bluuebunny/crossref_metadata_2025_split huggingface dataset:
The challenge of using the low back pain guidelines: a qualitative research
Authors: Dahan Rachel , Borkan Jeffry , Brown Judith‐Bell , Reis Shmuel , Hermoni Doron , Harris Stewart 
Published: August 2007

Abstract
Purpose  Current low back pain (LBP) clinical guidelines have helped to summarize the scientific evidence and research, but have failed to provide tools and guide family physicians (FPs). The purpose of this study is to identify barriers and facilitators for the implementation of LBP guidelines from family FPs’ perspective.
Methods  A qualitative focus group study of FPs in the north of Israel. Purposeful sampling was used to recruit participants, all of them board‐certified FPs. Four focus groups were created, and discussions were taped, transcribed and analysed for major themes.
Results  Focus groups findings have expanded the understanding of the intellectual and mental challenges faced by Israeli FPs caring for LBP patients and highlighted the many obstacles to implementing LBP guidelines. Physicians’ decision‐making, pertaining to LBP, functions on three levels simultaneously: the physicians’ agenda based on familiarity with the guidelines; their need to remain grounded in the context of the specific patient–doctor relationship; and the constraints and demands of the physician’s workplace, medical system and environment.
Conclusions  Despite an overall positive attitude towards LBP guideline implementation, FPs found it hard to come to terms with the conflicting dimensions of LBP patient care. The patient–doctor interaction determined the outcome of the encounter, whether it complied with the guidelines and whether the encounter leads to a healing process or to a vicious circle of unnecessary utilization of services.
Incidence, types and characteristics of aggressive behaviour in treatment facilities for adults with mild intellectual disability and severe challenging behaviour
Authors: Tenneij N. H. , Koot H. M. 
Published: August 2007

AbstractBackground Inpatient aggression in treatment facilities for persons with intellectual disability (ID) can have aversive consequences, for co‐clients and staff, but also for the aggressors themselves. To manage and eventually prevent inpatient aggressive incidents, more knowledge about their types and characteristics is necessary.Method In four facilities, totalling 150 beds, specialized in the treatment of adults with mild ID or severe challenging behaviour, aggressive incidents were registered during 20 weeks using the Staff Observation Aggression Scale‐Revised. Characteristics of auto‐aggressive and outwardly directed incidents and differences in their incidence in male and female clients in these facilities were compared.Results During the observation period of 20 weeks, 639 aggressive incidents were documented. Most of these (71%) were outwardly directed, predominantly towards staff, while most of the remaining incidents were of an auto‐aggressive nature. Of the 185 clients present during the observation period, 44% were involved in outwardly directed incidents (range per client 1–34), and 12% in auto‐aggressive incidents (range per client 1–92). Auto‐aggressive and outwardly directed incidents differed regarding source of provocation, means used during the incident, consequences of the incident and measures taken to stop the incident. The proportion of men and women involved in each type of incident was comparable, as well as the majority of the characteristics of outwardly directed incidents caused by men and women.Conclusions Although approximately half of all clients were involved in aggressive incidents, a small minority of clients were responsible for the majority of incidents. Therefore, better management and prevention of aggressive incidents for only a small group of clients could result in a considerable overall reduction of aggressive incidents in treatment facilities. Comparability of aggressive behaviour in these facilities shown by men and women and differences in characteristics of auto‐aggressive and outwardly directed incidents are discussed.
The association between metabolic syndrome, microalbuminuria and impaired renal function in the general population: impact on cardiovascular disease and mortality
Authors: Klausen K. P. , Parving H.‐H. , Scharling H. , Jensen J. S. 
Published: August 2007

Abstract.Objective:  Microalbuminuria and metabolic syndrome are both associated with cardiovascular disease (CVD). The aim of this study was to determine the potential association between numbers of components in the metabolic syndrome, different levels of microalbuminuria and renal function. We also aimed to determine the risk of death and CVD at different levels of microalbuminuria and renal function and numbers of components in the metabolic syndrome.Design:  Population‐based observational follow‐up studySetting:  Epidemiological research unit (Copenhagen City Heart Study).Subjects:  A total of 2696 men and women, 30–70 years of age.Baseline measures:  Urinary albumin excretion (UAE), creatinine clearance and metabolic risk factors were measured in 1992–1994.Main outcome measurements:  The participants were followed prospectively by registers until 1999–2000 with respect to CVD, and until 2004 with respect to death.Results:  We found a strong association between microalbuminuria and the metabolic syndrome: 2% with none and 18% with five metabolic risk factors had microalbuminuria (P < 0.001). No association between impaired renal function defined as creatinine clearance <60 mL min−1 and the metabolic syndrome was found. Microalbuminuria was associated with increased risk of death and CVD to a similar extend as the metabolic syndrome, irrespective of concomitant presence of metabolic syndrome (RR≈2; P < 0.001). Impaired renal function was not associated with increased risk of death and CVD in subjects with the metabolic syndrome.Conclusions:  Microalbuminuria (UAE >5 μg min−1) confers increased risk of death and CVD to a similar extent as the metabolic syndrome.
Immunomodulation by mesenchymal stem cells and clinical experience
Authors: Le Blanc K. , Ringdén O. 
Published: August 2007

