bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating insecticide‐treated bednets into a measles vaccination campaign achieves high, rapid and equitable coverage with direct and voucher‐based methods
Authors: Grabowsky Mark , Farrell Nick , Hawley William , Chimumbwa John , Hoyer Stefan , Wolkon Adam , Selanikio Joel 
Published: October 2005

SummaryPopulation coverage of insecticide‐treated nets (ITNs) in Africa falls well below the Abuja target of 60% while coverage levels achieved during vaccination campaigns in the same populations typically exceed 90%. Household (HH) cost of ITNs is an important barrier to their uptake. We investigated the coverage, equity and cost of linking distribution of free ITNs to a measles vaccination campaign. During a national measles vaccination campaign in Zambia, children in four rural districts were given a free ITN when they received their measles vaccination. In one urban district, children were given a voucher, which could be redeemed for a net at a commercial distribution site. About 1700 HHs were asked whether they received vaccination and an ITN during a measles campaign, as well as questions on assets (e.g. type roofing material or bicycle ownership) to assess HH wealth. Net ownership was calculated for children in each wealth quintile. In the rural areas, ITN coverage among children rose from 16.7% to 81.1% and the equity ratio from 0.32 to 0.88 and in the urban area from 50.7% to 76.2% (equity ratio: 0.66–1.19). The operational cost per ITN delivered was $0.35 in the rural area with direct distribution and $1.89 in the urban areas with voucher distribution. Mass distribution of ITNs through vaccination campaigns achieves rapid, high and equitable coverage at low cost.
Open randomized study of artesunate‐amodiaquine vs. chloroquine‐pyrimethamine‐sulfadoxine for the treatment of uncomplicated Plasmodium falciparum malaria in Nigerian children
Authors: Sowunmi A. , Fehintola F. A. , Adedeji A. A. , Gbotosho G. O. , Tambo E. , Fateye B. A. , Happi T. C. , Oduola A. M. J. 
Published: October 2005

SummaryBackground  Artemisinin‐based combination antimalarials are currently considered effective alternatives for the treatment of malaria in Africa, but there are few studies of such combinations in Nigerian children. We assessed the safety, treatment efficacy and effects on gametocyte carriage of the combination of artesunate plus amodiaquine and chloroquine plus pyrimethamine‐sulfadoxine in children.Methods  We evaluated 153 children who were aged 12 years or younger who had uncomplicated Plasmodium falciparum malaria. Patients were randomly assigned a combination of artesunate (4 mg/kg of body weight daily for 3 days) plus amodiaquine (30 mg/kg over 3 days), or chloroquine (25 mg/kg over 3 days) plus pyrimethamine‐sulfadoxine (25 mg/kg of the sulfadoxine component at presentation). The primary endpoints were the proportions of children with adequate clinical and parasitological response, late parasitological failure, late clinical failure and early treatment failure. The parasitological cure rates on days 14–28 were also used as the primary endpoints.Results  Both regimens were well tolerated; no child was withdrawn because of drug intolerance. All children treated with artesunate plus amodiaquine had adequate clinical and parasitological response (ACPR), while all but five children treated with chloroquine plus pyrimethamine‐sulfadoxine had similar response. Fever clearance times were similar in the two treatment groups. However, the proportion of patients whose parasitaemia cleared by day 2 was significantly higher (100 vs. 50%, P = 0.00001) and parasite clearance was significantly faster (1.7 ± 0.4 vs. 2.5 ± 0.8 days, P = 0.0001) in children treated with artesunate plus amodiaquine. The cure rates on days 21 (100%vs. 94%, P = 0.03) and 28 (100%vs. 90%, P = 0.003) were also significantly higher in children treated with artesunate plus amodiaquine than in those treated with chloroquine plus pyrimethamine‐sulfadoxine. Overall, a significantly higher proportion of children treated with chloroquine plus pyrimethamine‐sulfadoxine carried gametocytes at least once during follow‐up compared with those treated with artesunate plus amodiaquine [5 of 50 (10%) vs. 1 of 103 (0.97%), P = 0.01].Conclusion  The combination of artesunate plus amodiaquine is therapeutically superior to a combination of chloroquine plus pyrimethamine‐sulfadoxine, and significantly reduced gametocyte carriage following treatment.
Mutations in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase genes in Senegal
Authors: Ndiaye D. , Daily J. P. , Sarr O. , Ndir O. , Gaye O. , Mboup S. , Wirth D. F. 
Published: October 2005

