bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence‐based practice among primary care physicians in Kuwait
Authors: Ahmad Abeer S. H. , Al‐Mutar Nouf B. E. , Al‐Hulabi Fahad A. S. , Al‐Rashidee Eman S. L. , Doi Suhail A. R. , Thalib Lukman 
Published: December 2009

Abstract
Objectives  The level of evidence‐based practice (EBP) and awareness has not been previously assessed among primary care physicians in Kuwait. The objectives of this study were to quantify the level of EBP and awareness in Kuwait and identify the factors related to EBP.
Method  We used a cross sectional study that enrolled 332 primary care physicians in 57 primary care centres randomly chosen in Kuwait. A self‐administered questionnaire was used to collect the data with a response rate of about 93%.
Results  Although half of the physicians self reported that they use EBP most of the time, further analysis revealed that only about 24% of this group had a reasonable understanding of EBP. Most of the clinical practice in the Kuwaiti primary care system seems to be based on the clinician's own judgment or what they learned in the medical school and traditional text books, rather than evidence‐based sources. None of the physicians had an Internet connection at their work place and a vast majority of them had no access to international journals nor were confident about critical appraisal of published evidence.
Conclusion  Overall level of awareness of evidence‐based medicine (EBM) among primary care physicians in Kuwait was considerably low. Training in the areas of EBM as well as making sure the Kuwaiti primary care centres have access to evidence‐based sources are critically important if primary care in Kuwait were to become evidence based.
Clinical research: up from ‘clinical epidemiology’
Authors: Miettinen Olli S. , Bachmann Lucas M. , Steurer Johann 
Published: December 2009

AbstractClinical research must be understood to be the foundation of scientific medicine of the clinical type. But the essence of scientific clinical medicine remains a matter of profound confusion, even in clinical academia, and so does the essence of clinical research. The confusion now revolves, principally, around ‘clinical epidemiology’. We address clinical research in the meaning of quintessentially ‘applied’ clinical research, which we take to be the foundation of the scientific knowledge base of clinical medicine, of gnosis (dia‐, etio‐, pro‐) in it. More specifically, we address the essence, priorities, and status quo of this research – and argue that the requisite theory of this is not a matter of ‘clinical epidemiology’ but of theory of clinical research endogenous to clinical (rather than epidemiological) academia.
Rationality in medicine
Authors: Miettinen Olli S. 
Published: December 2009

AbstractKant taught that, ‘Where we find . . . illusions and fallacies . . . , there seems to be required a . . . code of mental legislation . . . founded upon the nature of reason and the objects of its exercise . . . which no fallacy will be able to withstand or escape from . . . ' I address, critically, the Flexnerian and EBM conceptions of scientific medicine and Groopman's ideas about errors of reasoning in the practice of medicine; I underscore the need for theory of medicine, founded on reason and governing cognition about and in the practice of medicine; and I sketch the dawn of rationality in medicine.
‘We hold these truths to be self‐evident’: deconstructing ‘evidence‐based’ medical practice
Authors: Devisch Ignaas , Murray Stuart J. 
Published: December 2009

Abstract
Rationale, aims and objectives  Evidence‐based medicine (EBM) claims to be based on ‘evidence’, rather than ‘intuition’. However, EBM's fundamental distinction between quantitative ‘evidence’ and qualitative ‘intuition’ is not self‐evident. The meaning of ‘evidence’ is unclear and no studies of quality exist to demonstrate the superiority of EBM in health care settings. This paper argues that, despite itself, EBM holds out only the illusion of conclusive scientific rigour for clinical decision making, and that EBM ultimately is unable to fulfil its own structural criteria for ‘evidence’.
Methods  Our deconstructive analysis of EBM draws on the work of the French philosopher, Jacques Derrida. Deconstruction works in the name of justice to lay bare, to expose what has been hidden from view. In plain language, we deconstruct EBM's paradigm of ‘evidence’, the randomized controlled trial (RCT), to demonstrate that there cannot be incontrovertible evidence for EBM as such. We argue that EBM therefore ‘auto‐deconstructs’ its own paradigm, and that medical practitioners, policymakers and patients alike ought to be aware of this failure within EBM itself.
Results  EBM's strict distinction between admissible evidence (based on RCTs) and other supposedly inadmissible evidence is not itself based on evidence, but rather, on intuition. In other words, according to EBM's own logic, there can be no ‘evidentiary’ basis for its distinction between admissible and inadmissible evidence. Ultimately, to uphold this fundamental distinction, EBM must seek recourse in (bio)political ideology and an epistemology akin to faith.
Evidence‐based medicine among hospital doctors in Jordan: awareness, attitude and practice
Authors: Al Omari Mousa , Khader Yousef , Jadallah Khaled , Dauod Ali Shakir , Al‐shdifat Amjad Ali Khalaf , Khasawneh Nofan M. 
Published: December 2009

