bluuebunny/crossref_metadata_2025_split huggingface dataset:
The development of a clinically useful tool for predicting the development of psychological disorder following injury
Authors: Mason S. , Farrow T. F. D. , Fawbert D. , Smith R. , Bath P. A. , Hunter M. , Woodruff P. W. , Turpin G. 
Published: September 2008

ObjectivesTo identify factors significantly associated with post‐traumatic stress disorder (PTSD), anxiety, and depression at 3 months post‐injury; to develop a generic model to predict the occurrence of PTSD, anxiety, and depression at 3 months post‐injury; and to validate this model in a test data set of patients.DesignProspective cohort study.MethodsParticipants were 823 patients attending an emergency department (ED) following accidental injury. Baseline questionnaires were completed, with 1 and 3 months postal follow‐ups. Predictor variables demonstrating significant associations with two of the three outcome measures (3‐month HAD anxiety and depression scores and PTSD symptoms) were included in multivariate regression models for each outcome. Non‐significant predictor variables were removed until all remaining independent variables made the most significant contribution to each of the three models. Models were validated using a test dataset.ResultsPrevious history of mental health problems, neuroticism score and having PTSD symptoms at 1 month predicted adverse outcomes at 3 months. When used on the test datasets, the areas under the receiver operating curve (ROC) curve for the models predicting outcomes at 3 months were: PTSD=0.91 (sensitivity=88.5%); anxiety=0.87 (sensitivity=93.7%); and depression=0.87 (sensitivity=96.7%).ConclusionsThe final model performed moderately well across the three outcomes and may be useful clinically as a generic rule‐out tool to identify those who will not require follow up, watchful waiting or intervention.
Sinnvoller Einsatz von Tumormarkern / Sensible use of tumor markers
Authors: Stieber Petra , Heinemann Volker 
Published: September 2008

Zusammenfassung
Als Tumormarker werden heute alle nachweisbaren oder messbaren Substanzen zusammengefasst, die auf einen Tumor hinweisen oder zu seiner Charakterisierung und Messung seiner Ausbreitung und Therapieansprechen beitragen können. Humorale zirkulierende Tumormarkersubstanzen als Vorstufen normaler Antigene, ektopisch gebildete Hormone oder Enzyme, ontogenetisch alte reaktivierte Antigene, hybridom-definierte Muzine und Zytokeratine sind unter den Tumormarkern von besonderem Interesse.
Es gibt bis heute keinen tumorspezifischen Biomarker, alle bislang bekannten Tumormarker sind physiologisch beim Menschen im Blut nachweisbar. Ihre diagnostische Bedeutung liegt mehr in der Quantität denn in der Qualität. Die gemessene Tumormarkerkonzentration reflektiert Tumormasse und -ausbreitung und ist primär von der Tumorblutversorgung abhängig. Im Einzelnen stellt sie ein integrales Maß aus der im Tumor vorhandenen Tumormarker-Expression, -Synthese, -Freisetzung, dem im Organismus ablaufenden Tumormarker-Katabolismus und der Tumormarker-Exkretion dar. Tumormarker-Änderungen ohne Korrelation zur Tumormasse können deshalb auch durch Störungen von Katabolismus und der Exkretion (Leber-, Niereninsuffizienz), durch Freisetzung infolge invasiver diagnostischer Maßnahmen (Endoskopie, Biopsie, Katheterisierung) oder durch akute Therapieeinwirkung (Operation, Radio-, Chemotherapie) auftreten.
Wegen Standardisierungsproblemen zwischen gleichen Tumormarker-Tests verschiedener Hersteller, muss bei einer punktuellen Diagnostik, z.B. mittels PSA die Interpretation immer auf den assayspezifischen Referenzangaben erfolgen und bei Verlaufsbestimmungen eines Patienten der gleiche Test vom selben Hersteller (evtl. im gleichen Labor bestimmt) herangezogen werden, das Testergebnis ist zusammen mit dem jeweils verwendeten Test und Hersteller anzugeben.
Von den potenziellen Indikationen für den Einsatz zirkulierender Tumormarker ist die zur Früherkennung/Screening eines Tumors bis auf die umstrittene von PSA beim Prostatakarzinom unrealistisch, die zur Tumorlokalisation (PSA; HTG) und für die Diagnose begrenzt, die für die Prognose zunehmend von Bedeutung und die für die Therapie-Überwachung und Rezidiverkennung die meist verwandte, im Kontext mit endoskopischen und bildgebenden Verfahren.
Unter kritischer Auswahl von Tumormarkern nach Zieltumor, bei Verlaufsbestimmungen unter Verwendung der gleichen Tests und unter Berücksichtigung eines verwertbaren Informationsgehalts leisten Tumormarker einen wichtigen Beitrag zur Diagnostik, Prognosefindung, Beurteilung der Therapieantwort und Rezidiverkennung. Die Qualität des Untersuchers geht besonders auf dem Sektor der onkologischen Labordiagnostik signifikant in die Qualität des erhobenen Befundes ein.
Regelungsansätze für genetische Tests und die Zunahme des individualisierten genetischen Wissens / Regulatory approaches for genetic tests and the increase in individualized genetic knowledge
Authors: Fuchs Michael 
Published: September 2008

