bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is nerve stimulation needed during an ultrasound‐guided lateral sagittal infraclavicular block?
Authors: GÜRKAN Y. , TEKIN M. , ACAR S. , SOLAK M. , TOKER K. 
Published: January 2010

Background: The objective of the study was to evaluate the influence of ultrasound (US) guidance alone vs. neurostimulation (NS) and US (NSUS) guidance techniques on block performance time and block success rate for the lateral sagittal infraclavicular block (LSIB).Methods: In a randomized and prospective manner, 110 adult patients scheduled for distal upper limb surgery were allocated to the US or the NSUS groups. In the US group, a local anesthetic (LA) was administered only with US guidance to produce a ‘U’‐shaped distribution around the axillary artery. In the NSUS group, LA was administered under US guidance only after electrolocation of one of the median, ulnar or radial nerve‐type responses. A total of 30 ml of LA (10 ml of levobupivacaine 5 mg/ml and 20 ml of lidocaine 20 mg/ml) was administered in both groups. Sensory block was tested at 10 min intervals for 30 min. Successful block was defined as analgesia or anesthesia of all five nerves distal to the elbow.Results: Block success rate was 94.5% in both groups. Block performance time was significantly shorter in the US than the NSUS group (157 ± 50 vs. 230 ± 104 s) (P=0.000). Block onset time was similar in both groups (12.5 ± 4.8 in the US vs. 12.8 ± 5.4 min in the NSUS groups). There were two arterial punctures in the NSUS group.Conclusions: During LSIB performance US guidance alone produces block success rate identical to both US and NS guidance yet with a shorter block performance time.
Premedication with clonidine is superior to benzodiazepines. A meta analysis of published studies
Authors: DAHMANI S. , BRASHER C. , STANY I. , GOLMARD J. , SKHIRI A. , BRUNEAU B. , NIVOCHE Y. , CONSTANT I. , MURAT I. 
Published: January 2010

Background: Premedication is considered important in pediatric anesthesia. Benzodiazepines are the most commonly used premedication agents. Clonidine, an α2 adrenoceptor agonist, is gaining popularity among anesthesiologists. The goal of the present study was to perform a meta‐analysis of studies comparing premedication with clonidine to Benzodiazepines.Methods: A comprehensive literature search was conducted to identify clinical trials focusing on the comparison of clonidine and Benzodiazepines for premedication in children. Six reviewers independently assessed each study to meet the inclusion criteria and extracted data. Original data from each trial were combined to calculate the pooled odds ratio (OR) or the mean differences (MD), 95% confidence intervals [95% CI] and statistical heterogeneity were accessed.Results: Ten publications fulfilling the inclusion criteria were found. Premedication with clonidine, in comparison with midazolam, exhibited a superior effect on sedation at induction (OR=0.49 [0.27, 0.89]), decreased the incidence of emergence agitation (OR=0.25 [0.11, 0.58]) and produced a more effective early post‐operative analgesia (OR=0.33 [0.21, 0.58]). Compared with diazepam, clonidine was superior in preventing post‐operative nausea and vomiting (PONV).Discussion: Premedication with clonidine is superior to midazolam in producing sedation, decreasing post‐operative pain and emergence agitation. However, the superiority of clonidine for PONV prevention remains unclear while other factors such as nausea prevention might interfere with this result.
Regional cerebral glucose metabolism during sevoflurane anaesthesia in healthy subjects studied with positron emission tomography
Authors: SCHLÜNZEN L. , JUUL N. , HANSEN K. V. , GJEDDE A. , COLD G. E. 
Published: January 2010

Background: The precise mechanism by which sevoflurane exerts its effects in the human brain remains unknown. In the present study, we quantified the effects of sevoflurane on regional cerebral glucose metabolism (rGMR) in the human brain measured with positron emission tomography.Methods: Eight volunteers underwent two dynamic 18F‐fluorodeoxyglucose positron emission tomography (PET) scans. One scan assessed conscious‐baseline metabolism and the other scan assessed metabolism during 1 minimum alveolar concentration (MAC) sevoflurane anaesthesia. Cardiovascular and respiratory parameters were monitored and bispectral index responses were registered. Statistical parametric maps and conventional regions of interest analysis were used to determine rGMR differences.Results: All subjects were unconsciousness at 1.0 MAC sevoflurane. Cardiovascular and respiratory parameters were constant over time. In the awake state, rGMR ranged from 0.24 to 0.35 μmol/g/min in the selected regions. Compared with the conscious state, total GMR decreased 56% in sevoflurane anaesthesia. In white and grey matter, GMR was averaged 42% and 58% of normal, respectively. Sevoflurane reduced the absolute rGMR in all selected areas by 48–71% of the baseline (P≤0.01), with the most significant reductions in the lingual gyrus (71%), occipital lobe in general (68%) and thalamus (63%). No increases in rGMR were observed.Conclusions: Sevoflurane caused a global whole‐brain metabolic reduction of GMR in all regions of the human brain, with the most marked metabolic suppression in the lingual gyrus, thalamus and occipital lobe.
The mismeasurement of sexual selection
Authors: Klug H. , Heuschele J. , Jennions M. D. , Kokko H. 
Published: January 2010

