bluuebunny/crossref_metadata_2025_split huggingface dataset:
GH sensitivity of GH‐deficient adults is dependent on gender but not timing of onset
Authors: Columb Breeda , Smethurst Linda E. , Mukherjee Annice , Jostel Andreas , Shalet Stephen M. , Murray Robert D. 
Published: August 2008

Summary
Background  Females secrete 2–3‐fold greater amounts of GH compared with males despite maintaining similar IGF‐I levels. IGF‐I generation tests in healthy subjects suggest this discordancy results from relative resistance to GH in females. In GHD females the presumed relative insensitivity to GH is reflected by a lower basal IGF‐I and the need for higher GH maintenance doses during replacement. Adults with severe GHD of childhood‐onset (CO) have lower basal IGF‐I SDS and require higher GH maintenance doses compared with adult‐onset (AO) patients with GHD of equal severity. We hypothesised CO‐GHD adults to be less sensitive to GH than AO‐GHD patients.
Methodology  In a single site study we analysed the incremental change in IGF‐I (ΔIGF‐I) in 116 GHD adults following initiation of GH replacement. The data were corrected to provide ΔIGF‐I/mg GH because of slight variances in initial GH dose.
Results  Following GH replacement ΔIGF‐I was 230 ± 245 and 356 ± 278 ng/ml/mg GH in females and males, respectively (P = 0·01). In CO and AO patients ΔIGF‐I was 282 ± 206 and 294 ± 292 ng/ml/mg GH, respectively (P = 0·83). Further analysis after stratification by both gender and timing of onset of GHD showed ΔIGF‐I was 226 ± 164, 324 ± 228, 231 ± 268, and 373 ± 304 ng/ml/mg GH in the CO females, CO males, AO females, and AO males, respectively (AO males vs. AO females, P = 0·03; CO males vs. CO females, P = 0·17; AO males vs. CO males, P > 0·05; AO females vs. CO females, P > 0·05). Multiple linear regression with ΔIGF‐I as the dependent variable and age, gender, BMI, baseline IGF‐I level, and timing of onset as independent variables showed ΔIGF‐I to be dependent on gender alone (R = 0·28, P = 0·004). Age (P = 0·44), BMI (P = 0·54), baseline IGF‐I level (P = 0·63) and timing of onset (P = 0·61) had no effect on ΔIGF‐I.
Conclusion  We have shown gender to have a significant impact on GH sensitivity in GHD adults, which, at least in part, explains differences in maintenance dosages during replacement. None of the additional variables impacted significantly on GH sensitivity. The lower basal IGF‐I SDS and higher GH replacement requirement reported in CO compared with AO patients cannot be explained by differences in sensitivity to GH.
Unplanned readmission within the most recent postoperative year of heart transplant patients in Taiwan
Authors: Huang Su‐Hsia , Wang Shoei‐Shen , Tai John Jen , Lou Meei‐Fang 
Published: August 2008

Aims.  The aim of this study was to examine the rate of unplanned readmissions within the most recent postoperative year for heart transplant patients and the causes and contributing factors leading to such readmissions.Background.  Advances in medical technology have significantly increased the survival rate of heart transplant patients. However, several postoperative complications make it common for patients to be readmitted to hospitals. An ‘unplanned readmission’ rate will better reflect the quality of postdischarge care than will mortality rate alone. Little research has been conducted on the heart transplant population in Taiwan.Design.  Descriptive, cross‐sectional.Methods.  Data were collected from a purposive sample by structured questionnaires and medical record reviews.Results.  Seventy‐one patients were recruited at different times after heart transplantation. The unplanned readmission rate was 35·2% in the most recent postoperative year. The unplanned readmission rate was 52·2% for patients who had received transplantation five years ago or less, which was significantly higher than that for patients who had received transplantation more than five years ago (27·1%). Leading causes of unplanned readmission included infection (31·8%), rejection (25·0%) and cardiac allograft vasculopathy (18·2%). Blood urea nitrogen and creatinine levels were significantly higher in readmitted patients than in patients who were not (t = 2·09, p < 0·05 and t = 2·12, p < 0·05, respectively).Conclusion.  To reduce unplanned readmissions, the health professionals must continuously evaluate and monitor for adverse effects of treatment on patients, providing suitable guidance to equip the patient with the knowledge and ability to manage symptoms appropriately.Relevance to clinical practice.  Continuous postoperative follow‐up should be performed for patients. Nurses can function as the patient’s evaluator, advisor, educator and advocator, to conduct postoperative care and carry out follow‐up plans to prevent readmission.
Does the body temperature change in older people?
Authors: Güneş Ülkü Yapucu , Zaybak Ayten 
Published: August 2008

