bluuebunny/crossref_metadata_2025_split huggingface dataset:
Notification of random hyperglycaemia to general practitioners by an emergency medicine team: impact of a simple intervention plan
Authors: Nicholls G. M. , Dissanayake A. M. , Hazell W. 
Published: June 2008

AbstractAim  To determine whether general practitioners (GPs) were being appropriately notified of patients’ elevated random glucose levels by emergency medicine (EM) staff, and to investigate whether two simple interventions improved the notification rate.Methods  Patients were included if their random venous plasma glucose (RVPG) at presentation to the Emergency Department (ED) was ≥ 7.8 mmol/l and if they were discharged directly to their GP. Patients with known impaired glucose metabolism (IGM) were excluded. Patient discharge summaries were reviewed over a 5‐month period before and a 5‐week period after two simple interventions: first, a targeted educational session for EM staff and second, modifications to the automated message accompanying laboratory results.Results  Before intervention, the GPs of 120 out of 178 patients received no notification of an elevated RVPG compared with 23 of 62 patients after intervention (P < 0.00001). Notification met a predefined standard in 25 of 178 patients before, and 34 of 62 patients after intervention (P < 0.01).Conclusions  EM staff education, together with an automated laboratory message, significantly improved the rate and quality of notification of elevated RVPG levels to GPs. These simple measures have the potential to hasten implementation of preventive and therapeutic measures in patients with IGM.
Autosomal dominant transmission of diabetes and congenital hearing impairment secondary to a missense mutation in the WFS1 gene
Authors: Valéro R. , Bannwarth S. , Roman S. , Paquis‐Flucklinger V. , Vialettes B. 
Published: June 2008

AbstractAims  Mutations of the WFS1 gene have been implicated in autosomal dominant diseases, such as low‐frequency sensorineural hearing impairment (LFSNHI) and/or diabetes mellitus and/or optic atrophy. The aim was to investigate WFS1 gene sequences in a family with diabetes mellitus and hearing impairment.Methods  Three members of a family with a maternally inherited combination of diabetes mellitus and hearing impairment, but no specific mutations in its mitochondrial genome, were investigated for mutations in the WFS1 gene.Results  This pedigree, in which the proband had non‐insulin‐dependent diabetes mellitus and congenital hearing impairment and his mother a triple combination of diabetes mellitus, hearing impairment and optic atrophy, was found to be associated with autosomal dominant transmission of the E864K mutation of the WFS1 gene.Conclusions  In the light of this confirmatory study, we recommend the systematic analysis of WFS1 gene sequences in patients with parentally inherited diabetes mellitus and deafness (± optic atrophy), in particular when diabetogenic mtDNA mutations have been excluded.
Continuous rise in incidence of childhood Type 1 diabetes in Germany
Authors: Ehehalt S. , Blumenstock G. , Willasch A. M. , Hub R. , Ranke M. B. , Neu A. ,   for the DIARY‐study Group Baden‐Württemberg
Published: June 2008

AbstractAims  To assess the incidence and the trend in incidence of Type 1 diabetes (T1DM) in children and adolescents < 15 years of age in Baden‐Württemberg (BW), Germany.Methods  BW is Germany's third largest federal state. All 31 paediatric departments in BW and one diabetes centre participated in the study. Case registration was done according to the EURODIAB criteria. The degree of ascertainment was 97.2%.Results  From 1987 to 2003, the age‐ and sex‐standardized incidence rate was 14.1/100 000 per year [95% confidence interval (CI) 13.7, 14.6, n = 4017]. The estimated annual increase in incidence was 3.8% (95% CI 1.1, 6.6). Compared with the first years of our registry, the current mean number of new cases of T1DM has doubled (1987–1989, n = 153; 2000–2003, n = 302). Generally, the highest rise in incidence occurred in the youngest age group of 0–4‐year‐old patients (5.8%; 95% CI 2.5, 9.3), followed by the age groups 5–9 (3.4%; 95% CI 0.8, 6.0) and 10–14 (2.7%; 95% CI 0.3, 5.1).Conclusions  In Germany, the number of children and adolescents with new‐onset T1DM has been rising at a faster pace than expected. A distinct shift to younger age at onset has been observed in Germany.
Disability pension, employment and obesity status: a systematic review
Authors: Neovius K. , Johansson K. , Rössner S. , Neovius M. 
Published: June 2008

