bluuebunny/crossref_metadata_2025_split huggingface dataset:
Innovative rural and remote primary health care models: What do we know and what are the research priorities?
Authors: Wakerman John 
Published: January 2009

Abstract This paper examines the literature pertaining to ‘innovative’ primary health care models in rural and remote areas in order to identify areas where knowledge is lacking and describes future research priorities. Although a number of reviews have identified successful primary health care models and synthesised principles that help to understand why they are successful, there is generally a dearth of rigorously collected information regarding rural and remote health service delivery. The evidence base that supports the superiority of any one model or models in a given context is thin because of the lack of systematic, policy‐informing evaluation of primary care innovations. The paper identifies the need for more rigorous health services evaluation information, including examination of optimal financing systems, the optimal range and mix of providers, and supports for team practice, appropriate community participation mechanisms, improved health information systems and relevant performance indicators.
Multidisciplinary management of complex care
Authors: Schofield Deborah , Fuller Jeffrey , Wagner Scott , Friis Leanne , Tyrell Bill 
Published: January 2009

Abstract Rural and remote areas of Australia are facing serious health workforce shortages. Multidisciplinary teams are one way of making the most of the rural workforce. In this paper, the advantages of multidisciplinary care in terms of patient outcomes, clinician satisfaction and system efficiency are considered with reference to an innovative rural multidisciplinary model that highlights how these positive outcomes can be achieved. Ways of developing the capacity of the future workforce for work in multidisciplinary teams are discussed.
Rural–urban disparities in health: How does Canada fare and how does Canada compare with Australia?
Authors: Pong Raymond W. , DesMeules Marie , Lagacé Claudia 
Published: January 2009

AbstractObjective:  To analyse rural–urban and intra‐rural disparities in health status in Canada and to compare Canada with Australia with respect to such disparities. Design:  Four indicators were used to show rural–urban and intra‐rural differences in health status: (i) mortality due to circulatory diseases, (ii) mortality due to cancer, (iii) injury‐related mortality; and (iv) all‐cause mortality. Rural was disaggregated into finer categories based on degree of remoteness, using the Metropolitan Influence Zone classification in Canada and the Accessibility/Remoteness Index of Australia. Comparisons were made using age‐standardised mortality rates and standardised mortality ratios. Participants:  Rural and urban populations of Canada and Australia. Results:  The study confirmed previous findings that rural Canadians tended to have poorer health status than their urban counterparts. However, when rural was disaggregated into finer categories, different health status patterns emerged. Although the most rural areas tended to have the worst health status, the least rural areas generally enjoyed good health. The Canada–Australia comparisons revealed convergence and divergence. Conclusions:  The similarities between Canada and Australia show that rural–urban disparities in health status are not limited to a particular country. For several causes of death, whereas the mortality risks in Rural 1 areas in Canada are significantly lower than in urban areas, the opposite is true in Australia, suggesting that although there are some common patterns across the two countries in relation to rural–urban health status disparities, nation‐specific uniqueness is to be expected.
High prevalence of vitamin D deficiency in north Indian adults is exacerbated in those with chronic kidney disease
Authors: JABBAR ZULFIKAR , AGGARWAL PARDEEP K , CHANDEL NIRUPAMA , KOHLI HARBIR S , GUPTA KRISHAN L , SAKHUJA VINAY , JHA VIVEKANAND 
Published: January 2009