Abstract
Objectives  The aim of this cross‐sectional study was to determine the awareness and attitude of hospital doctors towards evidence‐based medicine (EBM) and their related educational needs.
Methods  A questionnaire study was performed on a randomly selected sample of 386 hospital doctors from both a teaching hospital and the Ministry of Health general hospitals in Jordan. Attitude towards EBM, best method of moving from opinion‐based medicine to EBM, accessing and interpreting evidence and perceived barriers to practise EBM among participants were the main outcome measures.
Results  Participants welcomed promotion of EBM and 91.2% agreed that research findings are helpful in daily management of patients. About one‐third of respondents (32.7%) thought that the most appropriate way to move towards EBM was by seeking and applying EBM summaries. About one half of participants (47.9%) were unaware of Cochrane database and only 5% used it to help in clinical decision making. More than half (53.7%) reported that they had access to the Internet at their office. Only minority understand the technical terms used in EBM. The major barriers to practising EBM were threat to clinical freedom/judgement, limited resources and facilities, patient overload absence of library in the locally and lack of personal time.
Conclusions  Although there is a high support among doctors for the promotion of EBM, there is a deficit in knowledge and skills of EBM. Hence, the time appears ripe for planning and implementing an effective EBM educational programme for both undergraduate and postgraduate doctors.
On the causal structure of information bias and confounding bias in randomized trials
Authors: Shahar Eyal , Shahar Doron J. 
Published: December 2009

AbstractRandomized trials are undoubtedly different from observational studies, but authors sometimes propose differences between these designs that do not exist. In this article we examine two claims about randomized trials: first, a recent claim that the causal structure of exposure measurement (information) bias in a randomized trial differs from the causal structure of that bias in an observational study. Second, a long‐standing claim that confounding bias cannot operate in a randomized trial – if randomization was perfectly implemented. Using causal diagrams (causal directed acyclic graphs), we show that both claims are false in the context of an intention‐to‐treat analysis. We also describe a previously unrecognized mechanism of information bias, and suggest that the term ‘information bias’ should replace the terms ‘measurement bias’ and ‘observation bias’.
Role of aquaporins in root water transport of ectomycorrhizal jack pine (Pinus banksiana) seedlings exposed to NaCl and fluoride
Authors: LEE SEONG HEE , CALVO‐POLANCO MÓNICA , CHUNG GAP CHAE , ZWIAZEK JANUSZ J. 
Published: December 2009

ABSTRACTEffects of ectomycorrhizal (ECM) fungus Suillus tomentosus on water transport properties were studied in jack pine (Pinus banksiana) seedlings. The hydraulic conductivity of root cortical cells (Lpc) and of the whole root system (Lpr) in ECM plants was higher by twofold to fourfold compared with the non‐ECM seedlings. HgCl2 had a greater inhibitory effect on Lpc in ECM compared with non‐ECM seedlings, suggesting that the mercury‐sensitive, aquaporin (AQP)‐mediated water transport was largely responsible for the differences in Lpc between the two groups of plants. Lpc was rapidly and drastically reduced by the 50 mm NaCl treatment. However, in ECM plants, the initial decline in Lpc was followed by a quick recovery to the pre‐treatment level, while the reduction of Lpc in non‐ECM seedlings progressed over time. Treatments with fluoride reduced Lpc by about twofold in non‐ECM seedlings and caused smaller reductions of Lpc in ECM plants. When either 2 mm KF or 2 mm NaF were added to the 50 mm NaCl treatment solution, the inhibitory effect of NaCl on Lpc was rapidly reversed in both groups of plants. The results suggest that AQP‐mediated water transport may be linked to the enhancement of salt stress resistance reported for ECM plants.
Variation in salinity tolerance and shoot sodium accumulation in Arabidopsis ecotypes linked to differences in the natural expression levels of transporters involved in sodium transport
Authors: JHA D. , SHIRLEY N. , TESTER M. , ROY S. J. 
Published: December 2009