SummaryDisability pensions incur huge societal costs in many countries. In Sweden, the three greatest drivers of such productivity losses are musculo‐skeletal, circulatory and psychiatric disorders, all closely associated with weight status. We identified 16 studies investigating the body mass index (BMI)–disability pension relation. In cross‐sectional studies, a significantly greater proportion of obese compared with normal weight subjects were disability pensioners. In longitudinal studies, a J‐shaped relation with BMI was generally found in both men and women of various ages. Different definitions of obesity status complicated interpretation, as several studies mixed the underweight and normal weight, which appear to have different disability pension risks. In middle‐aged men, relative risks were elevated for circulatory causes only for the overweight and obese, while associations for mental disorders were similar in the underweight and overweight but much higher in the obese. In both sexes, monotonic increases and decreases were seen for circulatory and respiratory causes respectively. In intervention studies, reduced disability pension incidence and increased gainful employment were reported after surgery. In summary, BMI was significantly associated with disability pension, but the direction of causality may vary with underlying cause. Interventions had positive productivity effects in the morbidly obese, but whether this holds for the overweight remains to be proven.
INTEREST RATE RULES AND WELFARE IN OPEN ECONOMIES
Authors: Senay Ozge 
Published: June 2008

ABSTRACTThis paper analyses the welfare performance of a set of five alternative interest rate rules in an open economy stochastic dynamic general equilibrium model with nominal rigidities. A rule with a lagged interest rate term, high feedback on inflation and low feedback on output is found to yield the highest welfare for a small open economy. This result is robust across different degrees of openness, different sources of home and foreign shocks, alternative foreign monetary rules and different specifications for price‐setting behaviour. The same rule emerges as both the Nash and cooperative equilibria in a two‐country version of the model.
BIASED TECHNOLOGICAL SHOCKS, RELATIVE WAGE RIGIDITIES AND LOW‐SKILLED UNEMPLOYMENT
Authors: Pierrard Olivier , Sneessens Henri R. 
Published: June 2008

ABSTRACTThe contrast between the evolution over the last decades of the European Union (EU) and the US unemployment rates, especially for the low‐skilled, is well known. A consensus view is that these different outcomes can be explained by the interactions between common shocks and specific institutional setups. In this paper, we emphasize the interactions between technological changes and wages rigidities. We construct a fully calibrated general equilibrium model with two types of jobs and two types of workers, and with search unemployment. Our simulations show that with wage rigidities, technological changes suffice to generate a continuous rise in the low‐skilled unemployment rate and an almost unchanged high‐skilled unemployment rate. Without wage rigidities, the unemployment rates remain unchanged but the wage dispersion widens.
OVERINVESTMENT IN TEAM SPORTS LEAGUES: A CONTEST THEORY MODEL
Authors: Dietl Helmut M. , Franck Egon , Lang Markus 
Published: June 2008

ABSTRACTThis paper applies contest theory to provide an integrated framework of a team sports league and analyzes the competitive interaction between clubs. We show that dissipation of the league revenue arises from ‘overinvestment’ in playing talent as a direct consequence of the ruinous competitive interaction between clubs. This overinvestment problem increases if the discriminatory power of the contest function increases, revenue‐sharing decreases, and the size of an additional exogenous prize increases. We further show that clubs invest more when they play in an open league compared with a closed league. Moreover, the overinvestment problem within open leagues increases with the revenue differential between leagues.
Connecting with Parents: Mothers' Depressive Symptoms and Responsive Behaviors in the Regulation of Social Contact by One‐ and Young Two‐year‐olds
Authors: Dix Theodore , Cheng Nina , Day William H. 
Published: June 2008