SUMMARYAim:  Vitamin D is being increasingly recognized as an important player in disease. Hypovitaminosis D is widespread in chronic kidney disease (CKD) populations around the world. The vitamin D status of Indian CKD patients is not known.Methods:  Levels of 25(OH) vitamin D and parathyroid hormone (PTH) were measured in adult north Indian male patients with newly diagnosed stage IV–V CKD and matched control subjects drawn from the same population. A total of 100 (34 stage IV and 66 stage V) patients with CKD and 72 controls were studied.Results:  Only 4% control and 1% of CKD subjects had normal (>30 ng/mL) vitamin D levels. Approximately 68% of control and 77% of the CKD population had vitamin D deficiency (<15 ng/ml) whereas the remaining 38% control and 22% CKD patients had insufficient (15–30 ng/mL) vitamin D levels. Levels were lower in CKD subjects compared to their family members, and the CKD patients were significantly more likely to have severe vitamin D deficiency (<5 ng/mL). A strong negative correlation was noted between vitamin D and PTH. No significant correlation was found between vitamin D levels and body mass index, bodyfat percentage, serum albumin or calcium levels.Conclusion:  Vitamin D deficiency is highly prevalent in north Indians, and this is more pronounced in CKD subjects. There is a significant inverse correlation between the vitamin D and PTH levels. The clinical significance of this deficiency and the potential benefits to be derived from vitamin D supplementation in this population merits further studies.
Clinical outcome of tumor recurrence for Ta, T1 non‐muscle invasive bladder cancer from the data on registered bladder cancer patients in Japan: 1999–2001 report from the Japanese Urological Association
Authors: Kikuchi Eiji , Fujimoto Hiroyuki , Mizutani Yoichi , Okajima Eijiro , Koga Hiroshi , Hinotsu Shiro , Shinohara Nobuo , Oya Mototsugu , Miki Tsuneharu ,   the Cancer Registration Committee of the Japanese Urological Association
Published: January 2009

Objective:  To characterize the clinical outcome in a large contemporary series of Japanese patients with newly diagnosed Ta, T1 non‐muscle invasive bladder cancer who underwent transurethral bladder tumor resection with or without intravesical chemotherapy or Bacillus Calmette‐Guérin (BCG) therapy.Methods:  We developed a database incorporating newly diagnosed non‐muscle invasive bladder cancer data and outcomes from a Japanese bladder cancer registry between 1999 and 2001 and identified a study population of 3237 consecutive patients who had complete data based on pathological features. Median patient age was 69.9 years.Results:  The 1‐year, 3‐year, and 5‐year overall recurrence‐free survival rates were 77.0%, 61.3%, and 52.8%, respectively. In multivariate analyses, the multiplicity of bladder tumors, tumor size greater than 3 cm, pathological stage T1, tumor grade G3, and the absence of adjuvant intravesical instillation were independent risk factors for tumor recurrence. Overall, 1710 patients (52.8%) received intravesical instillation; chemotherapy in 1314 (76.8%) and BCG treatment in 396 (23.2%). In patients treated with intravesical chemotherapy in which an anthracycline chemo‐agent was used in 90.5% of the cases, multivariate analyses demonstrated that male gender, multiple bladder tumors, a tumor size greater than 3 cm, and pathological stage T1 were associated with tumor recurrence.Conclusions:  The accumulation and analysis of data from the Japanese National Bladder Cancer Registry made it possible to determine the clinical characteristics, management trends, and survival rates for the period studied. Further study with a dataset created from longer follow‐up data would be warranted to analyze tumor progression and disease survival.
Psychometric validation of the Japanese version of the International Consultation on Incontinence Questionnaire‐Short Form
Authors: Gotoh Momokazu , Homma Yukio , Funahashi Yasuhito , Matsukawa Yoshihisa , Kato Masashi 
Published: January 2009

Objective:  To evaluate the psychometric properties of the Japanese version of the International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF).Methods:  Two study samples of 180 patients with urinary incontinence were used for this psychometric evaluation. Analyses were carried out to examine the instrument's reliability and validity, as well as its responsiveness to change.Results:  For the ICIQ‐SF items and total scores, there was no particular floor or ceiling effect. The internal consistency was sufficiently high, with a Cronbach's alpha coefficient of 0.78. In the analysis of test‐retest reliability, high correlations were observed, with Kappa coefficients of 0.61 for item 1 and 0.62 for item 2, and with intra‐class correlation coefficients of 0.90 for item 3 and 0.91 for the total score. For the concurrent validity, the ICIQ‐SF scores were moderately to highly correlated with most of the King's Health Questionnaire (KHQ) subscales. When the severity groups, divided in quartiles, were compared with respect to the 1‐h pad test and the number of daily incontinence episodes, there seemed to be linear trends in most of the ICIQ‐SF scores. For responsiveness, changes in the ICIQ‐SF after treatment demonstrated statistically significant correlations of more than 0.5 with changes in some of the KHQ subscale scores. All of the ICIQ‐SF items and total scores significantly decreased after treatment.Conclusions:  The Japanese version of the ICIQ‐SF is a reliable, valid and responsive measure that performs well among patients with urinary incontinence.
Urates in uric acid renal calculi
Authors: Bellanato Juana , Cifuentes José‐Luis Rodríguez‐Miñón , Salvador Esperanza , Medina José‐Antonio 
Published: January 2009

