bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient‐specific recovery patterns over time measured by dependence in activities of daily living after stroke and post‐stroke care: The South London Stroke Register (SLSR)
Authors: Toschke A. M. , Tilling K. , Cox A. M. , Rudd A. G. , Heuschmann P. U. , Wolfe C. D. A. 
Published: August 2009

Background and purpose:  Data on patient‐specific recovery after stroke are lacking and the effects of complex healthcare interventions on the course of recovery were not reported. To quantify the recovery pattern up to 1 year post‐stroke and assess effects of evidence‐based treatments on the patient‐specific course of recovery allowing its prediction.Methods:  A total of 355 patients after first‐ever stroke from the population‐based South London Stroke Register (source population >270 000) participated in a substudy between August 2002 and October 2004. At 1, 2, 3, 4, 6, 8, 12, 26, and 52 weeks post‐stroke, Barthel Index (BI; ranging from 0 to 20) was documented. Multilevel growth models allowing predictions for patients with specific characteristics were calculated.Results:  Mean age was 70 years, 48% were male and 23% died within the first year. The age‐, gender‐ and stroke subtype‐adjusted BI curve sharply increased until week 8 to 24 depending on patient characteristics and subsequently plateaued. Multivariable analysis identified stroke unit care, appropriate secondary prevention and physiotherapy for those with disabilities as independent predictors of improved functional ability over time (P < 0.05). Patients receiving stroke unit care additionally gained 4 BI points within 6 months compared with their counterparts (P = 0.004).Conclusions:  Functional outcome in the general population showed an increase followed by a plateau. Care parameters reflecting guideline treatment independently improved recovery illustrating the beneficial effects of evidence‐based interventions on recovery in an unbiased population.
Simultaneous blockade of alpha and beta adrenoceptors impairs cutaneous wound healing in rats
Authors: Romana‐Souza B , Monte‐Alto‐Costa A 
Published: August 2009

AbstractBackground  Recent studies showed that propranolol administration (beta‐antagonist), but not phentolamine administration (alpha‐antagonist), delays cutaneous wound healing. However, alpha adrenoceptor activation may be participating in propranolol‐induced alterations.Objective  This study aims to investigate the effects of simultaneous blockade of beta and alpha adrenoceptors on cutaneous wound healing.Methods  Rats were treated with propranolol plus phentolamine dissolved in water. An excisional lesion was done and measured. Lesions were formalin‐fixed and paraffin‐embedded 21 days after wounding. Sections were stained with haematoxylin and eosin, toluidine blue and Sirius red, and immunostained for alpha‐smooth muscle actin or proliferating cell nuclear antigen.Results  Administration of propranolol plus phentolamine reduced wound contraction and re‐epithelialization, but increased cellular proliferation and the number of mast cells. There was no difference in myofibroblast density, collagen fibre organization and polymorphonuclear number between the control and treated groups.Conclusion  Simultaneous blockade of beta and alpha adrenoceptors impairs cutaneous wound healing. Furthermore, propranolol‐induced impairment on cutaneous wound healing does not occur through alpha adrenoceptor activation.
Noninvasive methods of detecting fetal anaemia: a systematic review and meta‐analysis
Authors: Pretlove SJ , Fox CE , Khan KS , Kilby MD 
Published: August 2009

Objectives  To estimate in a systematic review of the literature the diagnostic value of ultrasound and Doppler blood flow velocity in the evaluation of fetal anaemia.Study selection and data extraction  Literature from 2000 to 2008 was identified using MEDLINE and EMBASE, the Cochrane Library and relevant specialist register of the Cochrane Collaboration, and by checking reference lists of known primary studies and review articles. Studies were selected if the accuracy of the fetal ultrasound parameters or Doppler studies of blood flow in the fetal vessels was estimated compared with a reference standard. Data from the selected studies were abstracted as 2 × 2 tables comparing the diagnostic test result with the reference standard. Results were pooled where appropriate. Diagnostic accuracy was expressed as likelihood ratios.Results  Twenty‐five primary studies were identified containing suitable data on middle cerebral artery Doppler peak systolic velocity (MCA‐PSV). The largest group of studies whose data could be pooled containing nine studies gave a positive likelihood ratio of 4.30 (95% CI: 2.50 to 7.41) and a negative likelihood ratio of 0.30 (95% CI: 0.13 to 0.69) for 675 cases in detecting severe anaemia in the analysis.Discussion  Although middle cerebral artery peak systolic velocity Doppler has limited diagnostic accuracy, it remains the gold standard for noninvasive screening of fetal anaemia.
Haemostatic changes in the puerperium ‘6 weeks postpartum’ (HIP Study) — implication for maternal thromboembolism
Authors: Saha P , Stott D , Atalla R 
Published: August 2009

