bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of multiple birth on infant mortality in Bangladesh
Authors: Hong Rathavuth 
Published: September 2006

Aim: Levels of infant and child mortality in many developing countries remain unacceptably high, and they are disproportionably higher among high‐risk groups such as newborn and infant of multiple births, particularly in countries where advanced medical cares are available only at regional referral levels with limited access by the poor rural women and children. This study examined the relationship between high‐risk infant of multiple birth and infant mortality in Bangladesh.Methods: The analysis uses information on 7001 childbirths in 5 years preceding the 2004 Bangladesh Demographic and Health Survey to examine the relationship between multiple birth and infant mortality using multivariate analysis, controlling for child’s sex, birth order, prenatal care, delivery assistance; mother’s age at child birth, nutritional status, education level; household living conditions and several other risk factors.Results: Results indicate that children born multiple birth were more than six‐times as likely to die during infancy as those born singletons (hazard ratio = 6.51; 95% confidence interval: 4.10, 10.36). Controlling for all other risk factors does not change the strength and direction of the relationship (hazard ratio = 6.18; 95% confidence interval: 3.65, 10.46). Receiving prenatal care and access to safe drinking water are associated with lower risk.Conclusion: Multiple births are strongly negatively associated with infant survival in Bangladesh independent of other risk factors. This evidence suggests that improving maternal and child health at the community level, screening for high‐risk pregnancies and making referral services for these conditions more accessible to the rural women and children will be key to improving child survival in Bangladesh.
Different signal transduction cascades are activated simultaneously in the rat insular cortex and hippocampus following novel taste learning
Authors: Yefet Keren , Merhav Maayan , Kuulmann‐Vander Shelly , Elkobi Alina , Belelovsky Katya , Jacobson‐Pick Shlomit , Meiri Noam , Rosenblum Kobi 
Published: September 2006

AbstractNovel taste learning is a robust one‐trial incidental learning process, dependent on functional activity of the insular (taste) cortex. In contrast to that of the cortex, the role of the hippocampus in taste learning is controversial. We set out to identify the time courses of the activation of mitogen‐associated protein kinase (MAPK), transcription factor cAMP‐response element‐binding protein (CREB) and Akt/PKB (protein kinase B) in the insular cortex and hippocampus of rats subsequent to novel taste learning. Following taste learning, an early response (20 min) occurred at the same time in the insular cortex and the hippocampus. However, whereas MAPK was activated specifically in the insular cortex, CREB and Akt were phosphorylated in the hippocampus but not in the cortex. In addition, the immediate early gene, CCAAT/enhancer binding protein (C/EBPβ) was induced in both the hippocampus and the insular cortex 18 h following taste learning. The results demonstrate, for the first time, correlative activation and gene expression in the hippocampus following novel taste learning. Moreover, the results suggest that different signal transduction cascades necessary for taste learning are activated in concert in different brain structures, to enable taste learning and consolidation.
Rapid pH and PO2 changes in the tissue recording chamber during stoppage of a gas‐equilibrated perfusate: effects on calcium currents in ventral horn neurons
Authors: Carlin K. P. , Brownstone R. M. 
Published: September 2006

Abstract In vitro studies often use bicarbonate‐buffered saline solutions to mimic the normal extracellular environment of tissues. These solutions are typically equilibrated with gaseous O2 and CO2, the latter interacting with bicarbonate ions to maintain a physiological pH. In vitro tissue chambers, like those used for electrophysiology, are usually continually perfused with the gassed buffer, but stopping the perfusion to add expensive chemicals or acquire imaging data is a common practice. The present study demonstrates that this procedure leads to rapid (< 30 s) increases in pH and decreases in PO2 of the detained solution in the tissue chamber. During the first 200 s, pH increased by 0.4 units and resulted in a 25% PO2 reduction of the detained solution. The rates of these changes were dependent on the volume of solution in the chamber. In experiments using acute transverse slices from the lumbar spinal cord of neonatal (postnatal day 0–10) mice, perfusion stoppage of the same duration was accompanied by a 34.7% enhancement of the peak voltage‐gated calcium current recorded from ventral horn neurons. In these cells both low voltage‐activated and high voltage‐activated currents were affected. These currents were unaffected by decreasing PO2 when a CO2‐independent buffer was used, suggesting that changes in pH were responsible for the observed effects. It is concluded that the procedure of stopping a bicarbonate/CO2‐buffered perfusate results in rapid changes in pH and PO2 of the solution detained in the tissue chamber, and that these changes have the potential to covertly influence experimental results.
USPIO – enhanced rectal cancer specimen MRI: how well does it correlate with node identification at histopathology?
Authors: Rasheed S. , Guenther T. , Talbot I. , McDonald P. , Northover J. , Stirling J. , Culver L. , Glynne‐Jones R. , Padhani A. R. 
Published: September 2006

