bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current treatment protocols can offer a normal or near‐normal quality of life in the majority of patients with non‐functioning pituitary adenomas
Authors: Capatina Cristina , Christodoulides Constantinos , Fernandez Alberto , Cudlip Simon , Grossman Ashley B. , Wass John A. H. , Karavitaki Niki 
Published: May 2012

SummaryObjectiveNon‐functioning pituitary adenomas (NFA) may be associated with significant morbidity. Published data on the quality of life (QoL) of patients with NFA are scarce and conflicting. In view of the discordant findings and the advances in the management of these subjects, we aimed to evaluate the QoL in patients with NFA followed up in a tertiary endocrine UK referral centre.Subjects and MethodsAll consecutive patients with NFA attending the outpatient clinic in the Department of Endocrinology in Oxford over a 6‐month period (n = 193) were offered 3 health‐related QoL questionnaires [Short Form 36 (SF36), Nottingham Health Profile (NHP), European Quality of Life Scale (EuroQoL)] to complete. Patient outcomes (response rate 93·3%) were compared with age‐related UK reference values.ResultsNone of the QoL scores in the SF‐36 or the 5 dimensions of health in the EuroQoL was different from the reference values. The visual analogue scale (VAS) score (EuroQoL) was slightly compromised (P = 0·041). In the NHP questionnaire, males had no parameter significantly affected, whereas females performed worse in 1/6 areas (energy levels). Tumour recurrence was an independent predictor for compromised VAS score and for anxiety/depression (EuroQoL), and visual field defects for more frequent problems with interests/hobbies (NHP).ConclusionsOverall, the health‐related QoL and perception of subjective health in patients with NFA was not compromised to any major extent suggesting that we can now offer the prospect of treatment and replacement, which will provide a normal or near‐normal QoL. Specific groups are affected in various dimensions, necessitating measures to compensate for predisposing factors.
An unbalanced maternal diet in pregnancy associates with offspring epigenetic changes in genes controlling glucocorticoid action and foetal growth
Authors: Drake Amanda J. , McPherson Rhoanne C. , Godfrey Keith M. , Cooper Cyrus , Lillycrop Karen A. , Hanson Mark A. , Meehan Richard R. , Seckl Jonathan R. , Reynolds Rebecca M. 
Published: May 2012

SummaryObjectiveIn epidemiological studies, adverse early‐life conditions associate with subsequent cardiometabolic disease. Hypothesized causes include maternal malnutrition, foetal glucocorticoid overexposure and reduced growth factors. Animal studies suggest a role for epigenetic processes in maintaining early‐life effects into adulthood, but human relevance is unknown. We aimed to investigate relationships between an unbalanced maternal diet in pregnancy, neonatal and adult anthropometric variables with methylation at key genes controlling tissue glucocorticoid action and foetal growth.DesignWe studied 34 individuals aged 40 from the Motherwell cohort study whose mothers ate an unbalanced diet in pregnancy, previously linked with elevated blood pressure and cortisol in adult offspring.MeasurementsDNA methylation at 11β‐hydroxysteroid dehydrogenase type 2 (HSD2), glucocorticoid receptor (GR) and insulin‐like growth factor 2 (IGF2) was measured by pyrosequencing on buffy coat DNA.ResultsMethylation at specific CpGs in the HSD2 promoter and at one of the IGF2 differentially methylated regions (H19 ICR) correlated with neonatal anthropometric variables. CpG methylation within HSD2, GR and H19 ICR was positively associated with increased adiposity and blood pressure in adulthood. Methylation at GR (exon 1F) was increased in offspring of mothers with the most unbalanced diets in pregnancy.ConclusionsAlterations in DNA methylation at genes important in regulating circulating cortisol levels, tissue glucocorticoid action, blood pressure and foetal growth are present in adulthood in association with both early‐life parameters and cardiometabolic risk factors. The data indicate a persisting epigenetic link between early‐life maternal diet and/or foetal growth and cardiovascular disease risk in humans.
Response of stream‐breeding salamander larvae to sediment deposition in southern Appalachian (U.S.A.) headwater streams
Authors: CONOR KEITZER S. , GOFORTH REUBEN R. 
Published: May 2012

