bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glucocorticoid replacement therapy is independently associated with reduced bone mineral density in women with hypopituitarism
Authors: Ragnarsson Oskar , Nyström Helena Filipsson , Johannsson Gudmundur 
Published: July 2011

SummaryObjective  Patients with hypopituitarism have adverse cardiovascular morbidity and reduced bone mineral density (BMD). The objective of this study was to analyse the effects of glucocorticoid (GC) replacement on cardiovascular risk factors and BMD in patients with hypopituitarism.Design, patients and methods  This was a cross‐sectional study on 365 patients with hypopituitarism. Two‐hundred and four patients (56%) were ACTH insufficient (ACTHins), receiving a mean ± SD hydrocortisone equivalent (HCeq) dose of 20·5 ± 5·8 mg/day. The difference in BMD and cardiovascular risk profile between ACTH sufficient (ACTHsuff) and ACTHins patients, before commencement of GH replacement, was analysed by multiple linear and logistic regression.Results  ACTHins was independently associated with lower fasting glucose but not other cardiovascular risk factors. The mean HCeq dose per kg body weight was 15% higher in ACTHins women than in ACTHins men (P = 0·009). In women, ACTHins was independently associated with decreased BMD at the lumbar spine (P = 0·002) and femoral neck (P = 0·006) and the presence of osteopenia (P = 0·004). BMD was not different between ACTHins and ACTHsuff men.Conclusion  The current average HCeq dose of approximately 20 mg per day is not associated with an adverse metabolic profile, as compared with ACTHsuff patients with hypopituitarism. GC replacement in ACTHins women is independently associated with reduced BMD and higher prevalence of osteopenia.
Replication of genome‐wide association signals of type 2 diabetes in Han Chinese in a prospective cohort
Authors: Chang Yi‐Cheng , Chiu Yen‐Feng , Liu Pi‐Hua , Shih Kuang‐Chung , Lin Ming‐Wei , Sheu Wayne H.‐H. , Quertermous Thomas , Curb Jess David , Hsiung Chano A. , Lee Wei‐Jei , Lee Po‐Chu , Chen Yuan‐Tsong , Chuang Lee‐Ming 
Published: July 2011

SummaryBackground  A recent genome‐wide association study for type 2 diabetes in Han Chinese identified several novel genetic variants. We investigated their associations with quantitative measures to explore the mechanism by which these variants influence glucose homoeostasis. We also examined whether these variants predict progression to diabetes in a large prospective family based Chinese cohort.Methods  Five single nucleotide polymorphisms (SNPs) near the protein tyrosine phosphatase, receptor type, D (PTPRD), SRR, MAF/WWOX, and KCNQ1 genes were genotyped in 1138 subjects of Chinese origin from the Stanford Asia‐Pacific Program for Hypertension and Insulin Resistance study.Results  At baseline, the risk‐conferring rs7192960 C allele near the MAF/WWOX genes was associated with lower homoeostasis model assessment of β‐cell (HOMA‐β) (P = 0·01) and second‐phase insulin response in oral glucose tolerance test (OGTT) (P = 0·04). The risk‐conferring rs2237897 C alleles in the KCNQ1 gene were associated with higher fasting glucose (P = 0·009), lower HOMA‐β (P = 0·03), and lower first‐phase insulin response in OGTT (P = 0·03). Over an average follow‐up period of 5·43 years, participants with the risk‐conferring rs17584499 TT genotype in the PTPRD gene were more likely to progress from nondiabetes to diabetes than were noncarriers (hazard ratio: 8·82, P = 4 × 10−5). The risk‐conferring T allele in the PTPRD gene was associated with greater increase in homoeostasis model assessment of insulin resistance (HOMA‐IR) (P = 0·04) over time. PTPRD gene expression in human adipose tissues was negatively associated with fasting insulin levels and HOMA‐IR.Conclusion  Genetic variants near the KCNQ1 and MAF/WWOX genes are associated with reduced insulin secretion. The PTPRD genetic variant appears to be associated with progression to diabetes in Han Chinese, most likely through increased insulin resistance.
The varied presentation of metastatic melanoma in fine needle aspiration cytology of the breast
Authors: Ribu D. L. , Shield P. W. , Bligh J. F. 
Published: July 2011