AbstractMesenchymal stem cells (MSCs) from adult marrow can differentiate in vitro and in vivo into various cell types, such as bone, fat and cartilage. MSCs preferentially home to damaged tissue and may have therapeutic potential. In vitro data suggest that MSCs have low inherent immunogenicity as they induce little, if any, proliferation of allogeneic lymphocytes. Instead, MSCs appear to be immunosuppressive in vitro. They inhibit T‐cell proliferation to alloantigens and mitogens and prevent the development of cytotoxic T‐cells. In vivo, MSCs prolong skin allograft survival and have several immunomodulatory effects, which are presented and discussed in the present study. Possible clinical applications include therapy‐resistant severe acute graft‐versus‐host disease, tissue repair, treatment of rejection of organ allografts and autoimmune disorders.
Retinol‐binding protein 4 as a plasma biomarker of renal dysfunction and cardiovascular disease in type 2 diabetes
Authors: Cabré A. , Lázaro I. , Girona J. , Manzanares J. , Marimón F. , Plana N. , Heras M. , Masana L. 
Published: August 2007

Abstract.Objective.  The retinol‐binding protein 4 (RBP4) has been linked to the insulin resistance state in obesity and type 2 diabetes in animal studies. Data in humans are controversial and their relationship with organ damage in diabetic patients is lacking. We studied the association of plasma RBP4 with organ complications in type 2 diabetic patients.Setting.  Sant Joan University Hospital, Reus, Spain.Subjects.  165 nonsmoker type 2 diabetic subjects according to American Diabetes Association criteria, aged 36–79 years, without proteinuria or severely decreased glomerular filtration rates (MDRD‐GFR <30 mL min−1 1.73 m−2), were included in the study.Main outcome measure.  Plasma RBP4 concentrations were the primary outcome variable. Statistics were performed in relation to clinical and subclinical arteriosclerosis, renal function parameters and biochemical data.Results.  Plasma RBP4 concentrations were positively correlated with serum creatinine levels (r = 0.322, P < 0.001) and inversely correlated with MDRD‐GFR (r = −0.468, P = 0.009). Patients with moderately renal dysfunction (MDRD‐GFR <60 mL min−1 1.73 m−2) had higher plasma RBP4 concentrations than those with normal to mildly decreased GFR (55.3 ± 24.6 vs. 40.8 ± 15.4, P <0.001). Patients in the top quartile of RBP4 concentrations had an increased adjusted odds ratio for moderately renal dysfunction compared with lower quartiles (4.68; 95% CI: 1.52–14.36, P = 0.007). The presence of microalbuminuria was not associated with RBP4. Plasma RBP4 concentrations were higher in those subjects with previous clinical arteriosclerosis than in event‐free subjects (48.8 ± 24.2 vs. 40.6 ± 13.9, P = 0.045). The presence of retinopathy or polyneuropathy did not differ across RBP4 quartiles.Conclusions.  Plasma RBP4 concentration might be a biomarker of nephropathy and cardiovascular disease in type 2 diabetic subjects.
Regulation of inflammation‐related genes in human adipose tissue
Authors: Clement K. , Langin D. 
Published: August 2007

Abstract.The identification of a moderate increase in circulating inflammatory factors in obese subjects, the description of changes in inflammatory gene expression in adipose tissue (AT) and the discovery that macrophage cells infiltrate AT are observations contributing to the concept that human obesity is a chronic inflammatory illness. This concept has led to some revision of the physiopathology of obesity and of its related metabolic and cardiovascular co‐morbidities. Low‐grade inflammation in the AT and the subsequent production of specific biomarkers could actually link expanded fat mass to obesity complications. This review aims at providing an overview of the current knowledge brought up by human gene expression studies, notably those performed on a large scale in AT depots. The regulation of specific biomarkers related to inflammation and putative new candidates (i.e. cathepsins and serum amyloid A) is discussed in the context of weight loss programmes based on calorie restriction and physical exercise. The foreseen clinical and technological challenges are also summarized.
The role of endothelial cells in inflamed adipose tissue
Authors: Sengenès C. , Miranville A. , Lolmède K. , Curat C. A. , Bouloumié A. 
Published: August 2007