Aim.  The aim of this study was to determine the mean body temperatures in older people using mercury‐in‐glass thermometer.Background.  Older people are unable to regulate their body temperatures to the same degree as young adults because their responses to changes in body temperature are altered. Several published reports suggest that body temperature decreases with advancing age and has a greater variability in older populations. The aim of this study was to determine the mean body temperatures in older people.Design.  Non‐experimental.Methods.  Axillary body temperatures were taken in 133 older subjects in a nursing home for older people using mercury‐in‐glass thermometer. Temperatures were measured at 8 a.m., 2 p.m., and 6 p.m., over three consecutive days. Each subject had all three measurements taken on the same day.Results.  The mean age of the subjects was 77·2, SD 7·3. In the 133 older subjects, the mean axillary temperatures ranged from 35·1 to 36·4 °C (95·3–97·6 °F). The mean temperatures for those aged 65–74 was higher than in those aged 75–84 (p < 0.001) and those aged 85 and older (p < 0·001) at 6 p.m. but not at 8 a.m. or 2 p.m. We concluded that older people have mean axillary body temperatures lower than the reference point of 36·5 °C (97·7 °F).Relevance to clinical practice.  When assessing body temperature, it is important to take the age of the patient into consideration. Also, the reference point of 36·5 °C is inappropriate in older people, especially when diagnosing a febrile illness.
Incongruence between nurses’ and patients’ understandings and expectations of rehabilitation
Authors: Pryor Julie , O’Connell Beverly 
Published: August 2008

Aims and objectives.  To explore nurses’ understandings and expectations of rehabilitation and nurses’ perceptions of patients’ understandings and expectations of rehabilitation.Background.  Within the context of a broadening appreciation of the benefits of rehabilitation, interest in the nature of rehabilitation is growing. Some believe that rehabilitation services do not adequately meet the needs of patients. Others are interested in the readiness of patients to participate in rehabilitation.Design.  Qualitative.Method.  Grounded theory using data collected during interviews with nurses in five inpatient rehabilitation units and during observation of the nurses’ everyday practice.Findings.  According to nurses working in inpatient rehabilitation units, there is a marked incongruence between nurses’ understandings and expectations of rehabilitation and what they perceive patients to understand and expect.Conclusion.  Given these different understandings, an important nursing role is the education of patients about the nature of rehabilitation and how to optimise their rehabilitation.Relevance to clinical practice.  Before patients are transferred to rehabilitation, the purpose and nature of rehabilitation, in particular the roles of patients and nurses, needs to be explained to them. The understandings of rehabilitation that nurses in this study possessed provide a framework for the design of education materials and orientation programmes that inform patients (and their families) about rehabilitation. In addition, reinforcement of the differences between acute care and rehabilitation will assist patients new to rehabilitation to understand the central role that they themselves can play in their recovery.
An integrative literature review of lifestyle interventions for the prevention of type II diabetes mellitus
Authors: Madden Suzanne G , Loeb Susan J , Smith Carol A 
Published: August 2008

