bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantity and quality of retrograde menstruation: a case control study
Authors: Bokor Attila , Debrock Sophie , Drijkoningen Maria , Goossens Willy , Fülöp Vilmos , D'Hooghe Thomas 
Published: October 2009

Abstract

Background
The purpose of this study was to test the hypothesis that menstruation is associated with a higher concentration of endometrial cells in peritoneal fluid(PF) and with increased white and red blood cell concentration in PF when compared to nonmenstrual phases of the cycle.

Methods
PF was obtained at laparoscopy from 107 women with endometriosis (n = 59) and controls with a normal pelvis (n = 48) during the luteal (n = 46), follicular (n = 38) or menstrual (n = 23) phase of the cycle. Endometriosis was classified according to the classification of the American Society for Reproductive Medicine (rAFS into minimal (n = 25), mild(n = 20), moderate(n = 6) and severe(n = 8) disease. Cell counts (leucocytes, erythrocytes, thrombocytes) were determined on a cell counter. In a subset of 32 patients (13 controls and 19 women with endometriosis), PF was fixed, processed and thinlayers were prepared and stained with Papanicolaou method and with immunocytochemistry using monoclonal antibodies against cytokeratin 7(CK 7), CK 8/18, Ber-Ep4, vimentin, calretinin and CD68. Ber-Ep4 is a marker for cells with epithelial origin (in some cases for mesothelial cells as well). CD68 is specific for cells from monocyte/macrophage lineage; CK7 and CK8/18 are markers for both endometrial epithelial and mesothelial cells, whereas calretinin and vimentin are markers for both endometrial stromal and mesothelial cells.

Results
In comparison with the nonmenstrual phase of the cycle, analysis of PF during menstruation showed an increased concentration of leucocytes (3.3 × 109/L vs 0.8 × 109/L, P = 0.03), erythrocytes (0.3 × 1012/L vs 0.02 × 1012/L, P = 0.006), hematocrit (0.03 L/L vs 0.003 L/L, P = 0.01) and hemoglobin (0.8 g/dL vs 0.1 g/dL, P = 0.01). Mesothelial cells stained positively with CK7, CK8/18, vimentin, and calretinin. Cells positive for Ber-Ep4 were not observed, except in 2 patients with endometriosis investigated during menses. In all patients 50-98% of single cells were strongly positive for both vimentin and CD68.

Conclusion
When compared to nonmenstrual phases of the cycle, menstruation is associated with an increased concentration of red and white blood cells in PF. However, the presence of EM cells that are detectable by immunohistochemistry in PF is low during all phases of the cycle, including menstruation.
The effect of provider- and workflow-focused strategies for guideline implementation on provider acceptance
Authors: Flanagan Mindy E , Ramanujam Rangaraj , Doebbeling Bradley N 
Published: October 2009

Abstract

Background
The effective implementation of clinical practice guidelines (CPGs) depends critically on the extent to which the strategies that are deployed for implementing the guidelines promote provider acceptance of CPGs. Such implementation strategies can be classified into two types based on whether they primarily target providers (e.g., academic detailing, grand rounds presentations) or the work context (e.g., computer reminders, modifications to forms). This study investigated the independent and joint effects of these two types of implementation strategies on provider acceptance of CPGs.

Methods
Surveys were mailed to a national sample of providers (primary care physicians, physician assistants, nurses, and nurse practitioners) and quality managers selected from Veterans Affairs Medical Centers (VAMCs). A total of 2,438 providers and 242 quality managers from 123 VAMCs participated. Survey items measured implementation strategies and provider acceptance (e.g., guideline-related knowledge, attitudes, and adherence) for three sets of CPGs--chronic obstructive pulmonary disease, chronic heart failure, and major depressive disorder. The relationships between implementation strategy types and provider acceptance were tested using multi-level analytic models.

Results
For all three CPGs, provider acceptance increased with the number of implementation strategies of either type. Moreover, the number of workflow-focused strategies compensated (contributing more strongly to provider acceptance) when few provider-focused strategies were used.

