bluuebunny/crossref_metadata_2025_split huggingface dataset:
Service quality perceptions in primary health care centres in Greece
Authors: Papanikolaou Vicky , Zygiaris Sotiris 
Published: February 2012

AbstractContext  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres.Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece.Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others.Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations.Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services.
Making choices about medical interventions: the experience of disabled young people with degenerative conditions
Authors: Mitchell Wendy A. 
Published: February 2012

AbstractBackground  Current western policy, including the UK, advocates choice for service users and their families, taking greater control and being more involved in decision making. However, children’s role in health decision making, especially from their own perspective, has received less research attention compared to doctors and parents’ perspectives.Objective  To explore the perspective and experiences of disabled young people with degenerative conditions as they face significant medical interventions and engage in decision‐making processes.Design and methods  Findings from a longitudinal qualitative study of 10 young people (13–22 years) with degenerative conditions are reported. Individual semi‐structured interviews were conducted with participants over 3 years (2007–2010); the paper reports data from all three interview rounds. Interviews focused on medical intervention choices the young people identified as significant.Results  Although the young people in this study felt involved in the medical intervention choices discussed, findings demonstrate a complex and diverse picture of decision making. Results highlighted different decisional roles adopted by the young people, the importance of information heuristics and working with other people whilst engaging in complex processes weighing up different decisional factors.Discussion  Young people’s experiences demonstrate the importance of moving beyond viewing health choices as technical or rational decisions. How each young person framed their decision was important. Recognizing this diversity and the importance of emerging themes, such as living a normal life, independence, fear of decisions viewed as ‘irreversible’ and the role of parents and peers in decision making highlights that, there are clear practice implications including, active practitioner listening, sensitivity and continued holistic family working.
Thermographic imaging during nasal peanut challenge may be useful in the diagnosis of peanut allergy
Authors: Clark A. , Mangat J. , King Y. , Islam S. , Anagnostou K. , Foley L. , Deighton J. , Ewan P. 
Published: February 2012

AbstractBackgroundDouble‐blinded challenges are widely used for diagnosing food allergy but are time‐consuming and cause severe reactions. Outcome relies on subjective interpretation of symptoms, which leads to variations in outcome between observers. Facial thermography combined with nasal peanut challenge was evaluated as a novel objective indicator of clinical allergy.MethodsSixteen children with positive blinded peanut challenge underwent nasal challenge with 10 μg peanut protein or placebo. Mean skin temperatures were recorded from the mouth and nose using infrared thermography over 18 min.ResultsThe area under curve of nasal skin temperature was significantly elevated after peanut vs placebo (18.2 vs 4.8°Cmin). The maximum increase in temperature was also significantly greater after peanut: mean difference +0.9°C.ConclusionThis feasibility study shows thermography can detect inflammation caused by nasal challenges whilst employing one thousand‐fold less peanut than an oral challenge. This novel technique could be developed to provide a rapid, safe and objective clinical allergy test.
Stüve–Wiedemann syndrome and related bent bone dysplasias
Authors: Akawi N A , Ali B R , Al‐Gazali L 
Published: February 2012

Akawi NA, Ali BR, Al‐Gazali L. Stüve–Wiedemann syndrome and related bent bone dysplasias.Stüve–Wiedemann syndrome (SWS) is a severe congenital skeletal dysplasia associated with life threatening dysautonomic manifestations. Newborns affected with this condition exhibit distinctive shortening and bowing of the long bones with reduced bone volume. The majority of affected newborns die early due to neuromuscular complications namely hyperthermia, apnea, and swallowing difficulties. In this review, we provide an overall picture on the clinical, including long‐term management, molecular and cellular aspects of SWS and discuss briefly other related bent bone dysplasias.
Molecular phylogenetics reveals a pattern of biome conservatism in New World anchovies (family Engraulidae)
Authors: BLOOM D. D. , LOVEJOY N. R. 
Published: February 2012

