bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of the corneal endothelium and pseudoexfoliation syndrome in patients with senile cataract
Authors: Quiroga Lorena , Lansingh Van C , Samudio Margarita , Peña Fernando Y , Carter Marissa J 
Published: April 2010

AbstractBackground:  The characteristics of the corneal endothelium in patients with/without pseudoexfoliation syndrome (PEX) with senile cataract in Paraguay are unknown.Methods:  Endothelial density, mean coefficient of variation (%) in cell size and mean cell hexagonality (%) were measured using automated specular microscopy. Multivariate general linear model analysis was used to determine the effect of age, gender and PEX on endothelial characteristics. Analysis of variance tests analysed the effect of age on endothelial variables without regard to PEX status. Categories of <2000 and ≥2000 cells/mm2 were compared in the presence/absence of PEX using age as covariate to calculate odds ratios for corneal decompensation.Results:  Out of 468 eligible patients, 51 were excluded. Sixty‐one patients had PEX. Unadjusted mean endothelial cell density was 2451 cells/mm2; cell size coefficient of variation was 34.3; and the mean percentage of hexagonal cells was 57.7. Adjusting for age, only the mean difference between the groups with and without PEX for endothelial cell density was significant (PEX = 2315, no PEX = 2482, P = 0.002). Of the total study population, at‐risk endothelial cell densities were found in 46 eyes (11%); and 13 (28%) of those were found to have PEX. When PEX was present, the calculated odds ratio for corneal decompensation following surgery was 1.90 after adjustment for age.Conclusions:  Endothelial cell density data were consistent with published literature. Because Paraguay has a high prevalent of PEX, it is suggested that specular microscopy screening be carried out for all patients scheduled for intraocular surgery where feasible.
Ribonucleotide reductase subunit M1 expression in resectable, muscle‐invasive urothelial cancer correlates with survival in younger patients
Authors: Harshman Lauren C. , Bepler Gerold , Zheng Zhong , Higgins John P. , Allen Genevera I. , Srinivas Sandy 
Published: April 2010

OBJECTIVETo assess whether high ribonucleotide reductase subunit M1 (RRM1) expression in patients with resected, muscle‐invasive (T2–4NxM0) urothelial carcinoma (UC) correlated with longer overall survival (OS). RRM1 is the primary cellular target of gemcitabine and previous studies in resected early‐stage lung cancer have shown a survival benefit for patients with high expression.PATIENTS AND METHODSIn all, 84 radical cystectomy specimens with muscle‐invasive UC were identified from existing tissue microarrays. The patients' medical records were retrospectively reviewed to confirm pathology and stage. Specimens were analysed for RRM1 expression using automated quantitative analysis. The median value of RRM1 was established a priori as the threshold for high and low expression.RESULTSThe median age of the patients was 69 years. Stages were nearly equally distributed: 30%, 38%, and 32% for stage II, III, and IV, respectively. Most were high grade (99%) with no nodal involvement (69%). The median (range) OS was 2.0 (0–13.1) years. Tumoral RRM1 levels did not correlate with OS for the entire cohort, but when adjusted for age, high tumoral RRM1 expression in younger patients (aged <70 years) correlated with increased survival. Younger patients with high RRM1 expression had a median OS of 10.6 years compared with 1.6 years in older patients (P= 0.001). There was no difference in OS among low RRM1 expressors: 2.3 vs 1.6 years in younger and older patients, respectively (P= 0.22).CONCLUSIONSOur results suggest that high RRM1 expression may be prognostic for improved survival in patients with muscle‐invasive UC aged <70 years.
Migrant Women’s Transnationalism: Family Patterns and Policies
Authors: Pajnik Mojca , Bajt Veronika 
Published: April 2010

AbstractWhereas current policies on migration and integration are beginning to recognise family reunion as one of the most legitimate reasons for acceptance by a host society, they in most cases still do not account for the growing trend of feminisation of migration, and even rarely do they address specific migrants’ needs. As currently constituted, the integration bills envision a one‐way process that places migrants into a position where they cannot question, but only accept and fulfil the predetermined requirements of integration plans. But who are the women that migrate, what influence do their transnational experiences have on their families, and how do migration policies envision the reality of increasing transnationalism? This paper focuses on biographical interviews with migrant women in Slovenia as a valuable method to question current integration measurements, applied here to explore female migrants’ experiences in transnational family life and social networks. A gender sensitive approach is applied that critically evaluates the specificities of family reunification policies, which define women migrants as dependent family members. We discuss life trajectories of women migrants, focusing the debate on their own experiences in and with family life. This new empirical material is used to theorise gaps in contemporary migration research. Women migrants’ own reflections of transnational family ties show a great variety of experiences and their narratives are a unique window into motivational, political, as well as legal dimensions of migration.
Uterine rupture after previous caesarean section
Authors: Al‐Zirqi I , Stray‐Pedersen B , Forsén L , Vangen S 
Published: April 2010

