bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macular lesion resembling adult‐onset vitelliform macular dystrophy in Kearns–Sayre syndrome with multiple mtDNA deletions
Authors: Ascaso Francisco J , Lopez‐Gallardo Ester , Del Prado Eduardo , Ruiz‐Pesini Eduardo , Montoya Julio 
Published: May 2010

AbstractWe present the case of a 48‐year‐old woman with a clinically and histopathologically confirmed Kearns–Sayre syndrome who developed a maculopathy resembling an adult‐onset vitelliform macular dystrophy in her right eye. DNA analysis identified the presence of multiple deletions in the mtDNA of the muscle sample, with the common deletion of 4977 bp the most abundant. To the best of our knowledge, there have been no previous reports of such macular lesion occurring in association with Kearns–Sayre syndrome.
Cataract in indigenous Australians: the National Indigenous Eye Health Survey
Authors: Taylor Hugh R , Xie Jing , Arnold Anna‐Lena , Goujon Nicolas , Dunn Ross A , Fox Sarah , Keeffe Jill 
Published: May 2010

AbstractBackground:  To determine the prevalence of vision loss due to cataract in indigenous Australians.Methods:  A national, stratified, random cluster sample was selected in 30 communities across Australia. Data collection was undertaken in 2008. Adults 40 years and older were examined using a standardized protocol that included a questionnaire. The presence of visually significant cataract was assessed.Results:  Response rates were good and 1189 indigenous adults were examined and overall recruitment was 72%. Low vision (<6/12–6/60) due to cataract occurred in 2.52% (1.63–3.41%) and blindness (<6/60) in 0.59% (95% CI: 0.24–1.21%). The cataract coverage rate (proportion of those with visually significant cataract who had been operated on) was 65.3% (95% CI: 55.0–74.6%). Projections suggest that there are 3234 indigenous adults with vision loss from cataract.Conclusions:  Cataract remains a major cause of vision loss in Aboriginal and Torres Strait Islander peoples. There were no significant regional or state differences in the prevalence of cataract or of cataract surgical coverage, which suggests that increased cataract surgery services are required across the country to address cataract in indigenous Australians.
Closed‐form thermal stress intensity factors for an internal circumferential crack in a thick‐walled cylinder
Authors: GHAJAR R. , NABAVI S. M. 
Published: May 2010

ABSTRACTIn this paper the method of weight functions is employed to calculate the stress intensity factors for an internal circumferential crack in a thick‐walled cylinder. The pressurized cylinder is also subjected to convection cooling on the inner surface. Finite element method is used to determine an accurate weight function for the crack and a closed‐form thermal stress intensity factor with the aid of the weight function method is extracted. The influence of crack parameter and the heat transfer coefficient on the stress intensity factors are determined. Comparison of the results in the special cases with those cited in the literature and the finite element data shows that the results are in very good agreement.
Predictors of responders to insulin therapy at 1 year among adults with type 2 diabetes
Authors: Owen V. , Seetho I. , Idris I. 
Published: May 2010

Background: The effectiveness of insulin therapy to lower blood glucose levels in patients with type 2 diabetes (T2D) may depend on a variety of factors. This study aims to determine baseline parameters including body mass index (BMI) threshold that might predict responders to insulin therapy. Methods: This was a retrospective UK population‐based study derived from 358 general practices electronic dataset. We included all patients with T2D, diagnosed at the age of >18 years old and who were initiated on insulin from January 2000 to December 2006. Insulin responders were defined as HbA1c <7.5% and/or HbA1c reduction by >1% at 12 months postinsulin initiation. Results: Results are expressed in mean (s.d.). A total of 6032 patients were identified. Baseline age was 63 years (11.7). In all, 61% of patients (3696) responded to insulin. At 1‐year postinsulin initiation, HbA1c was significantly reduced (9.8 vs. 8.4%, p < 0.001) and weight increased (85.7 vs. 87.9 kg, p < 0.001). Using logistic regression model, older age (p < 0.001), lower BMI (p = 0.046), higher HbA1c (p < 0.001), basal‐bolus insulin therapy and premixed insulin compared to basal insulin alone at baseline were independent predictors of responders to insulin. Gender and social class were not significant predictors of insulin responders. A BMI of <35.3 was derived as a cut‐point for response to insulin (p = 0.038). Conclusion: Overall, insulin therapy confers significant HbA1c reduction and weight increase in patients with T2D. The responsiveness to insulin therapy however appears to depend on baseline age, BMI, HbA1c and insulin regime. Clinicians should take these factors into consideration when making a decision to initiate insulin therapy in patients with T2D.
Management of elderly patients with urothelial carcinoma of the bladder: guideline concordance and predictors of overall survival
Authors: Bolenz Christian , Ho Richard , Nuss Geoffrey R. , Ortiz Nicolas , Raj Ganesh V. , Sagalowsky Arthur I. , Lotan Yair 
Published: May 2010

