bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reference limits of serum TSH and free T4 are significantly influenced by race and age in an urban outpatient medical practice
Authors: Boucai Laura , Surks Martin I. 
Published: August 2008

SummaryObjective  The suitability of TSH reference limits derived from national databases to outpatient practices has not been established. We aimed to determine whether race and age influence the distribution of TSH and free T4 (fT4).Design  A cross‐sectional study of an urban outpatient medical practice.Participants  Patients (n = 22 116) without clinical evidence of thyroid disease or use of thyroid‐specific medications.Measurements  Comparison of TSH and fT4 distributions in specific racial and age groups including blacks, whites and Hispanics.Results  TSH was distributed at higher concentrations, without skew, in whites compared to blacks (median, 1·54 mIU/l vs. 1·18 mIU/l, P < 0·001) and in old (>80 years old) compared to young (20–29 years old) (median, 1·61 mIU/l vs. 1·13 mIU/l, P < 0·001). In all patients, blacks and whites, 3%, 8% and 5%, respectively, of those aged > 80 years were misclassified as having high TSH compared to those aged 20–29 years (P < 0·001). Using TSH limits from national databases resulted in significant misclassification of patients with raised or lowered TSH. Mean fT4 was significantly lower in blacks than whites (17·5 ± 4·38 pmol/l vs. 18·3 ± 3·99 pmol/l, P < 0·001), did not differ between young and old, but decreased progressively (average 7%) as TSH increased to > 4·5 mIU/l.Conclusions  Reference limits for TSH differ between races and with age. Use of race‐ and age‐specific reference limits decreases misclassification of patients with lowered or raised TSH in an urban practice. The unique fT4:TSH relationships of blacks and whites may be genetically determined. The implications of the small decrement in fT4 as TSH increases remain to be explored.
The response of Vallisneria spinulosa (Hydrocharitaceae) to different loadings of ammonia and nitrate at moderate phosphorus concentration: a mesocosm approach
Authors: LI WEI , ZHANG ZHAO , JEPPESEN ERIK 
Published: August 2008

Summary1. While phosphorus (P) is often considered the most important growth limiting factor for plants in lakes, recent studies of shallow lakes indicate that nitrogen (N) may be of greater importance than realized hitherto and that submerged macrophytes may be lost when the N concentration exceeds a certain threshold, as long as the concentration of P is sufficiently high.2. We studied the effects of different loadings of NH4‐N and NO3‐N on chlorophyll a and on a macrophyte tolerant of eutrophication, Vallisneria spinulosa (Hydrocharitaceae). In outdoor mesocosms we used water from a pond as control and created four levels of NH4‐N and NO3‐N (approximately 2.5, 5, 7.5 and 10 mg L−1) by dosing with NH4Cl and NaNO3, respectively. After the experiment, the plants were transferred back to a holding pond to study their recovery. In contrast to previous research, we used a low background concentration of phosphorus (TP 0.024 ± 0.003 mg L−1) so we could judge whether any effects of N were apparent when P is in short supply.3. Chlorophyll a increased significantly with N dosing for both forms of N, but the increase was highest in the NH4‐N dosed mesocosms (maximum 58 μg L−1 versus 42 μg L−1 in the NO3‐N mesocosms), probably due to a higher total inorganic N concentration (part of the added ammonia was converted to nitrate during the experiment).4. Although the number of ramets of V. spinulosa was not affected by the N treatment, the biomass increased up to concentrations of 7.5 mg L−1, while biomass at 10 mg L−1 remained at the control level for both N ions treatments. A similar pattern was apparent for the content of N and soluble sugar of the plant, while there were no differences in the plant P content among treatments. Five months after transplantation back to the pond no difference was found in the number of ramets or in biomass, except that the biomass of plants grown at 10 mg N L−1 during the experiment was greater than that in the control, while the N and P contents of plants were similar to those of the controls.5. Nitrogen concentration had little influence on the growth of the eutrophication tolerant submerged macrophyte at moderately low concentrations of phosphorus. Moreover, the two N ions showed no toxic effects, suggesting that loss of macrophytes observed in other studies, run at higher phosphorus concentrations, was probably related to enhanced shading by periphyton and/or phytoplankton rather than to any toxic effects of N.
Current review on squamous intraepithelial lesions of the larynx
Authors: Gale Nina , Michaels Leslie , Luzar Bostjan , Poljak Mario , Zidar Nina , Fischinger Janez , Cardesa Antonio 
Published: August 2008

