bluuebunny/crossref_metadata_2025_split huggingface dataset:
West of Scotland managed clinical network for head and neck cancer
Authors: Dawson F.R. , Savage S.A. , Struthers F. , Anderson M. , Brown K. , Conroy A. , Harvey A. , Lang K. , Leslie C. , McAteer C.A. , MacDonald H. , Peacock I. , Wilson J. , Ladley J. 
Published: November 2004

Background:  The Head and Neck Managed Clinical Network (MCN) was established in April 2002 with the aim of ensuring that no matter where a patient receives treatment, their treatment pathway will be the same. An advisory board was set up with representation from the five West of Scotland health board areas (Ayrshire and Arran, Argyll and Clyde, Greater Glasgow, Lanarkshire and Forth Valley).Method:  The Advisory Board consists of representatives from the multidisciplinary team including ear, nose and throat, maxillofacial and plastic surgeons, oncologists, radiotherapists, clinical nurse specialists, dietitians, speech and language therapists, palliative care consultant and a patient representative. The dietetic representative on the Advisory Board acts as a link to the 12 members of the Dietetic Subgroup. These dietitians are from across the West of Scotland health boards and local multidisciplinary teams and include both the primary and acute sector. A network manager was appointed in April 2003 and works within a team for the West of Scotland Cancer MCN's, which provide administration, audit, information, statistical and information technology, support to the network.Audit:  The network is committed in improving the quality of care and outcomes for patients with head and neck cancers. Agreement of the head and neck minimum dataset across Scotland has still to be achieved.Teleconferencing and clinical meetings:  The network has utilized telemedicine conferences to audit new complicated cases throughout the West of Scotland. Monthly meetings link surgeons, oncologists, radiotherapists, pathologist, dietitians, speech and language therapists and clinical nurse specialists in Glasgow, Ayrshire, Forth Valley, Argyll and Clyde and Lanarkshire to provide discussion and agreement in best patient care.Publications:  Patient information booklets are being developed to cover all areas of head and neck cancer. Dietitians have been involved in writing the dietetic component of the booklets and also in proof reading the booklets as a whole. Dietitians within this group have been working with the Scottish Nutrition and Diet Resources Initiative to develop a cancer diet information pack entitled ‘A Helping Hand’, which was published in February 2004.Patient pathways:  The MCN has been monitoring patient pathways, which are often complex in head and neck cancer patients.Conclusion:  Over time with the network, we envisage a powerful multidisciplinary group, which focuses on strategic planning of patient care, to assist delivery of service improvement and clinical benefit. To help achieve this goal, dietitians are sharing information on best practice and producing guidelines.
Interleukin‐8 promotes non‐rapid eye movement sleep in rabbits and rats
Authors: García‐García Fabio , Yoshida Hitoshi , Krueger James M. 
Published: November 2004

SummaryInterleukin‐8 (IL‐8) is a cytokine found in the brain. In this study, the ability of IL‐8 to induce sleep in rabbits and rats was investigated. Twenty‐seven Sprague–Dawley rats and 16 male New Zealand White rabbits were provided electroencephalographic (EEG) electrodes, a brain thermistor, and a lateral intracerebroventricular cannula. The animals were injected intracerebroventricularly (i.c.v.) with pyrogen‐free saline and, one of the following doses of IL‐8 on a separate day: 1.25 or 12.5 ng in rabbits and 10, 50, or 100 ng in rats. EEG, brain temperature, and motor activity were recorded for 23 h after the i.c.v. injections. IL‐8 increased time spent in non‐rapid eye movement sleep (NREMS) without affecting rapid eye movement sleep (REMS). In rabbits, both doses of IL‐8 promoted NREMS. In rats, the 10 and 50 ng doses of IL‐8 failed to affect sleep, but the 100 ng dose of IL‐8 enhanced NREMS. EEG slow‐wave activity during NREMS was increased after the high dose of IL‐8 in rabbits. IL‐8 also induced fever in rabbits but not rats. Heat inactivated IL‐8 did not alter any of the parameters measured. Current results support the notion that the brain cytokine network plays a role in sleep regulation.
Does cognitive dysfunction conform to a distinctive pattern in obstructive sleep apnea syndrome?
Authors: Incalzi Raffaele Antonelli , Marra Camillo , Salvigni Bruna Lorena , Petrone Albino , Gemma Antonella , Selvaggio David , Mormile Flaminio 
Published: November 2004