Objectives:  To investigate the presence of calcium urate, sodium, potassium and calcium in ‘pure’ uric acid calculi.Methods:  Ten spontaneously passed uric acid urinary calculi have been examined by stereoscopic microscopy, infrared spectroscopy, scanning electron microscopy and energy dispersive X‐Ray analysis.Results:  The analysis of selected uric acid calculi revealed the presence of a near‐pure calcium urate in two cases and of calcium enriched urate zones in all of the samples. Furthermore, in some cases complex urates containing sodium, potassium and calcium in different proportions appeared on the surface of the uric acid calculi studied, potassium being generally predominant. Ammonium urate was not detected.Conclusions:  Most urinary uric acid calculi are not pure in composition. ‘Complex urates’, sodium, potassium and calcium were found together in various proportions in many areas of uric acid stones.
Clinical pathway for tension‐free vaginal mesh procedure: Evaluation in 300 patients with pelvic organ prolapse
Authors: Kato Kumiko , Suzuki Shoji , Yamamoto Shigeki , Furuhashi Kenichi , Suzuki Koichi , Murase Tatsuro , Gotoh Momokazu 
Published: January 2009

Objectives:  To evaluate a clinical pathway of discharge on postoperative day 3 for the tension‐free vaginal mesh (TVM) procedure in patients with pelvic organ prolapse (POP).Methods:  Between May 2006 and December 2007, 305 consecutive women with POP quantification stage 3 or 4 were planned to undergo the TVM procedure in a single general hospital. Excluding five patients with concomitant hysterectomy, a pathway (removal of the indwelling urethral catheter on the next morning, discharge on postoperative day 3) was applied to the remaining 300 patients. The perioperative complications and postoperative hospitalization were prospectively evaluated in this case series.Results:  Perioperative complications were: bladder injury (11 cases, 3.7%), vaginal wall hematoma (two cases, 0.7%), rectal injury (one case, 0.3%) and temporary hydronephrosis (one case, 0.3%). None needed blood transfusion. The indwelling urethral catheters were removed on the next morning as in the pathway in 287 cases (95.6%), and none required clean intermittent catheterization at home. Postoperative hospitalization was within 3 days in 280 cases (93.3%). The six cases (2.0%) with longer hospitalization were due to complications (two cases of bladder injury, one of rectal injury, one of blood loss over 200 mL, one of temporary urinary retention, and one of hydronephrosis). Two patients were re‐hospitalized within one month due to vaginal bleeding or gluteal pain.Conclusions:  Patients generally accepted the pathway of discharge on postoperative day 3 in spite of the Japanese culture preferring a longer hospital stay.
Pigment dispersion syndrome and pigmentary glaucoma – a major review
Authors: Niyadurupola Nuwan , Broadway David C 
Published: January 2009

AbstractPigment dispersion syndrome (PDS) is an interesting condition that can lead to secondary open angle glaucoma. Pigmentary glaucoma is primarily a disease of young people, myopes and men. PDS is characterized by the presence of Krukenberg spindles, iris trans‐illumination defects, trabecular meshwork pigmentation and backward bowing of the iris. Posterior bowing of the iris causes rubbing of the pigmented iris epithelium against lens structures, liberation of pigment and trabecular meshwork changes that result in reduced aqueous outflow with the risk of glaucoma. Peripheral laser iridotomy can reverse backward bowing of the iris and may prevent progression of pigmentary glaucoma.
Graph models of habitat mosaics
Authors: Urban Dean L. , Minor Emily S. , Treml Eric A. , Schick Robert S. 
Published: January 2009

