bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined RET and Ki-67 assessment in sporadic medullary thyroid carcinoma: a useful tool for patient risk stratification
Authors: Mian Caterina , Pennelli Gianmaria , Barollo Susi , Cavedon Elisabetta , Nacamulli Davide , Vianello Federica , Negro Isabella , Pozza Giulia , Boschin Isabella Merante , Pelizzo Maria Rosa , Rugge Massimo , Mantero Franco , Girelli Maria Elisa , Opocher Giuseppe 
Published: March 2011

ObjectiveMedullary thyroid carcinoma (MTC) derives from the parafollicular C cells, being sporadic in 75% of cases and familial in 25%, due to RET proto-oncogene germinal mutations. In sporadic forms, stage at diagnosis is the most important negative prognostic factor. The aim of this study was to evaluate the prognostic impact of molecular and immunohistochemical markers in sporadic MTC.Design and methodsWe studied 60 patients with sporadic MTC. For each case, we sought RET somatic mutations in the primary cancer and in lymph node metastases. The primary cancer also underwent immunohistochemical examination for Ki-67.ResultsA somatic RET mutation was found in 38% of patients, being M918T in 52% of them. We observed a statistically significant association between RET mutations and male gender (P<0.01), tumor size (P<0.05), lymph nodes (P<0.05) and distant metastases (P<0.001), advanced stage (P<0.05), increased risk of persistent disease (P=0.01), and low overall survival (P<0.01). High Ki-67 levels were similarly associated with extra-thyroid spread (P<0.05), lymph nodes (P<0.05) and distant metastases (P<0.001), advanced stage (P=0.01), and low overall survival (P=0.01).Combining somatic RET analysis with Ki-67 assessment seems to be useful for increasing the specificity of Ki-67 assessment alone and identifying patients with a more aggressive cancer: in our series, only the patients who died during the follow-up had both a somatic RET mutation and a Ki-67 expression level >50 cells/mm2.ConclusionsThe combined evaluation of RET and Ki-67 could act as an adjuvant prognostic marker useful for ameliorating the initial risk stratification of patients with sporadic MTC.
Characterization of ABCC8 and KCNJ11 gene mutations and phenotypes in Korean patients with congenital hyperinsulinism
Authors: Park So Eun , Flanagan Sarah E , Hussain Khalid , Ellard Sian , Shin Choong Ho , Yang Sei Won 
Published: March 2011

ObjectiveCongenital hyperinsulinism (CHI) is characterized by persistent hypoglycemia due to the inappropriate insulin secretion. Inactivating mutations in the ABCC8 and KCNJ11 genes, which encode the sulfonylurea receptor 1 and Kir6.2 subunits of the ATP-sensitive K+ (KATP) channel in pancreatic β-cell, are the most common cause of CHI. We studied the genetic etiology and phenotypes of CHI in Korean patients.MethodsABCC8 and KCNJ11 mutational analysis was performed in 17 patients with CHI. Medical records were retrospectively reviewed to identify phenotypes.ResultsMutations (12 ABCC8 and three KCNJ11) were identified in 82% (14/17) of patients. Of these, nine ABCC8 mutations (E100X, W430X, c.1630+1G>C, D813N, Q923X, E1087_A1094delinsDKSDT, Q1134H, H1135W, and E1209Rfs) and one KCNJ11 mutation (W91X) were novel. Of the 14 patients, four had confirming recessively inherited CHI. The remaining ten patients had single heterozygous mutations. The majority (12/17) of patients were medically responsive. Of the five diazoxide-responsive patients, four had an ABCC8 mutation. The five patients unresponsive to medical management and one diazoxide-responsive patient underwent pancreatectomy and had diffuse histology. Of the operated six patients, two had recessively inherited mutations; three patients had a single heterozygous mutation (one maternally and two paternally inherited); and one patient had no identifiable KATP channel mutation.ConclusionsThis is the first study to report genotype and phenotype correlations among Korean patients with CHI. Mutations in ABCC8 and KCNJ11 are the most common causes of CHI in Korean patients. Similar to other studies, there is marked genetic heterogeneity and no clear genotype–phenotype correlation.
Risk Factors for Hand, Foot, and Mouth Disease and Herpangina and the Preventive Effect of Hand-washing
Authors: Ruan Feng , Yang Tao , Ma Huilai , Jin Yan , Song Shili , Fontaine Robert E. , Zhu Bao-Ping 
Published: March 2011