Squamous intraepithelial lesions (SILs) of the larynx, clinically usually defined as leukoplakia and chronic laryngitis, have remained the main controversial topic in laryngeal pathology for decades as regards classification, histological diagnosis and treatment. SILs are caused by smoking and alcohol abuse. There is also mounting evidence that gastroesophageal reflux is a potential aetiological factor. Human papillomavirus infection seems to play little if any role in laryngeal carcinogenesis.Histological classification of SILs is the central disputed aspect of these lesions. There are as yet no generally accepted criteria for histological grading of laryngeal SILs. Three currently used classifications of SILs are reviewed here: the dysplasia system, the Ljubljana classification and the binary system of squamous intraepithelial neoplasia. One of the most important issues of SILs is the risk of malignant transformation. Data in the literature are controversial because of inconsistent use of morphological criteria in different classifications. It is often difficult for clinicians to agree on the most appropriate therapeutic option for a particular grade of SIL that has been diagnosed. Transition from normal epithelium to SILs and squamous cell carcinoma is related to progressive accumulation of genetic changes leading to a clonal population of transformed epithelial cells. Despite extensive research into these genetic changes in laryngeal carcinogenesis, reliable genetic markers with diagnostic and prognostic value are still lacking.
Dendritic cells modulated by innate immunity improve collagen‐induced arthritis and induce regulatory T cells in vivo
Authors: Jaen Olivier , Rullé Sandrine , Bessis Natacha , Zago Abokouo , Boissier Marie‐Christophe , Falgarone Géraldine 
Published: August 2008

SummaryDendritic cells (DCs) mediate interactions between innate and specific immunity and may induce regulatory mechanisms. We investigated the effects of modulated DCs in mice with collagen‐induced arthritis (CIA) and tested the responses of cells to induced naturally occurring regulatory T cells. DCs were stimulated or not with DNA or lipopolysaccharide (LPS) for 24 hr. DC maturation was assayed, and then modulated DCs were intraperitoneally injected on day 14 into DBA/1 mice to treat CIA. In addition to arthritis scores and type 2 collagen (CII) response, the induction of CD4+ CD25+ T cells was analysed by flow cytometry in peripheral blood and the expression of Foxp3, transforming growth factor (TGF)‐β, interleukin (IL)‐10 and cytotoxic T‐lymphocyte antigen (CTLA)‐4 was quantified. Finally, the expression of indoleamine‐2,3‐dioxygenase (IDO) was assayed in DCs. In comparison with LPS‐stimulated DCs, plasmid‐stimulated DCs expressed lower levels of major histocompatibility complex (MHC) class II, CD40, CD80 and CD86 molecules and secreted less IL‐12p70, interferon (IFN)‐γ, IL‐10 and TNF‐α, displaying a semi‐mature phenotype. Compared with non‐stimulated DCs, stimulated DCs improved arthritis scores when injected after immunization, without modifying the T helper type 1 (Th1)/Th2 balance of the immune response against collagen. Stimulated DCs induced markers for regulatory T cells (Foxp3, TGF‐β1 and CTLA‐4) in vivo. Only LPS‐stimulated DCs expressed IDO, which may explain their better therapeutic efficacy. Regulatory mechanisms were induced using DCs modulated by innate immunity stimulators. Innate immunity mechanisms do not require the presence of the disease‐causing antigen, even in T‐ and B‐cell specific diseases. Our results have implications for the treatment of rheumatoid arthritis, an autoimmune disease whose triggering antigen has not been identified, and substantially clarify the role of regulatory T cells in CIA.
Selective impairment in dendritic cell function and altered antigen‐specific CD8+ T‐cell responses in diet‐induced obese mice infected with influenza virus
Authors: Smith Alexia G. , Sheridan Patricia A. , Tseng Raymond J. , Sheridan John F. , Beck Melinda A. 
Published: August 2008