SummaryObstructive sleep apnea (OSA) is a recognized cause of cognitive dysfunction. By using a cross‐sectional comparative study, we aimed to verify whether neuropsychological performance of untreated OSA patients conforms to a distinctive pattern. Forty‐nine newly diagnosed, untreated OSA patients, 27 with multi‐infarctual dementia (MID), 31 with mild to moderate dementia of Alzheimer type (DAT) and 63 with severe chronic obstructive pulmonary disease (COPD), all free from major comorbid dementing conditions were chosen for the study. The groups were matched for age and education. We found a bimodal distribution of cognitive performance in OSA group, which was therefore divided into two clusters having better (OSAb,n = 35) and worse (OSAw,n = 14) performance on a battery of 10 cognitive indexes. Cognitive performances of OSAb, OSAw, MID, DAT and COPD were compared by discriminant analysis. OSAb performed better than OSAw in all but one test. Deductive thinking and verbal attainment were more severely impaired in OSAw than in COPD patients. Constructive ability, deductive thinking and both verbal attainment and immediate memory were comparably impaired in OSAw and DAT. The mean neuropsychological scores of OSAw and MID were comparable, but 71% of OSAw patients had a distinctive cognitive profile, i.e. a group specific pattern of cognitive dysfunction, according to discriminant analysis. One of four newly diagnosed OSA patients had a severe and distinctive neuropsychological dysfunction mainly involving inductive and deductive thinking, and constructive ability. Some analogy with cognitive pattern of MID suggests that a mainly subcortical damage underlies this dysfunction.
Hybrid zone structure and the potential role of selection in hybridizing populations of native westslope cutthroat trout (Oncorhynchus clarki lewisi) and introduced rainbow trout (O. mykiss)
Authors: RUBIDGE EMILY M. , TAYLOR ERIC B. 
Published: November 2004

AbstractIntrogressive hybridization is a common feature of many zones of contact between divergent lineages of fishes. This is particularly common when taxa that are normally allopatric come into artificial (human‐induced) secondary contact. We examined 18 native populations of westslope cutthroat trout (Oncorhynchus clarki lewisi, WCT) to determine the extent of introgressive hybridization with introduced rainbow trout (O. mykiss, RBT) and the genetic structure of hybridizing populations in the upper Kootenay River, southeastern British Columbia, Canada. Using four diagnostic nuclear loci we calculated a hybrid index, inbreeding coefficient,FIS, and the linkage disquilibrium correlation coefficient,Rij, for each locality to determine the distribution of genotypes in each population. We also categorized the 142 hybrid individuals found across localities into four hybrid classes based on their genotypes. The majority of localities (11/18) showed a unimodal distribution of genotypes skewed towards genotypes of WCT. Two localities, however (lower Gold Creek and Lodgepole Creek) showed a flat to bimodal distribution and one site (lower Bull River) showed a unimodal distribution skewed towards RBT genotypes. The majority of hybrid individuals were classified genotypically as WCT backcrosses (59%) and post‐F1individuals (24%). We found a skewed ratio of pure WCT to pure RBT (17 : 1) and only four F1hybrids (3%), suggesting that the spread of RBT alleles may be facilitated by hybrids straying to neighbouring populations. We also tested for the action of selection in one population using cohort analyses, but found little evidence of differential selection between pure WCT and hybrid individuals. Pooled across age classes there were significant differences in genotypic frequencies among loci suggesting differential introgression. There was no asymmetry to the hybridization between rainbow trout and westslope cutthroat trout because both species’ mitochondrial DNA haplotypes were observed at similar frequencies in the hybrids. Our analyses suggest that hybrid swarms are likely to form in the upper Kootenay River drainage and that certain native WCT populations in British Columbia are at risk of local genomic extinction.
Fold interference patterns in the Late Palaeozoic Anti‐Atlas belt of Morocco
Authors: Séverine Caritg , Martin Burkhard , Romain Ducommun , Urs Helg , Lionel Kopp , Christian Sue 
Published: November 2004