BACKGROUND:Hygiene and social distancing are recommended control measures for hand, foot, and mouth disease (HFMD) and herpangina. However, empirical data to support this recommendation are limited.METHODS:During an outbreak of HFMD and herpangina due to infection by the human enterovirus 71, we defined a case as a vesicular papular rash on the hands, feet, buttocks, or oral mucosa and onset from April 30 to June 26, 2008. We selected 176 HFMD and herpangina case-children and a stratified random sample of 201 asymptomatic control-children; frequency matched according to residency status. We administered a questionnaire to the parents about their children's exposures and hygienic behaviors.RESULTS:Risk factors for HFMD and herpangina included playing with neighborhood children (odds ratio [OR]: 11 [95% confidence interval (CI): 6.2–17]), visiting an outpatient clinic for another reason ≤ 1 week before onset (OR: 20 [95% CI: 5.0–88]), and community exposures to crowded places (OR: 7.3 [95% CI: 4.1–13]). By using a score summarizing responses to 4 hand-washing questions, we found that 50% of the case-children and 2.5% of control-children had a poor score of 1 to 3, whereas 12% of the case-children and 78% of control-children had a good score of ≥7 (OR: 0.00069 [95% CI: 0.0022–0.022]) after we adjusted for residency, age, and community exposures by using logistic regression.CONCLUSIONS:Hand-washing by preschool-aged children and their caregivers had a significant protective effect against community-acquired HFMD and herpangina from the human enterovirus 71 infection.
Medically Underserved Girls Receive Less Evaluation for Short Stature
Authors: Grimberg Adda , Feemster Kristen A. , Pati Susmita , Ramos Mark , Grundmeier Robert , Cucchiara Andrew J. , Stallings Virginia A. 
Published: March 2011

OBJECTIVE:To determine if gender is associated with diagnostic evaluation by primary care pediatricians caring for children with growth-faltering.PATIENTS AND METHODS:This was a retrospective study of children who were attending 4 urban pediatric primary care practices affiliated with a tertiary pediatric hospital. Growth-faltering was defined as height at the &lt;5th percentile or a z-score decrease of ≥1.5 SDs before 18 months of age or ≥1 SD thereafter. For each child, height z score, age, gender, race, insurance, diagnostic tests, and subspecialist appointments were examined.RESULTS:Of 33 476 children, 3007 had growth-faltering (mean height: −1.5 ± 1.0 vs 0.3 ± 0.9 SDs in those without growth-faltering). Boys comprised 53% of the growth-faltering group (vs 51% of the nonfaltering group; P &lt; .01). Among children with growth-faltering, 2.8% had endocrinology appointments (vs 0.8% of others; P &lt; .0001) and 6% had gastroenterology appointments (vs 1.5% of others; P &lt; .0001). Subspecialty care was not associated with gender. Pediatricians ordered diagnostic tests for a significantly greater proportion of children with growth-faltering than others. In multivariate analysis of height z score among children with growth-faltering, tests for chromosomes (1.4% of short girls vs 0.4% of short boys; P &lt; .005) and growth hormone/insulin-like growth factor axis (0.9% of short girls vs 1.8% of short boys; P &lt; .05) were associated with gender. Thirty-five percent of the girls for whom chromosome testing was performed were 12 years old or older.CONCLUSIONS:Patterns in diagnostic testing of children with growth-faltering by their pediatricians may lead to underdiagnosis of Turner syndrome and growth hormone deficiency among girls.
Metabolic Profiles in Children During Fasting
Authors: van Veen Merel R. , van Hasselt Peter M. , de Sain-van der Velden Monique G. M. , Verhoeven Nanda , Hofstede Floris C. , de Koning Tom J. , Visser Gepke 
Published: March 2011

BACKGROUND:
Hypoglycemia is one of the most common metabolic derangements in childhood. To establish the cause of hypoglycemia, fasting tolerance tests can be used. Currently available reference values for fasting tolerance tests have limitations in their use in daily practice.

OBJECTIVE:
The aim of this study was to determine the reference values of metabolites involved in glucose homeostasis during fasting in healthy children.

METHODS:
This study included a retrospective analysis of 488 fasting tests. All tests of patients (n = 321) with disorders, including metabolic and endocrine disorders, were excluded, as were tests performed in children who were over- or underweight.