Introduction:  Detection of lymph node (LN) metastasis is important for the optimal management of rectal cancer patients. Ultrasmall‐particle superparamagnetic iron oxide (USPIO) contrast enhanced magnetic resonance imaging (MRI) has emerged as an effective method of assessing nodal involvement in various malignancies. We have investigated the correlation between nodes seen on specimen MRI and those found at histopathology and the optimum time interval between contrast injection and surgery in USPIO mesorectal lymphography.Method:  Thirteen rectal cancer patients underwent MRI before and 24 h after intravenous infusion of USPIO contrast (Sinerem®, Advanced Magnetics Inc, Cambridge, MA, USA). Total Mesorectal Excision (TME) surgery was followed by fixed specimen MRI. Lymph nodes seen on specimen MRI and those found at pathology were compared for studies performed <5 days and ≥5 days prior to surgery.Results:  Histopathological LNs found correlated well with those seen on specimen MRI (all patients, r = 0.73; P = 0.005, figure). Correlation was better for the <5 day group (r = 0.84; P = 0.01) than for the ≥5 day group (r = 0.54; P = 0.35). Discussion:  USPIO specimen MRI is useful in mesorectal LN assessment. We demonstrate good correlation between specimen MRI and histopathology and show that fewer errors occur in assessment when the time interval between contrast injection and surgery is <5 days.
Factors influencing lymph node retrieval in colorectal cancer and its effect on survival
Authors: Evans M. D. , Rees A. , Stamatakis J. D. , Karandikar S. S. 
Published: September 2006

Introduction:  NICE has set standards for lymph node (LN) harvest in surgery for colorectal cancer (CRC). We report the effect of the operating surgeon and reporting pathologist on lymph node yield and the role of LN yield on survival.Method:  Data on all patients with CRC treated in a single unit between 1999 and 2004 were collected in the ACPGBI database. Lymph node harvest was identified for each of three surgeons and three pathologists. Actuarial survival of all patients with Dukes’ stage B with greater than or less than 8 reported LNs and Dukes’ stage C were compared using log‐rank test (Kaplan–Meier method).Results:  A total of 380 cases had a curative resection with a unit median LN retrieval of 13.There was no difference in survival between Dukes’ stage B <8 LN (mean 42 months, 95% CI 29–55) and Dukes stage C (mean 45 months, 95% CI 29–51), log‐rank P = 0.7618. Survival between Dukes stage B (8 LN and Dukes C was significantly different (mean 58 months, 95% CI 53–64 vs 45 months, 95% CI 29–51), log‐rank P = 0.006.

Colorectal surgeon
Non colorectal
Pathologist

1 n = 183
2 n = 64
3 n = 86
n = 47
1 n = 200
2 n = 106
3 n = 57
Locum n = 17

Median lymph node observed (Range)
12*1–37
14*0–25
14*2–42
14* (1–32)
15** (2–42)
12** (1–32)
11** (0–29)
11** (2–39)

95% CI
12.5–14.5
11.7–14.6
13.3–16.6
12.–16.3
14.1–16.0
12.0–14.4
9.7–12.8
7.7–16.9

*P = 0.498 (Kruskal–Wallis).
**P < 0.0001 (Kruskal–Wallis).

