bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of dialysate calcium concentration in hemodialysis
Authors: TOUSSAINT Nigel , COONEY Patrick , KERR Peter G. 
Published: October 2006

AbstractThe dialysate calcium (Ca) concentration for hemodialysis (HD) patients can be adjusted to manage more optimally the body's Ca and phosphate balance, and thus improve bone metabolism as well as reduce accelerated arteriosclerosis and cardiovascular mortality. The appropriate dialysate Ca concentration allowing this balance should be prescribed to each individual patient depending on a multitude of variable factors relating to Ca load. A lower dialysate Ca concentration of 1.25 to 1.3 mmol/L will permit the use of vitamin D supplements and Ca‐based phosphate binders in clinical practice, with much less risk of Ca loading and resultant hypercalcemia and calcification. Low Ca baths are useful in the setting of adynamic bone disease where an increase in bone turnover is required. However, low Ca levels in the dialysate may also predispose to cardiac arrhythmias and hemodynamically unstable dialysis sessions with intradialytic hypotension. Higher Ca dialysate is useful to sustain normal serum Ca levels where patients are not taking Ca‐based binders or if Ca supplements are not able to normalize serum levels. Suppression of hyperparathyroidism is also effective with dialysate Ca of 1.75 mmol/L, but hypercalcemia, metastatic calcification, and oversuppression of parathyroid hormone are risks. Dialysate Ca of 1.5 mmol/L may be a compromise between bone protection and reduction in cardiovascular risk for conventional HD and is a common concentration used throughout the world. The increase in longer, more frequent dialysis such as short‐daily and nocturnal HD, however, provides another challenge with regard to optimal dialysate Ca levels and higher levels of 1.75 mmol/L are probably indicated in this setting. Difficulties in determining the ideal dialysate Ca occur because of the complex pathophysiology of bone and mineral metabolism in HD patients and there needs to be a balance between dialysis prescription and other treatment modalities. To optimize management of the abnormal Ca balance, other aspects of this disorder need to be more fully clarified and, with evolving medications for phosphate control and treatment of secondary hyperparathyroidism, as well as the emergence of a multitude of different HD regimes, further studies are required to make definitive recommendations. At present, we need to maintain flexibility with HD treatments and so dialysate Ca needs to be individualized to meet the specific requirements of patients by optimizing management of renal bone disease and simultaneously reducing metastatic calcification and cardiovascular disease.
Continuous online monitoring of ionic dialysance allows modification of delivered hemodialysis treatment time
Authors: CHESTERTON Lindsay J. , PRIESTMAN William S. , LAMBIE Stewart H. , FIELDING Catherine A. , TAAL Maarten W. , FLUCK Richard J. , MCINTYRE Christopher W. 
Published: October 2006

AbstractConsiderable intrinsic intrapatient variability influences the actual delivery of Kt/V. The aim of this study is to examine the feasibility of using continuous online assessment of ionic dialysance measurements (Kt/VID) to allow dialysis sessions to be altered on an individual basis. Ten well‐established chronic hemodialysis (HD) patients without significant residual renal function were studied (mean age 65±4.3 [38–81] years, mean length of time on dialysis 66±18 [14–189] months). These patients had all been receiving thrice‐weekly 4‐hr dialysis using Integra® dialysis monitors. Dialysis monitors were equipped with Diascan® modules permitting measurement of Kt/VID. Predicted treatment time required to achieve a Kt/VID≥1.1 (equivalent to a urea‐based method of 1.2) was calculated from the delivered Kt/VID at 60 and 120 min. Treatment time was reprogrammed at 2 hr (ensuring all planned ultrafiltration would be accommodated into the new modified session duration). Owing to practical issues, and to avoid excessively short dialysis times, these changes were censored at no more than±10% of the usual 240‐min treatment time (210–265 min). Data were collected from a total of 50 dialysis sessions. Almost all sessions (47/50) required modification of the standard treatment time: 13/50 sessions were lengthened and 34/50 shortened (mean length of session 232.2±2.5 [210–265] min). A Kt/VID of ≥1.1 was achieved in 39/50 sessions. The difference in mean urea‐based Kt/V poststudy (1.3±0.05 [1.1–1.6]) and mean achieved Kt/VID (1.16±0.02 [0.7–1.37]) was significant (p=0.002). The use of individualized variable dialysis treatment time using online ionic dialysance measurements of Kt/VID appears both practicable and effective at ensuring consistently delivered adequate dialysis.
Tuberculosis in end‐stage renal disease patients on hemodialysis
Authors: ABDELRAHMAN Mohammad , SINHA Ajit Kumar , KARKAR Ayman 
Published: October 2006