D. L. Ribu, P. W. Shield and J. F. Bligh  The varied presentation of metastatic melanoma in fine needle aspiration cytology of the breastObjective:  To identify cytomorphological patterns of metastatic melanoma (MM) in breast fine needle aspiration (FNA) specimens and highlight the differential diagnoses and features most useful in identifying MM.Methods:  The clinical, radiological and FNA findings of 16 cases were reviewed. Cytological features evaluated related to cell arrangement, size and shape of cells, nuclear and cytoplasmic features, and the presence or absence of necrosis.Results:  The series consisted of 14 females and two males, ranging in age from 24 to 83 years (mean = 50 years). A previous history of melanoma was available in 12/16 (75%) cases at the time of FNA reporting; however the clinical/radiological impression in 4/16 cases was of a breast cyst. The cases were classified into six morphological variants: classical (8/16), pseudopapillary (3/16), spindle‐cell (1/16), melanin‐rich (1/16), pleomorphic (2/16) and lymphoma‐like (1/16). The varying patterns raised a wide range of differential diagnoses; however, discohesion, binucleation and granular cytoplasm were the major features seen in 94% of all cases. In 14/16 cases (88%), plasmacytoid cells, prominent nucleoli and cytoplasmic vacuolation were identified. Melanin and multinucleation were detected in 44% of cases and intranuclear cytoplasmic invaginations in 63%. Necrosis was present in more than half of the cases (56%).Conclusion:  MM should be considered in the differential diagnosis of breast FNA specimens when atypical cells are seen that present as plasmacytoid cells in a dispersed or pseudopapillary pattern, or as spindle, pleomorphic or pigmented cells. These features, combined with clinical history and immunocytochemistry, may assist in correctly identifying MM and directing optimal treatment.
Pasture residue amount and sowing method effects on establishment of overseeded cool‐season grasses and on total annual production of herbage
Authors: Bartholomew P. W. , Schneider J. M. , Williams R. D. 
Published: July 2011

AbstractWarm‐season pasture residue may create problems for no‐till overseeding with cool‐season grasses in the USA Southern Plains. Removal of residue to facilitate overseeding, however, represents additional cost and labour that may not be available on small livestock farms. Field experiments were undertaken to assess the effects of above‐surface residues of warm‐season pasture averaging 1·62, 2·48 or 3·36 t DM ha−1 on establishment and herbage production of Italian ryegrass (Lolium multiflorum) or tall fescue (Festuca arundinacea) overseeded by broadcasting or by no‐till drilling into dormant warm‐season pasture. On average, no‐till drilling was more effective than broadcasting in establishing both grass species, but it was no more effective than broadcasting when used with the greatest amount of residue. Cool‐season grass production was increased by 0·16 when no‐till drilled, but combined yearly total herbage production of cool‐ and warm‐season grasses was increased by 0·07 when cool‐season grasses were established by broadcasting. Amount of residue at sowing did not significantly affect herbage yield of cool‐season grass, but increased residue in autumn resulted in a 0·16 increase in total herbage production in the year following sowing. Residue amount did not affect over‐winter survival of grass seedlings, and productivity benefits of increased residue are small compared with reduced harvest arising from underutilization of warm‐season pasture residue in autumn.
Dental fear in children and adolescents: a comparison of forms of anxiety management practised by general and paediatric dentists
Authors: DIERCKE KATJA , OLLINGER ISABELLE , BERMEJO JUSTO LORENZO , STUCKE KATHRIN , LUX CHRISTOPHER J. , BRUNNER MONIKA 
Published: July 2011

International Journal of Paediatric Dentistry 2011; 22: 60–67Background.  About 11% of children and adolescents suffer from dental fear. These young people run an increasing risk of undergoing more invasive treatments.Aim.  We researched the management of dental anxiety in young patients by general and paediatric dentists as well as by trained and untrained dentists.Design.  Eight hundred dentists in Germany were interviewed via e‐mail regarding their experience, treatment techniques, information material and complications during the treatment of fearful children. We also examined how difficult dentists judge the treatment of anxious children and how often they participate in continuing education courses.Results.  Paediatric dentists applied a greater spectrum of management techniques than general dentists. They used more often psychotherapeutic interventions and anxiety assessment questionnaires. Dentists who frequently attend in continuing education courses judged the treatment to be less difficult and also used psychotherapeutic interventions more often.Conclusions.  German paediatric dentists and dentists who take continuing education courses utilise a broader range of techniques to manage dental anxiety. They may be eminently suited to treat children with severe forms of anxiety. Therefore, dentists who treat young patients should participate in education programmes so as to reduce both the anxiety of their patients and their own anxiety.
Aggressive behaviour of inpatients with acquired brain injury
Authors: Visscher Ada JM , van Meijel Berno , Stolker Joost J , Wiersma Jan , Nijman Henk 
Published: July 2011

