bluuebunny/crossref_metadata_2025_split huggingface dataset:
A treatment decision aid may increase patient trust in the diabetes specialist. The Statin Choice randomized trial
Authors: Nannenga Michael R. , Montori Victor M. , Weymiller Audrey J. , Smith Steven A. , Christianson Teresa J. H. , Bryant Sandra C. , Gafni Amiram , Charles Cathy , Mullan Rebecca J. , Jones Lesley A. , Bolona Enrique R. , Guyatt Gordon H. 
Published: February 2009

AbstractAims  Decision aids in practice may affect patient trust in the clinician, a requirement for optimal diabetes care. We sought to determine the impact of a decision aid to help patients with diabetes decide about statins (Statin Choice) on patients’ trust in the clinician.Methods  We randomized 16 diabetologists and 98 patients with type 2 diabetes referred to a subspecialty diabetes clinic to use the Statin Choice decision aid or a patient pamphlet about dyslipidaemia, and then to receive these materials from either the clinician during the visit or a researcher prior to the visit. Providers and patients were blinded to the study hypothesis. Immediately after the clinical encounter, patients completed a survey including questions on trust (range 0 to total trust = 100), knowledge, and decisional conflict. Researchers reviewed videotaped encounters and assessed patient participation (using the OPTION scale) and visit length.Results  Overall mean trust score was 91 (median 97.2, IQR 86, 100). After adjustment for patient characteristics, results suggested greater total trust (trust = 100) with the decision aid [odds ratio (OR) 1.77, 95% CI 0.94, 3.35]. Total trust was associated with knowledge (for each additional knowledge point, OR 1.3, 95% CI 1.1, 1.6), patient participation (for each additional point in the OPTION scale, OR 1.1, 95% CI 1.1, 1.2), and decisional conflict (for every 5‐point decrease in conflict, OR 1.5, 95% CI 1.2, 1.9). Total trust was not associated with visit length, which the decision aid did not significantly affect. There was no significant effect interaction across the trial factors.Conclusions  Preliminary evidence suggests that decision aids do not have a large negative impact on trust in the physician and may increase trust through improvements in the decision‐making process.
Lay perceptions of the desired role and type of user involvement in clinical governance
Authors: Litva Andrea , Canvin Krysia , Shepherd Michael , Jacoby Ann , Gabbay Mark 
Published: February 2009

AbstractObjective  The aim of this paper is to explore variations in lay perceptions of user involvement in clinical governance.Context  The English National Health Service has sought to build a dependable health service through enhanced effectiveness, responsiveness and consistency. Clinical governance, a policy for improving service quality, is a key pillar of these reforms. It is a statutory duty of primary care organizations to ensure that users are involved in all service planning and decision making, including clinical governance. Yet surveys indicated that user involvement in clinical governance was underdeveloped and underutilized.Design  Focus groups were conducted with different types of lay people to explore their perceptions around public involvement in different aspects of clinical governance policy.Results  Content analysis of the transcripts reveals that different groups of lay people varied in their desired role perspective and preferred type of involvement in different aspects of clinical governance policy. Drawing upon existing models of user involvement, we identified three role perspectives that lay people could take in user involvement – consumer, advocate and citizen. We compared our findings regarding the desired type of involvement with existing models of user involvement, and identified a new type of involvement, overseeing, that is relevant to clinical governance policy.Conclusions  These findings suggest that to facilitate user involvement in clinical governance, it would be necessary to use different strategies to accommodate the differing role perspectives and types of involvement desired by different groups of lay people.
Drug‐specific in vitro release of IL‐2, IL‐5, IL‐13 and IFN‐γ in patients with delayed‐type drug hypersensitivity
Authors: Lochmatter P. , Beeler A. , Kawabata T. T. , Gerber B. O. , Pichler W. J. 
Published: February 2009

