bluuebunny/crossref_metadata_2025_split huggingface dataset:
Muscle Fiber Conduction Slowing and Decreased Levels of Circulating Muscle Proteins after Short-Term Dexamethasone Administration in Healthy Subjects
Authors: Minetto Marco A. , Botter Alberto , Lanfranco Fabio , Baldi Matteo , Ghigo Ezio , Arvat Emanuela 
Published: February 2010

AbstractContext: Glucocorticoids are known to decrease protein synthesis and impair membrane excitability of muscle fibers. However, their short-term effects on muscle structure and function of healthy subjects remain poorly understood.Objective: Our objective was to investigate whether steroid administration could decrease the circulating levels of muscle proteins and modify myoelectric indexes of sarcolemmal excitability and fatigability.Design: We conducted a single-blind, placebo-controlled study in 20 men randomized to receive dexamethasone (8 mg/d) or placebo for 1 wk. Blood sampling, force measurements for knee extensors and elbow flexors, and electrophysiological tests for biceps brachii, vastus lateralis and medialis, and tibialis anterior muscles were performed before and after the intervention.Results: Dexamethasone administration improved force by 6.0 ± 6.0% (P = 0.01) for elbow flexors and by 8.5 ± 5.5% (P &lt; 0.01) for knee extensors, decreased levels of creatine kinase by 50.5 ± 30.0% (P &lt; 0.01) and myoglobin by 41.8 ± 17.5% (P &lt; 0.01), and impaired sarcolemmal excitability, as shown by the decline of muscle fiber conduction velocity for the four muscles (range from −6 to −10.5%, P &lt; 0.05). Moreover, significant reductions of the myoelectric manifestations of fatigue were observed for the four muscles; the decrease in the rate of change of the mean frequency of the electromyographic power spectrum ranged from −22.6 to −43.9% (P &lt; 0.05). In contrast, no significant changes were observed in muscle excitability and fatigability in subjects who received the placebo.Conclusions: The demonstration that glucocorticoid-induced muscle impairments can be unraveled by means of blood sampling and noninvasive electrophysiological tests has clinical implications for the early identification of subclinical or preclinical forms of myopathy in treated patients.
Cholecalciferol loading dose guideline for vitamin D-deficient adults
Authors: van Groningen Lenneke , Opdenoordt Susanne , van Sorge Adriaan , Telting Darryl , Giesen Astrid , de Boer Hans 
Published: February 2010

IntroductionSevere vitamin D deficiency is very common. Evidence-based guidelines for rapid correction with high-dose oral cholecalciferol are not yet available.ObjectiveTo develop a practical cholecalciferol loading dose regimen.Materials and methodsA total of 208 vitamin D-deficient subjects (serum 25-hydroxyvitamin D3(25-OHD3) level <50 nmol/l), aged 18–88 years, were treated with solubilized cholecalciferol, 50 000 IU/ml. They received either 25 000 IU every fortnight for 8 weeks (total dose 100 000 IU), 25 000 IU every week for 6 weeks (total dose 150 000 IU), or 25 000 IU every week for 8 weeks (total dose 200 000 IU). Blood samples were collected at baseline and 10 days after the final dose of cholecalciferol.ResultsMost patients were severely vitamin D deficient: 76% had a serum 25-OHD3level <30 nmol/l at baseline. Cholecalciferol in a cumulative dose of 100 000, 150 000, and 200 000 IU increased mean serum 25-OHD3level by 29 nmol/l (95% confidence interval (CI): 23–35 nmol/l), 43 nmol/l (95% CI: 36–50 nmol/l), and 69 nmol/l (95% CI: 64–75 nmol/l) respectively. The change in 25-OHD3(Δ25-OHD3) was related to the dose per kilogram body weight (R2=0.38,P<0.0001), and is described by the equation: Δ25-OHD3=0.025×(dose per kg body weight).ConclusionThe cholecalciferol loading dose required to reach the serum 25-OHD3target level of 75 nmol/l can be calculated as follows: dose (IU)=40×(75−serum 25-OHD3)×body weight.
The Role of Advantageous Mutations in Enhancing the Evolution of a Recombination Modifier
Authors: Hartfield Matthew , Otto Sarah P , Keightley Peter D 
Published: February 2010

