bluuebunny/crossref_metadata_2025_split huggingface dataset:
No Association between Intraoperative Hypothermia or Supplemental Protective Drug and Neurologic Outcomes in Patients Undergoing Temporary Clipping during Cerebral Aneurysm Surgery
Authors: Hindman Bradley J. , Bayman Emine O. , Pfisterer Wolfgang K. , Torner James C. , Todd Michael M. 
Published: December 2009

Background
Although hypothermia and barbiturates improve neurologic outcomes in animal temporary focal ischemia models, the clinical efficacy of these interventions during temporary occlusion of the cerebral vasculature during intracranial aneurysm surgery (temporary clipping) is not established.

Methods
A post hoc analysis of patients from the Intraoperative Hypothermia for Aneurysm Surgery Trial who underwent temporary clipping was performed. Univariate and multivariate logistic regression methods were used to test for associations between hypothermia, supplemental protective drug, and short- (24-h) and long-term (3-month) neurologic outcomes. An odds ratio more than 1 denotes better outcome.

Results
Patients undergoing temporary clipping (n = 441) were assigned to intraoperative hypothermia (33.3 degrees +/- 0.8 degrees C, n = 208) or normothermia (36.7 degrees +/- 0.5 degrees C, n = 233), with 178 patients also receiving supplemental protective drug (thiopental or etomidate) during temporary clipping. Three months after surgery, 278 patients (63%) had good outcome (Glasgow Outcome Score = 1). Neither hypothermia (P = 0.847; odds ratio = 1.043, 95% CI = 0.678-1.606) nor supplemental protective drug (P = 0.835; odds ratio = 1.048, 95% CI = 0.674-1.631) were associated with 3-month Glasgow Outcome Score. The effect of supplemental protective drug did not significantly vary with temperature. The effects of hypothermia and protective drug did not significantly vary with temporary clip duration. Similar findings were made for 24-h neurologic status and 3-month Neuropsychological Composite Score.

Conclusion
In the Intraoperative Hypothermia for Aneurysm Surgery Trial, neither systemic hypothermia nor supplemental protective drug affected short- or long-term neurologic outcomes of patients undergoing temporary clipping.
Predicting Success on the Certification Examinations of the American Board of Anesthesiology
Authors: McClintock Joseph C. , Gravlee Glenn P. 
Published: December 2009

Background
Currently, residency programs lack objective predictors for passing the sequenced American Board of Anesthesiology (ABA) certification examinations on the first attempt. Our hypothesis was that performance on the ABA/American Society of Anesthesiologists In-Training Examination (ITE) and other variables can predict combined success on the ABA Part 1 and Part 2 examinations.

Method
The authors studied 2,458 subjects who took the ITE immediately after completing the first year of clinical anesthesia training and took the ABA Part 1 examination for primary certification immediately after completing residency training 2 yr later. ITE scores and other variables were used to predict which residents would complete the certification process (passing the ABA Part 1 and Part 2 examinations) in the shortest possible time after graduation.

Results
ITE scores alone accounted for most of the explained variation in the desired outcome of certification in the shortest possible time. In addition, almost half of the observed variation and most of the explained variance in ABA Part 1 scores was accounted for by ITE scores. A combined model using ITE scores, residency program accreditation cycle length, country of medical school, and gender best predicted which residents would complete the certification examinations in the shortest possible time.

Conclusions
The principal implication of this study is that higher ABA/ American Society of Anesthesiologists ITE scores taken at the end of the first clinical anesthesia year serve as a significant and moderately strong predictor of high performance on the ABA Part 1 (written) examination, and a significant predictor of success in completing both the Part 1 and Part 2 examinations within the calendar year after the year of graduation from residency. Future studies may identify other predictors, and it would be helpful to identify factors that predict clinical performance as well.
Defining DIOS and Constipation in Cystic Fibrosis With a Multicentre Study on the Incidence, Characteristics, and Treatment of DIOS
Authors: Houwen Roderick H , van der Doef Hubert P , Sermet Isabelle , Munck Anne , Hauser Bruno , Walkowiak Jaroslaw , Robberecht Eddy , Colombo Carla , Sinaasappel Maarten , Wilschanski Michael ,   ESPGHAN Cystic Fibrosis Working Group
Published: December 2009

