bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe statin‐induced rhabdomyolysis mimicking Guillain–Barré syndrome in four patients with diabetes mellitus treated with fusidic acid
Authors: Collidge T. A. , Razvi S. , Nolan C. , Whittle M. , Stirling C. , Russell A. J. C. , Mann A. C. , Deighan C. J. 
Published: February 2010

Diabet. Med. 27, 696–700 (2010)AbstractBackground  An interaction between fusidic acid and HMG coenzyme A reductase inhibitors (statins), resulting in rhabdomyolysis, has been described. Pain and mild weakness are common presenting symptoms.Case report  We report four patients with Type 2 diabetes prescribed long‐term statin treatment who, following treatment with fusidic acid, presented atypically with painless, severe flaccid paralysis suggestive of Guillain–Barré syndrome. This, together with nerve conduction studies consistent with Guillain–Barré syndrome, resulted in the delayed recognition of rhabdomyolysis in these cases.Conclusions  The addition of fusidic acid can precipitate rhabdomyolysis in patients with diabetes already taking a statin. This can present with rapidly progressive weakness resembling Guillain–Barré syndrome. We recommend that creatine kinase is checked in patients with diabetes on statin therapy who present with profound weakness and routinely in those commenced on prolonged courses of fusidic acid.
Prevalence and nature of anaemia in a prospective, population‐based sample of people with diabetes: Teesside anaemia in diabetes (TAD) study
Authors: Jones S. C. , Smith D. , Nag S. , Bilous M. T. , Winship S. , Wood A. , Bilous R. W. 
Published: February 2010

Diabet. Med. 27, 655–659 (2010)AbstractAims  Anaemia occurs in 25% of people attending hospital diabetes clinics, but this may not be representative of all people with diabetes. We aimed to determine the prevalence of anaemia in a prospective population‐based sample stratified by estimated glomerular filtration rate (eGFR) using the 4‐point Modification of Diet in Renal Disease (MDRD) formula.Methods  All 7331 patients on our district register were stratified by eGFR. Seven hundred and thirty were approached by letter on two occasions. Two hundred and thirty‐four (32%) returned questionnaires and blood samples. Responders (R), non‐responders (NR) and the whole cohort (C) were similar: mean ± sd age R 61.7 ± 12.7 years; NR 61.3 ± 15.1 years; C 61.8 ± 14.2 years; diabetes duration R 8.8 ± 8.6 years; NR 8.2 ± 7.9 years; C 7.5 ± 7.8 years, Type 1 diabetes R 10.1%, NR 10.8%, C 9.4%. Anaemia was defined using World Health Organization criteria: haemoglobin < 13 g/dl for men, < 12 g/dl for women.Results  Previously undiagnosed anaemia was present in 15% of the whole group, 36% with eGFR < 60 ml/min per 1.73 m2 and 9% of those with eGFR > 60 ml/min per 1.73 m2. Anaemia was as a result of erythropoietin deficiency in 34%, abnormal haematinics in 40% and was unexplained in 26% of patients. Five per cent of the patients had anaemia below the treatment threshold of 11 g/dl.Conclusions  The prevalence of unrecognized anaemia in population‐based cohorts is lower than that in hospital‐based studies. Current clinical surveillance in the UK is failing to detect anaemia in stage 3–5 chronic kidney disease (eGFR < 60 ml/min per 1.73 m2) and current guidelines will not detect 9% of diabetic patients with anaemia and an eGFR > 60 ml/min per 1.73 m2.
A systematic review of scoring systems for diabetic foot ulcers
Authors: Karthikesalingam A. , Holt P. J. E. , Moxey P. , Jones K. G. , Thompson M. M. , Hinchliffe R. J. 
Published: February 2010