Conclusion
Provider acceptance of CPGs depends on the type of implementation strategies used. Implementation effectiveness can be improved by using both workflow-focused as well as provider-focused strategies.
Can foot anthropometric measurements predict dynamic plantar surface contact area?
Authors: McPoil Thomas G , Vicenzino Bill , Cornwall Mark W , Collins Natalie 
Published: October 2009

AbstractBackgroundPrevious studies have suggested that increased plantar surface area, associated with pes planus, is a risk factor for the development of lower extremity overuse injuries. The intent of this study was to determine if a single or combination of foot anthropometric measures could be used to predict plantar surface area.MethodsSix foot measurements were collected on 155 subjects (97 females, 58 males, mean age 24.5 ± 3.5 years). The measurements as well as one ratio were entered into a stepwise regression analysis to determine the optimal set of measurements associated with total plantar contact area either including or excluding the toe region. The predicted values were used to calculate plantar surface area and were compared to the actual values obtained dynamically using a pressure sensor platform.ResultsA three variable model was found to describe the relationship between the foot measures/ratio and total plantar contact area (R2 = 0.77, p < 0.0001)). A three variable model was also found to describe the relationship between the foot measures/ratio and plantar contact area minus the toe region (R2 = 0.76, p < 0.0001).ConclusionThe results of this study indicate that the clinician can use a combination of simple, reliable, and time efficient foot anthropometric measurements to explain over 75% of the plantar surface contact area, either including or excluding the toe region.
Endovascular stenting of traumatic extracranial carotid artery dissections in the pediatric population: a case report
Authors: Chern Joshua J , Chamoun Roukoz B , Mawad Michel E , Whitehead William E , Curry Daniel J , Luerssen Thomas G , Jea Andrew 
Published: October 2009

Abstract

Background
Traumatic extracranial carotid artery injuries are rare in children. Treatment options include surgery, anticoagulation therapy and endovascular treatment. There have been only limited reports in the literature documenting endovascular carotid stent placement in the pediatric population. In these reports, stent deployment was utilized in the setting of pseudoaneurysm formation.

Case report
Here we report a case of endovascular carotid stenting for traumatic carotid dissection in a 15 year-old boy. An uncovered bare self-expanding stent was used to treat progressive high-grade stenosis in the early post-injury period.

Conclusion
At 6 months post-procedure, complete healing of the carotid artery was demonstrated on follow-up angiogram.
Changes in serum creatinine in the first 24 hours after cardiac arrest indicate prognosis: an observational cohort study
Authors: Hasper Dietrich , von Haehling Stephan , Storm Christian , Jörres Achim , Schefold Joerg C 
Published: October 2009

Abstract
Introduction
As patients after cardiac arrest suffer from the consequences of global ischemia reperfusion, we aimed to establish the incidence of acute kidney injury (AKI) in these patients, and to investigate its possible association to severe hypoxic brain damage.

Methods
One hundred and seventy-one patients (135 male, mean age 61.6 +/- 15.0 years) after cardiac arrest were included in an observational cohort study. Serum creatinine was determined at admission and 24, 48 and 72 hours thereafter. Serum levels of neuron-specific enolase (NSE) were measured 72 hours after admission as a marker of hypoxic brain damage. Clinical outcome was assessed at intensive care unit (ICU) discharge using the Pittsburgh cerebral performance category (CPC).

Results
AKI as defined by AKI Network criteria occurred in 49% of the study patients. Patients with an unfavourable prognosis (CPC 3-5) were affected significantly more frequently (P = 0.013). Whilst serum creatinine levels decreased in patients with good neurological outcome (CPC 1 or 2) over the ensuing 48 hours, it increased in patients with unfavourable outcome (CPC 3-5). ROC analysis identified DeltaCrea24 <-0.19 mg/dl as the value for prediction with the highest accuracy. The odds ratio for an unfavourable outcome was 3.81 (95% CI 1.98-7.33, P = 0.0001) in cases of unchanged or increased creatinine levels after 24 hours compared to those whose creatinine levels decreased during the first 24 hours. NSE levels were found to correlate with the change in serum creatinine in the first 24 hours both in simple and multivariate regression (both r = 0.24, P = 0.002).