AbstractWhen children act to involve mothers in positive interaction, they influence the amount, timing, and content of parent–child exchanges. By assessing children's smiling and positive initiation, we examined child behaviors that function to create positive interaction. In a non‐clinical North American sample of 103 mothers and their 14‐ to 27‐month‐olds, we observed that children attempted to connect positively with mothers (1) more with age, (2) more frequently and quickly immediately after mothers were responsive, (3) more with mothers who were generally supportive, and (4) more with mothers low in depressive symptoms. When mothers were high in depressive symptoms, age‐related increases in smiling and positive initiation were absent. Findings demonstrate the importance of maternal depression and responsiveness to child behaviors that involve mothers in ongoing activity. They suggest that both immediate cues and children's stored knowledge related to how mothers will respond may regulate children's positive connecting behaviors.
A Plan for Action: Key Perspectives from the Racial/Ethnic Disparities Strategy Forum
Authors: KING RODERICK K. , GREEN ALEXANDER R. , TAN‐McGRORY ASWITA , DONAHUE ELIZABETH J. , KIMBROUGH‐SUGICK JESSIE , BETANCOURT JOSEPH R. 
Published: June 2008

Context: Racial and ethnic disparities in health care in the United States have been well documented, with research largely focusing on describing the problem rather than identifying the best practices or proven strategies to address it. Methods: In 2006, the Disparities Solutions Center convened a one‐and‐a‐half‐day Strategy Forum composed of twenty experts from the fields of racial/ethnic disparities in health care, quality improvement, implementation research, and organizational excellence, with the goal of deciding on innovative action items and adoption strategies to address disparities. The forum used the Results Based Facilitation model, and several key recommendations emerged. Findings: The forum's participants concluded that to identify and effectively address racial/ethnic disparities in health care, health care organizations should: (1) collect race and ethnicity data on patients or enrollees in a routine and standardized fashion; (2) implement tools to measure and monitor for disparities in care; (3) develop quality improvement strategies to address disparities; (4) secure the support of leadership; (5) use incentives to address disparities; and (6) create a messaging and communication strategy for these efforts. This article also discusses these recommendations in the context of both current efforts to address racial and ethnic disparities in health care and barriers to progress. Conclusions: The Strategy Forum's participants concluded that health care organizations needed a multifaceted plan of action to address racial and ethnic disparities in health care. Although the ideas offered are not necessarily new, the discussion of their practical development and implementation should make them more useful.
Population Causes and Consequences of Leading Chronic Diseases: A Comparative Analysis of Prevailing Explanations
Authors: STUCKLER DAVID 
Published: June 2008

Context: The mortality numbers and rates of chronic disease are rising faster in developing than in developed countries. This article compares prevailing explanations of population chronic disease trends with theoretical and empirical models of population chronic disease epidemiology and assesses some economic consequences of the growth of chronic diseases in developing countries based on the experiences of developed countries. Methods: Four decades of male mortality rates of cardiovascular and chronic noncommunicable diseases were regressed on changes in and levels of country income per capita, market integration, foreign direct investment, urbanization rates, and population aging in fifty‐six countries for which comparative data were available. Neoclassical economic growth models were used to estimate the effect of the mortality rates of chronic noncommunicable diseases on economic growth in high‐income OECD countries. Findings: Processes of economic growth, market integration, foreign direct investment, and urbanization were significant determinants of long‐term changes in mortality rates of heart disease and chronic noncommunicable disease, and the observed relationships with these social and economic factors were roughly three times stronger than the relationships with the population's aging. In low‐income countries, higher levels of country income per capita, population urbanization, foreign direct investment, and market integration were associated with greater mortality rates of heart disease and chronic noncommunicable disease, less increased or sometimes reduced rates in middle‐income countries, and decreased rates in high‐income countries. Each 10 percent increase in the working‐age mortality rates of chronic noncommunicable disease decreased economic growth rates by close to a half percent. Conclusions: Macrosocial and macroeconomic forces are major determinants of population rises in chronic disease mortality, and some prevailing demographic explanations, such as population aging, are incomplete on methodological, empirical, and policy grounds. Rising chronic disease mortality rates will significantly reduce economic growth in developing countries and further widen the health and economic gap between the developed and developing world.
Universal ureteral stent placement at hysterectomy to identify ureteral injury: a decision analysis
Authors: Schimpf MO , Gottenger EE , Wagner JR 
Published: June 2008