ABSTRACTSalinity tolerance can be attributed to three different mechanisms: Na+ exclusion from the shoot, Na+ tissue tolerance and osmotic tolerance. Although several key ion channels and transporters involved in these processes are known, the variation in expression profiles and the effects of these proteins on Na+ transport in different accessions of the same species are unknown. Here, expression profiles of the genes AtHKT1;1, AtSOS1, AtNHX1 and AtAVP1 are determined in four ecotypes of Arabidopsis thaliana. Not only are these genes differentially regulated between ecotypes, the expression levels of the genes can be linked to the concentration of Na+ in the plant. An inverse relationship was found between AtSOS1 expression in the root and total plant Na+ accumulation, supporting a role for AtSOS1 in Na+ efflux from the plant. Similarly, ecotypes with high expression levels of AtHKT1;1 in the root had lower shoot Na+ concentrations, due to the hypothesized role of AtHKT1;1 in retrieval of Na+ from the transpiration stream. The inverse relationship between shoot Na+ concentration and salinity tolerance typical of most cereal crop plants was not demonstrated, but a positive relationship was found between salt tolerance and levels of AtAVP1 expression, which may be related to tissue tolerance.
ACO1, a gene for aminocyclopropane‐1‐carboxylate oxidase: effects on internode elongation at the heading stage in rice
Authors: IWAMOTO M. , BABA‐KASAI A. , KIYOTA S. , HARA N. , TAKANO M. 
Published: December 2009

ABSTRACTAlthough reports on a gene for 1‐amino‐cyclopropane‐1‐carboxylate (ACC) oxidase (ACO1) in rice (Oryza sativa L.) suggest that high levels of its transcript are associated with internode elongation of deep‐water rice during submergence, the role of ACO1 in rice development is largely unknown. The tissue‐specificity of ACO1 expression indicated that its transcript significantly accumulated in lower parts of elongating internodes at the heading stage. Histochemical analysis and in situ hybridization showed that the ACO1 expression was localized in the basal parts of leaf sheaths immediately above nodes or the lower parts of elongating internodes. To further examine the role of ACO1, ACO1‐deficient (aco1) and overexpressing (ACO1‐OX) mutants were characterized. The total length of the elongated internodes of aco1 mutants was slightly shorter than that of wild‐type plants and that of ACO1‐OX mutants was longer. Interestingly, expression of the ACC synthase gene ACS1 and ethylene signalling gene OsEIN2 was up‐regulated in the aco1 mutants. This study suggests that the ACO1 has a little effect on internode elongation at the heading stage, and that up‐regulation of the ACS1 and OsEIN2 expression may attenuate inhibition of internode elongation.
Mapping of the dog skin based on biophysical measurements
Authors: Oh Won‐Seok , Oh Tae‐Ho 
Published: December 2009

AbstractTrans epidermal water loss (TEWL), skin hydration status and pH were determined in 14 skin regions of five healthy male Beagle dogs (2–4 years) both before and after anaesthesia. Trans epidermal water loss was highest for the footpad and head and lowest for the inguinal region. Skin hydration status was higher in the ear but did not vary significantly in other regions. Skin pH was usually alkaline with the highest values on the lower back and tail. Following anaesthesia, TEWL and skin hydration were significantly lower on the head, upper back and footpad, and upper back and elbow respectively, while skin pH was unaffected by this procedure. While measurement of pH would seem to be valid anywhere on the body in anaesthetized dogs, regional factors should be considered when interpreting TEWL and skin hydration values and when treating regional skin diseases in veterinary practice.
Differential effects of nutrient availability on the secondary metabolism of Austrian pine (Pinus nigra) phloem and resistance to Diplodia pinea
Authors: Wallis C. , Eyles A. , Chorbadjian R. A. , Riedl K. , Schwartz S. , Hansen R. , Cipollini D. , Herms D. A. , Bonello P. 
Published: December 2009

