bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences with acute kidney injury complicating non‐fulminant hepatitis A
Authors: KIM HYUN W , YU MI H , LEE JANG H , CHANG JAI W , YANG WON S , KIM SOON B , LEE SANG K , PARK JUNG S , PARK SU‐KIL 
Published: June 2008

SUMMARY:Aim:  To describe the clinical features and to identify factors related to development of acute kidney injury in acute hepatitis A patients.Methods:  The study and control groups consisted of 21 and 425 patients who did or did not develop acute kidney injury, respectively, after acute hepatitis A from January 1997 to May 2007.Results:  There were 13 men and eight women; their mean age at diagnosis was 28.8 ± 8.2 years in the study group. Peak values for renal and liver function impairment consisted of a median serum creatinine of 4.6 mg/dL (range, 1.5–15.3 mg/dL) on day 6 (range, days 1–20) and a median total bilirubin of 10.7 mg/dL (range, 2.6–57.5 mg/dL) on day 8 (range, day 1–19). Serum creatinine concentrations returned to baseline level by a median of 16 days and total bilirubin levels returned to normal by a median of 62 days. Six of 21 (29%) patient underwent haemodialysis. Renal biopsies performed in two patients showed acute tubular necrosis and interstitial nephritis, respectively. Logistic regression analysis showed that a lower haematocrit, the presence of coagulopathy and high C‐reactive protein concentration on admission, and higher peak bilirubin value during the illness were associated with development of acute kidney injury.Conclusion:  Acute hepatitis A should be considered in the differential diagnosis of patients with acute kidney injury, even without fulminant hepatic failure. A lower haematocrit, the presence of coagulopathy and high C‐reactive protein level at presentation, and higher peak bilirubin level during the illness were associated with development of acute kidney injury in acute hepatitis A patients.
Chloroplast DNA content in Dinophysis (Dinophyceae) from different cell cycle stages is consistent with kleptoplasty
Authors: Minnhagen Susanna , Carvalho Wanderson F. , Salomon Paulo S. , Janson Sven 
Published: June 2008

SummaryKleptoplasty is the retention of plastids obtained from ingested algal prey, which can remain temporarily functional and be used for photosynthesis by the predator. With a new approach based on cell cycle analysis, we have addressed the question of whether the toxic, bloom‐forming dinoflagellate Dinophysis norvegica practice kleptoplasty or if they replicate their own plastid DNA. Dividing (G2) and non‐dividing (G1) D. norvegica cells from a natural population were physically separated with a flow cytometer based on their DNA content. Average numbers of nuclear and plastid rDNA copies were quantified with real‐time PCR both in the G1 and G2 group. Cells from the G1 group contained 5800 ± 340 copies of nuclear rDNA and 1300 ± 200 copies of plastid rDNA; cells from the G2 group contained 9700 ± 58 copies of nuclear rDNA and 1400 ± 220 copies of plastid rDNA (mean ± SD, n = 3). The ratio G2/G1 in average rDNA copies per cell was 1.67 for nuclear DNA and 1.07 for plastid DNA. These ratios show that plastid acquisition in D. norvegica is either uncoupled with the cell cycle, or plastids accumulate rapidly in the beginning of the cell cycle owing to feeding, as would be expected in a protist with kleptoplastic behaviour but not in a protist with own plastid replication. In addition, flow cytometry measurements on cells from the same population used for real‐time PCR showed that when kept without plastidic prey, live Dinophysis cells lost on average 36% of their plastid phycoerythrin fluorescence in 24 h. Together these findings strongly suggest that D. norvegica does not possess the ability for plastid replication.
Endoscopic haemostasis of staple‐line haemorrhage following colorectal resection
Authors: Malik A. H. , East J. E. , Buchanan G. N. , Kennedy R. H. 
Published: June 2008