AbstractEvolutionary transitions between marine and freshwater biomes are relatively rare events, yielding a widespread pattern of biome conservatism among aquatic organisms. We investigated biome transitions in anchovies (Engraulidae), a globally distributed clade of economically important fishes. Most anchovy species are near‐shore marine fishes, but several exclusively freshwater species are known from tropical rivers of South America and were previously thought to be the product of six or more independent freshwater invasions. We generated a comprehensive molecular phylogeny for Engraulidae, including representatives from 15 of 17 currently recognized genera. Our data support previous hypotheses of higher‐level relationships within Engraulidae, but show that most New World genera are not monophyletic and in need of revision. Ancestral character reconstruction reveals that New World freshwater anchovies are the product of a single marine to freshwater transition, supporting a pattern of biome conservatism. We argue that competition is the principal mechanism that regulates aquatic biome transitions on a continental scale.
Ventilatory mechanics from maniraptoran theropods to extant birds
Authors: TICKLE P. G. , NORELL M. A. , CODD J. R. 
Published: February 2012

AbstractShared behavioural, morphological and physiological characteristics are indicative of the evolution of extant birds from nonavian maniraptoran dinosaurs. One such shared character is the presence of uncinate processes and respiratory structures in extant birds. Recent research has suggested a respiratory role for these processes found in oviraptorid and dromaeosaurid dinosaurs. By measuring the geometry of fossil rib cage morphology, we demonstrate that the mechanical advantage, conferred by uncinate processes, for movements of the ribs in the oviraptorid theropod dinosaur, Citipati osmolskae, basal avialan species Zhongjianornis yangi, Confuciusornis sanctus and the more derived ornithurine Yixianornis grabaui, is of the same magnitude as found in extant birds. These skeletal characteristics provide further evidence of a flow‐through respiratory system in nonavian theropod dinosaurs and basal avialans, and indicate that uncinate processes are a key adaptation facilitating the ventilation of a lung air sac system that diverged earlier than extant birds.
Effects of (−)‐Epigallocatechin Gallate on the Motility and Penetrability of Frozen–Thawed Boar Spermatozoa Incubated in the Fertilization Medium
Authors: Kaedei Y , Naito M , Naoi H , Sato Y , Taniguchi M , Tanihara F , Kikuchi K , Nagai T , Otoi T 
Published: February 2012

ContentsEpigallocatechin gallate (EGCG) is the major polyphenol in green tea (Camellia sinensis) and is known for its antioxidant effects. The objective of the present study was to examine the effects of EGCG during in vitro fertilization (IVF) on the sperm quality and penetrability into oocytes. In the first experiment, the effects of concentration and incubation period of EGCG on the motility and penetrability of spermatozoa were examined. When frozen–thawed spermatozoa were incubated in IVF medium supplemented with 0 (control), 1, 50 and 100 μm EGCG for 1, 3 and 5 h, supplementation with 50 and 100 μm EGCG improved motility of the spermatozoa (p < 0.05), but not viability, as compared with the control group. When frozen–thawed spermatozoa were co‐incubated with in vitro‐matured (IVM) oocytes in IVF medium supplemented with 50 and 100 μm EGCG for 5 h, supplementation of EGCG had positive effects on sperm penetration rates. In the second experiment, the effects of supplementation of EGCG in IVF medium on penetrability of sperm from different boars and development of fertilized oocytes were evaluated. When frozen–thawed spermatozoa from six boars were co‐incubated with IVM oocytes in IVF medium supplemented with 50 μm EGCG, the effect of EGCG on sperm penetration and development of oocytes after fertilization was found to vary with individual boar. Our results indicate that motility and penetrability of boar spermatozoa are improved by co‐incubation with 50 μm EGCG, but the effects vary with individual boars.
Significance of Group III and IV muscle afferents for the endurance exercising human
Authors: Amann Markus 
Published: February 2012

