bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duplex ultrasonography is an efficient diagnostic tool for the detection of moderate to severe internal carotid artery stenosis
Authors: Nowak Jacek , Jogestrand Tomas 
Published: February 2007

SummaryBackground The aim of this prospective national muliticentre study with 10 participating university and county hospitals was to establish the diagnostic accuracy of carotid duplex sonography in the identification of ≥70% internal carotid artery (ICA) stenosis defined according to European Carotid Surgery Trial (ECST) criteria.Methods In 134 patients, aged 69 ± 9 years, ICA stenoses were identified by routine carotid duplex ultrasonography, confirmed angiographically within 2 months, and graded according to ESCT criteria. The accuracy of carotid duplex to detect ICA stenosis ≥70% was assessed using receiver operating characteristic (ROC) analysis with carotid angiography as a reference.Results Measurement of peak systolic velocity in ICA (PSVICA) identified ICA stenosis ≥70% with high diagnostic accuracy that was Doppler angle dependent resulting in different optimal PSVICA cut points within the angle range 0°–49° (1·7 m s−1) and 50°–62° (2·3 m s−1). The diagnostic discrimination was significantly better when narrow Doppler angles (0°–49°) were used (P<0·01) providing the sensitivity of 98 ± 2% and specificity of 94 ± 4%.Discussion Ultrasound duplex technique identifies moderate to severe (≥70%) ICA stenoses (ECST criteria) with high degree of accuracy that can be further improved by the use of Doppler angle specific optimal PSVICA cut points.
On the Move: International Migration in Southeast Asia since the 1980s
Authors: Kaur Amarjit 
Published: February 2007

AbstractMigration has been a persistent theme in Southeast Asian labour history and migrants have been either permanent settlers or temporary residents. In the second half of the nineteenth‐century migration coincided with European expansion into the region and was linked to economic development and labour market needs. Borders were porous, there was an empire‐wide sourcing of labour, and migration regimes were relatively stable. Since the 1980s migration has predominantly comprised intra‐Southeast Asian labour flows, is mediated by institutions and involves formal and informal channels. It has resulted in risks for specific categories of migrants and more stringent border controls by the state. Increasing global interdependence nevertheless, has created the conditions for international governance, and consequently, national policies are being shaped by, and respond to, the expanding global governance regime. Crucially, major international organisations such as the United Nations and its ancillary bodies both inform and direct themes in research and directions for policy.
Writing the Biography of the Prophet Muhammad: Problems and Solutions
Authors: Hoyland Robert 
Published: February 2007

AbstractThis article looks at the different approaches that medieval and modern, Muslim and Western scholars have adopted when attempting to write on the life of Muhammad. It considers the sources for his life and the different methodologies that have been devised for assessing their authenticity. It examines the degree to which Muhammad and the ingredients of the religion that he started were a part of the Late Antique world that he lived in and the way in which religious trends of that era might have impacted upon the formation of Islam. Finally, some suggestions are given for how one might take the study of the biography of Muhammad in different directions in the future.
Low IgE monoclonal gammopathy level in serum highlights 20‐yr survival in a case of IgE multiple myeloma
Authors: Hayes Michael J. , Carey John L. , Krauss John C. , Hedstrom Deborah L. , Gulbranson Ronald L. , Keren David F. 
Published: February 2007

AbstractThis report describes the diagnosis, follow‐up, and problems measuring serum immunoglobulin E (IgE) levels in a case of IgE myeloma with 20‐yr survival. Serum and urine protein electrophoresis, immunofixation, and the N Latex IgE test were used to characterize the monoclonal proteins. The diagnosis of multiple myeloma in a 56‐yr‐old man was based on 5.4 g/24 h of monoclonal free lambda chain in urine and bone marrow findings of 23.5% plasma cells (19% mature and 4.5% atypical). IgE lambda monoclonal protein in serum measured 506 000 μg/L (210 833 IU/mL). The lack of other clinical findings of multiple myeloma places this case in the category of ‘smoldering or indolent myeloma’. Measurement of serum IgE levels was complicated by the need to predilute serum to avoid antigen excess. Following chemotherapy, the patient went into clinical remission, eventually dying of complications of emphysema. This case expands the recognized clinical spectrum of IgE multiple myeloma.
Outcomes in patients with an emergency department diagnosis of fever of unknown origin
Authors: Ingarfield Sharyn L , Celenza Antonio , Jacobs Ian G , Riley Thomas V 
Published: February 2007