Abstract
Although the evolution of recombination is still a major problem in evolutionary genetics, recent theoretical studies have shown that recombination can evolve by breaking down interference (“Hill–Robertson effects”) among multiple loci. This leads to selection on a recombination modifier in a population subject to recurrent deleterious mutation. Here, we use computer simulations to investigate the evolution of a recombination modifier under three different scenarios of recurrent mutation in a finite population: (1) mutations are deleterious only, (2) mutations are advantageous only, and (3) there is a mixture of deleterious and advantageous mutations. We also investigate how linkage disequilibrium, the strength of selection acting on a modifier, and effective population size change under the different scenarios. We observe that adding even a small number of advantageous mutations increases the fixation rate of modifiers that increase recombination, especially if the effects of deleterious mutations are weak. However, the strength of selection on a modifier is less than the summed strengths had there been deleterious mutations only and advantageous mutations only.
Alterations in DNA Replication and Histone Levels Promote Histone Gene Amplification in Saccharomyces cerevisiae
Authors: Libuda Diana E , Winston Fred 
Published: February 2010

Abstract
Gene amplification, a process that increases the copy number of a gene or a genomic region to two or more, is utilized by many organisms in response to environmental stress or decreased levels of a gene product. Our previous studies in Saccharomyces cerevisiae identified the amplification of a histone H2A-H2B gene pair, HTA2-HTB2, in response to the deletion of the other H2A-H2B gene pair, HTA1-HTB1. This amplification arises from a recombination event between two flanking Ty1 elements to form a new, stable circular chromosome and occurs at a frequency higher than has been observed for other Ty1-Ty1 recombination events. To understand the regulation of this amplification event, we screened the S. cerevisiae nonessential deletion set for mutations that alter the amplification frequency. Among the deletions that increase HTA2-HTB2 amplification frequency, we identified those that either decrease DNA replication fork progression (rrm3Δ, dpb3Δ, dpb4Δ, and clb5Δ) or that reduce histone H3-H4 levels (hht2-hhf2Δ). These two classes are related because reduced histone H3-H4 levels increase replication fork pauses, and impaired replication forks cause a reduction in histone levels. Consistent with our mutant screen, we found that the introduction of DNA replication stress by hydroxyurea induces the HTA2-HTB2 amplification event. Taken together, our results suggest that either reduced histone levels or slowed replication forks stimulate the HTA2-HTB2 amplification event, contributing to the restoration of normal chromatin structure.
Ume6 Is Required for the MATa/MATα Cellular Identity and Transcriptional Silencing in Kluyveromyces lactis
Authors: Barsoum E , Sjöstrand J O O , Åström S U 
Published: February 2010

Abstract
To explore the similarities and differences of regulatory circuits among budding yeasts, we characterized the role of the unscheduled meiotic gene expression 6 (UME6) gene in Kluyveromyces lactis. We found that Ume6 was required for transcriptional silencing of the cryptic mating-type loci HMLα and HMRa. Chromatin immunoprecipitation (ChIP) suggested that Ume6 acted directly by binding the cis-regulatory silencers of these loci. Unexpectedly, a MATa ume6 strain was mating proficient, whereas a MATα ume6 strain was sterile. This observation was explained by the fact that ume6 derepressed HMLα2 only weakly, but derepressed HMRa1 strongly. Consistently, two a/α-repressed genes (MTS1 and STE4) were repressed in the MATα ume6 strain, but were expressed in the MATa ume6 strain. Surprisingly, ume6 partially suppressed the mating defect of a MATa sir2 strain. MTS1 and STE4 were repressed in the MATa sir2 ume6 double-mutant strain, indicating that the suppression acted downstream of the a1/α2-repressor. We show that both STE12 and the MATa2/HMRa2 genes were overexpressed in the MATa sir2 ume6 strain. Consistent with the idea that this deregulation suppressed the mating defect, ectopic overexpression of Ste12 and a2 in a MATa sir2 strain resulted in efficient mating. In addition, Ume6 served as a block to polyploidy, since ume6/ume6 diploids mated as pseudo a-strains. Finally, Ume6 was required for repression of three meiotic genes, independently of the Rpd3 and Sin3 corepressors.
Interns Overestimate the Effectiveness of Their Hand-off Communication
Authors: Chang Vivian Y. , Arora Vineet M. , Lev-Ari Shiri , D'Arcy Michael , Keysar Boaz 
Published: February 2010

OBJECTIVE:
Theories from the psychology of communication may be applicable in understanding why hand-off communication is inherently problematic. The purpose of this study was to assess whether postcall pediatric interns can correctly estimate the patient care information and rationale received by on-call interns during hand-off communication.