AbstractRecent studies have shown that there is an increase in the incidence of mycobacterium tuberculosis (MBT). This is more prevalent among immune compromised patients (those on dialysis) and recipients of organ transplants. Furthermore, extra‐pulmonary presentation appears to be more common and difficult to diagnose. We aimed in this study to assess and evaluate the presentation of MBT in a retrospective study conducted among 256 hemodialysis (HD) patients where 18 of them were diagnosed and managed for tuberculosis over a 10‐year period between 1990 and 2000. The mean age of the patients was 38 years (21–75 years). The mean interval between the onset of HD and the time of diagnosis was about 24 months (1–120 months). The diagnosis of tuberculosis was made either by isolation of acid‐fast bacilli (AFB), the typical caseating granuloma on biopsy, or by recovery of tubercle bacilli from the culture of the biopsy material. Extra‐pulmonary tuberculosis was more common (77.8%) than pulmonary tuberculosis (22.2%). The various extra‐pulmonary tuberculosis sites noted were cervical lymphadenitis (16.7%), gastrointestinal (16.7%), genitourinary (11.1%), peritonitis (11.1%), pleural effusion (5.6%), pericardial effusion (5.6%), miliary tuberculosis (5.6%), and pyrexia of unknown origin (5.6%). None of the patients with extra‐pulmonary tuberculosis had evidence of pulmonary tuberculosis. The atypical presentation with insidious onset was quite common. Anergy to tuberculin skin test was noticed in 56% of cases. All of our patients received modified antituberculosis treatment for 1 year with adequate response, and without undue side effects. We conclude that a high index of suspicion is required especially in the diagnosis of extra‐pulmonary tuberculosis, and when there is a high percentage of anergy to tuberculin skin test. Tissue biopsy both for characteristic histology and demonstration of MTB, either by staining or culture, remains the main criteria for the diagnosis of extra‐pulmonary tuberculosis.
Control of adipogenesis in ruminants
Authors: ROH Sang‐Gun , HISHIKAWA Daisuke , HONG Yeon‐Hee , SASAKI Shinichi 
Published: October 2006

ABSTRACTAdipose tissue is an important organ that is involved in the peripheral regulation of body homeostasis, specifically, energy intake, storage and expenditure. Since fat metabolism is of the utmost importance in ruminants, the signals and mechanisms which regulate adiposity for fattening have been studied and characterized by many different approaches. Adipogenesis in the adipose tissues of ruminants is triggered and modulated by several factors/genes, some of which (conjugated linoleic acid, tumor necrosis factor‐α and adipogenin) have been examined with respect to adipogenesis in ruminants by numerous researchers, including those in our group. The purpose of this article was to describe recent advances and insights into the molecular regulating processes of preadipocyte, adipocyte and adipose tissues in ruminants.
CHARACTERIZATION OF A DUPLEX POLYMERASE CHAIN REACTION ASSAY FOR THE DETECTION OF ENTEROTOXIGENIC STRAINS OF STAPHYLOCOCCUS AUREUS
Authors: TANG JUN‐NI , SHI XIAN‐MING , SHI CHUN‐LEI , CHEN HUAN‐CHUN 
Published: October 2006