Aims and objectives.  An integrative literature review was undertaken to determine what type II diabetes prevention programmes have been evaluated, what type of programme is the most effective and how adherent to lifestyle changes adults are after participating in a prevention programme.Background.  Type II diabetes is important because the disease is affecting millions of people worldwide. Obesity and sedentary lifestyles are preventable risk factors for type II diabetes, leading many researchers from around the world to examine different programmes that are focussed on prevention of the disease.Design.  Integrative literature review.Method.  Search of electronic databases.Results.  Diet, exercise, counselling and diet plus exercise were the types of prevention programmes, with the diet plus exercise being the most efficacious. Although many studies demonstrated excellent results initially, maintaining the effects of the lifestyle behaviour change proved to be difficult for participants, with only one study demonstrating the persistence of results after six years.Conclusion.  Future research should focus on long‐term maintenance programmes, rather than just short‐term prevention programmes to determine the need for booster interventions or other means to ultimately decrease the incidence of type II diabetes.Relevance to clinical practice.  As front‐line healthcare providers working across a broad array of settings, nurses are particularly well‐suited to play an integral part in future applications of diabetes prevention programmes. Lifestyle interventions are being delivered in a variety of settings and venues such as the workplace, the Internet and places of worship. In addition, at‐risk populations also can be targeted, particularly overweight and obese persons, with at least one parent having type II diabetes or persons with gestational diabetes.
A review of the early discharge experiences of stroke survivors and their carers
Authors: Pringle Jan , Hendry Charles , McLafferty Ella 
Published: August 2008

Aims and objectives.  Understanding the experiences of stroke patients and their carers during the early days following discharge from hospital is an important aspect of providing appropriate care during this crucial time.Background.  Due to the diverse changes that can result from a stroke, adjustment to returning home may raise many issues for those involved. A review of research was undertaken with the aim of identifying what is already known about experiences at this time.Design.  Systematic review.Method.  Search of electronic databases.Results.  The review revealed that recognition of the impact of stroke on patients and carers is improving, with many studies focussing on the longer‐term aspects of stroke recovery. Research into the early discharge experiences of stroke patients and/or their carers is often limited to retrospective, longitudinal studies. With the continuing shift towards care in the community, patients and carers can increasingly expect more recovery to be taking place at home at an even earlier stage. Earlier discharge may have important implications for those involved. The review also highlighted that patients with aphasia have frequently been excluded from stroke research and that social roles are important aspects in stroke recovery.Conclusions.  To prepare patients and carers better for the impact of returning home, further research is needed into their experiences at this significant time, particularly in the UK. There is also a need to facilitate the inclusion of those with aphasia in stroke research.Relevance to clinical practice.  An improved understanding of the issues facing stroke patients and carers during their early days at home should facilitate the preparation for discharge in the hospital setting and allow more focussed follow‐up services in the community.
Screening the risk of falls: a general or a specific instrument?
Authors: Heinze Cornelia , Dassen Theo , Halfens Ruud , Lohrmann Christa 
Published: August 2008

Aims and objectives.  The aim of this study is to investigate if a general instrument (Care Dependency Scale; CDS) has the same sensitivity and specificity as a specific instrument (Hendrich Fall Risk Model; HFRM) in a screening for fall risks.Background.  Falls of older patients are a common problem in hospitals. Apart from falls risk, nurses have to use many assessment tools to detect the patients’ different care problems. To decrease the workload it would be helpful to have a general instrument used as a first screening for possible risks for different healthcare problems, such as falls, instead of specific risk instruments for each individual healthcare problem.Design.  A prospective design was used by measuring each patient upon admission and by registering all falls during their hospital stay.Methods.  The sample consisted of 560 patients of a geriatric hospital in Germany. All of whom gave their informed consent to participate in the study. Nurses filled in the CDS and the HFRM at the time of hospital admission.Results.  The CDS (cut off point ≤54) had a sensitivity of 75% (47/63 fallers) and a specificity of 46% (227/497 non‐fallers). The HFRM (cut off point ≥11) had a sensitivity of 75% (47/63 fallers) and a specificity of 47% (237/497 non‐fallers).Conclusion.  The results of the CDS are similar to those of the HFRM in predicting falls.Relevance to clinical practice.  The use of the CDS is preferred as it is more general and more reliable than the HFRM. The workload for nursing staff can be decreased when only one instrument is used.
Phylogeography and recolonization of the Swiss Alps by the Valais shrew (Sorex antinorii), inferred with autosomal and sex‐specific markers
Authors: YANNIC G , BASSET P , HAUSSER J 
Published: August 2008