Zusammenfassung
Seit kurzem ist in den USA ein gesetzliches Verbot von Diskriminierungen aufgrund genetischer Informationen in Kraft. Die deutsche Bundesregierung hat mit den Eckpunkten für ein Gendiagnostikgesetz einen Schritt hin zur gesetzlichen Regelung unternommen. Der Artikel stellt die möglichen Ansatzpunkte einer Regulierung, insbesondere für prädiktive genetische Tests vor, analysiert, welche davon in Deutschland und den USA umgesetzt werden sollen, und fragt nach der Angemessenheit und Konsistenz. Eine weitere Anforderung an ein insgesamt wünschenswertes Gesetz ist seine Praktikabilität und Durchsetzbarkeit.
Array-CGH in der Routinediagnostik bei geistiger Entwicklungsstörung / Array CGH in the routine diagnostic work-up of mental retardation
Authors: Heinrich Uwe , von Voss Hubertus , Rost Imma 
Published: September 2008

Zusammenfassung
Die Array-CGH (Comparative Genomic Hybridization) ist heute zum unverzichtbaren Bestandteil der Diagnostik von mentalen Entwicklungsstörungen (mental retardation) im Kindesalter geworden. Eine Nachuntersuchung im eigenen Patientenkollektiv bei primär chromosomal unauffälligen Kindern mit mentalen Entwicklungsstörungen (n=194) ergab bei 17 Patienten (9%) mit der BAC- (Bacterial Artificial Chromosome) Array-CGH den Nachweis einer chromosomalen Imbalance als Ursache. Zur eindeutigen und schnellen Validierung von auffälligen CGH-Ergebnissen hat sich in einer kleinen Pilotstudie an 10 Patienten, insbesondere bei chromosomalen Duplikationen, der Einsatz einer zweiten, oligonukleotidbasierten Array-CGH-Plattform bewährt (sog. Kreuzvalidierung). Aufgrund unserer eigenen und der Erfahrungen anderer Arbeitsgruppen wird derzeit ein Stufenkonzept bei der genetischen Diagnostik von Kindern mit mentaler Retardierung unter kombiniertem Einsatz der BAC- und Oligonukelotid-Array-CGH sowie der Fluoreszenz-in-situ-Hybridisierung (FISH) empfohlen.
Genexpressionsstudien mit Microarrays und SAGE: Biologische und analytische Grundlagen / Gene expression studies with microarrays and SAGE: biological and analytical principles
Authors: Müller Holger , Neumaier Michael , Hoffmann Georg 
Published: September 2008

