bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rate of β-Cell Destruction in Type 1 Diabetes Influences the Development of Diabetic Retinopathy: Protective Effect of Residual β-Cell Function for More Than 10 Years
Authors: Nakanishi Koji , Watanabe Chizuru 
Published: October 2008

Context: Although residual β-cell function delays the onset and progression of diabetic retinopathy in patients with type 1 diabetes, the rate of β-cell destruction is variable.
Objective: The aim of the study was to clarify the influence of the rate of β-cell destruction on the development and progression of diabetic retinopathy in type 1 diabetes.
Design: We performed a historical cohort study regarding residual β-cell function and retinopathy.
Setting: The study was conducted in the outpatient clinic of a general hospital.
Patients: A total of 254 patients with type 1 diabetes participated.
Main Outcome Measures: Serum C-peptide and fundus findings were evaluated longitudinally.
Results: The cumulative incidence of mild nonproliferative diabetic retinopathy was higher in the patients without detectable β-cell function than in those with residual β-cell function at 20, 15, and 10 yr after the onset of diabetes (P = 0.013, P = 0.006, and P = 0.048, respectively), but not at 5 yr after the onset (P = 0.84). There were higher mean glycosylated hemoglobin values during the entire follow-up period in the patients without detectable β-cell function at 20 and 15 yr after the onset of diabetes (P = 0.030 and P = 0.042, respectively). Positivity for HLA-A24 and -DQA1*03, as well as the acute onset of diabetes, was associated with early β-cell loss and also with early development of diabetic retinopathy. Cox proportional hazards analysis showed that undetectable β-cell function at 20, 15, or 10 yr after the onset of diabetes was an independent risk factor for the development of diabetic retinopathy.
Conclusions: Undetectable β-cell function within 10 yr of the onset of type 1 diabetes is associated with the earlier occurrence of diabetic retinopathy.
Use of Complementary and Alternative Medicine by Patients Admitted to a Surgical Unit in Scotland
Authors: Shakeel Muhammad , Bruce Julie , Jehan Shah , McAdam Timothy K , Bruce Duff M 
Published: October 2008

INTRODUCTION Within the UK there are 50,000 practitioners of complementary medicine. Five million people have consulted such practitioners in one year. The aim of this study was to explore the use of complementary and alternative medicine (CAM) in patients attending general, vascular and cardiothoracic units at a regional Scottish centre. PATIENTS AND METHODS A questionnaire was administered to 450 patients attending the units over an 8-week period. The questionnaire consisted of demographic sections, a listing of 48 herbal preparations and alternative therapies, reasons for use and opinions on efficacy. RESULTS A total of 430 patients completed questionnaires (95%); age and sex were equally distributed over the sample. Of respondents, 68% (291 patients) had ever used CAM; 46% had used CAM in the preceding year. Half had used herbal preparations only, 13% non-herbal treatments and 35% both types of therapy. Only 10% were using CAM for the condition that led to their hospital admission. Two-thirds failed to inform their family physician about their use of CAM. CONCLUSIONS Despite concerns regarding the efficacy, safety and cost-effectiveness of complementary medicine, use amongst surgical patients is common.
Prospective Evaluation of a Novel One-Stop Testicular Clinic
Authors: Rochester Mark , Scurrell Sue , Parry John RW 
Published: October 2008

INTRODUCTION In 2003, the waiting time for routine scrotal assessment approached 6 months in our hospital. The patients' diagnostic pathway was not uniform and involved several delays between general practitioner, radiologist and urologist. If malignancy was suspected, patients were seen and assessed within 2 weeks. However, it was possible for patients with unsuspected malignancy to have their diagnosis delayed. PATIENTS AND METHODS Funding was provided by the NHS Modernisation Agency's Action On Urology project. Men who were referred by their general practitioner (GP) with a testicular or scrotal condition would be reviewed in a one-stop joint sonographer and urology nurse specialist clinic provided entirely within the urology department with rapid open access. Data were prospectively collected for 2 years. Source of referral, suspected diagnosis, findings and outcome were recorded. RESULTS A total of 1017 patients attended the clinic over this period; of these, 203 (4%) were referred under the ‘2-week wait’ criteria. Of patients attending the clinic, 79% were discharged to GP care, 8% were added to the waiting list for a surgical procedure and 20% were referred with ‘testicular lump’. Eleven patients were suspected to have testicular tumour on ultrasound and proceeded to orchidectomy in this period. One patient (0.1%) was found to have an unsuspected seminoma. The waiting time for all scrotal ultrasound examinations has fallen from 22 to 2 weeks. The waiting times for intravenous urography and general ultrasound were also significantly reduced following the introduction of this service (P = 0.005). CONCLUSIONS The majority of patients passing through this clinic are the ‘worried-well’ with benign scrotal pathology. They can now be seen within 2 weeks regardless of whether their GP suspects testicular tumour. This reduces anxiety in this large group of patients freeing capacity elsewhere in the diagnostic imaging department.
Role of Information Available Over the Internet: What are the Parents of Children Undergoing Tonsillectomy Likely to Find?
Authors: Roshan A , Agarwal S , England RJA 
Published: October 2008