Abstract.In recent years, the general concept has emerged that chronic low‐grade inflammation can be the condition linking excessive development of adipose tissue (AT) and obesity‐associated pathologies such as type II diabetes and atherosclerosis. Moreover, the evidence that the growth of the fat mass was associated with an accumulation of adipose tissue macrophages (ATM) has raised the hypothesis that the development of an inflammatory process within the growing fat mass is a primary event involved in the genesis of systemic metabolic and vascular alterations. As ATM originate from the bone marrow/blood compartment, enhanced macrophage recruitment to growing AT is suspected. However, the mechanisms responsible for attracting the blood cells and their entry into the fat mass remain to be clearly defined. The present review highlights the key role of endothelial cells in the control of the inflammatory process and describes the potential involvement of AT‐endothelial cells as well as the factors involved in the regulation of their phenotype in the ‘inflamed fat tissue’.
Tumour necrosis factor‐α in human adipose tissue – from signalling mechanisms to clinical implications
Authors: Rydén M. , Arner P. 
Published: August 2007

Abstract.From its initial implication in the development of cachexia in the early 1980s, it is now almost 15 years ago that tumour necrosis factor‐alpha (TNF‐α) was first shown to be involved in the development of insulin resistance in obesity. Since the original findings in mice, a wealth of data has been obtained in a variety of settings and species. This intensive research has demonstrated both similarities and differences between rodents and humans regarding the molecular mechanisms and metabolic consequences of TNF‐α overexpression. This review will focus on the role of TNF‐α in human white adipose tissue with particular emphasis on its regulation of lipolysis – an important pathway in adipocytes which is linked to insulin‐resistant phenotypes in obesity and the metabolic syndrome.
Niche partitioning of closely related symbiotic dinoflagellates
Authors: SAMPAYO EUGENIA M. , FRANCESCHINIS LORENZO , HOEGH‐GULDBERG OVE , DOVE SOPHIE 
Published: August 2007

AbstractReef‐building corals are fundamental to the most diverse marine ecosystems, yet a detailed understanding of the processes involved in the establishment, persistence and ecology of the coral–dinoflagellate association remains largely unknown. This study explores symbiont diversity in relation to habitat by employing a broad‐scale sampling regime using ITS2 and denaturing gradient gel electrophoresis. Samples from Pocillopora damicornis, Stylophora pistillata and Seriatopora hystrix all harboured host‐specific clade C symbiont types at Heron Island (Great Barrier Reef, Australia). While Ser. hystrix associated with a single symbiont profile along its entire depth distribution, both P. damicornis and Sty. pistillata associated with multiple symbiont profiles that showed a strong zonation with depth. It is shown that, with an increased sampling effort, previously identified ‘rare’ symbiont types within this group of host species are in fact environmental specialists. A multivariate approach was used to expand on the common distinction of symbionts by a single genetic identity. It shows merit in its capacity not only to include all the variability present within the marker region but also to reliably represent ecological diversification of symbionts. Furthermore, the cohesive species concept is explored to explain how niche partitioning may drive diversification of closely related symbiont lineages. This study provides thus evidence that closely related symbionts are ecologically distinct and fulfil their own niche within the ecosystem provided by the host and external environment.
Risk of ectoparasitism and genetic diversity in a wild lesser kestrel population
Authors: ORTEGO JOAQUÍN , APARICIO JOSE MIGUEL , CALABUIG GUSTAU , CORDERO PEDRO J. 
Published: August 2007

AbstractParasites and infectious diseases are major determinants of population dynamics and adaptive processes, imposing fitness costs to their hosts and promoting genetic variation in natural populations. In the present study, we evaluate the role of individual genetic diversity on risk of parasitism by feather liceDegeeriella rufain a wild lesser kestrel population (Falco naumanni). Genetic diversity at 11 microsatellite loci was associated with risk of parasitism by feather lice, with more heterozygous individuals being less likely to be parasitized, and this effect was statistically independent of other nongenetic parameters (colony size, sex, location, and year) which were also associated with lice prevalence. This relationship was nonlinear, with low and consistent prevalences among individuals showing high levels of genetic diversity that increased markedly at low levels of individual heterozygosity. This result appeared to reflect a genome‐wide effect, with no single locus contributing disproportionably to the observed effect. Thus, overall genetic variation, rather than linkage of markers to genes experiencing single‐locus heterosis, seems to be the underlying mechanism determining the association between risk of parasitism and individual genetic diversity in the study host–parasite system. However, feather lice burden was not affected by individual heterozygosity; what suggest that differences in susceptibility, rather than variation in defences once the parasite has been established, may shape the observed pattern. Overall, our results highlight the role of individual genetic diversity on risk of parasitism in wild populations, what has both important evolutionary implications and major consequences for conservation research on the light of emerging infectious diseases that may endanger genetically depauperated populations.
Nuclear vs. plastid data: complex Pleistocene history of a circumpolar key species
Authors: EIDESEN P. B. , ALSOS I. G. , POPP M. , STENSRUD Ø. , SUDA J. , BROCHMANN C. 
Published: August 2007