Objective.  To study the prevalence, nature and determinants of aggression among inpatients with acquired brain injury.Background.  Patients with acquired brain injury often have difficulty in controlling their aggressive impulses.Design.  A prospective observational study design.Methods.  By means of the Staff Observation Aggression Scale‐Revised, the prevalence, nature and severity of aggressive behaviour of inpatients with acquired brain injury was assessed on a neuropsychiatric treatment ward with 45 beds. Additional data on patient‐related variables were gathered from the patients’ files.Results.  In total, 388 aggressive incidents were recorded over 17 weeks. Of a total of 57 patients included, 24 (42%) patients had engaged in aggressive behaviour on one or more occasions. A relatively small proportion of patients (n = 8; 14%) was found to be responsible for the majority of incidents (n = 332; 86%). The vast majority of aggression incidents (n = 270; 70%) were directly preceded by interactions between patients and nursing staff. In line with this, most incidents occurred at times of high contact intensity. Aggressive behaviour was associated with male gender, length of stay at the ward, legal status and hypoxia as the cause of brain injury.Conclusion.  Aggression was found to be highly prevalent among inpatients with acquired brain injury. The results suggest that for the prevention of aggression on the ward, it may be highly effective to develop individually tailored interventions for the subgroup with serious aggression problems.Relevance to clinical practice.  Insight into the frequency, nature and determinants of aggressive behaviour in inpatients with acquired brain injury provides nurses with tools for the prevention and treatment of aggressive behaviour.
Hybrid speciation in sparrows II: a role for sex chromosomes?
Authors: ELGVIN TORE O. , HERMANSEN JO S. , FIJARCZYK ANNA , BONNET TIMOTHÉE , BORGE THOMAS , SÆTHER STEIN A. , VOJE KJETIL L. , SÆTRE GLENN‐PETER 
Published: July 2011

AbstractHomoploid hybrid speciation in animals is poorly understood, mainly because of the scarcity of well‐documented cases. Here, we present the results of a multilocus sequence analysis on the house sparrow (Passer domesticus), Spanish sparrow (P. hispaniolensis) and their proposed hybrid descendant, the Italian sparrow (P. italiae). The Italian sparrow is shown to be genetically intermediate between the house sparrow and Spanish sparrow, exhibiting genealogical discordance and a mosaic pattern of alleles derived from either of the putative parental species. The average variation on the Z chromosome was significantly reduced compared with autosomal variation in the putative parental species, the house sparrow and Spanish sparrow. Additionally, divergence between the two species was elevated on the Z chromosome relative to the autosomes. This pattern of variation and divergence is consistent with reduced introgression of Z‐linked genes and/or a faster‐Z effect (increased rate of adaptive divergence on the Z). FST‐outlier tests were consistent with the faster‐Z hypothesis: two of five Z‐linked loci (CHD1Z and PLAA) were identified as candidates for being subject to positive, divergent selection in the putative parental species. Interestingly, the two latter genes showed a mosaic pattern in the (hybrid) Italian sparrow; that is, the Italian sparrow was found to be fixed for Spanish sparrow alleles at CHD1Z and to mainly have house sparrow alleles at PLAA. Preliminary evidence presented in this study thus suggests that sex chromosomes may play a significant role in this case of homoploid hybrid speciation.
Effect of a biofilm‐degrading enzyme from an oral pathogen in transgenic tobacco on the pathogenicity of Pectobacterium carotovorum subsp. carotovorum
Authors: Ragunath C. , Shanmugam M. , Bendaoud M. , Kaplan J. B. , Ramasubbu N. 
Published: July 2011