Abstract
Sexual selection can explain major micro- and macro-evolutionary patterns. Much of current theory predicts that the strength of sexual selection (i) is driven by the relative abundance of males and females prepared to mate (i.e. the operational sex ratio, OSR) and (ii) can be generally estimated by calculating intra-sexual variation in mating success (e.g. the opportunity for sexual selection, Is). Here, we demonstrate the problematic nature of these predictions. The OSR and Is only accurately predict sexual selection under a limited set of circumstances, and more specifically, only when mate monopolization is extremely strong. If mate monopolization is not strong, using OSR or Is as proxies or measures of sexual selection is expected to produce spurious results that lead to the false conclusion that sexual selection is strong when it is actually weak. These findings call into question the validity of empirical conclusions based on these measures of sexual selection.
Ontogenetic shifts and temporal changes in the trophic patterns of the deep‐sea red shrimp,Aristaeomorpha foliacea(Decapods: Aristeidae), in the Eastern Ionian Sea (Eastern Mediterranean)
Authors: Kapiris Kostas , Thessalou‐Legaki Maria , Petrakis George , Conides Alexis 
Published: January 2010

AbstractThe purpose of this paper is to provide the first detailed data concerning the diet and feeding activity of the giant red shrimp,Aristaeomorpha foliacea, in the Eastern Ionian Sea (Eastern Mediterranean), in relation to season, size class and sex. Feeding activity inA. foliaceawas intense, based on its low vacuity index and high prey diversity, with a diet dominated by mesopelagic prey and less frequent occurrence of benthic taxa. Giant red shrimp displayed a highly diversified diet that exhibited slight seasonal fluctuations. The diets of both sexes consisted of 60 different prey categories belonging chiefly to three groups: crustaceans (e.g.decapods, such asPlesionikaspp. and Pasiphaeidae, amphipods), cephalopods (mainly Enoploteuthidae) and fishes (Myctophidae, Macrouridae). These three prey categories accounted for 72–82% of the relative abundance and total occurrence for males and 70–88% for females, respectively. Variation in food availability, as well as increased energy demands related to gonad development and breeding activity, appear to be critical factors driving temporal changes in feeding strategy. Feeding activity increased during spring and summer, which coincides with reproductive activities (mating, gonad maturation, egg‐laying). Females seem to be more active predators than males, consuming prey with greater swimming ability. However, ontogenetic shifts in diet were also apparent, despite high dietary overlap among small, medium and large females. Large individuals, which are more efficient predators, selected highly mobile prey (e.g.fishes), whereas small individuals consumed low‐mobility prey (e.g.copepods, ostracods, tanaids and sipunculans).
Hawaiian hotspots: enhanced megafaunal abundance and diversity in submarine canyons on the oceanic islands of Hawaii
Authors: Vetter Eric W. , Smith Craig R. , De Leo Fabio C. 
Published: January 2010

