bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing simulations in multi‐user virtual environments to enhance healthcare education
Authors: Rogers Luke 
Published: March 2010

AbstractComputer‐based clinical simulations are a powerful teaching and learning tool because of their ability to expand healthcare students' clinical experience by providing practice‐based learning. Despite the benefits of traditional computer‐based clinical simulations, there are significant issues that arise when incorporating them into a flexible, co‐operative and collaborative learning environment. Unlike traditional technologies; immersive multi‐user virtual environments such as Second Life can incorporate comprehensive learning materials with effective learning strategies, allowing healthcare students to obtain a simulated clinical experience in an immersive social environment. The purpose of this research was to investigate how a simulation could be optimised in Second Life to encourage teamwork and collaborative problem solving based on the habits, experiences and perceptions of nursing students towards Second Life as a simulation platform. The research was conducted by placing groups of nursing students in separate locations and exposing them to a series of clinical simulation developed in Second Life. The simulation involved a series of problem‐based scenarios, which incorporated concepts of technical skills, patient interaction, teamwork and situational awareness. Using qualitative feedback from a series of evaluative case studies, the study determined good practices and issues involved with a virtual computer‐based clinical simulation. A common theme which emerged from this research, which is discussed in this paper, was the student's ability to work in an artificial social structure where they could actively co‐construct mental models of technical and interpersonal skills through experiencing human interaction in a computer‐based simulated environment.
Constructive multiple‐choice testing system
Authors: Park Jooyong 
Published: March 2010

AbstractThe newly developed computerized Constructive Multiple‐choice Testing system is introduced. The system combines short answer (SA) and multiple‐choice (MC) formats by asking examinees to respond to the same question twice, first in the SA format, and then in the MC format. This manipulation was employed to collect information about the two different formats with no significant increase in testing time. Two empirical studies were carried out to examine whether meaningful information can be obtained using this system. One hundred and twenty nine fifth grade students (11 years old) were tested on science in Study 1, and 82 college students were tested for grade in Study 2. In both studies, consistent with previous research, students attained higher score in the MC format, the correlation between the SA format and the MC format was high, and the item discrimination was higher in the SA format when compared with the MC format. The unique finding from this study is that there were some cases where students chose a wrong MC option, even though they typed in the correct answer for the SA part. Possible applications of the system are discussed.
Online or face‐to‐face? An experimental study of examiner training
Authors: Chamberlain Suzanne , Taylor Rachel 
Published: March 2010

AbstractThousands of examiners are employed to mark candidate scripts from the suite of public examinations offered to students during the compulsory and post‐compulsory schooling phases in England, Northern Ireland and Wales. All examiners undergo training to ensure that they interpret correctly, and apply consistently, the mark scheme for their particular paper. Traditionally this training has been delivered face‐to‐face, but several benefits of an online training environment have been identified. This paper outlines the findings of an experimental study designed to quantify and compare the effects of face‐to‐face and online training on experienced examiners’ marking reliability. A sample of 89 experienced examiners was randomly allocated to either a face‐to‐face or online training group. The participants marked 30 General Certificate of Secondary Education History scripts prior to receiving training and another 30 scripts following training. Two measures of reliability were calculated: marking accuracy (absolute mark differences) and consistency (rank order correlations). The findings suggest that both modes of training had comparable, statistically significant positive effects on examiners’ accuracy and consistency. The evidence indicates that online training may be an effective alternative to face‐to‐face training for the purposes of standardising examiners’ marking.
Long‐term follow‐up of patients with asymptomatic occlusion of the internal carotid artery with good and impaired cerebral vasomotor reactivity
Authors: Kimiagar I. , Bass A. , Rabey J. M. , Bornstein N. M. , Gur A. Y. 
Published: March 2010

