bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demand for emergency health service: factors associated with inappropriate use
Authors: Carret Maria LV , Fassa Anaclaudia G , Kawachi Ichiro 
Published: August 2007

AbstractBackgroundThe inappropriate use of emergency room (ER) service by patients with non-urgent health problems is a worldwide problem. Inappropriate ER use makes it difficult to guarantee access for real emergency cases, decreases readiness for care, produces negative spillover effects on the quality of emergency services, and raises overall costs.MethodsWe conducted a cross-sectional study in a medium-sized city in southern Brazil. The urgency of the presenting complaint was defined according to the Hospital Urgencies Appropriateness Protocol (HUAP). Multivariable Poisson regression was carried out to examine factors associated with inappropriate ER use.ResultsThe study interviewed 1,647 patients over a consecutive 13-day sampling period. The prevalence of inappropriate ER use was 24.2% (95% CI 22.1–26.3). Inappropriate ER use was inversely associated with age (P = 0.001), longer stay in the waiting room, longer duration of symptoms and morning shift. However, the determinants of inappropriate ER use differed according age groups (P value for interaction = 0.04). Within the younger age-group (15–49 years), inappropriate ER use was higher among females, patients who reported visiting the ER because there was no other place to go, patients reporting that the doctor at the regular place of care refused to attend to them without a prior appointment, and individuals who reported that the PHC clinic which they use is open for shorter periods during the day. Among older patients (50+ years), those with highest level of education, absence of self-reported chronic diseases and lack of social support were more likely to engage in higher inappropriate ER use.ConclusionEfforts should be made to redirect inappropriate ER demand. Besides expanding access to, and improving the quality of primary and secondary care, it is important to mobilize social support for older patients, to enhance the relationship between different levels of care, as well as to develop campaigns to educate the public about the appropriate use of medical services.
Thottapalayam virus is genetically distant to the rodent-borne hantaviruses, consistent with its isolation from the Asian house shrew (Suncus murinus)
Authors: Yadav Pragya D , Vincent Martin J , Nichol Stuart T 
Published: August 2007

Abstract
Thottapalayam (TPM) virus belongs to the genus Hantavirus, family Bunyaviridae. The genomes of hantaviruses consist of three negative-stranded RNA segments (S, M and L) encoding the virus nucleocapsid (N), glycoprotein (Gn, Gc), and polymerase (L) proteins, respectively. The genus Hantavirus contains predominantly rodent-borne viruses, with the prominent exception of TPM virus which was isolated in India in 1964 from an insectivore, Suncus murinus, commonly referred to as the Asian house shrew or brown musk shrew. Analysis of the available TPM virus S (1530 nt) RNA genome segment sequence and the newly derived M (3621 nt) and L (6581 nt) segment sequences demonstrate that the entire TPM virus genome is very unique. Remarkably high sequence differences are seen at the nucleotide (up to S – 47%, M – 49%, L – 38%) and protein (up to N – 54%, Gn/Gc – 57% and L – 39%) levels relative to the rodent-borne hantaviruses, consistent with TPM virus having a unique host association.
CD117 immunoexpression in canine mast cell tumours: correlations with pathological variables and proliferation markers
Authors: Gil da Costa Rui M , Matos Eduarda , Rema Alexandra , Lopes Célia , Pires Maria A , Gärtner Fátima 
Published: August 2007

