bluuebunny/crossref_metadata_2025_split huggingface dataset:
Four novel CYP27A1 mutations in seven Italian patients with CTX
Authors: Gallus G. N. , Dotti M. T. , Mignarri A. , Rufa A. , Da Pozzo P. , Cardaioli E. , Federico A. 
Published: April 2010

Background and purpose:  Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disease, because of sterol 27‐hydroxylase deficiency. Clinical manifestations of CTX are tendon xanthomas, juvenile cataracts, osteoporosis, diarrhoea and multiple progressive neurological dysfunctions. More than 300 patients with CTX have been reported to date worldwide and about fifty different mutations identified in CYP27A1 gene. This study describes the clinical and laboratory findings of seven new patients.Methods:  We report the molecular and clinical characterization of seven new Italian patients with CTX carrying four novel mutations.Results:  We identified four novel mutations located in different exons, in particular in the region of exons 2–5 of the CYP27A1 gene. Phenotypical expression did not differ from classical CTX presentation except for absence of tendon xanthomas in two patients.
Epstein–Barr virus neutralizing and early antigen antibodies in multiple sclerosis
Authors: Lindsey J. W. , Hatfield L. M. , Vu T. 
Published: April 2010

Background:  Our objective was to determine whether antibodies against the Epstein–Barr virus (EBV) nuclear antigen‐1 (EBNA‐1), early antigen (EA), and EBV neutralizing antibodies (NeutAb) are altered in multiple sclerosis (MS).Methods:  We measured EBNA‐1 IgG, EA IgG, and EA IgA using quantitative ELISA. We measured NeutAb using a quantitative competitive ELISA. We studied 80 patients with MS, 80 matched controls, and 19 patients with MS with samples collected both whilst stable and in relapse.Results:  Epstein–Barr virus nuclear antigen‐1 IgG and EA IgA were increased in MS compared to controls. The EBNA‐1 index value was 23.3 ± 18.3 in the patients with MS (mean ± SD) and 16.3 ± 17.4 in the controls (P = 0.007, paired t‐test). EA IgA had a median value of 1.964 in the patients with MS and 1.248 in the controls (P = 0.029, Wilcoxon signed rank test). EA IgG and NeutAb were not significantly different. None of the antibody levels were altered in relapse. The correlation between concentrations of different antibodies was minimal.Conclusions:  IgG antibodies to EBNA‐1 are significantly increased in MS. IgA antibodies against EBV EA are also increased. The EBV neutralizing antibody response is similar in MS and controls.
The I/D polymorphism of the ACE1 gene is not associated with ischaemic stroke in Spanish individuals
Authors: Domingues‐Montanari S. , Fernandez‐Cadenas I. , Del Rio‐Espinola A. , Mendioroz M. , Ribo M. , Obach V. , Marti‐Fabregas J. , Freijo M. , Serena J. , Corbeto N. , Chacon P. , Alvarez‐Sabin J. , Montaner J. 
Published: April 2010

Background:  The angiotensin‐converting enzyme 1 (ACE1) gene has been extensively studied in stroke, yet generating conflicting results. The goal of our study was thus to clarify the influence of the ACE1 on the risk of suffering an ischaemic stroke (IS).Methods:  We genotyped the rs4341 (in linkage disequilibrium with the I/D polymorphism) of the ACE1 gene in 531 patients with IS and 549 healthy controls, and the rs1799752 (I/D polymorphism) in a subset of 68 patients with IS and 27 controls. We also performed functional studies by measuring serum ACE protein levels and enzymatic activity in 27 controls, 68 patients with IS at baseline and 35 patients with IS 24 h after onset of stroke symptoms.Results:  There was no association of the ACE1 variant with IS, although it affected ACE protein levels (P = 0.001). Indeed, patients with IS showed lower ACE levels than controls in the acute phase (115.9 ± 38.9 vs. 174.1 ± 56.1 ng/ml, P < 0.001), but not in the chronic phase (168.2 ± 51.2, P = 0.673), and ACE protein levels did not differ between IS etiologies. Similar results were found for ACE activity.Conclusions:  The D allele of the ACE1 I/D and ACE protein levels was not associated with a higher risk of IS in Spanish individuals.
University Efficiency: Complementariness versus Trade‐off between Teaching, Research and Administrative Activities
Authors: Sellers‐Rubio Ricardo , Mas‐Ruiz Francisco J. , Casado‐Díaz Ana B. 
Published: April 2010