Objective  We aim to measure the thrombotic changes during the postnatal period up to 6 weeks after delivery and assess the extent of the risk period.Design Prospective observational study.Setting  Queen Elizabeth II, an acute District General Hospital, Hertfordshire.Population  Women booked at the antenatal clinic and prepared to deliver at the hospital.Methods  We assessed the haemoglobin, platelet count and function, fibrinogen, prothrombin time, activated partial thromboplastin time, protein C, S and antithrombin level and as well as rotational thromboelastometry (ROTEM) from predelivery till 6 weeks postpartum.Results  A total 50 women were recruited of which four dropped out. Results compared against the finding at 6 weeks after delivery. Platelet was significantly elevated on day 19 compared to day 42 (P < 0.001). Fibrinogen was elevated from predelivery till day 15 after delivery (P < 0.01). Prothrombin time (PT) was low till day 15 (P < 0.05) and activated partial thromboplastin time (APTT) was significantly lower till day 3 after delivery (P < 0.001). ROTEM revealed low clotting time (CT) at predelivery and continued to be low till day 7. Clot formation time (CFT) significantly low till day 25 (P < 0.05). Maximum clot firmness, alpha angle and amplitude at 20 minutes were raised till day 19 (P < 0.001, P < 0.01 and P < 0.001 respectively). While, comparing vaginal delivery against caesarean section there were nonsignificant increase in thrombotic parameters in caesarean section.Conclusion  Coagulation screens as well as thomboelastometry suggest a persistent hypercoagulation during the first 3 weeks after delivery.
Maternal complications and pregnancy outcome in women with mechanical prosthetic heart valves treated with enoxaparin
Authors: McLintock C , McCowan LME , North RA 
Published: August 2009

Objective  To determine maternal and fetal outcomes in women with mechanical heart valves managed with therapeutic dose enoxaparin during pregnancy.Design  Retrospective audit.Setting  Hospital‐based high‐risk antenatal clinics.Population  Pregnant women with mechanical heart valves attending high‐risk antenatal clinics, treated with enoxaparin (1 mg/kg twice daily) during pregnancy.Methods  Women with mechanical heart valves treated with enoxaparin at any stage during pregnancy (1997–2008) identified using a database of women with mechanical heart valves attending the high‐risk clinics and a prospective database of women prescribed enoxaparin for any indication during pregnancy.Main outcome measures  Maternal outcomes included thromboembolic and haemorrhagic complications. Pregnancy and fetal outcomes included miscarriage, stillbirth, baby death and live birth, small‐for‐gestational‐age infants, warfarin embryopathy and warfarin‐related fetal loss.Results  Thirty‐one women underwent 47 pregnancies. In 34 pregnancies (72.3%), anticoagulation was with predominantly enoxaparin and 13 (27.7%) pregnancies women received mainly warfarin, with enoxaparin given in the first trimester and/or peri‐delivery. Seven (14.9%) thrombotic complications occurred, of which five (10.6%) were associated with enoxaparin treatment. Non‐compliance or sub‐therapeutic anti‐Xa levels contributed in each case. Antenatal and postpartum haemorrhagic complications occurred in eight (17%) and 15 (32%) pregnancies respectively. Of 35 pregnancies continuing after 20 weeks’ gestation, 96% (22/23) of women taking predominantly enoxaparin had a surviving infant compared with 75% (9/12) in women taking primarily warfarin. Four perinatal deaths occurred, three attributable to warfarin.Conclusions  Compliance with therapeutic dose enoxaparin and aspirin during pregnancy in women with mechanical heart valves is associated with a low risk of valve thrombosis and good fetal outcomes, but close monitoring is essential.
Haplotype structure and allele frequencies ofCYP2B6in Spaniards and Central Americans
Authors: Arenaz Izaskun , Vicente Jorge , Fanlo Ana , Vásquez Patricia , Medina Juan Carlos , Conde Blanca , González‐Andrade Fabricio , Sinués Blanca 
Published: August 2009