AbstractTo fully understand the contemporary genetic structure of plants, both nuclear and plastid markers are needed. Three chloroplast DNA (cpDNA) lineages, which probably diverged before the major Pleistocene glaciations, have been identified in the circumpolar/circumborealVaccinium uliginosum. Here we investigate its nuclear DNA variation using nuclear ribosomal internal transcribed spacer (ITS) sequences, DNA ploidy level measurements and amplified fragment length polymorphisms (AFLPs). We also extend the cpDNA dataset. Two ITS lineages, corresponding to diploids and tetraploids, respectively, were identified. However, both main sequence types apparently occurred in most individual plants but showed ploidy‐biased homogenization and possibly reflect paralogy predating the origin ofV.uliginosum. The ploidy levels were largely consistent with the cpDNA lineages, suggesting that the initial cpDNA divergence followed early polyploidizations. Five main AFLP groups were identified, consistent with recent glacial refugia in Beringia, western Siberia, the southern European mountains and areas south/east of the Scandinavian and Laurentide ice sheets. Except from the southern European mountains, there has been extensive expansion from all refugia, resulting in several contact zones. Surprisingly, the presumably older ploidy and cpDNA patterns were partly inconsistent with the main AFLP groups and more consistent with AFLP subgroups. A likely major driver causing the inconsistencies is recent nuclear gene flow via unreduced pollen from diploids to tetraploids. This may prevent cytoplasmic introgression and result in overlayed patterns formed by processes dominating at different time scales. The data also suggest more recent polyploidizations, as well as several chloroplast capture events, further complicating this scenario. This study highlights the importance of combining different marker systems to unravel intraspecific histories.
Role of inbreeding depression and purging in captive breeding and restoration programmes
Authors: LEBERG PAUL L. , FIRMIN BRIGETTE D. 
Published: August 2007

AbstractInbreeding depression is a major force affecting the evolution and viability of small populations in captive breeding and restoration programmes. Populations that experience small sizes may be less susceptible to future inbreeding depression because they have been purged of deleterious recessive alleles. We review issues related to purging, as they apply to the management of small populations, and discuss an experiment we conducted examining purging in populations of mosquitofish (Gambusia affinis). Purging is an important process in many small populations, but the literature contains a diversity of responses to purging both within and among studies. With the exception that slow inbreeding results in more purging and less threat to population viability, there seem to be few consistent trends that aid in prediction of how a purging event will affect a population. In our examination of purging on population viability in mosquitofish, single or multiple bottlenecks do not appear to have resulted in any purging of the influence of genetic load on population growth. Rather, serial bottlenecks resulted in a marked decline in population growth and an increase in extinction. Our results, taken together with those of reviewed studies, suggest that in small populations there is great uncertainty regarding the success of any single purging event in eliminating inbreeding depression, together with the high likelihood that purging will depress population viability through the fixation of deleterious alleles. In management of captive breeding and restoration programmes, the common practice of avoiding inbreeding and small population sizes should be followed whenever possible.
Genetic consequences of interbreeding between farmed and wild Atlantic salmon: insights from the transcriptome
Authors: ROBERGE CHRISTIAN , NORMANDEAU ÉRIC , EINUM SIGURD , GUDERLEY HELGA , BERNATCHEZ LOUIS 
Published: August 2007

AbstractLarge annual escapees of farmed Atlantic salmon enhance the risk of extinction of wild populations through genetic and ecological interactions. Recently, we documented evolutionary change in gene transcription between farmed and wild Atlantic salmon after only five generations of artificial selection. While differences for most quantitative traits are expected to gradually dilute through repeated backcrossing to wild populations, the genetic basis of gene transcription has been shown to be largely nonadditive and hybrid crosses may display unexpected inheritance patterns. This makes it difficult to predict to what extent interbreeding between farmed and wild individuals will change the genetic makeup of wild salmon populations. Here, we compare the genome‐wide gene transcription profiles of Norwegian wild salmon to that of a second generation hybrid cross [backcross: (Farmed X Wild) X Wild]. Over 6% (298, q‐value < 0.01) of the detected genes exhibited highly significantly different transcription levels, and the range and average magnitude of those differences was strikingly higher than previously described between pure farmed and wild strains. Most differences appear to result from nonadditive gene interactions. These results suggest that interbreeding of fugitive farmed salmon and wild individuals could substantially modify the genetic control of gene transcription in natural populations exposed to high migration from fish farms, resulting in potentially detrimental effects on the survival of these populations. This further supports the idea that measures to considerably reduce the number of escaped farmed salmon and their reproduction in the wild are urgently needed.