AbstractObjective:  To describe the outcomes in patients given an ED diagnosis of fever of unknown origin (FUO).Methods:  A retrospective analysis of ED records linked to hospital morbidity, mortality and microbiology records of patients presenting to Western Australia’s teaching hospitals from July 2000 to July 2003.Results:  There were 3218 presentations diagnosed with FUO, 2049 (63.7%) children (median age 1.8 years) and 1169 (36.3%) adults (median age 56.0 years). FUO accounted for 0.3% of adult and 1.5% of paediatric ED presentations. Overall, 1997 (62.1%, 95% confidence interval 60.4–63.8%) were admitted (82% adults vs 50.7% children; P < 0.001). Adults had a longer median length of stay than children (4 days vs 2 days; P < 0.001) and a higher proportion of positive blood cultures (admissions 15.1%vs 4.9%; P < 0.001) commonly with Escherichia coli. Streptococcus pneumoniae was the most common organism isolated from children. Of 3053 FUO index presentations, 338 (11.1%, 95% confidence interval 10.0–12.2%) re‐presented. Children were more likely to re‐present than adults (13.5% of 1959 vs 6.8% of 1094; P < 0.001).Conclusions:  Fever of unknown origin is diagnosed less frequently in adults than in children. Adult patients are more likely to be admitted, have longer lengths of stay and have positive blood cultures. Although FUO is diagnosed infrequently in the ED, blood cultures remain useful in the evaluation of unexplained fever, particularly in adults as age increases.
Utility of urine drug screening: A Clinical audit
Authors: Murnion Bridin P , Granot Ron , Day Richard O 
Published: February 2007

AbstractObjective:  To assess requesting patterns and clinical utility of urine drug screens (UDS).Methods:  All UDS requests received between March 2002 and October 2002 were identified. Two trained assessors reviewed case histories and categorized the utility of the UDS and gave a utility score using a Visual Analogue Scale.Results:  Of 171 UDS requested, 67.3% were men. Age range was 15–92 (mean 36) years. In total, 70.8% were received from accident and emergency centre (AEC). Clinical utility was identified in only 85 of 171 UDS. Sixty‐one per cent of requests from AEC were defined as having no clinical utility. Twenty‐four per cent of requests originating from other specialities were identified as having no clinical utility. Overall, a test was more likely to be of utility if it was requested from non‐AEC than from AEC (Pearson’s χ2 two‐sided t‐test, P < 0.0001). Indications for UDS were toxic ingestion (33.3%), psychosis (15.2%), impaired consciousness (13.5%), behavioural disturbance (4.1%), confusion with HIV infection (3.5%), alleged adulteration (3.5%), seizure (9.4%), cardiac arrest (1.8%) and miscellaneous (15.8%).Conclusions:  Our data show excessive requesting for UDS in routine overdose, contrary to international guidelines. Requests for UDS originating from AEC are more likely to have no utility than those from other specialities. Availability of point of care UDS might increase use of UDS, but cost‐effectiveness and utility must be assessed.
Validation of emergency physician ultrasound in diagnosing hydronephrosis in ureteric colic
Authors: Watkins Stuart , Bowra Justin , Sharma Praneal , Holdgate Anna , Giles Alan , Campbell Lewis 
Published: February 2007

AbstractObjective:  Patients presenting to the ED with obstructive nephropathies benefit from early detection of hydronephrosis. Out of hours radiological imaging is expensive and disruptive to arrange. Emergency physician ultrasound (EPU) could allow rapid diagnosis and disposition. If accurate it might avert the need for formal radiological imaging, exclude an obstruction and improve patient flow through the ED.Methods:  This was a prospective study of a convenience sample of all adult non‐pregnant patients with presumed ureteric colic attending the ED with prior ethics committee approval. An emergency physician or registrar performed a focused ultrasound scan and were blinded to the patient’s other management. A computerized tomography scan was also performed for all patients while in the ED or within 24 h of the EPU. The accuracy of EPU detection of hydronephrosis was determined; using computerized tomography scans reported by a senior radiologist as the ‘gold‐standard’.Results:  Sixty‐three patients with suspected ureteric colic were enrolled of whom 57 completed both EPU and computerized tomography imaging. Forty‐nine had confirmed nephrolithiasis by computerized tomography with 39 having evidence of hydronephrosis. Overall prevalence of hydronephrosis was 68% (95% confidence interval [CI] 56–79%); compared with computerized tomography, EPU had a sensitivity of 80% (95% CI 65–89%); specificity of 83% (95% CI 61–94%); positive predictive value of 91% (95% CI 75–98%) and negative predictive value of 65% (95% CI 43–83%). The overall accuracy was 81% (95% CI 69–89%).Conclusion:  Although the accuracy of detection of hydronephrosis after focused training in EPU is encouraging, further experience and training might improve the accuracy of EPU and allow its use as a screening tool.
Foraging Association between Coatis (Nasua nasua) and Birds of the Atlantic Forest, Brazil
Authors: Beisiegel Beatriz de Mello 
Published: February 2007

