bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teamwork and Team Decision‐making at Multidisciplinary Cancer Conferences: Barriers, Facilitators, and Opportunities for Improvement
Authors: Lamb Benjamin W. , Sevdalis Nick , Arora Sonal , Pinto Anna , Vincent Charles , Green James S. A. 
Published: May 2011

AbstractBackgroundAnecdotally, multidisciplinary cancer conferences (MCCs) do not always function optimally. MCC members’ experiences with and attitudes toward MCCs are explored, and barriers to and facilitators of effective team‐working are identified.MethodsA total of 19 semistructured interviews were conducted with surgeons, oncologists, nurses, and administrators. Interviews explored participants’ opinions on MCC attendance, information presentation, case discussion, leadership, team decision‐making, and possible improvements to MCC meetings.ResultsNonattendance was associated with not having protected time to attend the MCC. Contributions to MCC discussions were unequal among the participants, and patient‐centered information was ignored. Good leadership was necessary to foster inclusive case discussion. Members were positive about MCCs, but protected time, improved case selection, and working in a more structured way were possible improvements.ConclusionsResults are consistent with previous research: Members of the MCC are positive about the benefits of MCCs, although improving the way MCCs work is a goal.
Genetische Risiken der assistierten Reproduktion
Authors: Ludwig M. , Ludwig A.K. 
Published: May 2011

Zusammenfassung
Kinderwunschpatienten müssen vor einer Behandlung über die genetischen Risiken individuell beraten werden. Chromosomenanomalien sind für etwa 5% der männlichen Subfertilität verantwortlich. Im Fall einer Azoospermie liegt die Rate bei 15%. Daher sollte bei einer männlichen Subfertilität bei einer Spermienzahl <20 Mio./ml eine Chromosomenanalyse bei beiden Partnern durchgeführt werden, da ein erhöhtes Risiko für genetische Veränderungen besteht. Ein Klinefelter-Syndrom oder eine Robertson-Translokation können für eine männliche Subfertilität verantwortlich sein. Mutationen des CFTR-Gens sowie Veränderungen des Y-Chromosoms findet man gehäuft bei männlicher Subertiltät. Mikrodeletionen treten am häufigsten am langen Arm des Y-Chromosoms auf (Yq) und betreffen Gene, die direkt in die Spermatogenese involviert sind, insbesondere das AZF-Gen.
Bezüglich Schwangerschaftsverlauf und neonatalem Outcome der Kinder müssen Kinderwunschpatienten darüber aufgeklärt werden, dass während der Schwangerschaft und der Geburt häufiger Komplikationen auftreten als nach Spontankonzeption. Das Fehlgeburtsrisiko ist um das 1,3-Fache erhöht, dies ist jedoch vermutlich Folge der Subfertilität sowie weiterer Risikofaktoren, die die Paare mitbringen, und nicht Folge der Therapie. Das Risiko für Schwangerschaftskomplikationen wie Präeklampsie, Wachstumsretardierung und Totgeburt ist ebenfalls erhöht. Zudem ist das Fehlbildungsrisiko sowohl bei der IVF-Therapie als auch bei der ICSI-Therapie um das 1,3-Fache erhöht.
Genetische Aspekte bei Spermatogenesestörungen
Authors: Tüttelmann F. 
Published: May 2011

Zusammenfassung
Bei unerfülltem Kinderwunsch, der etwa 10–15% aller Paare betrifft, zeigt sich in etwa der Hälfte der Fälle eine (Mit-)Ursache aufseiten des ansonsten gesunden Mannes, bei dem sich i. d. R. eine eingeschränkte Spermienzahl im Ejakulat (Oligo- oder Azoospermie) findet. Zu den klinisch relevanten genetischen Ursachen für Spermatogenesestörungen gehören insbesondere Chromosomenaberrationen (inkl. Klinefelter-Syndrom) und Y-chromosomale Mikrodeletionen der AZF-Loci. Mutationen im CFTR-Gen können neben einer Mukoviszidose zu einer isolierten obstruktiven Azoospermie ohne Spermatogenesestörung führen. Nach der andrologischen Basisdiagnostik sollten entsprechend den Befunden die genetischen Untersuchungen veranlasst werden. Chromosomenstörungen finden sich mit abnehmender Spermienzahl häufiger. Bei einer Oligozoospermie stehen Veränderungen (z. B. Translokationen) der Autosomen im Vordergrund, während für eine Azoospermie in 10–15% ein Klinefelter-Syndrom ursächlich ist. Die klassischen AZF-Deletionen finden sich ausschließlich bei Männern mit hochgradiger Oligo- oder Azoospermie und haben prognostische Bedeutung: Bei Trägern einer kompletten AZFa- oder AZFb-Deletion ist im Gegensatz zu Männern mit AZFc-Deletion eine Hodenbiopsie mit dem Ziel der Spermiengewinnung nicht erfolgversprechend. Daneben kommen in seltenen Fällen syndromale Formen und spezifische Spermiendefekte (Globozoospermie, Zilienstrukturdefekte) als genetische Ursachen einer Infertilität in Frage.
Habituelle Aborte
Authors: Preisler-Adams S. , Bogdanova N. 
Published: May 2011