INTRODUCTION The aim of this study was to assess the quality of information available on the world wide web to parents of children undergoing tonsillectomy. MATERIALS AND METHODS The main data source was from internet searches using the five most popular search engines and the keyword ‘tonsillectomy’ with default settings. The first 50 web links in each search were evaluated with the LIDA Instrument (assessing accessibility, usability and reliability criteria). We also assessed the readability of the sites using the Flesch reading ease score (FRES). RESULTS Of the 250 possible links, 113 new links were included the remaining being repetitions, inactive links or restricted access sites. The websites had an average accessibility score of 42/63 (66.7%; range, 26–57), a usability score of 29/54 (53.7%; range, 7–49), and are liability score of 17/51 (33.3%; range, 0–49). The Flesch reading ease score was 43.8 (range, 3–84.4). CONCLUSIONS Health information available on the internet varies greatly. Highly ranked websites on popular search engines may not be the most reliable. Overall, the websites had low scores for reliability, with poor engagability, content production and conflict of interest declaration. Patients should be given previously assessed references on the internet to prevent them being misled by in accurate or commercially motivated information.
www.Accurate Information for Varicose Vein patients.com?
Authors: Scurr James RH , Hufton Alison , Jeffrey Victoria , Vallabhaneni S Rao 
Published: October 2008

INTRODUCTION The aim of this study was to review the information available to the public regarding the treatment of varicose veins on dedicated UK-based websites. PATIENTS AND METHODS Websites were identified by using the Google® search engine. All identified websites were examined, noting the range of treatments explained and their stated potential complications. Website ownership was also recorded. RESULTS A total of 49 websites were identified, belonging to individual physicians (21), private clinics or groups (15), national institutions (4) and device/drug manufacturers (4). Five websites were simply redirecting portals and, hence, were excluded from further analysis. Treatment methods discussed were conventional surgery (32), endovenous laser [EVLA] and/or radiofrequency ablation [RFA] (31), and ultrasound-guided foam sclerotherapy [UGFS] (27). Only 19 websites (43%) discussed all treatment methods. Complications mentioned following surgery were: cutaneous nerve damage (56%), recurrence (56%), infection (53%), bleeding (41%) and venous thrombo-embolism (38%). Complications following EVLA/RFA were: cutaneous nerve damage (42%), recurrence (42%), venous thrombo-embolism (39%) and burns (35%). Complications following UGFS were: pigmentation (59%), venous thrombo-embolism (48%), ulceration (41%), recurrence (41%), allergy (26%) and visual disturbance (26%). CONCLUSIONS Over 50% of the websites examined did not mention all the management methods now available for varicose veins. More importantly, the majority of the websites did not warn of the common complications of intervention. Currently, information on the Internet cannot be relied upon to supplement informed consent and may actually generate unrealistic patient expectations.
The Acute Blue Finger: Management and Outcome
Authors: Cowen R , Richards T , Dharmadasa A , Handa A , Perkins JMT 
Published: October 2008