AbstractUsing one male‐inherited, one female‐inherited and eight biparentally inherited markers, we investigate the population genetic structure of the Valais shrew (Sorex antinorii) in the Swiss Alps. Bayesian analysis on autosomal microsatellites suggests a clear genetic differentiation between two groups of populations. This geographically based structure is consistent with two separate postglacial recolonization routes of the species into Switzerland from Italian refugia after the last Pleistocene glaciations. Sex‐specific markers also confirm genetic structuring among western and eastern areas, since very few haplotypes for either Y chromosome or mtDNA genome are shared between the two regions. Overall, these results suggest that two already well‐differentiated genetic lineages colonized the Swiss Alps and came into secondary contact in the Rhône Valley. Low level of admixture between the two lineages is likely explained by the mountainous landscape structure of lateral valleys orthogonal to the main Rhône valley.
Protonophore‐ and pH‐insensitive glucose and sucrose accumulation detected by FRET nanosensors in Arabidopsis root tips
Authors: Chaudhuri Bhavna , Hörmann Friederike , Lalonde Sylvie , Brady Siobhan M. , Orlando David A. , Benfey Philip , Frommer Wolf B. 
Published: August 2008

SummaryAlthough soil contains only traces of soluble carbohydrates, plant roots take up glucose and sucrose efficiently when supplied in artificial media. Soluble carbohydrates and other small metabolites found in soil are in part products from exudation from plant roots. The molecular nature of the transporters for uptake and exudation is unknown. Here, fluorescence resonance energy transfer (FRET) glucose and sucrose sensors were used to characterize accumulation and elimination of glucose and sucrose in Arabidopsis roots tips. Using an improved image acquisition set‐up, FRET responses to perfusion with carbohydrates were detectable in roots within less than 10 sec and over a wide concentration range. Accumulation was fully reversible within 10–180 sec after glucose or sucrose had been withdrawn; elimination may be caused by metabolism and/or efflux. The rate of elimination was unaffected by pre‐incubation with high concentrations of glucose, suggesting that elimination is not due to accumulation in a short‐term buffer such as the vacuole. Glucose and sucrose accumulation was insensitive to protonophores, was comparable in media differing in potassium levels, and was similar at pH 5.8, 6.8 and 7.8, suggesting that both influx and efflux may be mediated by proton‐independent transport systems. High‐resolution expression mapping in root tips showed that only a few proton‐dependent transport of the STP (Sugar Transport Protein) and SUT/SUC (Sucrose Transporter/Carrier) families are expressed in the external cell layers of root tips. The root expression maps may help to pinpoint candidate genes for uptake and release of carbohydrates from roots.
Auxin‐induced fruit‐set in tomato is mediated in part by gibberellins
Authors: Serrani Juan Carlos , Ruiz‐Rivero Omar , Fos Mariano , García‐Martínez José Luis 
Published: August 2008

SummaryTomato (Solanum lycopersicumL.) fruit‐set and growth depend on gibberellins (GAs). Auxins, another kind of hormone, can also induce parthenocarpic fruit growth in tomato, although their possible interaction with GAs is unknown. We showed that fruit development induced by the auxins indole‐3‐acetic acid and 2,4‐dichlorophenoxyacetic acid (2,4‐D) were significantly reduced by the simultaneous application of inhibitors of GA biosynthesis, and that this effect was reversed by the application of GA3. This suggested that the effect of auxin was mediated by GA. Parthenocarpic fruits induced by 2,4‐D had higher levels of the active GA1, its precursors and metabolites, than unpollinated non‐treated ovaries, but similar levels as those found in pollinated ovaries. Application experiments of radioactive‐labelled GAs to unpollinated ovaries showed than 2,4‐D altered GA metabolism (both biosynthesis and catabolism)in vivo. Transcript levels of genes encoding copalyldiphosphate synthase (SlCPS), SlGA20ox1, SlGA20ox2 and SlGA20ox3, and SlGA3ox1 were higher in unpollinated ovaries treated with 2,4‐D. In contrast, transcript levels ofSlGA2ox2(out of the fiveSlGA2oxgenes known to encode this kind of GA‐inactivating enzyme) were lower in ovaries treated with 2,4‐D. Our results support the idea that auxins induce fruit‐set and growth in tomato, at least partially, by enhancing GA biosynthesis (GA 20‐oxidase, GA 3‐oxidase and CPS), and probably by decreasing GA inactivation (GA2ox2) activity, thereby leading to higher levels of GA1. The expression of diverse Aux/indole‐3‐acetic acid (IAA) and auxin response factors, which may be involved in this effect of auxin, was also altered in 2,4‐D‐induced ovaries.
Specificities of leucocyte alloantibodies in transfusion‐related acute lung injury and results of leucocyte antibody screening of blood donors
Authors: Reil A. , Keller‐Stanislawski B. , Günay S. , Bux J. 
Published: August 2008