Summary1. Increased fine sediment deposition is a prevalent threat to stream biodiversity and has been shown to impact stream‐breeding salamanders negatively. However, their complex life histories make it difficult to determine which stage is affected.2. We conducted field experiments from 26 August to 11 September 2010 and 11 October to 11 November 2010 in two southern Appalachian headwater streams (U.S.A.) to examine the response of larval salamanders to increased fine sediment deposition. Fine sediment was increased in artificial stream channels by 0, 33 and 67%. The number of larvae observed at the end of the experiments was used to determine whether larval microhabitat selection was influenced by fine sediment deposition. A concurrent survey of aquatic larvae in three nearby streams complemented this experiment. Stream substratum composition at survey sites was quantified to examine the effects of fine sediment on larval salamander abundance.3. Increases in fine sediment deposition failed to explain the number of larval salamanders detected in stream channels. Similarly, a negligible effect of fine sediment was observed on abundance estimates.4. These results suggest that fine sediment deposition has a minimal impact on aquatic salamander larvae. Therefore, the effects of increased fine sediment loads on stream‐breeding salamanders may not be the result of deleterious effects on the aquatic larvae but instead may be the result of effects on other stages. Management efforts that consider these other stages are therefore needed to protect stream‐breeding salamander communities.
Herbivore‐induced aspen volatiles temporally regulate two different indirect defences in neighbouring plants
Authors: Li Tao , Holopainen Jarmo K. , Kokko Harri , Tervahauta Arja I. , Blande James D. 
Published: May 2012

Summary1. Many plant species have two inducible indirect defences against herbivores, emission of volatile organic compounds (VOCs) and secretion of extrafloral nectar (EFN). Moreover, herbivore‐induced VOCs can serve as airborne signals in plant–plant communication, inducing and/or priming defences in undamaged neighbouring plants. However, it remains largely unknown, particularly in woody plants, whether herbivore‐induced VOCs induce and/or prime these two indirect defences simultaneously.2. We investigated the VOC‐mediated induction and priming of VOC emission and EFN secretion in the woody plant hybrid aspen (Populus tremula × Populus tremuloides) in the context of plant–plant communication. Hybrid aspen saplings were exposed to VOCs released either from herbivore‐infested or uninfested conspecifics and subsequently challenged by herbivores. VOCs and EFN from exposed plants were collected throughout experiments. Additionally, local and systemic EFN induction was investigated.3. Exposure to VOCs from infested plants directly induced secretion of EFN sugars but not emission of volatile terpenes. Upon subsequent herbivore attack, however, plants previously exposed to herbivore‐induced VOCs released significantly more terpenes than unexposed plants, whereas EFN secretion was not increased, indicating that herbivore‐induced VOCs prime VOC emission but not EFN secretion. This switching in the indirect defence priority from induced EFN secretion to primed VOC emission may reflect the potential fitness disadvantages of VOC emission and EFN secretion on their own. In addition, feeding by Epirrita autumnata larvae reduced EFN sugar production both locally and systemically, which disagrees with previous findings and suggests that EFN secretion varies depending on plant and herbivore species.4. Thereby, our work has parallels and divergences from the most significant previous studies. Nevertheless, it suggests that plants can respond differently to early warning signals and ensuing herbivory and in doing so fine‐tune their different indirect defences timely to achieve optimal use of resources.
How do temperate bryophytes face the challenge of a changing environment? Lessons from the past and predictions for the future
Authors: Désamoré Aurélie , Laenen Benjamin , Stech Michael , Papp Beata , Hedenäs Lars , Mateo Ruben G. , Vanderpoorten Alain 
Published: May 2012