AbstractBackgroundCutaneous mast cell tumours are one of the most common neoplasms in dogs and show a highly variable biologic behaviour. Several prognosis tools have been proposed for canine mast cell tumours, including histological grading and cell proliferation markers. CD117 is a receptor tyrosine kinase thought to play a key role in human and canine mast cell neoplasms. Normal (membrane-associated) and aberrant (cytoplasmic, focal or diffuse) CD117 immunoexpression patterns have been identified in canine mast cell tumours. Cytoplasmic CD117 expression has been found to correlate with higher histological grade and with a worsened post-surgical prognosis. This study addresses the role of CD117 in canine mast cell tumours by studying the correlations between CD117 immunoexpression patterns, two proliferation markers (Ki67 and AgNORs) histological grade, and several other pathological variables.ResultsHighly significant (p < 0,001) correlations were found between CD117 immunostaining patterns and histological grade, cell proliferation markers (Ki67, AgNORs) and tumoral necrosis. Highly significant (p < 0,001) correlations were also established between the two cellular proliferation markers and histological grade, tumour necrosis and epidermal ulceration. A significant correlation (p = 0.035) was observed between CD117 expression patterns and epidermal ulceration. No differences were observed between focal and diffuse cytoplasmic CD117 staining patterns concerning any of the variables studied.ConclusionThese findings highlight the key role of CD117 in the biopathology of canine MCTs and confirm the relationship between aberrant CD117 expression and increased cell proliferation and higher histological grade. Further studies are needed to unravel the cellular mechanisms underlying focal and diffuse cytoplasmic CD117 staining patterns, and their respective biopathologic relevance.
The influence of smoking and other risk factors on the outcome after radiochemotherapy for anal cancer
Authors: Mai Sabine Kathrin , Welzel Grit , Haegele Verena , Wenz Frederik 
Published: August 2007

Abstract
Background
Smoking is an important risk factor for the development of cancer. Smoking during radiochemotherapy therapy may have a negative influence on prognosis. We evaluated the effect of smoking during radiochemotherapy on the outcome for patients with anal cancer.

Methods
Sixty-eight patients (34 smokers, 34 non-smokers) treated by radiochemotherapy for anal cancer were analysed. The effect of smoking during radiochemotherapy and other risk factors (gender, T- and N category, tumor site, dose, therapy protocol) on disease-specific survival (DSS), local control (LC) and colostomy free survival (CFS) was evaluated.

Results
There was a significant difference in age and male:female ratio between the two groups. With a median follow up of 22 months (max. 119) DSS, LC, and CFS were 88%, 84% and 84%. A significant difference in local control between smokers (S) and non-smokers (NS) was found (S 74% vs. NS 94%, p = .03). For DSS and CFS a difference in terms of outcome between smokers and non-smokers was seen (DSS: S 82% vs. NS 96%, p = .19, CFS: S 75% vs. 91%, p = .15), which did not reach statistical significance. In multivariate analyses only gender had a significant association with LC and T category with CFS. The other risk factors did not reach statistical significance.

Conclusion
Even though our evaluation reached statistical significance only in univariate analysis, we suggest, that the role of smoking during radiochemotherapy for anal cancer should not be ignored. The potential negative effect on prognosis should be explained to patients before therapy.
Combined sterno-clavicular approach as an alternative technique in hybrid exclusion of aortic arch aneurysm
Authors: Protopapas Aristotle D , Rao Christopher , Choong Andrew , Cheshire Nicholas JW , Athanasiou Thanos 
Published: August 2007

Abstract

Background
We describe a modified access technique for the proximal (open) part of single stage hybrid exclusion of aneurysm of the aortic arch.

Case presentation
3 patients had a bifurcated Dacron graft for the innominate and left subclavian arteries and an additional end-to-side anastomosis of the left common carotid artery on the limb to the left subclavian artery. With our modification, access to the left subclavian artery is by left subclavicular incision and creation of an anterior tunnel via the left thoracic outlet from the origin of the left subclavian artery along its anatomical course to the subclavicular plane.

Discussion
Advantages and disadvantages of this technique in relation to anatomy and pathology.
Species-specific shifts in centromere sequence composition are coincident with breakpoint reuse in karyotypically divergent lineages
Authors: Bulazel Kira V , Ferreri Gianni C , Eldridge Mark DB , O'Neill Rachel J 
Published: August 2007

Abstract
Background
It has been hypothesized that rapid divergence in centromere sequences accompanies rapid karyotypic change during speciation. However, the reuse of breakpoints coincident with centromeres in the evolution of divergent karyotypes poses a potential paradox. In distantly related species where the same centromere breakpoints are used in the independent derivation of karyotypes, centromere-specific sequences may undergo convergent evolution rather than rapid sequence divergence. To determine whether centromere sequence composition follows the phylogenetic history of species evolution or patterns of convergent breakpoint reuse through chromosome evolution, we examined the phylogenetic trajectory of centromere sequences within a group of karyotypically diverse mammals, macropodine marsupials (wallabies, wallaroos and kangaroos).