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVETo study guideline recommendation (GR)‐concordance rates of treatment in elderly patients with urothelial carcinoma of the bladder (UCB) and to identify predictors of survival.PATIENTS AND METHODSThe records of 206 consecutive patients aged ≥75 years (median age 79 years; range 75–95) were reviewed. All patients underwent transurethral resection (TUR) or biopsy of UCB. The European Association of Urology and American Urological Association guidelines were used as reference when evaluating concordance with GRs and clinical outcome. Univariable and multivariable analyses were performed to identify predictors of survival.RESULTSThe overall GR‐concordance rate of treatment was 88.8% (183 of 206 patients). Patients who were older (P= 0.017), who underwent prior treatment for UCB (P= 0.010), and had greater comorbidities (P= 0.001) were less likely to undergo treatment following GRs. With a median (mean; range) follow‐up of 14.7 (22.6; 0.3–111.5) months, 79 patients died (38.3%). More comorbidities (unadjusted Charlson comorbidity index; P= 0.007), a Karnofsky performance status (KPS) score of ≤80 (P= 0.001) and more advanced initial pathological tumour stage (P= 0.019) independently predicted reduced overall survival (OS). In the subgroup of patients with indication for cystectomy (n= 99), there was a trend for longer OS in patients treated with curative intent (cystectomy or radio‐chemotherapy) compared with conservative treatment with TUR ± intravesical therapy only (P= 0.095).CONCLUSIONSThe vast majority of elderly patients with UCB received adequate treatment at our tertiary institution. The KPS score, more comorbidities and more advanced pathological tumour stage are predictors for reduced OS and should be considered to optimize patient care.
The establishment of an integrated skills training centre for undergraduate nursing education
Authors: Lee L.Y.K. , Lee J.K.L. , Wong K.F. , Tsang A.Y.K. , Li M.K. 
Published: May 2010

LEE L.Y.K., LEE J.K.L., WONG K.F., TSANG A.Y.K. & LI M.K. (2010) The establishment of an integrated skills training centre for undergraduate nursing education. International Nursing Review57, 359–364Aim:  This paper details the experience of establishing an integrated skills training centre for use in undergraduate nursing education in The Open University of Hong Kong.Background:  Skills training is an essential element in undergraduate nursing education. Owing to the increasing complexity of the health‐care system and patient health needs, undergraduate nursing students should be well prepared for integrated skills competency, critical thinking and rapid decision‐making. To achieve this goal, the use of simulation as a skills training tool is being recommended.Conclusion:  The Clinical Nursing Education Centre is established. It adopts simulation as a teaching and learning tool. It has four specific education units, namely: (1) clinical simulation education unit, (2) virtual reality education unit, (3) nursing skills education unit, and (4) Chinese medicinal education unit. These units are specifically designed for the teaching and learning of nursing skills related to general, mental and Chinese medicinal nursing from elementary to advanced level. Experiences pertaining to the conceptualization, exploration and actualization phases of the establishment are presented. Details of the structure and specific functions of the centre are also illustrated. Finally, there is discussion on the challenges encountered during the establishment process and how they were overcome.
Traditional practices used by infertile women in Turkey
Authors: Ayaz S. , Efe S. Yaman 
Published: May 2010