RESULTS:
In 167 fasting tests performed in the study, hypoglycemia was reached in 52 (31%) tests. On the basis of the time until hypoglycemia was reached, 3 age groups could be defined: (1) children aged 0 to 24 months (median 15 months) (n = 49); (2) children aged 25 to 84 months (median 45 months) (n = 79); (3) and children aged 85 to 216 months (median 106 months) (n = 39). In all groups, a significant increase in ketone body levels and a significant decrease in glucose levels in plasma were observed during fasting. Younger children had a faster increase in ketone body levels and a faster decrease in glucose levels in plasma than older children.

CONCLUSIONS:
Reference values of the metabolites involved in glucose homeostasis during fasting in children were generated. Those values can be used to determine whether a child has a normal fasting response. For high-risk children, guidelines concerning maximum fasting time and dietary intervention during illness are of the utmost importance.
Compliance With National Guidelines for Physical Activity in U.S. Preschoolers: Measurement and Interpretation
Authors: Beets Michael W. , Bornstein Daniel , Dowda Marsha , Pate Russell R. 
Published: March 2011

OBJECTIVE:
The National Association for Sport and Physical Education (NASPE) guidelines for preschoolers recommend 120 minutes of physical activity daily. Two issues, however, create a situation whereby substantial variation in estimated prevalence rates of (in)active preschoolers are reported. First, NASPE guidelines have been interpreted in multiple ways. Second, objective monitoring via accelerometry is the most widely accepted measure of preschoolers' physical activity, yet multiple cut points provide vastly different estimates of physical activity. This study aimed to estimate the prevalence of preschoolers meeting NASPE guidelines and illustrate the differences among rates, given guideline interpretations, and cut points.

PATIENTS AND METHODS:
Three- to 5-year-old children (n = 397) wore ActiGraph accelerometers for an average of 5.9 days. NASPE guidelines were expressed in 3 ways: 120 minutes daily of light-to-vigorous physical activity; 120 minutes daily of moderate-to-vigorous physical activity; and 60 minutes daily of moderate-to-vigorous physical activity. Estimates of 120 minutes daily of light-to-vigorous physical activity, 120 minutes daily of moderate-to-vigorous physical activity, and 60 minutes daily of moderate-to-vigorous physical activity were calculated on the basis of 4 common accelerometer cut points for preschoolers: Pate, Reilly and Puyau, Sirard, and Freedson.

RESULTS:
Prevalence rates varied considerably, with estimates ranging from 13.5% to 99.5%, 0.0% to 95.7%, and 0.5% to 99.5% for 120 minutes daily of light-to-vigorous physical activity, 120 minutes daily of moderate-to-vigorous physical activity, and 60 minutes daily of moderate-to-vigorous physical activity, respectively.

CONCLUSIONS:
The variation in NASPE guidelines, coupled with different accelerometer cut points, results in disparate estimates of (in)active preschoolers. This limits the ability to estimate population prevalence levels of physical activity that can be used to guide public health policy. Development of new guidelines should focus on an explicit delineation of physical activity and attempt to standardize the measurement of preschoolers' physical activity.
Acceptability of Testing Children for Tobacco-Smoke Exposure: A National Parent Survey
Authors: Winickoff Jonathan P. , Tanski Susanne E. , McMillen Robert C. , Ross Kaile M. , Lipstein Ellen A. , Hipple Bethany J. , Friebely Joan , Klein Jonathan D. 
Published: March 2011

BACKGROUND:
Tests are available to measure children's exposure to tobacco smoke. One potential barrier to testing children for tobacco-smoke exposure is the belief that parents who smoke would not want their child tested. No previous surveys have assessed whether testing children for exposure to tobacco smoke in the context of their child's primary care visit is acceptable to parents.

OBJECTIVE:
To assess whether testing children for tobacco-smoke exposure is acceptable to parents.

DESIGN AND METHODS:
We conducted a national random-digit-dial telephone survey of households from September to November 2006. The sample was weighted by race and gender, based on the 2005 US Census, to be representative of the US population.

RESULTS:
Of 2070 eligible respondents contacted, 1803 (87.1%) completed the surveys. Among 477 parents in the sample, 60.1% thought that children should be tested for tobacco-smoke exposure at their child's doctor visit. Among the parental smokers sampled, 62.0% thought that children should be tested for tobacco-smoke exposure at the child's doctor visit. In bivariate analysis, lower parental education level, allowing smoking in the home, nonwhite race, and female gender were each associated (P &lt; .05) with wanting the child tested for tobacco-smoke exposure.