Background:  The most prevalent drug hypersensitivity reactions are T‐cell mediated. The only established in vitro test for detecting T‐cell sensitization to drugs is the lymphocyte transformation test, which is of limited practicability. To find an alternative in vitro method to detect drug‐sensitized T cells, we screened the in vitro secretion of 17 cytokines/chemokines by peripheral blood mononuclear cells (PBMC) of patients with well‐documented drug allergies, in order to identify the most promising cytokines/chemokines for detection of T‐cell sensitization to drugs.Methods:  Peripheral blood mononuclear cell of 10 patients, five allergic to β‐lactams and five to sulfanilamides, and of five healthy controls were incubated for 3 days with the drug antigen. Cytokine concentrations were measured in the supernatants using commercially available 17‐plex bead‐based immunoassay kits.Results:  Among the 17 cytokines/chemokines analysed, interleukin‐2 (IL‐2), IL‐5, IL‐13 and interferon‐γ (IFN‐γ) secretion in response to the drugs were significantly increased in patients when compared with healthy controls. No difference in cytokine secretion patterns between sulfonamide‐ and β‐lactam‐reactive PBMC could be observed. The secretion of other cytokines/chemokines showed a high variability among patients.Conclusion:  The measurement of IL‐2, IL‐5, IL‐13 or IFN‐γ or a combination thereof might be a useful in vitro tool for detection of T‐cell sensitization to drugs. Secretion of these cytokines seems independent of the type of drug antigen and the phenotype of the drug reaction. A study including a higher number of patients and controls will be needed to determine the exact sensitivity and specificity of this test.
Neuroticism, extraversion, stressful life events and asthma: a cohort study of middle‐aged adults
Authors: Loerbroks A. , Apfelbacher C. J. , Thayer J. F. , Debling D. , Stürmer T. 
Published: February 2009

Background:  Stressful life events can trigger asthma exacerbations, but could also contribute to the development of incident asthma. However, only few studies have investigated the association between stressful life events and adult asthma prospectively. Likewise, stress‐related personality traits (e.g. neuroticism and extraversion) may increase asthma risk, but this has been examined in only one prospective study. We therefore aimed to investigate the association between neuroticism, extraversion, stressful life events and incident asthma.Methods:  A population‐based sample of 5114 middle‐aged adults completed questionnaires between 1992 and 1995. Among those alive in 2002/2003, 4010 (83%) were followed‐up by questionnaires. Exposures of interest included neuroticism, extraversion and three stressful life events (unemployment, having broken off a life partnership and death of a close person). Associations with incident asthma were estimated by multivariable risk ratios (RR) and 95% confidence intervals (95% CI) using Poisson regression.Results:  High vs low neuroticism predisposed to developing asthma (RR = 3.07, 95% CI = 1.71–5.48), but high extraversion did not (RR = 1.30, 95% CI = 0.79–2.15). Having broken off a life partnership significantly increased asthma risk (RR = 2.24, 95% CI = 1.20–4.21) in contrast to death of a close person (RR = 1.06, 95% CI = 0.64–1.75) or unemployment (RR = 1.65, 95% CI = 0.72–3.78).Conclusions:  High levels of neuroticism may increase the risk of asthma in middle‐aged adults. Having broken off a life partnership was the only stressful event, which was associated with incident asthma. Synthesized with evidence from earlier studies, this could reflect that interpersonal conflicts may increase asthma risk, possibly along an immunological pathway.
Associations of β2‐adrenergic receptor genotypes and haplotypes with wheezing illness in Taiwanese schoolchildren
Authors: Lee Y.‐L. , Wang S.‐T. , Tsai C.‐H. , Guo Y. L. 
Published: February 2009

Background: Increasing attention was focused on the β2‐adrenergic receptor gene (ADRB2), whose genetic variability has been implicated as a risk factor for asthma‐related phenotypes. However, only a few studies reported the associations by utilizing haplotypic approaches. We therefore examined the relationship of childhood wheezing illness with polymorphisms at codons 16 and 27, and evaluated the influence of polymorphisms individually and in combination as haplotypes.Methods: We conducted a genetic case–control study comprising 215 wheezing children and 183 nonwheezing controls, all of whom were selected from 2524 fourth‐ to ninth‐grade schoolchildren in southern Taiwan.Results: All participants were homozygous at the ADRB2 Thr164 locus. After controlling for possible confounders, ADRB2 Glu27 allele was significantly associated with wheezing illness in all genetic models, but the risks on Arg16Gly genotypes were inconclusive. Estimated frequencies for the three main hyplotypes were Arg16/Gln27 57.2%, Gly16/Gln27 35.3%, Gly16/Glu27 7.4% in wheezing children, and Arg16/Gln27 56.3%, Gly16/Gln27 32.2%, Gly16/Glu27 10.4% in controls. The protective effect of Gly16/Glu27 haplotype remained relative to all other ADRB2 haplotypes [adjusted relative risk (aRR) = 0.58; 95% confidence interval (CI) 0.35–0.97]. As compared with children without Gly16/Glu27 haplotype, those with Gly16/Glu27 haplotype had a significantly lower risk for wheezing illness (aRR = 0.56; 95% CI 0.33–0.99). The copy numbers of Gly16/Glu27 haplotype also showed a clear dose‐response relationship on the decreased risks. No significant association was found with the prevalence of wheezing illness for other haplotypes.Conclusion: We concluded that ADRB2 Glu27 allele and Gly16/Glu27 haplotype were significantly protective factors for wheezing illness in Taiwanese schoolchildren.
Inbreeding, energy use and condition
Authors: KETOLA T. , KOTIAHO J. S. 
Published: February 2009