SummaryNutrient availability can modulate the incidence and severity of plant diseases. We examined the effects of fertility on (i) host resistance and (ii) secondary metabolite production in the Pinus nigra Arnold –Diplodia pinea (Desm.) Kickx pathosystem. Following preconditioning of trees to one of three fertility levels for one growing season, phloem tissue of one branch was harvested for chemical analyses while another branch on the same whorl was inoculated with the fungus to assess resistance. Nutrient availability had concave and convex quadratic effects on concentrations of total monoterpenes and total phenolics respectively, but had no effect on fungal lesion lengths. Lesion lengths were negatively correlated with lignin, suggesting that this compound is an important factor in resistance. Counteracting effects of nutrient availability on phenolic and terpenoid pathways may explain why fertility had no effect on expression of disease resistance.
First Report and the Genetic Variability of Cucumber green mottle mosaic virus Occurring on Bottle Gourd in Myanmar
Authors: Kim Ok‐Kyung , Mizutani Tadasuke , Natsuaki Keiko T. , Lee Key‐Woon , Soe Khin 
Published: December 2009

AbstractBottle gourd [Lagenaria siceraria (Mol.) Standl.] plants showing leaf mosaic and mottle were observed in Myanmar in 2007 and shown by RT‐PCR and ELISA to be infected with Cucumber green mottle mosaic virus (CGMMV). This is the first report of the virus occurring in Myanmar. Despite considerable differences in geographical origins, natural host species and year of sampling of 22 CGMMV isolates, we found low genetic variation of the CP gene except for isolates GR3 and GR5, which showed similarity higher than 97%; based on the MP gene, and 16 CGMMV isolates showed similarity higher than 94% in nucleotide identities by pairwise comparison. Using MluI restriction endonuclease for CP genes, the CGMMV isolates fell into three types: Type I and Type II were included in the SH group and Type III in the W group. The two CGMMV isolates from Myanmar were found to belong to Type I and Type III, respectively.
Helicobacter pylori colonization of the human gastric epithelium: A bug's first step is a novel target for us
Authors: Sheu Bor‐Shyang , Yang Hsiao‐Bai , Yeh Yu‐Chun , Wu Jiunn‐Jong 
Published: December 2009

AbstractAfter Helicobacter pylori enters the stomach, three steps are vital for infection: (i) establishing colonization; (ii) evading host immunity; and (iii) invading gastric mucosa; the last step is what is associated with diverse outcomes. Urease activity and motility mediated by the flagella of H. pylori are important in harboring colonies beneath the gastric mucus in niches adjacent to the epithelium. Several putative adhesins attach the organism to the gastric epithelium and prompt the succeeding processes for evading host immunity and invading the mucosa. Successful colonization is thus the leading and critical step. From another point of view, this can be a novel target to control this common and important infection. This review summarizes the putative adhesins that influence the evasion of host immunity, and how these could determine different clinico‐pathologic outcomes. The putative adhesins include the interplay between bacterial and host Lewis antigens (type I: Lea and Leb; type II: Lex and Ley), the dominant pathway between BabA and Leb, the SabA adhesin binding to sialylated Lex that is upregulated in inflamed gastric tissue or those with weak‐Leb, the CagL apparatus to adapt with the α5β1 integrin to mediate a type IV secretory system for CagA translocation into the epithelium; and other outer membrane proteins as HopZ, AlpA/AlpB, or OipA, without known corresponding receptors. This review implicates the adhesins vital for bugs that could be alternatively provided as novel targets for us to overcome the colonization.
A challenge to chronic kidney disease in Asia: The report of the second Asian Forum of Chronic Kidney Disease Initiative
Authors: TSUKAMOTO YUSUKE , JHA VIVEKANAND , BECKER GAVIN , CHEN HUNG CHUN , PERKOVIC VLADO , PRODJOSUDJADI WIGUNO , TUNGSANGA KRIANG , WANG HAIYAN , MORAD ZAKI 
Published: December 2009

