bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk for severe hypoglycaemia with unawareness in GH‐deficient patients during the insulin tolerance test
Authors: Holmer H. , Link K. , Erfurth E. M. 
Published: January 2006

SummaryObjective  The insulin tolerance test (ITT) has been suggested as the gold standard for diagnosing GH deficiency (GHD). The ITT is, however, potentially hazardous. Glucose monitoring during the ITT varies between centres and there is surprisingly little information on the actual level of blood glucose nadir and the duration of hypoglycaemia in patients undergoing the ITT. The aim of the present study was to closely monitor the blood glucose level and to register the presence of symptoms and signs of hypoglycaemia during the ITT.Design and patients  Sixteen patients (seven women), aged 22–59 years were consecutively recruited for an ITT, and showed GHD (peak GH < 3 µg/l).Results  In five (31%) of the patients unawareness of hypoglycaemia was recorded, the median nadir blood glucose level was 1·4 mmol/l (range 1·1–1·9) and the duration of blood glucose < 2·2 mmol/l was 25 min (range 20–33). The remaining 11 patients were symptomatic, and tiredness (n = 6) and dizziness (n = 3) were the most frequent symptoms. In these symptomatic patients the median nadir blood glucose level was 1·3 mmol/l (range 1·0–1·6) and the duration of blood glucose < 2·2 mmol/l was 25 min (range 15–30).Conclusions  In patients with GHD subjected to the ITT, symptoms of hypoglycaemia were scarce and a third showed unawareness. Close blood glucose monitoring is recommended at the ITT as low nadir blood glucose levels and long duration of hypoglycaemia may be present irrespective of symptoms of hypoglycaemia. Recommendations for intervention with intravenous glucose, at unacceptable low blood glucose levels or at prolonged hypoglycaemia, are warranted.
Intravenous glucose intake independently related to intensive care unit and hospital mortality: an argument for glucose toxicity in critically ill patients
Authors: van Der Voort Peter H. J. , Feenstra Rieneke A. , Bakker Andries J. , de Heide Loek , Boerma E. Christiaan , van Der Horst Iwan C. C. 
Published: January 2006

SummaryObjective It is assumed that the toxic effects of glucose play a role in the outcome of critically ill patients. We studied the impact of the amount of infused glucose as a determinant of mortality.Design A retrospective cohort study design was used as blood glucose levels in critically ill patients are nowadays tightly controlled.Patients Long‐stay critically ill patients (7–30 days).Measurements The association between the mean amount of glucose infusion and both intensive care unit (ICU) and hospital mortality was determined. We corrected for the mean glucose serum concentration, the mean dosage of insulin and for severity of illness, using the acute physiology and chronic health evaluation (APACHE II) score.Results Of the 2042 admitted patients, 273 met the inclusion criteria. The mean length of stay was 14·4 days [interquartile range (IQR) 9–18]. Hospital mortality was significantly lower for patients with a mean glucose level below 8 mmol/l (30/79; 38%) compared to patients with a level above 8 mmol/l (104/194; 54%, P = 0·023). Logistic stepwise multivariate regression analysis for both ICU and hospital mortality as dependent variables showed that APACHE II score and the mean daily amount of infused glucose were associated with mortality.Conclusion In long‐stay ICU patients without blood glucose level control, the ICU and hospital mortality was independently related to the mean amount of infused glucose. In addition, mortality in patients with a mean glucose level above 8·0 mmol/l was higher. Both these determinants of mortality can exert their effects by insulin‐independent uptake of glucose with subsequent toxic intracellular effects.
Dietary intervention increases n‐3 long‐chain polyunsaturated fatty acids in skeletal muscle membrane phospholipids of obese subjects. Implications for insulin sensitivity
Authors: Haugaard Steen B. , Madsbad Sten , Høy Carl‐Erik , Vaag Allan 
Published: January 2006