AbstractUniversity managers should be aware of the importance that efficiency has for their own universities, orientating their actions towards research and teaching excellence. This study estimates teaching and research efficiency of the different departments of a university and tests the complementariness versus trade‐off between them. The results obtained show high levels of efficiency for the departments analysed, which is important for budget allocation, as one of the main challenges faced by a university is the allocation of budgets to different departments. The results also support the trade‐off between teaching efficiency and research activity, the complementariness between teaching efficiency and research efficiency, between research efficiency and time deducted from teaching, as well as the complementariness between research efficiency and administration activity.
Finnish Higher Education Expansion and Regional Policy
Authors: Saarivirta Toni 
Published: April 2010

AbstractThis paper concentrates on the expansion of Finnish higher education between the 1960s and 1970s, exposes its background in the light of the policy decisions that were made, compares the unique features of this expansion with those of certain other countries, discusses the impact of the controlled ‘top down’ governance of higher education policy, and describes the Finnish higher education system today. The paper argues that the driving forces behind universal mass higher education were, on the one hand, changes in the structure of society, and on the other hand, individual demand for education but also increased need for skills in production processes. This was the case in Finland as well but the Finnish higher education expansion was also characterised by regionalism. The actual location of universities in the era of expansion was a function of local political actors who were able to have an influence on ruling political parties.
The Established Church and Evangelical Theology: John Wesley's Ecclesiology
Authors: RAINEY DAVID 
Published: April 2010

AbstractFrom the earliest years of the eighteenth century evangelical revival in Great Britain, John Wesley developed a particular ecclesiology. If John Wesley can be accused of having an overly pragmatic bent, this certainly was not true of his ecclesiology. His understanding of church order developed early during the revival and was eventually put into full practice in the controversial year 1784. This article defends the view that sacramental theology dictated the direction of church order according to John Wesley. Those who have interpreted Wesley as primarily a pragmatist on ecclesial practice have misinterpreted his own writings on the topic.
God's Free Grace and the Freedom of the Church: Theological Aspects of the Barmen Declaration
Authors: WEINRICH MICHAEL 
Published: April 2010

AbstractThis article explores the fundamental theological decisions of the ‘six evangelical truths’ of the Barmen Theological Declaration of 1934 on the occasion of its 75th anniversary. Seeing it in close proximity to the theology of Karl Barth, the essay considers in turn the substance and ongoing significance of the Declaration's reaffirmation of the First Commandment, its iteration of the threefold form of the Word of God, its repudiation of natural theology, its ringing affirmation of the positive freedom of the church and, finally, its ecumenical importance as an impulse to Christian unity.
Rethinking ‘Enthusiasm’: Christoph Blumhardt on the Discernment of the Spirit
Authors: ZAHL SIMEON 
Published: April 2010

AbstractThis article uses resources from the theology of Christoph Blumhardt to argue that Luther was mistaken in identifying a necessary theological connection between ‘enthusiastic’ views of the Spirit and naive anthropology. It demonstrates that Blumhardt successfully combined an abiding concern over the problem of spiritual self‐deception together with a pneumatology that affirmed the importance of affective experience of the Spirit not mediated exclusively by the proclaimed Word of Scripture, through a conviction that the most reliable sign of the Spirit's activity is ‘negative’, in suffering and visceral encounter with divine judgement, in the first instance. This critical ‘enthusiasm’ helps explain Blumhardt's singular critique of the nationalistic ‘Spirit of August’ from the start of World War I.
Psoriatic arthritis – what the dermatologist needs to know
Authors: Laws P , Barton A , Warren RB 
Published: April 2010