AbstractSubmarine canyons are important sources of habitat heterogeneity on the slopes of continents and islands, but the study of canyon ecology has been largely restricted to continental margins. Here we use visual and video surveys from 36 submersible dives to evaluate the role of canyons as abundance and diversity hotspots for megafauna in the Hawaiian Archipelago, an island chain embedded in an oligotrophic ocean. We surveyed megafauna in canyon and slope settings at depths of 350–1500 m along the margins of four islands: the low ‘islands’ of Nihoa and Maro Reef, and the high islands of Oahu and Moloka’i. Megafaunal communities in canyons differed significantly from those in nearby slope habitats at all depths. Highly mobile fishes and invertebrates were consistently more abundant in canyons than on nearby slopes at the same depth off all islands, suggesting that canyons may be important sources of larvae for surrounding habitats. In the few cases where megafaunal abundances were similar or higher on the slope, the differences were typically driven by higher slope abundance of sessile suspension feeders or animals with limited mobility, i.e. by organisms which are likely to have difficulty with high currents and sediment transport in canyons. Megafaunal species richness and diversity generally trended higher within canyons, especially for the highly mobile taxa. Canyons contained 41 megafaunal species never observed on the slope, and increased estimated regional species richness by 25–30 species, indicating that canyons enhanced beta and gamma (regional) biodiversity. An expected trend of greater enhancement of diversity and abundance in canyons on the margins of high versus low oceanic islands was not observed, although megafauna were generally more abundant in both canyon and slope habitats on the high islands (Oahu and Moloka’i). We conclude that submarine canyons on both low and high islands in the Hawaiian Archipelago may provide keystone structures, enhancing megafaunal abundance, providing source populations for the open slope, and enhancing local and regional species diversity.
Entities and frequency of neonatal diabetes: data from the diabetes documentation and quality management system (DPV)
Authors: Grulich‐Henn J. , Wagner V. , Thon A. , Schober E. , Marg W. , Kapellen T. M. , Haberland H. , Raile K. , Ellard S. , Flanagan S. E. , Hattersley A. T. , Holl R. W. 
Published: January 2010

Diabet. Med. 27, 709–712 (2010)AbstractAims  The aim of this study was to elucidate the entities and the frequency of neonatal diabetes mellitus (NDM) in a large representative database for paediatric diabetes patients in Germany and Austria.Methods  Based on the continuous diabetes data acquisition system for prospective surveillance (DPV), which includes 51 587 patients with onset of diabetes before the age of 18 years from 299 centres in Germany and Austria, we searched for patients with onset of diabetes mellitus in the first 6 months of life.Results  Ninety patients were identified, comprising 0.17% of all paediatric cases in the DPV registry. This represented an incidence of approximately one case in 89 000 live births in Germany. A monogenic basis for NDM was established in 30 subjects (seven UPD6, 10 KCNJ11, seven ABCC8, two FOXP3, two PDX1, one INS, one EIF2AK3). Pancreatic hypoplasia or agenesis was reported in 10 patients and seven subjects were classified as having Type 1 diabetes by their centres. Transient neonatal diabetes (TNDM) accounted for approximately 10% of all cases with NDM. No aetiology was defined in 41 subjects, which may reflect incomplete genetic testing or novel genetic aetiologies.Conclusion  Based on a large database, we identified a higher rate of NDM in Germany than has been reported previously. Full molecular genetic testing should be performed in all patients diagnosed before 6 months of age.
Diabetes and other glucose metabolism abnormalities in Mexican Zapotec and Mixe Indians
Authors: Escobedo J. , Chavira I. , Martínez L. , Velasco X. , Escandón C. , Cabral J. 
Published: January 2010

Diabet. Med. 27, 412–416 (2010)AbstractAims  Aboriginal populations are experiencing an explosive rise in the prevalence of Type 2 diabetes. The purpose of this study was to estimate the prevalence of diabetes and other glucose metabolism abnormalities in Mexican Zapotec and Mixe Indians and to determine their association with known risk factors.Methods  A cross‐sectional study was conducted in the southern Mexican state of Oaxaca. Two communities of Zapotec population and three of Mixe population were randomly chosen. Mexican Indians ≥ 35 years old were invited to participate; 394 Zapotec and 730 Mixe Indians participated. Diabetes and other glucose metabolism abnormalities were diagnosed using standard World Health Organization criteria after an oral glucose tolerance test. Prevalence and odds ratio (OR) were estimated with 95% confidence intervals (95% CI).Results  The crude prevalence of diabetes was 8.19% (95% CI 6.7–9.9%) and the age‐ and sex‐adjusted prevalence was 8.27%, significantly higher among Zapotec (8.71%) than among Mixe Indians (6.90%). The prevalence of impaired glucose tolerance was 9.9% and 4.7% of the studied subjects had impaired fasting glucose. The main risk factors related to the occurrence of diabetes were a family history of diabetes (OR 4.1; 95% CI 1.9–8.8), obesity (OR 3.0; 95% CI 1.6–5.6), hypertension (OR 2.6; 95% CI 1.5–4.7) and a high‐risk waist–hip ratio (4.6; 95% CI 1.2–17.7).Conclusions  The prevalence of diabetes is high in this population, the highest so far reported in Mexican Indians. Mexico’s health system faces a huge challenge to avert the advanced spread of diabetes in this susceptible population.
Diabetes Care Protocol: effects on patient‐important outcomes. A cluster randomized, non‐inferiority trial in primary care
Authors: Cleveringa F. G. W. , Minkman M. H. , Gorter K. J. , Van Den Donk M. , Rutten G. E. H. M. 
Published: January 2010