Zusammenfassung
Habituelle Aborte (HA) betreffen etwa 1–3% aller Paare mit Kinderwunsch. Sowohl parentale Chromosomenberrationen, erworbene und vererbte Thrombophilie, Autoimmundefekte, Hormonstörungen als auch Fehlbildungen der weiblichen Genitalien sind bekannte Risikofaktoren für HA. Um Einblicke in die Pathophysiologie von Schwangerschaften zu erbringen, die durch wiederholte Fehlgeburten unterbrochen werden, fassen wir in dieser Übersichtsarbeit – gestützt auf Forschungsberichte und internationale Leitlinien – die aktuellen Erkenntnisse hinsichtlich Diagnose und Behandlung der HA zusammen.
Hypogonadotroper Hypogonadismus aufgrund eines IHH oder Kallmann-Syndroms beim Mann
Authors: Behre H.M. , Tüttelmann F. , Ledig S. , Wieacker P. 
Published: May 2011

Zusammenfassung
Beim männlichen Geschlecht wird die Prävalenz des isolierten hypogonadatropen Hypogonadismus (IHH)/Kallmann-Syndroms auf etwa 1:10.000 geschätzt. Leitsymptom für den IHH ist die ausbleibende Pubertätsentwicklung in Kombination mit erniedrigten Gonadotropinen und einer verminderten Testosteronkonzentration. Wenn zusätzlich eine Anosmie/Hyposmie (in etwa 60% der Fälle) vorliegt, spricht man von einem Kallmann-Syndrom. IHH/Kallmann-Syndrom sind klinisch und genetisch sehr heterogene Krankheitsbilder. Die genetische Diagnostik und therapeutischen Möglichkeiten werden diskutiert.
Can Redesigning a Laboratory Request form Reduce the Number of Inappropriate PSA Requests without Compromising Clinical Outcome
Authors: Powles L.A.R. , Rolls A.E. , Lamb B.W. , Taylor E. , Green J.S.A. 
Published: May 2011

Introduction: Unnecessary laboratory utilization due to inappropriate test-ordering behaviour among hospital clinicians and community general practitioners is an ongoing problem in many hospitals and primary care trusts throughout the UK and abroad. In January 2007, our hospital removed the ‘tick box’ for PSA from its laboratory tests request form, in a managed way, with the intention of reducing unnecessary requests for this test. Here we address the impact this action had on the number of PSA tests being requested and its downstream effects on prostate cancer diagnosis. Methods: Using our laboratory database we compared the number of hospital and local GP requests for PSA, before and after modification of our laboratory form (requests from 2004 to 2006 were compared to 2007). We then correlated this data with the number of fast-track target referrals (2 week wait) from primary care for suspected prostate cancer, the results of prostate biopsies, and the number of prostate cancers being diagnosed, over the same time period. Results: Mann—Whitney non-parametric testing demonstrated a 17% reduction in the median number of PSA requests since the change was introduced ( p = 0.001). Subset analysis revealed an 18% reduction in GP requests ( p = 0.002). However no change was found in the number of prostate cancer diagnoses being made ( p = 0.86) and the number of target referrals for suspected prostate cancer ( p = 0.59) in the months of April, May, June, July, August and September of 2004–2006 as compared to the same months in 2007. The rate of patients undergoing biopsy increased in the post intervention period from 15.5 to 18.5 patients per month. The rate of negative biopsies remained stable, changing from 7.2 to 7.3 per month, and the rate of positive biopsies increased from 8.3 to 11.2 per month. This change reduced the false negative rate (suspected cancer, negative biopsy) from 46% to 40% in the period following the intervention. The rate of target referrals leading on to cancer showed a small increase after the intervention from 2.9 to 3.3 per month. Conclusions: Our study shows that with this simple modification to the design of our laboratory request form, whereby the doctor must make an active written decision to order a PSA test, there was a significant reduction in the number of PSA requests, both in the hospital and in the community, without patient safety being compromised as measured by maintaining the number of fast-track target referrals for suspected prostate cancer and the number of prostate cancers diagnosed.
Short‐ and long‐term behavioral effects of exposure to 21%, 40% and 100% oxygen after perinatal hypoxia–ischemia in the rat
Authors: Woodworth K. Nina , Palmateer Julie , Swide Joseph , Grafe Marjorie R. 
Published: May 2011