Please cite this paper as: Al‐Zirqi I, Stray‐Pedersen B, Forsén L, Vangen S. Uterine rupture after previous caesarean section. BJOG 2010;117:809–820.Objective  To determine the risk factors, percentage and maternal and perinatal complications of uterine rupture after previous caesarean section.Design  Population‐based registry study.Population  Mothers with births ≥28 weeks of gestation after previous caesarean section (n = 18 794), registered in the Medical Birth Registry of Norway, from 1 January 1999 to 30 June 2005.Methods  Associations of uterine rupture with risk factors, maternal and perinatal outcome were estimated using cross‐tabulations and logistic regression.Main outcome measure  Odds of uterine rupture.Results  A total of 94 uterine ruptures were identified (5.0/1000 mothers). Compared with elective prelabour caesarean section, odds of rupture increased for emergency prelabour caesarean section (OR: 8.63; 95% CI: 2.6–28.0), spontaneous labour (OR: 6.65; 95% CI: 2.4–18.6) and induced labour (OR: 12.60; 95% CI: 4.4–36.4). The odds were increased for maternal age ≥40 years versus <30 years (OR: 2.48; 95% CI: 1.1–5.5), non‐Western (mothers born outside Europe, North America or Australia) origin (OR: 2.87; 95% CI: 1.8–4.7) and gestational age ≥41 weeks versus 37–40 weeks (OR: 1.73; 95% CI: 1.1–2.7). Uterine rupture after trial of labour significantly increased severe postpartum haemorrhage (OR: 8.51; 95% CI: 4.6–15.1), general anaesthesia exposure (OR: 14.20; 95% CI: 9.1–22.2), hysterectomy (OR: 51.36; 95% CI: 13.6–193.4) and serious perinatal outcome (OR: 24.51 (95% CI: 11.9–51.9). Induction by prostaglandins significantly increased the odds for uterine rupture compared with spontaneous labour (OR: 2.72; 95% CI: 1.6–4.7). Prelabour ruptures occurred after latent uterine activity or abdominal pain in mothers with multiple or uncommon uterine scars.Conclusion  Trial of labour carried greater risk and graver outcome of uterine rupture than elective repeated caesarean section, although absolute risks were low. A review of labour management and induction protocol is needed.
A systematic review of the effectiveness of training in emergency obstetric care in low‐resource environments
Authors: van Lonkhuijzen L , Dijkman A , van Roosmalen J , Zeeman G , Scherpbier A 
Published: April 2010

Please cite this paper as: van Lonkhuijzen L, Dijkman A, van Roosmalen J, Zeeman G, Scherpbier A. A systematic review of the effectiveness of training in emergency obstetric care in low‐resource environments. BJOG 2010;117:777–787.Background  Training of healthcare workers can play an important role in improving quality of care, and reducing maternal and perinatal mortality and morbidity.Objectives  To assess the effectiveness of training programmes aimed at improving emergency obstetric care in low‐resource environments.Search strategy  We searched Pubmed, Embase, Popline and selected websites, and manually searched bibliographies of selected articles. Language was not an exclusion criterion.Selection criteria  All papers describing postgraduate training programmes aimed at improving emergency obstetric care in low‐resource environments were included.Data collection and analysis  Two reviewers independently extracted the data and classified these according to the level of the measured effects (reaction of participants, improved knowledge and skills, changes in behaviour and outcomes in practice). Any disagreements were resolved by discussion with a third author until agreement was reached.Main results  A total of 38 papers were selected. Training programmes vary considerably in length, content and design. The evaluation of effects is often hampered by inadequate study design and the use of non‐validated measuring instruments. Most papers describe positive reactions, increased knowledge and skills, and improved behaviour after training. Outcome is assessed less frequently, and positive effects are not always demonstrated. Measures that can contribute to a positive effect of training programmes include hands‐on practise, team approaches and follow‐up on training efforts.Author’s conclusions  Training programmes may improve quality of care, but strong evidence is lacking. Policymakers need to include evaluation and reporting of effects in project budgets for new training programmes.
What measured blood loss tells us about postpartum bleeding: a systematic review
Authors: Sloan NL , Durocher J , Aldrich T , Blum J , Winikoff B 
Published: April 2010

