bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toward an improved legislative framework for China's land degradation control
Authors: Ke Zhou , Xia Cao , Baiping Tan 
Published: April 2008

Abstract The Chinese government has recently been attaching increasing importance to the application of effective legal tools to tackle land degradation (LD) issues. Based on the concept of sustainable development, China began developing and reaping the benefits of environmental and natural resources legislation including LD control regulations in the 1990s. In the past three years, some central‐western provinces in China have been implementing a “

People's Republic of China/Global Environment Facility (PRC/GEF

) Partnership on LD Control of Dryland Ecosystems”, which is based on an integrated ecosystem management (IEM) approach. IEM is designed to achieve a balanced, scientific and participatory approach to natural resources management, which creates the potential to improve the quality of Chinese environmental law and policy procedures. The paper studies the existing Chinese national laws and regulations pertinent to LD control within 9 areas covering land, desertification, soil erosion, grassland, forest, water, agriculture, wild animals and plants, and environment protection in detail, against IEM principles and basic legal elements. The main objective is to identify problems and provide feasible solutions and recommendations for the improvement of the existing laws and regulations. The authors conclude that the development of an improved national legislative framework is essential if LD control is to be successfully achieved. The paper is partly based on Component 1 — Improving Policies, Laws and Regulations for Land Degradation Control under PRC/GEF Partnership on Land Degradation in Dryland Ecosystems (TA 4357).
Assessment of the Enabling Rural Innovation (ERI) approach: Case studies from Malawi and Uganda
Authors: Kaaria Susan , Njuki Jemimah , Abenakyo Annet , Delve Robert , Sanginga Pascal 
Published: April 2008

Abstract This paper presents lessons from applying an innovative action research approach for linking smallholder farmers to markets, in eastern and southern Africa. The Enabling Rural Innovation (ERI) approach aims to strengthen social organization and entrepreneurial capacity in rural communities. It focuses on fostering community‐based capacity for the inclusion of rural women and the poor in analyzing and accessing market opportunities. Using case studies from Malawi and Uganda the paper assesses the outcomes of ERI on rural communities with a focus on human capital, gender issues and investment in natural resource management. Results show that households are benefiting significantly from linkages to markets in terms of increasing household incomes, and accumulating assets. Skills in analyzing markets and in negotiating with traders have increased among smallholder farmers. The integration of gender in the approach has led to changes in gender decision making patterns at household and community level towards a more shared decision‐making process. The results however show a difference in skills between men and women, with women showing lower levels of skills acquisition. Farmer participatory research has increased investments in improved technologies such as fertilizer applications for soil fertility management.
Antiepileptic drugs—best practice guidelines for therapeutic drug monitoring: A position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic Strategies
Authors: Patsalos Philip N. , Berry David J. , Bourgeois Blaise F. D. , Cloyd James C. , Glauser Tracy A. , Johannessen Svein I. , Leppik Ilo E. , Tomson Torbjörn , Perucca Emilio 
Published: April 2008

Summary Although no randomized studies have demonstrated a positive impact of therapeutic drug monitoring (TDM) on clinical outcome in epilepsy, evidence from nonrandomized studies and everyday clinical experience does indicate that measuring serum concentrations of old and new generation antiepileptic drugs (AEDs) can have a valuable role in guiding patient management provided that concentrations are measured with a clear indication and are interpreted critically, taking into account the whole clinical context. Situations in which AED measurements are most likely to be of benefit include (1) when a person has attained the desired clinical outcome, to establish an individual therapeutic concentration which can be used at subsequent times to assess potential causes for a change in drug response; (2) as an aid in the diagnosis of clinical toxicity; (3) to assess compliance, particularly in patients with uncontrolled seizures or breakthrough seizures; (4) to guide dosage adjustment in situations associated with increased pharmacokinetic variability (e.g., children, the elderly, patients with associated diseases, drug formulation changes); (5) when a potentially important pharmacokinetic change is anticipated (e.g., in pregnancy, or when an interacting drug is added or removed); (6) to guide dose adjustments for AEDs with dose‐dependent pharmacokinetics, particularly phenytoin.
Wind turbines, flicker, and photosensitive epilepsy: Characterizing the flashing that may precipitate seizures and optimizing guidelines to prevent them
Authors: Harding Graham , Harding Pamela , Wilkins Arnold 
Published: April 2008