SummaryObjective  Cross‐sectional studies suggest that the fatty acid (FA) composition of phospholipids in skeletal muscle cell membrane may modulate insulin sensitivity in humans. We examined the impact of a hypocaloric low‐fat dietary intervention on membrane FA composition and insulin sensitivity.Design  Muscle membrane FA profiles were determined in muscle (vastus lateralis) biopsies from 21 obese subjects before and after 6 months of dietary restriction. Diet instructions emphasized low intake of FA of marine origin by recommending lean fish and prohibiting fatty fish and fish oil supplements. Insulin resistance was estimated by the homeostasis model assessment (HOMA‐IR).Results  The mean weight loss was 5·1 kg (range −15·3 to +1·3 kg). BMI decreased from 36·5 to 34·9 kg/m2 (P = 0·003). Saturated FA (SFA) decreased 11% (P = 0·0001). Polyunsaturated FA (PUFA)n‐6 increased 4% (P = 0·003). Long‐chain PUFAn‐3 increased 51% (P = 0·0001), mainly due to a 75% increase (P < 0·0001) in docosahexaenoic acid. Changes in HOMA‐IR correlated significantly with changes in long‐chain PUFAn‐3 (R = –0·57, P < 0·01), SFA (R = 0·58, P < 0·01) and waist circumference (R = 0·46, P < 0·05). A multivariate linear regression analysis that included changes in weight, fat mass, waist circumference, plasma lipids, PUFA, SFA and long‐chain PUFAn‐3 indicated that SFA and long‐chain PUFAn‐3 were independent predictors of HOMA‐IR (R2 = 0·33, P < 0·01).Conclusions  A hypocaloric low‐fat dietary intervention programme increased incorporation of long‐chain PUFAn‐3 and reduced SFA in skeletal muscle membrane phospholipids of obese subjects, a setting that may impact on insulin action.
Sociodemographic and behavioural correlates of severe dental fluorosis
Authors: WONDWOSSEN F. , ÅSTRØM A. N. , BJORVATN K. , BÅRDSEN A. 
Published: January 2006

Summary.Objectives.  The aim of this study was to identify sociodemographic and behavioural factors associated with the prevalence of severe dental fluorosis in moderate‐ and high‐fluoride areas of the Ethiopian Rift Valley.Methods.  Three hundred and six adolescents (12–15 years) and 233 mothers participated in the study. The children were examined for dental fluorosis according to the Thylstrup–Fejerskov Index (TFI). The children and their mothers were subsequently interviewed. Sixty mothers had more than one participating child. In order to perform a paired parent/child analysis, a total of 73 younger siblings had to be excluded.Results.  Among the remaining 233 children, the prevalence of severe dental fluorosis (TFI ≥ 5) was 24·1% and 75·9% in the moderate‐ and high‐fluoride areas, respectively. According to bivariate as well as multivariate analyses, a number of sociodemographic and behavioural factors were related to severe fluorosis. The odds for having severe fluorosis varied according to the fluoride concentration of the drinking water, age, consumption of tea, length of breastfeeding and method of storing water. The adjusted odds ratios ranged from 2·6 to 26·1. Breastfeeding for > 18 months and the use of clay pots for storing drinking water helped protect against severe dental fluorosis. Bivariate analyses indicated that being male and consuming fish might be associated with higher TFI scores.Conclusion.  In order to avoid dental fluorosis, low‐fluoride drinking water should be provided in the relevant villages. A prolonged period of breastfeeding, the use of clay pots for storing water, and possibly a reduced intake of tea and whole fish in infants might also help to avoid severe fluorosis in children growing up in traditionally fluoride‐endemic areas.
Dental follicle infection following a dog bite
Authors: WRIGHT G. , MUIR M. L. , BRYAN R. , SMITH A. J. , HOSEY M. T. 
Published: January 2006

Summary.Animal bite wounds and their subsequent infection are relatively common. Incidence rates for dog bites are significantly higher among children aged 0–9 years, especially among boys. Although bite wounds may initially look innocuous, they frequently lead to serious infection with a potential for life‐threatening complications. The microbiology of dog bite wounds is usually polymicrobial, typically including anaerobes, Staphylococcus aureus and Pasteurella species. A case is described of a 22‐month‐old boy who, subsequent to a dog bite over the left maxilla, suffered infection of the dental follicle of the primary maxillary canine with Pasteurella multocida. The infection proved difficult to treat, requiring several attempts at incision and drainage of the abscess together with systemic antibiotics, and resulted in the eventual loss of the tooth.
Mixed dentition space analysis in a Jordanian population: comparison of two methods
Authors: ABU ALHAIJA E. S. J. , QUDEIMAT M. A. 
Published: January 2006