AbstractGraph theory is a body of mathematics dealing with problems of connectivity, flow, and routing in networks ranging from social groups to computer networks. Recently, network applications have erupted in many fields, and graph models are now being applied in landscape ecology and conservation biology, particularly for applications couched in metapopulation theory. In these applications, graph nodes represent habitat patches or local populations and links indicate functional connections among populations (i.e. via dispersal). Graphs are models of more complicated real systems, and so it is appropriate to review these applications from the perspective of modelling in general. Here we review recent applications of network theory to habitat patches in landscape mosaics. We consider (1) the conceptual model underlying these applications; (2) formalization and implementation of the graph model; (3) model parameterization; (4) model testing, insights, and predictions available through graph analyses; and (5) potential implications for conservation biology and related applications. In general, and for a variety of ecological systems, we find the graph model a remarkably robust framework for applications concerned with habitat connectivity. We close with suggestions for further work on the parameterization and validation of graph models, and point to some promising analytic insights.
Visualization of Pseudomonas genomic structure by abundant 8–14mer oligonucleotides
Authors: Davenport Colin F. , Wiehlmann Lutz , Reva Oleg N. , Tümmler Burkhard 
Published: January 2009

SummaryUnder‐ and over‐represented mono‐ to hexanucleotides are signatures of bacterial genomes, but the compositional biases of octa‐ to tetradecanucleotides have not yet been explored. Thirteen completely sequenced genomes of the Pseudomonas genus were searched for highly overrepresented 8–14mers. Between 59–989 overrepresented 8–14mers were found to exceed the applied threshold value. All genomic data sets of the 13 strains showed a consistent pattern, with individual oligomers clustering in either non‐coding or coding regions. Non‐coding oligonucleotides were typically part of longer repeats. Coding oligonucleotides were evenly distributed in the core genome, preferred one reading frame and matched with the local tetranucleotide usage patterns. Genomic islands were recognized by the depletion of overrepresented oligonucleotides. Several mainly coding 8–14mers occurred in genomes on average every 10 000 bp or less. Such frequently occurring 8–14mers could become useful markers for species identification. In the future of next‐generation ultra‐high throughput DNA sequencing, the composition of bacterial metagenomes may be quantified by scanning the primary sequence reads for these 8–14mer markers.
A second cycle of tamsulosin in patients with distal ureteric stones: a prospective randomized trial
Authors: Porpiglia Francesco , Fiori Cristian , Ghignone Gianpaolo , Vaccino Davide , Billia Michele , Morra Ivano , Ragni Francesca , Scarpa Roberto M. 
Published: January 2009

OBJECTIVETo evaluate, in a prospective randomized pilot study, the effectiveness and safety of tamsulosin, administered in patients with distal ureteric stones and who have already undergone an unsuccessful first cycle of medical expulsive therapy (MET).PATIENTS AND METHODSWe evaluated the effectiveness and safety of tamsulosin, administered as a further therapy, in patients previously unsuccessfully treated with combined expulsive 10‐day therapy (tamsulosin + deflazacort) for distal ureteric stones. Ninety‐one patients were enrolled and randomized into two groups, each receiving a different therapy for 10 days. Group A (46 patients) received a further cycle of tamsulosin (0.4 mg daily), and group B (45) did not. Age, gender, stone size, time to expulsion, number of acute episodes of colic during treatment and analgesic consumption were recorded. Patients who were not stone‐free after the study period had ureteroscopy. The results were compared statistically using Student’s t‐, chi‐square test and Fisher’s exact test.RESULTSThe groups were comparable inage, gender and stone size (5.93 mm for group A and 6.03 mm for group B). The expulsion rate was significantly higher in group A (80%) than in group B (49%) (P < 0.01), whilst there were no differences between the groups in the number of colic episodes and analgesic use. There were no reported side‐effects of medical therapy.CONCLUSIONSA second cycle of 10 days of MET with tamsulosin in nonresponders to a 10‐day first cycle of MET with tamsulosin and deflazacort is safe and effective, and therefore should be considered as an option in the management of uncomplicated distal ureteric stones.
Priming third‐party ostracism increases affiliative imitation in children
Authors: Over Harriet , Carpenter Malinda 
Published: January 2009

Abstract Human beings are intensely social creatures and, as such, devote significant time and energy to creating and maintaining affiliative bonds with group members. Nevertheless, social relations sometimes collapse and individuals experience exclusion from the group. Fortunately for adults, they are able to use behavioral strategies such as mimicry to reduce their social exclusion. Here we test whether children, too, increase their imitation following an experience of ostracism. Given humans’ profound need to belong, we predicted that the mere hint of social exclusion – even third‐party social exclusion – would be sufficient to increase affiliative imitation in 5‐year‐olds. As predicted, children primed with videos in which one shape was ostracized by a group of other shapes subsequently imitated the actions of a model more closely than children in a control condition. These findings highlight just how sensitive humans are to social exclusion and demonstrate that children, like adults, modify their social behavior in response to ostracism.
Articular chondrocytes express connexin 43 hemichannels and P2 receptors – a putative mechanoreceptor complex involving the primary cilium?
Authors: Knight M. M. , McGlashan S. R. , Garcia M. , Jensen C. G. , Poole C. A. 
Published: January 2009