Conclusions:  This study demonstrates that within a single unit the reporting pathologist significantly influences LN yield in CRC treatment and that a minimum of eight lymph nodes needs to be examined to stage CRC as Dukes’ C accurately. In this unit the surgeon was not a significant variable.
Evaluation of a ‘lower GI electronic referral protocol’: analysis of 300 referral episodes
Authors: John S. K. , Jones O. M. , Howell R. , Fozard J. B. 
Published: September 2006

Introduction:  Appropriate destination and referral urgency of patients with colorectal symptoms is a prerequisite for efficient diagnosis of colorectal cancers (CRC). We aim to evaluate the efficacy of an electronic referral protocol (ERP) for lower GI symptoms in primary care.Method:  Three hundred referrals including 100 consecutive CRC (group A), 100 actual fast‐track referrals (group B) and 100 routine referrals (group C) were run through the ERP. The ability of the ERP to filter out CRC from all three groups was assessed.Results:  Only 25% of group A had actually been referred as ‘fast‐track’. The ERP appropriately identified 73% of these cases as ‘fast‐track’ (P = 0.02). The ERP identified 49% of group B patients as ‘fast‐track’, including eight of the 11 cancers in this group. The ERP downgraded from fast‐track 19 of the 28 patients in group B without pathology. In group C, three of the four patients with CRC were upgraded to ‘fast‐track’ and overall 18 routine referrals were directed ‘fast‐track’.Conclusion:  This preliminary study suggests that a ‘Lower GI electronic referral protocol’ in primary care might be more efficient in achieving the twin aims of channelling more patients with CRC through the fast‐track referral pathway, whilst reducing inappropriate referrals through this route. Further studies are needed to see if this ERP will increase the yield from the ‘fast‐track’ referral pathway.
Preoperative plasma MMP‐2 expression is prognostic in colorectal cancer
Authors: Tutton M. G. , Sharif S. P. , Eccles S. A. , George M. L. , Abulafi A. M. 
Published: September 2006

Introduction:  The gelatinases (MMP‐2 and MMP‐9) are important in colorectal cancer invasion and metastasis. Plasma concentrations of the gelatinases correlate with clinical stage in colorectal cancer; however, whether this gives prognostic information is unknown.Method:  Gelatinase mRNA and protein levels in tumour and plasma were determined respectively by RT‐PCR, ELISA and gelatin zymography in a prospective study of 75 colorectal cancer patients. At follow‐up, 40 patients were alive with a median survival of 75 months (range 72–80).Results:  Expression of the gelatinases was significantly increased within tumour relative to normal colon and within plasma of cancer patients (P < 0.01; Mann–Whitney U‐test). Within plasma, total MMP‐2 and MMP‐9 expression (MMP plus MMP/TIMP complexes), determined by ELISA, and free MMP‐2(72 kDa) determined by gelatin zymography, increased significantly with Dukes’ stage (P < 0.001; Kruskal–Wallis test). As well as correlating with Dukes’ stage, lymphatic and vascular invasion, Kaplan–Meier survival analysis showed that only elevated plasma MMP‐2 was significantly associated with a worse prognosis: free MMP‐2 (worse prognosis with increasing quartile; P < 0.05) and total MMP‐2 (upper quartile cut‐off limit; P = 0.04).Discussion:  In addition to being an indicator of colorectal cancer invasion, plasma MMP‐2 levels may provide a simple, non‐invasive preoperative test for prognosis in colorectal cancer.
Rectal sensory dysfunction is prevalent in faecal incontinence
Authors: Gooneratne M. , Lunniss P. J. , Hickey F. , Williams N. S. , Scott S. M. 
Published: September 2006

Introduction:  There has been increasing interest in the role of rectal sensitivity in continence, particularly as the advent of sacral nerve stimulation (SNS). Both rectal hypersensitivity (RHyper) and hyposensitivity (RHypo) have been described in patients with faecal incontinence (FI). We aimed to determine the prevalence of rectal sensory dysfunction according to the nature of FI.Method:  A retrospective study of 627 patients (mean age 55 years, range 20–88; 512 F) presenting with FI to a tertiary referral centre, were divided according to their isolated symptoms of urge incontinence (UI), passive incontinence (PI), post defaecatory leakage (PDL), or combined UI and PI/PDL. Patients underwent anorectal physiological assessment including rectal sensitivity to balloon distension. RHyper was classified when the maximum tolerated volume was below the Institution's normal range, and RHypo was deemed present when any of the three sensory distension thresholds were elevated above normal.Results:  Numbers (percentages) of patient classified according to symptoms and results of rectal sensory testing

OVERALL
UI
PI
PDL
UI + PI/PDL

Normal
416 (66)
117 (28)
114 (19)
56 (12)
97 (23)

RHyper
138 (22)
55 (40)*
27 (14)
5 (3)
43 (31)*

RHypo
73 (12)
19 (26)
24 (25)*
12 (14)**
13 (18)

*P < 0.05.
**P = 0.003 (RHyper vs RHypo).