ABSTRACTTwo bird species,Leucopternis polionotaandDendrocincla fuliginosa, frequently follow coatis (Nasua nasua)while they forage in the Atlantic forest of southeastern Brazil. Two other avian species,Trogon rufusandHabia rubica, have also been observed following coatis. This “following foraging behavior” is more frequent during the dry season when coatis forage in trees. For the birds, this can represent a coping strategy with the reduced resource availability during the drier season.
Fallen Branches as Part of Leaf‐Cutting Ant Trails: Their Role in Resource Discovery and Leaf Transport Rates inAtta cephalotes
Authors: Farji‐Brener Alejandro G. , Barrantes G. , Laverde O. , Fierro‐Calderón K. , Bascopé F. , López Adriana 
Published: February 2007

ABSTRACTFallen branches, logs, and exposed roots (fallen branches hereafter) commonly form part of the trunk trail system of leaf‐cutting ants that inhabit the tropical rain forest. We studied the role of fallen branches on resource discovering and on leaf transport rates inAtta cephalotes. Fallen branches were common components of theA. cephalotestrail system; they were present in all the nests, and in the majority of the trunk trails examined (13/16). A field experiment revealed that, at the beginning of their foraging activity, ants discovered food sources located at the end of fallen branches earlier than those located on the leaf litter. Additionally, laden ants walked faster along a fallen branch than along soil tracks of the trunk trails. This increment in speed was higher in slow‐walking ants (e.g., with larger loads) than in fast‐walking ants (e.g., with smaller loads). These results suggest that the presence of fallen branches may direct the searching effort of leaf‐cutters and increase the foraging speed of laden ants when these structures are part of the trunk trail system. The advantages of using fallen branches as part of a trail system, and their potential consequences in the spatial foraging pattern of leaf‐cutting ants, are discussed.
Upland Soil Charcoal in the Wet Tropical Forests of Central Guyana
Authors: Hammond David S. , Steege Hans ter , Van Der Borg Klaas 
Published: February 2007

ABSTRACTA soil charcoal survey was undertaken across 60,000 ha of closed‐canopy tropical forest in central Guyana to determine the occurrence, ubiquity, and age of past forest fires across a range of terra firme soil types. Samples were clustered around six centers consisting of spatially nested sample stations. Most charcoal was found between 40 and 60 cm depth with fewest samples yielding material at 0–20 cm depth. The first core yielded charcoal at most stations. Charcoal ages of a random subsample ranged from less than 200 YBP to 9500 YBP with a noticeable peak between 1000 and 1250 YBP. Results reinforce a view that most closed‐canopy tropical forests in eastern Amazonia have been subject to palaeo‐fire events of unknown severity with a peak in charcoal age consistently appearing between 1000 and 2000 YBP. The two samples dated to the early Holocene represent some of the oldest indicators of paleo‐fire known from upland Neotropical forest soils. Ubiquitous soil charcoal in central Guyana further indicate both forest resilience to fire and the widespread propensity for regional forests to burn, particularly during anomalous periods of drought.
Explaining Leaf Herbivory Rates on Tree Seedlings in a Malaysian Rain Forest
Authors: Eichhorn Markus P. , Fagan K. C. , Compton Stephen G. , Dent Daisy H. , Hartley Sue E. 
Published: February 2007