Summary.Aims.  To test the reliability of the Moyers charts and the Tanaka and Johnston equations in Jordanians and to derive coefficients of correlation between the combined mesiodistal widths of the four permanent mandibular incisors and the combined widths of the canine and premolars of the maxillary and mandibular quadrants.Methods.  The dental models of the dentition of 130 male and 96 female Jordanian subjects (age range is 14–16 years) with complete permanent dentition were randomly selected. The mesiodistal width of the four permanent mandibular incisors, maxillary and mandibular canines, and premolar teeth were measured using a vernier gauge caliper to the nearest 0·1 mm. The actual teeth measurements were then compared with the predicted values derived from the Tanaka and Johnston equations and Moyers probability tables. Correlation and linear regression analyses were performed between the predicted and actual tooth size for Jordanian children and standard regression equations were developed.Results.  Except for the maxillary arch in male subjects, Tanaka and Johnston regression equations underestimated the mesiodistal widths of permanent canines and premolars. On the other hand, there were no statistically significant differences between actual mesiodistal widths of canines and premolars and the predicted widths from Moyers charts at the 65% and 75% level for the lower and upper arches in male subjects and at the 85% level for the upper and lower arches in female subjects. For the newly developed regression equations, the correlation coefficients between the sum of the mandibular four incisors and the sum of the canine and premolars were 0·60 (for lower) and 0·51 (for upper) in male subjects and 0·59 and 0·64, respectively, in female subjects.Conclusions.  (1) Tanaka and Johnston prediction method was not accurate when applied to a Jordanian population. (2) Moyers method for prediction can be used for Jordanian children at different probability levels for male and female subjects.
A sociodental approach to assessing dental needs of children: concept and models
Authors: GHERUNPONG S. , TSAKOS G. , SHEIHAM A. 
Published: January 2006

Summary.Objectives.  Traditional normative methods of assessing dental needs do not correspond to current concepts of ‘health’ and ‘need’. Although there is dental research on quality of life, evidence‐based practice, and oral behaviours, those concepts are rarely applied to dental needs estimation. Dental needs are usually calculated mainly from clinical data and are likely to be inaccurate. A structured comprehensive method for assessing dental needs is required. The objectives of this study are to develop and test a new sociodental system of needs assessment for overall dental needs of primary schoolchildren. Furthermore, normative and sociodental estimates of need are compared.Design.  The study developed a theoretical framework and pathway algorithms of sociodental needs assessment and applied them to assessing overall dental needs. Normative dental needs were assessed using standard normative criteria. The child oral impacts on daily performances (Child‐OIDP) was used to assess oral impacts, and a self‐administered questionnaire was used to obtain information on demographic variables and oral behaviours. Data were analysed according to the developed algorithms.Setting.  A cross‐sectional survey in Suphanburi Province, Thailand.Participants.  All 1126 children aged 11–12 years in a town.Main results.  The sociodental approach was acceptable and not costly. In all, 54·4% had normative need under the dental needs model for life‐threatening and progressive conditions, but only 16·6% had high propensity‐related need; the remaining 37·8% would require dental health education or oral health promotion (DHE/OHP) or both and appropriately adjusted clinical interventions. Under the basic model of dental needs, 45·1% had normative need. Two‐thirds of them (30·9%) had impact‐related need and the remaining 14·2% did not have oral impacts and therefore should only receive dental health education. Only one‐third of those with impact‐related need had high propensity and were suitable for evidence‐based conventional treatments; the remaining two‐thirds should receive DHE/OHP and alternative clinical interventions.Conclusions.  A sociodental system of dental needs assessment was developed and tested on school children. It decreased the estimates of conventionally assessed dental treatment needs and introduced a broader approach to care.
The relationship between tree size and epiphyte species richness: testing four different hypotheses
Authors: Flores‐Palacios Alejandro , García‐Franco José G. 
Published: January 2006