AbstractObjective  Bleeding from stapled colonic stapled anastomoses is rare, but occasionally may be severe enough to require re‐operation, with associated morbidity. Endoscopic therapy is a potential alternative.Method  We examined a large 15‐year prospective series of patients who had undergone colorectal resection with stapled anastomosis. We reviewed the management of cases where severe postoperative rectal bleeding had occurred.Results  In six of 777 (0.8%) patients, bleeding occurred that was severe enough to require intervention. In the first three cases, conventional re‐operation was performed. In the latter three cases, endoscopic therapy (adrenaline injection, diathermy or endoscopic clipping) was used to control the bleeding. No complications occurred as a result of endoscopic therapy, either patient or anastomosis related.Conclusion  Endoscopic management using standard endoscopic techniques appears safe and effective for haemostasis in colorectal stapled anastomotic bleeding. Endoscopic therapy should probably be attempted before re‐operation is considered.
Family history of diabetes impacts on interactions between minimal model estimates of insulin sensitivity and glucose effectiveness
Authors: Lopez X. , Bouché C. , Tatro E. , Goldfine A. B. 
Published: June 2008

Aims/hypothesis:  Insulin resistance and glucose effectiveness (SG) are major determinants of glucose tolerance and independently predict the development of type 2 diabetes in individuals with a family history of disease. We examined the inter‐relationship between insulin sensitivity (SI) and SG in offspring of two parents with type 2 diabetes and in individuals with no family history of diabetes.Methods:  Fifty non‐diabetic individuals, including 26 offspring of two type 2 diabetic parents (family history, FH+) and 24 with no family history of diabetes (FH−) similar in gender, age, ethnicity and body mass index (BMI) were studied. Each subject underwent a 100‐g oral glucose tolerance test (OGTT) and insulin modified frequently sampled intravenous glucose tolerance, analysed using the Bergman’s minimal model (MINMOD).Results:  Thirteen subjects of the FH+ group and nine of the FH− group had impaired glucose tolerance (IGT). SI and SG were independent variables in the FH+ group, while they correlated highly with each other in the FH− group (r = 0.69, p = 0.0002). The relationship between SI and SG persisted when analysing the IGT and normal glucose tolerance subgroups separately, demonstrating that these associations were not because of differences in glycaemia. Consistently, SG strongly correlated with additional measures of insulin resistance only in the FH− group, including fasting insulin (r = 0.56, p = 0.004), homeostasis model assessment of insulin resistance (r = 0.57 p = 0.003) and BMI (r = 0.66, p = 0.0004).Conclusions:  These results demonstrate that familial factors impart important physiological differences in the inter‐relationship between insulin‐dependent and insulin‐independent glucose disposal, which may be important in modulating risk for development of disease.
Expenditure on diabetes treatments and achievement of glycaemic control: retrospective analysis
Authors: Eaton S. , Brent S. , Shah N. , Masters G. 
Published: June 2008

AbstractAims  To establish if a relationship exists between the prescribing costs of diabetes treatments and the achievement of Quality and Outcome Framework DM6 standards of glycaemic control.Methods  A retrospective cross‐sectional study of all 92 primary care organizations in the north of England comparing net ingredient cost of diabetes treatments, corrected for diabetic population, with the percentage of patients achieving HbA1c < 7.4% (Quality and Outcome Framework DM6 indicator).Results  The overall net ingredient cost for diabetes treatments varies from £225 to £382 per person per year. On regression analysis, expenditure on all diabetes treatments, on glitazones or on blood glucose test strips have no significant impact upon the percentage of people achieving an HbA1c < 7.4%. There is an inverse relationship between spending on analogue insulins and target achievement (r = −0.08, P = 0.001).Conclusions  At primary care organization level, there is no association between weighted expenditure on diabetes treatments and achievement of glycaemic control targets. Although there are limitations to what can be inferred from analyses of this type, these data support a judicious and carefully directed approach to the use of newer, more expensive treatments until clear evidence of added benefit is forthcoming.
Outcomes of pregnancies in women with pre‐gestational diabetes mellitus and gestational diabetes mellitus; a population‐based study in New South Wales, Australia, 1998–2002
Authors: Shand A. W. , Bell J. C. , McElduff A. , Morris J. , Roberts C. L. 
Published: June 2008