Conclusion:  One‐third of all patients with FI have a sensory abnormality, predominantly RHyper. RHyper was most significantly associated with symptoms of UI. The increased prevalence of RHypo in patients with PI and PDL is likely to be related to overflow. SNS, perhaps by modulating rectal afferent pathways, may improve incontinence by normalizing extremes of rectal sensitivity.
Predicting nutritional outcome after extensive small bowel resection
Authors: Hyder S. A. , George B. D. 
Published: September 2006

Introduction:  Extensive small bowel resection often results in the need for long‐term nutritional support. This study aimed to assess the factors affecting long term nutritional outcome following extensive small bowel resection.Method:  Patients who underwent extreme small bowel resection were assessed. Indication for small bowel resection, length of remaining small bowel, presence of ileocaecal valve, colonic resection and long term total parental nutritional (TPN) requirements were recorded.Results:  There were 24 patients of age range 28–79 (median 49 years). Fourteen were male. Indications for small bowel resection included Inflammatory bowel disease (n = 13) Mesenteric ischemia (n = 8) and miscellaneous (n = 3). Patients were divided into three groups:Conclusion:  Small bowel resection leaving <100 cm of small bowel is associated with a 70% chance of needing long‐term TPN. Presence of ileocaecal valve and/or some colon reduces the risk of long term TPN.
Analysis of Case‐Only Studies Accounting for Genotyping Error
Authors: Cheng K. F. 
Published: September 2006

SummaryThe case‐only design provides one approach to assess possible interactions between genetic and environmental factors. It has been shown that if these factors are conditionally independent, then a case‐only analysis is not only valid but also very efficient. However, a drawback of the case‐only approach is that its conclusions may be biased by genotyping errors. In this paper, our main aim is to propose a method for analysis of case‐only studies when these errors occur. We show that the bias can be adjusted through the use of internal validation data, which are obtained by genotyping some sampled individuals twice. Our analysis is based on a simple and yet highly efficient conditional likelihood approach. Simulation studies considered in this paper confirm that the new method has acceptable performance under genotyping errors.
Community‐Acquired Bacterial Meningitis in Older People
Authors: Weisfelt Martijn , Van De Beek Diederik , Spanjaard Lodewijk , Reitsma Johannes B. , De Gans Jan 
Published: September 2006

OBJECTIVES: To describe clinical features of bacterial meningitis in older people.DESIGN: Cohort study.SETTING: Hospitals in the Netherlands.PARTICIPANTS: Patients aged over 16 with community‐acquired bacterial meningitis, confirmed using cerebrospinal fluid culture.MEASUREMENTS: Data were collected prospectively. The cohort was dichotomized with respect to age (≥60 vs 17–59).RESULTS: Two hundred fifty‐seven of 696 episodes of community‐acquired bacterial meningitis (37%) occurred in elderly patients and 439 (63%) in younger adults. Older people more often presented with the triad of fever, neck stiffness, and altered mental status than younger adults (58% vs 36%; P<.001). In older people, meningitis was due to Streptococcus pneumoniae in 176 episodes (68%). In younger adults, Neisseria meningitidis was the most common pathogen, responsible for 221 episodes (50%). Elderly patients more often developed complications than younger adults (72% vs 57%; P<.001), which resulted in a higher mortality rate (34% vs 13%; P<.001). Older people tended to die more often from cardiorespiratory failure (25% vs 11%; P=.06), whereas younger adults more often died from brain herniation (23% vs 2%; P=.004).CONCLUSION: Elderly patients with bacterial meningitis often present with classic symptoms of bacterial meningitis. Bacterial meningitis within this age group is predominantly due to S. pneumoniae and is associated with high morbidity and mortality rates. Whereas older people die frequently of cardiorespiratory failure, younger adults more often die of brain herniation.
Reducing Suicidal Ideation in Depressed Older Primary Care Patients
Authors: Unützer Jürgen , Tang Lingqi , Oishi Sabine , Katon Wayne , Williams John W. , Hunkeler Enid , Hendrie Hugh , Lin Elizabeth H.B. , Levine Stuart , Grypma Lydia , Steffens David C. , Fields Julie , Langston Christopher ,   for the IMPACT Investigators
Published: September 2006