Summary Wind turbines are known to produce shadow flicker by interruption of sunlight by the turbine blades. Known parameters of the seizure provoking effect of flicker, i.e., contrast, frequency, mark‐space ratio, retinal area stimulated and percentage of visual cortex involved were applied to wind turbine features. The proportion of patients affected by viewing wind turbines expressed as distance in multiples of the hub height of the turbine showed that seizure risk does not decrease significantly until the distance exceeds 100 times the hub height. Since risk does not diminish with viewing distance, flash frequency is therefore the critical factor and should be kept to a maximum of three per second, i.e., sixty revolutions per minute for a three‐bladed turbine. On wind farms the shadows cast by one turbine on another should not be viewable by the public if the cumulative flash rate exceeds three per second. Turbine blades should not be reflective.
Abnormalities in diffusion tensor imaging of the uncinate fasciculus relate to reduced memory in temporal lobe epilepsy
Authors: Diehl Beate , Busch Robyn M. , Duncan John S. , Piao Zhe , Tkach Jean , Lüders Hans O. 
Published: April 2008

Summary
Aims: To use Diffusion Tensor Imaging (DTI) to explore structural integrity and connectivity of the uncinate fasciculus (UF) in patients with temporal lobe epilepsy (TLE) and its relationship to memory performance.
Methods: DTI and UF reconstruction were performed in 28 patients with TLE (18 left, 10 right) and 10 normal controls. Differences between left and right UF fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values and correlations between DTI measures and memory scores in the TLE groups were computed.
Results: In controls, FA was higher in the left than right UF (p < 0.01). In left TLE, FA values were lower and ADC values higher than controls in the left UF and ADC values were higher in the right UF (all p < 0.05). In right TLE, ADCs were higher in the left and right UF compared to controls, and FA was reduced in the left UF (all p < 0.05). In left TLE, ADCs in the left UF were negatively correlated with Auditory Immediate (p < 0.05) and Delayed Memory (p < 0.01). Visual Delayed Memory was positively correlated with reduced FA in the ROI of the right UF and increased radial diffusivities (p < 0.05). No significant correlations were found in right TLE. Thus, DTI values correlated with memory scores in the expected direction in patients with left TLE.
Conclusions: Abnormal diffusion measures in the UF ipsilateral to the epileptogenic zone suggest that integrity of the UF is related to memory performance in patients with left TLE. Larger sample sizes are needed to evaluate structure‐function correlations further.
Prescribing and monitoring hemodialysis in a 3‐4 ×/week setting
Authors: DAUGIRDAS John T. 
Published: April 2008

AbstractThe basics of targeting, writing, adjusting, and monitoring a hemodialysis prescription are reviewed for patients being dialyzed 3 or 4 times a week. K/DOQI 2006 adequacy guidelines and practice recommendations are reviewed, and a practical method using a variety of nomograms is suggested to monitor and adjust the desired level of Kt/V.
A king‐size dialysis bed: A couple on hemodialysis for more than 30 years
Authors: ATERINI Stefano , AMATO Marcello 
Published: April 2008

AbstractDialysis patients exhibit a higher morbidity and mortality rate than those in the general population of comparable age. Survival on dialysis has become significantly longer and is mainly related to comorbid factors. Patients are usually the main research subjects, but caregivers play a pivotal role in patients' well‐being. Here we describe the remarkable case of wife and husband both on hemodialysis for 32 years.
Determinants of C‐reactive protein in chronic hemodialysis patients: Relevance of dialysis catheter utilization
Authors: HUNG Adriana , PUPIM Lara , YU Chang , SHINTANI Ayumi , SIEW Edward , AYUS Carlos , HAKIM Raymond M. , IKIZLER Talat Alp 
Published: April 2008