AbstractPsoriasis is commonly associated with a co‐existent arthritis known as psoriatic arthritis (PsA). Although there is some treatment overlap for psoriasis and psoriatic arthritis, it is possible that dermatologists may not diagnose or treat appropriately patients who are developing psoriatic arthritis at an early stage of the disease process when joint damage may be preventable. In this article we review the criteria for diagnosis of this sero‐negative arthritis, look at the clinical indications for referral to a rheumatologist and discuss evolving treatment options relevant to both conditions.
Disability, Respect and Justice
Authors: BARCLAY LINDA 
Published: April 2010

abstractRecent political philosophers have argued that criteria of social justice that defend distributing resources to individuals on the basis of the disadvantages of their natural endowments are disrespectful and disparaging. Clearly influenced by the social model of disability, Elizabeth Anderson and Thomas Pogge have recently defended criteria of social justice that distribute resources to people with disabilities on the basis of eliminating discrimination, not making up for so‐called natural disadvantage. I argue that it is implausible to suggest that just entitlements for people with disability can be secured solely by eliminating discrimination. Resources for people with disabilities must sometimes be justified on the grounds that some natural endowments pose disadvantages even in societies that do not discriminate. I argue further that there need be nothing at all disrespectful about this way of explaining disadvantage; nor have proponents of the social model of disability or political philosophers provided any compelling reasons for supposing that it is disrespectful. There is thus no motivation for Anderson's and Pogge's attempts to secure justice for people with disabilities by appealing solely to the imperative to eliminate discrimination.
Beyond Mental Competence
Authors: EDWARDS CRAIG 
Published: April 2010

abstractJustification for psychiatric paternalism is most easily established where mental illness renders the person mentally incompetent, depriving him of the capacity for rational agency and for autonomy, hence undermining the basis for liberal rights against paternalism. But some philosophers, and no doubt some doctors, have been deeply concerned by the inadequacy of the concept of mental incompetence to encapsulate some apparently appealing cases for psychiatric paternalism. We ought to view mental incompetence as just one subset of a broader justification for psychiatric paternalism. The very basis of liberal limitations on psychiatric paternalism, whether described in terms of rights to autonomy or as respect for differences in values and lifestyles, presupposes a sense of moral persistence, and hence some sufficiently persistent self. Paternalistic intervention is warranted when we are unable to govern our lives in a manner consistent with the goals and values that comprise that ‘self’. One way that can occur is when we lack the mental capacities required for autonomy, such that we are unable to interpret and interact with our environment in order to meaningfully pursue our goals, i.e. mental incompetence. But it can also occur when we are subject to impositions that alter our goals without altering our capacity to pursue them — i.e. when it is our ‘self’ that is impaired rather than our competence.
Reexploring Differences among For‐Profit and Nonprofit Dialysis Providers
Authors: Lee Donald K. K. , Chertow Glenn M. , Zenios Stefanos A. 
Published: April 2010

Objective.To determine whether profit status is associated with differences in hospital days per patient, an outcome that may also be influenced by provider financial goals.Data Sources.United States Renal Data System Standard Analysis Files and Centers for Medicare and Medicaid Services cost reports.Design.We compared the number of hospital days per patient per year across for‐profit and nonprofit dialysis facilities during 2003. To address possible referral bias in the assignment of patients to dialysis facilities, we used an instrumental variable regression method and adjusted for selected patient‐specific factors, facility characteristics such as size and chain affiliation, as well as metrics of market competition.Data Extraction Methods.All patients who received in‐center hemodialysis at any time in 2003 and for whom Medicare was the primary payer were included (N=170,130; roughly two‐thirds of the U.S. hemodialysis population). Patients dialyzed at hospital‐based facilities and patients with no dialysis facilities within 30 miles of their residence were excluded.Results.Overall, adjusted hospital days per patient were 17±5 percent lower in nonprofit facilities. The difference between nonprofit and for‐profit facilities persisted with the correction for referral bias. There was no association between hospital days per patient per year and chain affiliation, but larger facilities had inferior outcomes (facilities with 73 or more patients had a 14±1.7 percent increase in hospital days relative to facilities with 35 or fewer patients). Differences in outcomes among for‐profit and nonprofit facilities translated to 1,600 patient‐years in hospital that could be averted each year if the hospital utilization rates in for‐profit facilities were to decrease to the level of their nonprofit counterparts.Conclusions.Hospital days per patient‐year were statistically and clinically significantly lower among nonprofit dialysis providers. These findings suggest that the indirect incentives in Medicare's current payment system may provide insufficient incentive for for‐profit providers to achieve optimal patient outcomes.
Job Stress and Job Satisfaction: Home Care Workers in a Consumer‐Directed Model of Care
Authors: Delp Linda , Wallace Steven P. , Geiger‐Brown Jeanne , Muntaner Carles 
Published: April 2010