Diabet. Med. 27, 544–549 (2010)AbstractAims  Foot ulcers are a common and important complication of diabetes. Variation in the clinical presentation of this disease has resulted in a paucity of evidence from comparable studies to guide optimal clinical management. A validated scoring system might help clinicians and researchers in everyday assessment and management of patients or the development and assessment of new therapies. The aim of the present review was to critically appraise the published literature of wound scoring systems for diabetic foot ulcers.Methods  An electronic search was performed using the EMBASE and MEDLINE databases from 1966 until 2009 for scoring systems for diabetic foot ulcers. The literature review conformed to PRISMA statement standards.Results  The literature search identified 197 articles, of which 180 were excluded. Eleven scoring systems and six validation or comparative studies are described.Conclusions  Many scoring systems exist for classification of the diabetic foot, few of which have been validated. Detailed scoring systems offer a valuable method for the comparison of data from different diabetic foot centres. Simplistic scoring systems may be used in clinical practice and the choice of scoring system should be determined by the population under study.
Safety and tolerability of high doses of taspoglutide, a once‐weekly human GLP‐1 analogue, in diabetic patients treated with metformin: a randomized double‐blind placebo‐controlled study1,2
Authors: Ratner R. , Nauck M. , Kapitza C. , Asnaghi V. , Boldrin M. , Balena R. 
Published: February 2010

Diabet. Med. 27, 556–562 (2010)AbstractAims  The study objective was to investigate the safety and tolerability of up‐titration to high doses of taspoglutide, a once‐weekly human glucagon‐like peptide‐1 analogue, in subjects with Type 2 diabetes inadequately controlled on metformin alone.Methods  In this double‐blind phase II trial, subjects were randomized to placebo or taspoglutide (20 mg; three separate groups) administered once weekly by subcutaneous injection for 4 weeks. This was followed by dose maintenance at 20 mg, or titration to 30 mg (20/30) or 40 mg (20/40) once weekly with matched placebo for an additional 4 weeks. Subjects were monitored for adverse events (AEs) throughout the study and 4‐week follow‐up.Results  One hundred and twenty‐nine subjects were randomized and treated [mean age 57 years, mean baseline glycated haemoglobin (HbA1c), 7.9%]. The most frequently reported AEs were nausea and vomiting. The number of patients reporting gastrointestinal AEs did not increase following titration to higher doses of taspoglutide or when continuing the initial 20 mg regimen. Three subjects were withdrawn from the study as a result of gastrointestinal AEs (one before and two after titration to higher doses). Although not designed to investigate efficacy, improvement in glycaemic control was observed in all active arms of the study. The proportion of subjects achieving HbA1c < 7.0% after 8 weeks of treatment was 72, 53 and 70% in the 20/20‐, 20/30‐ and 20/40‐mg arms, respectively, vs. 19% for placebo.Conclusions  Taspoglutide was safe, well tolerated at high doses and efficacious for lowering HbA1c. Up‐titration of dose was not associated with a worsening AE profile.
National Support for Film Production in the EU: An Analysis of the Commission Decision‐Making Practice
Authors: Bellucci Lucia 
Published: February 2010

AbstractThis article deals with the cultural welfare concerning cinema, a medium capable of both painting and shaping society. It aims to investigate the impact of the European integration on national film promotional law, by studying the European Commission decision‐making practice in the field of State aid to cinematographic works. The analysis shows that this practice can be understood in two main phases that are delineated by the adoption of specific criteria. These criteria are explored by highlighting the most elucidating cases. Furthermore, this analysis discloses two relevant conflicts: within the Commission itself and between the Commission and the Member States. Particular emphasis is placed on the latter, which is explored with regard to: the European national film agencies' polarisation of the conflict, the main form of dispute settlement adopted by the Commission, and the legal obligations imposed by Member States upon TV broadcasters to invest in audiovisual1 production. The analysis ends with an evaluation of the above‐mentioned impact and a few remarks on some unresolved issues related to the conflict between the Commission and the Member States.
Functional specialization and ontogenetic scaling of limb anatomy in Alligator mississippiensis
Authors: Allen Vivian , Elsey Ruth M. , Jones Nicola , Wright Jordon , Hutchinson John R. 
Published: February 2010