AbstractIn energetic terms, fitness may be seen to be dependent on successful allocation of energy between life‐history traits. In addition, fitness will be constrained by the energy allocation ability, which has also been defined as condition. We suggest here that the allocation ability, estimated as the difference between total energy budget and maintenance metabolism, may be used as a measure of condition. We studied this possibility by measuring the resting metabolic rate and metabolism during forced exercise in Gryllodes sigillatus crickets. To verify that these metabolic traits are closely related to fitness, we experimentally manipulated the degree of inbreeding of individuals belonging to the same pedigree, hence enabling analysis of both inbreeding depression and heritability of traits. We found that inbreeding increased maintenance metabolism, whereas total energy budget was rather insensitive to inbreeding. Despite this, inbreeding led to decreased allocation ability. Overall, metabolic traits exhibited strong inbreeding depression and rather low heritabilities, a pattern that is typical of traits under strong selection. However, traditionally used condition indices were not affected by inbreeding and did not covary with metabolic traits. Moreover, in contrast to the common, but largely untested, tenet, it seems that high resting metabolic rate is indicative of low rather than high quality.
Division of labour within flowers: heteranthery, a floral strategy to reconcile contrasting pollen fates
Authors: VALLEJO‐MARÍN M. , MANSON J. S. , THOMSON J. D. , BARRETT S. C. H. 
Published: February 2009

AbstractIn many nectarless flowering plants, pollen serves as both the carrier of male gametes and as food for pollinators. This can generate an evolutionary conflict if the use of pollen as food by pollinators reduces the number of gametes available for cross‐fertilization. Heteranthery, the production of two or more stamen types by individual flowers reduces this conflict by allowing different stamens to specialize in ‘pollinating’ and ‘feeding’ functions. We used experimental studies ofSolanum rostratum(Solanaceae) and theoretical models to investigate this ‘division of labour’ hypothesis. Flight cage experiments with pollinating bumble bees (Bombus impatiens) demonstrated that although feeding anthers are preferentially manipulated by bees, pollinating anthers export more pollen to other flowers. Evolutionary stability analysis of a model of pollination by pollen consumers indicated that heteranthery evolves when bees consume more pollen than should optimally be exchanged for visitation services, particularly when pollinators adjust their visitation according to the amount of pollen collected.
Body shape evolution among ploidy levels of the Squalius alburnoides hybrid complex (Teleostei, Cyprinidae)
Authors: CUNHA C. , BASTIR M. , COELHO M. M. , DOADRIO I. 
Published: February 2009

AbstractHybridization, ploidy level and genomic constitution may be important to respond to different environments, by producing different phenotypes and thus reducing competitive interaction. Through geometric morphometrics, we examined variation in body size and shape among biotypes of the Squalius alburnoides hybrid complex and their sperm donor (Squalius carolitertii). Results showed that S. carolitertii is significantly larger in size than the biotypes of the complex. No significant relationship was observed between ploidy and body size among S. alburnoides biotypes. Significant variation in body shape was found between S. carolitertii and S. alburnoides, and between tetraploids and the other biotypes. These differences in biotypes may reduce resource competition, highlighting the potential importance of resource availability favouring one biotype over another. In S. alburnoides, the adaptation to different trophic niches through modification of trophic morphology, body shapes, and feeding behaviour, may result from an increase in ploidy and genomic constitution. This adaptation may account also for the formation and maintenance of this nonsexual complex.
Detecting defects in conifers with ground penetrating radar: applications and challenges
Authors: Butnor J. R , Pruyn M. L. , Shaw D. C. , Harmon M. E. , Mucciardi A. N. , Ryan M. G. 
Published: February 2009

