bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single‐staged anterior and posterior spinal fusion: A safe and effective alternative for severe and rigid adolescent idiopathic scoliosis in China
Authors: Li Ming , Ni Jianqiang , Li Yang , Fang Xiutong , Gu Suxi , Zhang Zhiyu , Zhu Xiaodong 
Published: April 2009

Aim:  Delayed treatment of adolescent idiopathic scoliosis (AIS) is common in Mainland China because of the lack of public education about health care resulting in the reluctance to undergo surgery. This leads to a high incidence of complex cases where surgeons may not be trained in advanced procedures. We report the efficacy of single‐staged anterior and posterior spinal fusion for correction of severe AIS in China.Methods:  A retrospective review was performed of 31 consecutive cases in which patients were treated at the Orthopaedic Department of Changhai Hospital in Shanghai between 2001 and 2004 with a combined anterior and posterior spinal fusion with screws, hooks, sublaminar wires or cables.Results:  Thirty‐one patients with AIS with Lenke type 1, 2, 3 and 4 curves were included for analysis. At least one of the curves was ≥90° in each patient. The mean coronal and sagittal Cobb angles of the main thoracic curve were 98° and 22° before surgery, 50.5° and 21° after surgery, and 53.7° and 24° at follow‐up, respectively. No neurological deficits or deaths occurred. Solid arthrodesis with coronal and sagittal balance was achieved in all patients.Conclusions:  A single‐stage anterior release and fusion and posterior fusion for treatment of severe AIS is good alternative to pedicle screws/vertebrectomy on the basis of risk–benefit balance, and can be performed by surgeons not experienced in more complex procedures. The risk of pulmonary complications may be preferable to the risk of severe neurological complications when thoracic pedicle screws are applied, especially when surgeons are not adequately trained in their use.
Can parents accurately screen children at risk of developmental delay?
Authors: Dixon Glenys , Badawi Nadia , French Davina , Kurinczuk Jennifer J 
Published: April 2009

Aim:  To evaluate the validity and potential value of the parent‐completed Infant/Child Monitoring Questionnaire (IMQ) as a screening measure for developmental delay in high‐risk infants.Methods:  One hundred and forty‐one term infants born with moderate or severe newborn encephalopathy (NE) and 374 randomly selected comparison infants were administered a Griffiths Mental Development Scales (GMDS) assessment and an IMQ concurrently. Concordance of classifications between measures was compared for agreement, sensitivity, specificity, positive predictive value, negative predictive value, false positives and false negatives.Results:  Overall, sensitivity and specificity of the IMQ for infants with NE averaged across all age groups was 87%, positive predictive value 57% and negative predictive value 97%. The IMQ did not perform as well for comparison infants with a sensitivity of 50%, specificity 94%, positive predictive value 15% and negative predictive value 99% averaged across all age groups. Overall under‐referral for infants with NE was 13%, compared with 50% for comparison infants.Conclusions:  Use of the IMQ as an accurate screening measure in infants ‘at risk’ of developmental delay is supported. The low sensitivity of the IMQ for the comparison infants indicates a need for caution when considering its application for general population screening.
Promising outcomes of an adolescent chronic fatigue syndrome inpatient programme
Authors: Gordon Brett , Lubitz Lionel 
Published: April 2009

Introduction:  Chronic fatigue syndrome (CFS) is a condition of prolonged and disabling fatigue, which is accompanied by characteristic constitutional and neuropsychiatric symptoms. In children and adolescents, this condition occurring at a developmentally vulnerable time adds to the disability affecting self‐concept, autonomy, body image, socialisation, sexuality and academic problems. This case series looks at the effects of a graded exercise programme on physical outcomes, fatigue and mental state in an adolescent population.Methods:  Data sets from 16 adolescents who completed combined exercise training as part of the 4‐week inpatient intensive CFS programme at the Austin Hospital, Melbourne were analysed. All patients completed an exercise assessment and three questionnaires before beginning any training. A paediatrician (LL) confirmed the diagnosis according to the Fukuda criteria in all patients. Exercise was carefully supervised and prescribed daily by an exercise physiologist (BG) according to each individual's ability and response with the basic aim of increasing exercise tolerance and improving muscle strength and endurance.Results:  There was an 18% improvement in volitional time to fatigue (P= 0.02) and 17% improvement in peak oxygen uptake (VO2peak) (P= 0.01). Upper body strength and function improved with a remarkable 70% increase in the number of push‐ups. Fatigue severity was reported to improve by 13% (P= 0.01) and depression index improved significantly by 42% (P= 0.02).Conclusions:  The significance of these improvements cannot be underestimated as an improvement in physical capacity through increased time to fatigue and less severe fatigue allows adolescents to resume school, social and family activities.
Varicella immunisation practice: Implications for provision of a recommended, non‐funded vaccine
Authors: Marshall Helen , Ryan Philip , Roberton Don , Beilby Justin 
Published: April 2009

