bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disparities in appendicitis rupture rate among mentally ill patients
Authors: Tsay Jen-Huoy , Lee Cheng-Hua , Hsu Yea-Jen , Wang Pen-Jen , Bai Ya-Mei , Chou Yiing-Jenq , Huang Nicole 
Published: November 2007

Abstract

Background
Many studies have been carried out that focus on mental patients' access to care for their mental illness, but very few pay attention on these same patients' access to care for their physical diseases. Acute appendicitis is a common surgical emergency. Our population-based study was to test for any possible association between mental illness and perforated appendicitis. We hypothesized that there are significant disparities in access to timely surgical care between appendicitis patients with and without mental illness, and more specifically, between patients with schizophrenia and those with another major mental illness.

Methods
Using the National Health Insurance (NHI) hospital-discharge data, we compared the likelihood of perforated appendix among 97,589 adults aged 15 and over who were hospitalized for acute appendicitis in Taiwan between the years 1997 to 2001. Among all the patients admitted for appendicitis, the outcome measure was the odds of appendiceal rupture vs. appendicitis that did not result in a ruptured appendix.

Results
After adjusting for age, gender, ethnicity, socioeconomic status (SES) and hospital characteristics, the presence of schizophrenia was associated with a 2.83 times higher risk of having a ruptured appendix (odds ratio [OR], 2.83; 95% confidence interval [CI], 2.20–3.64). However, the presence of affective psychoses (OR, 1.15; 95% CI: 0.77–1.73) or other mental disorders (OR, 1.58; 95% CI: 0.89–2.81) was not a significant predictor for a ruptured appendix.

Conclusion
These findings suggest that given the fact that the NHI program reduces financial barriers to care for mentally ill patients, they are still at a disadvantage for obtaining timely treatment for their physical diseases. Of patients with a major mental illness, schizophrenic patients may be the most vulnerable ones for obtaining timely surgical care.
Evaluating an educational intervention to improve the accuracy of death certification among trainees from various specialties
Authors: Villar Jesús , Pérez-Méndez Lina 
Published: November 2007

Abstract
Background
The inaccuracy of death certification can lead to the misallocation of resources in health care programs and research. We evaluated the rate of errors in the completion of death certificates among medical residents from various specialties, before and after an educational intervention which was designed to improve the accuracy in the certification of the cause of death.

Methods
A 90-min seminar was delivered to seven mixed groups of medical trainees (n = 166) from several health care institutions in Spain. Physicians were asked to read and anonymously complete a same case-scenario of death certification before and after the seminar. We compared the rates of errors and the impact of the educational intervention before and after the seminar.

Results
A total of 332 death certificates (166 completed before and 166 completed after the intervention) were audited. Death certificates were completed with errors by 71.1% of the physicians before the educational intervention. Following the seminar, the proportion of death certificates with errors decreased to 9% (p < 0.0001). The most common error in the completion of death certificates was the listing of the mechanism of death instead of the cause of death. Before the seminar, 56.8% listed respiratory or cardiac arrest as the immediate cause of death. None of the participants listed any mechanism of death after the educational intervention (p < 0.0001).

Conclusion
Major errors in the completion of the correct cause of death on death certificates are common among medical residents. A simple educational intervention can dramatically improve the accuracy in the completion of death certificates by physicians.
The most dangerous hospital or the most dangerous equation?
Authors: Tu Yu-Kang , Gilthorpe Mark S 
Published: November 2007

Abstract
Background
Hospital mortality rates are one of the most frequently selected indicators for measuring the performance of NHS Trusts. A recent article in a national newspaper named the hospital with the highest or lowest mortality in the 2005/6 financial year; a report by the organization Dr Foster Intelligence provided information with regard to the performance of all NHS Trusts in England.

Methods
Basic statistical theory and computer simulations were used to explore the relationship between the variations in the performance of NHS Trusts and the sizes of the Trusts. Data of hospital standardised mortality ratio (HSMR) of 152 English NHS Trusts for 2005/6 were re-analysed.

Results
A close examination of the information reveals a pattern which is consistent with a statistical phenomenon, discovered by the French mathematician de Moivre nearly 300 years ago, described in every introductory statistics textbook: namely that variation in performance indicators is expected to be greater in small Trusts and smaller in large Trusts. From a statistical viewpoint, the number of deaths in a hospital is not in proportion to the size of the hospital, but is proportional to the square root of its size. Therefore, it is not surprising to note that small hospitals are more likely to occur at the top and the bottom of league tables, whilst mortality rates are independent of hospital sizes.