Please cite this paper as: Sloan N, Durocher J, Aldrich T, Blum J, Winikoff B. What measured blood loss tells us about postpartum bleeding: a systematic review. BJOG 2010;117:788–800.Background  Meta‐analyses of postpartum blood loss and the effect of uterotonics are biased by visually estimated blood loss.Objectives  To conduct a systematic review of measured postpartum blood loss with and without prophylactic uterotonics for prevention of postpartum haemorrhage (PPH).Search strategy  We searched Medline and PubMed terms (labour stage, third) AND (ergonovine, ergonovine tartrate, methylergonovine, oxytocin, oxytocics or misoprostol) AND (postpartum haemorrhage or haemorrhage) and Cochrane reviews without any language restriction.Selection criteria  Refereed publications in the period 1988–2007 reporting mean postpartum blood loss, PPH (≥500 ml) or severe PPH (≥1000 ml) following vaginal births.Data collection and analysis  Raw data were abstracted into Excel by one author and then reviewed by a co‐author. Data were transferred to SPSS 17.0, and copied into RevMan 5.0 to perform random effects meta‐analysis.Main results  The distribution of average blood loss (29 studies) is similar with any prophylactic uterotonic, and is lower than without prophylaxis. Compared with no uterotonic, oxytocin and misoprostol have lower PPH (OR 0.43, 95% CI 0.23–0.81; OR 0.73, 95% CI 0.50–1.08, respectively) and severe PPH rates (OR 0.61, 95% CI 0.29–1.29; OR 0.74, 95% CI 0.52–1.04, respectively). Oxytocin has lower PPH (OR 0.65, 95% CI 0.60–0.70) and severe PPH (OR 0.71, 95% CI 0.56–0.91) rates than misoprostol, but not in developing countries.Conclusion  Oxytocin is superior to misoprostol in hospitals. Misoprostol substantially lowers PPH and severe PPH. A sound assessment of the relative merits of the two drugs is needed in rural areas of developing countries, where most PPH deaths occur.
RHEOLOGICAL PROPERTIES OF AQUEOUS DISPERSIONS OF TRAGACANTH AND GUAR GUMS AT DIFFERENT CONCENTRATIONS
Authors: CHENLO F. , MOREIRA R. , SILVA C. 
Published: April 2010

ABSTRACT Rheological studies of tragacanth and guar gums dispersions were carried out by means of steady shear (3 to 1000/s) and small amplitude oscillatory shear experiments (0.1 to 10 rad/s) for concentrations up to 8.9 g/L for tragacanth and 7.6 g/L for guar gum at 25C using stress controlled rheometer. The dispersions exhibited shear‐thinning characteristics. A simplified Cross model was adequate to fit the shear‐dependent viscosity behavior for both gums. Model parameters for guar gum were correlated with concentration employing power functions (with flow index constant) and for tragacanth gum the dependence was linear for flow index, power for time constant and exponential for zero‐shear rate viscosity. Mechanical spectra revealed that dispersions behave as dilute systems of coil polymers with trend to entangled systems at the highest concentrations. Loss and storage moduli were correlated with frequency and the resulting parameters were correlated with concentration. Cox–Merz rule holds satisfactorily. PRACTICAL APPLICATIONSGuar and tragacanth gums are natural thickeners that have many applications in pharmaceutical, food, paper, textile, oil painting and cosmetic industries, among others. The addition of these hydrocolloids at low concentration to systems can give a great variety of functions such as enhancement of viscosity, improvement of texture, formation of films, encapsulation of flavors, creation of gel‐structures, etc. In this work, mathematical relationships are proposed for the variation of apparent viscosity and loss and storage moduli with concentration for both gums.
Surgical treatment of iris and ciliary body melanoma: follow‐up of a 25‐year series of patients
Authors: Klauber Stefan , Jensen Peter K. , Prause Jan U. , Kessing Svend V. 
Published: April 2010

Abstract.Purpose:  To evaluate outcome of surgical resection of iris and irido‐ciliary melanomas.Method:  Retrospective analysis of all cases treated in Denmark 1975–1999 with clinical follow‐up in 2002 and death certificate analysis in 2008. A quality of life questionnaire was completed at follow‐up.Results:  A total of 53 patients were identified. Of these, 47 were examined at follow‐up. Median observation time was 7.15 years (range 0.3–27.4 years). Five patients had died of nonmelanoma causes, and one could not be reached because of immigration. None of the patient had melanoma metastases, and none had died of melanoma‐related causes. Only one patient had a local recurrence, which was successfully treated by cryotherapy. The quality of life‐related questions demonstrated that most patients (40) suffered from photophobia, and eight patients had changed their driving habits, not driving at night time. However, none had changed job as a consequence of the surgical treatment. Only two patients were emotionally affected by the diagnosis of iris melanoma.Conclusion:  Resection of small iris and irido‐ciliary melanomas is a safe and efficient procedure, provided that strict diagnostic and surgical procedures are followed and the preoperative intraocular pressure is normal.
Evidence‐based medicine knowledge, attitudes, and practices among doctors in Sri Lanka
Authors: Abeysena Chrishantha , Jayawardana Pushpa , Wickremasinghe Rajitha , Wickramasinghe Uthpala 
Published: April 2010