ABSTRACTObjectives:Various definitions for distal intestinal obstruction syndrome (DIOS), meconium ileus equivalent, and constipation in patients with cystic fibrosis (CF) are used. However, an unequivocal definition for DIOS, meconium ileus equivalent, and constipation is preferred. The aims of this study were, therefore, to seek consensus on the definitions for DIOS and constipation in patients with CF and to determine the incidence, characteristics, and treatment of DIOS in a cohort of paediatric patients with CF.Methods:During the 2005 European Society for Paediatric Gastroenterology, Hepatology, and Nutrition meeting in Porto a group of paediatric gastroenterologists discussed the definition of DIOS and constipation in CF. Subsequently, all patients younger than or equal to 18 years with complete DIOS according to the definition agreed upon and diagnosed during the years 2001 to 2005 in 8 CF centres were studied.Results:Distal intestinal obstruction syndrome was defined as an acute complete or incomplete faecal obstruction in the ileocaecum, whereas constipation was defined as gradual faecal impaction of the total colon. Fifty‐one episodes of DIOS in 39 patients were recorded, giving an overall incidence of 6.2 (95% confidence interval, 4.4–7.9) episodes per 1000 patient‐years. Of the 39 patients with DIOS, 20% experienced a relapse, 92% were pancreatic insufficient, 44% had a history of meconium ileus at birth, and 82% had a severe genotype. Conservative treatment was effective in 49 of 51 DIOS episodes (96%).Conclusions:The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition CF Working Group definitions of DIOS and constipation in CF are specific and make a clear distinction between these 2 entities. The incidence of DIOS in the present study was considerably higher than reported previously.
Conceptualization and Treatment of Chronic Abdominal Pain in Pediatric Gastroenterology Practice
Authors: Schurman Jennifer V , Hunter Heather L , Friesen Craig A 
Published: December 2009

ABSTRACTObjectives:The aim of this study was to examine how children with abdominal pain presently are viewed, assessed, and treated by pediatric gastroenterologists across North America, as well as how perspectives have changed since initial release of the Rome criteria for functional gastrointestinal disorders approximately 15 years ago.Patients and Methods:One hundred seventy‐four full members of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition completed a pediatric gastroenterology practice survey designed by the authors in 2006. The responses were examined for practice patterns and specific knowledge/use of the Rome criteria. The responses were also compared with historical data from 151 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition members who completed a similar survey in 1992.Results:There were few changes in the evaluation, treatment, or outcomes for children with abdominal pain for the past 15 years. Knowledge of the Rome criteria was common, but use in practice was not; several specific problems with the criteria were identified. A mismatch also appeared between belief in the importance of psychological factors in the creation/maintenance of pediatric abdominal pain and integration of these factors as part of standard evaluation and treatment. Finally, controversy emerged regarding both the term “functional” and the importance of histologic inflammation in the pathophysiology of pediatric abdominal pain.Conclusions:The evolution and dissemination of the Rome criteria for the past 15 years have not substantially changed evaluation or treatment practices for children with abdominal pain. Many areas of inconsistency and controversy remain. More focused research is needed to better understand this common pain condition and to establish an effective treatment program that can be disseminated across practitioners.
Variable Clinical Spectrum of the Most Common Inborn Error of Bile Acid Metabolism—3β‐hydroxy‐Δ5‐C27‐steroid Dehydrogenase Deficiency
Authors: Subramaniam Pushpa , Clayton Peter T , Portmann Bernard C , Mieli‐Vergani Giorgina , Hadžić Nedim 
Published: December 2009

