bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polymorphism of the oestrogen receptor beta gene (ESR2) is associated with susceptibility to Graves’ disease
Authors: Kisiel Bartlomiej , Bednarczuk Tomasz , Kostrzewa Grażyna , Kosinska Joanna , Mi2kiewicz Piotr , Plazinska Maria Teresa , Bar‐Andziak Ewa , Królicki Leszek , Krajewski Pawel , Ploski Rafal 
Published: September 2010

SummaryObjective  To investigate whether a polymorphism in the ESR2 gene (rs4986938, previously associated with endometriosis, ovulatory dysfunction and premature onset of coronary heart disease) increases the risk of Graves’ disease (GD).Subjects and design  A cohort of 375 GD patients (300 females and 75 males) and 1001 individuals representative of the background population of Poland (502 males and 499 females) were genotyped for rs4986938 using allele‐specific polymerase chain reaction (PCR).Results  We found an increased frequency of the ESR2 A allele among the patients vs. controls (38·0%vs. 32·7%, OR = 1·26, P = 0·009) that was caused by a co‐dominant (OR = 1·25, P = 0·01, Pfor model fit = 0·127) or a recessive (OR = 1·67, P = 0·003, Pfor model fit = 0·554) effect. The association was found in both sexes (OR = 1·21, P = 0·046 and OR = 1·53, P = 0·029, respectively, for co‐dominant and recessive models in females, and OR = 1·44, P = 0·034 and OR = 2·29, P = 0·01, respectively, for the two models in males) and was more pronounced among the DRB1*03‐negative (OR = 1·63, P = 0·0002) than DRB1*03‐positive patients (OR = 1·04, P = 0·822). No other statistically significant associations between the ESR2 genotype and GD subsets were found (age of onset, smoking, clinically evident ophthalmopathy, family history of GD, and PTPN22 and CTLA4 (CT60) genotypes were analysed).Conclusions  In a Polish population the ESR2 A allele is associated with GD with a strength comparable to polymorphisms of PTPN22 and CTLA4 CT60 loci (OR ~ 1·7). The association with ESR2 is found in both sexes and may be particularly strong among the DRB1*03‐negative individuals.
Association between serum TSH, free T4 and serum liver enzyme activities in a large cohort of unselected outpatients
Authors: Targher Giovanni , Montagnana Martina , Salvagno Gianluca , Moghetti Paolo , Zoppini Giacomo , Muggeo Michele , Lippi Giuseppe 
Published: September 2010

SummaryObjective  Although overt thyroid dysfunction is associated with some liver abnormalities, there is a dearth of information on liver function tests across thyroid function tests. We assessed the relationship between serum liver enzyme activity and thyroid function tests in a cohort of adult individuals.Design, patients and measurements  We performed a retrospective analysis on the database of the Clinical Chemistry Laboratory at the Verona University Hospital to retrieve results of serum liver enzyme activities [alanine aminotransferase (ALT), γ‐glutamyltransferase (GGT)] and thyroid function tests (TSH and free T4), which have been performed on the whole cohort of outpatient adults consecutively referred by general practitioners for routine blood testing during the last 3 years.Results  Cumulative results for serum GGT, ALT and TSH concentrations were retrieved for 10 292 (68·3% females) outpatient adults with a wide range of age and thyroid function tests. Subjects were categorized according to serum TSH concentrations as follows: < 0·1, 0·1–0·35, 0·36–4·5, 4·6–10 and >10 mU/l. Serum GGT and ALT concentrations increased steadily across the increasing TSH categories (P < 0·0001 for trends), ranging from mean values of 36 to 62 U/l for GGT and from 29 to 41 U/l for ALT, respectively. Similarly, there was a negative, graded, relationship between serum GGT and ALT concentrations and free T4 categories. The results did not change after adjusting for gender, age, lipids and fasting glucose concentrations.Conclusions   Our findings suggest that hypothyroidism and thyroid function tests, even within the reference range, are associated with slightly increased serum GGT and ALT activity concentrations.
Effects of environmental stress cascade up through four trophic levels in a salt marsh study system
Authors: MOON DANIEL C. , MOON JAMIE C. 
Published: September 2010