Objective To assess knowledge, attitudes, and practices on evidence‐based medicine (EBM) among doctors in selected hospitals in Sri Lanka. Methods A cross‐sectional descriptive study was conducted among 315 doctors in five government hospitals in Sri Lanka between December 2007 and January 2008. A pre‐tested self‐administered questionnaire was used to gather information on knowledge, attitudes, and practices. Results Of the 407 invited, 315 doctors participated, among whom, 87% (271) had heard the term EBM, 30% (n= 94) were aware of the Cochrane Library, and 8.5% (n= 27) were current users of it. Forty‐seven per cent (n= 148) claimed to understand the terms systematic review and 37% (n= 115) meta‐analysis. Twenty‐four per cent (n= 77) had been exposed to some form of EBM training. All three components of EBM were known by 18% (n= 56) of participants. Attitudes toward EBM were positive among 76% (n= 239), 80% (n= 251) believed the practice of EBM would lead to improved patient care, and 77% (n= 243) considered EBM to be fundamental to professional practice. Just 3% (n= 13) considered it unimportant. EBM was used in clinical practice by 54% (n= 169) of participants. Thirty‐six per cent (n= 114) referred to EBM sources when relevant. Available clinical guidelines were referred to by 56% (n= 176), and 34% (n= 107) thought that available guidelines provide sufficient support for the practice of EBM. The main barriers to practicing EBM were insufficient resources, overwork, lack of exposure to EBM, and lack of time and lack of endorsement of the need to practice EBM. Conclusions Knowledge and practices of EBM among Sri Lanka doctors were poor. However, attitudes toward EBM were relatively good.
Development of a Recombinant Epsilon Toxoid Vaccine against Enterotoxemia and Its Use as a Combination Vaccine with Live Attenuated Sheep Pox Virus against Enterotoxemia and Sheep Pox
Authors: Chandran Dev , Naidu Sureddi Satyam , Sugumar Parthasarathy , Rani Gudavalli Sudha , Vijayan Shahana Pallichera , Mathur Deepika , Garg Lalit C. , Srinivasan Villuppanoor Alwar 
Published: April 2010

ABSTRACT
Sheep pox and enterotoxemia are important diseases of sheep, and these diseases cause severe economic losses to sheep farmers. The present study was undertaken to evaluate the potential of formaldehyde-inactivated recombinant epsilon toxin as a vaccine candidate. The potency of the recombinant epsilon toxoid with aluminum hydroxide as an adjuvant in sheep was determined. Vaccinated sheep were protected against enterotoxemia, with potency values of >5 IU being protective. Further, the use of this construct in a combination vaccine against sheep pox resulted in the sheep being protected against both sheep pox and enterotoxemia.
Options for Inactivation, Adjuvant, and Route of Topical Administration of a Killed, Unencapsulated Pneumococcal Whole-Cell Vaccine
Authors: Lu Ying-Jie , Yadav Puja , Clements John D. , Forte Sophie , Srivastava Amit , Thompson Claudette M. , Seid Robert , Look Jee , Alderson Mark , Tate Andrea , Maisonneuve Jean-François , Robertson George , Anderson Porter W. , Malley Richard 
Published: April 2010