AbstractBiomarkers of inflammation, especially C‐reactive protein (CRP), have been consistently shown to predict poor outcomes in chronic hemodialysis (CHD) patients. However, the determinants of CRP and the value of its monitoring in CHD patients have not been well defined. We conducted a retrospective cohort study to evaluate possible determinants of the inflammatory response in CHD patients with a focus on dialysis catheter utilization. Monthly CRP were measured in 128 prevalent CHD patients (mean age 56.6 years [range 19–90], 68% African Americans, 39% diabetics [DM]) over a mean follow‐up of 12 months (range 2–26 months). There were a total of 2405 CRP measurements (median 5.7 mg/L; interquartile range [IQR] 2.4–16.6 mg/L). The presence of a dialysis catheter (p<0.002), cardiovascular disease (p=0.01), male gender (p=0.005), higher white blood cell count (p<0.0001), elevated phosphorus (p=0.03), and lower cholesterol (p=0.02) and albumin (p<0.0001) concentrations were independent predictors of elevated CRP in the multivariate analysis. Additionally, CRP levels were significantly associated with the presence of a catheter, when comparing the levels before and after catheter insertion (p=0.002) as well as before and after catheter removal (p=0.009). Our results indicate that the presence of a hemodialysis catheter is an independent determinant of an exaggerated inflammatory response in CHD patients representing a potentially modifiable risk factor.
A new safety device for hemodialysis
Authors: AHLMÉN Jarl , GYDELL Karl‐Henrik , HADIMERI Henrik , HERNANDEZ Isabel , ROGLAND Björn , STRÖMBOM Ulf 
Published: April 2008

AbstractAccidental venous needle dislodgement during hemodialysis may cause serious bleeding including a sometimes fatal outcome. The venous pressure gauge of the dialysis monitor does not react when dislodgement occurs. A sensor patch put as an adhesive over the venous needle puncture site connected to an alarm unit by an optic fiber has been clinically tested in 5 dialysis departments. A small amount of blood on the sensor activates a light and sound alarm. A simple questionnaire was filled out by the nurses at each dialysis concerning their feeling of safety when the new device was used. Forty‐one patients, mean age 65 years, have tested the new safety device. Two hundred test dialyses were studied, after exclusion of 13 tests. One hundred seventy‐nine tests reacted positively on blood. In another 6 dialyses, a warning light appeared on the alarm unit indicating a failure in the sensor patch. Thus, the alarm functioned in 92.5% of all tests. After a small modification of the sensor patches there were only 2 dialyses (2/71) without an activated alarm on blood, i.e., 97.2% positive alarm reactions. The answers of the nurses indicated that they had an increased feeling of safety when using the new safety device, with a mean value of 3.4 points on a visual scale from 0 to 5 where 5 meant very much increased safety. In a situation when the dialysis monitors today do not react on bleedings from venous needle dislodgements, the new alarm safety device fulfils a known shortage in routine dialysis safety. In situations where supervision during a dialysis session may be insufficient as, for example, in home hemodialysis and self‐care dialysis or in other situations when the patient is sleeping, the device may be life saving.
Clinical correlates and treatment of bone/joint pain and difficulty with sexual arousal in patients on maintenance hemodialysis
Authors: CARREON Myra , FRIED Linda F. , PALEVSKY Paul M. , KIMMEL Paul L. , ARNOLD Robert M. , WEISBORD Steven D. 
Published: April 2008

AbstractBone/joint pain and difficulty with sexual arousal are prevalent, frequently severe, and potentially treatable in patients on maintenance hemodialysis. However, the mediators and adequacy of treatment for these symptoms have been less well studied. We sought to assess the clinical correlates and treatment of these symptoms in patients receiving chronic hemodialysis. Using the Dialysis Symptom Index, we assessed the presence and severity of bone/joint pain and difficulty with sexual arousal in 75 patients on chronic hemodialysis. Associations of demographic and clinical variables with these 2 symptoms were assessed. We also recorded the use of analgesics for bone/joint pain and, among men, phosphodiesterase‐5 inhibitors for difficulty with sexual arousal. Twenty‐eight patients (37%) reported bone/joint pain, of whom 20 (71%) described it as moderate to severe. Nineteen of 50 male patients (38%) reported difficulty with sexual arousal, which was described as moderate to severe by 15 (79%). Patients' demographic and clinical characteristics were not correlated with bone/joint pain. Among men, there were no correlations between patients' demographic and clinical characteristics and difficulty with sexual arousal. Only 48% of patients with bone/joint pain were receiving analgesics, while 21% of men who described difficulty with sexual arousal were receiving phosphodiesterase‐5 inhibitors. Demographic, clinical, and dialysis‐related variables are poorly correlated with bone/joint pain and difficulty with sexual arousal. However, these symptoms are prevalent and under‐treated, which should spur efforts to assess the impact of improving provider assessment and treatment of these symptoms on patient outcomes, including health‐related quality of life.
Is Blastocystis hominis a new etiologic factor or a coincidence in iron deficiency anemia?
Authors: Yavasoglu Irfan , Kadikoylu Gurhan , Uysal Hilal , Ertug Sema , Bolaman Zahit 
Published: April 2008