AbstractThis study was aimed to investigate the potential differences in allele frequencies of theCYP2B6gene between Spaniards and Central Americans. Three single nucleotide polymorphisms of theCYP2B6gene 516 G>T, 785 A>G and 1459 C>T were assayed by a polymerase chain reaction in 180 Spaniards and 182 Central Americans. The allele frequencies forCYP2B6*1,CYP2B6*4,CYP2B6*5,CYP2B6*6,CYP2B6*9in Spaniards and Central Americans were 0.593 and 0.642, 0.062 and 0.073, 0.113 and 0.030, 0.215 and 0.230, 0.014 and 0.023, respectively.CYP2B6*5was less prevalent among Central Americans than in Spaniards (P < 0.001). In comparison to other previously studied populations, theCYP2B6*5allele frequency among Spaniards was similar to other Caucasian or African groups, and higher than that in Asian populations. TheCYP2B6*5allele frequency in Central Americans was lower than that in Africans or Caucasian groups and higher than in Asians. The results indicate the presence of ethnic differences inCYP2B6genetic variants between Spaniards and Central Americans, and support the need for further investigations to explore whether these differences significantly alter the efficacy or toxicity of CYP2B6 substrate drugs.
Association between inosine triphosphate pyrophosphohydrolase deficiency and azathioprine‐related adverse drug reactions in the Chinese kidney transplant recipients
Authors: Xiong Hui , Xin Hua‐Wen , Wu Xiao‐Chun , Li Qing , Xiong Lei , Yu Ai‐Rong 
Published: August 2009

AbstractAzathioprine (AZA) is a thiopurine prodrug commonly used in patients with kidney transplantation. The aim of this study is to explore in patients with kidney transplantation whether AZA‐related side effects can be explained by the inosine triphophate pyrophosphatase (ITPA) or thiopurine S‐methyltransferase (TPMT) polymorphisms using both pheno‐and genotyping. Erythrocyte ITPA and TPMT activity of 155 patients with kidney transplantation and AZA therapy was determined by HPLC. The frequencies of ITPA and TPMT polymorphisms were detected. Among 155 patients, three cases with zero activity were homozygote for 94C>A. The allele frequency of the 94C>A polymorphism was 0.12. Allele for the IVS2+21A>C mutation in the patients of this study was not found. Thirty‐five cases had stopped azathioprine medication or were on reduced dose due to AZA‐related side effects, including hematotoxicity (n = 12), hepatotoxicity (n = 18), gastrointestinal toxicity (n = 5, one patient developed hepatotoxicity simultaneously) and flu‐like symptoms (n = 1). No statistical significant associations between ITPA 94C>A phenotype or genotype and AZA‐related hematotoxicity or hepatotoxicity could be detected. However, five patients who developed gastrointestinal disturbance, two patients were homozygote for 94C>A and other three patients had 94C>A heterozygous allele. The patient who experienced flu‐like symptoms were the remaining homozygote for 94C>A. This study demonstrates that ITPA activity reduced in patients with 94C>A mutation (P < 0.01). Patients with ITPA 94C>A homozygous allele are at high risk to develop AZA‐related gastrointestinal toxicity and flu‐like symptoms (P < 0.01). TPMT wild‐type/ITPA variant (homozygote) is closely related to the AZA‐induced side effects (P < 0.01).
The Use of Physical Restraints in Home Care in the Netherlands
Authors: De Veer Anke J. E. , Francke Anneke L. , Buijse Rian , Friele Roland D. 
Published: August 2009