AbstractCrocodylians exhibit a fascinating diversity of terrestrial gaits and limb motions that remain poorly described and are of great importance to understanding their natural history and evolution. Their musculoskeletal anatomy is pivotal to this diversity and yet only qualitative studies of muscle‐tendon unit anatomy exist. The relative masses and internal architecture (fascicle lengths and physiological cross‐sectional areas) of muscles of the pectoral and pelvic limbs of American alligators (Alligator mississippiensis Daudin 1801) were recorded for an ontogenetic series of wild specimens (n = 15, body masses from 0.5 to 60 kg). The data were analysed by reduced major axis regression to determine scaling relationships with body mass. Physiological cross‐sectional areas and therefore muscle force‐generating capacity were found to be greater in the extensor (anti‐gravity) muscles of the pelvic limb than in the pectoral limb, reflecting how crocodylians differ from mammals in having greater loading of the hindlimbs than the forelimbs. Muscle masses and architecture were generally found to scale isometrically with body mass, suggesting an ontogenetic decrease in terrestrial athleticism. This concurs with the findings of previous studies showing ontogenetic decreases in limb bone length and the general scaling principle of a decline of strength : weight ratios with increasing size in animals. Exceptions to isometric scaling found included positive allometry in fascicle length for extensor musculature of both limbs, suggesting an ontogenetic increase in working range interpreted as increasing postural variability – in particular the major hip extensors – the interpretation of which is complicated by previous described ontogenetic increase of moment arms for these muscles.
The elastic network of articular cartilage: an immunohistochemical study of elastin fibres and microfibrils
Authors: Yu Jing , Urban Jill P. G. 
Published: February 2010

AbstractThe elastic network of articular cartilage was investigated by immunohistochemistry using specific antibodies to elastin and fibrillin‐1. Articular cartilage was dissected from defined regions of bovine metacarpophalangeal joints. Elastin fibres and microfibrils were dual‐immunostained by labelling with distinct fluorescent dyes. A conventional fluorescence microscope combined with a polarized light filter was used to study the organization and degree of colocalization of elastin fibres, microfibrils and of the collagen network. We observed an elaborately organized elastic network. In the uppermost superficial zone, where few cells were present, elastin fibres and microfibrils formed a dense three dimensional network showing some degree of colocalization. The thickness and organization of this elastic network varied dramatically from region to region and was most extensive in the metacarpal palmar region. In the middle and deep zones, very few elastin fibres were observed but microfibrils formed a network in the inter‐territorial matrix and dense network around the cells. Our finding of a three dimensional network of dense, well organized elastin fibres and microfibrils in the surface zone of the articular cartilage matrix, and a dense network of microfibrils around the cells deeper into the tissue suggests the elastic network could play both a mechanical and a biological role in articular cartilage.
Predictors of cerebral palsy in very preterm infants: the EPIPAGE prospective population‐based cohort study
Authors: BEAINO GHADA , KHOSHNOOD BABAK , KAMINSKI MONIQUE , PIERRAT VÉRONIQUE , MARRET STÉPHANE , MATIS JACQUELINE , LEDÉSERT BERNARD , THIRIEZ GÉRARD , FRESSON JEANNE , ROZÉ JEAN‐CHRISTOPHE , ZUPAN‐SIMUNEK VÉRONIQUE , ARNAUD CATHERINE , BURGUET ANTOINE , LARROQUE BÉATRICE , BRÉART GÉRARD , ANCEL PIERRE‐YVES ,   for the EPIPAGE Study Group
Published: February 2010

Aim  The aim of this study was to assess the independent role of cerebral lesions on ultrasound scan, and several other neonatal and obstetric factors, as potential predictors of cerebral palsy (CP) in a large population‐based cohort of very preterm infants.Method  As part of EPIPAGE, a population‐based prospective cohort study, perinatal data and outcome at 5 years of age were recorded for 1812 infants born before 33 weeks of gestation in nine regions of France in 1997.Results  The study group comprised 942 males (52%) and 870 females with a mean gestational age of 30 weeks (SD 2wks; range 24–32wks) and a mean birthweight of 1367g (SD 393g; range 450–2645g). CP was diagnosed at 5 years of age in 159 infants (prevalence 9%; 95% confidence interval [CI] 7–10%), 97 males and 62 females, with a mean gestational age of 29 weeks (SD 2wks; range 24–32wks) and a mean birthweight of 1305g (SD 386g; range 500–2480g). Among this group, 67% walked without aid, 14% walked with aid, and 19% were unable to walk. Spastic, ataxic, and dyskinetic CP accounted for 89%, 7%, and 4% of cases respectively. The prevalence of CP was 61% among infants with cystic periventricular leukomalacia, 50% in infants with intraparenchymal haemorrhage, 8% in infants with grade I intraventricular haemorrhage, and 4% in infants without a detectable cerebral lesion. After controlling for cerebral lesions and obstetric and neonatal factors, only male sex (odds ratio [OR] 1.52; 95% CI 1.03–2.25) and preterm premature rupture of membranes or preterm labour (OR 1.72; 95% CI 0.95–3.14) were predictors of the development of CP in very preterm infants.Interpretation  Cerebral lesions were the most important predictor of CP in very preterm infants. In addition, infant sex and preterm premature rupture of membranes or preterm labour were also independent predictors of CP.
Influenza A/H1N1 (2009) infection in pregnancy—an Asian perspective
Authors: Lim ML , Chong CY , Tee WSN , Lim WY , Chee JJ 
Published: February 2010