SummaryThere is a clear link between obesity and metabolic disorders; however, little is known about the effect of obesity on immune function, particularly during an infection. We have previously reported that diet‐induced obese mice are more susceptible to morbidity and mortality during influenza infection than lean mice. Obese mice displayed aberrant innate immune responses characterized by minimal induction of interferon (IFN)‐α/β, delayed expression of pro‐inflammatory cytokines and chemokines, and impaired natural killer cell cytotoxicity. To further examine the abnormal immune response of diet‐induced obese mice, we analysed the cellularity of their lungs during influenza virus infection. We found delayed mononuclear cell entry with a marked decrease in dendritic cells (DCs) throughout the infection. Given the critical role of the DC in activating the cell‐mediated immune response, we also analysed the functional capacity of DCs from obese mice. We found that, while obesity did not interfere with antigen uptake and migration, it did impair DC antigen presentation. This was probably attributable to an altered cytokine milieu, as interleukin (IL)‐2, IL‐12, and IL‐6 were differentially regulated in the obese mice. Overall, this did not impact the total number of virus‐specific CD8+ T cells that were elicited, but did affect the number and frequency of CD3+ and CD8+ T cells in the lung. Thus, obesity interferes with cellular responses during influenza infection, leading to alterations in the T‐cell population that ultimately may be detrimental to the host.
Development of an ELA‐DRA gene typing method based on pyrosequencing technology
Authors: Díaz S. , Echeverría M. G. , It V. , Posik D. M. , Rogberg‐Muñoz A. , Pena N. L. , Peral‐García P. , Vega‐Pla J. L. , Giovambattista G. 
Published: August 2008

AbstractThe polymorphism of equine lymphocyte antigen (ELA) class II DRA gene had been detected by polymerase chain reaction–single‐strand conformational polymorphism (PCR‐SSCP) and reference strand‐mediated conformation analysis. These methodologies allowed to identify 11 ELA‐DRA exon 2 sequences, three of which are widely distributed among domestic horse breeds. Herein, we describe the development of a pyrosequencing‐based method applicable to ELA‐DRA typing, by screening samples from eight different horse breeds previously typed by PCR‐SSCP. This sequence‐based method would be useful in high‐throughput genotyping of major histocompatibility complex genes in horses and other animal species, making this system interesting as a rapid screening method for animal genotyping of immune‐related genes.
On identifiability of (co)variance components in animal models with competition effects
Authors: Cantet R.J.C. , Cappa E.P. 
Published: August 2008

SummaryThere is an increased interest in estimating the (co)variance components of additive animal models with direct and competition effects (AMC). However, some attempts to estimate the dispersion parameters in different animal species faced problems of convergence or inaccurate estimates when pen effects entered the model. We argue that the problem relates to lack of identifiability of the (co)variance components in some AMC. The check for identifiability of the dispersion parameters in mixed models with linear (co)variance structure requires that all the eigenvalues of the restricted maximum likelyhood information matrix (I(θ)) be positive. We show, by way of simple numerical examples, that the singularity of I(θ) is due to confounding between fixed pen effects and the additive competition effects (SBVs). It is also observed that setting pen effects as random does not always remedy the collinearity with SBVs. An alternative AMC is presented in which the incidence matrix of the SBVs can be written as a function of the ‘intensity of competition’ (IC) among animals in the same pen. Examples are presented in which the ICs are related to time. The distribution of families of full and half sibs across pens also plays a role in the identifiability and asymptotic variances of the (co)variance components.
Employer‐sponsored occupational therapy professional development in a multicampus facility: A quality project
Authors: Cusick Anne , Convey Monica , Novak Iona , McIntyre Sarah 
Published: August 2008

Aim:  To critically assess and develop recommendations for professional development (PD) for occupational therapists in a multisite specialist cerebral palsy occupational therapy service. Method:  Quality improvement project based on principles of participatory action research: audit of PD resources/activity; stakeholder consultations and literature review. Results:  The PD program goal, resources, strategies, activities and evaluations conducted at the centre were identified and described. Areas for improvement were identified by critically considering the PD program in the context of reviewed literature. There was an assumption that personal change through PD would help attain the organisational goal of clinically competent practitioners who use evidence‐based practice in a family‐centred context. Recommendations:  Future PD plans and evaluations need to explicitly address this assumption. The use of structured reflection and the ‘clinical reasoning’ conceptual framework was recommended as one way to help personal change from PD to have workplace impact. This project provides a precedent and guide to occupational therapy PD planners regarding a whole‐of‐organisation approach to developing and maintaining competence through PD.
Interrater reliability of the Personal Care Participation Assessment and Resource Tool (PC‐PART) in a rehabilitation setting
Authors: Turner Christopher , Fricke Janet , Darzins Peteris 
Published: August 2008