Summary

With the onset of dynamic whole‐body exercise, contraction‐induced mechanical and biochemical stimuli within locomotor muscle cause an increase in the discharge frequency of thinly myelinated (Group III) and unmyelinated (Group IV) nerve fibres located within the muscle.
These thin fibre muscle afferents project to various sites within the central nervous system and thereby substantially influence the exercising human.
First, Group III/IV muscle afferents are the afferent arm of cardiovascular and ventilatory reflex responses that are mediated in the nucleus tractus solitarius and the ventrolateral medulla. Therefore, neural feedback from working skeletal muscle is a vital component in providing a high capacity for endurance exercise because muscle perfusion and O2 delivery determine the fatigability of skeletal muscle.
Second, Group III/IV muscle afferents facilitate ‘central fatigue’ (failure, or unwillingness, of the central nervous system to ‘drive’ motoneurons) by exerting inhibitory influences on central motor drive during exercise.
Thus, Group III/IV muscle afferents play a substantial role in a human's susceptibility to fatigue and capacity for endurance exercise.
Biomarkers of endothelial dysfunction in patients with primary focal segmental glomerulosclerosis
Authors: ZHANG QINGYAN , ZENG CAIHONG , FU YOUJUAN , CHENG ZHEN , ZHANG JIONG , LIU ZHIHONG 
Published: February 2012

ABSTRACTAim:  Endothelial dysfunction occurs in nephrotic syndrome (NS) and may constitute a link between NS and vascular complications. Focal segmental glomerulosclerosis (FSGS) is a common cause of NS. This study aimed to assess endothelial markers at different stages of FSGS and define whether they were associated with thromboembolic complications and disease activity.Methods:  Forty‐four patients with nephrotic‐range proteinuria and biopsy‐proven primary FSGS were included in this study. Nine of them had concurrent thromboembolisms. Thirty‐two sex‐ and age‐ matched healthy volunteers served as controls. Endothelial markers including circulating endothelial cells (CECs), soluble thrombomodulin (sTM), von Willebrand factor (vWf), soluble vascular cell adhesion molecule‐1 (sVCAM‐1) and sE‐selectin were assessed at the commencement of the study in all participants and were repeated at 2, 6 and 12 months of follow‐up in patients without thromboembolisms.Results:  Patients with FSGS during active stage showed significantly higher levels of CECs, sTM, vWf, sVCAM‐1 and sE‐selectin when compared with controls. Moreover, patients with thromboembolisms had higher CECs and vWf than those without thromboembolisms. In patients without thromboembolisms, endothelial markers except sE‐selectin had inverse correlations with serum albumin and were positively related to cholesterol. Multiple analyses showed that cholesterol and serum albumin were independent predictors of CECs and sTM, and vWf and sVCAM‐1, respectively. At follow‐up, these markers systematically decreased as the disease went into remission, but the increase in vWf and sVCAM‐1 persisted even in patients obtaining complete remission for nearly a year. In patients with no response, levels of endothelial markers exhibited no obvious change.Conclusion:  Patients with FSGS had elevated markers of endothelial dysfunction, which were largely related to the activity of the disease. Meanwhile, levels of CECs and vWf were higher in patients concurrent with thromboembolisms.
Association of childhood family environments with the risk of social withdrawal (‘hikikomori’) in the community population in Japan
Authors: Umeda Maki , Kawakami Norito ,   The World Mental Health Japan Survey Group 2002–2006
Published: February 2012

Aims:  Hikikomori is a form of social withdrawal among those who retreat from social interaction for protracted periods of time. This study examines family‐related childhood factors for hikikomori using the retrospective data derived from a population‐based survey.Methods:  We derived data from World Mental Health Survey Japan. The subjects of this study were community residents aged 20–49 years (n = 708). Multiple logistic regression was applied to examine the association between the lifetime experience of hikikomori and childhood family environment, adjusting for sex, age, and respondents' history of common mental disorders.Results:  Father's high educational level (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 1.6–22.9), mother's common mental disorders (OR = 5.9, 95%CI = 1.1–33.3), and mother's panic disorders (OR = 6.6, 95%CI = 1.1–39.1) were significantly and positively associated with hikikomori after controlling for respondents' sex, age, and history of mental disorders.Conclusions:  Our findings suggest that hikikomori cases are more likely to occur in families where the parents have high levels of education. Maternal panic disorder may be another risk factor for children to develop hikikomori.
Transmission of the major skin microbiota, Malassezia, from mother to neonate
Authors: Nagata Rie , Nagano Hiroshi , Ogishima Daiki , Nakamura Yasushi , Hiruma Masataro , Sugita Takashi 
Published: February 2012