AYAZ S. & YAMAN EFE S. (2010) Traditional practices used by infertile women in Turkey. International Nursing Review57, 383–387Background:  Numerous traditional methods are used in the treatment of infertility around the world.Aim:  To identify the traditional practices of infertile women using one clinic in Ankara, Turkey.Design and Methods:  The population comprised all women (5700) who attended one infertility outpatient clinic in 2007. The sample was calculated using sample calculation formula and 410 women were included in the study. The survey method was used for data collection.Findings:  Of the responding women, 27.3% had tried a traditional practice, and 67.8% who tried traditional practices used an herbal mixture. The reason for the women's use of a traditional practice was ‘hope’ (66.9%), and 15.2% of them had experienced an adverse effect related with traditional practice. Maternal education level, perceived economic status, duration of marriage all significantly affected the use of traditional practices (P < 0.05). The women who had received unsuccessful medical treatment for infertility and who had experienced side effects after medical treatment had a higher rate of use of traditional practice (P < 0.05).Conclusions:  Almost one in three of the women who responded to the questionnaire had tried traditional methods, and some experienced adverse effects related to the practice. For couples with infertility problems, educational programmes and consultation services should be organized with respect to their traditional culture. Women should be informed about the hazards of traditional practices and avoidance of harmful practices, and continuous emotional support must be provided for infertile couples. In the future, nursing staff should play a much larger role in these supportive services.
Climate change, unpredictable cold waves and possible brakes on plant migration
Authors: Jalili Adel , Jamzad Ziba , Thompson Ken , Araghi M. K. , Ashrafi Sohaila , Hasaninejad Maryam , Panahi Parisa , Hooshang Neda , Azadi Rahman , Tavakol M. S. , Palizdar Maryam , Rahmanpour Afsoun , Farghadan Farhood , Mirhossaini S. G. , Parvaneh Kamyar 
Published: May 2010

ABSTRACTAim  Increases in annual mean temperature in the course of current climate change are expected to facilitate mass species migration towards higher altitudes and latitudes. However, this migration may be slowed, or even temporarily reversed, by infrequent and unpredictable episodes of low winter temperatures. Iran experienced a severe cold wave in January and February 2008, giving an opportunity to observe the effects on a large number of woody plant species, many growing further north than their natural ranges.Location  The study was carried out in the National Botanical Garden of Iran (35°44′20.06″ N; 51°10′25.66″ E).Method  To estimate the damage caused to each individual woody plant in the garden, we adopted the following protocol; at the start of the growing season, at the end of March and beginning of April 2008, all woody species were inspected for damage. In the case of evergreens this took the form of obvious damage to foliage, usually manifested as severe browning. In the case of deciduous species, damage was recognized by the failure of all or part of the plant to produce new leaves; all affected individual plants were labelled. In July all labelled plants were rechecked and, based on whole or partial above‐ground die‐back, a final list of damaged individuals was produced.Results  As expected, the majority of native and exotic species introduced from cold temperate habitats showed no freezing injuries. Many woody species in the garden were damaged or killed, despite their previous survival and growth, in many cases for up to 40 years. The majority of taxa (101 out of a total of 145) that suffered freezing‐induced damage were evergreens.Main conclusions  The results indicate that despite an increase in mean annual temperature, unpredictable lethal cold waves may retard the expansion of plants towards higher altitudes and latitudes. Broadleaved evergreen species from warm climates were particularly badly affected, with many species suffering high rates of mortality.
Electrostatic Halftoning
Authors: Schmaltz Christian , Gwosdek Pascal , Bruhn Andrés , Weickert Joachim 
Published: May 2010

AbstractWe introduce a new global approach for image dithering, stippling, screening and sampling. It is inspired by the physical principles of electrostatics. Repelling forces between equally charged particles create a homogeneous distribution in flat areas, while attracting forces from the image brightness values ensure a high approximation quality. Our model is transparent and uses only two intuitive parameters: One steers the granularity of our halftoning approach, and the other its regularity. We evaluate two versions of our algorithm: A discrete version for dithering that ties points to grid positions, as well as a continuous one which does not have this restriction, and can thus be used for stippling or sampling density functions. Our methods create very few visual artefacts, reveal favourable blue‐noise behaviour in the frequency domain, and have a lower approximation error under Gaussian convolution than state‐of‐the‐art methods.
Ruptured symptomatic internal carotid artery dorsal wall aneurysm with rapid configurational change. Clinical experience and management outcome: an original article
Authors: Lee C.‐C. , Hsieh T.‐C. , Wang Y.‐C. , Lo Y.‐L. , Lee S.‐T. , Yang T.‐C. 
Published: May 2010