Background:  The Personal Care Participation Assessment and Resource Tool (PC‐PART), formerly the Handicap Assessment and Resource Tool (HART), assesses the domains of clothing, hygiene, nutrition, mobility, safety, residence and supports. Aim:  To examine the interrater reliability of the PC‐PART in a rehabilitation setting. Methods:  Assessments made by the researcher were compared to the interdisciplinary rehabilitation team. The research and standard assessments occurred within three working days. Raters were blind to each other's scores. Sample participants were a consecutive case‐series of rehabilitation clients with varied diagnoses, activity limitations and participation restrictions. Of 66 consecutive patients seen during the a priori determined enrolment period, 25 were included in the study (nine males and 16 females, aged 44–85 years). The remaining 41 patients did not meet the inclusion criteria.Conclusion:  The PC‐PART has good interrater reliability. Clinicians, administrators and researchers can be reassured about this aspect of the validity of the tool.
Reliability of the Perceive, Recall, Plan and Perform System of Task Analysis: A criterion‐referenced assessment
Authors: Nott Melissa T. , Chapparo Christine , Heard Robert 
Published: August 2008

Objective:  To conduct preliminary examination of the rater and test‐reliability of the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis, an ecological measure designed to assess task‐embedded information processing capacity during occupational therapy assessment of confused and agitated adults following traumatic brain injury. Methods:  Occupational therapists observed and scored client performance using the PRPP System of Task Analysis. Correlational analysis and measures of agreement were performed to determine interrater and intrarater reliability. Test procedures were examined for reliability and internal consistency. Results:  Interrater and test reliability considered three factors: therapists, clients and tasks. A moderate level of interrater reliability was achieved between trained therapists (intraclass correlation coefficient (ICC) = 0.60). Test procedures were highly reliable (ICC = 0.88). Across two measurement occasions, therapists showed a tendency towards harder rating on the second test occasion (

–4.5%; 95% confidence interval for

: –10.67%→ 3.17%). Conclusion:  The findings of this study support the use of criterion‐referenced tests in the area of occupational performance measurement. Occupational therapists achieved moderate interrater reliability when measuring the performance of adults with brain injury on various activities of daily living. Test procedures were found to be highly reliable in measuring the occupational performance of adults demonstrating confusion and agitation typical to the stage of post‐traumatic amnesia following head injury.
Association of vitamin D receptor gene polymorphisms in Iranian patients with inflammatory bowel disease
Authors: Naderi Nosratollah , Farnood Alma , Habibi Manijeh , Derakhshan Faramarz , Balaii Hedieh , Motahari Zahra , Agah Mohammad R , Firouzi Farzad , Rad Mahta G , Aghazadeh Rahim , Zojaji Homayoun , Zali Mohammad R 
Published: August 2008

AbstractBackground and Aims: The vitamin D receptor (VDR) gene maps to a region on chromosome 12 shown to be linked to inflammatory bowel disease (IBD). Many studies have recognized the relation of VDR gene polymorphisms with inflammatory and autoimmune disorders. Determining the frequency of these polymorphisms and their possible relation with IBD can improve understandings about the genetic background of these diseases. The objective of this study was to assess the association of VDR gene polymorphisms (Apa I, Taq I, Bsm I, Fok I) with IBD in Iran.Methods: In this case control designed study 150 patients with ulcerative colitis, 80 patients with Crohn's disease and 150 Age and Sex matched healthy controls from Iranian origin were enrolled. These patients were referred to a tertiary center during a two‐year period (2004–2006). Assessment of VDR gene polymorphisms was performed by the polymerase chain reaction—restriction fragment length polymorphism (PCR‐RFLP) method. The genotype–phenotype association for these polymorphisms was analyzed.Results: Only the frequency of the Fok I polymorphism was significantly higher in ulcerative colitis and Crohn's groups. The frequency of the polymorphic allele f was higher in ulcerative colitis and Crohn's patients comparing with controls (P = 0.011 andP < 0.001, respectively). The f/f genotype was also significantly more frequent (P < 0.001), while the F/F genotype was less presented in Crohn's patients compared to controls (P < 0.001). No genotype–phenotype association was observed with any mutations.Conclusions: This study suggests a probable association of the Fok I polymorphism in VDR receptor gene and Crohn's susceptibility in Iranian population.
Clinical experiences of solid pseudopapillary tumors of the pancreas in China
Authors: Yang Feng , Fu De‐liang , Jin Chen , Long Jiang , Yu Xian‐jun , Xu Jin , Ni Quan‐xing 
Published: August 2008