ABSTRACTObjective:We studied the clinical features of children with 3β‐hydroxy‐Δ5‐C27‐steroid dehydrogenase (3β‐HSDH) deficiency presenting to King's College and Great Ormond Street hospitals between 1989 and 2005. The diagnosis was made biochemically by detection of sulphated dihydroxycholenoic acids and trihydroxycholenoic acids in urine by fast atom bombardment mass spectrometry or electrospray ionisation tandem mass spectrophotometry and a plasma bile acid profile showing absent or low cholic and chenodeoxycholic acid levels and high concentrations of 3β‐7α‐dihydroxy‐5‐cholenoic acid and 3β‐7α‐12α‐trihydroxy‐5‐cholenoic acid.Results:Eighteen children (12 male) with 3β‐HSDH deficiency were identified and diagnosed at a median age of 1.35 years (range 8 weeks–11 years). The presenting features included neonatal cholestasis (n = 11), rickets (n = 8, 1 of whom also had hypocalcaemic tetany, seizures, and normal liver biochemical markers), hepatomegaly (n = 7), pruritus (n = 3), and steatorrhoea and failure to thrive (n = 3). Ten children had low serum 25‐OH vitamin D levels, of whom 8 also had low vitamin E and 6 had low vitamin A serum levels. Liver histology showed giant cell change and hepatocyte disarray in all with added features of cholestasis in 11, bridging fibrosis in 6, micronodular cirrhosis in 1, fatty change in 1, and active lobular and portal inflammation in 1. Five patients were treated with cholic acid and chenodeoxycholic acid (7 mg · kg−1 · day−1 of each), 7 with chenodeoxycholic acid only (7–18 mg · kg−1 · day−1), and 1 with cholic acid (8 mg · kg−1 · day−1) only. Repeated liver biopsies performed in 4 patients 6 months after starting replacement therapy showed improved histological changes. Three children died untreated before 5 years of age. After a median follow‐up of 5.5 years (range 1–17 years) 12 out of 13 treated children have no clinical signs of liver disease or of fat‐soluble vitamin deficiency.Conclusions:3β‐HSDH deficiency is a rare inborn error of metabolism with diverse clinical features. Early replacement treatment leads to clinical and biochemical control and prevents chronic liver and bone disease, at least in the medium term.
Studies of the Kinetic Mechanism of Maize Endosperm ADP-Glucose Pyrophosphorylase Uncovered Complex Regulatory Properties
Authors: Boehlein Susan K. , Shaw Janine R. , Stewart Jon D. , Hannah L. Curtis 
Published: December 2009

Abstract
ADP-glucose pyrophosphorylase catalyzes the synthesis of ADP-glucose (ADP-Glc) from Glc-1-phosphate (G-1-P) and ATP. Kinetic studies were performed to define the nature of the reaction, both in the presence and absence of allosteric effector molecules. When 3-phosphoglycerate (3-PGA), the putative physiological activator, was present at a saturating level, initial velocity studies were consistent with a Theorell-Chance BiBi mechanism and product inhibition data supported sequential binding of ATP and G-1-P, followed by ordered release of pyrophosphate and ADP-Glc. A sequential mechanism was also followed when 3-PGA was absent, but product inhibition patterns changed dramatically. In the presence of 3-PGA, ADP-Glc is a competitive inhibitor with respect to ATP. In the absence of 3-PGA—with or without 5.0 mm inorganic phosphate—ADP-Glc actually stimulated catalytic activity, acting as a feedback product activator. By contrast, the other product, pyrophosphate, is a potent inhibitor in the absence of 3-PGA. In the presence of subsaturating levels of allosteric effectors, G-1-P serves not only as a substrate but also as an activator. Finally, in the absence of 3-PGA, inorganic phosphate, a classic inhibitor or antiactivator of the enzyme, stimulates enzyme activity at low substrate by lowering the K M values for both substrates.
What is associated with low food intake in older people with dementia?
Authors: Lin Li‐Chan , Watson Roger , Wu Shiao‐Chi 
Published: December 2009

Aims.  The aim of this study was to investigate the risk factors of institutionalised older people for developing low food intake.Background.  Eating difficulties among patients with dementia have been identified in western society and typically progress as dementia advances. Findings from previous studies reflect that low food intake or weight loss might not be a consequence of people with dementia being unable or unwilling to eat independently.Design.  The study consisted of observers’ training and mealtime observations. Each data collector received two days of didactic and clinical training. Observation was done for two days during lunch and dinner.Methods.  Four hundred seventy‐seven participants were selected from residents with dementia at nine dementia special care units in licensed long‐term care facilities in northern and central Taiwan. Data were collected using the Barthel index, Mini‐Mental State Examination (MMSE), and the Edinburgh Feeding Evaluation in Dementia (EdFED) scale.Results.  The prevalence of low food intake at meals in residents with dementia in LTCF’s was 30·7%. Eating difficulty, no feeding assistance, moderate dependence, fewer family visits, being female and older, were six independent factors associated with low food intake after controlling for all other factors.Conclusion.  Nursing staff need to assess residents’ feeding ability to continue to self‐feed. Also, to supervise the feeding of residents with moderate dependency and provide appropriate verbal or physical assistance at meal times is recommended.Relevance to clinical practice.  Constructing strategies to encourage families to visit their older relatives in institutions is recommended.
Relationships between nurse care‐giving behaviours and preterm infant responses during bathing: a preliminary study
Authors: Liaw Jen‐Jiuan , Yang Luke , Chou Hsiu‐Ling , Yang Meei‐Horng , Chao Shih‐Ching 
Published: December 2009