Background:  Aneurysms located at non‐branching sites, protruding from the dorsal wall of the supraclinoid internal carotid artery (ICA) with rapid configurational changes, were retrospectively reviewed in effort to identify and characterize these high‐risk aneurysms.Methods:  A total of 447 patients with 491 intracranial aneurysms were treated from March 2005 to August 2008, and of these, eight patients had ICA dorsal wall aneurysms. Four of them suffered subarachnoid hemorrhage (SAH), and all had aneurysms undergoing rapid configuration changes during the treatment course. Digital subtraction cerebral angiography (DSA) performed soon after the SAH events. Data analyzed were patient age, sex, Hunt and Kosnik grade, time interval from first DSA to second DSA, aneurysm treatment, and modified Rankin scale score after treatment for 3 months. Success or failure of therapeutic management was examined among the patients.Results:  Digital subtraction cerebral angiography showed only lesions with small bulges in the dorsal walls of the ICAs. However, the patients underwent DSA again for re‐bleeding or for post‐treatment follow‐up, confirming the SAH source. ICA dorsal wall aneurysms with rapid growth and configurational changes were found on subsequent DSA studies.Conclusions:  Among the four patients, ICA dorsal wall aneurysms underwent rapid growth with configurational change from a blister type to a saccular type despite different management. ICA trapping including the lesion segment can be considered as the first treatment option if the balloon occlusion test (BOT) is successful. If a BOT is not tolerated by the patient, extracranial–intracranial bypass revascularization surgery with endovascular ICA occlusion is another treatment option.
EFNS guidelines for the molecular diagnosis of neurogenetic disorders: motoneuron, peripheral nerve and muscle disorders
Authors: Burgunder J.‐M. , Schöls L. , Baets J. , Andersen P. , Gasser T. , Szolnoki Z. , Fontaine B. , Van Broeckhoven C. , Di Donato S. , De Jonghe P. , Lynch T. , Mariotti C. , Spinazzola A. , Tabrizi S. J. , Tallaksen C. , Zeviani M. , Harbo H. F. , Finsterer J. 
Published: May 2010

Objectives:  These EFNS guidelines on the molecular diagnosis of motoneuron disorders, neuropathies and myopathies are designed to summarize the possibilities and limitations of molecular genetic techniques and to provide diagnostic criteria for deciding when a molecular diagnostic work‐up is indicated.Search strategy:  To collect data about planning, conditions and performance of molecular diagnosis of these disorders, a literature search in various electronic databases was carried out and original papers, meta‐analyses, review papers and guideline recommendations reviewed.Results:  The best level of evidence for genetic testing recommendation (B) can be found for the disorders with specific presentations, including familial amyotrophic lateral sclerosis, spinal and bulbar muscular atrophy, Charcot‐Marie‐Tooth 1A, myotonic dystrophy and Duchenne muscular dystrophy. For a number of less common disorders, a precise description of the phenotype, including the use of immunologic methods in the case of myopathies, is considered as good clinical practice to guide molecular genetic testing.Conclusion:  These guidelines are provisional and the future availability of molecular‐genetic epidemiological data about the neurogenetic disorders under discussion in this article will allow improved recommendation with an increased level of evidence.
Efficacy and safety of Cerebrolysin in moderate to moderately severe Alzheimer’s disease: results of a randomized, double‐blind, controlled trial investigating three dosages of Cerebrolysin
Authors: Alvarez X. A. , Cacabelos R. , Sampedro C. , Aleixandre M. , Linares C. , Granizo E. , Doppler E. , Moessler H. 
Published: May 2010