Diabet. Med. 27, 442–450 (2010)AbstractAims  The Diabetes Care Protocol (DCP) combines task delegation, intensification of diabetes treatment and feedback. It reduces cardiovascular risk in Type 2 diabetes (T2DM) patients. This study determines the effects of DCP on patient‐important outcomes.Methods  A cluster randomized, non‐inferiority trial, by self‐administered questionnaires in 55 Dutch primary care practices: 26 practices DCP (1699 patients), 26 usual care (1692 patients). T2DM patients treated by their general practitioner were included. Main outcome was the 1‐year between‐group difference in Diabetes Health Profile (DHP‐18) total score. Secondary outcomes: DHP‐18 subscales, general perceived health [Medical Outcomes Study 36‐Items Short Form Health Survey (SF‐36), Euroqol 5 Dimensions (EQ‐5D) and Euroqol visual analogue scale (EQ‐VAS)], treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire; DTSQ status) and psychosocial self‐efficacy (Diabetes Empowerment Scale Short Form; DES‐SF). Per protocol (PP) and intention‐to‐treat (ITT) analyses were performed: non‐inferiority margin Δ = −2%. At baseline 2333 questionnaires were returned and 1437 1 year thereafter.Results  Comparing DCP with usual care, DHP‐18 total score was non‐inferior: PP −0.88 (95% CI −1.94 to 0.12), ITT −0.439 (95% CI −1.01 to 0.08), SF‐36 ‘health change’ improved: PP 3.51 (95% CI 1.23 to 5.82), ITT 1.91 (95% CI 0.62 to 3.23), SF‐36 ‘social functioning’ was inconclusive: PP −1.57 (95% CI −4.3 to 0.72), ITT −1.031 (95% CI −2.52 to −0.25). Other DHP and SF‐36 scores were inconsistent or non‐inferior. DHP‐18 ‘disinhibited eating’ was significantly worse in PP analyses. For EQ‐5D/EQ‐VAS, DTSQ and DES‐SF, no significant between‐group differences were found.Conclusion  DCP does not seem to influence health status negatively, therefore diabetes care providers should not shrink from intensified treatment. However, they should take possible detrimental effects on ‘social functioning’ and ‘disinhibited eating’ into account.
Risks of marathon running and hypoglycaemia in Type 1 diabetes
Authors: Graveling A. J. , Frier B. M. 
Published: January 2010

Diabet. Med. 27, 585–588 (2010)AbstractBackground  Exercise‐induced hypoglycaemia is common in people with insulin‐treated diabetes and if severe can provoke neurological morbidity including coma and seizures. Depending on the duration and demands of the physical activity, various strategies can be used to limit the risk of hypoglycaemia with strenuous exercise. However, metabolic events occurring in the 48 h before the exercise can influence the risk and responses to exercise‐induced hypoglycaemia.Case report  A 27‐year‐old man with Type 1 diabetes suffered an episode of nocturnal hypoglycaemia which provoked a tonic‐clonic seizure. Despite this he ran in a marathon the following day during which he collapsed with severe hypoglycaemia and a further associated seizure. He subsequently developed severe myalgia accompanied by a pronounced and persistent elevation of plasma creatine kinase, indicating rhabdomyolysis, and deranged liver function, suggestive of hypoxic hepatitis. The biochemical abnormalities and symptoms lasted for several weeks.Conclusions  The case highlights the dangers of intense and prolonged physical exercise following severe hypoglycaemia, demonstrating the risks of acute damage to skeletal muscle and to organs such as the liver, in addition to the risk of severe neuroglycopenia and the induction of seizures. The mechanisms underlying these problems are discussed. People with insulin‐treated diabetes should be advised not to undertake prolonged intensive exercise after severe hypoglycaemia.
Pediatric bipolar disorder: evidence for prodromal states and early markers
Authors: Luby Joan L. , Navsaria Neha 
Published: January 2010