Objective  Iatrogenic ureteral injury during gynaecological surgery is associated with increased morbidity when not diagnosed during the initial surgery. Preoperative insertion of ureteral catheters may enhance intraoperative recognition of injury and repair, but it is controversial. We sought to analyse the costs of this approach.Design/setting/population  A decision‐tree analysis of clinical scenarios of using universal ureteral catheterisation compared with no catheterisation was conducted for benign abdominal hysterectomy and radical hysterectomy.Methods  Diagnostic‐Related Groups and Current Procedural Terminology coding and reimbursement information were used as calculated for Medicare patients in the USA.Main outcome measures  Differences in projections of total hospital‐related costs related to clinical scenarios of perioperative care for women undergoing hysterectomy with or without ureteral catheterisation.Results  Universal ureteral catheterisation is cost saving when the rate of ureteral injury during benign abdominal hysterectomy or radical hysterectomy is greater than 3.2%.Conclusions  The cost savings of universal ureteral catheterisation at hysterectomy depend on the injury rate but are minimal at common levels of injury.
Reducing multiple pregnancy in assisted reproduction technology: towards a policy of single blastocyst transfer in younger women
Authors: Kalu E , Thum M‐Y , Abdalla H 
Published: June 2008

Objectives  To investigate the effects of single blastocyst transfer (SBT) on live birth and multiple pregnancy in women undergoing in vitro fertilisation (IVF).Design  Descriptive cohort study.Setting  A London private IVF/postgraduate training unit.Sample  A total of 700 fresh and 102 frozen blastocyst cycles performed between January 2005 and December 2006.Methods  Young women aged 25–37 years and those aged 38–43 years were further divided into those who had SBT and those who received two blastocysts (double blastocyst transfer [DBT]). Live birth and multiple pregnancy rates were compared between groups. Cumulative live birth was compared between women who had DBT and those who received a SBT followed by a frozen blastocyst if the fresh cycle was unsuccessful.Main outcome measures  Live birth rate, cumulative live birth rate, multiple pregnancy rate, uptake of SBT.Results  Among women aged 25–37 years, live birth rate following SBT was 59.0 versus 60.7% following DBT. The twin pregnancy rate in this group was 2.3 and 47.6% respectively. For women aged 38–43 years, live birth following SBT was 29.4% and multiple pregnancy rate was 33.3%. DBT in older women gave a higher live birth rate (44.3%) and a multiple pregnancy rate of 36.4%. Cumulative live birth following SBT in women aged 25–37 years was 72.8% versus 60.5% following DBT. Among the women aged 38–43 years, cumulative live birth was higher (63.3%) following DBT versus 28.6% following SBT.Conclusion  Single blastocyst transfer followed by transfer of a frozen blastocyst if the preceding fresh cycle was unsuccessful resulted in a better cumulative live birth and lower twin pregnancy in young women. In older women, two fresh blastocysts gave better results than one fresh followed by a frozen cycle. Older women should have the option of replacing two fresh blastocysts as this optimises their chances of taking home a baby.
Maternal temperature during labour
Authors: Schouten FD , Wolf H , Smit BJ , Bekedam DJ , De Vos R , Wahlen I 
Published: June 2008