Aim:  In Australia in 2003 a two‐tiered immunisation schedule was introduced consisting of funded (National Immunisation Program) and non‐funded but recommended vaccines (Best Practice Schedule), including varicella vaccine. The aim of this study was to examine immunisation practice when a vaccine is recommended but not funded by Government.Methods:  A survey was sent to 600 randomly selected general practitioners (GPs) in South Australia between June and August 2005, prior to provision of Federal funding for varicella vaccine.Results:  Although varicella was considered an important disease to prevent by 89% of GPs, only 25% of GPs always discussed the non‐funded immunisation with parents at the time of a routine immunisation visit. Female GPs were more likely to discuss immunisation with recommended, non‐funded vaccines than male GPs. Those who were supportive of varicella prevention were more likely to discuss immunisation with the non‐funded vaccine. GPs who always provided information about the disease were more likely to have parents accept their advice about varicella vaccine (62.7%) than those who never provided information (40%). GPs reported parental refusal of varicella vaccine was due to the cost and perception that varicella is a mild disease.Conclusions:  The results of this study showed variability in prescribing practices for a non‐funded vaccine. Recommending a vaccine without provision of funding may lead to ‘mixed messages’ for immunisation providers and parents with resultant low coverage. Funding a vaccine is likely to reduce variability in provision of the vaccine and improve coverage in the community.
Prevalence and determinants of cytomegalovirus infection in pre‐school children
Authors: O'Brien Timothy P , Thompson John MD , Black Peter N , Becroft David MO , Clark Phillipa M , Robinson Elizabeth , Wild Christopher , Mitchell Edwin A 
Published: April 2009

Aim:  The aim of this study is to measure the seroprevalence of cytomegalovirus (CMV) infection in 3.5‐year‐old children, and identify the determinants of seropositivity.Methods:  A total of 1714 children were enrolled at birth. Approximately half were small for gestational age and half were appropriate for gestational age. Information on the children was collected at birth, 1 year and 3.5 years. At 3.5 years blood was collected and tested for CMV‐specific immunoglobulin by an enzyme‐linked immunosorbent assay in 530 children.Results:  The weighted seroprevalence of CMV was 32.8% (95% confidence interval (CI) 27.4–38.1%). The seroprevalence of CMV varied markedly by ethnicity (European: 26.5% (95% CI 20.9–32.2%); Maori: 68.0% (44.0–92.0%); Pacific: 74.5% (56.3–92.6%); Indian: 50.0% (20.2–79.8%); Chinese: 47.2% (10.8–83.5%); Other: 21.9% (0.0–52.7%); P < 0.001). Socio‐economic factors, number of siblings, day care centres attendance, maternal smoking, breastfeeding and other factors examined were not related to CMV seropositivity.Conclusions:  The seroprevalence of CMV in New Zealand pre‐school children is similar to that reported from other developed countries. The finding of marked ethnic differences is unexplained by socio‐economic factors, or other factors that were examined.
Morphological evaluation of Schnyder's crystalline corneal dystrophy by laser scanning confocal microscopy and Fourier‐domain optical coherence tomography
Authors: Jing Yang , Wang Liya 
Published: April 2009