AbstractBryophytes are a group of early land plants, whose specific ecophysiological and biological features, including poikilohydry, sensitivity to moderately high temperature and high dispersal ability, make them ideal candidates for investigating the impact of climate changes. Employing a combined approach of species distribution modelling (SDM) and molecular phylogeography in the temperate moss Homalothecium sericeum, we explore the significance of the Mediterranean refugia, contrasting the southern and northern refugia hypotheses, determine the extent to which recolonization of previously glaciated areas has been facilitated by the high dispersal ability of the species and make predictions on the extent to which it will be impacted by ongoing climate change. The Mediterranean areas exhibit the highest nucleotidic diversities and host a mixture of ancestral, endemic and more recently derived haplotypes. Extra‐Mediterranean areas exhibit low genetic diversities and Euro‐Siberian populations display a significant signal of expansion that is identified to be of Euro‐Siberian origin, pointing to the northern refugia hypothesis. The SDMs predict a global net increase in range size owing to ongoing climate change, but substantial range reductions in southern areas. Presence of a significant phylogeographical signal at different spatial scales suggests, however, that dispersal limitations might constitute, as opposed to the traditional view of spore‐producing plants as efficient dispersers, a constraint for migration. This casts doubts about the ability of the species to face the massive extinctions predicted in the southern areas, threatening their status of reservoir of genetic diversity.
Incident radiation and the allocation of nitrogen within Arctic plant canopies: implications for predicting gross primary productivity
Authors: Street Lorna E. , Shaver Gaius R. , Rastetter Edward B. , van Wijk Mark T. , Kaye Brooke A. , Williams Mathew 
Published: May 2012

AbstractArctic vegetation is characterized by high spatial variability in plant functional type (PFT) composition and gross primary productivity (P). Despite this variability, the two main drivers of P in sub‐Arctic tundra are leaf area index (LT) and total foliar nitrogen (NT). LT and NT have been shown to be tightly coupled across PFTs in sub‐Arctic tundra vegetation, which simplifies up‐scaling by allowing quantification of the main drivers of P from remotely sensed LT. Our objective was to test the LT–NT relationship across multiple Arctic latitudes and to assess LT as a predictor of P for the pan‐Arctic. Including PFT‐specific parameters in models of LT–NT coupling provided only incremental improvements in model fit, but significant improvements were gained from including site‐specific parameters. The degree of curvature in the LT–NT relationship, controlled by a fitted canopy nitrogen extinction co‐efficient, was negatively related to average levels of diffuse radiation at a site. This is consistent with theoretical predictions of more uniform vertical canopy N distributions under diffuse light conditions. Higher latitude sites had higher average leaf N content by mass (NM), and we show for the first time that LT–NT coupling is achieved across latitudes via canopy‐scale trade‐offs between NM and leaf mass per unit leaf area (LM). Site‐specific parameters provided small but significant improvements in models of P based on LT and moss cover. Our results suggest that differences in LT–NT coupling between sites could be used to improve pan‐Arctic models of P and we provide unique evidence that prevailing radiation conditions can significantly affect N allocation over regional scales.
Marine invertebrate skeleton size varies with latitude, temperature and carbonate saturation: implications for global change and ocean acidification
Authors: Watson Sue‐Ann , Peck Lloyd S. , Tyler Paul A. , Southgate Paul C. , Tan Koh Siang , Day Robert W. , Morley Simon A. 
Published: May 2012