CONCLUSIONS:
The majority of nonsmoking and smoking parents want their children tested for tobacco-smoke exposure during the child's health care visit.
Intravenous Immunoglobulin in Neonates With Rhesus Hemolytic Disease: A Randomized Controlled Trial
Authors: Smits-Wintjens Vivianne E. H. J. , Walther Frans J. , Rath Mirjam E. A. , Lindenburg Irene T. M. , te Pas Arjan B. , Kramer Christine M. , Oepkes Dick , Brand Anneke , Lopriore Enrico 
Published: March 2011

BACKGROUND:
Despite limited data, international guidelines recommend the use of intravenous immunoglobulin (IVIg) in neonates with rhesus hemolytic disease.

OBJECTIVE:
We tested whether prophylactic use of IVIg reduces the need for exchange transfusions in neonates with rhesus hemolytic disease.

DESIGN AND SETTING:
We performed a randomized, double-blind, placebo-controlled trial in neonates with rhesus hemolytic disease. After stratification for treatment with intrauterine transfusion, neonates were randomly assigned for IVIg (0.75 g/kg) or placebo (5% glucose). The primary outcome was the rate of exchange transfusions. Secondary outcomes were duration of phototherapy, maximum bilirubin levels, and the need of top-up red-cell transfusions.

RESULTS:
Eighty infants were included in the study, 53 of whom (66%) were treated with intrauterine transfusion(s). There was no difference in the rate of exchange transfusions between the IVIg and placebo groups (7 of 41 [17%] vs 6 of 39 [15%]; P = .99) and in the number of exchange transfusions per patient (median [range]: 0 [0–2] vs 0 [0–2]; P = .90) or in duration of phototherapy (4.7 [1.8] vs 5.1 [2.1] days; P = .34), maximum bilirubin levels (14.8 [4.7] vs 14.1 [4.9] mg/dL; P = .52), and proportion of neonates who required top-up red-cell transfusions (34 of 41 [83%] vs 34 of 39 [87%]; P = .76).

CONCLUSIONS:
Prophylactic IVIg does not reduce the need for exchange transfusion or the rates of other adverse neonatal outcomes. Our findings do not support the use of IVIg in neonates with rhesus hemolytic disease.
Azo Dyes, Their Environmental Effects, and Defining a Strategy for Their Biodegradation and Detoxification
Authors: Gudelj Ivana , Hrenović Jasna , Dragičević Tibela , Delaš Frane , Šoljan Vice , Gudelj Hrvoje 
Published: March 2011

Azo Boje, Njihov Utjecaj Na Okoliš I Potencijal Biotehnološke Strategije Za Njihovu Biorazgradnju I DetoksifikacijuIntenzivan industrijski razvoj popraćen je sve većom kompleksnošću sastava otpadnih voda, što u smislu učinkovite zaštite okoliša i održivog razvoja nalaže potrebu pospješivanja kvalitete postojećih te uvođenjem novih postupaka obrade otpadnih voda, kao iznimno važnog čimbenika u interakciji čovjeka i okoliša. Posebnu znanstveno-tehnološku pozornost zahtijevaju novosintetizirani ksenobiotici, poput azo-boja, koji su u prirodi veoma teško razgradivi. Azo-boje podložne su bioakumulaciji, a zbog alergijskih, kancerogenih, mutagenih i teratogenih svojstava nerijetko su prijetnja zdravlju ljudi i očuvanju okoliša. Primjenu fizikalnokemijskih metoda za uklanjanje azo-boja iz otpadnih voda često ograničavaju visoke cijene, potrebe za odlaganjem nastalog štetnog mulja ili nastanak toksičnih sastojaka razgradnje. Biotehnološki postupci su, zbog mogućnosti ekonomične provedbe i postizanja potpune biorazgradnje, a time i detoksifikacije, sve zastupljeniji u obradi svih vrsta otpadnih voda, pa tako i onih koje sadržavaju azo-boje.
Undiagnosed AIDS in Patients with Progressive Dyspnoea: An Occupational Risk for Healthcare Workers in Croatia
Authors: Miše Kornelija , Vučković Maja , Jurčev-Savičević Anamarija , Gudelj Ivan , Perić Irena , Miše Joško 
Published: March 2011