AbstractA 29‐year‐old Chinese woman with Schnyder's crystalline corneal dystrophy was referred to our clinic. Ocular examination revealed abnormal deposits of cholesterol and lipid within the corneal stroma, appearing as crystalline needle‐shaped deposits, in both eyes. In vivo laser scanning confocal microscopy revealed pathological alterations of the normal corneal anatomy in the patient, such as highly reflective crystalline structures in the anterior‐and mid‐stroma. The images acquired from Fourier‐domain optical coherence tomography indicated that the main presence of crystalline deposits was localized within the anterior stroma, extending from the basal epithelium layer to a depth of 80 to 150 µm. To the best of the author's knowledge, it is consistent with the results of the previous histological study.
Report of an unusual case of a conjunctival cyst with Liesegang rings
Authors: Levy Jaime , Ilsar Michael , Deckel Yael , Pe'er Jacob 
Published: April 2009

AbstractLiesegang rings are laminated precipitation structures well recognized in the field of chemistry. We present a rare case of a 64‐year‐old man who sought examination for a conjunctival cystic lesion of several months’ duration, located in the right nasal bulbar conjunctiva near the plica semilunaris. The lesion was excised completely and uneventfully under local anaesthesia. Histopathological examination revealed a large folded cyst in the substantia propria. The cyst contained multiple eosinophilic concentrically spherical and oval structures of variable size with an amorphous central core compatible with Liesegang rings. No fungal or parasitic organisms were identified. This is the first photographically documented case of Liesegang rings appearing in the conjunctiva. Liesegang ring formation should be taken into account during histopathological examination of a conjunctival cyst and not be misdiagnosed as a parasitic infection.
Histopathology of a functioning mitomycin‐C trabeculectomy
Authors: Liang Steve Y‐W , Lee Graham A , Whitehead Kevin 
Published: April 2009

AbstractThe ideal trabeculectomy bleb is diffuse, normally vascularized and characterized by microcystic change in the overlying conjunctiva. We compare and contrast the histopathology of a normally functioning mitomycin‐C trabeculectomy site obtained from an eye enucleated for iris melanoma with abnormal blebs discussed in the literature. Representative sections of the normally functioning bleb were examined under the light microscope. The conjunctiva is composed of a uniform three‐layered non‐keratinizing stratified squamous epithelium overlying a single layer of oedematous basal cells. The conjunctival stroma consisted of loose connective tissue, traversed by capillaries and scattered small cystic spaces lined by endothelial cells. There were no goblet cells and few inflammatory cells and fibroblasts. The scleral trapdoor was evident as a cleft in the scleral wall in communication with the anterior chamber at the surgically created sclerostomy. Because the histopathological findings in our case correlate well with this clinical appearance, we conclude that whereas augmentation with anti‐metabolites, such as mitomycin‐C, can be associated with significantly altered conjunctival histopathology and consequent hypotony, but, if used carefully, normal architecture is conserved.
Towards functional molecular fingerprints
Authors: Dumont Maxime , Harmand Jérôme , Rapaport Alain , Godon Jean‐Jacques 
Published: April 2009

SummaryOne of the most important challenges in microbial ecology is to determine the ecological function of dominant microbial populations in their environment. In this paper we propose a generic method coupling fingerprinting and mathematical tools to achieve the functional assigning of bacteria detected in microbial consortia. This approach was tested on a nitrification bioprocess where two functions carried out by two different communities could be clearly distinguished. The mathematical theory of observers of dynamical systems has been used to design a dynamic estimator of the active biomass concentration of each functional community from the available measurements on nitrifying performance. Then, the combination of phylotypes obtained by fingerprinting that best approximated the estimated trajectories of each functional biomass was selected through a random optimization method. By this way, a nitritation or nitratation function was assigned to each phylotype detected in the ecosystem by means of functional molecular fingerprints. The results obtained by this approach were successfully compared with the information obtained from 16S rDNA identification. This original approach can be used on any biosystem involving n successive cascading bioreactions performed by n communities.
Diversity and abundance of freshwater Actinobacteria along environmental gradients in the brackish northern Baltic Sea
Authors: Holmfeldt Karin , Dziallas Claudia , Titelman Josefin , Pohlmann Kirsten , Grossart Hans‐Peter , Riemann Lasse 
Published: April 2009