AbstractAim  To determine population‐based rates and outcomes of pre‐gestational diabetes mellitus (pre‐GDM) and gestational diabetes mellitus (GDM) in pregnancy.Methods  This was a cross‐sectional study, using linked population databases, of all women, and their infants, discharged from hospital following birth in New South Wales (NSW) between 1 July 1998 and 31 December 2002. Women with, and infants exposed to pre‐GDM or GDM were compared with those without diabetes mellitus for pregnancy characteristics and outcomes.Results  Women with a singleton pregnancy (n = 370 703) and their infants were included: 1248 women (0.3%) had pre‐GDM and 17 128 (4.5%) had GDM. Of those women with pre‐GDM, 57% had Type 1 diabetes, 20% had Type 2 diabetes and for 23% the type of diabetes was unknown. Major maternal morbidity or mortality was more common in women with pre‐GDM (7.9%) [odds ratio (OR) 3.2, 95% confidence interval (CI) 2.6, 3.9] and in women with GDM (3.1%) (OR 1.2, 95% CI 1.1, 1.4) when compared with women without diabetes (2.6%). Major infant morbidity or mortality occurred more frequently in infants exposed to pre‐GDM compared with no diabetes (13.6% vs. 3.1%) (OR 5.0, 95% CI 4.2, 5.8) and in infants exposed to GDM compared with no diabetes (3.2% vs. 2.3%) (OR 1.4, 95% CI 1.3, 1.5).Conclusions  Pre‐GDM and GDM continue to be associated with an increased risk of adverse maternal and neonatal outcomes; however, women with GDM have adverse outcomes less frequently. Rates of GDM and pre‐GDM appear to be increasing over time. Clinicians should consider the potential for adverse outcomes, and arrange referral to appropriate services.
Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale Study, a prospective cohort study
Authors: Prompers L. , Huijberts M. , Apelqvist J. , Jude E. , Piaggesi A. , Bakker K. , Edmonds M. , Holstein P. , Jirkovska A. , Mauricio D. , Tennvall G. R. , Reike H. , Spraul M. , Uccioli L. , Urbancic V. , Van Acker K. , Van Baal J. , Van Merode F. , Schaper N. 
Published: June 2008

AbstractAims  To determine current management and to identify patient‐related factors and barriers that influence management strategies in diabetic foot disease.Methods  The Eurodiale Study is a prospective cohort study of 1232 consecutive individuals presenting with a new diabetic foot ulcer in 14 centres across Europe. We determined the use of management strategies: referral, use of offloading, vascular imaging and revascularization.Results  Twenty‐seven percent of the patients had been treated for > 3 months before referral to a foot clinic. This varied considerably between countries (6–55%). At study entry, 77% of the patients had no or inadequate offloading. During follow‐up, casting was used in 35% (0–68%) of the plantar fore‐ or midfoot ulcers. Predictors of use of casting were male gender, large ulcer size and being employed. Vascular imaging was performed in 56% (14–86%) of patients with severe limb ischaemia; revascularization was performed in 43%. Predictors of use of vascular imaging were the presence of infection and ischaemic rest pain.Conclusion  Treatment of many patients is not in line with current guidelines and there are large differences between countries and centres. Our data suggest that current guidelines are too general and that healthcare organizational barriers and personal beliefs result in underuse of recommended therapies. Action should be undertaken to overcome these barriers and to guarantee the delivery of optimal care for the many individuals with diabetic foot disease.
Small‐fibre involvement in diabetic patients with neuropathic foot pain
Authors: Vlckova‐Moravcova E. , Bednarik J. , Belobradkova J. , Sommer C. 
Published: June 2008

AbstractAims  To assess small‐fibre involvement in diabetic patients with neuropathic pain.Methods  Peripheral nerve function was assessed in 30 patients with Type 2 diabetes mellitus (T2DM, n = 24) or impaired glucose tolerance (IGT, n = 6), and clinical symptoms of neuropathic pain in the feet, using nerve conduction studies, autonomic tests, thermal quantitative sensory testing (T‐QST) and quantification of intra‐ and subepidermal nerve fibre densities in skin punch biopsies.Results  Clinical signs of isolated small‐fibre sensory involvement were present in 13 patients [pure small‐fibre neuropathy (pSFN)], seven patients had isolated positive sensory symptoms without neurological deficits (pSFN–). Ten patients had concomitant electrophysiological and/or clinical signs of large‐fibre sensory involvement [mixed‐fibre neuropathy (MFN)]. Twenty‐seven patients (90%) had both reduced skin innervation and abnormalities of the T‐QST parameters. Two other patients displayed either abnormal skin innervation or T‐QST, and only one patient had normal findings on both tests. The criteria of small‐fibre neuropathy (SFN) were met in all 20 patients without large‐fibre involvement. Small‐fibre involvement was also present in the 10 MFN patients. Both T‐QST and skin biopsy parameters revealed significant differences between these clinical subgroups, with increased severity of small‐fibre involvement in the MFN group. Autonomic dysfunction was found in 43% of patients and did not correlate with either clinical, T‐QST or skin biopsy data.Conclusions  Although the exact mechanism of neuropathic pain in diabetic patients is not known, pain is almost invariably accompanied by small‐fibre dysfunction and pathology irrespective of autonomic or large‐fibre involvement.
Obesity and intermediate clinical outcomes in diabetes: evidence of a differential relationship across ethnic groups
Authors: Millett C. , Khunti K. , Gray J. , Saxena S. , Netuveli G. , Majeed A. 
Published: June 2008