AbstractIron deficiency anemia (IDA) is a frequent health problem. Gut parasites such as N. americanus and A. duodenale are known to cause blood loss, but the role of Blastocystis hominis is uncertain. In this study, 212 patients (193 female, 19 male, mean age 41 SD 15 yrs) with IDA were enrolled and 90 persons without IDA (78 female, 12 male, mean age 45 SD 17 yrs). Microscopic examination of stools for B. hominis using the native lugol method was done three times on each subject. If any specimen contained five or more cysts per ×400 field, the person was considered positive. B. hominis was found in 48 out of 212 subjects with IDA (22.6%) and in five of 90 (5.6%) subjects without IDA. This difference is highly statistically significant (P < 0.001). Few subjects had other gut parasites and there was no statistical difference in the ir frequencies between IDA and non‐IDA subjects. Blastocystis hominis may play a role in the development of IDA either on its own or in conjunction with some other agent.
Excellent prognosis and prevalence of HCV infection of primary hepatic and splenic non‐Hodgkin’s lymphoma
Authors: De Renzo Amalia , Perna Fabiana , Persico Marcello , Notaro Rosario , Mainolfi Ciro , De Sio Ilario , Ciancia Giuseppe , Picardi Marco , Del Vecchio Luigi , Pane Fabrizio , Rotoli Bruno 
Published: April 2008

AbstractBackground:  Primary Hepatic (PHL) and Primary Splenic (PSL) non‐Hodgkin’s Lymphoma are rare entities. Small series of PHL and PSL have been reported, suggesting a non‐fortuitous association with Hepatitis C Virus (HCV) infection. The prognosis is believed to be dismal, with early recurrence and short survival.Patients:  We retrospectively reviewed all PHL and PSL patients diagnosed at our institution between 1990 and 2005.Results:  Twenty‐five adult patients were identified, six with PHL and 19 with PSL. Twenty‐four patients had a B‐cell lymphoma, defined as Diffuse Large B‐cell lymphoma in 18. The prevalence of HCV infection was 68% among PSL and 66% among PHL. Combination chemotherapy was the mainstay of treatment for PHL and PSL; all but one patient with PSL underwent splenectomy before chemotherapy. Complete remission was achieved in all the cases after frontline therapy; only four patients relapsed but responded to additional chemotherapy courses. Most patients presented with aggressive histological subtypes; 92% were alive at a median follow up of 79 months. HCV infection did not appear to influence the results of therapy.Conclusion:  Our study confirms the rarity of PHL and PSL, shows a high prevalence of HCV infection, and demonstrates that the outcome of patients with PHL and PSL may be favourable.
Screening of glucose/insulin metabolic alterations in men with multiple skin tags on the neck
Authors: Sudy Emilio , Urbina Francisco , Maliqueo Manuel , Sir Teresa 
Published: April 2008