Please cite this paper as: Lim M, Chong C, Tee W, Lim W, Chee J. Influenza A/H1N1 (2009) infection in pregnancy—an Asian perspective. BJOG 2010;117:551–556.Objective  To describe the characteristics of an obstetric population with influenza A/H1N1 (2009) infection, with a focus on the need for hospitalisation and complications.Design  Cohort study.Setting  Tertiary referral centre.Population  Two hundred and eleven pregnant women with influenza A/H1N1 (2009) infection diagnosed by nasopharyngeal swab polymerase chain reaction (PCR).Methods  Obstetric patients presenting to our centre were recruited and followed up. Data collected included demographic and clinical information.Main outcome measures  H1N1 and pregnancy complications, and hospitalisation needs.Results  The median age of the cohort was 29.0 years (range 16–42 years), the median gestation at referral was 23.0 weeks (range 4–38 weeks), the median time interval between illness onset and presentation was 2.0 days (range 1–7 days), and the median time interval between illness onset and commencement of oseltamivir was 2.0 days (range 1–11 days). Hospital admission was significantly associated with the presence of co‐morbidity (OR 4.14, 95% CI 1.82–9.37, P = 0.0001), breathlessness (OR 5.2, 95% CI 2.19–12.41, P = 0.0003) and sore throat (OR 0.35, 95% CI 0.16–0.73, P = 0.005). There were two cases of pneumonia complicating H1N1 infection, but no mortality. Nine cases developed pregnancy complications. All women recovered.Conclusions  The need for hospitalisation was significantly associated with breathlessness and co‐morbidity. There was minimal morbidity and no mortality observed. We attribute this to early presentation, diagnosis and treatment.
A structural basis for the inhibition of collagen‐stimulated platelet function by quercetin and structurally related flavonoids
Authors: Wright Bernice , Moraes Leonardo A , Kemp Charles F , Mullen William , Crozier Alan , Lovegrove Julie A , Gibbins Jonathan M 
Published: February 2010

Background and purpose: Molecular mechanisms underlying the links between dietary intake of flavonoids and reduced cardiovascular disease risk are only partially understood. Key events in the pathogenesis of cardiovascular disease, particularly thrombosis, are inhibited by these polyphenolic compounds via mechanisms such as inhibition of platelet activation and associated signal transduction, attenuation of generation of reactive oxygen species, enhancement of nitric oxide production and binding to thromboxane A2receptors.In vivo, effects of flavonoids are mediated by their metabolites, but the effects and modes of action of these compounds are not well‐characterized. A good understanding of flavonoid structure–activity relationships with regard to platelet function is also lacking.Experimental approach: Inhibitory potencies of structurally distinct flavonoids (quercetin, apigenin and catechin) and plasma metabolites (tamarixetin, quercetin‐3′‐sulphate and quercetin‐3‐glucuronide) for collagen‐stimulated platelet aggregation and 5‐hydroxytryptamine secretion were measured in human platelets. Tyrosine phosphorylation of total protein, Syk and PLCγ2 (immunoprecipitation and Western blot analyses), and Fyn kinase activity were also measured in platelets. Internalization of flavonoids and metabolites in a megakaryocytic cell line (MEG‐01 cells) was studied by fluorescence confocal microscopy.Key results: The inhibitory mechanisms of these compounds included blocking Fyn kinase activity and the tyrosine phosphorylation of Syk and PLCγ2 following internalization. Principal functional groups attributed to potent inhibition were a planar, C‐4 carbonyl substituted and C‐3 hydroxylated C ring in addition to a B ring catechol moiety.Conclusions and implications: The structure–activity relationship for flavonoids on platelet function presented here may be exploited to design selective inhibitors of cell signalling.
Six‐ and 9‐Month‐Old Infants Discriminate Between Goals Despite Similar Action Patterns
Authors: Marsh Heidi L. , Stavropoulos Jennifer , Nienhuis Tom , Legerstee Maria 
Published: February 2010