METHODS:
Pediatric interns at the University of Chicago were interviewed about the hand-off. Postcall interns were asked to predict what on-call interns would report as the important pieces of information communicated during the hand-off about each patient, with accompanying rationale. Postcall interns also guessed on-call interns' rating of how well the hand-offs went. Then, on-call interns were asked to list the most important pieces of information for each patient that postcall interns communicated during the hand-off, with accompanying rationale. On-call interns also rated how well the hand-offs went. Interns had access to written hand-offs during the interviews.

RESULTS:
We conducted 52 interviews, which constituted 59% of eligible interviews. Seventy-two patients were discussed. The most important piece of information about a patient was not successfully communicated 60% of the time, despite the postcall intern's believing that it was communicated. Postcall and on-call interns did not agree on the rationales provided for 60% of items. In addition, an item was more likely to be effectively communicated when it was a to-do item (65%) or an item related to anticipatory guidance (69%) compared with a knowledge item (38%). Despite the lack of agreement on content and rationale of information communicated during hand-offs, peer ratings of hand-off quality were high.

CONCLUSIONS:
Pediatric interns overestimated the effectiveness of their hand-off communication. Theories from communication psychology suggest that miscommunication is caused by egocentric thought processes and a tendency for the speaker to overestimate the receiver's understanding. This study demonstrates that systematic causes of miscommunication may play a role in hand-off quality.
Anti-Vascular Endothelial Growth Factor Therapies and Cardiovascular Toxicity: What Are the Important Clinical Markers to Target?
Authors: Vaklavas Christos , Lenihan Daniel , Kurzrock Razelle , Tsimberidou Apostolia Maria 
Published: February 2010

AbstractLearning ObjectivesAfter completing this course, the reader will be able to: Promptly recognize cardiovascular adverse events associated with anti-VEGF therapy in order to formulate treatment plans to counteract them.Explain possible mechanisms by which bevacizumab, sunitinib, and sorafenib lead to cardiovascular complications and develop strategies for managing these complications.Describe the role of RAAS in vasoconstriction and capillary rarefaction and strategize the use of RAAS inhibition to manage these toxicities.This article is available for continuing medical education credit at CME.TheOncologist.comBackground.Therapies targeting vascular endothelial growth factor (VEGF) are associated with hypertension, cardiotoxicity, and thromboembolic events.Methods.All prospective phase I–III clinical trials published up to December 2008 of approved anti-VEGF therapies (bevacizumab, sunitinib, sorafenib) and relevant literature were reviewed.Results.The rates of Common Toxicity Criteria (version 3) grade 3–4 hypertension with bevacizumab, sunitinib, and sorafenib were 9.2%, 6.9%, and 7.2%, respectively. Grade 3–4 left ventricular systolic dysfunction was noted in 0.3%, 1.4%, and 0.05% of patients, respectively, whereas the rates of grade 3–4 thromboembolism were 9.6%, 1.2%, and 3.8%, respectively. The renin–angiotensin–aldosterone system (RAAS) may play a key role in vasoconstriction and capillary rarefaction, which are unleashed when VEGF signaling is targeted. Inhibiting RAAS may be the optimal approach for managing these toxicities.Conclusions.In anticipation of cardiovascular complications with anti-VEGF therapies, early detection and personalized management may improve clinical outcomes and tolerance.
Depression in Nursing Homes: Prevalence, Recognition, and Treatment
Authors: Kramer Dietmar , Allgaier Antje-Kathrin , Fejtkova Sabina , Mergl Roland , Hegerl Ulrich 
Published: February 2010