SummarySenegal recently (2004) switched to sulfadoxine‐pyrimethamine (SP) with amodiaquine as first line therapy for malaria in response to increasing chloroquine resistance. In anticipation of emerging resistance to SP as a result of this change in drug pressure, we set out to define the baseline prevalence of SP‐associated mutations in the dhfr and dhps genes in Plasmodium falciparum using geographically diverse and longitudinally collected samples. A total of 153 blood samples were analysed from patients (5 years or older) with mild malaria after informed consent was obtained. Longitudinal samples were collected between 2000 and 2003 in Pikine, a suburb of Dakar. Geographically diverse site sampling was carried out in 2003. The mutation prevalence in DHFR codons 51, 59 and 108 is 65%, 61% and 78% in Pikine, 2003. The overall prevalence of the triple mutation that is associated with high‐level pyrimethamine resistance is 61%. The mutation prevalence rate in DHPS codons 436 and 437 is 21% and 40%, respectively. There is significant geographic variation in genotypic resistance, as samples from Pikine in 2003 had higher mutation prevalence in the pfdhfr and pfdhps genes compared to samples from Tambacounda (P < 0.015). In summary, this study demonstrates a high background prevalence of SP resistance mutations already present in P. falciparum in Senegal.
Post‐surgical assessment of excised tissue from patients with Buruli ulcer disease: progression of infection in macroscopically healthy tissue
Authors: Bretzel G. , Siegmund V. , Racz P. , van Vloten F. , Ngos F. , Thompson W. , Biason P. , Adjei O. , Fleischer B. , Nitschke J. 
Published: October 2005

SummaryObjective  The current standard of treatment of Buruli ulcer disease (BUD) is surgical excision of lesions. Excision size is determined macroscopically assuming the complete removal of all infected tissue. However, dissemination of infection beyond the excision margins into apparently healthy tissue, possibly associated with recurrences, cannot be excluded in this way. To assess the central to peripheral progression of Mycobacterium ulcerans infection and the mycobacterial infiltration of excision margins, excised tissue was examined for signs of infection.Methods  20 BUD lesions were excised in general anaesthesia including all necrotic and subcutaneous adipose tissue down to the fascia and at an average of 40 mm into the macroscopically unaffected tissue beyond the border of the lesion. Tissue samples were subjected to PCR and histopathology.Results  Although the bacillary load decreased from central to peripheral, M. ulcerans infection was detected throughout all examined tissue specimens including the peripheral segments as well as excision margins of all patients. During the post‐operative hospitalization period (averaging 2 months) no local recurrences were observed.Conclusion  Available data suggest a correlation of surgical techniques with local recurrences. The results of this study indicate the unnoticed early progression of mycobacterial infection into macroscopically healthy tissue. Thus, the removal of all infected tissue cannot always be verified visually by the surgeon. Provided that long‐term follow up of patients with positive excision margins will establish the clinical relevance of these findings, on‐site laboratory assessment of excised tissue in combination with follow up may contribute to reduce recurrence rates.
Short communication: Soil‐transmitted helminthiasis in Uganda: epidemiology and cost of control
Authors: Kabatereine N. B. , Tukahebwa E. M. , Kazibwe F. , Twa‐Twa J. M. , Barenzi J. F. Z. , Zaramba S. , Stothard J. R. , Fenwick A. , Brooker S. 
Published: October 2005

SummaryA countrywide description of the distribution of soil‐transmitted helminths in Uganda is reported, based on data for 20 185 schoolchildren from 271 schools. The overall prevalence of Ascaris lumbricoides, Trichuris trichiura and hookworm was 6.3%, 5.0% and 43.5%, respectively. The prevalence of A. lumbricoides and T. trichiura was unevenly distributed in the country with prevalence greatest in south‐western Uganda whereas hookworm was generally more homogeneously distributed. Based on preliminary cost analysis of an ongoing school‐based control programme, the financial delivery cost per schoolchild treated with albendazole is estimated to be between US$ 0.04 and 0.08 in different districts.
Midazolam for patients undergoing upper gastrointestinal endoscopy: A prospective, single‐blind and randomized study to determine the appropriate amount and time of initiation of endoscopy
Authors: YI SUN YOUNG , SHIN JEONG EUN 
Published: October 2005