SummaryMultiple skin tags appear associated with abnormalities in glucose/insulin metabolism. Clinical and metabolic glucose/insulin characteristics of men with multiple (8 or more) skin tags on the neck were compared with a control group with few or none. Both groups were divided in two subgroups according to normal or abnormal laboratory findings. In the study subgroup with normal laboratory findings the number of skin tags varied from 8–33, whereas in those with abnormal laboratory findings the range was 9–65. Eight or more skin tags were related with statistically significant laboratory glucose/insulin abnormalities: basal hyperinsulinemia (p<0.002), postprandial hyperinsulinemia (p<0.003), and postprandial hyperglycemia (p<0.01). In the multiple skin tag group 77 % had diverse laboratory abnormalities, including insulin resistance, basal hyperinsulinemia, postprandial hyperinsulinemia, glucose intolerance or type 2 diabetes, in contrast with the control group, where only 33 % showed laboratory abnormalities. One‐third of the study group had acanthosis nigricans. Only 15 % of patients with metabolic abnormalities did not show any cutaneous expression of glucose/insulin alterations (9 or more skin tags on the neck, acanthosis nigricans, or waist circumference greater than 95 cm). Multiple skin tags were more sensitive than acanthosis nigricans in identifying those with alterations in the glucose/insulin metabolism (77 vs. 32 % respectively), although less specific (68 vs.100%). Multiple skin tags should raise suspicion of insulin resistance or hyperinsulinemia.
The Importance of Location for Tobacco Cessation: Rural–Urban Disparities in Quit Success in Underserved West Virginia Counties
Authors: Northridge Mary E. , Vallone Donna , Xiao Haijun , Green Molly , Blackwood Julia Weikle , Kemper Suzanne E. , Duke Jennifer , Watson Kimberly A. , Burrus Barri , Treadwell Henrie M. 
Published: April 2008

ABSTRACT:
Context:

Adults who live in rural areas of the United States have among the highest smoking rates in the country. Rural populations, including Appalachian adults, have been historically underserved by tobacco control programs and policies and little is known about their effectiveness. Purpose: To examine the end‐of‐class quit success of participants in A Tobacco Cessation Project for Disadvantaged West Virginia Communities by place of residence (rural West Virginia and the urban area of Greater Charleston). Methods: This collaborative program was implemented in 5 underserved rural counties in West Virginia and consisted of 4 intervention approaches: (1) a medical examination; (2) an 8‐session educational and behavioral modification program; (3) an 8‐week supply of pharmacotherapy; and (4) follow‐up support group meetings. Findings: Of the 725 program participants, 385 (53.1%) had successfully quit using tobacco at the last group cessation class they attended. Participants who lived in rural West Virginia counties had a lower end‐of‐class quit success rate than those who lived in the urban area of Greater Charleston (unadjusted odds ratio [OR]= 0.69, 95% confidence interval [CI]= 0.48, 0.99), even after taking into account other characteristics known to influence quit success (adjusted OR = 0.58, 95% CI = 0.35, 0.94). Conclusions: Tobacco control programs in rural West Virginia would do well to build upon the positive aspects of rural life while addressing the infrastructure and economic needs of the region. End‐of‐class quit success may usefully be viewed as a stage on the continuum of change toward long‐term quit success.
Vital Signs Screening for Alcohol Misuse in a Rural Primary Care Clinic: A Feasibility Study
Authors: Seale J. Paul , Guyinn Monique R. , Matthews Michael , Okosun Ike , Dent M. Marie 
Published: April 2008

ABSTRACT:
Context: Alcohol misuse is more common in rural areas, and rural problem drinkers are less likely to seek alcohol treatment services. Rural clinics face unique challenges to implementing routine alcohol screening and intervention. Purpose: To assess the feasibility of using the single alcohol screening question (SASQ) during routine nursing vital signs in a rural clinic, and to determine its effect on alcohol screening and intervention rates. Methods: Patient exit interviews were used to identify alcohol misuse and to measure changes in screening and intervention rates. Chi‐square tests were used to compare rates of screening across study phases, while odds ratios from logistic regression analyses were used to quantify association between nurse screening and clinician intervention. Findings: Exit interviews were completed by 126 current drinkers (41 before vital signs screening implementation and 85 afterward). Screening rates for alcohol misuse rose from 14.6% at baseline to 20.0% (P = .027) after screening implementation. Clinician intervention rates among alcohol misusers rose from 6.3% to 11.8% (P = .039). Nurse screening increased the odds of clinician intervention (OR 1.47; 95% CI 1.10‐1.95). Conclusions: Vital signs screening proved to be feasible in this rural clinic and produced modest but significant increases in alcohol screening by nurses and brief interventions by clinicians. Additional studies are needed to define effective strategies for further increasing these rates.