SummaryOur objective was to test ground penetrating radar (GPR) to non‐destructively estimate decay volumes in living coniferous trees. GPR is geophysical tool which uses an antenna to propagate short bursts of electromagnetic energy in solid materials and measure the two‐way travel time and amplitude of reflected signals. We compared estimates of bole decay from data collected with a SIR 3000 GPR system equipped with a 900 MHz antenna to measurements of decay from stem cross sections and increment cores for three conifer species (Pseudotsuga menziesii, Thuja plicata and Tsuga heterophylla). We found that near‐surface decay, air‐filled voids and desiccated boles had unique electromagnetic signatures, which could be separated from other defects. GPR successfully estimated the percent area of air‐filled cavities and was not significantly different than results from destructive sampling. However, separation of incipient to severe decay from benign reflectors (e.g. moisture gradient between sapwood and heartwood) in conifers was much less diagnostic than with angiosperms. A limited assessment of Acer saccharum showed that GPR has potential to detect defects in angiosperms; however, more research is needed to outline the full range of detectable defects. Based on the trees in this study, the potential for GPR to detect decay‐related defects in conifers seems limited. Despite problems detecting decay, reflections originating from the sapwood : heartwood boundary may prove useful to determine thickness of functional sapwood in conifers, but accurate quantification will require further technical development.
Assessing the impacts and potential control of terrestrial plant colonization of a reservoir bed during an extreme drawdown event
Authors: Boulding A. , Baldwin D. S. 
Published: February 2009

AbstractExtended periods of drawdown of reservoirs can result in the ‘terrestrialization’ of the lake bottom sediments, which describes the process whereby the exposed dry sediment takes on soil‐like qualities. Opportunistic colonization of lake bed by terrestrial plants can occur under such conditions. A survey of plant communities of a large reservoir (Lake Hume) following its extreme drawdown, resulted in significant quantities of carbon, nitrogen and phosphorus being bound up in the terrestrial vegetation that colonized the lake bed. The phosphorus uptake from the sediment into plant material particularly could represent a significant pathway for phosphorus re‐mobilization back into the lake. The potential of using stock grazing as a control measure for mitigating the effects of terrestrial plant colonization is also discussed.
A preliminary hydrosedimentary view of a highly turbid, tropical, manmade lake: Cointzio Reservoir (Michoacán, Mexico)
Authors: Anne‐Sophie Susperregui , Nicolas Gratiot , Michel Esteves , Christian Prat 
Published: February 2009

AbstractThis study represents the first limnological assessment of Cointzio Reservoir (Michoacán, Mexico). A full three‐dimensional scan of temperature, conductivity and turbidity was done for the reservoir during two field surveys at the end of the 2005 rainy season (December 2005), and before the beginning of the next season (May 2006). These parameters also were measured continuously during the 2006 rainy season. Analysis of data within the context of local climate trends at a multidecadal scale indicates the reservoir can amplify seasonal features because of its morphometric properties. Between June to December, the reservoir behaved as a fluvial system, exhibiting a rapid, efficient mixing of the water column. Between January to May, the reservoir developed substantial stratification, and exhibited typical lacustrine characteristics. These alternate phases of fluvial and lacustrine regimes, associated with a high water turbidity throughout the year (Secchi depth of ≈0.2 m) contributes to stress on this aquatic ecosystem.
Microbial processes at the land–water interface, and cross‐domain causal relationships, as influenced by atmospheric deposition of pollutants in three freshwater lakes in India
Authors: Pandey Jitendra , Pandey Usha 
Published: February 2009