Background:  Cerebral hemodynamic status might be prognostic for either the symptomatic or asymptomatic course of carotid occlusive disease. It is determined by evaluating cerebral vasomotor reactivity (VMR). We assessed VMR in asymptomatic patients with total occlusion of the internal carotid artery (ICA) and followed them to evaluate the role of impaired VMR in predicting ischaemic stroke (IS).Methods:  Thirty‐five patients (21 men, mean age ± SD 68 ± 7.5 years) with unilateral asymptomatic ICA occlusion were studied by transcranial Doppler and the Diamox test (intravenous 1.0 g acetazolamide) and followed for 48 months or until reaching the end‐points of IS, transient ischaemic attack, or vascular death. VMR% was evaluated by recording the percent differences in peak systolic blood flow velocities in each middle cerebral artery at baseline and after Diamox administration.Results:  Based on VMR% calculations, 14 (40%) patients had good VMRs and 21 (60%) had impaired VMRs. The global annual risk of ipsilateral ischaemic events was 5.7%. The annual ipsilateral ischaemic event risk was 1.8% in patients with good VMRs, whilst it was 7.1% in patients with impaired VMRs. An impaired VMR was significantly correlated with ipsilateral IS (Kaplan–Meier log rank statistic, P = 0.04).Conclusions:  Our results support the value of VMR assessment for identifying asymptomatic patients with carotid occlusion who belong to a high‐risk subgroup for IS. New trials using extracranial‐to‐intracranial bypass surgery in patients with asymptomatic ICA occlusion and impaired VMRs are warranted.
The Wildlife Picture Index: monitoring top trophic levels
Authors: O'Brien T. G. , Baillie J. E. M. , Krueger L. , Cuke M. 
Published: March 2010

AbstractAlthough recent biodiversity loss has been compared with cataclysmic mass extinctions, we still possess few indicators that can assess the extent or location of biodiversity loss on a global scale. The Convention on Biological Diversity (CBD) has mandated development of indicators that can meet the needs of monitoring biodiversity by 2010. To date, many indicators rely on unwarranted assumptions, secondary data, expert opinion and retrospective time series. We present a new biodiversity indicator, the Wildlife Picture Index (WPI) that targets medium and large‐sized terrestrial birds and mammals in forested and savannah ecosystems that. The WPI is a composite indicator based on the geometric mean of relative occupancy estimates derived from camera trap sampling at a landscape scale. It has been designed to meet the needs of a CBD indicator while avoiding many of the pitfalls that characterize some CBD indicators. We present an example using 8 years of camera trap data from Bukit Barisan Selatan National Park, Indonesia to show that the WPI is capable of detecting changes in the rate of loss of biodiversity, a key requirement of a CBD indicator. We conclude that the WPI should be effective at monitoring top trophic levels in forest and savannah ecosystems using primary data and can fill the gap in knowledge about trends in tropical biodiversity.
Developmental homoplasy: convergence in cellular differentiation
Authors: Graham Anthony 
Published: March 2010

AbstractThere is an accumulating body of evidence that highlights the fact that one can identify convergence in programmes of cellular differentiation. That is, that a particular differentiated cell/tissue type can be generated via non‐identical paths. Convergence is also seen in evolution and here it is termed homoplasy, thus one could term convergence in cellular differentiation, developmental homoplasy. It is important to appreciate its existence as it can confound our understanding of cellular differentiation. In particular, it highlights the point that the analysis of cellular differentiation in one region of the body may not generate an understanding that is generally applicable. The existence of the phenomenon of developmental homoplasy may lie in the evolutionary history of developmental processes, which are assembled over phylogenetic time. Such convergence in cellular differentiation may also have significance for understanding disease state and disease repair.
Prevalence and associated factors of non‐alcoholic fatty liver disease in patients with type‐2 diabetes mellitus
Authors: Leite Nathalie C. , Salles Gil F. , Araujo Antonio L. E. , Villela‐Nogueira Cristiane A. , Cardoso Claudia R. L. 
Published: March 2010

AbstractBackground/Aims: Diabetic patients have an increased prevalence and severity of non‐alcoholic fatty liver disease (NAFLD). We aimed to investigate the prevalence and the factors associated with the presence of ultrasonographic NAFLD in type‐2 diabetic individuals.Methods: In a cross‐sectional design study, 180 type‐2 diabetic patients were submitted to a complete clinical and laboratory evaluation and abdominal ultrasonography for NAFLD detection and grading. Statistical analysis included bivariate tests, analysis of variance (anova, for increasing severity of steatosis) and multivariate logistic regression.Results: The prevalence of ultrasonographic NAFLD was 69.4% [95% confidence interval (CI): 58.3–82.7%]. Patients with NAFLD were more obese, had a higher waist circumference and serum triglyceride and alanine aminotransferase (ALT) levels than those without steatosis. Neither diabetic degenerative complication, nor glycaemic control was associated with liver steatosis. On multivariate analysis, a high serum triglycerides level [>2.82 mmol/L, odds ratio (OR): 3.7–4.1, 95% CI: 1.2–13.3] and a high‐normal ALT level (≥40 U/L, OR: 2.5–2.7, 95% CI: 1.2–5.9) were independently associated with hepatic steatosis, together with either the presence of obesity (OR: 7.1, 95% CI: 3.0–17.0) or of increased waist circumference (OR: 4.8, 95% CI: 1.9–12.2).Conclusions: Type‐2 diabetic patients have a high prevalence of ultrasonographic NAFLD and its presence is associated with obesity, mainly abdominal, hypertriglyceridaemia and high‐normal ALT levels. Non‐alcoholic fatty liver disease in diabetic patients may develop and progress independent of the diabetes progression itself.
The effect  of  1  month  of  therapy with midodrine, octreotide‐LAR and albumin in refractory ascites: a pilot study
Authors: Tandon Puneeta , Tsuyuki Ross T. , Mitchell Lesley , Hoskinson Michael , Ma Mang M. , Wong Winnie W. , Mason Andrew L. , Gutfreund Klaus , Bain Vincent G. 
Published: March 2010