Background:  Cerebrolysin is a neuropeptide preparation mimicking the effects of neurotrophic factors. This subgroup analysis assessed safety and efficacy of Cerebrolysin in patients with moderate to moderately severe Alzheimer’s disease (AD) (ITT data set: N = 133; MMSE: 14–20) included in a dose‐finding study (ITT data set: N = 251; MMSE: 14–25). Results of the mild AD subgroup (ITT data set: N = 118; MMSE: 21–25) are also presented.Methods:  Patients with AD received 100 ml IV infusions of Cerebrolysin (10, 30 or 60 ml diluted in saline; N = 32, 34 and 35, respectively) or placebo (saline; N = 32) over twelve weeks (5 days per week for 4 weeks and 2 days per week for another 8 weeks). Primary efficacy criteria ADAS‐cog+ (Alzheimer’s Disease Assessment Scale Cognitive Subpart Modified) and CIBIC+ (Clinical Interview‐based Impression of Change with Caregiver Input) were assessed 24 weeks after baseline.Results:  At week 24, Cerebrolysin improved the global clinical function significantly with all three dosages and induced significant improvements in cognition, initiation of activities of daily living (ADL) and neuropsychiatric symptoms at 10‐, 30‐ and 60‐ml doses, respectively. Treatment effects on total ADL and other secondary parameters (MMSE, Trail‐making test) were not significant. Cerebrolysin was safe and well tolerated.Conclusions:  These results demonstrate the efficacy of Cerebrolysin in moderate to moderately severe AD, showing dose‐specific effects similar to those reported for patients with mild to moderate AD. The benefits of Cerebrolysin in advanced AD need to be confirmed in larger trials.
T2 lesions and rate of progression of disability in multiple sclerosis
Authors: Mostert J. P. , Koch M. W. , Steen C. , Heersema D. J. , De Groot J. C. , De Keyser J. 
Published: May 2010

Background and purpose:  To assess the predictive value of T2 lesions on the rate of progression of disability in multiple sclerosis (MS).Methods:  We reanalyzed T2 lesion number and load on brain MRI scans, performed before 1997, of 186 MS patients, who were clinically followed. There were 90 patients with progressive MS (35 secondary progressive and 55 primary progressive), and 96 with relapsing remitting MS. The rate of progression of disability was measured by time to sustained progression of disability (defined as an increase in ≥ 1 point when the Expanded Disability Status Scale (EDSS) was 5.5 or less and an increase in EDSS of ≥ 0.5 point when the EDSS was 6.0 or higher), and by the Multiple Sclerosis Severity Score (MSSS).Results:  During follow‐up (median 15 years, IQR 12–17 years), 94% of the patients with progressive MS and 50% of the patients with relapsing remitting MS had progression of disability. Higher T2 lesion number and load were modestly associated with a higher rate of disease progression on the MSSS and a shorter time to progression of disability in relapsing remitting MS, but not in progressive MS.Conclusions:  Our findings indicate that the amount of T2 lesions has a small predictive value for progression of disability in relapsing remitting MS, but has no influence on the rate of progression in progressive MS.
Reduction in medication‐overuse headache after short information. The Akershus study of chronic headache
Authors: Grande R. B. , Aaseth K. , Benth J. Š. , Lundqvist C. , Russell M. B. 
Published: May 2010

Objective:  Our aim was to investigate the course of medication‐overuse headache in the general population and the effect of simple advice regarding medication overuse.Design:  Prospective cohort study. Participants were identified in a cross‐sectional epidemiological sample of 30 000 persons aged 30–44 from the general Norwegian population. People with chronic headache (≥15 days per month for at least 3 months) and medication overuse received short information about the possible role of medication overuse in headache chronification. A cohort was followed up 1½ years later. The diagnostic criteria of the International Classification of Headache Disorders and data splitting methodology were used.Setting:  Akershus University Hospital, Oslo, Norway.Participants: A total of 109 participants with chronic primary headache and medication overuse were available for follow‐up (85% participation rate).Main outcome measure:  Change in medication days and headache days per month.Results:  At baseline chronic tension‐type headache was found in 92% of participants; 8% had chronic migraine or new daily persistent headache. Migraine co‐occurrence was found in 53%. The mean duration of chronic headaches were 8–18 years, the mean duration of medication overuse between 5 and 10 years prior to intervention. At follow up, the mean medication days were significantly reduced from 22 days to 6 days per month, and 76% no longer had medication overuse. Forty‐two percent no longer had chronic headache and the headache index was reduced by 24%.Conclusion:  Our examination and short information served as a modified brief intervention which can improve chronic headache and medication overuse in the general population.