INTRODUCTION The objective was to assess the management, and short- and longer-term outcome of patients presenting with an acute blue finger. PATIENTS AND METHODS This was a retrospective, case-note review and prospective follow-up by telephone and general practitioner enquiry. All patients who presented with sudden onset blue discolouration of a finger within the previous 72 h, with normal radial and ulnar pulses, were included. RESULTS From 2000 to 2006, 22 patients, 15 female, 7 male, were reviewed. Median age was 56 years (range, 19–88 years). Median time from onset of blue finger was 6 days (range 1 day to 3 months). In most cases (17), no underlying cause was identified. Five patients had an underlying cause; two had symptoms compatible with Raynaud's phenomenon, one patient had signs (later confirmed on MRA) of arterial thoracic outlet syndrome and two had polycythaemia (haemoglobin > 17 g/dl). Otherwise, all laboratory investigations were normal. Upper limb duplex, echocardiogram and 24-h cardiac tapes were normal in all cases. Median follow-up was 19 months. Three patients had recurrent symptoms in the finger. No patient suffered tissue loss or loss of digit(s), and none had stroke or arterial embolisation. CONCLUSIONS The acute blue finger is a benign condition not suggestive of arterial embolisation. Tissue or digit loss is not a threat and, in the longer term, there is no threat of embolisation to other vascular sites.
Diagnostic and Therapeutic Performance of Video-Assisted Thoracoscopic Surgery (Vats) in Investigation and Management of Pleural Exudates
Authors: Medford ARL , Awan YM , Marchbank A , Rahamim J , Unsworth-White J , Pearson PJK 
Published: October 2008

INTRODUCTION Video-assisted thoracoscopic surgery (VATS) is the gold standard investigation for diagnosis of pleural exudates. It is invasive and it is important to ensure that it is performed to acceptable national standards. We assumed that VATS empyema fluid culture would not contribute further to microbiological diagnosis in referred culture-negative empyemas. PATIENTS AND METHODS Eighty-six consecutive external referrals for VATS for diagnosis of a cytology-negative pleural exudate (or for further management of the exudate) were studied retrospectively. Diagnostic yield, pleurodesis efficacy and complications were compared to national standards and good practice recommendations. VATS empyema fluid microbiological culture results were compared to pre-VATS empyema fluid culture results. RESULTS VATS was performed well within national standards with a diagnostic yield of 82.3% for cytology-negative exudates, 100% pleurodesis efficacy, 5.8% postoperative fever, with only one significant complication (1.2% rate) and no deaths. Compliance with good practice pleural fluid documentation points was greater than 70%. VATS empyema fluid culture positivity (84.6%) was significantly higher than pre-VATS fluid culture (35%). CONCLUSIONS VATS was performed to acceptable standards. These data confirm the utility and safety of VATS in the right context but also suggest the potential diagnostic utility of VATS empyema fluid culture. Further studies are required to investigate this latter possibility further.
Genetic and Environmental Influences on Adiponectin, Leptin, and BMI Among Adolescents in Taiwan: A Multivariate Twin/Sibling Analysis
Authors: Liu Pi-Hua , Jiang Yi-Der , Chen Wei J. , Chang Ching-Chung , Lee Tso-Ching , Sun H. Sunny , Chuang Lee-Ming 
Published: October 2008

AbstractCirculating levels of leptin and adiponectin are closely associated with obesity. However, it is not known whether there are common shared genes or environment exerting influences on the levels of leptin, adiponectin, and BMI. We aimed to assess the relative contribution of genes and environment to adiponectin, leptin, and BMI individually as well as simultaneously to the three measures. Our subjects included a total of 228 twin/sibling pairs aged 12 to 18 (130 monozygotic twins, 68 dizygotic twins and 30 sibling pairs) were recruited from the middle schools. Multivariate analyses were applied to twin/sibling data using structural equation modeling. The results showed that intraclass correlations for adiponectin, leptin and BMI were higher in the MZ twins than those in the DZ/SP group. The relative contribution of genes to adiponectin (39%) was comparable to those of shared environment (40%). In contrast, leptin and BMI were influenced mostly by genes (74% and 89%, respectively). The multivariate genetic analyses showed that a latent factor underlying the three measures was identified, with BMI being equivalent to this latent factor. The BMI-dependent genetic factor explains only 15% and 34% of variation of adiponectin and leptin, respectively. These data indicate a differential contribution of genetic factors for the variation of adiponectin, leptin and BMI. More importantly, only a small portion of the genetic influences on adiponectin and leptin was attributed to BMI. Our findings provided more insight into the complex regulation of adiponectin and leptin in obesity.
An Application of Salivary DNA in Twin Research of Chinese Children
Authors: Zhang Yue , Ji Chengye 
Published: October 2008