Conclusions
In this large cohort of patient after cardiac arrest, we found that AKI occurs in nearly 50% of patients when the new criteria are applied. Patients with unfavourable neurological outcome are affected more frequently. A significant association between the development of AKI and NSE levels indicating hypoxic brain damage was observed. Our data show that changes in serum creatinine may contribute to the prediction of outcome in patients with cardiac arrest. Whereas a decline in serum creatinine (> 0.2 mg/dL) in the first 24 hours after cardiac arrest indicates good prognosis, the risk of unfavourable outcome is markedly elevated in patients with constant or increasing serum creatinine.
A retrospective cohort pilot study to evaluate a triage tool for use in a pandemic
Authors: Christian Michael D , Hamielec Cindy , Lazar Neil M , Wax Randy S , Griffith Lauren , Herridge Margaret S , Lee David , Cook Deborah J 
Published: October 2009

Abstract
Introduction
The objective of this pilot study was to assess the usability of the draft Ontario triage protocol, to estimate its potential impact on patient outcomes, and ability to increase resource availability based on a retrospective cohort of critically ill patients cared for during a non-pandemic period.

Methods
Triage officers applied the protocol prospectively to 2 retrospective cohorts of patients admitted to 2 academic medical/surgical ICUs during an 8 week period of peak occupancy. Each patient was assigned a treatment priority (red -- 'highest', yellow -- 'intermediate', green -- 'discharge to ward', or blue/black -- 'expectant') by the triage officers at 3 separate time points (at the time of admission to the ICU, 48, and 120 hours post admission).

Results
Overall, triage officers were either confident or very confident in 68.4% of their scores; arbitration was required in 54.9% of cases. Application of the triage protocol would potentially decrease the number of required ventilator days by 49.3% (568 days) and decrease the total ICU days by 52.6% (895 days). On the triage protocol at ICU admission the survival rate in the red (93.7%) and yellow (62.5%) categories were significantly higher then that of the blue category (24.6%) with associated P values of < 0.0001 and 0.0003 respectively. Further, the survival rate of the red group was significantly higher than the overall survival rate of 70.9% observed in the cohort (P < 0.0001). At 48 and 120 hours, survival rates in the blue group increased but remained lower then the red or yellow groups.

Conclusions
Refinement of the triage protocol and implementation is required prior to future study, including improved training of triage officers, and protocol modification to minimize the exclusion from critical care of patients who may in fact benefit. However, our results suggest that the triage protocol can help to direct resources to patients who are most likely to benefit, and help to decrease the demands on critical care resources, thereby making available more resources to treat other critically ill patients.
Puerperal psychosis: identifying and caring for women at risk
Authors: Jones Ian , Smith Sue 
Published: October 2009

SummaryPuerperal (postpartum) psychosis – the acute onset of a manic or psychotic episode shortly after childbirth – most commonly occurs in women with a bipolar disorder diathesis who have a vulnerability to a specific childbirth-related trigger. Women with bipolar disorder are at particularly high risk of puerperal psychosis, with a severe affective episode following between 25 and 50% of deliveries. Suicide is a leading cause of maternal death in the UK and it is clear that we must do more to identify and better manage women at high risk of illness related to childbirth. The clinical picture of puerperal psychosis can vary dramatically from hour to hour and can escalate quickly to a true psychiatric emergency. It is vital that clinical services identify women who are unwell and can respond quickly to the severity of illness, delivering treatment in the most appropriate setting for the mother and her baby.
Interpersonal dynamics and multidisciplinary teamwork
Authors: Reiss David , Kirtchuk Gabriel 
Published: October 2009

SummaryAnalysing interpersonal dynamics is an approach through which the multidisciplinary team can develop a shared understanding of their patients. This empirically based method provides an insight into repeated patterns of dysfunctional behaviour, which not only have been evident in the past, but are currently having an impact on the patient's relationships with caring staff. The technique is accessible to any team member with only minimal training required. It provides the team with a coherent map of the patient's relationship patterns that underpins the formulation of an effective strategy for care. The multidisciplinary team is then able to work towards shared goals, supporting all members in their provision of effective interventions within the full range of therapeutic modalities. The approach promotes positive staff–patient interactions and provides an additional dimension to the assessment and management of risk.
Understanding community care law in England and Wales
Authors: Allen Danny 
Published: October 2009