ZusammenfassungDiese Arbeit setzt eine im Jahr 2003 begonnene Publikationsserie über die Analytik und Auswertung von Genexpressionsstudien der Arbeitsgruppe Bioinformatik der DGKL e.V. (www.dgkl.de/bioinformatik) fort. Sie beschreibt die beiden wichtigsten Techniken für die Erfassung genomweiter Expressionsprofile, DNA-Microarrays (Biochips) und Serial Analysis of Gene Expression (SAGE), aus dem kritischen Blickwinkel der Labordiagnostik.Als Expressionsprofil bezeichnet man eine Liste aller in einem Gewebe vorkommenden mRNA-Spezies (Transkripte) mit Angabe der zugehörigen Menge. Von den 10 bis 20 pg Gesamt-RNA pro Zelle sind nur 1 bis 5% mRNA, die sich auf ca. 35000 zelltypspezifische Transkripte verteilen. So liegen die meisten in extrem geringen Mengen von rund einem Molekül pro Zelle vor, einige jedoch in 10000-fach höherer Konzentration. Das bedeutet eine erhebliche analytische Herausforderung.Beide Verfahren haben Stärken und Schwächen: Microarray-Experimente liefern mit weniger Aufwand in kürzerer Zeit semi-quantitative Ergebnisse, können aber nur bekannte Genprodukte analysieren. SAGE ist extrem kosten- und zeitaufwendig und schwer zu interpretieren, zählt aber definierte Sequenzabschnitte und entdeckt prinzipiell jede in der Probe vorkommende mRNA. Bedingt durch die Vielzahl und mangelnde Standardisierbarkeit der analytischen und präanalytischen Teilschritte leiden beide Verfahren unter Präzisions- und Richtigkeitsproblemen und können auch divergierende Aussagen liefern. Ein Signal, das mit Microarrays hoch exprimiert erscheint, kann mit SAGE nicht nachweisbar sein und umgekehrt. Neuere Verfahren der Hochdurchsatz-Sequenzierung könnten dazu beitragen, die Lücke zwischen den beiden Techniken zu schließen.
CEA, CYFRA 21-1, NSE, and ProGRP in the diagnosis of lung cancer: a multivariate approach / CEA, CYFRA 21-1, NSE und ProGRP in der Diagnostik des Lungenkarzinoms: eine multivariate Analyse
Authors: Gruber Christine , Hatz Rudolf , Reinmiedl Judith , Nagel Dorothea , Stieber Petra 
Published: September 2008

Abstract
We retrospectively studied the single and combined diagnostic value of carcinoembryonic antigen (CEA), cytokeratin fragment 19 (CYFRA 21-1), neuron specific enolase (NSE) and pro-gastrin-releasing peptide (ProGRP), which were routinely analysed in patients with lung tumours of unknown origin at the time of admission to hospital. Inclusion criteria were the determination of CEA (AxSYM/Abbott), CYFRA 21-1 (ElecSys/Roche) and NSE (Kryptor/Brahms). We examined 1747 patients, where 1325 suffered from lung cancer (LC; small cell lung cancer, SCLC: n=194; non-small cell lung cancer, NSCLC: n=1015; others: n=116), 318 from benign lung diseases and 104 from lung metastases due to another primary malignancy. As ProGRP (ELISA ALSI/IBL) became available only recently, there are less data points of this marker. In total, 99.8% of LC patients released at least one of the four biomarkers (defined as values exceeding the median of healthy controls), and for the discrimination between benign disease (BD) and malignant lung disease each marker reached 100% tumour specificity at high levels (CEA: 20 ng/mL; CYFRA 21–1: 40 ng/mL; NSE: 45 ng/mL; ProGRP: 250 pg/mL). At a specificity of >99%, ProGRP reached the highest diagnostic efficacy for SCLC with 57% true positive results, CEA had the highest capacity (17%) to detect malignant lung tumours in general and adenocarcinomas of the lung with 29%. CYFRA 21-1 was dominant for squamous cell carcinomas (12%). Combining the four markers leads with the prerequisite of high specificity (>99%) to 50% true positives for malignant lung tumours, 44% for NSCLC, 36% for squamous cell carcinomas, 53% for adenocarcinomas, and 78% for SCLC, respectively. In cases of lung tumours of unknown origin, the combined use of CEA, CYFRA 21-1, NSE and ProGRP is useful for the differentiation between benign and primary or secondary malignant disease and suggests the assignment to histological subtypes.
Einsatz der Genchiptechnologie in der Erregerdiagnostik / Use of DNA microarrays in microbiological diagnostics
Authors: Cullen Paul , Funke Harald , Klein Hanns-Georg , Langmann Thomas , Neumaier Michael 
Published: September 2008