AbstractMechanical loading is essential for the health and homeostasis of articular cartilage, although the fundamental mechanotransduction pathways are unclear. Previous studies have demonstrated that cyclic compression up‐regulates proteoglycan synthesis via an intracellular Ca2+signalling pathway, mediated by the release of ATP. However, the mechanism(s) of ATP release has not been elucidated. The present study examines expression of the putative mechanosensitive ATP‐release channel, connexin 43 and whether it is expressed on the chondrocyte primary cilium, which acts as a mechanosensor in a variety of other cell types. In addition the study characterized the expression of a range of purine receptors through which ATP may activate downstream signalling events controlling cell function. Bovine articular chondrocytes were isolated by sequential enzyme digestion and seeded in agarose constructs. To verify the presence of functional hemichannels, Lucifer yellow (LY) uptake into viable cells was quantified following treatment with a hemichannel agonist (EGTA) and antagonist (flufenamic acid). LY uptake was observed in 45% of chondrocytes, increasing to 83% following EGTA treatment (P < 0.001). Treatment with the hemichannel blocker, flufenamic acid, significantly decreased LY uptake to less than 5% with and without EGTA. Immunofluorescence and confocal microscopy confirmed the presence of primary cilia and the expression of connexin 43. Approximately 50% of bovine chondrocyte primary cilia were decorated with connexin 43. Human chondrocytesin situwithin cartilage explants also expressed connexin 43 hemichannels. However, expression was confined to the upper 200 µm of the tissue closest to the articular surface. Immunofluorescence revealed the expression of a range of P2X and P2Y receptor subtypes within human articular cartilage. In conclusion, the expression of functional hemichannels by articular chondrocytes may represent the mechanism through which mechanical loading activates ATP release as part of a purinergic mechanotransduction pathway. Furthermore, the expression of connexin 43 on the chondrocyte primary cilium suggests the possible involvement of the cilium in this pathway.
Beta‐keratins of turtle shell are glycine‐proline‐tyrosine rich proteins similar to those of crocodilians and birds
Authors: Dalla Valle Luisa , Nardi Alessia , Toni Mattia , Emera Deena , Alibardi Lorenzo 
Published: January 2009

AbstractThis study presents, for the first time, sequences of five beta‐keratin cDNAs from turtle epidermis obtained by means of 5′‐ and 3′‐rapid amplification of cDNA ends (RACE) analyses. The deduced amino acid sequences correspond to distinct glycine‐proline‐serine‐tyrosine rich proteins containing 122–174 amino acids. In situ hybridization shows that beta‐keratin mRNAs are expressed in cells of the differentiating beta‐layers of the shell scutes. Southern blotting analysis reveals that turtle beta‐keratins belong to a well‐conserved multigene family. This result was confirmed by the amplification and sequencing of 13 genomic fragments corresponding to beta‐keratin genes. Like snake, crocodile and avian beta‐keratin genes, turtle beta‐keratins contain an intron that interrupts the 5′‐untranslated region. The length of the intron is variable, ranging from 0.35 to 1.00 kb. One of the sequences obtained from genomic amplifications corresponds to one of the five sequences obtained from cDNA cloning; thus, sequences of a total of 17 turtle beta‐keratins were determined in the present study. The predicted molecular weight of the 17 different deduced proteins range from 11.9 to 17.0 kDa with a predicted isoelectric point of 6.8–8.4; therefore, they are neutral to basic proteins. A central region rich in proline and with beta‐strand conformation shows high conservation with other reptilian and avian beta‐keratins, and it is likely involved in their polymerization. Glycine repeat regions, often containing tyrosine, are localized toward the C‐terminus. Phylogenetic analysis shows that turtle beta‐keratins are more similar to crocodilian and avian beta‐keratins than to those of lizards and snakes.