AbstractUntil recently, supplementation with 100% oxygen was standard therapy for newborns who required resuscitation at birth or suffered later hypoxic–ischemic events. Exposure to high concentrations of oxygen, however, may worsen oxidative stress induced by ischemic injury. In this study we investigated the short‐ and long‐term behavioral outcomes in rats that had undergone hypoxic–ischemic brain injury on postnatal day 7, followed by 2 h exposure to 21%, 40%, or 100% oxygen, compared to normal controls. There were no differences in the development of walking, head lifting and righting reflexes from postnatal days 9 to 15. Cliff avoidance showed some abnormal responses in the H21 animals. From postnatal days 28 to 56, three tests of sensorimotor coordination were performed weekly: ledged tapered beam, cylinder, and bilateral tactile stimulation. The ledged tapered beam test without prior training of animals was sensitive to injury, but did not distinguish between treatment groups. The cylinder test showed a greater use of the unimpaired limb in female 21% and 40% oxygen groups compared to controls. Performance in both cylinder and the beam tests showed a correlation with the degree of brain injury. The bilateral tactile stimulation test showed that the male 21% oxygen groups had worse sensory asymmetry than male 40% or 100% oxygen groups, but was not statistically significantly different from controls.We thus found a minor benefit to post‐hypoxia–ischemic treatment with 100% and 40% oxygen compared to 21% in one test of early motor skills. Our results for long‐term sensorimotor behavior, however, showed conflicting results, however, as males treated with 40% or 100% oxygen had less sensory asymmetry (better performance) in the bilateral tactile stimulation test than males treated with 21% oxygen, while females had impaired motor performance in the cylinder test with both 21% and 40% oxygen.
Intermittent Catheterization With a Hydrophilic‐Coated Catheter Delays Urinary Tract Infections in Acute Spinal Cord Injury: A Prospective, Randomized, Multicenter Trial
Authors: Cardenas Diana D. , Moore Katherine N. , Dannels‐McClure Amy , Scelza William M. , Graves Daniel E. , Brooks Monifa , Busch Anna Karina 
Published: May 2011

ObjectiveTo investigate whether intermittent catheterization (IC) with a hydrophilic‐coated catheter delays the onset of the first symptomatic urinary tract infection (UTI) and reduces the number of symptomatic UTIs in patients with acute spinal cord injury (SCI) compared with IC with standard, uncoated catheters.DesignA prospective, randomized, parallel‐group trial.SettingFifteen North American SCI centers. Participants were followed up while in the hospital or rehabilitation unit (institutional period) and up to 3 months after institutional discharge (community period). The maximal study period was 6 months.ParticipantsA total of 224 subjects with traumatic SCI of less than 3 months' duration who use IC.MethodsThe participants were randomized within 10 days of starting IC to either single‐use hydrophilic‐coated (SpeediCath) or polyvinyl chloride uncoated (Conveen) catheters.Main Outcome MeasurementsThe time from the first catheterization to the first antibiotic‐treated symptomatic UTI was measured as well as the total number of symptomatic UTIs during the study period.ResultsThe time to the first antibiotic‐treated symptomatic UTI was significantly delayed in the hydrophilic‐coated catheter group compared with the uncoated catheter group. The delay corresponded to a 33% decrease in the daily risk of developing the first symptomatic UTI among participants who used the hydrophilic‐coated catheter. In the institutional period, the incidence of antibiotic‐treated symptomatic UTIs was reduced by 21% (P < .05) in the hydrophilic‐coated catheter group.ConclusionsThe use of a hydrophilic‐coated catheter for IC is associated with a delay in the onset of the first antibiotic‐treated symptomatic UTI and with a reduction in the incidence of symptomatic UTI in patients with acute SCI during the acute inpatient rehabilitation. Using a hydrophilic‐coated catheter could minimize UTI‐related complications, treatment costs, and rehabilitation delays in this group of patients, and reduce the emergence of antibiotic‐resistant organisms.
A Preliminary Report on the Effects of the Level of Spinal Cord Injury on the Association Between Central Adiposity and Metabolic Profile
Authors: Gorgey Ashraf S. , Gater David R. 
Published: May 2011

