonographers and is especially valuable for differential diagnosis of endometriotic cysts.
Postpartum smoking relapse among women who quit during pregnancy: Cross‐sectional study in Japan
Authors: Yasuda Takako , Ojima Toshiyuki , Nakamura Mieko , Nagai Akiko , Tanaka Taichiro , Kondo Naoki , Suzuki Kohta , Yamagata Zentaro 
Published: July 2013

AbstractAimTo determine the postpartum smoking relapse rate among women in Japan who quit smoking during pregnancy and to clarify factors related to smoking relapse.MethodsA self‐administered questionnaire survey was conducted as a cross‐sectional study of all mothers of children who underwent health checkups after birth in randomly selected municipalities in Japan from May to July 2009. Using valid data of 20 601 mothers, smoking rate was calculated. In addition, χ2‐test and multiple logistic regression analysis were used to clarify related factors to the smoking relapse.ResultsThe smoking rates among women were 15.8% at the time when they became pregnant, 5.1% during pregnancy and 11.3% after giving birth. Among women who smoked at the time they became pregnant, the smoking rate during pregnancy was 31.1%. Among women who quit smoking during pregnancy, the postpartum smoking relapse rate was 41.0%. The odds ratios (95% confidence interval) for factors in smoking relapse were 0.72 (0.60–0.88) for women spending time with their child in a relaxed mood, 0.67 (0.47–0.94) for women having someone to talk to on the Internet about childrearing, 1.94 (1.60–2.35) for women who worked and 3.37 (2.61–4.35) for women whose partner smoked after they gave birth.ConclusionIt is hoped that future research will establish methods to further support smoking cessation and the continuation of smoking cessation after childbirth, and develop mechanisms to spread knowledge about the harm of smoking in society and encourage women not to start.
Facility‐based review of 296 maternal deaths at a tertiary centre in India: Could they be prevented?
Authors: Goswami Deepti , Rathore Asmita Muthal , Batra Swaraj , Dubey Chandan , Tyagi Shakun , Wadhwa Leena 
Published: July 2013

AbstractAimsThe aim of this study was to identify causes of maternal mortality at the facility and to assess the standard of care, deficiencies in health services and preventability of these deaths using facility‐based maternal death reviews.Material and MethodsThis was a prospective study at a tertiary care hospital that included all women who died during pregnancy or within 42 days of being pregnant during 2005–2010.ResultsA review of 296 maternal deaths revealed that 59% of these occurred in medical wards. Indirect maternal deaths (54%) outnumbered the direct deaths (46%). Main causes were hepatitis (18%), hemorrhage (10%) and puerperal sepsis (10%). Only 5% of the women had received antenatal care at the facility. One‐third (34%) were referred from other centers. The majority (74%) were critically sick at admission. Most of the women (62%) died postpartum. Substandard care and deficient health services were identified in 8% and 20% of the cases, respectively. Sixteen (5%) maternal deaths were deemed preventable and another 36 (12%) possibly preventable. Since most of the preventable deaths (12/16) were due to hemorrhage, measures to control postpartum hemorrhage were promoted at the facility. Findings of the maternal death reviews were regularly conveyed to the State Health Department for prioritization and resource allocation to prevent maternal mortality.ConclusionMore maternal deaths occurred in the medical than in the obstetrics wards at the facility. The leading causes were hepatitis, hemorrhage and puerperal sepsis. Most of the deaths were non‐preventable as the women were critically sick at admission; however, substandard care and health service deficiency were contributory in some of the cases.
Optimal timing of prophylactic antibiotic for cesarean delivery: A randomized comparative study
Authors: Bhattacharjee Nabendu , Saha Shyama Prasad , Patra Kajal Kumar , Mitra Udayan , Ghoshroy Samir Chandra 
Published: July 2013