AbstractThere is great concern over the future effects of ocean acidification on marine organisms, especially for skeletal calcification, yet little is known of natural variation in skeleton size and composition across the globe, and this is a prerequisite for identifying factors currently controlling skeleton mass and thickness. Here, taxonomically controlled latitudinal variations in shell morphology and composition were investigated in bivalve and gastropod molluscs, brachiopods, and echinoids. Total inorganic content, a proxy for skeletal CaCO3, decreased with latitude, decreasing seawater temperature, and decreasing seawater carbonate saturation state (for CaCO3 as calcite (Ωcal)) in all taxa. Shell mass decreased with latitude in molluscs and shell inorganic content decreased with latitude in buccinid gastropods. Shell thickness decreased with latitude in buccinid gastropods (excepting the Australian temperate buccinid) and echinoids, but not brachiopods and laternulid clams. In the latter, the polar species had the thickest shell. There was no latitudinal trend in shell thickness within brachiopods. The variation in trends in shell thickness by taxon suggests that in some circumstances ecological factors may override latitudinal trends. Latitudinal gradients may produce effects similar to those of future CO2‐driven ocean acidification on CaCO3 saturation state. Responses to latitudinal trends in temperature and saturation state may therefore be useful in informing predictions of organism responses to ocean acidification over long‐term adaptive timescales.
Tertiary prophylaxis in adults: is there a rationale?
Authors: Gringeri A. , Lambert T. , Street A. , Aledort L. 
Published: May 2012

SummaryThere is lack of evidence‐based recommendations or clear‐cut consensus regarding the clinical and economic utility of regular prophylaxis started in adulthood, with the aim of keeping the clinical situation from getting worse by prevention of further bleeds contributing to increasing musculo‐skeletal or other morbidity in haemophilia. Such a prophylaxis program has been shown in relatively small cohorts to be effective in reducing bleeding occurrence, with a variable effect on the joint status, but with significantly higher factor consumption and consequently higher costs than on‐demand therapy. There has been no attempt to identify subsets of patients who may benefit from “tertiary” prophylaxis more than others, for example, due to their bleeding phenotype and/or requirements for product issued on‐demand or to identify the dosage that provides the optimal balance of clinical benefit and cost effectiveness. This article reviews the published literature on prophylaxis started beyond the age of 18 years, the barriers to the uptake of prophylaxis programs particularly in adults and highlights areas in need of further research.
Haemophilia Care in Europe: the ESCHQoL study
Authors: Schramm W. , Gringeri A. , Ljung R. , Berger K. , Crispin A. , Bullinger M. , Giangrande P. L. F. , Von Mackensen S. , Mantovani L. G. , Nemes L. , Serban M. ,   For the eschqol study group
Published: May 2012

SummaryThe aim of this study was to determine the clinical conditions of patients with haemophilia within Europe as recommended by the European Commission. In this multicentre, cross‐sectional, ambispective study, conducted within 21 European countries patients' clinical data were collected, amongst others haemophilia type, severity, treatment pattern, use of factor products, bleeding, orthopaedic joint scores and infections. A total of 1400 patients, 84.3% with haemophilia A and 15.7% with haemophilia B were enrolled by 42 centres between 2004 and 2006. Thereof, 417 were children (30.0%) and 983 were adults (70.0%). About 70% of patients had severe factor deficiency (<1%). More than half of the adults were carriers of chronic infections (12.6% HIV, 55.8% HCV), compared to only 3.8% children (no HIV, 2.9% HCV). Patients were grouped according to per capita amount of clotting factor used in patients' region of residence in 2005: region 1: >5 IU; region 2: 2–5 IU; region 3: <2 IU. Paediatric and adult patients in region 3 had median numbers of three and eight joint bleeds, respectively, with worse joint scores compared to region 1 with zero and one bleed. Prophylactic therapy was used in only 31.3% children and 8.9% adults with severe haemophilia in region 3 compared to 93.7% and 54.1%, respectively, in region 1. Statistical analysis revealed that residence in areas with low factor consumption/availability is the most prominent risk factor for joint disease. Access of European patients with haemophilia to optimal care with safe factor VIII concentrates is limited and depends on the region of residence.
Analysis of F9 point mutations and their correlation to severity of haemophilia B disease
Authors: Hamasaki‐Katagiri N. , Salari R. , Simhadri V. L. , Tseng S. C. , Needlman E. , Edwards N. C. , Sauna Z. E. , Grigoryan V. , Komar A. A. , Przytycka T. M. , Kimchi‐Sarfaty C. 
Published: May 2012