1. Although in recent years there have been a number of studies demonstrating trophic cascades in terrestrial systems, it is still unclear what environmental conditions enable or enhance such cascades, especially among four trophic levels.2. In this study, the influence of environmental stress (increased soil pore water salinity) on a four trophic level study system in a Florida salt marsh was examined by experimentally increasing soil pore water salinity. Effects of increased salinity on the quality of the host plant, Batis maritima, were assessed, as were resulting effects on the lepidopteran herbivore Ascia monuste, and the primary parasitoids and hyperparasitoids of its caterpillars.3. Increased salinity altered host‐plant quality, which subsequently affected the consumer species. These effects of altered plant quality cascaded up through the herbivore and primary parasitoid to the hyperparasitoid Hypopteromalus inimicus, influencing its density, sex ratio, body size, and initial egg load.4. These results demonstrate how heterogeneity in environmental stress can result in effects that cascade up through four trophic levels. We suggest that such strong effects at higher trophic levels may be more likely in systems in which relationships are more specific and intimate such as those among hosts, parasitoids, and hyperparasitoids.
Analytical decision model for sample size and effectiveness projections for use in planning a population‐based randomized controlled trial of colorectal cancer screening
Authors: Chiu Sherry Y‐H , Malila Nea , Yen Amy M‐F , Anttila Ahti , Hakama Matti , Chen H‐H 
Published: September 2010

AbstractRationale, aims and objectives  Population‐based randomized controlled trials (RCTs) often involve enormous costs and long‐term follow‐up to evaluate primary end points. Analytical decision‐simulated model for sample size and effectiveness projections based on primary and surrogate end points are necessary before planning a population‐based RCT.Method  Based on the study design similar to two previous RCTs, transition rates were estimated using a five‐state natural history model [normal, preclinical detection phase (PCDP) Dukes' A/B, PCDP Dukes' C/D, Clinical Dukes' A/B and Clinical Dukes' C/D]. The Markov cycle tree was assigned transition parameters, variables related to screening and survival rate that simulated results of 10‐year follow‐up in the absence of screening for a hypothetical cohort aged 45–74 years. The corresponding screened arm was to simulate the results after the introduction of population‐based screening for colorectal cancer with fecal occult blood test with stop screen design.Results  The natural course of mean sojourn time for five‐state Markov model were estimated as 2.75 years for preclinical Dukes' A/B and 1.38 years for preclinical Dukes' C/D. The expected reductions in mortality and Dukes' C/D were 13% (95% confidence intervals: 7–19%) and 26% (95% confidence intervals: 20–32%), respectively, given a 70% acceptance rate and a 90% colonoscopy referral rate. Sample sizes required were 86 150 and 65 592 subjects for the primary end point and the surrogate end point, respectively, given an incidence rate up to 0.0020 per year.Conclusions  The sample sizes required for primary and surrogate end points and the projection of effectiveness of fecal occult blood test for colorectal cancer screening were developed. Both are very important to plan a population‐based RCT.
Friction and shear highly associated with pressure ulcers of residents in long‐term care – Classification Tree Analysis (CHAID) of Braden items
Authors: Lahmann Nils A. , Tannen Antje , Dassen Theo , Kottner Jan 
Published: September 2010

AbstractAims  Among various risk assessment scales for the development of pressure ulcers in long‐term care residents that have been published in the last three decades, the Braden scale is among the most tested and applied tools. The sum score of the scale implies that all items are equally important. The aim of this study is to show whether specific items are of greater significance than others and therefore have a higher clinical relevance.Design  Data analysis of six pressure ulcer prevalence studies (2004–2009).Methods  A total of 17 666 residents (response rate 79.6%) in 234 long‐term care facilities participated in 6 annual point prevalence studies that were conducted from 2004 to 2009 throughout Germany. For the classification of the sample regarding pressure ulcers as a dependent variable and the Braden items as predictor variables, Chi‐square Automatic Interaction Detector (CHAID) for modelling classification trees has been used.Results  Pressure ulcer prevalence was 5.4% including pressure ulcer grade 1 and 3.4% for pressure ulcer grades 2–4. CHAID analysis for the classification tree provided the item ‘friction and shear’ as the most important predictor for pressure ulcer prevalence. On the second level, the strongest predictors were ‘nutrition’ and ‘activity’ and on the third level they were ‘moisture’ and ‘mobility’. Residents with problems regarding ‘friction and shear’ and poor nutritional status present with an 18.0 (14.8) pressure ulcer prevalence which is 3–4 times higher than average.Conclusion  CHAID analyses have shown that all items of the Braden scale are not equally important. For residents in long‐term care facilities in Germany, the existence of ‘friction and shear’ as a potential and especially as a manifest problem has had the strongest association with pressure ulcer prevalence.
Outcome following a first manic episode: cross‐national US and Taiwan comparison
Authors: Strakowski Stephen M , Tsai Shang‐Ying , DelBello Melissa P , Chen Chiao‐Chicy , Fleck David E , Adler Caleb M , Arndt Stephan , Amicone Jennifer 
Published: September 2010