Objective: Depression is very common in people above 65 years living in long-term care. However, little is known about how well depression is recognized and how adequately it is treated. Therefore, the present study aimed at assessing accuracy of the unaided clinical diagnosis of the attending physicians, and the medical treatment situation in nursing home residents. Methods: A random sample of 97 residents of 10 nursing homes in Munich was examined with the Section A “Affective Syndrome” of the Structured Clinical Interview (SCID) for DSM-IV to detect depression. Information concerning clinical diagnosis and medication was obtained from the subjects' medical records. Results: 14.4% suffered acutely from major depression, 14.4% suffered from minor depression, and 18.6% were diagnosed as depressive according to the physician and nursing records. In total, 27.8% received antidepressants. Merely 42.9% of the subjects with acute major depression were diagnosed by their attending physicians as depressive, and only half of them received an antidepressant; 17.5% received antidepressants without a diagnosis of depression in their physician and nursing records. In accordance with the guidelines, 73.3% of the antidepressants prescribed were SSRIs or newer antidepressants. Only 20.0% were tricyclic antidepressants. Conclusions: Findings show that depression is relatively frequent in residents of nursing homes. Moreover, it is insufficiently recognized by physicians and is even more seldom adequately treated. Also, a significant proportion of residents receive antidepressants without a documented associated indication. Therefore, the recognition and guideline-based treatment of depression should be improved in this high-risk group.
Trajectory of Posttraumatic Stress Disorder Caused by Myocardial Infarction: A Two-Year Follow-up Study
Authors: Abbas Chiara C. , Schmid Jean-Paul , Guler Erika , Wiedemar Lina , Begré Stefan , Saner Hugo , Schnyder Ulrich , Von Känel Roland 
Published: February 2010

Objective: A substantial proportion of patients develop posttraumatic stress disorder (PTSD) following myocardial infarction (MI). Previous research on the trajectory over time of PTSD in post-MI patients is scant and refers to self-rated posttraumatic symptoms. The aim of this study was to investigate the longitudinal course of an interviewer-rated diagnosis of PTSD and PTSD symptom severity following MI. Methods: Study participants were 40 patients (78% men, mean age 54 α 8 years) who were diagnosed with PTSD using the Clinician-administered PTSD Scale (CAPS) after an average of 5 α 4 months (range 2–16 months) following an index MI. After a mean follow-up of 26 α 6 months (range 12–36 months), 24 patients underwent a second diagnostic interview. Results: Two-thirds of patients ( n = 16) still qualified for a diagnosis of PTSD at follow-up. In all 24 patients, total PTSD symptoms ( p = 0.001), re-experiencing symptoms ( p < 0.001), avoidance symptoms ( p = 0.015), and, with borderline significance, hyperarousal symptoms ( p < 0.06) had all decreased over time. However, in the subgroup of the 16 patients who had retained PTSD diagnostic status at follow-up, symptoms of avoidance ( p = 0.23) and of hyperarousal ( p = 0.48) showed no longitudinal decline. Longer duration of follow-up was associated with a greater decrease in avoidance symptoms ( p = 0.029) and, with borderline significance, in re-experiencing symptoms ( p < 0.07) across all patients. Conclusion: Although PTSD symptomatology waned over time and in relation to longer follow-up, two-thirds of patients still qualified for a diagnosis of PTSD 2 years after the initial diagnosis. In post-MI patients, clinical PTSD is a considerably persistent condition.
A Randomized Trial of the Effect of Prayer on Depression and Anxiety
Authors: Boelens Peter A. , Reeves Roy R. , Replogle William H. , Koenig Harold G. 
Published: February 2010

Objective: To investigate the effect of direct contact person-to-person prayer on depression, anxiety, positive emotions, and salivary cortisol levels. Design, Setting, and Participants: Cross-over clinical trial with depression or anxiety conducted in an office setting. Following randomization to the prayer intervention or control groups, subjects (95% women) completed Hamilton Rating Scales for Depression and Anxiety, Life Orientation Test, Daily Spiritual Experiences Scale, and underwent measurement of cortisol levels. Individuals in the direct person-to-person prayer contact intervention group received six weekly 1–hour prayer sessions while those in the control group received none. Rating scales and cortisol levels were repeated for both groups after completion of the prayer sessions, and a month later. ANOVAs were used to compare pre- and post-prayer measures for each group. Results: At the completion of the trial, participants receiving the prayer intervention showed significant improvement of depression and anxiety, as well as increases of daily spiritual experiences and optimism compared to controls ( p < 0.01 in all cases). Subjects in the prayer group maintained these significant improvements ( p < 0.01 in all cases) for a duration of at least 1 month after the final prayer session. Participants in the control group did not show significant changes during the study. Cortisol levels did not differ significantly between intervention and control groups, or between pre- and post-prayer conditions. Conclusions: Direct contact person-to-person prayer may be useful as an adjunct to standard medical care for patients with depression and anxiety. Further research in this area is indicated.
Exploring the Link between Religious Attitudes and Subjective Well-Being in Chronic Pain Patients
Authors: Dezutter Jessie , Luyckx Koen , Büssing Arndt , Hutsebaut Dirk 
Published: February 2010