Zusammenfassung
Seit der Geburt der Mikrobiologie vor etwas mehr als 100 Jahren hat sich die technische Grundlage der Keimzüchtung und -identifizierung kaum geändert. Rasche Fortschritte in der Molekularbiologie und die Entwicklung hochparalleler Ansätze, wie die sogenannte Genchip-Technologie während der letzten Jahre, versprechen jedoch eine schnellere, genauere und breitere Identifizierung von Erregern und ihrer Resistenzen gegen Antibiotika. Vor diesem Hintergrund wird gelegentlich sogar der Untergang der klassischen Bakteriologie heraufbeschworen. Wie aus den beschriebenen Beiträgen hervorgeht, liegt jedoch ein solches Szenario immer noch in der Zukunft. Die Gründe hierfür sind einerseits die hohen technischen Anforderungen an automatisierbare molekularbiologische Methoden, andererseits unzureichende Kenntnisse der genetischen Grundlagen der Resistenzentwicklung. Weitere Probleme sind die nicht ausreichende Sensitivität sowie die prinzipielle Unfähigkeit solcher Systeme, vitale von bereits abgetöteten Bakterien unterscheiden zu können.
Inducing puberty
Authors: Delemarre Eveline M , Felius Bram , Delemarre-van de Waal Henriette A 
Published: September 2008

Puberty is the result of increasing pulsatile secretion of the hypothalamic gonadotropin releasing hormone (GnRH), which stimulates the release of gonadotropins and in turn gonadal activity.In general in females, development of secondary sex characteristics due to the activity of the gonadal axis, i.e., the growth of breasts, is the result of exposure to estrogens, while in boys testicular growth is dependent on gonadotropins and virilization on androgens.Hypogonadotropic hypogonadism is a rare disease. More common is the clinical picture of delayed puberty, often associated with a delay of growth and more often familial occurring. Especially, boys are referred because of the delay of growth and puberty. A short course (3–6 months) of androgens may help these boys to overcome the psychosocial repercussions, and during this period an increase in the velocity of height growth and some virilization will occur.Hypogonadotropic hypogonadism may present in a congenital form caused by developmental disorders, some of which are related to a genetic disorder, or secondary to hypothalamic–pituitary dysfunction due to, among others, a cerebral tumor.In hypogonadotropic hypogonadism puberty can be initiated by the use of pulsatile GnRH, gonadotropins, and sex steroids. Sex steroids will induce development of the secondary sex characteristics alone, while combined administration of gonadotropins and GnRH may induce gonadal development including fertility.
Hypercholesterolemia, eligibility for lipid-lowering therapy and therapeutic success: population-based study in a Portuguese urban population
Authors: Alves Luis , Azevedo Ana 
Published: September 2008