Objectives:  Bipolar disorder (BD) is recognized as a significant psychiatric condition worldwide, yet little is known about cross‐national differences in the course of illness. This information might clarify features of the disorder that are illness versus culturally specific. Therefore, the aim of this study was to identify differential and shared outcome predictors in first‐episode manic bipolar patients in Cincinnati, OH, USA and Taipei, Taiwan.Methods:  DSM‐IV bipolar patients were identified at the time of their first manic or mixed episode and were prospectively followed in a naturalistic, longitudinal study for one year. Patients were recruited from a first psychiatric hospitalization at university‐affiliated, urban hospitals in Taipei and Cincinnati. The primary outcome measures were remission, recovery, recurrence and percent of follow‐up spent with affective symptoms and syndromes. Treatment adherence was also assessed, as were a number of possible mediator variables.Results:  The two patient groups showed a number of significant differences in index clinical presentation on characteristics previously associated with outcome in other studies (e.g., substance abuse). The patients in Taipei showed significantly better outcome on virtually all measures. Some of these findings reflected differences in index (mediator) variables, whereas others persisted after controlling for potential baseline confounds.Conclusions:  The early course of BD varies between Chinese and American patients. Some of this variance results from demographic and clinical cross‐national differences in premorbid variables. Other sources of variance remain to be identified.
Brain systems underlying response flexibility in healthy and bipolar adolescents: an event‐related fMRI study
Authors: Nelson Eric E , Vinton Deborah T , Berghorst Lisa , Towbin Kenneth E , Hommer Rebecca E , Dickstein Daniel P , Rich Brendan A , Brotman Melissa A , Pine Daniel S , Leibenluft Ellen 
Published: September 2010

Objectives:  Previous studies have indicated abnormalities in response flexibility in pediatric bipolar disorder (BD). Dysfunction in response flexibility may contribute to the pattern of behavioral and emotional dysregulation that is characteristic of BD, since depressed and manic patients respond inflexibly to emotional stimuli (i.e., anhedonia in the case of depression or inappropriate positive affect in the case of mania). The present study was undertaken to determine if neuronal responses differed between BD and control subjects on a simple motor response flexibility task.Methods:  To elucidate the neural substrates mediating response flexibility in pediatric BD, we studied 25 youth with BD and 17 age‐, gender‐ and IQ‐matched controls (CON) as they performed the change task while undergoing event‐related functional magnetic resonance imaging (fMRI). The change task is a new fMRI task that requires subjects to both inhibit and replace a prepotent motor response with another motor response after the initial response has been cued.Results:  On correctly performed change trials relative to correctly performed go trials, BD patients generated significantly more activity in the left dorsolateral prefrontal cortex (DLPFC) and in the primary motor cortex than did healthy controls, even though performance levels did not differ across groups.Conclusions:  These results indicate that functional deficits within the left DLPFC may mediate deficits in response flexibility in pediatric BD. This deficit may extend beyond the realm of motor control and also affect emotion regulation.
The early manifestations of bipolar disorder: a longitudinal prospective study of the offspring of bipolar parents
Authors: Duffy Anne , Alda Martin , Crawford Leah , Milin Robert , Grof Paul 
Published: September 2010