Aims. The purpose of this study was to explore the relationships between specific nurse care‐giving behaviours and preterm infant behavioural responses during bathing and to identify nurse behaviours associated with infant ‘stress’.Background. Although recent advances in medical technology have improved neonatal intensive care, the high mortality and morbidity rates in preterm infants have not decreased proportionally. As caregivers strive to reduce infant mortality and morbidity, a factor for consideration is which caregiver behaviours are associated with preterm infant well‐being.Design. A descriptive correlational design.Method. Convenience samples of 24 preterm infants and 12 nurses were recruited. A total of 120 baths were videotaped. Infant and nurse behaviours were measured using the coding schemes developed by the researchers. Pearson coefficient correlation, non‐parametric Kruskal–Wallis test,t‐test and generalised linear models were methods for data analysis.Results. As nurses provided more support, stress was reduced in the infants, and their self‐regulation during the bath was enhanced especially by the use of ‘containment’ and ‘positional support’. Conversely, non‐therapeutic caregiver behaviours including ‘rapid and rough handling’ of the baby, ‘chatting with other people’ and ‘inappropriate handling’ increased infant ‘stress’ during the bath.Conclusion. The findings provide new information about the link between care‐giving and infant responses and how caregivers can better interact with preterm infants during a very sensitive period of brain development.Relevance to clinical practice. How nurses take care of the preterm infants influences their responses to care‐giving stimuli. To interact better with the infant during care‐giving procedures, nurses need to provide more supportive care‐giving behaviours especially ‘position support’ and ‘containment’ based on the infant’s needs, and avoid care‐giving that may be too rough and occur too quickly without attending the baby’s stressful signals, positioning the baby in hyperextension posture, or chatting with other people during procedures.
Clinical trials: the challenge of recruitment and retention of participants
Authors: Gul Raisa B , Ali Parveen A 
Published: December 2009

Aims and objectives.  This article, based on the available literature, attempts to discuss the importance of recruitment and retention of research participants, the associated barriers and challenges, and various strategies to overcome these barriers.Background.  The inability to recruit and retain the required participants in a research project poses serious threats to both the internal and the external validity of a research study. Despite serious implications, the issues of recruitment and retention do not receive due attention in research and publications. Literature suggests a lack of coordinated efforts to collect information on the outcomes of recruitment experiences in clinical trials and population studies. Studies often mention the number of participants who refuse to participate; however, the majority of the studies often fail to mention the specific reasons insufficient recruitment or retention of the participants.Design.  A methodological paper.Method.  Various participant‐, context‐, environment‐ and research‐related factors are examined that affect the phenomenon of recruitment and retention of the participants in a study.Results.  Delayed or inefficient recruitment also has financial and ethical implications. Although there are many pieces of information scattered throughout academic journals on recruitment and retention of participants in research, few authors have dealt with the issue holistically. It is imperative for researchers to understand the importance of recruitment and retention of research participants, the associated barriers and challenges, and various strategies to overcome these barriers.Conclusion.  Appropriate recording and reporting of the problems faced while recruiting and retaining the participants in research studies can help not only in understating the challenge, but will also help in devising the strategies to overcome this problem. This article was an attempt to synthesise and review the available literature on recruitment and retention issues, which demand extensive theoretical and conceptual thinking as part of the research design.Relevance to practice. An understanding of the challenges and issues related to recruitment and retention can help researchers to think ahead about the strategies to overcome these issues and consequently save the time and energy of the participants, researchers and funding agencies.
Autoantibodies to Neurotrophic Receptors TrkA, TrkB and TrkC in Patients with Acute Chagas’ Disease
Authors: Lu B. , Luquetti A. O. , Rassi A. , PereiraPerrin M. 
Published: December 2009