The hypothesis that dispersin B (DspB), an enzyme from the periodontal pathogen Aggregatibacter actinomycetemcomitans that degrades the extracellular matrix polysaccharide PGA, will inhibit biofilm formation of the soft rot pathogen Pectobacterium carotovorum subsp. carotovorum in infected plants was tested by constitutive expression of DspB in tobacco plants. All the transgenic plants expressed properly folded and active DspB enzyme, although at different expression levels. In virulence assays, even the transgenic plant line D10, which produced a low level of DspB compared to other lines, showed significant resistance against P. carotovorum subsp. carotovorum, suggesting that DspB could be a valuable agent for biological control of P. carotovorum subsp. carotovorum infection in crop plants.
Preparing for national school‐based deworming in Kenya: the validation and large‐scale distribution of school questionnaires with urinary schistosomiasis
Authors: Kihara Jimmy , Mwandawiro Charles , Waweru Beth , Gitonga Caroline W. , Brooker Simon 
Published: July 2011

SummaryObjective  School questionnaires of self‐reported schistosomiasis provide a rapid and simple approach for identifying schools at high risk of Schistosoma haematobium and requiring mass treatment. This study investigates the reliability of school questionnaires to identify such schools and infected children within the context of a national school‐based deworming programme in Kenya.Methods  Between November 2008 and March 2009, 6182 children from 61 schools in Coast Province, Kenya were asked by an interviewer whether they had blood in urine or urinary schistosomiasis (kichocho), and their results were compared with results from microscopic examination of urine samples. Subsequently, in 2009, a school‐based questionnaire survey for self‐reported schistosomiasis was distributed by the Ministry of Education to all schools in Coast Province, and its results were compared against results from the parasitological survey. The questionnaire survey results were linked to a schools database and mapped.Results  Prevalence of self‐reported blood in urine was lower among girls than boys among all ages. The use of a 30% threshold of reported blood in urine was both highly sensitive (91.7%) and specific (100%) in identifying high (>50%) prevalence schools in Coast Province. Questionnaires were however less reliable in diagnosing S. haematobium infection in individuals, particularly among young girls. Comparable levels of reliability were observed when the questionnaire was distributed through the existing education systems and administered by class teachers.Conclusions  The results confirm that blood in urine questionnaires can be reliably used to target mass treatment with praziquantel at national scales. The mapped results of the Ministry of Education survey serve to describe the spatial variation of urinary schistosomiasis and identify schools requiring mass treatment.
Health workers’ perceptions of obstetric critical incident audit in Thyolo District, Malawi
Authors: Bakker Wouter , van den Akker Thomas , Mwagomba Beatrice , Khukulu Rex , van Elteren Marianne , van Roosmalen Jos 
Published: July 2011

SummaryObjective  To assess perceptions held by health workers in a Malawian district about obstetric critical incident audit. Insight into factors contributing to participation and endorsement may help to improve the audit process and reduce facility‐based maternal and neonatal mortality and morbidity.Methods  This study involves semi‐structured interviews with 25 district health workers, a focus group discussion and observation of audit sessions in health facilities in Thyolo District, Malawi, between August 2009 and January 2010. Data were analysed with maxqda 2010.Results  Findings were categorized into four major areas: (i) general knowledge of audit, (ii) participation in local audit and feedback sessions, (iii) the ability to reproduce the local audit cycle and (iv) effects and outcomes of audit and feedback. All health workers were familiar with the concept of audit and could reproduce the local cycle. Most health workers classified audit as an instructive and helpful tool to improve the quality of their work, provided that it is performed in a manner that enhances motivation and on‐the‐job learning.Conclusions  Contradictory to recent reports from other African settings, which showed negative effects of audit on health workers’ motivation, staff in this district considered audit and feedback valuable tools to enhance the quality of the care they provide. Audit has become part of the professional routine in the district, and its educational value was considered its most important appeal.
Different strategies of Lotus japonicus, L. corniculatus and L. tenuis to deal with complete submergence at seedling stage
Authors: Striker G. G. , Izaguirre R. F. , Manzur M. E. , Grimoldi A. A. 
Published: July 2011