ABSTRACT Sequence analysis demonstrated that all reported primers based on the thermonuclease (TNase) gene (nuc) used in the detection of the foodborne pathogen Staphylococcus aureus were derived from the nuclease gene, instead of the thermonuclease gene. In this study, two pairs of primers targeting the sequences of the nuc and 16S ribosomal RNA genes were designed in a duplex polymerase chain reaction (PCR) assay for the detection of S. aureus, particularly those of the enterotoxigenic strains. After optimization of the amplification conditions by uniform design, two specific products were amplified in the PCR detection system: a 223‐bp nuc fragment and a 565‐bp 16S rDNA fragment. Evaluation tests demonstrated that this duplex PCR method has high specificity for only S. aureus. The detection limit of the assay was 9.35 pg/µL using S. aureus genomic DNA. The sensitivity for direct detection of milk samples sparked with S. aureus was 104–105 cfu/mL, and the sensitivity was 1 cfu/mL as an initial concentration when an enrichment process was used. A PCR‐based detection assay for enterotoxin gene was performed in parallel with the detection of the nuc‐encoded TNase activity in several S. aureus strains, and a good correlation between TNase production and enterotoxigenicity was demonstrated in all the strains tested.
DNA SEQUENCE ANALYSIS OF rpoB GENE MUTATIONS IN RIFAMPICIN‐RESISTANT MYCOBACTERIUM TUBERCULOSIS
Authors: ZAKI MAYSAA EL‐SAYED , HASSANIN NADIA 
Published: October 2006

ABSTRACT Multidrug‐resistant tuberculosis (MDR‐TB) is an increasing health problem, which contributes to mortality from tuberculosis (TB). Rifampicin (RIF) resistance is considered a marker for MDR‐TB. Resistance to RIF results from mutation in the gene encoding the beta subunit of RNA polymerase (rpoB) of the mycobacterial tuberculosis (MTB) complex. The aim of this study was to assess the presence of RIF‐resistant TB strains using the BACTEC 460 TB system (Becton Dickinson Microbiology System, Cockeysville, MD) and to determine the pattern of rpoB gene mutations in those strains by line probe assay in combination with DNA sequence analysis. The study was carried out on 60 patients with pulmonary TB. Sputum samples were cultured in the BACTEC 460 system. Positive TB cultures were subjected to antimycobacterial susceptibility by BACTEC 460 and agar proportional susceptibility test. RIF‐resistant strains were further evaluated by line probe assay for the presence of rpoB mutations and DNA sequence analysis for detection of type of mutation. All sputum samples yielded growth by both conventional and BACTEC 460 system. Of the isolated TB bacilli, 20.0, 20.7, 6.7 and 3.3% were resistant to RIF, isoniazid (INH), ethambutol and streptomycin, respectively. Twenty percent were MDR‐TB. The line probe assay had 100% sensitivity and 95.8% specificity. The most common mutations detected by DNA sequencer were detected within the 69‐bp hypervariable region of the rpoB gene, mostly His 526Tyr and Ser531 Leu mutations. From this study, we could conclude that the most frequent drug resistance of TB was for RIF and INH. The most frequent sequence mutations were detected within the 69‐bp hypervariable region of the rpoB gene as His526Tyr and Ser531 Leu mutations. The line probe assay was a simple, reliable and rapid screening tool for early detection and characterization of RIF‐resistant Mycobacterium tuberculosis strains.
Acute Stroke Care at Rural Hospitals in Idaho: Challenges in Expediting Stroke Care
Authors: Gebhardt James G. , Norris Thomas E. 
Published: October 2006

ABSTRACT:
Context: Thrombolytics are currently the most effective treatment for stroke. However, the National Institute for Neurological Disorders and Stroke criteria for initiation of thrombolytic therapy, most notably the 3‐hour time limit from symptom onset, have proven challenging for many rural hospitals to achieve. Purpose: To provide a snapshot of stroke care at rural hospitals in Idaho and to investigate the experiences of these hospitals in expediting stroke care. Methods: Using a standard questionnaire, a telephone survey of hospital staff at 21 rural hospitals in Idaho was performed. The survey focused on acute stroke care practices and strategies to expedite stroke care. Findings: The median number of stroke patients treated per year was 23.3. Patient delays were reported by 77.8% of hospitals, transport delays by 66.7%, in‐hospital delays by 61.1%, equipment delays by 22.2%, and ancillary services delays by 61.1%. Approximately 67% of hospitals had implemented a clinical pathway for stroke and 80.0% had provided staff with stroke‐specific training. No hospitals surveyed had a designated stroke team, and only 33.3% reported engaging in quality improvement efforts to expedite stroke care. Thrombolytics (tPA) were available and indicated for stroke at 55.6% of the hospitals surveyed. Conclusions: Rural hospitals in Idaho face many difficult challenges as they endeavor to meet the 3‐hour deadline for thrombolytic therapy, including limited resources and experience in acute stroke care, and many different types of prehospital and in‐hospital delays.
Practice Locations of Graduates of Family Physician Residency and Nurse Practitioner Programs: Considerations Within the Context of Institutional Culture and Curricular Innovation Through Titles VII and VIII
Authors: Edwards Joellen B. , Wilson Jim L. , Behringer Bruce A. , Smith Patricia L. , Ferguson Kaethe P. , Blackwelder Reid B. , Florence Joseph A. , Bennard Bruce , Tudiver Fred 
Published: October 2006