AbstractBackground and Aims:  Midazolam is currently the most used sedative agent in endoscopy. The present study was designed to examine the appropriate dose of midazolam, time of initiation of endoscopy after midazolam infusion, and to prove the necessity of flumazenil as an antidote.Methods:  One hundred and eighty patients undergoing diagnostic gastroscopy were assigned three different amounts of intravenous midazolam in prospective, single‐blinded and randomized setting as follows: (i) group I 0.03 mg/kg midazolam; (ii) group II 0.06 mg/kg midazolam; and (iii) group III 0.09 mg/kg midazolam. Endoscopy was initiated 30, 60 and 90 s after infusion of midazolam within each group. After endoscopy, patients were divided into two groups, one receiving flumazenil and one placebo in a double‐blind fashion. The ease of the procedure, the conscious sedative state, the paradoxical response, the level of satisfaction and anterograde amnesia were assessed using a 100 mm visual analog scale.Results:  The endoscopist's assessments were not changed by the different doses of midazolam; however, significant differences were observed in the paradoxical responses (P < 0.05). The level of satisfaction with endoscopy was notably different between group I and the other two groups (P < 0.05). Amnesia was boosted according with increasing doses of midazolam (P < 0.05). The time until discharge after endoscopy was significantly different between group III and the other two groups (P < 0.05) and the discharge time was reduced in the flumazenil subgroup compared with the placebo subgroup in group III (P < 0.05). Group II (0.06 mg/kg) reported good levels of satisfaction, fewer paradoxical responses and short discharge time without any side‐effects. Comparing the time of initiation of endoscopy (at 30, 60 and 90 s after midazolam) in each group, there were no significant differences in the level of satisfaction, conscious sedative state and amnesia.Conclusions:  Midazolam should be administered at a dose of 0.06 mg/kg and the endoscopy should be initiated 30 s after midazolam injection for appropriate effects without any side‐effects. Flumazenil is not necessary, except in the case of the use of a high dose (above 0.09 mg/kg) of midazolam.
Impact of loss of heterozygosity of encoding phosphate and tensin homolog on the prognosis of gastric cancer
Authors: OKI EIJI , KAKEJI YOSHIHIRO , BABA HIDEO , TOKUNAGA ERIKO , NAKAMURA TOSHIHIKO , UEDA NAOYUKI , FUTATSUGI MOTONORI , YAMAMOTO MANABU , IKEBE MASAHIKO , MAEHARA YOSHIHIKO 
Published: October 2005

AbstractBackground and Aim:  Encoding phosphate and tensin homolog (PTEN) is a cancer suppressor gene and it has been assumed that gene mutation and loss of heterozygosity (LOH) occurs frequently in various types of carcinoma. However, the role of LOH of PTEN and its outcome variables in gastric cancer have not been well established. In the present study, we investigated the roles of PTEN, LOH and their outcomes.Methods:  Fresh frozen tumor samples from 119 gastric cancer patients with a primary diagnosis of gastric carcinoma were evaluated for LOH of PTEN using an automated sequencer. Results were compared with pathological parameters. The median follow‐up period was 559 days.Results:  Loss of heterozygosity of PTEN was observed in 17.1% of patients (13/76) diagnosed with gastric cancer. No particular relationship was found with any clinicopathological factor. However, the prognosis of patients with LOH of PTEN was significantly poor. Multivariate analyses revealed that vascular invasion, invasion depth, LOH of PTEN, histology and lymph node metastasis were correlated with survival of the patient.Conclusions:  Even though mutation of PTEN in gastric cancer has rarely been reported, according to our findings, LOH of PTEN frequently occurs in gastric cancers and is correlated with disease‐related deaths. The LOH of PTEN is an independent prognostic factor and PTEN is a candidate as a haploinsufficient tumor suppressor in gastric cancers.
Fatty liver and the metabolic syndrome among Shanghai adults
Authors: FAN JIAN‐GAO , ZHU JUNE , LI XING‐JIAN , CHEN LAN , LU YUAN‐SAN , LI LUI , DAI FEI , LI FENG , CHEN SHI‐YAO 
Published: October 2005