AbstractAim  To examine associations between obesity, ethnicity and intermediate clinical outcomes in diabetes.Methods  Population‐based, cross‐sectional study using electronic primary care medical records of 7300 people with diabetes from White, Black and south Asian ethnic groups.Results  The pattern of obesity differed within ethnic groups, with rates significantly higher in younger when compared to older Black (women, 63% vs. 44%, P = 0.002; men, 37% vs. 20%, P = 0.005) and south Asian (women, 47% vs. 27%, P = 0.01; men, 21% vs. 13%, P = 0.05) people. Obese people with diabetes were significantly less likely to achieve an established target for blood pressure control (adjusted odds ratio 0.50, 95% confidence interval 0.42, 0.59). Differences in mean systolic blood pressure in obese and normal weight persons were significant in the White group but not in the Black groups or south Asian groups (6.9 mmHg, 1.9 mmHg and 2.7 mmHg, respectively). Differences in mean diastolic blood pressure between obese and normal weight persons were 4.8 mmHg, 3.6 mmHg and 3.4 mmHg in the White, Black and south Asian groups. Mean HbA1c and achievement of an established treatment target did not differ significantly with obesity in any ethnic group.Conclusions  Obesity is more prevalent amongst younger people than older people with diabetes in ethnic minority groups. The relationship between obesity and blood pressure control in diabetes differs markedly across ethnic groups. Major efforts must be implemented, especially in young people, to reduce levels of obesity in diabetes and improve long‐term outcomes.
INFORMAL CENTRAL BANK INDEPENDENCE: AN ANALYSIS FOR THREE EUROPEAN COUNTRIES
Authors: Cobham David , Cosci Stefania , Mattesini Fabrizio 
Published: June 2008

ABSTRACTChanges in formal and informal central bank independence (CBI) in France, Italy and the United Kingdom in the period from the mid‐1970s to the 1990s are examined; the major changes occurred in the 1990s, after the disinflations of the 1980s. Broad trends in the informal independence of central banks (CBs), defined as the ability to pursue price stability regardless of the government's preferences, are identified on the basis of a monetary policy narrative and an analysis of a set of qualitative determinants of informal independence. The most important determinants are the social/political acceptance that monetary policy is the sphere of the CB, the existence of anti‐inflationary commitments in the form of intermediate targets for monetary policy, the degree of social consensus on the means and ends of macroeconomic policy, and the relative technical expertise of the CB. These broad trends help to explain some of the inflation experience of the 1980s and 1990s, which cannot be understood in terms of changes to formal CBI.
UNEMPLOYMENT PERSISTENCE AND THE NAIRU: A BAYESIAN APPROACH
Authors: Berger Tino , Everaert Gerdie 
Published: June 2008

ABSTRACTThis paper estimates the United States and euro area NAIRU in a Bayesian framework. We set out a simple structural model explaining unemployment by demand and supply factors, which are treated as unobserved variables that have observable effects on measured unemployment, output and inflation. The model allows for unemployment persistence and a time‐varying core inflation rate. The results show that although cyclical shocks are very persistent, most of the increase in European unemployment is driven by structural factors. The degree of persistence is lower in the United States but demand shocks seem to be more important in explaining variation in unemployment.
THE (IR)RELEVANCE OF THE NRU FOR POLICY MAKING: THE CASE OF DENMARK
Authors: Karanassou Marika , Sala Hector , Salvador Pablo F. 
Published: June 2008