Conclusion
This statistical phenomenon needs to be taken into account in the comparison of hospital Trusts performance, especially with regard to policy decisions.
Social mobilisation, drug coverage and compliance and adverse reactions in a Mass Drug Administration (MDA) Programme for the Elimination of Lymphatic Filariasis in Sri Lanka
Authors: Weerasooriya Mirani V , Yahathugoda Channa T , Wickramasinghe Darshana , Gunawardena Kithsiri N , Dharmadasa Rohan A , Vidanapathirana Kanchana K , Weerasekara Saman H , Samarawickrema Wilfred A 
Published: November 2007

Abstract
Background
In Sri Lanka filariasis is endemic in Southern, Western and North Western provinces covering eight districts designated as implementation units in the Programme for the Elimination of Lymphatic Filariasis (PELF). Despite control activities over sixty years including multidose diethylcarbamazine, 6 mg/kg treatment microfilaria rates had persisted at low levels. Following systematic social mobilisation the first MDA with DEC albendazole combination was conducted in 2002.

Methods
We investigated the extent social mobilisation had reached the people, their drug compliance and adverse reactions. Three localities were selected from each district to pick target population samples for pre-tested questionnaire. Three teams each with six people visited one district each day. One team worked from three starting points in one locality. A member applied eight part questionnaire to one family member totalling 150–160 people from one locality. Questions included social mobilisation, drug compliance and adverse reactions.

Results
Information was disseminated by television, radio, banners and leaflets, to a lesser extent by people. Information reached more people in the periphery than in Colombo. 35.2% from Colombo municipality were unaware of the MDA. Drug coverage was 79.6%, home delivery 71.7% and delivery centres 7.9%. 35.6% in Colombo district and 53.4% from Colombo municipality did not receive drugs. Drugs were consumed by 71.4%. 28.6% who did not comply included 20.4% who did not receive them. 91.4% showed no adverse reactions, 7.5% were mild, 1.1% recovered with home remedies.

Conclusion
Drug compliance showed significant positive correlation with awareness of the MDA. Door to door delivery was more successful than delivery from centres. More delivery centres conveniently located would have rectified this disparity. Poor awareness and compliance in Colombo and urban areas could be rectified with separate strategy for urban areas. More time for MDA and trained adequate manpower would ensure coverage to achieve elimination.
Adaptive sequence evolution in a color gene involved in the formation of the characteristic egg-dummies of male haplochromine cichlid fishes
Authors: Salzburger Walter , Braasch Ingo , Meyer Axel 
Published: November 2007

AbstractBackgroundThe exceptionally diverse species flocks of cichlid fishes in East Africa are prime examples of parallel adaptive radiations. About 80% of East Africa's more than 1 800 endemic cichlid species, and all species of the flocks of Lakes Victoria and Malawi, belong to a particularly rapidly evolving lineage, the haplochromines. One characteristic feature of the haplochromines is their possession of egg-dummies on the males' anal fins. These egg-spots mimic real eggs and play an important role in the mating system of these maternal mouthbrooding fish.ResultsHere, we show that the egg-spots of haplochromines are made up of yellow pigment cells, xanthophores, and that a gene coding for a type III receptor tyrosine kinase,colony-stimulating factor 1 receptor a(csf1ra), is expressed in egg-spot tissue. Molecular evolutionary analyses reveal that the extracellular ligand-binding and receptor-interacting domain ofcsf1raunderwent adaptive sequence evolution in the ancestral lineage of the haplochromines, coinciding with the emergence of egg-dummies. We also find thatcsf1rais expressed in the egg-dummies of a distantly related cichlid species, the ectodine cichlidOphthalmotilapia ventralis, in which markings with similar functions evolved on the pelvic fin in convergence to those of the haplochromines.ConclusionWe conclude that modifications of existing signal transduction mechanisms might have evolved in the haplochromine lineage in association with the origination of anal fin egg-dummies. That positive selection has acted during the evolution of a color gene that seems to be involved in the morphogenesis of a sexually selected trait, the egg-dummies, highlights the importance of further investigations of the comparative genomic basis of the phenotypic diversification of cichlid fishes.
Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans
Authors: Menkarios Cathy , Azria David , Laliberté Benoit , Moscardo Carmen Llacer , Gourgou Sophie , Lemanski Claire , Dubois Jean-Bernard , Aillères Norbert , Fenoglietto Pascal 
Published: November 2007

Abstract

Background
To compare the dosimetric advantage of three different intensity-modulated radiation therapy (IMRT) plans to a three dimensional (3D) conventional radiation treatment for anal cancer with regards to organs-at-risk (OAR) avoidance, including iliac bone marrow.