AbstractNeurotrophic receptors TrkA and TrkC double up as receptors that Trypanosoma cruzi uses to invade cells and as autoantigen in T. cruzi‐infected individuals (with Chagas’ disease). Consequently, autoantibodies against TrkA and TrkC (ATA) potently block T. cruzi invasion in vitro and in ATA‐immunized mice. Thus, ATA could keep T. cruzi invasion in check in Chagas’ disease. However, ATA has been examined only in patients with chronic Chagas’ disease. To determine whether ATA potentially participate in the early stage of infection, we analysed the sera of 15 patients with acute Chagas’ disease, 4–66 years of age. We find that all sera contain high antibody titres to TrkA, TrkB and TrkC, but not to other growth factor receptors, indicating that ATA are produced relatively soon after T. cruzi infection by an age‐independent process. One individual, who acquired the disease after an accidental laboratory infection, converted to Trk‐antibody (Ab)‐seronegative when progressing to the chronic phase. ATA from acute patients were of low avidity (K0 <24.8 × 10−8 m) and of IgM and IgA isotypes. In contrast, ATA from chronic patients were of high avidity (Ko = 1.4 to 4.5 × 10−8 m) and of the IgG2 isotype. Therefore, ATA underwent affinity maturation and class switch when patients progressed from acute to chronic disease. Thus, it may be that Trk autoimmunity, which starts in the acute Chagas’ disease, plays a role in attenuating parasitemia and tissue parasitism that characterizes the acute/chronic phase transition of Chagas’ disease.
Increased mucosal expression of GATA‐3 and STAT‐4 in pediatric ulcerative colitis
Authors: Ohtani Kiyotaka , Ohtsuka Yoshikazu , Ikuse Tamaki , Baba Yosuke , Yamakawa Yoko , Aoyagi Yo , Fujii Tohru , Kudo Takahiro , Nagata Satoru , Shimizu Toshiaki 
Published: December 2009

AbstractBackground:  Serum pro‐inflammatory cytokine levels are frequently elevated in the acute phase of pediatric inflammatory bowel disease (IBD). Because the role of pro‐inflammatory cytokine in the acute phase of pediatric IBD has not been well investigated, the serum levels of pro‐inflammatory cytokines and the expression of Th1 and Th2 signaling molecules in mucosa from the acute phase of pediatric IBD were examined.Methods:  Twenty children with ulcerative colitis (UC; mean age, 9.95 ± 4.10 years) and 12 with Crohn's disease (CD; mean age, 10.0 ± 4.90 years) were enrolled for the serum cytokine (interleukin [IL]‐4, IL‐5, IL‐6, tumor necrosis factor‐α, tumor growth factor‐β1, and interferon‐γ) assay. Expression of T‐helper cell 1 (Th1) (T‐box expressed in T cells: T‐bet and signal transducer and activator of transcription‐4: STAT‐4) and Th2 (GATA‐3 and STAT‐6) signaling molecules was examined on real‐time polymerase chain reaction using mucosal samples from eight children in the acute phase of UC, eight with CD and eight controls.Results:  Significant elevation of serum IL‐4 and IL‐6 levels was detected at the acute phase of pediatric UC and CD compared with levels at remission (P < 0.05 in each). The mucosal expression of GATA‐3 and STAT‐4 was significantly enhanced in the acute phase of pediatric UC compared with normal mucosa. No significant difference was observed in the expression of all examined molecules in the acute phase of pediatric CD.Conclusions:  IL‐4 and its signaling molecule GATA‐3, as well as the Th1 signaling molecule STAT‐4, are involved in the pathogenesis of acute phase of pediatric UC.
CORPORATE GOVERNANCE IN JAPAN AND THE UK: CODES, THEORY AND PRACTICE
Authors: Mizuno Mitsuru , Tabner Isaac T. 
Published: December 2009

AbstractWe reflect on the evolution of corporate governance and the role of institutional investors in enhancing governance in Japan and the UK. Japan places emphasis on stakeholder capitalism, whereas the UK places emphasis on shareholder capitalism. Nonetheless, in both countries, institutional investors have exerted significant influence on the evolution of corporate governance. Institutional investors in the UK have more power over company management than their Japanese counterparts, although it is alleged that these powers are not exercised to their best potential in either country.