Objective. To investigate determinants of job satisfaction among home care workers in a consumer‐directed model.Data Sources/Setting. Analysis of data collected from telephone interviews with 1,614 Los Angeles home care workers on the state payroll in 2003.Data Collection and Analysis. Multivariate logistic regression analysis was used to determine the odds of job satisfaction using job stress model domains of demands, control, and support.Principal Findings. Abuse from consumers, unpaid overtime hours, and caring for more than one consumer as well as work‐health demands predict less satisfaction. Some physical and emotional demands of the dyadic care relationship are unexpectedly associated with greater job satisfaction. Social support and control, indicated by job security and union involvement, have a direct positive effect on job satisfaction.Conclusions. Policies that enhance the relational component of care may improve workers' ability to transform the demands of their job into dignified and satisfying labor. Adequate benefits and sufficient authorized hours of care can minimize the stress of unpaid overtime work, caring for multiple consumers, job insecurity, and the financial constraints to seeking health care. Results have implications for the structure of consumer‐directed models of care and efforts to retain long‐term care workers.
Patient Panel of Underserved Populations and Adoption of Electronic Medical Record Systems by Office‐Based Physicians
Authors: Li Chenghui , West‐Strum Donna 
Published: April 2010

Objectives. To examine the association between patient panels of underserved populations and adoption of electronic medical records (EMRs) among office‐based physicians.Data Sources. Two thousand three hundred and twenty‐six office‐based physicians who responded and saw patients in the 2005 and 2006 National Ambulatory Medical Care Surveys.Study Design. This study used a cross‐sectional design. The unit of analysis was the office‐based physician. EMR adoption was defined based on functionalities (No EMR, Limited, or Comprehensive). An EMR was considered to have “comprehensive” functionalities if it included computerized orders for prescriptions and tests, test results, and clinical notes by physicians. Patient panels of underserved populations were measured as proportions of racial/ethnic minorities, Medicaid recipients, or self‐pay/no charge/charity care patients treated by a physician using the reported sociodemographic characteristics in patient records linked to their treating physicians. Data were analyzed using multivariate regression analyses controlling for other patient‐panel characteristics and characteristics of physicians and their practices.Principal Findings. We found a negative association between the proportion of Hispanics treated by a physician and physician adoption of EMRs with “comprehensive” functionalities after adjusting for other covariates.Conclusions. Physicians treating high shares of Hispanic patients may have lower access to EMRs with essential functionalities.
Implications of the California Nurse Staffing Mandate for Other States
Authors: Aiken Linda H. , Sloane Douglas M. , Cimiotti Jeannie P. , Clarke Sean P. , Flynn Linda , Seago Jean Ann , Spetz Joanne , Smith Herbert L. 
Published: April 2010

Objectives. To determine whether nurse staffing in California hospitals, where state‐mandated minimum nurse‐to‐patient ratios are in effect, differs from two states without legislation and whether those differences are associated with nurse and patient outcomes.Data Sources. Primary survey data from 22,336 hospital staff nurses in California, Pennsylvania, and New Jersey in 2006 and state hospital discharge databases.Study Design. Nurse workloads are compared across the three states and we examine how nurse and patient outcomes, including patient mortality and failure‐to‐rescue, are affected by the differences in nurse workloads across the hospitals in these states.Principal Findings. California hospital nurses cared for one less patient on average than nurses in the other states and two fewer patients on medical and surgical units. Lower ratios are associated with significantly lower mortality. When nurses' workloads were in line with California‐mandated ratios in all three states, nurses' burnout and job dissatisfaction were lower, and nurses reported consistently better quality of care.Conclusions. Hospital nurse staffing ratios mandated in California are associated with lower mortality and nurse outcomes predictive of better nurse retention in California and in other states where they occur.
Little evidence for different phenomenology in poststroke depression
Authors: Cumming T. B. , Churilov L. , Skoog I. , Blomstrand C. , Linden T. 
Published: April 2010