AbstractThe effects of long‐term atmospheric deposition of pollutant elements on the trans‐surface causative relationships at three lake sites having different catchment characteristics were investigated in this study. The selected determinants included lake productivity, bottom sediment quality, and a suite of microbial variables (microbial biomass (Cmic); basal respiration; substrate‐induced respiration; bacterial:fungal ratio; metabolic quotient; and alkaline phosphatase and FDAase activities) measured at the land–water interface, in relation to atmospheric deposition of phosphate; nitrate; ammonium; sulphate; calcium; and magnesium. The results indicated significant between‐site differences (P < 0.001) in the atmospheric deposition of phosphate (0.21–1.96 kg.h−1.year−1); nitrate (2.77–28.05 kg.h−1.year−1); ammonium (0.58–11.60 kg.h−1.year−1); sulphate (5.64–32.15 kg.h−1.year−1); calcium (4.50–30.00 kg.h−1.year−1); and magnesium (1.50–12.15 kg.h−1.year−1), as well as a consistently increasing input of these ions across time. The catchment vegetation had important effects on microbial variables that, in turn, affected lake productivity. Interfaces of woodland lake were found to be rich in phenolics, supporting low Cmic and activities. Except for alkaline phosphatase, which declined over time, atmospheric deposition of pollutant elements increased the Cmic and activities at the land–water interface. The time lag correlation analysis indicated the Cmic and lake productivity relationships were significantly altered by atmospherically driven nitrogen and phosphorus inputs, with a time lag of 2–3 years. Despite being supportive, aerial nutrient inputs appeared to have a destabilizing effect on both, microbial biomass and lake productivity variables. These observations indicate that if present atmospheric deposition trends of pollutant elements continue, it will modify the cross‐domain causative relationships of inland lentic systems over the long term. These study results are relevant for the formulation of strategies for managing freshwater tropical lakes.
Spatial and seasonal variations in phytoplankton community structure in alkaline–saline Lake Nakuru, Kenya
Authors: Okoth Oyoo Elijah , Mucai Muchiri , Shivoga Wiliam A. , Miller Scott N. , Rasowo Joseph , Ngugi Charles Chege 
Published: February 2009

AbstractSpatial and seasonal variations of phytoplankton, expressed in terms of species composition, cell density, biovolumes and biomass, collected at 10 sampling sites in alkaline–saline Lake Nakuru, Kenya, were investigated monthly from March 2004 to February 2005, in relation to selected physical and chemical water quality parameters. A total of eight species, belonging to five genera and three classes, were recorded. The Cyanophyceae comprised the bulk of the phytoplankton, followed by Euglenophyceae, while Bacillariophyceae were the least abundant. Arthrospira fusiformis was the most dominant species, in terms of density, among the Cyanophyceae, while Euglena spp. and Navicula elkabs dominated the Euglenophyceae and Bacillariophyceae density, respectively. Seasonal variations in phytoplankton species composition, density and biomass were significant (P < 0.05) with minimum cell density and biomass occurring during the dry season, and being maximum following the end of the two rainy seasons from May to November 2004, suggesting the possible influence of various environmental factors on the lake. Sampling sites located close to the inlets of inflowing rivers exhibited significantly (P < 0.05) higher phytoplankton cell density and biomass than those by the inshore sites. Soluble reactive phosphorus, ammonia‐nitrogen, conductivity and total alkalinity accounted for most of the variations in the cell densities of phytoplankton species.
Review of 120 anal cancer patients
Authors: Young S. C. , Solomon M. J. , Hruby G. , Frizelle F. A. 
Published: February 2009

AbstractObjective  Chemoradiotherapy is the mainstay of treatment for the majority of patients with anal cancer, with abdominoperineal resection reserved for salvage. The purpose of this study was to evaluate our results after radiotherapy with or without chemotherapy, and/or surgery in terms of overall survival and colostomy free survival in patients with anal cancer.Method  A review of patients diagnosed with anal cancer between 1991 and 2004 was performed. The principle end‐points of the study were overall and colostomy‐free survival.Results  One hundred and twenty patients were identified. The T stage distribution was T1 32, T2 44, T3 19, T4 17 and TX 8. Eighteen patients had clinically involved regional nodes. Eighty patients received radiotherapy as a component of their treatment. Twenty‐four of the 80 patients had a colostomy. The most common late toxicity was faecal incontinence. The overall survival and colostomy‐free survival rates for all 120 patients were 58% and 79% at 5 years, respectively. For the 80 patients who received radiotherapy, the corresponding figures were 66% and 82% at 5 years, respectively.Conclusion  Chemoradiation is effective organ preserving treatment for anal cancer. Grade 1 and 2 faecal incontinence is a relatively common late toxicity experienced by patients.