OBJECTIVES: To gain more knowledge of the application of physical restraints to restrict, restrain, or prevent movement by elderly people living at home.DESIGN: Survey.SETTING: Nursing staff in Dutch home care.PARTICIPANTS: One hundred fifty‐seven nursing staff in home care (registered nurses and certified nursing assistants) from a randomly selected and nationally representative panel returned the questionnaire (response rate 72%).MEASUREMENTS: A structured questionnaire on the use of physical restraints.RESULTS: Four of every five nursing staff members have applied physical restraints. The use of bed rails, putting the client in a deep chair or using a chair with a table, and locking doors to prevent wandering were most frequently applied, often at the request of the client or his or her family. Protection of the client is the reason most frequently given for these actions. Almost all respondents (94%) know of no alternatives, nor does consensus exist on what is considered to be a physical restraint.CONCLUSION: Guidelines are necessary regarding the course of action to be taken when a client is in danger of hurting him‐ or herself. Further education on and due consideration of the use of physical restraints in home care are also required.
Sex biased intra‐tree oviposition site selection and larval foraging behavior of a specialist herbivore
Authors: Johns Rob C. , Quiring Dan T. , Ostaff Don P. 
Published: August 2009

AbstractHeterogeneity in the quality of oviposition and feeding sites within plants can significantly influence the distribution and abundance of herbivorous insects, but remains poorly understood. Field surveys and a manipulative study were conducted to evaluate the influence of variation within the crown of black spruce, Picea mariana (Mill.) B.S.P. (Pinaceae), on adult oviposition and larval feeding behavior of yellowheaded spruce sawfly, Pikonema alaskensis Rohwer (Hymenoptera: Tenthredinidae). Most eggs were laid in the mid to lower crown of 1.5–2 m tall trees. However, most of the few eggs that were laid in the upper crown (i.e., whorl 2) were female. Fourth and fifth instars dispersed acropetally, from the mid and lower to the upper crown, causing high defoliation in the upper crown. Late‐instar females were generally more abundant than males on the leader, the most apical shoot on a tree where eggs and early instars rarely occurred, strongly suggesting that more females than males disperse acropetally. This hypothesis was supported in a manipulative experiment, where only 15–20% of larvae in all‐male broods, but almost three‐quarters of larvae in mixed broods, dispersed to the upper crown. To our knowledge, this is only the second study to explicitly demonstrate preferential allocation of progeny sex through oviposition site selection by a herbivorous insect, and the first study to unambiguously demonstrate sex‐biased dispersal by the juveniles of an insect whose adult females can fly. This study emphasizes the important role of intra‐plant variation in shaping both oviposition site selection and the dispersal behavior of juvenile phytophagous insects within their hosts, and suggests that sex‐biased foraging behaviors may be necessary for some insects to accommodate the respective needs of immature females and males within heterogeneous host plants.
Effects of post‐teneral nutrition and ginger root oil exposure on longevity and mortality in bait treatments of sterile male Ceratitis capitata
Authors: Andrés Victoria San , Pérez‐Panadés Jordi , Carbonell Emilio A. , Castañera Pedro , Urbaneja Alberto 
Published: August 2009

AbstractArea‐wide Sterile Insect Technique (SIT) programmes against medfly, Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), are being increasingly implemented worldwide. A key issue for SIT is to release sterile males that are sufficiently competitive with males from the wild population. Post‐teneral nutrition and ginger root oil (GRO) exposure of sterile males prior to release have been shown to improve male competitiveness or performance. However, few studies are available on the effect of post‐teneral nutrition and ginger oil exposure on longevity and mortality in bait treatments by sterile male C. capitata. In this study, we found that longevity was increased by the addition of protein to the standard pre‐release sugar diet, whereas exposure to GRO did not influence the longevity of sterile males. Mortality in spinosad baits was influenced both by diet and GRO exposure. Sterile males on a protein‐deprived diet suffered greater mortality than sterile males fed with both sugar and protein. When sterile males were fed on the protein‐deprived diet, GRO exposure increased their mortality. However, no significant differences were found in adults on the sugar‐protein diet, whether or not they had been exposed to GRO. These results show, for the first time, a negative effect of GRO exposure in terms of increasing mortality in proteinaceous bait treatments, a common practice in areas where SIT is implemented. Nevertheless, this effect could be reduced by the addition of protein to the standard pre‐release diet. The implications of these results for SIT programmes against C. capitata are discussed.
Periodontal status of teeth with crown–root fractures: results two years after adhesive fragment reattachment
Authors: Eichelsbacher Florian , Denner Walter , Klaiber Bernd , Schlagenhauf Ulrich 
Published: August 2009