Cumming TB, Churilov L, Skoog I, Blomstrand C, Linden T. Little evidence for different phenomenology in poststroke depression.Objective:  It remains unclear whether mood depressive disorders after stroke have a distinct phenomenology. We evaluated the symptom profile of poststroke depression (PSD) and assessed whether somatic symptoms were reported disproportionately by stroke patients.Method:  The sample was 149 stroke patients at 18 months poststroke and 745 age‐ and sex‐matched general population controls. A comprehensive psychiatric interview was undertaken and depression was diagnosed according to DSM‐III‐R criteria.Results:  Depressed controls reported more ‘inability to feel’ (P = 0.002) and ‘disturbed sleep’ (P = 0.008) than depressed stroke patients. Factor analysis of the 10 depressive symptoms identified two main factors, which appeared to represent somatic and psychological symptoms. There was no difference in scores on these two factors between stroke patients and controls.Conclusion:  Phenomenology of depression at 18 months poststroke is broadly similar but not the same as that described by controls. Somatic symptoms of depression were not over‐reported by stroke patients.
The prognosis and incidence of social phobia in an elderly population. A 5‐year follow‐up
Authors: Karlsson B. , Sigström R. , Waern M. , Östling S. , Gustafson D. , Skoog I. 
Published: April 2010

Karlsson B, Sigström R, Waern M, Östling S, Gustafson D, Skoog I. The prognosis and incidence of social phobia in an elderly population. A 5‐year follow‐up.Objective:  To examine the prognosis and incidence of social fears and phobia in an elderly population sample followed for 5 years.Method:  A general population sample (N = 612) of non‐demented men (baseline age 70) and women (baseline age 70 and 78–86) was investigated in 2000–2001 and in 2005–2006 with semi‐structured psychiatric examinations including the Comprehensive Psychopathological Rating Scale, and the Mini International Neuropsychiatric Interview. Social phobia was diagnosed according to the DSM‐IV criteria.Results:  Among nine individuals with DSM‐IV social phobia in 2000, 5 (55.6%) had no social fears in 2005, and 1 (11.1%) still met the criteria for DSM‐IV social phobia. Among individuals without DSM‐IV social phobia in 2000 (N = 603), 12 (2.0%) had DSM‐IV social phobia in 2005.Conclusion:  These findings challenge the notion that social phobia is a chronic disorder with rare occurrence in old age.
Antidepressant medication prevents suicide in depression
Authors: Isacsson G. , Reutfors J. , Papadopoulos F. C. , Ösby U. , Ahlner J. 
Published: April 2010

Isacsson G, Reutfors J, Papadopoulos FC, Ösby U, Ahlner J. Antidepressant medication prevents suicide in depression.Objective:  Ecological studies have demonstrated a substantial decrease in suicide in parallel with an increasing use of antidepressants. To investigate on the individual level the hypothesis that antidepressant medication was a causal factor.Method:  Data on the toxicological detection of antidepressants in 18 922 suicides in Sweden 1992–2003 were linked to registers of psychiatric hospitalization as well as registers with sociodemographic data.Results:  The probability for the toxicological detection of an antidepressant was lowest in the non‐suicide controls, higher in suicides, and even higher in suicides that had been psychiatric in‐patients but excluding those who had been in‐patients for the treatment of depression.Conclusion:  The finding that in‐patient care for depression did not increase the probability of the detection of antidepressants in suicides is difficult to explain other than by the assumption that a substantial number of depressed individuals were saved from suicide by postdischarge treatment with antidepressant medication.