Summary Actinobacteria are highly abundant in pelagic freshwater habitats and also occur in estuarine environments such as the Baltic Sea. Because of gradients in salinity and other environmental variables estuaries offer natural systems for examining factors that determine Actinobacteria distribution. We studied abundance and community structure of Bacteria and Actinobacteria along two transects in the northern Baltic Sea. Quantitative (CARD‐FISH) and qualitative (DGGE and clone libraries) analyses of community composition were compared with environmental parameters. Actinobacteria accounted for 22–27% of all bacteria and the abundance changed with temperature. Analysis of 549 actinobacterial 16S rRNA sequences from four clone libraries revealed a dominance of the freshwater clusters acI and acIV, and two new subclusters (acI‐B scB‐5 and acIV‐E) were assigned. Whereas acI was present at all stations, occurrence of acII and acIV differed between stations and was related to dissolved organic carbon (DOC) and chlorophyll a (Chl a) respectively. The prevalence of the acI‐A and acI‐B subclusters changed in relation to total phosphorus (Tot‐P) and Chl a respectively. Community structure of Bacteria and Actinobacteria differed between the river station and all other stations, responding to differences in DOC, Chl a and bacterial production. In contrast, the composition of active Actinobacteria (analysis based on reversely transcribed RNA) changed in relation to salinity and Tot‐P. Our study suggests an important ecological role of Actinobacteria in the brackish northern Baltic Sea. It highlights the need to address dynamics at the cluster or subcluster phylogenetic levels to gain insights into the factors regulating distribution and composition of Actinobacteria in aquatic environments.
A phylogenetic approach to detect selection on the target site of the antifouling compound irgarol in tolerant periphyton communities
Authors: Eriksson K. M. , Antonelli A. , Nilsson R. H. , Clarke A. K. , Blanck H. 
Published: April 2009

SummaryUsing DNA sequence data for phylogenetic assessment of toxicant targets is a new and promising approach to study toxicant‐induced selection in communities. Irgarol 1051 is a photosystem (PS) II inhibitor used in antifouling paint. It inhibits photosynthesis through binding to the D1 protein in PS II, which is encoded by the psbA gene found in genomes of chloroplasts, cyanobacteria and cyanophages. psbA mutations that alter the target protein can confer tolerance to PS II inhibitors. We have previously shown that irgarol induces community tolerance in natural marine periphyton communities and suggested a novel tolerance mechanism, involving the amino acid sequence of a turnover‐regulating domain of D1, as contributive to this tolerance. Here we use a large number of psbA sequences of known identity to assess the taxonomic affinities of psbA sequences from these differentially tolerant communities, by performing phylogenetic analysis. We show that periphyton communities have high psbA diversity and that this diversity is adversely affected by irgarol. Moreover, we suggest that within tolerant periphyton the novel tolerance mechanism is present among diatoms only, whereas some groups of irgarol‐tolerant cyanobacteria seem to have other tolerance mechanisms. However, it proved difficult to identify periphyton psbA haplotypes to the species or genus level, which indicates that the genomic pool of the attached, periphytic life forms is poorly studied and inadequately represented in international sequence databases.
Changes in the onset of spring growth in shrubland species in response to experimental warming along a north–south gradient in Europe
Authors: Prieto Patricia , Peñuelas Josep , Niinemets Ülo , Ogaya Romà , Schmidt Inger K. , Beier Claus , Tietema Albert , Sowerby Alwyn , Emmett Bridget A. , Láng Edit Kovács , Kröel‐Dulay György , Lhotsky Barbara , Cesaraccio Carla , Pellizzaro Grazia , De Dato Giovanbattista , Sirca Costantino , Estiarte Marc 
Published: April 2009