AbstractAim For epiphytic plants trees are habitat units, and tree size determines epiphyte species richness. While growing, trees generate vertical microhabitats that are exploited by epiphytes. One would expect to find four different types of relationship between tree size and epiphyte species richness: positive linear (young trees), neutral (old trees), negative (old decaying trees) and positive asymptotic (trees of mixed size class in a mature forest). We tested these relationships in plots of colonizing sweetgum trees in pastureland, isolated remnant trees in pastureland (old oaks) and sweetgum and oaks in a pristine forest.Location The study was carried out in a landscape shaped by the fragmentation of lower montane cloud forest in San Andrés Tlalnelhuayocan (19°30′56′′ N and 96°59′50′′ W; 1500–1600 m a.s.l.) in central Veracruz, Mexico.Methods We measured the d.b.h. of all oaks and sweetgum trees (d.b.h. ≥ 5 cm) present in pastureland and in three 100 m2plots of a lower montane cloud forest. All trees were climbed and species richness of the epiphytes recorded.Results As expected, colonizer trees in pastureland showed a linear positive relationship. Although we found evidence that remnant oaks in pastureland had a neutral relationship between tree size and epiphyte species richness, the low power of the test did not allow us to make conclusions about the kind of relationship. Mixed size‐class pristine forest trees showed a positive linear relationship between tree size and epiphyte species richness instead of a positive asymptotic one.Main conclusions Our results suggest that in the study area epiphyte communities are unsaturated, as the number of species increases with tree size and does not reach a ceiling. This evidence supports the idea that the species–area relationship is not asymptotic. However, the epiphyte community on remnant pastureland oaks may be saturated as epiphyte species richness did not increase with tree size, but a larger sample size is needed to confirm the neutral pattern. Neutral, asymptotic and negative patterns in the relationship between tree size and epiphyte species richness depend on the saturation of the trees by epiphytes. Other studies have suggested tree saturation, but further research is necessary in order to confirm or rule out these patterns.
An evaluation of the influence of environment and biogeography on community structure: the case of Holarctic mammals
Authors: Rodríguez J. , Hortal J. , Nieto M. 
Published: January 2006

AbstractAim  To evaluate the influence of environment and biogeographical region, as a proxy for historical influence, on the ecological structure of Holarctic communities from similar environments. It is assumed that similarities among communities from similar environments in different realms are the result of convergence, whereas their differences are interpreted as being due to different historical processes.Location  Holarctic realm, North America and Eurasia above 25° N.Methods  Checklists of mammalian species occurring in 96 Holarctic localities were collected from published sources. Species were assigned to one of 20 functional groups defined by diet, body size and three‐dimensional use of space. The matrix composed of the frequencies of functional groups in the 96 localities is used as input data in a correspondence analysis (CA). The localities are classified into nine groups according to Bailey's ecoregions (used as a surrogate of regional climate), and the positions of the communities in the dimensions of the CA are compared in relation to ecoregion and realm. Partial regression was used to test for the relative influence of ecoregion and realm over each dimension and to evaluate the effect of biogeographical realm on the variation in the factor scores of the communities of the same ecoregion.Results  In some cases, mammalian communities from areas with similar regional climates exhibit convergence in community structure, irrespective of the biogeographical realm where they are located. However, all of them are clearly subdivided into Nearctic and Palearctic subsets. Differences in the composition of the regional pools only partially explain differences in local communities between realms.Main conclusions  Holarctic mammalian communities from regions with widely different climates differ in ecological structure irrespective of their biogeographical location. On the other hand, the structures of Nearctic and Palearctic communities from regions of similar climate radically differ in some features. Thus, although present climatic conditions influence community structure, contingent historic processes associated with each region also play a major role in determining community structure.
Parental longevity and mortality amongst Japanese men and women: the JACC Study
Authors: IKEDA A. , ISO H. , TOYOSHIMA H. , KONDO T. , MIZOUE T. , KOIZUMI A. , INABA Y. , TAMAKOSHI A. ,   JACC STUDY GROUP
Published: January 2006

Abstract.Objectives.  To examine whether the risk of mortality varies according to parents’ age at death.Design and subjects.  A large prospective study in Japanese men and women from 45 communities across Japan. A total of 51 485 men and women aged 40–79 years completed self‐administered questionnaires at baseline and followed up for 9.6 years.Results.  The risk of mortality from stroke, cardiovascular disease, and all causes was 20–30% lower in men and women with fathers who died at age ≥80 years, compared with those with fathers whose age at death was <60 years. A similar reduction was found when the age at death of mothers was ≥85 years compared with <65 years. Furthermore, the risk reduction was more evident amongst persons with both parents being long‐lived parents compared with those with being short‐lived parents, especially for death from cardiovascular disease.Conclusions.  Our findings indicate that parental longevity could be a predictor for reduced risk of mortality from stroke, cardiovascular disease, and all causes for both Japanese men and women.
Nutritional evaluation of commercial dry dog foods by near infrared reflectance spectroscopy
Authors: Alomar D. , Hodgkinson S. , Abarzúa D. , Fuchslocher R. , Alvarado C. , Rosales E. 
Published: January 2006