Objective: The aim of the present study was to explore the relations between religious attitudes and subjective well-being in a sample of chronic pain (CP) patients and to investigate whether these associations would differ from those obtained with healthy controls. Method: A total of 155 CP patients (72% women) and 166 healthy controls (72% women) completed questionnaires on pain, religious attitudes, and subjective well-being. The religious attitudes focused both on religiosity as such (Inclusion vs Exclusion of Transcendence) as on the cognitive approach of religious contents (Symbolic vs Literal). Results: Mean-level analyses showed significant differences between the CP and control samples on subjective well-being and Literal Exclusion. Mediation analyses found a direct influence of sample (CP vs control) on subjective well-being as well as an indirect effect via Literal Exclusion. Correlation analyses revealed that Literal Exclusion correlated negatively with well-being in both samples, whereas Literal Inclusion did not. The differential variable between the two samples was the symbolic approach of religion (Symbolic Inclusion and Exclusion), which was significantly associated with higher levels of well-being only in the CP sample. Conclusion: A literal approach toward religion in combination with a rejection of religion (Literal Exclusion) was, in general—both for CP patients as for healthy controls—associated with lower levels of well-being. In CP patients (but not in healthy controls), a symbolic approach toward religion (regardless of Inclusion or Exclusion of religion) was significantly associated with higher levels of subjective well-being.
A Prospective Observational Study of Decisional Capacity Determinations in an Academic Medical Center
Authors: Kahn Debra R. , Bourgeois James A. , Klein Sally C. , Iosif Ana-Maria 
Published: February 2010

Objective: The main goals of this observational study were to clarify and categorize decisional capacity assessments performed by a psychosomatic medicine (PSM) consult service at an academic medical center. Areas of investigation included types of decisional capacity requests, the relationship between Folstein Mini-Mental State Exam (MMSE) and PSM decisional capacity determination, psychiatric diagnoses of patients, and the agreement between primary clinician capacity assessment and that of the PSM clinician. Method: This was a prospective study of 100 consecutive decisional capacity consultations. Twelve requests were for second consultations for patients previously seen, for a net of 88 patients. Results: In 77 cases, patients lacked decisional capacity. Assessments for capacity to leave against medical advice (AMA), capacity to accept medical/surgical procedures, capacity to refuse medical/surgical procedures, and capacity to participate in discharge planning were nearly equally frequent. An MMSE cutoff score of < 21 was found to be 100% specific and 69% sensitive for identifying the patients without capacity, while a cutoff of < 24 was found to be 83% sensitive and 90% specific for identifying patients without capacity. The primary psychiatric diagnosis was a cognitive disorder in 52 cases. In 38 of the 39 cases where the primary team believed the patient lacked capacity, the PSM service agreed. In only two of the seven cases where primary teams believed patients had capacity did the PSM team agree. Conclusions: The MMSE was a useful predictor of capacity determination by PSM personnel, but using MMSE alone results in a number of erroneous determinations. Cognitive disorders were the most common primary psychiatric diagnoses in decisional capacity cases. Primary teams tended to be more accurate when they found patients to lack capacity.
Relationship between Child Abuse and Adult Smoking
Authors: Spratt Eve G. , Back Sudie E. , Yeatts Sharon D. , Simpson Annie N. , McRae-Clark Aimee , Maria Megan M. Moran-Santa , Price Kimber L. , Hartwell Karen T. , Brady Kathleen T. 
Published: February 2010

Objective: A strong association between a history of child abuse and subsequent psychiatric disorders including substance use has been demonstrated. However, few studies have examined the relationship between child abuse and cigarette smoking in individuals without co-occurring psychiatric disorders. In this study, the relationship between severe childhood abuse and smoking were examined in a group of adults without significant psychopathology. Methods: Participants ( N = 57) represent the control group of a larger study of substance dependence. Participants were without major DSM-IV psychopathology, including substance use disorders, major depression, or posttraumatic stress disorder. The Early Trauma Inventory [20] assessed history of exposure to traumatic events prior to age 18. Results: The majority of individuals with, as compared to without, a history of severe child abuse (79% vs. 47%, p = .02) were current cigarette smokers. The odds of smoking was four times as high in participants with versus without a severe childhood abuse history (OR = 4.0, p = 0.04). Conclusions: Although preliminary, the findings demonstrate a strong link between early childhood trauma and later adult cigarette smoking among individuals without significant substance use or other psychopathology.