Results
The evolution of three classes of centromere sequences across nine species within the genus Macropus (including Wallabia) were compared with the phylogenetic history of a mitochondrial gene, Cytochrome b (Cyt b), a nuclear gene, selenocysteine tRNA (TRSP), and the chromosomal histories of the syntenic blocks that define the different karyotype arrangements. Convergent contraction or expansion of predominant satellites is found to accompany specific karyotype rearrangements. The phylogenetic history of these centromere sequences includes the convergence of centromere composition in divergent species through convergent breakpoint reuse between syntenic blocks.

Conclusion
These data support the 'library hypothesis' of centromere evolution within this genus as each species possesses all three satellites yet each species has experienced differential expansion and contraction of individual classes. Thus, we have identified a correlation between the evolution of centromere satellite sequences, the reuse of syntenic breakpoints, and karyotype convergence in the context of a gene-based phylogeny.
PyCogent: a toolkit for making sense from sequence
Authors: Knight Rob , Maxwell Peter , Birmingham Amanda , Carnes Jason , Caporaso J Gregory , Easton Brett C , Eaton Michael , Hamady Micah , Lindsay Helen , Liu Zongzhi , Lozupone Catherine , McDonald Daniel , Robeson Michael , Sammut Raymond , Smit Sandra , Wakefield Matthew J , Widmann Jeremy , Wikman Shandy , Wilson Stephanie , Ying Hua , Huttley Gavin A 
Published: August 2007

AbstractWe have implemented in Python the COmparative GENomic Toolkit, a fully integrated and thoroughly tested framework for novel probabilistic analyses of biological sequences, devising workflows, and generating publication quality graphics. PyCogent includes connectors to remote databases, built-in generalized probabilistic techniques for working with biological sequences, and controllers for third-party applications. The toolkit takes advantage of parallel architectures and runs on a range of hardware and operating systems, and is available under the general public license from http://sourceforge.net/projects/pycogent.
Quantitative genomics of locomotor behavior in Drosophila melanogaster
Authors: Jordan Katherine W , Carbone Mary Anna , Yamamoto Akihiko , Morgan Theodore J , Mackay Trudy FC 
Published: August 2007

Abstract
Background
Locomotion is an integral component of most animal behaviors, and many human health problems are associated with locomotor deficits. Locomotor behavior is a complex trait, with population variation attributable to many interacting loci with small effects that are sensitive to environmental conditions. However, the genetic basis of this complex behavior is largely uncharacterized.

Results
We quantified locomotor behavior of Drosophila melanogaster in a large population of inbred lines derived from a single natural population, and derived replicated selection lines with different levels of locomotion. Estimates of broad-sense and narrow-sense heritabilities were 0.52 and 0.16, respectively, indicating substantial non-additive genetic variance for locomotor behavior. We used whole genome expression analysis to identify 1,790 probe sets with different expression levels between the selection lines when pooled across replicates, at a false discovery rate of 0.001. The transcriptional responses to selection for locomotor, aggressive and mating behavior from the same base population were highly overlapping, but the magnitude of the expression differences between selection lines for increased and decreased levels of behavior was uncorrelated. We assessed the locomotor behavior of ten mutations in candidate genes with altered transcript abundance between selection lines, and identified seven novel genes affecting this trait.

Conclusion
Expression profiling of genetically divergent lines is an effective strategy for identifying genes affecting complex behaviors, and reveals that a large number of pleiotropic genes exhibit correlated transcriptional responses to multiple behaviors.
MicroRNAs show a wide diversity of expression profiles in the developing and mature central nervous system
Authors: Kapsimali Marika , Kloosterman Wigard P , de Bruijn Ewart , Rosa Frederic , Plasterk Ronald HA , Wilson Stephen W 
Published: August 2007

Abstract
Background
MicroRNA (miRNA) encoding genes are abundant in vertebrate genomes but very few have been studied in any detail. Bioinformatic tools allow prediction of miRNA targets and this information coupled with knowledge of miRNA expression profiles facilitates formulation of hypotheses of miRNA function. Although the central nervous system (CNS) is a prominent site of miRNA expression, virtually nothing is known about the spatial and temporal expression profiles of miRNAs in the brain. To provide an overview of the breadth of miRNA expression in the CNS, we performed a comprehensive analysis of the neuroanatomical expression profiles of 38 abundant conserved miRNAs in developing and adult zebrafish brain.