AbstractTwo main strategies allow plants to deal with submergence: (i) escape from below water by means of shoot elongation, or (ii) remaining quiescent under the water until water subsides and then resume growth. We investigated these strategies in seedlings of Lotus japonicus, L. corniculatus and L. tenuis subjected to control and submergence for 12 days, with a subsequent 30‐day recovery period. All three species survived submergence but used different strategies. Submerged seedlings of L. japonicus exhibited an escape strategy (emerging from water) as a result of preferential carbon allocation towards shoot mass and lengthening, in detriment to root growth. In contrast, seedlings of L. corniculatus and L. tenuis became quiescent, with no biomass accumulation, no new unfolding of leaves and no shoot elongation. Upon de‐submergence, seedlings of L. japonicus had the lowest recovery growth (a biomass and shoot height 58% and 40% less than controls, respectively), L. corniculatus was intermediate and L. tenuis showed the greatest recovery growth. Previously submerged seedlings of L. tenuis did not differ from their controls, either in final shoot biomass or shoot height. Thus, for the studied species, quiescence appears to be an adequate strategy for tolerance of short‐term (i.e., 12 days) complete submergence, being consistent with field observations of L. tenuis colonisation of flood‐prone environments.
Cardinal John Henry Newman and ‘the ideal state and purpose of a university’: nurse education, research and practice development for the twenty‐first century
Authors: Rolfe Gary 
Published: July 2011

ROLFE G. Nursing Inquiry 2012; 19: 98–106 [Epub ahead of print]Cardinal John Henry Newman and ‘the ideal state and purpose of a university’: nurse education, research and practice development for the twenty‐first centuryCardinal John Henry Newman’s book, The Idea of a University, first published in the mid nineteenth century, is often invoked as the epitome of the liberal Enlightenment University in discussions and debates about the role and purpose of nurse education. In this article I will examine Newman’s book in greater detail and with a more critical eye than is generally the case in the writing of nurse academics. In particular, I will focus on the claims that Newman was a champion of the Enlightenment University of the nineteenth century, that he promoted the idea of ‘disinterested’ universal knowledge for its own sake, that he was an early advocate of the pursuit of knowledge through scientific research, and the supposition that he would have welcomed the discipline of nursing into the University. In each case, I will suggest that these claims are based on an extremely selective reading of Newman’s work. I will conclude by employing the example of practice development to propose an alternative way for nursing to find its place in the modern University that does not involve a retreat into what I will argue is an outdated and nostalgic view of the aims and purpose of higher education.
DOUBLE‐BALLOON ENTEROSCOPY IN THE EVALUATION OF SMALL BOWEL DISORDERS IN PEDIATRIC PATIENTS
Authors: SHEN RUIZHE , SUN BO , GONG BIAO , ZHANG SHU , CHENG SHIDAN 
Published: July 2011

Background:  The aim of the present study was to investigate the indications, clinical utility, feasibility and safety of double‐balloon enteroscopy (DBE) in the diagnosis and management of small intestinal diseases in pediatric patients.Methods:  This is a retrospective analysis of pediatric patients younger than 18 years referred to Shanghai Rui Jin Hospital from May 2003 to June 2008 for investigation of suspected small bowel disorders. Demographic, clinical, procedural and outcome data were collected for analysis.Results:  A total of 35 DBE were carried out in 30 children with a mean age of 13 years. Indications for DBE were obscure gastrointestinal (GI) bleeding (n = 22), chronic abdominal pain (n = 4), chronic diarrhea (n = 3), and incomplete small bowel obstruction (n = 1). DBE evidenced pathological findings in 29 patients (96.7%). DBE altered management in 90% of patients with positive findings. Follow up was obtained on all patients with a mean (range) of 40 months (14–75 months). The procedure was successful in all patients and there were no serious complications related to sedation.Conclusion:  DBE is feasible and safe and has a high diagnostic yield and therapeutic impact on the diagnosis and management of small bowel disorders in selected pediatric patients.
Rescue therapy with local intra‐arterial urokinase after poor clinical response with intravenous recombinant tissue plasminogen activator in acute ischaemic stroke
Authors: Lee L. H. , Chryssidis S. , Jannes J. 
Published: July 2011

AbstractWe report a case of combined intravenous and intra‐arterial thrombolysis in a patient presenting with acute ischaemic stroke. Progression to intra‐arterial thrombolysis in patients who fail to show clinical improvement within 6 h of symptom onset might be a safe treatment option at centres with access to stroke specialist and endovascular services. The purpose of this report is to demonstrate the efficacy and potential benefits of this rescue therapy.