ABSTRACTSeedlings of five species of dipterocarp trees were planted in experimental plots in rain forest gaps in Sabah, Malaysia, and the rates of herbivory on their mature leaves recorded over 6 mo. A novel method was used to estimate the feeding pressure exerted by the local insect herbivore community, derived from the relative abundances of the dominant generalist herbivores and their feeding preferences. Characteristics of the leaves related to their defense and nutritional value were measured—phenolic content, laminar fracture toughness, laminar thickness, and nitrogen content. Three main groups of herbivorous insects were present—coleopteran and lepidopteran herbivores, which were sampled by hand from the seedlings, and orthopteran herbivores, which were sampled by sweep netting. The feeding preferences of the main coleopteran and orthopteran herbivores were determined using laboratory feeding trials. Combining variables in a Principal Components Analysis, a clear separation was found between the five seedling species along the first extracted component. This correlated closely with herbivory rates between species. The first extracted component comprised a negative influence of phenolic content and positive effects of nitrogen content, laminar fracture toughness, abundances of coleopteran and lepidopteran herbivores, and estimated feeding pressure of the coleopteran community. Further studies are required to determine the potential applications of the latter measure of estimated herbivore community impact.
Cholesterol‐lowering management of stroke: Inconsistencies of evidence and practice
Authors: MOREY Belinda , ASH Susan , READ Stephen 
Published: February 2007

AbstractCholesterol‐lowering treatment by statins is an important and costly issue; however, its role in stroke has not been well documented. The aim of the present study was to review literature and current practice regarding cholesterol‐lowering treatment for stroke patients. A literature review was conducted on lipids in stroke and their management with both statins and diet, including the cost‐effectiveness of medical nutrition therapy. Qualifying criteria and prescription procedures of the Pharmaceutical Benefits Scheme (PBS) were also reviewed. Data on lipid levels and statin prescriptions were analysed for 468 patients admitted to a stroke unit. The literature shows that management with both medication and diet can be effective, especially when combined; however, 60% of patients with an ischaemic event had fasting total cholesterol measures ≥4 mmol/L (n = 231), with only 52% prescribed statins on discharge (n = 120). Hypercholesterolaemia is an underdiagnosed and undertreated risk factor within the stroke population. It appears that the PBS has not kept pace with advances in the evidence in terms of statin use in the stroke population, and review is needed. The present review should address the qualifying criteria for the stroke population and recommendations on referral to dietitians for dietary advice. Cholesterol‐lowering treatment for both stroke patients and the wider population is an area that needs awareness raising and review by the PBS, medical practitioners and dietitians. The role of dietary and pharmacological treatments needs to be clearly defined, including adjunct therapy, and the cost‐effectiveness of medical nutrition therapy realised.
Immunogenicity, Reactogenicity, and Immune Memory after Primary Vaccination with a Novel
Haemophilus influenzae
-
Neisseria meningitidis
Serogroup C Conjugate Vaccine
Authors: Schmitt Heinz-J. , Maechler Gudrun , Habermehl Pirmin , Knuf Markus , Saenger Roland , Begg Norman , Boutriau Dominique 
Published: February 2007

ABSTRACT

We evaluated two formulations of a new combined
Haemophilus influenzae
type b (Hib)-meningococcal serogroup C (MenC)-tetanus toxoid (TT) conjugated vaccine and two formulations of a new MenC-TT vaccine (trials 711202/001 and 711202/008; clinical trial register numbers NCT00135486 and NCT00135564 [
www.ClinicalTrials.gov
]). A total of 520 healthy infants were randomized to receive primary vaccination (at 2, 3, and 4 months) with either MenC-TT plus diphtheria-tetanus-acellular pertussis (DTPa)-hepatitis B virus (HBV)-inactivated poliovirus (IPV)/Hib, Hib-MenC-TT plus DTPa-HBV-IPV, or MenC-CRM
197
plus DTPa-HBV-IPV/Hib (control). At 12 to 15 months, subjects received a polysaccharide challenge with meningococcal polysaccharide C plus a DTPa-HBV-IPV/Hib booster. Immune responses were assessed 1 month after dose 2, 1 month after dose 3, and prior to and 1 month after the booster. After primary vaccination, there was no difference between groups in seroprotection rates as measured by titers of serum bactericidal antibody (SBA) to MenC (≥1:8) or concentrations of anti-polyribosyl ribitol phosphate (PRP) antibody (≥0.15 μg/ml). Prior to the booster, there was no difference between groups in SBA seroprotection rates, whereas anti-PRP seroprotection rates were significantly higher after priming with Hib-MenC-TT. Booster doses induced large increases in SBA and anti-PRP antibodies in primed groups, indicating successful priming with induction of immune memory. Reactogenicity and safety were similar in all groups during the primary and booster phases. A novel combined Hib-MenC-TT conjugate vaccine induced MenC and Hib responses comparable to those induced by licensed monovalent vaccines. A Hib-MenC-TT conjugate vaccine provides vaccination against two major pathogens in a single injection and is a suitable candidate for use in primary or booster vaccination schedules.
Retrospective Species Identification of Microsporidian Spores in Diarrheic Fecal Samples from Human Immunodeficiency Virus/AIDS Patients by Multiplexed Fluorescence In Situ Hybridization
Authors: Graczyk Thaddeus K. , Johansson Michael A. , Tamang Leena , Visvesvara Govinda S. , Moura Laci S. , DaSilva Alexandre J. , Girouard Autumn S. , Matos Olga 
Published: February 2007