Results
Our results show miRNAs have a wide variety of different expression profiles in neural cells, including: expression in neuronal precursors and stem cells (for example, miR-92b); expression associated with transition from proliferation to differentiation (for example, miR-124); constitutive expression in mature neurons (miR-124 again); expression in both proliferative cells and their differentiated progeny (for example, miR-9); regionally restricted expression (for example, miR-222 in telencephalon); and cell-type specific expression (for example, miR-218a in motor neurons).

Conclusion
The data we present facilitate prediction of likely modes of miRNA function in the CNS and many miRNA expression profiles are consistent with the mutual exclusion mode of function in which there is spatial or temporal exclusion of miRNAs and their targets. However, some miRNAs, such as those with cell-type specific expression, are more likely to be co-expressed with their targets. Our data provide an important resource for future functional studies of miRNAs in the CNS.
Randomized Dose-Ranging Trial of Tamoxifen at Low Doses in Hormone Replacement Therapy Users
Authors: Decensi Andrea , Gandini Sara , Serrano Davide , Cazzaniga Massimiliano , Pizzamiglio Maria , Maffini Fausto , Pelosi Giuseppe , Daldoss Cristina , Omodei Umberto , Johansson Harriet , Macis Debora , Lazzeroni Matteo , Penotti Mauro , Sironi Laura , Moroni Simona , Bianco Vanda , Rondanina Gabriella , Gjerde Jennifer , Guerrieri-Gonzaga Aliana , Bonanni Bernardo 
Published: August 2007

Purpose The combination of hormone replacement therapy (HRT) and low-dose tamoxifen may retain the benefits while reducing the risks of either agent. We assessed the optimal biologic dose and schedule of tamoxifen in HRT users using surrogate end point biomarkers and menopausal symptoms. Subjects and Methods Two hundred ten current or de novo HRT users were randomly assigned to one of the following four arms: tamoxifen 1 mg/day and placebo/week, placebo/day and tamoxifen 10 mg/week, tamoxifen 5 mg/day and placebo/week, or both placebos for 12 months. The primary end point was the change of plasma insulinlike growth factor 1 (IGF-I) through 12 months, and secondary end points were IGF-I/IGF binding protein-3 (IGFBP-3) ratio, fibrinogen, antithrombin III, C reactive protein, C-telopeptide, mammographic percent density, and endometrial thickness. Endometrial proliferation was assessed by Pipelle biopsy in superficial, deep glandular, and stromal compartments after 12 months. Results Compared with placebo, IGF-I declined in all tamoxifen arms (P = .005), with a greater change on 5 mg/day (P = .019 v 10 mg/week or 1 mg/day). Tamoxifen increased IGFBP-3 and lowered antithrombin-III, C reactive protein, and mammographic density, with greater effects of 5 mg/day. Tamoxifen increased endometrial thickness but not Ki-67 expression, which was lower on 5 mg/day among the three doses. Menopausal symptoms were not significantly worsened by tamoxifen. Conclusion Doses of tamoxifen ≤ 5 mg/day modulate favorably biomarkers of breast carcinogenesis and cardiovascular risk in HRT users with no increase of endometrial proliferation and menopausal symptoms. A dose of 5 mg/day was the most effective and has been selected for a phase III trial in HRT users.
Drugstore personnel's management of a tuberculosis suspect: consideration of actual and perceived management
Authors: Rojpibulstit Malee , Chongsuvivatwong Virasakdi 
Published: August 2007

Abstract

Objective
To explore drugstore personnel's knowledge and practice on management of a suspected case of tuberculosis (TB).