Background:  Childhood bipolar disorder remains a controversial but increasingly diagnosed disorder that is associated with significant impairment, chronic course and treatment resistance. Therefore, the search for prodromes or early markers of risk for later childhood bipolar disorder may be of great importance for prevention and/or early identification.Methods:  Literature searches were conducted to identify reviews, case reports and empirical papers addressing the issue of prodromes of childhood bipolar disorder.Results:  A total of 54 articles were found that related to bipolar prodromes, risk factors for later childhood bipolar disorder, childhood risk for adult bipolar disorder, mania manifestations in early childhood, and neuropsychological and biological markers of childhood bipolar disorder. A review of articles suggest (a) childhood bipolar prodromes may be detectable prior to the onset of the disorder, (b) prodromal symptoms may display episodicity during childhood, (c) there is evidence of possible endophenotypic markers such as deficits in executive function, sustained attention, and emotion labeling, (d) there is a potential association with functional, structural, and biochemical alterations evident in brain structures involved in mood regulation, (e) a link between childhood bipolar disorder with early tempermental markers, such as emotional regulation and behavioral disinhibition and (f) there is some early but promising evidence of effective psychotherapeutic preventions.Conclusions:  There has been very limited investigation of early prodromes of childhood bipolar disorder. Based on the promising findings of prodromes as well as high‐risk states and possible endophenotypic markers, more controlled and targeted investigations into the early markers of bipolar disorder appear warranted and potentially fruitful. Until such longitudinal studies with appropriate controls are conducted, specific markers for bipolar prodromes will remain elusive, although evidence suggests they are manifest in at least some subgroups. The finding of promising psychotherapeutic prevention programs underscores the need to find specific and sensitive markers of bipolar prodromes in childhood.
Assessment of cognitive and adaptive behaviour among individuals with congenital insensitivity to pain and anhidrosis
Authors: LEVY EREZ DANIELLA , LEVY JACOV , FRIGER MICHAEL , AHARONI‐MAYER YAEL , COHEN‐ILUZ MORAN , GOLDSTEIN ESTHER 
Published: January 2010

Aim  Individuals with congenital insensitivity to pain with anhidrosis (CIPA) are reported to have mental retardation* but to our knowledge no detailed study on the subject has ever been published. The present study assessed and documented cognitive and adaptive behaviour among Arab Bedouin children with CIPA.Methods  Twenty‐three Arab Bedouin children (12 females, 11 males) with CIPA aged between 3 and 17 years (mean 9y 7mo, SD 4y 2mo) were assessed. They were compared with 19 healthy siblings of the affected children aged between 5 and 13 years (mean 8y 11mo, SD 2y 10m). All of the children in the comparison group, but only half of the CIPA group, were attending school. The children were evaluated using a standardized, non‐verbal intelligence test, the Leiter International Performance Scale – Revised, and an adaptive behaviour questionnaire, the Vineland Adaptive Behaviour Scales, 2nd edition.Results  Based on scores on the intelligence test and the adaptive behaviour scale, children with CIPA functioned in the mental retardation range (mean IQ scores: CIPA group 53.8, comparison group 83.32 [p<0.001]; adaptive behaviour: CIPA group 68.1, comparison group 104.88 [p<0.001]). IQ was significantly higher among the children with CIPA aged up to 7 years 11 months than among the older children 73.83 vs 45.21 (p<0.001).Interpretation  As a group, the younger children with CIPA may be functioning above the mental retardation range. We propose that early intervention addressing these children’s needs and developing an appropriate educational system, might improve their outcome.
Lower‐extremity selective voluntary motor control in patients with spastic cerebral palsy: increased distal motor impairment
Authors: FOWLER EILEEN G , STAUDT LORETTA A , GREENBERG MARCIA B 
Published: January 2010

Aim  Multiple impairments contribute to motor deficits in spastic cerebral palsy (CP). Selective voluntary motor control (SVMC), namely isolation of joint movement upon request, is important, but frequently overlooked. This study evaluated the proximal to distal distribution of SVMC impairment among lower extremity joints.Method  Using a recently developed tool, the Selective Control Assessment of the Lower Extremity (SCALE), we evaluated the SVMC of the hip, knee, ankle, subtalar joint, and toes in a cross‐sectional, observational study of 47 participants with spastic, diplegic, hemiplegic, and quadriplegic CP (22 males, 25 females; mean age 11y 9mo, SD 4y 8mo; Gross Motor Function Classification System levels I–IV).Results  Statistically significant decreases in SCALE scores from hip to toes were found using the Page statistical test for trend (p<0.001). Statistically significant differences (p<0.05) were found between all joint pairs, except toes versus subtalar, toes versus ankle, and right ankle versus subtalar joints. Cross‐tabulation of score frequencies for all pairs revealed that proximal joint scores were higher or equal to distal ones 81 to 100% of the time. Excluding toes versus subtalar joints, proximal scores exceeded distal ones 94 to 100% of the time.Interpretation  We confirmed increasing proximal to distal SVMC impairment, which may have implications for treatment and research.