Objective:  A major aim of this longitudinal high‐risk study is to identify reliable early indicators of emerging bipolar disorder (BD) among offspring from well‐characterized parents.Methods:  High‐risk offspring were recruited from families in which one parent had BD diagnosed on the basis of the Schedule for Affective Disorders and Schizophrenia – Lifetime version (SADS‐L) interviews and DSM‐IV diagnostic criteria and the other parent was well. Bipolar parents were further subdivided on the basis of response or non‐response to long‐term lithium. A comparison group of offspring was recruited from well parents diagnosed on the basis of either SADS‐L interviews or the family history method. All consenting offspring from high‐risk and control families were assessed longitudinally with the Schedule for Affective Disorders and Schizophrenia for School‐aged Children – Present and Lifetime version (KSADS‐PL) interviews and DSM‐IV diagnoses were made on a blind consensus review. The offspring were reassessed on average annually, as well as at any time symptoms developed.Results:  Antecedent conditions to BD in both high‐risk groups included sleep and anxiety disorders, while attention‐deficit hyperactivity disorder and pre‐psychotic conditions were antecedents among the offspring of lithium non‐responders only. Among those offspring developing BD, the index mood episode was almost always depressive.Conclusions:  Despite a specific genetic risk, BD began with non‐specific psychopathology and/or depressive disorders in a majority of offspring. Therefore, diagnosis based only on cross‐sectional assessment of symptoms appears to be insufficient for the accurate early detection of emerging BD. Other parameters such as family history and associated antecedents should be taken into account.
Antidepressant‐associated switches from depression to mania in severe bipolar disorder
Authors: Carlson Gabrielle A , Finch Stephen J , Fochtmann Laura J , Ye Qing , Wang Qing , Naz Bushra , Bromet Evelyn J 
Published: September 2010

Objectives:  To determine whether switching from depression to mania is part of the natural history of bipolar illness or results from antidepressant (AD) treatment by examining bipolar patients with psychosis early in their illness course.Methods:  A multi‐facility cohort of 123 first‐admission inpatients, aged 15–60 years, with DSM‐IV bipolar disorder (BD) with psychotic features, was followed for four years, and 76 individuals experienced at least one episode of depression. Frequency of and risk factors for switches from depression to mania, time to switch, and duration of the subsequent manic episode were examined in relation to AD use (with anti‐manic and/or antipsychotic medications).Results:  The 76 respondents experienced 113 depressive episodes. Those prescribed ADs had more depressive episodes and spent more time depressed than non‐users. A total of 23 depressive episodes in 17 respondents ended in a manic/hypomanic/mixed episode (20%). The time to switch and duration of the subsequent manic episode were not significantly different for the seven respondents and nine episodes involving AD treatment versus the 10 respondents and 14 episodes without ADs. None of the risk factors (age of onset ≤18 years, childhood psychopathology, depressive first episode, substance abuse at index admission, bipolar family history, type of AD used) was associated with switching.Conclusions:  In this sample with severe BD, switching from depression to mania was not associated with AD treatment. Respondents who experienced switching appeared to have a more relentless form of BD. In only a few did ADs appear to be responsible for the switch.
Factors associated with mental health service utilization among bipolar youth
Authors: Rizzo Christie J , Esposito‐Smythers Christianne , Swenson Lance , Birmaher Boris , Ryan Neal , Strober Michael , Chiappetta Laurel , Valeri Sylvia , Hunt Jeffrey , Axelson David , Leonard Henrietta , Keller Martin 
Published: September 2010

Objectives:  This study aims to characterize patterns of mental health service utilization within a sample of bipolar youth. Demographic variables, youth bipolar characteristics, youth comorbid conditions, and parental psychopathology were examined as predictors of treatment utilization across different levels of care.Methods:  A total of 293 bipolar youth (aged 7–17 years) and their parents completed a diagnostic interview, family psychiatric history measures, and an assessment of mental health service utilization. Demographic and clinical variables were measured at baseline and mental health service use was measured at the six‐month follow‐up.Results:  Approximately 80% of bipolar youth attended psychosocial treatment services over the span of 6 months. Of those who attended treatment, 67% attended only outpatient services, 22% received inpatient/partial hospitalization, and 12% received residential/therapeutic school‐based services. Using multinomial logistic regression, older age, female gender, and bipolar characteristics, including greater symptom severity and rapid cycling, were found to predict higher levels of care. Youth suicidal and non‐suicidal self‐injurious behavior, comorbid conduct disorder, and parental substance use disorders also predicted use of more restrictive treatment settings.Conclusions:  Results underscore the importance of assessing for and addressing suicidality, comorbid conduct disorder, and parental substance use disorders early in the treatment of bipolar youth to potentially reduce the need for more restrictive levels of care.
Complicated grief and impaired sleep in patients with bipolar disorder
Authors: Maytal Guy , Zalta Alyson K , Thompson Elizabeth , Chow Candice W , Perlman Carol , Ostacher Michael J , Pollack Mark H , Shear Katherine , Simon Naomi M 
Published: September 2010