Method
Seventy randomly selected drugstores in Songkhla province of Southern Thailand were visited by simulated clients (SCs) who asked for medication for relieving a one-month cough with fever. All questions asked by the drugstore personnel, advice given and drugs dispensed were noted and analysed. The drugstores were subsequently visited and the managers were interviewed.

Key findings
For the SC study, 55 out of 70 (79%) drugstore personnel took a history before dispensing drugs, but only 14 (20%) asked about cough duration. Only four drugstore personnel identified TB as a possible diagnosis for a case with one-month cough and fever, and only three recommended the SC to see a doctor. From the interviews, 46 (66%) perceived the probability of encountering TB at their workplace to be low. The knowledge on symptoms of suspected TB was poor. Sixty-eight (97%) would suspect TB if and only if the client with prolonged cough also had tiredness, weight loss, difficulty breathing or haemoptysis. In contrast to their practice with the SC, 46 (66%) claimed that they would recommend a client with one-month cough and fever to see a doctor.

Conclusions
The majority of drugstore personnel failed to detect suspected TB cases and did not give a proper referral. Interventions to educate drugstore personnel to recognise symptoms of suspected TB and to become aware in TB epidemics in this setting are urgently needed.
The benefits of providing benefit information in a patient information leaflet
Authors: Bersellini Elisabetta , Berry Diane 
Published: August 2007

Abstract

Objective
To examine the effects of providing two different types of written information about medicine benefits in a patient information leaflet (PIL).

Setting
Participants were 358 adult volunteers from the general population recruited from a London railway station and central Reading.

Method
The study used a controlled empirical methodology in which people were given a hypothetical, but realistic, scenario about visiting their doctor and being prescribed medication. They then read an information leaflet about the medicine that contained neither, one, or both benefit statements, and finally completed a number of Likert rating scales. Outcome measures included perceived satisfaction and helpfulness of the information, effectiveness and appropriateness of the medicine, benefit and risk to health, and intention to comply.

Key findings
Both types of benefit information led to significantly higher ratings on all of the measures taken.

Conclusions
Provision of a relatively short ‘benefit’ statement can significantly improve people's judgements and intention to take a medicine. The findings are important and timely as the European Union is currently considering reviewing their regulations to allow for the inclusion of limited non-promotional benefit information in PILs.
Reducing medication errors: perceived information needs of healthcare practitioners
Authors: Warner Bruce , Gerrett David 
Published: August 2007

Abstract

Objective
The aim of this study was to determine the perceived information needs of healthcare practitioners (HCPs) in relation to reducing medication error.
The objectives were to gather, identify and list relevant perceptions from medical and pharmaceutical HCPs in primary and secondary settings. Progressive data reduction and refining techniques were used to identify the key perceived issues for consideration in information transfer so as to minimise medication error.

Setting
One acute NHS foundation trust in Southern Derbyshire, one acute NHS foundation trust in Sheffield and one primary care trust in Sheffield.

Method
Following ethical and managerial approval, 30 semi-structured interviews guided by hypothetical case-based scenarios were undertaken with: medical prescribers in secondary care general medicine and care of the elderly; medical prescribers in primary care; hospital pharmacists; and, community pharmacists. Following a thematic analysis of transcripts using NUDist software, a series of summary statements was established. These were ranked by HCPs according to their perceptions of the relative importance to the research objective. Key statements, as determined by the kappa test of agreement, were identified and further refined to produce questions that were explored at a multidisciplinary focus group in July 2005.

Key findings
Data analysis identified that it was of paramount importance there should be a minimum dataset, including diagnosis, medication and rationale behind medication changes, which should be available to all HCPs involved in the medication aspects of a patient's care. This core information should be overseen by a multidisciplinary working party. Access to additional information should be determined on an individual basis. Further it was important that the gatekeeper of patient-specific information should normally be the general practitioner, in conjunction with properly informed and counselled patients wherever possible.

Conclusion
Medical and pharmaceutical HCPs have a clear understanding of the complex issues concerning availability of patient information, and critically agree the need to share information. If HCPs are able to share relevant patient information then there is an understanding that medication error will be minimised.