BackgroundWe aimed to estimate i) the prevalence of hypercholesterolemia, ii) the proportion of individuals eligible for treatment with lipid-lowering drugs, and iii) therapeutic success, according to the European guidelines on cardiovascular disease prevention in clinical practice.DesignPopulation-based cross-sectional study.MethodsWe surveyed a representative sample of the population of Porto aged 40–65 years. Trained interviewers collected data from 1215 subjects (789 women) on demographic variables, medical history, and medication using structured questionnaires. A fasting venous blood sample was withdrawn. Subjects were considered low risk or high risk as indicated in the European guidelines. Hypercholesterolemia was defined as total cholesterol (TC) ≥5 mmol/l or low-density-cholesterol (LDL-C) ≥3 mmol/l in low-risk subjects, TC ≥4.5 mmol/l or LDL-C ≥2.5 mmol/l in high-risk subjects or being medicated with lipid-lowering drugs. Eligibility for treatment was defined as being high risk and having TC ≥4.5 mmol/l, LDL-C ≥2.5 mmol/l or being on treatment. We defined therapeutic success as having TC <4.5 mmol/l and LDL-C<2.5 mmol/l among medicated subjects.ResultsOverall, 84.9% (95% confidence interval (95% CI): 82.7–86.8) of subjects had hypercholesterolemia and 9.1% (95% CI: 7.5–10.8) were medicated with lipid-lowering drugs. Men were more likely to be eligible for treatment (42.4%) than women (22.4%; OR=2.69, 95% CI 2.07–3.52). Therapeutic success was less frequent in men (46.8%) than in women (66.7%), (OR=0.39, 95% CI 0.17–0.87).ConclusionStrict interpretation of the European guidelines would label 85% of the general population in this age group as hypercholesterolemic and a third eligible for drug treatment. Questions arise regarding medicalization, resource allocation, and sustainability within the healthcare system.
Modeling bioaccumulation using characteristic times
Authors: Powell Adrian , Mackay Don , Webster Eva , Arnot Jon A. 
Published: September 2008

Abstract
A new formulation of existing mass balance models for bioaccumulation is derived and applied to organisms that respire either water or air. This model employs characteristic time parameters and equations that are mathematically equivalent to those used in existing concentration-rate constant and fugacity models. The equivalence of these traditional formulations and the novel formulation is demonstrated. In all three formulations, the required information includes various physiological and dietary parameters as well as chemical concentrations in food and in the respired medium of water or air. Chemical properties are described by the octanol–water or octanol–air partition coefficient and a metabolic biotransformation half-life. Bioaccumulation, biomagnification, and all uptake and loss rates are expressed using characteristic times that have readily identifiable chemical or biological significance. The ability of the characteristic time formulation to provide an evaluation of the bioenergetic consistency of organism properties is briefly discussed. The model is applied illustratively to a trout as a water-respiring organism and to a wolf as an air-respiring organism, and the results are discussed. It is concluded that the use of characteristic time parameters and equations provides valuable additional insights regarding the relative importance of the various uptake and loss processes and, thus, is complementary to the conventional approaches for modeling bioaccumulation phenomena in a variety of organisms.
Effect of a Low–Resource-Intensive Lifestyle Modification Program Incorporating Gymnasium-Based and Home-Based Resistance Training on Type 2 Diabetes Risk in Australian Adults
Authors: Payne Warren R. , Walsh Kerry J. , Harvey Jack T. , Livy Michelle F. , McKenzie Kylie J. , Donaldson Alex , Atkinson Meredith G. , Keogh Jennifer B. , Moss Robert S. , Dunstan David W. , Hubbard Wendy A. 
Published: September 2008

OBJECTIVE—The purpose of this study was to assess the effectiveness of a low–resource-intensive lifestyle modification program incorporating resistance training and to compare a gymnasium-based with a home-based resistance training program on diabetes diagnosis status and risk.
RESEARCH DESIGN AND METHODS—A quasi-experimental two-group study was undertaken with 122 participants with diabetes risk factors; 36.9% had impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) at baseline. The intervention included a 6-week group self-management education program, a gymnasium-based or home-based 12-week resistance training program, and a 34-week maintenance program. Fasting plasma glucose (FPG) and 2-h plasma glucose, blood lipids, blood pressure, body composition, physical activity, and diet were assessed at baseline and week 52.
RESULTS—Mean 2-h plasma glucose and FPG fell by 0.34 mmol/l (95% CI −0.60 to −0.08) and 0.15 mmol/l (−0.23 to −0.07), respectively. The proportion of participants with IFG or IGT decreased from 36.9 to 23.0% (P = 0.006). Mean weight loss was 4.07 kg (−4.99 to −3.15). The only significant difference between resistance training groups was a greater reduction in systolic blood pressure for the gymnasium-based group (P = 0.008).
CONCLUSIONS—This intervention significantly improved diabetes diagnostic status and reduced diabetes risk to a degree comparable to that of other low–resource-intensive lifestyle modification programs and more intensive interventions applied to individuals with IGT. The effects of home-based and gymnasium-based resistance training did not differ significantly.
Combined Task Delegation, Computerized Decision Support, and Feedback Improve Cardiovascular Risk for Type 2 Diabetic Patients
Authors: Cleveringa Frits G.W. , Gorter Kees J. , van den Donk Maureen , Rutten Guy E.H.M. 
Published: September 2008