SummaryHaemophilia B is an X‐linked recessive disorder caused by deficiency of functional coagulation factor IX, which results almost exclusively from mutations in the F9 gene. We sought to determine features, which could distinguish between mutations that cause severe disease symptoms from those that cause non‐severe disease symptoms. Towards this objective, we have performed a statistical analysis of reported point mutations in F9. These include: potential local changes in mRNA free energy, codon usage, charge and type of mutated amino acid, location of the mutation with regard to protein secondary structure and functional domain and amino acids' evolutionary conservation scores. Wilcoxon signed‐rank tests showed highly significant differences between severe and non‐severe disease causing mutations in their effect on free energy of small mRNA fragments and evolutionarily conserved amino acids. Our results suggest that information at the mRNA level as well as conservation of the amino acid correlate well with disease severity. This study demonstrates that computational tools may be used to characterize the severity of haemophilia B associated with point mutations and suggests their utility in predicting the outcome of sequence changes in recombinant proteins.
Acute pain management and assessment: are guidelines being implemented in developing countries (Lebanon)
Authors: Zeitoun Abeer A. , Dimassi Hani I. , Chami Bahija A. , Chamoun Nibal R. 
Published: May 2012

AbstractRationale  Pain assessment and treatment is influenced by subjective perception of pain. Despite the international efforts to implement guidelines and protocols for pain management, pain continues to be regarded as a complication rather than a primary problem. The literature pertaining to the adequacy of pain management in the Middle East is frail. This study focuses on revealing the implemented practices of initial pain assessment, follow‐up and re‐evaluation of pain treatment in Lebanese hospitals.Aim and objectives  The objective of this study is to evaluate the presence and effectiveness of acute pain management and its impact on the quality of life in hospitals throughout Lebanon, in both cancer and non‐cancer populations.Methods  A Lebanese multi‐centre, prospective, chart review study was conducted over a period of 3 months. Data on demographics, pain medication, dose, route, duration and adjunct pain management were collected. Appropriateness of pain management was determined as per World Health Organization guidelines. Institutional Review Board approvals were obtained from each hospital.Results  Results from 582 participants revealed that 50% of initial pain assessment intensity scores were based on the assumptions of health care professionals. Furthermore, as pain severity scores increased, the adequacy of pain management decreased. Only 22% of the patients had a daily follow‐up, and the majority of those continued to receive inappropriate therapy.Conclusion  This study reflects the lack of a well‐structured system for pain management in Lebanese hospitals. It underlines the need for pain research in the region. It also highlights the need for implementing the recommendations discussed to minimize risk and optimize pain management.
Problem perception, technology and effectiveness in medical practice
Authors: Holmberg Leif 
Published: May 2012

AbstractRationale, aims and objectives  Evidence‐based medicine and clinical guidelines have been found difficult to implement in the clinical practice – mainly because lack of evidence quality and guidelines that, generally, do not account for variations in the medical cases. Variation in the medical cases enhances task uncertainty and uncertainty seems to be further enhanced through clinical guidelines. In this article, concept development is attempted, where task uncertainty is classified into a few medical problem‐solving processes according to differences in medical technology and in the (initial) perception of the medical problem. Furthermore is argued the need for using different strategies in evaluating performance quality in medical health care depending on the variation in the degree of task uncertainty.Method  Qualitative data about medical activities related to certain diseases are used to exemplify problem‐solving processes representing different types of task uncertainty.Results  It is argued that the main characteristics of medical problem‐solving processes vary according to differences in medical technology and perception of perceived medical problem. Four main medical problem‐solving processes are defined and demonstrated through empirical examples.Conclusion  What may be regarded as rational behaviour is different for each type of problem‐solving processes. Consequently, the processes need different organizational settings and need to be evaluated according to different criteria. Furthermore, from a practical point of view, development and education related to problem perception would seem as important as development of medical technology.