AbstractBackground:  Skin surface colonization starts after birth. It is thought that early microbial colonization affects the development of skin immune functions. Although Malassezia is the predominant fungus in the skin microbiota in healthy individuals, the microorganism is associated with atopic dermatitis and seborrheic dermatitis. In the present study, transmission of skin microbiota from mothers to their neonates was elucidated using the Malassezia microbiota as an indicator.Methods:  Temporal changes in the level of Malassezia colonization of the skin from 27 neonates and mothers were investigated by real‐time polymerase chain reaction assay. The genotypes of Malassezia colonizing the neonate and mother were also determined.Results:  Malassezia was detected from 89% and 100% of neonate samples on days 0 and 1 after birth, respectively. Subsequently, the level of Malassezia colonization of the neonates increased with time, whereas that of the mothers did not change. The Malassezia diversity of neonates shifted to the adult type by day 30. The genotype of Malassezia colonizing the skin of neonates agreed well with that of Malassezia colonizing the skin of the mothers.Conclusion:  Fungal microbiota colonization of neonates began on day 0, and the fungal microbiota of neonates had changed to the adult type by day 30. To our knowledge, this is the first report of a molecular analysis of the fungal microbiota of neonates.
Clinical characteristics of neonates With VACTERL association
Authors: Oral Akgun , Caner Ibrahim , Yigiter Murat , Kantarci Mecit , Olgun Hasim , Ceviz Naci , Salman Ahmet Bedii 
Published: February 2012

AbstractBackground:  The VACTERL association (VA) is the non‐random co‐occurrence of vertebral anomalies, anal atresia, cardiovascular malformations, tracheoesophageal fistula and/or esophageal atresia, renal anomalies, and/or limb anomalies, and is referred to by the first letters of its components. Studies investigating the clinical characteristics of VA patients and probing of the observed current six component types are limited, and none of them is focused on neonates. We investigated the clinical characteristics of our patients diagnosed as having VA in the newborn period.Methods:  We retrospectively reviewed the neonates whose final diagnosis was VACTERL association. Presence of at least three components of previously reported six anomalies was accepted as VACTERL association. Sex, birthweight, gestational age, postnatal age, anomalies of the systems that are included in VA, and the other features were recorded.Results:  There was a male predominance (14/11) of 28 patients; and there were three patients with ambiguous genitalia. The most common observed VACTERL component was vertebral anomalies (n= 26), followed by anal atresia (n= 19), tracheoesophageal fistula/esophageal atresia (n= 17), renal anomalies (n= 15), limb anomalies (n= 15) and cardiac anomalies (n= 14). The most frequent combination was VCTL (n= 4). Fifteen (57%) patients had non‐VACTERL anomalies and the most frequent of these was ambiguous genitalia (n= 3).Conclusion:  VA patients may have different clinical characteristics in different populations, and clinicians may miss some component features if the patients are evaluated after the neonatal period.
Isoproterenol stress test during catheterization of patients with coarctation of the aorta
Authors: Kim Ki‐Sung , Eryu Yoshihiko , Asakai Hiroko , Hayashi Taiyu , Kaneko Masahide , Kato Hitoshi 
Published: February 2012