AbstractAim: This series of case reports evaluated the impact of adhesive crown–root fragment reattachment in periodontally healthy teeth suffering from crown–root fractures on various parameters of periodontal health over a time course of 2 years.Material and Methods: A total of 20 teeth with crown–root fractures in 18 periodontally healthy subjects were evaluated. After open‐flap access, crown–root fragments were adhesively reattached to the root stub. In all cases, the vertical difference between the alveolar bone crest and the fracture line was 1 mm, i.e. violating the biological width. Subsequently, clinical attachment level (CAL), probing pocket depth (PPD), bleeding on probing (BoP) and gingival index (GI) scores were recorded at 6, 12 and 24 months postoperatively for the restored teeth as well as plaque index (PlI) and periodontal screening index (PSI) values for the whole dentition.Results: Two years after therapy, recorded CAL, PPD, BoP, GI, PlI and PSI scores revealed healthy periodontal conditions in 18 out of 20 treated teeth. Two teeth had suffered again from fragment fracture due to new traumata.Conclusions: Adhesive fragment reattachment in periodontally healthy teeth affected by crown–root fractures had no detrimental impact on periodontal health over a time course of 2 years.
The Moral Philosophy of Raimond Gaita and Some Questions of Method in the Philosophy of Religion
Authors: Wynn Mark 
Published: August 2009

AbstractRaimond Gaita's moral philosophy is distinguished by, among other things, its attention to the role of embodied, enacted witness in disclosing certain moral values, and its understanding of the emotions as forms of thought. In this paper, I consider how Gaita's insights on these matters may be applied to certain questions in the philosophy of religion, paying particular attention to the nature of religious experience and ‘the problem of evil’. I suggest that Gaita's discussion of how we come to recognise moral values or ‘meanings’ can be extended to the question of how we might recognise religious meanings. On this view, religious experience may take the form of an appreciation of the meaning borne by a material context (rather than, for example, some supra-sensory encounter with a supernatural agent), and our sense of the goodness or otherwise of the world may be answerable to the authoritative example of particular lives.
The yeast ubiquitin ligase Rsp5 downregulates the alpha subunit of nascent polypeptide‐associated complex Egd2 under stress conditions
Authors: Hiraishi Hiroyuki , Shimada Takashi , Ohtsu Iwao , Sato Taka‐Aki , Takagi Hiroshi 
Published: August 2009

The ubiquitination and subsequent degradation of stress‐induced abnormal proteins are indispensable to cell survival. We previously showed that a yeast (Saccharomyces cerevisiae) mutant carrying a single amino acid change, Ala401Glu, in RSP5, which encodes an essential E3 ubiquitin ligase, is hypersensitive to various stresses. To identify the protein substrates of Rsp5, we performed a comparative proteome analysis of the wild‐type and rsp5 mutant strains under stress conditions. The results we obtained indicate that several proteins, including the α‐subunit of nascent polypeptide‐associated complex (αNAC, Egd2) accumulated in the rsp5 mutant. To investigate whether or not Rsp5 ubiquitinates these proteins in a stress‐dependent manner, cell extracts were analyzed by immunoprecipitation followed by western blotting after exposure to temperature upshift. Interestingly, Egd2 was ubiquitinated in the wild‐type cells but not in the rsp5 mutant cells under these stress conditions. We also detected in vitro ubiquitination of Egd2 by Rsp5 at elevated temperature. Moreover, Egd2 was ubiquitinated in the egd1 and not4 deletion mutants lacking βNAC and the RING‐type ubiquitin ligase Not4, respectively, indicating that ubiquitination of Egd2 is independent of Egd1 and Not4. We also showed that, under stress conditions, Egd2 was mainly degraded via the proteasome pathway. These results strongly suggest that Rsp5 is involved in selective ubiquitination and degradation of stress‐induced unstable proteins, such as Egd2.Structured digital abstract
MINT‐7228949: EGD2 (uniprotkb:P38879) physically interacts (MI:0915) with ubiquitin (uniprotkb:P61864) by anti‐tag co‐immunoprecipitation (MI:0007)