Objective  The aim of this study was to describe the variation of normal maternal temperature during labour.Design  A prospective cohort study.Setting  Two hospitals in Amsterdam, the Netherlands.Population  All women with a live singleton pregnancy and a gestational age of 36 weeks or more admitted to the delivery ward from June 2000 to January 2002.Methods  Maternal temperature was measured rectally every 2–3 hours from admission until the beginning of second stage, and 1‐hour postpartum. Normal labour (n = 843) was defined as gestational age ≥37 weeks, spontaneous onset of labour, rupture of membranes <18 hours before birth, normal progress of labour without the need for augmentation or epidural analgesia and spontaneous vaginal delivery of a healthy infant. The remaining group was classified as abnormal (n = 2209).Main outcome measures  Rectal measured temperature in degrees Celsius.Results  The mean temperature during labour in the complete study population increased from 37.1°C at the beginning of labour to 37.4°C after 22 hours. Temperature in the abnormal labour group was equal to the normal labour group during the first 3 hours of labour (P > 0.05) but increased thereafter.Conclusions  At the beginning of labour, temperature was 37.1°C. Temperature increased slowly during labour and was 37.4°C (2SD 1.2) after 22 hours. The upper 2SD limit for normal temperature did not follow a circadian pattern and time of day is not relevant for the classification of normal versus elevated temperature.
The use of JJ stent in the management of deep endometriosis lesion, affecting or potentially affecting the ureter: a review of our practice
Authors: Weingertner AS , Rodriguez B , Ziane A , Gibon E , Thoma V , Osario F , Haddad C , Wattiez A 
Published: June 2008

Objective  With the increasing number of operative laparoscopies performed for the treatment of deep pelvic endometriosis, technical difficulties and risk of complications inevitably increase. We report our experience using JJ stents, in women treated for deep pelvic endometriosis, with regard to prevention and management of ureteral lesions.Design  Descriptive retrospective analysis between March 2004 and March 2007.Setting  Department of Obstetrics and Gynaecology, University Hospital, Strasbourg, France.Population and methods  Cases of women who underwent laparoscopic surgery for severe endometriosis and who needed a JJ stent in their management were recorded. Laparoscopic surgery was performed at the Department of Obstetrics and Gynaecology at CMCO‐SIHCUS and Hautepierre Hospitals, Strasbourg, which are referral centres in the treatment of deep endometriosis.Main outcome measures  To evaluate the contribution of JJ stent in the prevention and management of ureteral lesions from endometriotic origin and/or iatrogenic origin in women treated for deep pelvic endometriosis.Results  A total of 145 women had surgery for deep pelvic endometriosis. Seventeen (11.7%) women had a JJ ureteral stent inserted. In 82.4% of women, the stent was inserted pre‐ or peroperatively. We noted three ureteral complications, of which only one needed management by laparotomy.Conclusions  Except in extreme cases, management of ureteral endometriosis should be performed laparoscopically. Ureteral lesions whether iatrogenic, or secondary to endometriotic disease, can be treated by cystoscopy, JJ stent and laparoscopy. The combination of these three elements is the optimal management and is unlikely to cause subsequent complications. Laparotomy and its associated morbidity should be avoided.
Insulin blocks cytochrome c release in the reperfused brain through PI3‐K signaling and by promoting Bax/Bcl‐XL binding
Authors: Sanderson Thomas H. , Kumar Rita , Sullivan Jonathon M. , Krause Gary S. 
Published: June 2008

AbstractThe critical event of the intrinsic pathway of apoptosis following transient global brain ischemia is the release of cytochrome c from the mitochondria. In vitro studies have shown that insulin can signal specifically via phosphatidylinositol‐3‐OH‐kinase (PI3‐K) and Akt to prevent cytochrome c release. Therefore, insulin may exert its neuroprotective effects during brain reperfusion by blocking cytochrome c release. We hypothesized that insulin acts through PI3‐K, Akt, and Bcl‐2 family proteins to inhibit cytochrome c release following transient global brain ischemia. We found that a single bolus of insulin given immediately upon reperfusion inhibited cytochrome c release for at least 24 h, and produced a fivefold improvement in neuronal survival at 14 days. Moreover, insulin’s ability to inhibit cytochrome c release was completely dependent on PI3‐K signaling and insulin induces phosphorylation of Akt through PI3‐K. In untreated animals, there was an increase in mitochondrial Bax at 6 h of reperfusion, and Bax binding to Bcl‐XL was disrupted at the mitochondria. Insulin prevented both these events in a PI3‐K‐dependent manner. In summary, insulin regulates cytochrome c release through PI3‐K likely by activating Akt, promoting the binding between Bax and Bcl‐XL, and by preventing Bax translocation to the mitochondria.