ABSTRACT

In order to assess the applicability of multiplexed fluorescence in situ hybridization (FISH) assay for the clinical setting, we conducted retrospective analysis of 110 formalin-stored diarrheic stool samples from human immunodeficiency virus (HIV)/AIDS patients with intestinal microsporidiosis collected between 1992 and 2003. The multiplexed FISH assay identified microsporidian spores in 94 of 110 (85.5%) samples: 49 (52.1%) were positive for
Enterocytozoon bieneusi
, 43 (45.8%) were positive for
Encephalitozoon intestinalis
, 2 (2.1%) were positive for
Encephalitozoon hellem
, and 9 samples (9.6%) contained both
E. bieneusi
and
E. intestinalis
spores. Quantitative spore counts per ml of stool yielded concentration values from 3.5 × 10
3
to 4.4 × 10
5
for
E. bieneusi
(mean, 8.8 × 10
4
/ml), 2.3 × 10
2
to 7.8 × 10
4
(mean, 1.5 × 10
4
/ml) for
E. intestinalis
, and 1.8 × 10
2
to 3.6 × 10
2
for
E. hellem
(mean, 2.7 × 10
2
/ml). Identification of microsporidian spores by multiplex FISH assay was more sensitive than both Chromotrope-2R and CalcoFluor White M2R stains; 85.5% versus 72.7 and 70.9%, respectively. The study demonstrated that microsporidian coinfection in HIV/AIDS patients with intestinal microsporidiosis is not uncommon and that formalin-stored fecal samples older than 10 years may not be suitable for retrospective analysis by techniques targeting rRNA. Multiplexed FISH assay is a reliable, quantitative fluorescence microscopy method for the simultaneous identification of
E. bieneusi
,
E. intestinalis
, and
E. hellem
, as well as
Encephalitozoon cuniculi
, spores in fecal samples and is a useful tool for assessing spore shedding intensity in intestinal microsporidiosis. The method can be used for epidemiological investigations and applied in clinical settings.
Use of Sequence Analysis of the NS5B Region for Routine Genotyping of Hepatitis C Virus with Reference to C/E1 and 5′ Untranslated Region Sequences
Authors: Murphy Donald G. , Willems Bernard , Deschênes Marc , Hilzenrat Nir , Mousseau Roger , Sabbah Sidney 
Published: February 2007

ABSTRACTNucleotide sequence analysis of the NS5B region was performed to identify genotypes of 8,479 hepatitis C virus (HCV) RNA-positive patient samples collected in the Canadian province of Quebec. Genotypes could be determined for 97.3% of patients. Genotypes 1 to 6 were found in 59.4, 9.0, 25.7, 3.6, 0.6, and 1.8% of patients, respectively. Two isolates did not classify within the six genotypes. The subtype 1 distribution was 76.7% 1a, 22.6% 1b, and 0.7% others, while the subtype 2 distribution was 31.8% 2a, 47.6% 2b, 10.9% 2c, 4.1% 2i, and 5.6% others. Subtype 3a accounted for 99.1% of genotype 3 strains, while all genotype 5 samples were of subtype 5a. The subtype 4 distribution was 39.2% 4a, 15.4% 4k, 11.6% 4d, 10.2% 4r, and 23.6% others. The subtype 6 distribution was 40.4% 6e, 20.5% 6a, and 39.1% others. The 5′ untranslated region (5′UTR) sequences of subtype 6e were indistinguishable from those of genotype 1. All samples that did not classify within the established subtypes were also sequenced in C/E1 and 5′UTR. C/E1 phylogenetic reconstructions were analogous to those of NS5B. The sequences identified in this study allowed the provisional assignments of subtypes 1j, 1k, 2m, 2r, 3i, 4q, 6q, 6r, and 6s. Sixty-four (0.8%) isolates classifying within genotypes 1 to 6 could not be assigned to one of the recognized subtypes. Our results show that genotyping of HCV by nucleotide sequence analysis of NS5B is efficient, allows the accurate discrimination of subtypes, and is an effective tool for studying the molecular epidemiology of HCV.