ABSTRACT:
Background: Studies have described the aggregate results of federal funding for health professions education at the national level, but analysis of the long‐term impact of institutional participation in these programs has been limited. Purpose: To describe and assess federally supported curricular innovations at East Tennessee State University designed to promote family medicine and nurse practitioner graduate interest in rural and underserved populations. Methods: Descriptive analysis of a survey to determine practice locations of nurse practitioner graduates (1992‐2002) and graduates of 3 family medicine residencies (1978‐2002). Graduates’ (N = 656) practice locations were documented using specific federal designations relating to health professions shortages and rurality. Results: Overall, 83% of family medicine residency and 80% of nurse practitioner graduates selected practice locations in areas with medically underserved or health professions shortage designations; 48% of family physicians and 38% of nurse practitioners were in rural areas. Conclusions: Graduates who study in an educational setting with a mission‐driven commitment to rural and community health and who participate in curricular activities designed to increase their experience with rural and underserved populations choose, in high numbers, to care for these populations in their professional practice.
Physical and Mental Health and Access to Care Among Nonmetropolitan Veterans Health Administration Patients Younger Than 65 Years
Authors: West Alan , Weeks William B. 
Published: October 2006

ABSTRACT:
Context: The 4.5 million military veterans treated by the Veterans Health Administration (VA) are believed to experience poorer physical and mental health than nonveterans. Furthermore, nonmetropolitan residents have less access to medical services, whether or not they are veterans in VA care. A direct comparison of metropolitan and nonmetropolitan veterans and nonveterans on a national health survey has not been reported, so it is not known whether nonmetropolitan VA patients experience similar medical need or access as other nonmetropolitan residents. Purpose: We sought to compare the perceptions of health status and access to care among metropolitan and nonmetropolitan veterans in VA care, other veterans, and nonveterans in a large national sample surveyed under the same conditions. Methods: Male respondents to the 2000 Behavioral Risk Factor Surveillance System health survey were divided into veterans or nonveterans, VA users or nonusers, metropolitan or nonmetropolitan residents, and 1 of 3 age groups (18‐44, 45‐64, and 65+). Responses to questions about current health status, health coverage, and access to care were submitted to chi‐square analyses or analyses of variance, using SUDAAN software to compute survey error variance. Findings: Nonmetropolitan VA patients younger than 65 years consistently reported the worst physical and mental health status and reduced access to care. Conclusions: VA can anticipate increasing demand for mental and physical health care among rural veterans younger than 65 years.
Tautochronic Vibration Absorbers for Rotating Systems
Authors: Shaw Steven W. , Schmitz Peter M. , Haddow Alan G. 
Published: October 2006

Abstract
This paper describes an analytical and experimental investigation of the dynamic response and performance of a special type of centrifugal pendulum vibration absorber used for reducing torsional vibrations in rotating systems. This absorber has the property that it behaves linearly out to large amplitudes, and thus experiences no frequency detuning. Previous analytical work on such tautochronic absorbers has considered the response, dynamic stability, and performance of single- and multi-absorber systems. In particular, it is known that these absorbers, when perfectly tuned to the order of the applied torque, do not exhibit hysteretic jumps in the response, but multi-absorber systems can experience instabilities that destroy the symmetry of their synchronous response. In this work we extend the theory to include linear de-tuning of the absorbers, which can be used as a design parameter to influence absorber performance, both in terms of rotor vibration reduction and operating range. This paper reviews the basic analysis, which employs scaling and averaging, and extends it to include the detuning. In addition, systematic experiments of systems with one and two absorbers are carried out. The experimental results are unique in that the test facility is capable of varying the excitation order, thereby allowing one to obtain order-response curves that are useful for design purposes. The experimental results are found to be in excellent agreement with the analytical predictions, and these clearly demonstrate the tradeoffs faced when selecting absorber tuning.
Sequencing of the
porB
Gene: a Step toward a True Characterization of
Neisseria meningitidis
Authors: Abad R. , Alcalá B. , Salcedo C. , Enríquez R. , Uría M. J. , Diez P. , Vázquez J. A. 
Published: October 2006