Methods
Five patients with T1-3 N0-1 anal cancer and five with T4 and/or N2-3 tumors were selected. Clinical tumor volume (CTV) included tumor, anal canal and inguinal, peri-rectal, and internal/external iliac nodes (plus pre-sacral nodes for T4/N2-3 tumors). Four plans were generated: (A) AP/PA with 3D conformal boost, (B) pelvic IMRT with conformal boost (C) pelvic IMRT with IMRT boost and (D) IMRT with simultaneous integrated boost (SIB). The dose for plans (A) to (C) was 45 Gy/25 followed by a 14.4 Gy/8 boost, and the total dose for plan (D) (SIB) was 59.4 Gy/33. Coverage of both PTV and the volume of OAR (small bowel, genitalia, iliac crest and femoral heads) receiving more than 10, 20, 30, and 40 Gy (V10, V20, V30, V40) were compared using non parametric statistics.

Results
Compared to plan (A), IMRT plans (B) to (D) significantly reduced the V30 and V40 of small bowel, bladder and genitalia for all patients. The V10 and V20 of iliac crests were similar for the N0-1 group but were significantly reduced with IMRT for the N2-3/T4 group (V20 for A = 50.2% compared to B = 33%, C = 32.8%, D = 34.3%). There was no statistical difference between 2-phase (arm C) and single-phase (SIB, arm D) IMRT plans.

Conclusion
IMRT is superior to 3D conformal radiation treatment for anal carcinoma with respect to OAR sparing, including bone marrow sparing.
Voith Turbo Transmissions
Authors: Hahn Wilhelm 
Published: November 2007

The fundamental difference between a hydraulic coupling and a torque converter is that in the former the impeller and runner work directly together without the interposition of a guide wheel or reaction member. A torque converter, on the other hand, requires stationary guide vanes to deflect the flow, usually as a means of obtaining a higher torque at a correspondingly lower speed at the output shaft. The relationship between the power, torque, and number of revolutions at input and output in such a torque converter is examined theoretically, and the conditions of design to give the best efficiency for various applications are considered. It is desirable that the torque curve actually attainable in practice shall approach as nearly as possible the ideal curve. This cannot be realized by means of the usual torque converter, but an essential improvement can be obtained by adding a hydraulic coupling to the torque converter, and changing over at the appropriate time to direct drive through the coupling. Various applications of such a Voith turbo transmission are described, and comparison is made with other forms of transmission.
Noise
Authors: Hutchinson A. C. 
Published: November 2007

The nature of noise problems is outlined mainly from the mechanical engineering viewpoint, but it is pointed out that the effects of noise on normal people are generally small. The more important phenomena of the physical mechanism of sound are recapitulated and the explanation of hearing according to Helmholtz is given. Scales of measurement for both physical size and loudness are discussed, and it is shown how the enormous variations in magnitude of acoustical quantities led to the artifice of logarithmic measurement while it is emphasized that this “decibel” scale is not a subjective scale of loudness. From the research of Churcher, King, and Davies it is inferred that the idea of loudness is roughly proportional to the fourth root of sound power intensity. A brief account is given of the principal pieces of apparatus available for research, namely: stethoscopes, audiometers, both subjective and objective, frequency analysers, and silent rooms, and there is a section dealing with the interpretation of evidence thus obtained. The relations between various quantities are indicated in this section and a recommendation is made for the equipment desirable for researches into machine noise. It is suggested that attempts at elimination of a noise at the source are likely to be more profitable than acoustical treatment, in which latter category the phenomena of sound reflection, absorption, and confinement are noted. Problems are differentiated into those of air-borne and material-borne noise. There is also a note on the history of the subject, and appendixes are added containing: (1) some formulæ and tables of quantities; (2) a discussion on the units quoted in physical sound measurements, and (3) a bibliography. Since the reading of the paper, the recommendations of the British Standards Institution have dealt with the greater part of Appendix II.
Association of the ATP-Binding Cassette Transporter A1 R230C Variant With Early-Onset Type 2 Diabetes in a Mexican Population
Authors: Villarreal-Molina M. Teresa , Flores-Dorantes M. Teresa , Arellano-Campos Olimpia , Villalobos-Comparan Marisela , Rodríguez-Cruz Maricela , Miliar-García Angel , Huertas-Vazquez Adriana , Menjivar Marta , Romero-Hidalgo Sandra , Wacher Niels H. , Tusie-Luna M. Teresa , Cruz Miguel , Aguilar-Salinas Carlos A. , Canizales-Quinteros Samuel ,   the Metabolic Study Group
Published: November 2007