AbstractAims:  To discuss the clinical experiences of solid pseudopapillary tumors (SPTs) of the pancreas by summarizing clinical information of patients with this disease in China.Methods:  Chinese literature concerning SPTs of the pancreas published between January 1996 and October 2006 were retrospectively reviewed and analyzed.Results:  A total of 390 cases had been reported, among which 47 were men, with a female to male ratio of 7.30:1. Mean age of the patients was 25.3 years old, more than 50 per cent were between 10 and 24 years. The mean diameter of the tumor was 8.4 cm (range, 2 cm–25 cm). There was no significant difference in patient age and tumor size between male and female. Major clinical presentations included abdominal pain or discomfort, and palpable abdominal masses, however, nearly one third of all patients were asymptomatic. The rate of pre‐operative misdiagnosis was rather high. Those who tested positive to metastases or invasions, 14.4% of the patients were diagnosed as malignant SPTs. Sex, age, symptoms, tumor size and tumor markers were not significant clinical factors to predict SPTs with malignant potential. Surgical procedures mainly included pancreatoduodenectomy, distal pancreatectomy and local resection. Three patients developed local recurrence, and one patient developed hepatic metastasis, all within four years after tumor resection. Five patients with malignant SPTs died due to tumor progression within 25 months after surgery.Conclusions:  Surgical resection is the most effective means for curing this rare tumor. Despite metastasis, a good satisfactory effect could be achieved by surgical debulking. At least 4‐yearly follow‐up is mandatory for all patients undergoing surgical resection.
Gastric myoelectrical and motor abnormalities in children and adolescents with functional recurrent abdominal pain
Authors: Devanarayana Niranga M , De Silva DG Harendra , De Silva H Janaka 
Published: August 2008

AbstractBackground and Aims:  Recurrent abdominal pain is common among children and adolescents. The majority of the affected patients have no apparent cause for their symptoms. This study evaluated gastric myoelectrical activity and motility abnormalities in children and adolescents with functional recurrent abdominal pain.Methods:  Forty‐two children with functional recurrent abdominal pain [19 (45.2%) males, mean 8 years, SD 3 years, 19 functional abdominal pain, 9 irritable bowel syndrome, 9 functional dyspepsia, 1 abdominal migraine, 1 aerophagia and 3 non‐specific abdominal pain according to Rome III criteria] and 20 healthy children [10 (50%) males, mean 9 years, SD 2.7 years] from the same geographical area underwent electrogastrography (EGG), and ultrasonographic assessment of gastric emptying rate and antral motility.Results:  Average gastric emptying rate, amplitude of antral contractions and antral motility index were lower in patients (46.5%, 74.3% and 6.5 respectively) compared to controls (66.17%, 89% and 8.3 respectively) (P < 0.001). Gastric emptying rate had a negative correlation with scores obtained for severity of symptoms (r = −0.63, P < 0.0001). Postprandial dominant frequency instability co‐efficient (post‐DFIC) was higher in patients than in controls (27.83% vs 18.3%, P = 0.0087), and correlated with the symptom score (r = 0.26, P = 0.045).Conclusions:  Gastric emptying and antral motility were significantly impaired in patients, indicating a possible role for gastric motility disturbances in the pathogenesis of childhood functional recurrent abdominal pain. Further studies, including therapeutic trials, are needed to confirm this association and for recommendation of prokinetic drugs in its management.