AbstractBackground: The pathogenesis of refractory ascites (RA) is linked to splanchnic vasodilation. We hypothesized that a combination of midodrine, octreotide long‐acting release (LAR) and albumin would result in increased natriuresis, better control of ascites and an improvement in renal function in patients with RA±Type 2 hepatorenal syndrome.Methods: A prospective pilot study in patients with RA as defined by the International Ascites Club. Consecutive patients received an intramuscular injection of octreotide‐LAR, 50 g of albumin three times per week and midodrine titrated to increase the systolic blood pressure for 1 month.Results: Ten patients with RA were enrolled and eight with complete data to 1 month post‐treatment were included in the analysis. There was no change in renal function but there was a trend towards a reduction in the volume of ascites removed by paracentesis (P=0.08) and a significant reduction in the plasma renin (P=0.01) and aldosterone concentrations (P=0.01). Interestingly, there was a transient worsening in the model for end‐stage liver disease (MELD) score (P=0.01). The deterioration in MELD was completely reversible after discontinuation of therapy.Conclusions: To our knowledge, this is the first study of prolonged midodrine, octreotide and albumin therapy in RA. We observed a significant reduction in the plasma renin and aldosterone concentrations and a trend towards a reduction in the volume of ascites removed by paracentesis without an effect on renal function. The beneficial effects are at the expense of a reversible deterioration in the MELD score. Large controlled trials are needed before this therapy can be routinely recommended.
Differential vascular endothelial growth factor A protein expression between small hepatocellular carcinoma and cirrhosis correlates with serum vascular endothelial growth factor A and α‐fetoprotein
Authors: Ginanni Corradini Stefano , Morini Sergio , Liguori Francesca , Carotti Simone , Onetti Muda Andrea , Antonella Burza Maria , Siciliano Maria , Molinaro Antonio , Cantafora Alfredo , Blotta Ida , Merli Manuela , Berloco Pasquale , Rossi Massimo , Francesco Attili Adolfo , Gaudio Eugenio 
Published: March 2010

AbstractBackground/Aims: Drugs with antivascular endothelial growth factor A (anti‐VEGF‐A) action are under clinical evaluation with encouraging results in advanced hepatocellular carcinoma (HCC). The relative VEGF‐A protein expression in non‐advanced HCC and in the cirrhotic non‐tumoral tissue in the same patient, a variable that could be important for treatment efficacy, has been investigated with conflicting results, only using the cirrhotic tissue surrounding the neoplasm (CS).Methods: We measured, for the first time, VEGF‐A expression in non‐advanced HCC and in the respective CS and cirrhotic tissue at a distance from the tumour (CD), in 24 patients who underwent liver transplantation.Results: VEGF‐A protein was more expressed (P<0.05) in HCC than in CD, while no difference was found between HCC and CS. In HCC patients with a serum α‐fetoprotein (AFP) higher than 20 ng/ml, VEGF‐A protein expression in HCC was higher than in the corresponding CD in 83% of cases and AFP and serum VEGF‐A corrected for the platelet count positively correlated with the differential VEGF‐A protein expression between HCC and CD.Conclusion: Our data provide a rationale for clinical trials involving anti‐VEGF‐A treatments in patients with non‐advanced HCC, and suggest that serum AFP and VEGF‐A are variables to be taken into account in these studies.
Clinical and histological impact of previous hepatitis B virus infection in patients with chronic hepatitis C
Authors: Carvalho‐Filho Roberto J. , De Lucca Schiavon Leonardo , Narciso‐Schiavon Janaína L. , Sampaio Juliana P. , Lanzoni Valéria P. , Gomes Ferraz Maria L. , Benedito Silva Antonio E. 
Published: March 2010