ABSTRACTWe reconsider the central role of the natural rate of unemployment (NRU) in forming policy decisions. We show that the unemployment rate does not gravitate towards the NRU due to frictional growth, a phenomenon that encapsulates the interplay between lagged adjustment processes and growth in dynamic labour market systems. We choose Denmark as the focal point of our empirical analysis and find that the NRU explains only 33% of the unemployment variation, while frictional growth accounts for the remaining 67%. Therefore, our theoretical and empirical findings raise doubts as to whether the NRU should play such a key instrumental role in policy making.
‘You'd Be Good at That’: Gender Patterns in Parent‐Child Talk about Courses
Authors: Tenenbaum Harriet R. 
Published: June 2008

AbstractThis study examined the parent‐child dyad as a context in which children's gender‐stereotyped course selections are reinforced. Fifty four children from two age groups (Ms = 10.67 and 12.71 years) and their mothers and fathers selected courses for when children reached secondary school. Afterwards, children and parents discussed their decisions. Parents of sons selected fewer foreign language courses than mathematics, language arts or science courses, whereas parents of daughters selected fewer science and foreign language than mathematics or language arts courses. Girls selected fewer science than language arts courses, whereas boys selected fewer foreign language than mathematics or science courses. Although parents' course selections followed gender‐stereotyped patterns for language arts and science, their discouraging comments were not confined to cross‐gender‐stereotyped domains. Instead, parents made more discouraging comments in general to daughters than to sons. Counter to the hypotheses, daughters made more encouraging comments about science courses than did sons while talking to mothers. The findings suggest that parents and children may show gender‐differentiated preferences for children before children are old enough to make course decisions.
“Developing Good Taste in Evidence”: Facilitators of and Hindrances to Evidence‐Informed Health Policymaking in State Government
Authors: JEWELL CHRISTOPHER J. , BERO LISA A. 
Published: June 2008

Context: Policymaking is a highly complex process that is often difficult to predict or influence. Most of the scholarship examining the role of research evidence in policymaking has focused narrowly on characteristics of the evidence and the interactions between scientists and government officials. The real‐life context in which policymakers are situated and make decisions also is crucial to the development of evidence‐informed policy. Methods: This qualitative study expands on other studies of research utilization at the state level through interviews with twenty‐eight state legislators and administrators about their real‐life experiences incorporating evidence into policymaking. The interviews were coded inductively into the following categories: (1) the important or controversial issue or problem being addressed, (2) the information that was used, (3) facilitators, and (4) hindrances. Findings: Hindrances to evidence‐informed policymaking included institutional features; characteristics of the evidence supply, such as research quantity, quality, accessibility, and usability; and competing sources of influence, such as interest groups. The policymakers identified a number of facilitators to the use of evidence, including linking research to concrete impacts, costs, and benefits; reframing policy issues to fit the research; training to use evidence‐based skills; and developing research venues and collaborative relationships in order to generate relevant evidence. Conclusions: Certain hindrances to the incorporation of research into policy, like limited budgets, are systemic and not readily altered. However, some of the barriers and facilitators of evidence‐informed health policymaking are amenable to change. Policymakers could benefit from evidence‐based skills training to help them identify and evaluate high‐quality information. Researchers and policymakers thus could collaborate to develop networks for generating and sharing relevant evidence for policy.
State Responses to New Flexibility in Medicaid
Authors: COUGHLIN TERESA A. , ZUCKERMAN STEPHEN 
Published: June 2008

Context: States have long lobbied to be given more flexibility in designing their Medicaid programs, the nation's health insurance program for the low‐income, the elderly, and individuals with disabilities. The Bush administration and the Deficit Reduction Act of 2005 have put in place policies to make it easier to grant states this flexibility. Methods: This article explores trends in states' Medicaid flexibility and discusses some of the implications for the program and its beneficiaries. The article uses government databases to identify the policy changes that have been implemented through waivers and state plan amendments. Findings: Since 2001, more than half the states have changed their Medicaid programs, through either Medicaid waivers or provisions in the Deficit Reduction Act of 2005. These changes are in benefit flexibility, cost sharing, enrollment expansions and caps, privatization, and program financing. Conclusions: With a few important exceptions, these changes have been fairly circumscribed, but despite their expressed interest, states have not yet fully used this flexibility for their Medicaid programs. However, states may exercise this newly available flexibility if, for example, the nation's health care system is not reformed or an economic downturn creates fiscal pressures on states that must be addressed. If this happens, the policies implemented during the Bush administration could lead to profound changes in Medicaid and could be carried out relatively easily.