SummaryAlthough psychiatrists in England and Wales are generally familiar with the Mental Health Act 1983 and the Mental Capacity Act 2005, there is a body of law that is available to assist patients in the community with which they are generally less familiar. There are two main reasons for this. The first is that it is a rather confused amalgam of different statutes and case law affecting each other in ways that are less than clear. The other is that the care programme approach (CPA) was meant to cut through all this and make care provision straightforward. In fact, the latter has never been the case and community care law has always sat uneasily alongside the CPA, but in October 2008 the CPA was withdrawn from some patients with mental health problems. This article explains what is meant by community care law and how psychiatrists can use it to help their patients.
Atypical Progeroid Syndrome due to Heterozygous Missense LMNA Mutations
Authors: Garg Abhimanyu , Subramanyam Lalitha , Agarwal Anil K. , Simha Vinaya , Levine Benjamin , D'Apice Maria Rosaria , Novelli Giuseppe , Crow Yanick 
Published: October 2009

Context: Hutchinson-Gilford progeria syndrome (HGPS) and mandibuloacral dysplasia are well-recognized allelic autosomal dominant and recessive progeroid disorders, respectively, due to mutations in lamin A/C (LMNA) gene. Heterozygous LMNA mutations have also been reported in a small number of patients with a less well-characterized atypical progeroid syndrome (APS).
Objective: The objective of the study was to investigate the underlying genetic and molecular basis of the phenotype of patients presenting with APS.
Results: We report 11 patients with APS from nine families, many with novel heterozygous missense LMNA mutations, such as, P4R, E111K, D136H, E159K, and C588R. These and previously reported patients now reveal a spectrum of clinical features including progeroid manifestations such as short stature, beaked nose, premature graying, partial alopecia, high-pitched voice, skin atrophy over the hands and feet, partial and generalized lipodystrophy with metabolic complications, and skeletal anomalies such as mandibular hypoplasia and mild acroosteolysis. Skin fibroblasts from these patients when assessed for lamin A/C expression using epifluorescence microscopy revealed variable nuclear morphological abnormalities similar to those observed in patients with HGPS. However, these nuclear abnormalities in APS patients could not be rescued with 48 h treatment with farnesyl transferase inhibitors, geranylgeranyl transferase inhibitors or trichostatin-A, a histone deacetylase inhibitor. Immunoblots of cell lysates from fibroblasts did not reveal prelamin A accumulation in any of these patients.
Conclusions: APS patients have a few overlapping but some distinct clinical features as compared with HGPS and mandibuloacral dysplasia. The pathogenesis of clinical manifestations in APS patients seems not to be related to accumulation of mutant farnesylated prelamin A.
Particulate organic matter as a food source for a coral reef sponge
Authors: Hadas E. , Shpigel M. , Ilan M. 
Published: October 2009

SUMMARY
The ability of sponges to feed in diverse (including oligotrophic)ecosystems significantly contributes to their ubiquitous aquatic distribution. It was hypothesized that sponges that harbour small amounts of symbiotic bacteria in their mass feed mainly on particulate organic matter (POM). We examined the nearly symbiont-free (by microscopic observation) filter-feeding Red Sea sponge Negombata magnifica in order to: (a) study removal efficiency of naturally occurring organic particles, (b) measure the total amount of absorbed particulate organic carbon (POC) and nitrogen (PON), and(c) estimate organic carbon and nitrogen flux in this sponge. Total amount of organic carbon and nitrogen in the Gulf of Aqaba was found to be 48.46±5.69 μg l–1 and 6.45±0.7 μg l–1, respectively. While detritus contributed 54% of POC,most PON (84%) came from planktonic microorganisms, mainly prokaryotes. Particle removal efficiency ranged from 99% (the cyanobacterium Synechococcus sp.) to 37% (for eukaryotic cells &gt;8 μm). On average, N. magnifica ingested 480 μg C day–1g–1 (wet mass, WM) sponge and 76.6 μg N day–1 g–1 sponge. Ingested POC balanced 85%of the sponge's energetic demand but more is needed for biomass production because it cannot digest all of the carbon. 54.4±16.1 μg N day–1 g–1 (WM) nitrogen was excreted as total ammonia nitrogen (TAN); however, nitrogen allowance should be higher because more nitrogen is deposited for sponge biomass during growth. It is hypothesized that the discrepancy in the nutritional requirements should be covered by the sponge absorbing carbon and nitrogen from sources that are not dealt with in the present research, such as dissolved organic carbon and nitrogen. This study highlights the significance of detritus as a carbon source, and prokaryotes as a PON source in sponge feeding.
The effects of trapping and blade angle of notched dentitions on fracture of biological tissues
Authors: Anderson Philip S. L. 
Published: October 2009