AbstractBackground and Aim:  To explore the relationship between fatty liver and the metabolic syndrome in the adults of Shanghai and evaluate the value of fatty liver as a marker for risk factor clustering.Methods:  Questionnaires, physical examinations, laboratory tests (blood lipid and glucose) and real‐time liver ultrasonographies were performed in Shanghai adults and analyzed using randomized, multistage, stratified cluster sampling. Prevalence of the metabolic syndrome was defined by the National Cholesterol Education Program–Adult Treatment Panel III (NCEP‐ATPIII) criteria with the exception of abdominal obesity (waist circumference > 90 cm in men and > 80 cm in women); fatty liver was diagnosed in accordance with the presence of an ultrasonographic pattern consistent with ‘bright’ liver (brightness and posterior attenuation of liver).Results:  The study population consisted of 3175 subjects (1218 men) with a mean (± SD) age of 52.4 ± 15.1 years. Metabolic syndrome and fatty liver were found in 726 (22.87%) and 661 (20.82%) of sampled cases, respectively. After adjustment by age and sex, the prevalence of the metabolic syndrome and fatty liver in the general population of Shanghai were 15.30 and 17.29%, respectively. The risk for fatty liver in subjects with abdominal obesity, diabetes, dyslipidemia and hypertension increased 32.78‐fold (95% confidence interval (CI) 14.85–72.35), 31.58‐fold (95% CI 14.18–70.35), 22.64‐fold (95% CI 10.26–49.99) and 23.25‐fold (95% CI 10.54–51.30), respectively, compared with controls, whereas the risk for fatty liver in subjects with metabolic syndrome was increased by 39.33‐fold (95% CI 17.77–87.05). After the 661 patients with fatty liver had been stratified by body mass index (BMI), the prevalence of abdominal obesity, hypertension and the metabolic syndrome were increased from 25.0, 47.2 and 36.1%, respectively, in people with normal BMI to 81.0, 73.8 and 55.4%, respectively, in obese persons. However, the prevalence of hypertriglyceridemia, high fasting glucose and low high‐density lipoprotein–cholesterol showed no significant changes with increased BMI. Moreover, among fatty liver patients with normal BMI, the detection rate for one or more features of metabolic disorders was as high as 83.3% and that for five features was 2.8%. Compared with obesity (BMI ≥ 25 kg/m2) and abdominal obesity, fatty liver had the highest clustering rate, specificity, positive predictive value and attributable risk percentage in detecting risk factor clustering in both sexes.Conclusions:  There is a high prevalence of metabolic syndrome and fatty liver among Shanghai adults. Metabolic disorders are closely related to fatty liver; moreover, fatty liver appears to be a good predictor for the clustering of risk factors for metabolic syndrome.
Expression of retinoid receptors in multiple cell lineages in the gastric mucosae of mice and humans
Authors: KARAM SHERIF M , HASSAN WAIL M , JOHN RONY 
Published: October 2005

AbstractBackground and Aim:  In mice and humans, the gastric epithelial progenitors undergo proliferation and bipolar migration from the isthmus associated with their differentiation into mucus‐, acid‐ and pepsinogen‐secreting cell lineages. Little is known about factors that control the dynamics of these isthmal progenitor cells. Retinoids have long been known as chemopreventive agents against gastric mucosal damage and carcinogenesis. The aim of the present study was to examine the cellular localization of the various retinoid receptors proteins (RAR and RXR) in the gastric epithelium of mice and humans.Methods:  Gastric antral biopsies of normal individuals and the oxyntic and antral regions of the mouse stomach were processed for immunohistochemistry using anti‐RAR and anti‐RXR antibodies. To label the progenitor cell zone, some sections were also probed with antibodies specific for proliferating cell nuclear antigen.Results:  The immunoprobed oxyntic mucosal sections of the mice showed that RXRβ protein was present in the epithelial isthmal cells, neck cells, zymogenic cells and some pit and parietal cells. In addition, RARβ was found in isthmal and neck cells, and RARγ was mainly found in neck cells. In the mouse antrum, only RXRβ was detected in the isthmal cells and their pit and gland cell descendents. In humans, immunoprobed antral sections showed that RARβ, RARγ, RXRα and RXRγ proteins are expressed in the isthmal, pit and gland cells.Conclusions:  Retinoid receptors are expressed in multiple cell lineages of the mouse and human gastric epithelium and may, therefore, account for the possible effects of retinoids on gastric epithelial cell proliferation and differentiation.
Natural history of endocrine failure in tropical chronic pancreatitis: A longitudinal follow‐up study
Authors: MOHAN VISWANATHAN , BARMAN KARUNA KANTA , RAJAN VENKATA SUBBARAO , CHARI SURESH T , DEEPA RAJ 
Published: October 2005