AbstractSince saliva collection is noninvasive, painless and inexpensive, it may become an alternative to obtain genomic DNA, which is critical to evaluate zygosity and the role of genetic factors in twin research. This study provided a rough description of salivary DNA in Chinese twin children, and presented the DNA yield and quality extracted from saliva in a large-scale children sample, which supplied an example for saliva sample using in genetic epidemiology. Three milliliters of saliva was collected from 356 twin children aged 6 to 15, and DNA was extracted by a com mercial DNA isolation kit. The DNA yield and purity was determined by spectrophotometry at 260nm and 280nm. The zygosity determination of the same-sex twins and the assay of Polymerase Chain Reaction-Restriction Fragment Length Polymorphism indicated the quality of salivary DNA. The amount of extracted DNA from three milliliters of saliva was about 34.91μg (2.20 ~ 122.04μg), average OD260/280 values was 1.84. Saliva DNA is a reliable sample for the determination of twins' zygosity. We conclude that saliva may be a feasible and reliable source of DNA for genetic epidemiology studies, especially for twin research.
Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation
Authors: Klein Katharina , Gregor Hubertus , Hirtenlehner-Ferber Kora , Stammler-Safar Maria , Witt Armin , Hanslik Andreas , Husslein Peter , Krampl Elisabeth 
Published: October 2008

AbstractThe objective of our study was to evaluate the correlation of the cervical length at 20–25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20–25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%,p= .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159;p= .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks.
Neuer Echtzeitkern zur Verbesserung von Dynamik und Sicherheit eines navigierten Chirurgie-Assistenzroboters A Novel Real Time Core for Dynamics and Safety Enhancement of a Navigated Surgical Assistance Robot
Authors: Schneider Hans-Christian , Wahrburg Jürgen 
Published: October 2008

Zusammenfassung
modiCAS (= modular interactive Computer Assisted Surgery) ist die softwarebasierte Integration von Planungssystem, Navigationssystem, Kraftsensorik, mechatronischem Manipulator und anwendungsspezifischen Operationswerkzeugen zu einem interaktiven Chirurgie-Assistenzsystem. Es ermöglicht dem Chirurgen die planungsgerechte und reproduzierbar genaue Durchführung operativer Eingriffe mit einem hohen Maß an intuitiver Bedienbarkeit. Eine Kernfunktionalität von modiCAS ist das mechatronikgestützte, navigierte Nachführen der verwendeten Operationswerkzeuge bei kleinen Patientenverlagerungen in Echtzeit. Dieser Beitrag beschreibt die derzeitige Umgestaltung des Echtzeitkerns sowie zukünftige Forschungsziele hinsichtlich einer Verbesserung der dynamischen und sicherheitstechnischen Eigenschaften.
Optimierung von Wirbelstromspulen. Verbesserte Fehlerdetektion bei der Heißdrahtprüfung Optimised Eddy Current Sensor. Improved Defect Detection on Hot Wire Steel
Authors: Ricken Werner , Hartmann Knut , Becker Wolf-Jürgen , Perez Carmen , Gonzalo Leandro 
Published: October 2008

Zusammenfassung
Verschiedene Wirbelstrom-Spulen der Heißdrahtprüfung wurden untersucht. Fehler beim Warmwalzen von Stahldrähten wurden sowohl mit Messungen der Spulenimpedanz als auch durch die Erfassung des Übertragungsverhaltens gekoppelter Wirbelstromspulen detektiert. Für eine hohe Messempfindlichkeit bei ausreichender Robustheit des Sensors wurden Spulen mit weichmagnetischen Ferritmaterialien verwandt. Der Einsatz von weichmagnetischem Kernmaterial verbessert die Fehlerdetektion von Durchlaufspulen. Messungen zeigen einen geringeren Lift-off-Effekt und dadurch wird ein verbessertes Verhältnis zwischen Nutz- und Störsignal erzielt. Durch Variation von Wicklungsparametern wie Windungszahl und Geometrie wurde ein optimaler Arbeitspunkt gefunden. Ein Wirbelstrom-Sensorarray wird zurzeit entwickelt, um lange Längsfehler sicher detektieren zu können.
Hochauflösende Wirbelstromprüfung mittels GMR-Sensorik am Beispiel supraleitender Drähte High Resolution Eddy Current Testing of Superconducting Wires by Means of GMR Sensors
Authors: Kreutzbruck Marc , Bernau Hendrik , Allweins Kai 
Published: October 2008