ObjectivesTo determine the effects of the level of injury on visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and the VAT:SAT ratio in individuals with tetraplegia (T‐spinal cord injury [SCI]) and paraplegia (P‐SCI) and the relationships among central adiposity and glucose and lipid profile.DesignCross‐sectional and correlation.SettingsClinical hospital and academic settings.MethodsThirteen individuals with motor complete SCI were divided into T‐SCI (n = 6, C5‐C7, American Spinal Injury Association Impairment Scale [AIS] A and B) and P‐SCI (n = 7, T4‐T11, AIS A and B) groups. Both groups underwent overnight fasting to measure serum lipid profile, plasma glucose, and insulin responses to an oral glucose tolerance test, which was followed by magnetic resonance imaging to quantify VAT and SAT cross‐sectional areas (CSA) and volume across multi‐axial slices.ResultsThe CSA and volumes of VAT and SAT were not different between T‐SCI and P‐SCI. VAT CSA was related to the fasting glucose in both groups, with nonsignificant association with glucose area under the curve. The CSA and volume of SAT were strongly associated with lipid profile outcomes in the T‐SCI (r = 0.86‐0.99, P < .02) but not in the P‐SCI.ConclusionThe preliminary work suggests that the level of injury does not appear to influence the distribution of VAT and SAT. VAT and SAT distribution could not explain the difference noted in glucose and insulin profiles between the T‐SCI and P‐SCI groups. Finally, SAT is a strong predictor of lipid profile in individuals with T‐SCI.
Systemic Inflammation and Reduced Pulmonary Function in Chronic Spinal Cord Injury
Authors: Garshick Eric , Stolzmann Kelly L. , Gagnon David R. , Morse Leslie R. , Brown Robert 
Published: May 2011

ObjectiveTo evaluate the relationship between systemic inflammation and pulmonary function in persons with chronic spinal cord injury (SCI).DesignCross‐sectional study.SettingVeterans Affairs Medical Center.ParticipantsFifty‐nine men with chronic SCI participating in a prior epidemiologic study.MethodsStandardized assessment of pulmonary function and measurement of plasma C‐reactive protein (CRP) and interleukin‐6 (IL‐6).Main Outcome MeasurementsForced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC).ResultsPersons with the highest values of IL‐6 had the lowest %‐predicted FEV1 and FVC. There was a significant inverse linear trend between quartile of IL‐6 and %‐predicted FEV1 (P < .001) and FVC (P < .006), unadjusted and adjusted for SCI level and completeness of injury, obstructive lung disease history, smoking, and body mass index (P = .010‐.039). Although not as strong as for IL‐6, there also were similar trends for %‐predicted FEV1 and FVC with CRP.ConclusionsIn chronic SCI, higher levels of IL‐6 and CRP were associated with a lower FEV1 and FVC, independent of level and completeness of injury. These results suggest that the reduction of pulmonary function after SCI is related not only to neuromuscular impairment but also to factors that promote systemic inflammation.
Adverse Effects of Corticosteroids on Bone Metabolism: A Review
Authors: Mitra Raj 
Published: May 2011

AbstractGlucocorticoid (GC) exposure is the most common etiology of drug‐induced (secondary) osteoporosis. Twenty percent of all cases of osteoporosis have been attributed to GC exposure. Significant risk factors for the development of fractures after GC exposure include age older than 65 years, prolonged GC exposure (>3 months), positive family history of osteoporosis, and low calcium intake. GCs are known to inhibit bone remodeling and to increase fracture risk. GC exposure alters the fragile balance between osteoclast and osteoblast activity in bone metabolism. GC stimulates osteoclast‐mediated bone resorption and reduces osteoblast‐mediated bone formation, which results in increased overall net bone resorption. Specifically, the 2 main effects of GCs on bone metabolism are (1) inducing apoptosis in osteoblasts and osteocytes, thereby decreasing bone formation, and (2) prolonging the lifespan of osteoclasts and increasing bone resorption. The risk of fracture decreases 3 months after cessation of GC therapy; thus, a 3‐month period may be ideal between GC exposures in patients at high risk for the development of osteoporosis. Patients managed with GCs who are at high risk for the development of secondary osteoporosis should have appropriate diagnostic testing; pre‐GC exposure medication management (ie, use of bisphosphonates, human parathyroid hormone); and a limitation of GC therapy, with a wait period of 3 months between GC exposures if possible.
MAIZE (ZEA MAYS) LEAF ANGLE AND EMERGENCE AS AFFECTED BY SEED ORIENTATION AT PLANTING
Authors: TORRES GUILHERME , VOSSENKEMPER JACOB , RAUN WILLIAM , TAYLOR RANDY 
Published: May 2011