AbstractBackground:Recent reports suggest that hepatitis C virus (HCV) carriers with serological markers of prior hepatitis B virus (HBV) infection have more advanced liver fibrosis, irrespective of HBV‐DNA detection.Aims:We sought to assess the prevalence and impact of previous HBV infection in patients with HCV chronic infection.Methods:This cross‐sectional study included hepatitis B surface antigen‐ and human immunodeficiency virus‐negative subjects with positive HCV‐RNA. All patients had prior parenteral exposure as the probable source of HCV infection. Serum samples were tested for HBV‐DNA using a commercial assay. The METAVIR system was used for histological analysis.Results:One‐hundred and eleven patients were evaluated. Thirty‐one out of 111 patients (28%) tested positive for antihepatitis B core antigen (anti‐HBc). HBV‐DNA was not detected in any sample. Anti‐HBc‐positive patients showed higher histological grading, staging and a higher fibrosis progression rate. By multivariate analysis, anti‐HBc‐positivity was predictive of moderate to severe activity [odds ratio (OR)=3.532;P=0.032] and significant hepatic fibrosis (OR=3.364;P=0.017). After approximately 20 years of infection, advanced liver fibrosis (F3/F4) can be expected in 13% of anti‐HBc‐negative subjects who acquired HCV before the age of 30 and in 57% of those anti‐HBc‐positive patients who were infected by HCV after 30 years of age (P<0.001).Conclusion:Previous HBV infection is common among HCV carriers and may exert a negative impact on the natural history of HCV infection, independently of the presence of significant HBV replication.
Non‐alcoholic fatty liver disease prevalence among school‐aged children and adolescents in Iran and its association with biochemical and anthropometric measures
Authors: Alavian Seyed‐Moayed , Mohammad‐Alizadeh Amir‐Hooshang , Esna‐Ashari Farzaneh , Ardalan Gelayol , Hajarizadeh Behzad 
Published: March 2010

AbstractObjective: To investigate the prevalence of non‐alcoholic fatty liver disease (NAFLD) as well as the determination of associated metabolic abnormalities in Iranian school‐aged children and adolescents.Method: Data were obtained from 966 children aged 7–18 years in Iran by a cross‐sectional survey in 2007. These children were subjected to a complete anthropometric and laboratory measurement and abdominal ultrasonography for liver echogenicity and size. A questionnaire was also used to obtain information on demographical and medical history, dietary habit, alcohol consumption and cigarette smoking.Results: Fatty liver was diagnosed by ultrasound in 7.1% of children. The prevalence of elevated alanine aminotransferase (ALT) was 1.8%. NAFLD was significantly more common in the older group (12.5 against 3.5%, P<0.0001). The odds ratios (OR) (95% confidence interval) for NAFLD in children having elevated ALT, high fasting insulin, total cholesterol, low density lipoprotein (LDL) cholesterol, triglyceride and insulin resistance (IR) were 10.9 (3.9–30.4), 2.8 (1.6–4.8), 2.8 (1.5–5.1), 2.8 (1.5–5.3), 2.5 (1.3–4.8) and 4.4 (1.6–12.3) respectively. Therefore, NAFLD was significantly associated with increasing age, ALT, fasting insulin, total cholesterol, LDL cholesterol, triglyceride and IR. In multiple logistic regression analysis, ALT (OR=1.2; P<0.01), total cholesterol (OR=1.01; P<0.01) and waist circumference (OR=1.14, P<0.0001) were independent metabolic factors predictive of NAFLD after adjustment for other variables.Conclusion: There was a strong relationship between NAFLD and the abnormal metabolic variables in children. It will be very useful if children are assessed for variables such as waist circumference, fasting blood sugar, fasting insulin and serum lipid profile in order to screen those susceptible to NAFLD.
Association between combinations of glutathione‐S‐transferase M1, T1 and P1 genotypes and non‐alcoholic fatty liver disease
Authors: Hori Masaharu , Oniki Kentaro , Nakagawa Takehiro , Takata Keiji , Mihara Shuichi , Marubayashi Toru , Nakagawa Kazuko 
Published: March 2010