Zusammenfassung
Aufgrund eines anhaltenden Trends der Miniaturisierung von Bauteilen sowie eines gesteigerten Qualitätsanspruches in Fertigung und Instandhaltung besteht ein wachsender Bedarf für hochauflösende zerstörungsfreie Prüfverfahren. Ein derzeit vielversprechender Lösungsansatz in der elektromagnetischen Prüfung wird durch die magnetischen Mikrosysteme eröffnet. Insbesondere die jüngst mit dem Physik-Nobelpreis ausgezeichnete GMR-Technologie bietet neben einer hohen Feldempfindlichkeit zugleich hervorragende Ortsauflösungen mit Schichtabmessungen bis in den unteren μm-Bereich. Hierdurch werden magnetische Feldverteilungen bei der Wirbelstromprüfung oder der Streuflussprüfung mit einem gegenüber Spulensystemen erhöhten Signal/Rausch-Verhältnis (SNR) und einer verbesserten Ortsauflösung gemessen. Im vorliegenden Beitrag wird das Potenzial der MR-Technologie anhand der Wirbelstromprüfung von Drähten verdeutlicht. Hierbei wird ein kreuzförmiges GMR-Sensor-Array um den zu untersuchenden Draht positioniert. Jeder einzelne GMR-Sensor misst dabei mit einer Feldempfindlichkeit von etwa 200pT/√Hz und einer Ortsauflösung von 100μm. Der Nachweis von im Durchmesser etwa 200μm großen Defekten in einer Tiefenlage von 200μm unterhalb der Drahtoberfläche gelingt mit einem SNR von über 400. Oberflächendefekte ähnlicher Größenordnung können mit einem SNR von nahezu 104 detektiert werden. Ein derart hohes SNR birgt in Kombination mit der hohen örtlichen Auflösung Potenzial für eine 3D-Fehlerlokalisierung. Unter Verwendung eines analytischen Ansatzes sowie auf FEM beruhende Dateninversionsalgorithmen können Defekte mit einer Abmessung von größer 200μm auf einige 10μm exakt lokalisiert werden.
El problema de la nación en las independencias americanas: Una propuesta teórica
Authors: Vejo Tomás Pérez 
Published: October 2008

El punto de partida de este artículo es que las naciones no son la causa de las guerras de independencia sino su consecuencia. La propuesta, intentar una nueva relectura de los conflictos que tuvieron lugar en la Monarquía Católica en la segunda década del siglo XIX a partir de una mirada que intente evitar lo que hay de construcción posterior e incluir las nuevas aportaciones que desde diversos campos, especialmente desde la teoría política, se han hecho sobre el concepto de nación en los últimos años. Las guerras de independencia son vistas como un problema de soberanía y no como un enfrentamiento entre naciones.
This article maintains that nations were not the cause of the wars of independence but their consequence. It proposes a new evaluation of the conflicts that took place in the Catholic Monarchy during the second decade of the nineteenth century. The evaluation seeks to avoid subsequent constructions and to include new contributions that from different fields, especially from political theory, have been made about the concept of nation in recent years. It considers the wars of independence as a problem of sovereignty and not as a conflict between nations.
Por lealtad al rey, a la patria y a la religión. Los años de transición en la provincia de Zacatecas: 1808–1814
Authors: Fuentes Mariana Terán 
Published: October 2008

El artículo pretende dar cuenta de los motivos de lealtad a la patria, al rey y a la religión que esgrimieron distintos actores involucrados en el proceso de insurgencia en la provincia de Zacatecas. Más específicamente se explica la participación, composición y tendencias que tuvo el ayuntamiento de la ciudad de Zacatecas.
The article seeks to explain the reasons why the leading actors of the process of independence in the Province of Zacatecas expressed loyalty to the patria, the king, and the Catholic religion. More specifically, it examines the role, composition, and activities of the Ayuntamiento of the City of Zacatecas.