Behne, Carpenter, Call, and Tomasello (2005) showed that 9‐ to 18‐month‐olds, but not 6‐month‐olds, differentiated between people who were unwilling and unable to share toys. As the outcome of the two tasks is the same (i.e., the toy is not shared), the infants must respond to the different goals of the actor. However, visual habituation paradigms have shown an earlier onset of goal awareness. The present study reconciles this disparity by replicating the findings of Behne et al. with both 6‐ and 9‐month‐olds, using similar tasks and additional response measures.
Similarity and Rules United: Similarity‐ and Rule‐Based Processing in a Single Neural Network
Authors: Verguts Tom , Fias Wim 
Published: February 2010

AbstractA central controversy in cognitive science concerns the roles of rules versus similarity. To gain some leverage on this problem, we propose that rule‐ versus similarity‐based processes can be characterized as extremes in a multidimensional space that is composed of at least two dimensions: the number of features (Pothos, 2005) and the physical presence of features. The transition of similarity‐ to rule‐based processing is conceptualized as a transition in this space. To illustrate this, we show how a neural network model uses input features (and in this sense produces similarity‐based responses) when it has a low learning rate or in the early phases of training, but it switches to using self‐generated, more abstract features (and in this sense produces rule‐based responses) when it has a higher learning rate or is in the later phases of training. Relations with categorization and the psychology of learning are pointed out.
Fishing for the Right Words: Decision Rules for Human Foraging Behavior in Internal Search Tasks
Authors: Wilke Andreas , Hutchinson John M. C. , Todd Peter M. , Czienskowski Uwe 
Published: February 2010

AbstractAnimals depleting one patch of resources must decide when to leave and switch to a fresh patch. Foraging theory has predicted various decision mechanisms; which is best depends on environmental variation in patch quality. Previously we tested whether these mechanisms underlie human decision making when foraging for external resources; here we test whether humans behave similarly in a cognitive task seeking internally generated solutions. Subjects searched for meaningful words made from random letter sequences, and as their success rate declined, they could opt to switch to a fresh sequence. As in the external foraging context, time since the previous success and the interval preceding it had a major influence on when subjects switched. Subjects also used the commonness of sequence letters as a proximal cue to patch quality that influenced when to switch. Contrary to optimality predictions, switching decisions were independent of whether sequences differed little or widely in quality.
The Robert Wood Johnson Foundation Clinical Scholars Program and Emergency Medicine
Authors: Landman Adam , Meisel Zachary F. 
Published: February 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:1–6 © 2010 by the Society for Academic Emergency MedicineAbstractSpecialized research training for emergency physicians (EPs) may strengthen overall patient care through the development and improvement of clinical evidence in emergency care. One way an increasing number of emergency physicians have acquired these skills is through the Robert Wood Johnson Foundation Clinical Scholars Program (CSP), a 2‐year fellowship that trains physicians to be leaders in improving health care. In addition to providing training in health policy and health services research, the CSP emphasizes the translation of research into action through leadership training, program development, and community‐based participatory research. This article provides an in‐depth look at the CSP and its impact on emergency medicine (EM). To date, 41 EPs have trained through the program, with increasing numbers in recent years. Graduates have gone on to become leaders in academia, public health, private industry, and foundations. Past and present EM‐trained Clinical Scholars are working to find creative solutions for the challenges posed by the U.S. health care system and improve the delivery of emergency care. Emergency physicians who wish to conduct research or work with communities, organizations, practitioners, and policy‐makers to address issues essential to the health and well‐being of all Americans should consider the Robert Wood Johnson Foundation CSP.