ABSTRACTAim  To test whether the onset of spring growth in European shrublands is advanced in response to the warmer conditions projected for the next two decades by climate models, and, if there is a change, whether it differs across Europe.Location  The studied sites spanned a broad north–south European gradient with average annual temperatures (8.2–15.6 °C) and precipitation (511–1427 mm).Methods  ‘Bud break’ was monitored in eight shrub and grass species in six European sites under control and experimentally warmer conditions generated by automatic roofs covering vegetation during the night.Results  Species responsive to increased temperatures were Vaccinium myrtillus and Empetrum nigrum in Wales, Deschampsia flexuosa in Denmark, Calluna vulgaris in Netherlands, Populus alba in Hungary and Erica multiflora in Spain. Although the acceleration of spring growth was the commonest response to warming treatments, the responses at each site were species specific and year dependent. Under experimental warming 25% of cases exhibited a significantly earlier onset of the growing season and 10% had a significantly delayed onset of vegetative growth. No geographical gradient was detected in the experimental warming effects. However, there was a trend towards a greater dominance of phenological advances with more intense the warming treatments. Above 0.8 °C warming, only advancements were recorded.Main conclusions  Our results show that warmer temperatures projected for the next decades have substantial potential effects on the phenology of the spring growth of dominant species in different European shrublands, with a dominant trend towards advancements the more intense the warming is. However, our study also demonstrates the overall difficulties of applying simple predictive relationships to extrapolate the effects of global change on phenology. Various combinations of environmental factors occur concurrently at different European sites and the interactions between different drivers (e.g. water and chilling) can alter phenology significantly.
Seedling recruitment, survival and facilitation in alpine Pinus uncinata tree line ecotones. Implications and potential responses to climate warming
Authors: Batllori Enric , Camarero J. Julio , Ninot Josep M. , Gutiérrez Emilia 
Published: April 2009

ABSTRACTAims  Alpine tree line ecotones are harsh environments where low temperatures constrain tree regeneration and growth. However, the expected upward shift of tree line ecotones in response to climate warming has not been ubiquitous. The lack of coupling between tree line dynamics and climate warming might be explained by factors other than climate variation that determine seedling recruitment in these ecotones. We want to assess how the availability of suitable habitat for establishment and the effects of facilitation on seedling survival and growth affect tree recruitment within tree line ecotones and modulate their responses to climate.Location  We evaluate the relevance of these factors for Pinus uncinata tree line ecotones in the Catalan Pyrenees (north‐east Spain) and Andorra.Methods  We analysed the microhabitat of naturally established seedlings in rectangular plots at the tree line ecotone, assessing the habitat type and the proximity to potentially protective elements that may improve microsite conditions. We tested whether krummholz individuals influence regeneration at the tree line by performing a transplantation field experiment to evaluate the extent of facilitation on seedling survival and growth in height. A total of 820 seedlings were transplanted at different distances and orientations (resulting in 12 positions) from krummholz mats and monitored over 2 years.Results  Safe sites for P. uncinata recruits consisted of sparse vegetation covering bare soil, gravel or litter, and close to protective elements that may ameliorate microsite conditions. The field experiment showed that directional positive interactions enhance seedling survival and growth, altering the spatial patterns of recruit survivorship, especially during harsh winter conditions (shallow and irregular snowpack).Main conclusions  Our results suggest that scarce availability of safe sites and uneven facilitation by krummholz control seedling recruitment patterns within alpine tree line ecotones. Such constraints may distort or counter the response of tree line ecotones to climate warming at local and regional scales.
Bodily Chiasms
Authors: Letiche Hugo 
Published: April 2009

The theory of the body I want to explore here, assumes that researcher and researched are part of the same flesh of the world and can be understood in radical conjunction and not in duality. An interview is examined, first from the lifeworld (nursing) research paradigm and thereafter on the hand of Merleau-Ponty's concept of the reversibility of touching and being touched, wherein ‘subject’ (who touches) and ‘object’ (who is touched) are radically interrelated and coconstituted. Merleau-Ponty develops his reflections on this radical interaction as the ‘chiasm’. Although investigating the ‘chiasm’ can be seen as lifeworld research, the more common lifeworld approach only leads to rich description, which lacks the radical relational understanding of Merleau-Ponty's insights. I believe that acknowledgement of the chiasms of interrelationship reveals complex processes of enfoldment taking place between researcher and researched, writer and reader. All of them are enclosed in what Merleau-Ponty called the enfoldments or flesh of the world; which makes it very difficult to determine who touches whom and who is touched by whom. Research, when it tries to see, interpret and study the other, focuses on the visible of touching and being touched; but these inherently carry with them the invisible of the same actions. The consequences of these relationships for my study of a specific elderly woman are explored here.