ABSTRACT

Variations in class 2/3 (PorB) proteins form the basis for meningococcal serotyping. Antibodies against these proteins are bactericidal, making serotyping results useful not only for epidemiological surveillance of meningococcal disease but also for identifying potential vaccine components. A total of 20 to 60% of meningococcal B and C isolates from any given population are nontypeable (NT) using a panel of monoclonal antibodies. To analyze the mechanisms responsible for the nonserotypeability characteristic in
Neisseria meningitidis
, we (i) established the nucleotide sequences of
porB
gene in 146 meningococcal strains (95 not recognized by the serotyping panel), (ii) identified 18 new allelic variants of the
porB
gene, (iii) correlated allelic variants with serotypes, (iv) suggest the nontypeability characteristic in those 95 NT strains, and (v) reject the possibility of variation in the levels of PorB expression.
Emergency department screening for risk for post-traumatic stress disorder among injured children: Table 1
Authors: Ward-Begnoche W L , Aitken M E , Liggin R , Mullins S H , Kassam-Adams N , Marks A , Winston F K 
Published: October 2006

Objective:To discuss the successes and challenges associated with the implementation of a post-traumatic stress disorder (PTSD) screening tool in two pediatric emergency departments (ED).Methods:The STEPP screening tool has been developed previously on an inpatient population of motor vehicle trauma patients. It was applied here to the general ED population at two different pediatric trauma centers. Nurse screeners were trained and a convenience sample of patients with unintentional injuries who met study criteria were screened in the ED. Feedback from nurse screeners was obtained.Results:The process of implementing a screening tool to identify patients and their families significantly at risk for PTSD symptomatology presented some barriers, but overall acceptability of the process was high for both the emergency department staff and the patient. Recommendations for others considering implementation of screening programs in the ED are offered.Conclusions:Future research using screening protocols in the ED should, in their design, attempt to capitalize on the successes identified in the current protocol and circumvent barriers also encountered.
Regulation of hdm2 by Stress-Induced hdm2alt1 in Tumor and Nontumorigenic Cell Lines Correlating with p53 Stability
Authors: Dias Chrisanne S. , Liu Yan , Yau Amy , Westrick Lindsay , Evans Susan C. 
Published: October 2006

Abstract
Alternative and aberrant splicing of hdm2 occurs in tumor and normal tissues. However, the factors that induce these splice variants and whether they are translated to protein products in vivo is unknown, making it difficult to decipher which of these hdm2 transcripts have a normal physiologic function or contribute to carcinogenesis. We investigated the conditions that induce this post-transcriptional modification of hdm2 in tumor and nontumorigenic cell lines. We showed that UV and γ radiation as well as cisplatin treatment induced alternative splicing of hdm2, which resulted in a single splice variant, hdm2alt1, irrespective of the cell type. Interestingly, the mechanism of UV-induced splicing is independent of p53 status. Immunoanalysis revealed that, after UV radiation, HDM2ALT1 protein was expressed and interacted with HDM2 that correlated to increased p53 protein levels and its accumulation in the nucleus, whereas HDM2 localized more to the cytoplasm with a decrease in its RNA and protein level. We propose that stress-induced HDM2ALT1 regulates HDM2 at two levels, RNA and protein, further modulating the p53-HDM2 interaction or interactions of HDM2 with other cell cycle regulatory proteins. This kind of regulation may possibly restrict oncogenic functions of HDM2 and contribute to the many protective responses triggered by certain stress signals. Our data imply that HDM2ALT1 possesses a normal physiologic function in damaged cells, perhaps facilitating cellular defense. (Cancer Res 2006; 66(19): 9467-73)