OBJECTIVE—The Diabetes Care Protocol combines task delegation (a practice nurse), computerized decision support, and feedback every 3 months. We studied the effect of the Diabetes Care Protocol on A1C and cardiovascular risk factors in type 2 diabetic patients in primary care.
RESEARCH DESIGN AND METHODS—In a cluster randomized trial, mean changes in cardiovascular risk factors between the intervention and control groups after 1 year were calculated by generalized linear models.
RESULTS—Throughout the Netherlands, 26 intervention practices included 1,699 patients and 29 control practices 1,692 patients. The difference in A1C change was not significant, whereas total cholesterol, LDL cholesterol, and blood pressure improved significantly more in the intervention group. The 10-year coronary heart disease risk estimate of the UK Prospective Diabetes Study improved 1.4% more in the intervention group.
CONCLUSIONS—Delegation of routine diabetes care to a practice nurse combined with computerized decision support and feedback did not improve A1C but reduced cardiovascular risk in type 2 diabetes patients.
C-Reactive Protein, Insulin Resistance, and Metabolic Syndrome in a Population With a High Burden of Subclinical Infection
Authors: Howard Barbara V. , Best Lyle , Comuzzie Anthony , Ebbesson Sven O. E. , Epstein Stephen E. , Fabsitz Richard R. , Howard Wm. James , Silverman Angela , Wang Hong , Zhu Jianhui , Umans Jason 
Published: September 2008

OBJECTIVE—To explore relationships between C-reactive protein (CRP), subclinical infection, insulin resistance, and metabolic syndrome.
RESEARCH DESIGN AND METHODS—Data from 1,174 Eskimos, aged ≥18 years, from the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study were analyzed; 40 participants with diabetes were eliminated. Baseline assessment included interviews, physical exam, and blood and urine sampling. Metabolic syndrome was assessed using Adult Treatment Panel III criteria. CRP and antibodies to common pathogens were measured.
RESULTS—Although CRP was related in univariate analyses to insulin resistance and metabolic syndrome, relations were attenuated or eliminated after adjustment for relevant covariates. CRP was not higher among those with impaired fasting glucose (IFG), and pathogen burden was not related to insulin resistance, metabolic syndrome, or IFG.
CONCLUSIONS—Pathogen burden and inflammation do not seem to be related to insulin resistance, metabolic syndrome, or IFG in this population. The inflammatory process may reflect insulin resistance or its correlates but most likely is not causative.
Determination of Total Polyphenol Content in Food with the Flow-Injection Method
Authors: Berend Suzana , Grabarić Zorana 
Published: September 2008

Odredivanje polifenola u namirnicama metodom ubrizgavanja u protokU ovom radu predložena je modificirana automatizirana metoda ubrizgavanja u protok za odredivanje sadržaja ukupnih polifenola u namirnicama bazirana na Folin-Ciocalteauovoj reakciji u 0,5 mol L-1NaOH. Metoda omogućuje automatiziranu analizu različitih uzoraka brzinom protoka 55 uzoraka na sat uz upotrebu galne kiseline kao standarda. Primjenom predložene metode na konkretne uzorke (bijelo i crno vino, zeleni, indijski te čaj od lipe, metvice i kamilice i bistri voćni sokovi od crnog ribiza i višnje), odreden je njihov "indeks ukupnih polifenola" s većom repetibilnošću za razliku od ranije objavljenih metoda, manje ovisno o razrjedenju uzorka. U odnosu na "batch" metodu, ova je metoda visoko tolerantna prema najčešćim interferentima (SO2, reducirajući šećeri i askorbinska kiselina). Rezultati dobiveni predloženom metodom pokazali su relativno slaganje s onima dobivenim referentnom Folin-Ciocalteauovom metodom.