OBJECTIVES: To determine the effect of a primary care–based collaborative care program for depression on suicidal ideation in older adults.DESIGN: Randomized, controlled trial.SETTING: Eighteen diverse primary care clinics.PARTICIPANTS: One thousand eight hundred one adults aged 60 and older with major depression or dysthymia.INTERVENTION: Participants randomized to collaborative care had access to a depression care manager who supported antidepressant medication management prescribed by their primary care physician and offered a course of Problem Solving Treatment in Primary Care for 12 months. Participants in the control arm received care as usual.MEASUREMENTS: Participants had independent assessments of depression and suicidal ideation at baseline and 3, 6, 12, 18, and 24 months. Depression was assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (SCID). Suicidal ideation was determined using the SCID and the Hopkins Symptoms Checklist.RESULTS: At baseline, 139 (15.3%) intervention subjects and 119 (13.3%) controls reported thoughts of suicide. Intervention subjects had significantly lower rates of suicidal ideation than controls at 6 months (7.5% vs 12.1%) and 12 months (9.8% vs 15.5%) and even after intervention resources were no longer available at 18 months (8.0% vs 13.3%) and 24 months (10.1% vs 13.9%). There were no completed suicides in either group. Information on suicide attempts or hospitalization for suicidal ideation was not available.CONCLUSION: Primary care–based collaborative care programs for depression represent one strategy to reduce suicidal ideation and potentially the risk of suicide in older primary care patients.
Effects of plant and prey characteristics on the predatory behavior of Delphastus catalinae
Authors: Guershon Moshe , Gerling Dan 
Published: September 2006

AbstractNymphal setosity of the whitefly Bemisia tabaci Gennadius (Homoptera: Aleyrodidae) has been reported to be induced by mechanical stimuli such as leaf tomentosity, and related to the predatory performance of the coccinellid Delphastus catalinae (Horn) (Coleoptera: Coccinellidae). In this study, a possible adaptive value of this phenomenon for the whitefly is shown through the combined effects of leaf and prey characteristics on the walking and predatory behaviors of the beetle. Leaf tomentosity significantly affected the walking patterns of the beetle and therefore its searching abilities, thus indirectly increasing the influence of prey distribution upon predator's efficiency. Moreover, while searching on tomentose leaves, the beetles showed preference for the smooth prey phenotype. This behavior was found dependent on the experience of the beetle in previous encounters. These results are pertinent to intraspecific competition between the different nymphal phenotypes and to the predatory efficiency of this beetle, which is utilized in biological control of whiteflies.
Remarkable susceptibility of the diamondback moth (Plutella xylostella) to ingestion of Pir toxins from Photorhabdus luminescens
Authors: Blackburn Michael B. , Farrar Robert R. , Novak Nicole G. , Lawrence Susan D. 
Published: September 2006

AbstractGenes encoding Pir toxins were cloned and sequenced from Photorhabdus luminescens (Enterobacteriaceae) strain Hm. Cultures of Escherichia coli expressing the Pir A and B proteins were highly toxic when fed to larvae of Plutella xylostella L. (Lepidoptera: Plutellidae), as had been reported previously. Histological examination of P. xylostella larvae fed with recombinant E. coli revealed gross abnormalities of the midgut epithelium, with profound swelling and shedding of the apical membranes. However, the recombinant E. coli had no effect on the growth or mortality of larval Heliothis virescens F. (Lepidoptera: Noctuidae), Manduca sexta L. (Lepidoptera: Sphingidae), Lymantria dispar L. (Lepidoptera: Lymantriidae), or Leptinotarsa decemlineata Say (Coleoptera: Chrysomelidae). Based on these results, P. xylostella is at least 300‐fold more susceptible to Pir toxins than other insect species tested, suggesting that they may not be broadly useful as insecticidal proteins. Because Pir B has sequence similarities with N‐terminal portions of Cry proteins from Bacillus thuringiensis, we also tested the recombinant E. coli against a strain of P. xylostella that is resistant to the Cry 1A toxin, but found no difference in mortality between resistant and susceptible strains.