ABSTRACT:Background:  The Asian Forum of Chronic Kidney Disease Initiative started in 2007 in Hamamatsu, Japan when delegates from 16 countries joined together to facilitate collaboration in studying chronic kidney disease (CKD) in the Asia–Pacific region. Based on the outcome of the first meeting, the second meeting was organized as a consensus conference to frame the most relevant issues, and develop research recommendations and action plan.Proceedings:  The meeting was held on 4 May 2008 as a pre‐conference meeting to the 11th Asian Pacific Congress of Nephrology in Kuala Lumpur. This meeting consisted of three sessions: Session I was dedicated to the estimation of glomerular filtration rate and the standardization of serum creatinine measurements. Session II discussed specific considerations in the aetiology of and risk factors for end‐stage renal disease in Asia. We concluded that there were regional specific problems that might lead to a very high prevalence of end‐stage renal disease. Session III discussed the issue of facilitation of coordination and integration of the CKD initiative between developed and developing countries in the Asia–Pacific region.Conclusion:  The following action plans were formulated: (i) validating the existing global estimated glomerular filtration rate equation or creating a new one using serum creatinine standardized by a central laboratory; (ii) establishing a pan‐Asian CKD registry to facilitate risk analysis of CKD and its comorbidities; (iii) adapting existing clinical practice guidelines for CKD detection and management to address specific problems in this region; and (iv) working closely with other international professional organizations to promote manpower development and education in different aspects of CKD in developing countries.
Behavioural and cognitive abnormalities in an imprinting centre deletion mouse model for Prader–Willi syndrome
Authors: Relkovic Dinko , Doe Christine M. , Humby Trevor , Johnstone Karen A. , Resnick James L. , Holland Anthony J. , Hagan Jim J. , Wilkinson Lawrence S. , Isles Anthony R. 
Published: December 2009

AbstractThe genes in the imprinted cluster on human chromosome 15q11–q13 are known to contribute to psychiatric conditions such as schizophrenia and autism. Major disruptions of this interval leading to a lack of paternal allele expression give rise to Prader–Willi syndrome (PWS), a neurodevelopmental disorder with core symptoms of a failure to thrive in infancy and, on emergence from infancy, learning disabilities and over‐eating. Individuals with PWS also display a number of behavioural problems and an increased incidence of neuropsychiatric abnormalities, which recent work indicates involve aspects of frontal dysfunction. To begin to examine the contribution of genes in this interval to relevant psychological and behavioural phenotypes, we exploited the imprinting centre (IC) deletion mouse model for PWS (PWS‐IC+/−) and the five‐choice serial reaction time task (5‐CSRTT), which is primarily an assay of visuospatial attention and response control that is highly sensitive to frontal manipulations. Locomotor activity, open‐field behaviour and sensorimotor gating were also assessed. PWS‐IC+/− mice displayed reduced locomotor activity, increased acoustic startle responses and decreased prepulse inhibition of startle responses. In the 5‐CSRTT, the PWS‐IC+/− mice showed deficits in discriminative response accuracy, increased correct reaction times and increased omissions. Task manipulations confirmed that these differences were likely to be due to impaired attention. Our data recapitulate several aspects of the PWS clinical condition, including findings consistent with frontal abnormalities, and may indicate novel contributions of the imprinted genes found in 15q11–q13 to behavioural and cognitive function generally.
Four Documents, a Non‐Citizen, and a Diplomatic Controversy: The Documentation of Identity in the Mid‐Nineteenth Century
Authors: ROBERTSON CRAIG 
Published: December 2009

AbstractA forgotten diplomatic controversy centered on the claim to U.S. protection by a yet‐to‐be‐naturalized citizen is analyzed to offer insights into the mid‐nineteenth century understanding of the status and function of the documentation of individual identity. It makes clear the documentation of identity had a contested and gradual development. Documentation was contested in that people (both officials and members of the public) struggled to understand how it was that a document identified a person. This uncertainty centered not only on who had the authority to document identity, but how that authority was represented on a document. Beyond its mid‐nineteenth century and U.S. focus this essay is intended to provide the context for an understanding of the administrative, bureaucratic, and social developments that had to occur before identification documents could play a pivotal role in the development of the twentieth century state. In this way it suggests that official identification is an important object of analysis for debates about the articulation of information and governing in state formation.