OBJECTIVE—The ATP-binding cassette transporter A1 (ABCA1) R230C variant is associated with low HDL cholesterol levels, obesity, and the metabolic syndrome in Mexican-Mestizos. Because a pivotal role for ABCA1 in pancreatic β-cell function was recently observed in the mouse model, we assessed the association of this variant with type 2 diabetes in this population.
RESEARCH DESIGN AND METHODS—The initial group included 446 unrelated Mexican individuals: 244 with type 2 diabetes aged 20–69 years (121 with onset ≤45 years), and 202 nondiabetic control subjects aged &gt;50 years. An independent study group included 242 type 2 diabetic case subjects and 225 control subjects with similar characteristics.
RESULTS—R230C/C230C genotypes were significantly more frequent in type 2 diabetic individuals (24.6%) than in control subjects (11.4%) in the initial study group (OR 2.501; P = 0.001). After stratifying by age at diagnosis, the association was significant only in the early-onset group (age at diagnosis ≤45 years) (OR 3.776, P = 3.3 × 10−6). Both associations remained significant after adjusting for admixture (P = 0.0008 and P = 8.1 × 10−6, respectively). Similar trends were observed in the independent study group, and the combined analysis of both populations showed a highly significant association of the R230C variant with type 2 diabetes, particularly with that of early onset (P = 7.6 × 10−6 and 9.4 × 10−8, respectively).
CONCLUSIONS—The R230C ABCA1 variant is associated with type 2 diabetes, particularly of early onset, in the Mexican-Mestizo population.
The Type and the Position of HNF1A Mutation Modulate Age at Diagnosis of Diabetes in Patients with Maturity-Onset Diabetes of the Young (MODY)-3
Authors: Bellanné-Chantelot Christine , Carette Claire , Riveline Jean-Pierre , Valéro René , Gautier Jean-François , Larger Etienne , Reznik Yves , Ducluzeau Pierre-Henri , Sola Agnès , Hartemann-Heurtier Agnès , Lecomte Pierre , Chaillous Lucy , Laloi-Michelin Marie , Wilhem Jean-Marie , Cuny Pierre , Duron Françoise , Guerci Bruno , Jeandidier Nathalie , Mosnier-Pudar Helen , Assayag Michel , Dubois-Laforgue Danièle , Velho Gilberto , Timsit José 
Published: November 2007

OBJECTIVE—The clinical expression of maturity-onset diabetes of the young (MODY)-3 is highly variable. This may be due to environmental and/or genetic factors, including molecular characteristics of the hepatocyte nuclear factor 1-α (HNF1A) gene mutation.
RESEARCH DESIGN AND METHODS—We analyzed the mutations identified in 356 unrelated MODY3 patients, including 118 novel mutations, and searched for correlations between the genotype and age at diagnosis of diabetes.
RESULTS—Missense mutations prevailed in the dimerization and DNA-binding domains (74%), while truncating mutations were predominant in the transactivation domain (62%). The majority (83%) of the mutations were located in exons 1- 6, thus affecting the three HNF1A isoforms. Age at diagnosis of diabetes was lower in patients with truncating mutations than in those with missense mutations (18 vs. 22 years, P = 0.005). Missense mutations affecting the dimerization/DNA-binding domains were associated with a lower age at diagnosis than those affecting the transactivation domain (20 vs. 30 years, P = 10−4). Patients with missense mutations affecting the three isoforms were younger at diagnosis than those with missense mutations involving one or two isoforms (P = 0.03).
CONCLUSIONS—These data show that part of the variability of the clinical expression in MODY3 patients may be explained by the type and the location of HNF1A mutations. These findings should be considered in studies for the search of additional modifier genetic factors.
25-Hydroxyvitamin D, IGF-1, and Metabolic Syndrome at 45 Years of Age
Authors: Hyppönen Elina , Boucher Barbara J. , Berry Diane J. , Power Chris 
Published: November 2007