SummaryNear infrared reflectance spectroscopy (NIRS) was used to predict the nutritional value of dog foods sold in Chile. Fifty‐nine dry foods for adult and growing dogs were collected, ground and scanned across the visible/NIR range and subsequently analysed for dry matter (DM), crude protein (CP), crude fibre (CF), total fat, linoleic acid, gross energy (GE), estimated metabolizable energy (ME) and several amino acids and minerals. Calibration equations were developed by modified partial least squares regression, and tested by cross‐validation. Standard error of cross validation (SECV) and coefficient of determination of cross validation () were used to select best equations. Equations with good predicting accuracy were obtained for DM, CF, CP, GE and fat. Corresponding values for and SECV were 0.96 and 1.7 g/kg, 0.91 and 3.1 g/kg, 0.99 and 5.0 g/kg, 0.93 and 0.26 MJ/kg, 0.89 and 12.4 g/kg. Several amino acids were also well predicted, such as arginine, leucine, isoleucine, phenylalanine–tyrosine (combined), threonine and valine, with values for and SECV (g/kg) of 0.89 and 0.9, 0.94 and 1.3, 0.91 and 0.5, 0.95 and 0.9, 0.91 and 0.5, 0.93 and 0.5. Intermediate values, appropriate for ranking purposes, were obtained for ME, histidine, lysine and methionine–cysteine. Tryptophan, minerals or linoleic acid were not acceptably predicted, irrespective of the mathematical treatment applied. It is concluded that NIR can be successfully used to predict important nutritional characteristics of commercial dog foods.
Why wait for a colonoscopy? An easy cure
Authors: Shoaib A. , Hamade A. , Zia A. , Basnyat P S. , Taffinder N. 
Published: January 2006

AbstractObjective  Three thousand five hundred and forty‐nine patients are waiting for a colonoscopy in the Kent and Medway cancer network. New guidelines identify those who require surveillance for polyp, cancer, IBD and family history. Our hypothesis was that most of the patients on the waiting list would no longer need a colonoscopy if the new guidelines were applied.Patients and methods  We compared the ACPGBI guidelines for screening/surveillance colonoscopy with the indications in 411 notes of one hospital's waiting list and removed patients as appropriate. In the second part of study we analysed 192 patients attending colonoscopy in seven hospitals in the region and calculated the potential impact of the guidelines on our waiting lists.Results  Of 411 patients on the waiting list in one hospital, only 98 (24%) needed to remain on the list. 142 (34%) were cancelled completely. One hundred and seventy‐one (42%) were taken off the ‘waiting’ list and rebooked for a later date since according to the new guidelines the colonoscopy was not due yet. Of 192 colonoscopies actually performed during the study period in 7 hospitals of Kent and Medway cancer network, 72 (38%) were for surveillance. Two thirds of those were not in line with the guidelines. As a result of implementing the guidelines, waiting times for diagnostic colonoscopy fell from 12 to 4 weeks for urgent, and from 40 to 15 weeks for routine referrals.Conclusion  A quarter of the 8000 colonoscopies performed annually in our region are unnecessary when compared to the guidelines. More than three quarters of our waiting list could be removed by reviewing the notes. Implementing the guidelines in one cancer network would save £1 million per year even on conservative estimates of £500 per colonoscopy. It would also reduce the waiting times for diagnostic colonoscopy.
What we are really doing with ICT in physical education: a national audit of equipment, use, teacher attitudes, support, and training
Authors: Thomas Andrew , Stratton Gareth 
Published: January 2006

AbstractThis paper reports on the results from a detailed national audit of information communication technology (ICT) in physical education (PE), examining attitudes, training, numbers of pieces of equipment and hardware owned, and its employment and use across nine Local Education Authorities, six types of schools, and four types of Specialist College. After setting the context, a summary of the survey methods used and an overview of the findings from 500 schools are presented. Results from 252 questionnaires returned suggested that the majority of PE teachers felt that ICT was a valuable teaching tool; however, parity of training and ownership of equipment were not standard across the range of schools or regions. Furthermore, the data suggest a growing trend in ICT use in PE across England.