Background  Antibody‐mediated transfusion‐related acute lung injury (TRALI) is an important cause of transfusion‐associated morbidity and death. Preventive strategies are currently a matter of debate.Methods  Specificities of leucocyte antibodies implicated in previous severe TRALI reactions were determined using standard techniques. Based on these results, a leucocyte antibody screening strategy for the testing of parous female donors was introduced.Results  Of 36 TRALI cases, 17, 12, four and three were due to human leucocyte antigen (HLA) class II, human neutrophil alloantigen (HNA), HLA class I, and mixtures of HLA class I and II antibodies, respectively. HNA‐3a antibodies accounted for 10 of 12 HNA antibody‐mediated reactions and 6 of 10 fatalities including one after transfusion of red blood cells. Investigation 5332 parous female donors showed leucocyte antibodies in 473 samples, resulting in an alloimmunization rate of 8·9%. Sixty‐one per cent of these donors presented HLA class I, 19% class II, 12% HLA class I and II antibodies and 5% HNA antibodies. Additional HLA class I antibodies were found in 39% of HLA class II and in 17% of HNA antibodies containing sera. Our restrictive plasma strategy did not result in a shortage of plasma or platelets. No antibody‐mediated TRALI case was observed since introduction of the policy of plasma from male, nulliparous or tested multiparous donors.Conclusion  Compared to HLA class I antibodies, those directed against HLA class II and HNA‐3a were of greater clinical relevance. Isolated HLA class I antibody screening was found to be insufficient for leucocyte antibody screening.
Toddlers can adaptively change how they categorize: same objects, same session, two different categorical distinctions
Authors: Horst Jessica S. , Ellis Ann E. , Samuelson Larissa K. , Trejo Erika , Worzalla Samantha L. , Peltan Jessica R. , Oakes Lisa M. 
Published: August 2008

Abstract Two experiments demonstrate that 14‐ to 18‐month‐old toddlers can adaptively change how they categorize a set of objects within a single session, and that this ability is related to vocabulary size. In both experiments, toddlers were presented with a sequential touching task with objects that could be categorized either according to some perceptually salient dimension corresponding to a taxonomic distinction (e.g. animals vs. vehicles) or to some less obvious dimension (e.g. rigid vs. deformable). In each experiment, children with larger productive vocabularies responded to both dimensions, showing evidence of sensitivity to each way of categorizing the items. Children with smaller productive vocabularies attended only to the taxonomically related categorical grouping. These experiments confirm that toddlers can adaptively shift the basis of their categorization and highlight the dynamic interaction between the child and the current task in early categorization.
What makes relational reasoning smart? Revisiting the perceptual‐to‐relational shift in the development of generalization
Authors: Bulloch Megan J. , Opfer John E. 
Published: August 2008

AbstractDevelopment of reasoning is often depicted as involving increasing use of relational similarities and decreasing use of perceptual similarities (‘the perceptual‐to‐relational shift’). We argue that this shift is a special case of a broader developmental trend: increasing sensitivity to the predictive accuracy of different similarity types. To test this hypothesis, we asked participants (3‐, 4‐, 5‐year‐olds and adults) to generalize novel information on two types of problems – offspring problems, where relational matches yield accurate generalizations, and prey problems, where perceptual matches yield accurate generalizations. On offspring problems, we replicated prior findings of increasing relational matches with age. However, we observed decreasing relational matches on prey problems. Provided feedback on their responses, 3‐year‐olds showed the same trend. Findings suggest that the relational shift commonly observed in categorization and analogical reasoning may reflect a general increase in children's sensitivity to cue validity rather than an overall preference to generalize over perceptual similarity.