OBJECTIVE—Hypovitaminosis D and reduced IGF-1 are associated, individually, with metabolic syndrome. Physiological interactions between vitamin D and IGF-1 are reported; this is the first study to investigate their combined associations with metabolic syndrome prevalence.
RESEARCH DESIGN AND METHODS—Data on 25-hydroxyvitamin D (25(OH)D), IGF-1, and metabolic syndrome abnormalities (abdominal obesity; raised A1C, blood pressure, and triglycerides; and low HDL cholesterol) were collected from 6,810 British white subjects in the 1958 cohort, surveyed during 2002–2004 (age 45 years).
RESULTS—IGF-1 concentrations increased with 25(OH)D up to ∼75–85 nmol/l but not thereafter. Both 25(OH)D and IGF-1 were inversely associated with metabolic syndrome. There was an interaction between 25(OH)D and IGF-1 (P = 0.025) on metabolic syndrome prevalence: IGF-1 was not significantly associated with metabolic syndrome among those with the lowest levels of 25(OH)D (P &gt; 0.09), whereas higher 25(OH)D was associated with metabolic syndrome at all IGF-1 concentrations (P ≤ 0.006). Metabolic syndrome prevalence was lowest for participants with the highest concentrations of both 25(OH)D and IGF-1 (odds ratio for highest vs. lowest third of both 0.26 [95% CI 0.17–0.40], P &lt; 0.0001; adjusted for sex, month, hour, inactivity, alcohol consumption, smoking, and social class). 25(OH)D was associated with the prevalence of high A1C, blood pressure, and triglycerides after adjustment for IGF-1, obesity, and social and lifestyle variations (P ≤ 0.004 for all comparisons).
CONCLUSIONS—Serum 25(OH)D is inversely associated with metabolic syndrome, whereas the inverse association with IGF-1 was found only among those without hypovitaminosis D. These results suggest that metabolic syndrome prevalence is the lowest when both 25(OH)D and IGF-1 are high.
Proinflammatory Effects of Advanced Lipoxidation End Products in Monocytes
Authors: Shanmugam Narkunarajaa , Figarola James L. , Li Yan , Swiderski Piotr M. , Rahbar Samual , Natarajan Rama 
Published: November 2007

OBJECTIVE—The reactions of carbohydrate- or lipid-derived intermediates with proteins lead to the formation of Maillard reaction products, which subsequently leads to the formation of advanced glycation/lipoxidation end products (AGE/ALEs). Levels of AGE/ALEs are increased in diseases like diabetes. Unlike AGEs, very little is known about ALE effects in vitro. We hypothesized that ALEs can have proinflammatory effects in monocytes.
RESEARCH DESIGN AND METHODS—In a profiling approach, conditioned media from THP-1 cells either cultured in normal glucose (5.5 mmol/l) or treated with MDA-Lys or MDA alone were hybridized to arrays containing antibodies to 120 known human cytokines/chemokines. Pathway analyses with bioinformatics software were used to identify signalling networks.
RESULTS—Synthetic ALE (malondialdehyde-lysine [MDA-Lys]) (50 μmol/l) could induce oxidant stress and also activate the transcriptional factor nuclear factor-κB (NF-κB) in THP-1 monocytes. MDA-Lys also significantly increased the expression of key candidate proinflammatory genes, interferon-γ–inducible protein-10, β1- and β2-integrins, cyclooxygenase-2 (COX-2), monocyte chemoattractant protein-1 (MCP-1), interleukin-6 and -8, and inducible nitric-oxide synthase, which are also associated with monocyte dysfunction. Several key target proinflammatory proteins were significantly induced by MDA-Lys relative to normal glucose or MDA alone, including MCP-1; tumor necrosis factor ligand superfamily member-14; chemokine CC motif ligand-11 (CCL11); growth-related oncogene-α, -β, and -γ; and chemokine CXC motif ligand-13. Bioinformatics analyses identified a network of chemokine signaling among MDA-Lys–regulated genes. MDA-Lys also increased monocyte binding to vascular smooth muscle and endothelial cells. Furthermore, plasma from diabetic rats showed significantly higher levels of MDA-Lys and CCL11.
CONCLUSIONS—These new results suggest that ALEs can promote monocyte activation and vascular complications via induction of inflammatory pathways and networks.
The amicus view: What they're saying about Hall Street Associates, and why
Authors: Bleemer Russ 
Published: November 2007

AbstractExcerpts are provided from each of the five friend‐of‐the‐court briefs in Hall Street Associates v. Mattel, which is to be argued this month in the U.S. Supreme Court, as well as the filers' interests in the case. The Court also takes another arbitration case for the current term, and the American Arbitration Association issues new mediation rules