ABSTRACT

We previously reported that ethanol-killed cells of a noncapsulated strain of
Streptococcus pneumoniae
, given intranasally with cholera toxin as an adjuvant, protect rats against pneumonia and mice against colonization of the nasopharynx and middle ear by capsulated pneumococci of various serotypes. The acceleration of pneumococcal clearance from the nasopharynx in mice is CD4
+
T cell-dependent and interleukin 17A (IL-17A) mediated and can be antibody independent. Here, anticipating human studies, we have demonstrated protection with a new vaccine strain expressing a nonhemolytic derivative of pneumolysin and grown in bovine-free culture medium. Killing the cells with chloroform, trichloroethylene, or beta-propiolactone—all used without postinactivation washing—produced more-potent immunogens than ethanol, and retention of soluble components released from the cells contributed to protection. Two sequential intranasal administrations of as little as 1 μg of protein (total of cellular and soluble combined) protected mice against nasopharyngeal challenge with pneumococci. Nontoxic single and double mutants of
Escherichia coli
heat-labile toxin were effective as mucosal adjuvants. Protection was induced by the sublingual and buccal routes, albeit requiring larger doses than when given intranasally. Protection was likewise induced transdermally with sonicates of the killed-cell preparation. Thus, this whole-cell antigen can be made and administered in a variety of ways to suit the manufacturer and the vaccination program and is potentially a solution to the need for a low-cost vaccine to reduce the burden of childhood pneumococcal disease in low-income countries.
Evaluation of the Bio-Rad BioPlex 2200 Syphilis Multiplex Flow Immunoassay for the Detection of IgM- and IgG-Class Antitreponemal Antibodies
Authors: Gomez E. , Jespersen D. J. , Harring J. A. , Binnicker M. J. 
Published: April 2010

ABSTRACT

The laboratory diagnosis of syphilis is based primarily upon serologic findings. Historically, serologic testing for syphilis has relied on assays such as rapid plasma reagin, fluorescent treponemal antibody absorption,
Treponema pallidum
particle agglutination (TP-PA), and more recently, enzyme immunoassay (EIA). In this study, we evaluated the performance of a novel multiplex flow immunoassay (BioPlex 2200 Syphilis; Bio-Rad Laboratories, Hercules, CA) for the detection of antitreponemal IgG- and IgM-class antibodies. Serum specimens (
n
= 1,008) submitted for routine treponema-specific antibody testing by syphilis IgM and IgG EIA (Trep-Chek; Phoenix-Biotech, Mississauga, Ontario, Canada) were also analyzed by the BioPlex Syphilis multiplex assay. Specimens showing discordant results were repeat tested, with further discrepancies being arbitrated by TP-PA. Compared directly to the results of EIA, the BioPlex IgG assay demonstrated 98.7% (77/78) sensitivity and 99.4% (916/930) specificity. Compared to the Trep-Chek IgM EIA, the BioPlex IgM assay showed 80% (4/5) sensitivity and 97.9% (652/666) specificity. These results indicate that the BioPlex Syphilis multiplex assay shows similar serological agreement with EIA while allowing for a fully automated random-access platform that provides faster (1.7 h for 100 samples versus 4.5 h by EIA) and higher-throughput (800 samples per 9 h versus 200 samples by EIA) analysis of the syphilis serologic response.
A Low-Molecular-Weight Entry Inhibitor of both CCR5- and CXCR4-Tropic Strains of Human Immunodeficiency Virus Type 1 Targets a Novel Site on gp41
Authors: Murray Edward J. , Leaman Daniel P. , Pawa Nishant , Perkins Hannah , Pickford Chris , Perros Manos , Zwick Michael B. , Butler Scott L. 
Published: April 2010

ABSTRACT

A low-molecular-weight human immunodeficiency virus type 1 (HIV-1) inhibitor, PF-68742 (molecular weight, 573), has been identified in a high-throughput screen for compounds that block HIV-1 envelope glycoprotein (Env)-mediated fusion. The compound is shown to be potent against R5 and X4 isolates in both cell-cell fusion and antiviral assays (50% effective concentrations of ∼0.1 to 1 μM). Postfusion and HIV-1 pseudotyping control experiments confirm that PF-68742 is an entry inhibitor with Env as the specific target for antiviral action. PF-68742 was not able to block binding of monomeric gp120 to soluble CD4 or the binding of gp120:CD4 complexes to cell-associated CCR5, thus distinguishing PF-68742 from described gp120 antagonists and coreceptor binders. Escape variants of HIV-1
NL4-3
were selected, and all resistant viruses were found to contain a common G514R (HxB2 numbering) mutation in Env, located proximal to the furin cleavage site in the fusion peptide of gp41. When introduced into wild-type NL4-3 gp41, G514R conferred resistance to PF-68742. Resistance via G514R is shown to be associated with enhancement of virion infectivity by PF-68742 that may result from altered properties of inhibitor-bound Env, rather than from a loss of compound binding. Wild-type viruses and those with substitutions in the disulfide loop (DSL) region of gp41 were also examined for PF-68742 sensitivity. Here, complete resistance to PF-68742 was found to occur through changes outside of position 514, including in the gp41 DSL region. The results highlight PF-68742 as a starting point for novel therapies against HIV-1 and provide new insights into models of Env-mediated fusion.