Objectives:  To examine the relationship of sleep disturbance with complicated grief (CG) in patients with bipolar disorder (BD).Methods:  Adults with DSM‐IV BD were asked if they ever experienced significant loss and, if so, completed the Inventory of Complicated Grief. Subjective sleep disturbance was assessed with the Pittsburgh Sleep Quality Index (PSQI). The association of CG with sleep disturbance was assessed in univariate t‐tests, and in multivariate analyses controlling for the presence of anxiety disorder comorbidity and current bipolar recovery status.Results:  Individuals with CG had significantly higher mean PSQI scores (10.9 versus 7.9, p = 0.003) than those without CG. Further, within the group of BD participants who had experienced a significant loss, those with CG had significantly poorer sleep (p = 0.01). CG remained significantly associated with greater sleep impairment after adjustment for comorbid anxiety disorder and bipolar mood state. This additive impairment in sleep with CG comorbidity was evident for four of the PSQI component scales: sleep quality, sleep duration, sleep efficiency and sleep disturbance.Conclusions:  Our data indicate a significant association of CG with poor sleep in individuals with BD. Disturbed sleep may be a mechanism by which CG increases the burden of illness in BD.
A prospective open‐label treatment trial of ziprasidone monotherapy in children and adolescents with bipolar disorder
Authors: Biederman Joseph , Mick Eric , Spencer Thomas , Dougherty Meghan , Aleardi Megan , Wozniak Janet 
Published: September 2010

Objective:  To assess the effectiveness and tolerability of ziprasidone for treating pediatric mania.Methods:  This was an eight‐week, open‐label, prospective study of ziprasidone monotherapy (57.3 ± 33.9 mg/day) in 21 bipolar youth [manic, mixed, or bipolar not otherwise specified (NOS); 6–17 years old]. Assessments included the Young Mania Rating Scale (YMRS), Clinical Global Impressions‐Improvement scale (CGI‐I), and Brief Psychiatric Rating Scale (BPRS). Adverse events were assessed through spontaneous self‐reports, vital signs, weight monitoring, and laboratory analysis.Results:  Fourteen of the 21 youth (67%) completed the study. Ziprasidone treatment was associated with clinically and statistically significant improvement in mean YMRS scores (−10.8 ± 8.4, p < 0.0001) and 57% had a CGI‐I ≤2 at endpoint. Ziprasidone was well tolerated with no statistically significant increase in body weight (0.6 ± 0.4 kg, p = 0.2) or QTc interval (−3.7 ± 4.7, p = 0.5).Conclusions:  Open‐label ziprasidone treatment was associated with a significant short‐term improvement of symptoms of pediatric bipolar disorder. Future placebo‐controlled, double‐blind studies are warranted.
Light therapy for bipolar disorder: a case series in women
Authors: Sit Dorothy , Wisner Katherine L , Hanusa Barbara H , Stull Stacy , Terman Michael 
Published: September 2010

Objectives:  To perform a dose‐ranging safety and efficacy study of bright light therapy for depression in women with bipolar disorder (BD).Methods:  Nine women with DSM‐IV BD I or II in the depressed phase were exposed to 50 lux (illuminance at the receiving surface) red light for two weeks, after which they received 7,000 lux light therapy for two‐week epochs of 15, 30 and 45 min daily. The Structured Interview Guide for the Hamilton Depression Rating Scale with Atypical Depression Supplement and the Mania Rating Scale were used to assess mood symptoms. Four patients received morning light and five patients received midday light.Results:  Three of the four subjects treated with morning light developed mixed states. The fourth subject achieved a full, sustained response. To decrease the risk of inducing mixed episodes, we changed the time of light exposure to midday. Of the five women who received midday light therapy, two achieved full response and two showed early improvement but required a dose increase to sustain response. One woman remained depressed with 45 min of midday light but responded fully to a switch to morning light, 30 min daily.Conclusions:  Women with bipolar illness are highly sensitive to morning bright light treatment; the induction of mixed states is a substantial risk. Initiating treatment with a brief duration (15 min) of midday light for bipolar depression is advisable.