AbstractBackground and Aims:  Diabetes in tropical chronic pancreatitis (TCP), also known as fibrocalculous pancreatic diabetes (FCPD), is frequently seen at diagnosis. The aim of the present study was to determine the natural history of endocrine failure in TCP subjects without diabetes at baseline.Methods:  Of 73 TCP subjects without diabetes according to World Health Organization (WHO) criteria at baseline who were seen at an out‐patient center, 54 (74.0%) underwent periodic oral glucose tolerance tests on follow up. Another 54 sex‐matched, non‐diabetic subjects without chronic pancreatitis served as controls. Baseline demographic and clinical characteristics were noted.Results:  After a median follow up of 5.0 years in TCP subjects and 7.0 years in controls, 27 of 54 TCP subjects (50%) developed diabetes compared with 14 of 54 controls (25.9%). Of the TCP subjects, those who developed diabetes on follow up were older (31 ± 12 vs 23 ± 11 years; P = 0.013), had a higher body mass index (21.7 ± 4.4 vs 18.2 ± 3.5 kg/m2; P = 0.004), higher 2 h post‐load plasma glucose (8.8 ± 1.9 vs 6.7 ± 1.4 mmol/L; P < 0.001) and lower fecal chymotrypsin (2.1 ± 1.2 vs 4.3 ± 2.5 U/g; P < 0.001) at baseline compared with those who did not develop diabetes. The median time for the development of diabetes after diagnosis of TCP was 9.6 years (compared with 14.4 years among controls). Only 2 of 13 TCP subjects (15.4%) who had undergone surgical interventions during the normal glucose tolerance phase developed diabetes during follow up.Conclusions:  In TCP, there is progressive deterioration of endocrine pancreatic function, with development of diabetes in 50% of patients upon follow up, suggesting that FCPD is merely a later stage in the course of TCP. Early surgery may prevent the development of diabetes in TCP subjects.
What are teenagers reading? Adolescent fiction reading habits and reading choices
Authors: Hopper Rosemary 
Published: October 2005

AbstractWhat are adolescents choosing to read? This is an important question because of potential divergence between school students' reading interests and reading expectations in school. This article considers the findings from a study of the reading over one week in May 2002 of 707 school students aged between 11 and 15, undertaken in 30 schools in the south‐west of England. The findings are related to earlier research by, amongst others, Whitehead, Benton, and Hall and Coles. The article reflects on adolescent reading choices, influences on those choices and the importance of validating all reading experience, including the new literacies.
Space Science News: Special Edition, a resource for extending reading and promoting engagement with newspapers in the science classroom
Authors: Jarman Ruth , McClune Billy 
Published: October 2005

AbstractThis paper describes the development of an innovative resource, comprising authentic newspaper articles and associated activities, designed to broaden the range of reading material available for use in the science classroom. Science teachers' response to the publication is discussed. The resource was very well received, indicating that, given appropriate material, science specialists demonstrate a willingness to use media text in their classrooms. However, while all viewed the publication as a valuable science resource and many saw its potential for promoting literacy through science, only a few recognised it as a vehicle for encouraging, among students, critical engagement with science in the media. This suggests that further intervention may be necessary if this outcome is to be achieved.
Examining England's National Curriculum assessments: an analysis of the KS2 reading test questions, 1993–2004
Authors: Kispal Anne 
Published: October 2005

AbstractThe Year 6 National Curriculum reading test has become a familiar and established annual experience at the end of the primary phase in schools throughout England. From 1993 onwards, each year the national reading test for 11‐year‐olds has consisted of a different set of texts, accompanied by a different set of questions. With over a decade's accumulation of national assessment materials, the National Foundation for Educational Research decided to fund a project to take stock of the reading test, scrutinise what children have been expected to do over the years, and track the evolution of the assessment. A new taxonomy of question focuses, introduced by the Qualifications and Curriculum Authority in 2003, provided the opportune moment to conduct a retrospective re‐categorisation of all the questions that had ever appeared in a Key Stage 2 reading test. This paper reports on that exercise and reveals that some forms of questioning remain constant and reappear every year, while others are subject to variation.