AbstractBackground/Aims: Glutathione‐S‐transferases (GSTs) play a crucial role in antioxidant defence mechanisms, by detoxifying xenobiotics and by inactivating endogenous byproducts of oxidative stress. Functional failure, as a sequel of an altered GST genotype, may thus aggravate non‐alcoholic fatty liver disease (NAFLD). This study investigated whether the GSTs genotypes could affect the risk for NAFLD.Methods: A cross‐sectional case–control analysis included 253 Japanese participants in a health screening programme. The GSTM1 null, GSTT1 null and GSTP1 Ile105Val variant genotypes were determined as putative high‐risk genotypes.Results: The incidence of NAFLD was 27.3%. The frequency of the GSTM1 null genotype was higher in NAFLD than in the control [adjusted odds ratio (OR), 2.00; 95% confidence intervals (CI), 1.01–3.95]. Moreover, any combination of two putative high‐risk genotypes exhibited a higher risk for NAFLD with an adjusted OR from 3.52 (95% CI, 1.08–11.43)–4.01 (95% CI, 1.28–12.56). However, the significance for the combination of GSTM1 null and GSTT1 null genotypes only remained after Bonferroni's correction. In addition, the risk for NAFLD increased as the number of high‐risk genotypes, and the OR among three high‐risk genotypes carriers was 9.67 (95% CI: 1.61–58.26).Conclusion: This is the first report to show the impact of the GSTs genotypes on the development of NAFLD. This finding, which should be confirmed in further studies in larger populations, may help to develop a more targeted prevention programme at an early stage for subjects with an increased risk for NAFLD.
Non‐invasive assessment of liver fibrosis by stiffness measurement in patients with chronic hepatitis B
Authors: Marcellin Patrick , Ziol Marianne , Bedossa Pierre , Douvin Catherine , Poupon Raoul , De Lédinghen Victor , Beaugrand Michel 
Published: March 2010

AbstractBackground: The need for new non‐invasive tools to assess liver fibrosis in chronic liver diseases has been largely advocated. Liver stiffness measurement (LSM) using transient elastography (FibroScan®, Echosens™) has been shown to be correlated to liver fibrosis in various chronic liver diseases. This study aims to assess its diagnosis accuracy in patients with chronic hepatitis B.Patients and methods: We prospectively enrolled 202 patients with chronic hepatitis B in a multicentre study. Patients underwent liver biopsy (LB) and LSM. METAVIR and Ishak liver fibrosis stages were assessed by two pathologists.Results: LSM or LB was considered unreliable in 29 patients. Statistical analysis was conducted in 173 patients. LSM was significantly (P<0.001) correlated with METAVIR (r=0.65) and Ishak fibrosis stage (0.65). The area under receiver‐operating characteristic curves were 0.81 (95% confidence intervals, 0.73–0.86) for F≥2, 0.93 (0.88–0.96) for F≥3 and 0.93 (0.82–0.98) for F=4. Optimal LSM cut‐off values were 7.2 and 11.0 kPa for F≥2 and F=4, respectively, by maximizing the sum D of sensitivity and specificity, and 7.2 and 18.2 kPa by maximizing the diagnosis accuracy.Conclusion: In conclusion, LSM appears to be reliable for detection of significant fibrosis or cirrhosis in HBV patients and cut‐off values are only slightly different from those observed in HCV patients.
Prevalence and virological features of occult hepatitis B virus infection in female sex workers who work uncontrolled in Turkey
Authors: Pinarbasi Binnur , Onel Derya , Cosan Fulya , Akyuz Filiz , Dirlik Nezihe , Cakaloglu Yilmaz , Badur Selim , Besisik Fatih , Demir Kadir , Okten Atilla , Kaymakoglu Sabahattin 
Published: March 2010

AbstractBackground: There is little information about the prevalence of occult hepatitis B virus infection (OHBVI). We have investigated the prevalence and virological features of OHBVI among female sex workers (FSWs) in Istanbul.Methods: Hepatitis B surface antigen (HBsAg) was tested in FSWs who work uncontrolled and were admitted to Venereal Diseases Hospital. HBV DNA and anti‐HBs were investigated in all the HBsAg‐negative cases. Hepatitis B envelope (HBe) antigen, anti‐HBe, anti‐hepatitis B core (HBc) antigen, HBV genotype, S gene and precore (PC)/basic core promoter (BCP) mutations were determined in HBV DNA‐positive sera.Results: Two hundred and eighty‐six volunteers were enrolled and 32.5% (n=93) of them had anti‐HBs positivity. HBV DNA (range 30–209 copy/ml) was positive in 11 anti‐HBs‐negative and two anti‐HBs‐positive cases. The prevalence of OHBVI was 4.5% (13/286). Anti‐HBc was positive in 77% (10/13) of those with OHBVI and anti‐HBe positivity was 53.8% (7/13). Only genotype D was present in all occult HBV‐infected cases. One PC (G1896A) and one BCP (T1762/A1764) mutation was found, but S gene mutation was not detected in any of the samples.Conclusion: In this population, OHBVI may have a negligible role in the horizontal transmission because of a very low viral load, and PC and core promoter mutations are very rare.