AbstractBackground:  The exercise test is considered useful in selecting high‐risk patients with repaired coarctation of the aorta (CoA), but it is difficult to obtain the cooperation of pediatric patients. The present study determines the feasibility of the isoproterenol stress test (IST) among pediatric patients with CoA.Methods:  Thirteen patients with repaired or mild preoperative CoA aged 1–207 (median 13) months underwent 16 IST during cardiac catheterization. Peak‐to‐peak pressure gradients (PG) over the coarctation site were measured at baseline and at IST. Balloon angioplasty (BAP) was applied to patients with significant stenosis on angiography.Results:  The PG between the ascending and the descending aorta was significantly higher at IST than at baseline (20.5 ± 11.5 vs 5.6 ± 3.9 mmHg, P < 0.0001). Heart rate, the systolic blood pressure measured at the ascending aorta, and pulse pressure were all significantly higher at IST than at baseline. The PG at IST decreased >10 mmHg in three of six patients after BAP.Conclusions:  Significant pressure gradients over the coarctation site develop at IST in pediatric patients with repaired CoA or in preoperative patients with mild coarctation.
Lens thickness and associated factors
Authors: Jonas Jost B , Nangia Vinay , Gupta Rajesh , Sinha Ajit , Bhate Karishma 
Published: February 2012

AbstractBackground:  To determine the normative data for lens thickness and its associated factors in a population‐based study.Design:  Population‐based study.Participants:  The Central India Eye and Medical Study included 4711 subjects (aged 30+ years).Methods:  The subjects underwent a detailed ophthalmological examination including measurement of the lens thickness by sonography.Main Outcome Measure:  Sonographic lens thickness measurement.Results:  After excluding pseudophakic or aphakic eyes, lens thickness measurements were available for 9046 eyes of 4610 (97.9%) subjects with a mean age of 49.1 ± 13.2 years (range: 30–100 years) and a mean refractive error of −0.11 ± 1.77 dioptres (median, 0 dioptres; range, −21.75 to +7.75 dioptres). Mean lens thickness was 3.95 ± 0.49 mm. In multivariate analysis, a thick lens was significantly associated with higher age (P < 0.001), male gender (P < 0.001), higher body stature (P = 0.02), higher body mass index (P = 0.003), thicker central cornea (P = 0.008), shallower anterior chamber depth (P < 0.001) and hyperopic refractive error (P < 0.001). After adjustment for ocular and systemic parameters, lens thickness decreased with higher degree of nuclear cataract.Conclusions:  In the rural Central Indian population, a thick lens was associated with higher age, male gender, high body stature, high body mass index, hyperopia, thick central cornea, shallow anterior chamber depth and nuclear cataract. The data may be helpful to explain anatomic relationships of the anterior segment of the eye and to elucidate risk factors of diseases associated with ocular dimensions.
Incidence of visual impairment and blindness in indigenous Australians within Central Australia: the Central Australian Ocular Health Study
Authors: Landers John , Henderson Tim , Craig Jamie E 
Published: February 2012

AbstractBackground:  To estimate the incidence and causes of visual impairment and blindness among indigenous Australians living in Central Australia.Design:  Clinic‐based cohort study.Participants:  A total of 1884 individuals aged ≥20 years living in one of 30 remote communities within the statistical local area of ‘Central Australia’.Methods:  From those initially recruited, 608 (32%) participants were reviewed again between 6 months and 3 years (median 2 years). Patients underwent Snellen visual acuity testing and subjective refraction. Following this, an assessment of their anterior and posterior segments was made. Baseline results were compared with those who were reviewed.Main Outcome Measures:  The annual incidence rates and causes of bilateral visual impairment (vision worse than Snellen visual acuity 6/12 in the better eye) and bilateral blindness (Snellen visual acuity worse than 6/60 in the better eye).Results:  The annual incidence of bilateral visual impairment and blindness was 6.82% (8.12% for those aged ≥40 years) per year and 0.50% (0.62% for those aged ≥40 years) per year, respectively. Refractive error, followed by cataract and diabetic retinopathy, were the main causes for incident bilateral visual impairment and blindness.Conclusion:  This study has demonstrated rates of incident bilateral blindness and visual impairment among the indigenous Australian population within Central Australia, which are substantially higher than those from the non‐indigenous population. Services need to address the underlying causes of this incident vision loss to reduce visual morbidity in indigenous Australians living in central Australia.