Undiagnosed AIDS in Patients with Progressive Dyspnoea: An Occupational Risk for Healthcare Workers in CroatiaPulmonary diseases are well documented and diverse in many patients with HIV in clinical stages 3 and 4. It is not unusual that these patients, most of whom do not know that they are already HIV-infected, are first examined and hospitalised by respiratory medicine specialists. While HIV-infection is relatively simple to diagnose if accompanied by advanced clinical manifestations and is regularly checked in patients with increased risk, this is not the case in low-risk patients, particularly in countries with low-level HIV epidemic and therefore low index of suspicion. Regular examination involves a series of tests, often including bronchoscopy with transbronchal lung biopsy in order to identify an interstitial lung disease and/or progressive dyspnoea. It is not uncommon that patients provide false or incomplete information about their lifestyle, which can mislead the clinician. At this point, HIV-infection is usually not suspected and healthcare workers may not strictly be following the safety principles which are otherwise applied when HIV-infection is known or suspect, although universal precautions are routine practice. At this point, the risk of exposure is the highest and HIV-transmission to healthcare workers is the most likely to occur. The cases presented here indicate that patients with progressive dyspnoea, which is typical of interstitial lung diseases, should undergo HIV-testing as a part of good clinical practice, even in a country with low-level HIV epidemic.
Determination of Lead in Croatian Wines by Graphite Furnace Atomic Absorption Spectrometry
Authors: Tariba Blanka , Pizent Alica , Kljaković-Gašpić Zorana 
Published: March 2011

Determination of Lead in Croatian Wines by Graphite Furnace Atomic Absorption SpectrometryA method has been developed for direct determination of lead in wine by graphite furnace atomic absorption spectrometry (GFAAS) with Zeeman-effect background correction. The thermal behaviour of Pb during pyrolysis and atomisation stages was investigated without matrix modifier and in the presence of Pd(NO3)2, Pd(NO3)2+ Mg(NO3)2× 6H2O, and NH4H2PO4+ Mg(NO3)2× 6H2O as matrix modifiers. A simple 1:1 dilution of wine samples with Pd(NO3)2as a matrix modifier proved optimal for accurate determination of Pb in wine. Mean recoveries were 106 % for red and 114 % for white wine, and the detection limit was 3 μg L-1. Within-run precision of measurements for red and white wine was 2.1 % and 1.8 %, respectively. The proposed method was applied for analysis of 23 Croatian wines. Median Pb concentrations were 33 μg L-1, range (16 to 49) μg L-1in commercially available wines and 46 μg L-1, range (14 to 559) μg L-1in home-made wines. There were no statistically significant differences (P<0.05) in Pb concentration between commercial and home-made wines or between red and white wines.
Cadmium Toxicity Revisited: Focus on Oxidative Stress Induction and Interactions with Zinc and Magnesium
Authors: Matović Vesna , Buha Aleksandra , Bulat Zorica , Đukić-Ćosić Danijela 
Published: March 2011

Cadmium Toxicity Revisited: Focus on Oxidative Stress Induction and Interactions with Zinc and MagnesiumDiscovered in late 1817, cadmium is currently one of the most important occupational and environmental pollutants. It is associated with renal, neurological, skeletal and other toxic effects, including reproductive toxicity, genotoxicity, and carcinogenicity. There is still much to find out about its mechanisms of action, biomarkers of critical effects, and ways to reduce health risks. At present, there is no clinically efficient agent to treat cadmium poisoning due to predominantly intracellular location of cadmium ions. This article gives a brief review of cadmium-induced oxidative stress and its interactions with essential elements zinc and magnesium as relevant mechanisms of cadmium toxicity. It draws on available literature data and our own results, which indicate that dietary supplementation of either essential element has beneficial effect under condition of cadmium exposure. We have also tackled the reasons why magnesium addition prevails over zinc and discussed the protective role of magnesium during cadmium exposure. These findings could help to solve the problem of prophylaxis and therapy of increased cadmium body burden.
Application of Kernel Estimation in Analysis of Labour Productivity of the Largest Polish Firms in 2004-2008
Authors: Batóg Barbara , Batóg Jacek , Mojsiewicz Magdalena 
Published: March 2011

Application of Kernel Estimation in Analysis of Labour Productivity of the Largest Polish Firms in 2004-2008The parametric methods of statistical and econometric analysis are not always useful in examination of labour productivity of economic entities. In previous works the Authors found that the labour productivity is characterized by the lack of stable regularities in the range of structure and interdependency. In that case it is possible to apply non-parametric methods. In the paper the Authors tried to model the distributions of the labour productivity in time by means of kernel estimation using classical approaches (Epanechnikov, Rosenblatt) and the new proposition called kernel B. It seems that proposed approach is a useful merger of the statistical modeling theory and economic practice which allows to analyze the changes in the labour productivity - the essential factor for long-term economic growth and the welfare of society. The empirical results show that the labour productivity in the largest Polish companies had increased in 2004-2008 but the growths had not the same dynamics in different economic sectors.