AbstractAimCesarean delivery is associated with a significantly higher postoperative infection rate than that following vaginal birth and other surgical procedures. This study compared whether antibiotic prophylaxis administered preoperatively was more effective in preventing infectious morbidity following cesarean delivery than administration at cord clamping.Material and MethodsIn a randomized comparative trial, 953 women with a period of gestation of more than 34 weeks, scheduled to have cesarean section, were randomly assigned to the prophylactic single‐dose antibiotic administration either preoperatively (study group) or at cord clamping (control group). Primary outcome measure was postoperative maternal infectious morbidity and secondary outcome measures were neonatal complications, and postoperative maternal hospital stay and stay of neonates in the neonatal intensive care unit.ResultsWound complications in the form of indurations, erythema and discharge, were significantly fewer in the study group as compared to the control group (10/476 vs 25/477, P = 0.010, conditional maximum likelihood estimate of odds ratio = 0.388 and 95% confidence interval = 0.175–0.805). Women in the study group also had fewer incidents of endomyometritis when compared to the control group (1.47% vs 3.56%; P = 0.041; conditional maximum likelihood estimate of odds ratio = 0.404). There was no significant difference in neonatal outcomes between the two groups. Mean postoperative stay of mothers in hospital was significantly shorter in the study group (P = 0.009, 95% confidence interval = −0.368 to −0.052) but neonatal intensive care unit stay of neonates was similar in both groups.ConclusionAdministration of prophylactic antibiotic at 30–60 min before skin incision resulted in better maternal outcome when infectious morbidity and postoperative hospital stay were concerned, without influencing the neonatal outcome.
Laparoscopic ovarian‐sparing surgery for a young woman with an exophytic ovarian fibroma
Authors: Hasegawa Akiko , Koga Kaori , Asada Kayo , Wada‐Hiraike Osamu , Osuga Yutaka , Kozuma Shiro 
Published: July 2013

AbstractOvarian fibroma can occur in young women of reproductive age. Despite its benign feature, most surgical removals are done in open surgery with oophorectomy. However, an ovarian‐sparing tumor resection can be an option, especially for an exophytic type of fibroma, which accounts for more than half of ovarian fibromas. Here we report a case of exophytic ovarian fibroma in a young woman treated by laparoscopic ovarian‐sparing surgery. A 27‐year‐old woman presented with a pelvic mass. Magnetic resonance imaging revealed an 11 cm × 8 cm solid mass connected to the normal‐appearing left ovary by a pedicle‐like structure. A clinical diagnosis of an exophytic ovarian fibroma was made, and laparoscopic ovarian‐sparing surgery with an intraoperative pathological examination was planned. The tumor was resected by cutting the pedicle, morcellated in a pouch and removed. All procedures were performed laparoscopically and the affected ovary was completely preserved. Having confirmation of its benign characteristics by the intraoperative examination, no further excision was performed. The patient conceived 3 months after the surgery and no recurrence was reported. We propose that gynecologists should consider laparoscopic ovarian‐sparing surgery for exophytic ovarian fibroma in women of reproductive age.
Diagnostic significance of total creatine kinase and its isoform in tubal ectopic pregnancy
Authors: Soundravally Rajendiran , Krishna Latha Thammineni , Soundara Raghavan Subrahmanian , Ananthanarayanan Palghat Hariharan , Srilatha Krishnamoorthy 
Published: July 2013

AbstractAimTubal ectopic pregnancy (tEP) must be diagnosed as early as possible because it is one of the leading causes of pregnancy‐related death in the first trimester. The aim of this study was to evaluate the diagnostic value of serum total creatine kinase (CK) and its isoforms in diagnosis of tEP.MethodsThe study included 32 tEP cases, and gestational age‐matched intrauterine (IU) abortion and normal pregnancy cases (n = 31 each). Serum total CK and CK‐MB fraction were measured by the principle of spectrophotometry and CK‐MM fraction was calculated from the above parameters. Serum β‐hCG was measured using chemiluminescent immunoassay. All study parameters were measured at the time of presentation.ResultsSerum β‐hCG levels were significantly low in patients with both tEP and IU abortion than normal pregnancy. Women with tEP had higher concentrations of total CK, CK‐MM and lower concentrations of CK‐MB% compared to both gestational age‐matched IU pregnancy controls and IU abortion. Receiver–operator characteristic analysis revealed that the optimal cut‐off for total CK, CK‐MM and CPK‐MB% as predictors of ruptured EP were 147 IU/L, 135 IU/L and 10%, respectively, with the former two having higher specificity, and latter high sensitivity.ConclusionEstimation of CK and its CK isoenzyme fractions can aid in quick and accurate diagnosis of tEP.