SUMMARYMaize (Zea mays) seed orientation at planting can influence emerging leaf angle. If leaf angle were consistent among plants without leaf overlap, large numbers of these bilaterally symmetrical plants could be arranged to optimize light interception and possibly increase grain yields or maintain grain yield with a lower population. The objectives were to evaluate the effect of seed orientation in soil on the angle of maize leaves relative to the planted row and on emergence rate. Seeds were planted 2.5 cm deep in diverse combinations of flat, cotyledon down, cotyledon up, on their side, radicle up and radicle down. Each seed orientation was repeated 10 times. Data on days to emergence and leaf angle were collected. In three experiments, maize seeds planted flat with the cotyledon up resulted in homogenous and faster emergence, and maize leaves aligned perpendicular to the direction of the maize row. Similar results were achieved with maize seeds planted parallel to the row with the radicle down. Random placement of maize seeds resulted in random orientation of maize leaves and lower emergence rates. The effects of controlled leaf geometry could facilitate planting higher populations with the potential for increasing grain yield and/or allow the maintenance of grain yields while reducing seed rates.
A randomized controlled trial of an Internet-based cognitive-behavioural skills package for carers of people with anorexia nervosa
Authors: Grover M. , Naumann U. , Mohammad-Dar L. , Glennon D. , Ringwood S. , Eisler I. , Williams C. , Treasure J. , Schmidt U. 
Published: May 2011

BackgroundAnorexia nervosa (AN) poses a major burden on families. Carers (e.g. parents or partners) of people with AN are often highly distressed and may inadvertently respond in ways that can contribute to the maintenance of the disorder, e.g. through high levels of over-involvement and criticism [also known as expressed emotion (EE)]. This study aimed to evaluate the efficacy of a novel web-based systemic cognitive-behavioural (CBT) intervention for carers of people with AN, designed to reduce carer distress and teach skills in how to offer effective support.MethodCarers of people with AN (n=64) were randomly allocated to either the web-intervention, overcoming anorexia online, with limited clinician supportive guidance (by email or phone), or toad-hocusual support from the UK patient and carer organization Beat. Carer outcomes were assessed at post-treatment (4 months) and follow-up (6 months).ResultsCompared with the control intervention, web-based treatment significantly reduced carers' anxiety and depression (primary outcome) at post-treatment, with a similar trend in carers' EE. Other secondary outcomes did not favour the online intervention. Gains were maintained at follow-up.ConclusionsThis is the first ever study to use an online CBT program to successfully reduce carer distress and improve carers' ability to support the person with AN.
Prospective relationships of ADHD symptoms with developing substance use in a population-derived sample
Authors: Sihvola E. , Rose R. J. , Dick D. M. , Korhonen T. , Pulkkinen L. , Raevuori A. , Marttunen M. , Kaprio J. 
Published: May 2011

BackgroundClinically ascertained reports suggest that boys and girls with attention deficit hyperactivity disorder (ADHD) may differ from each other in their vulnerability to substance use problems.MethodA total of 1545 Finnish adolescents were assessed for DSM-IV-based ADHD symptoms by their parents and classroom teachers using standardized rating scales at age 11–12 years. At age 14, substance use disorders and psychiatric co-morbidity were assessed with the Semi-Structured Assessment for the Genetics of Alcoholism, providing DSM-III-R/DSM-IV diagnoses for Axis I disorders. At age 17.5, substance use was assessed by multi-item questionnaire.ResultsAlthough baseline ADHD symptoms were less common among females, they were more predictive of adverse substance use outcomes once conduct disorder and previous substance use were controlled for. Only in females were baseline ADHD symptoms significant predictors of alcohol abuse and dependence and illicit drug use at age 14. At the age of 17.5, parents' reports of inattentiveness and hyperactivity were significant predictors for frequent alcohol use in both sexes, but they were more predictive of frequent alcohol and illicit drug use in girls. Impulsivity in teachers' ratings predicted frequent alcohol use and illicit drug use in boys. Parental reports of inattentiveness in their 11-/12-year-old daughters were a consistent predictor for illicit drug use across adolescence.ConclusionsInattentiveness and hyperactivity may be more predictive of alcohol use disorders and maladaptive patterns of alcohol and illicit drug use among girls than boys. The importance of these behavioural symptoms should be assessed further in the community, as they could jeopardize adolescents' successful transitioning into adult roles.