SUMMARYThe material properties of food can exert a significant influence on tooth morphology. Although the stiffness or toughness of a material is usually of prime concern, other aspects of material properties (such as extensibility)can be of equal importance. Previous experimental work on the effect blade shape has on fracturing biological materials indicated a notched blade greatly reduced the work required to cut tough tissue. As a notched blade both traps materials and cuts at an angle, it is not clear which of these features leads to increased cutting efficiency. This paper tests whether the ability to cut at an angle or trap the material has the greater effect on the work to fracture required to cut tough tissues with different levels of extensibility(asparagus and fish muscle). Results show that the work to fracture required to cut more extensible materials is reduced by up to 50% when a trapping mechanism alone is used in comparison with an angled blade alone. For less extensible materials, the trapping ability of a notch seems to have no effect,whereas the angled blade reduces work to fracture by up to 25% relative to a straight blade. The aspects of blade shape most important to the breaking down of foods depend upon the relative stiffness or toughness, as well as other material properties.
Stress hormones and the fitness consequences associated with the transition to a novel diet in larval amphibians
Authors: Ledón-Rettig Cris C. , Pfennig David W. , Crespi Erica J. 
Published: October 2009

SUMMARYClosely related species often specialize on different types of prey, but little is known about the fitness consequences of making an evolutionary transition to a novel diet. Spadefoot toad larvae provide a unique opportunity to reconstruct these evolutionary events. Although most anuran larvae feed on detritus or plankton, Spea larvae have also evolved the ability to consume large anostracan fairy shrimp. To investigate the changes that may have accompanied the shift to shrimp prey, we compared shrimp-induced physiological responses of Spea larvae with those of its sister genus, Scaphiopus, that has not made this transition. Although Spea larvae performed equally well on either diet, shrimp-fed Scaphiopus larvae experienced reduced growth and developmental rates,as well as elevated levels of the stress hormone corticosterone when compared with those that ate the ancestral detritus diet. These results suggest that ancestral Spea likely experienced reduced fitness when they first adopted a carnivorous feeding strategy.
Concentrated and linked epidemics of both HSV-2 and HIV-1/HIV-2 infections in Senegal: public health impacts of the spread of HIV
Authors: Kane C Toure , Diawara S , Ndiaye H D , Diallo P A N , Wade A S , Diallo A G , Belec L , Mboup S 
Published: October 2009

The objective of this article is to report seroprevalences on HIV and herpes simplex virus 2 (HSV-2) in female sex workers (FSW) and in two sentinel populations of pregnant women living in Senegal. Serosurveys of HIV and HSV-2 were conducted in two unselected sentinel populations from Dakar, Senegal, and its provinces, including in 2003 only pregnant women and 2006 pregnant women and FSW. The population study involved 888 pregnant women and 604 FSW. In pregnant women, HIV and HSV-2 seroprevalences were, respectively, 1.01% and 15.65%. There was no association between HSV-2 and HIV infection, whatever the age. In contrast, the seroprevalence of HIV infection in the group of FSW was high, reaching 22.9% in women over 30 years old. FSW above 20 years of age harboured much higher HSV-2 seroprevalences that those found in pregnant women of similar age groups. In FSW, strong associations between HSV-2 and age, and among HSV-2 and HIV-1 as well HIV-2, were evidenced. In conclusion, HIV epidemic remains concentrated in high-risk groups of the Senegalese population, such as the FSW population in which the seroprevalence of HSV-2 infection is very high. Intervention against STI including HSV-2 is urgently needed to prevent the spreading of HIV epidemic.