AbstractWe document two phases of folding within the central part of the Late Palaeozoic Anti‐Atlas chain of Morocco. A first generation of SW–NE folds involve a horizontal shortening of 10–20%, accommodated by polyharmonic buckle folding of contrasting wavelengths in Ordovician Jbel Bani quartzites and Devonian Jbel Rich carbonates. A second generation of folds with similar style and wavelengths in an E–W direction lead to complex interference patterns. Dome and basins are developed within the Jbel Rich and within Lower Cambrian dolomites. Both folding phases are related to thick‐skinned uplift of Precambrian basement in a Laramide style. In contrast to the typical Rocky Mountain foreland style, however, cover deformation in the Anti‐Atlas is mostly decoupled from the undying basement along thick incompetent horizons such as the Lower Cambrian Lie‐de‐Vin and Silurian shales.
Effectiveness of intermittent preventive treatment with sulphadoxine‐pyrimethamine for control of malaria in pregnancy in western Kenya: a hospital‐based study
Authors: van Eijk A. M. , Ayisi J. G. , Ter Kuile F. O. , Otieno J. A. , Misore A. O. , Odondi J. O. , Rosen D. H. , Kager P. A. , Steketee R. W. , Nahlen B. L. 
Published: November 2004

SummaryObjective  To monitor the effectiveness of intermittent preventive treatment (IPT) with sulphadoxine‐pyrimethamine (SP) for the control of malaria in pregnancy at delivery in the Provincial Hospital in Kisumu, Kenya, and to assess the effect of IPT in participants in a cohort study.Methods  Between June 1999 and June 2000, information on IPT and birth outcome was collected in 2302 consecutive deliveries. A group of 889 women, who were enrolled in a cohort to assess the interaction between malaria and HIV, were analysed separately because of the enrolment criteria and different access to health care.Results  The prevalence of placental malaria was 13.8% and of low birthweight (LBW) was 12.2%. In multivariable analysis, IPT (≥1 dose of SP) was associated with a reduction in placental malaria and LBW [adjusted odds ratio (OR) 0.56, 95% confidence interval (CI) 0.39–0.83 and OR 0.65, 95% CI 0.45–0.95, respectively]. An adjusted mean increase in birthweight of 61 g was seen (95% CI 22–101 g) for each increment in number of SP doses (≥2 doses grouped together). IPT was associated with a reduction in placental malaria in HIV‐seronegative women (OR 0.49, 95% CI 0.28–0.86) but this was not significant among HIV‐seropositive women (OR 0.45, 95% CI 0.20–1.05). A significant effect on birthweight could not be detected among participants in the HIV‐cohort.Conclusions  This evaluation confirms that IPT with SP is effective in reducing placental malaria and LBW. It will be important to increase coverage of IPT and to extend IPT to antenatal clinics in peri‐urban and rural areas.
Short Communication: An assessment of the use of malaria rapid tests by village health volunteers in rural Laos
Authors: Mayxay Mayfong , Newton Paul N. , Yeung Shunmay , Pongvongsa Tiengkham , Phompida Samlane , Phetsouvanh Rattanaxay , White Nicholas J. 
Published: November 2004

SummaryRapid malaria diagnosis, a key component of malaria control strategies, is hampered by the expense and training requirements of reliable microscopy. Rapid malaria antigen tests may improve the diagnosis of malaria in the rural tropics. After 1 h training 64 village health volunteers (VHVs) from rural Laos, with no previous laboratory experience, performed two malaria rapid diagnostic tests (ParacheckPfTM and OptiMALTM) accurately. The reliability of six VHVs was assessed longitudinally, over 10 months with different frequencies of retraining. Compared with microscopy, error rates in dipstick interpretation were low (<2%) for both tests and were not associated with retraining frequency (P > 0.2). Previously untrained Lao VHVs performed malaria rapid tests reliably with high sensitivity and specificity after minimal training.
Water sources are associated with childhood diarrhoea prevalence in rural east‐central Mali
Authors: Plate David K. , Strassmann Beverly I. , Wilson Mark L. 
Published: November 2004

SummaryBackground  Water supply improvements generally reduce the incidence of diarrhoea. However, populations with limited access to a safe water supply may continue to draw water from unimproved sources, thereby increasing their risk of diarrhoea. Furthermore, young children who are not breastfed may be even more susceptible to water‐borne diarrhoeal pathogens. Our study explored the interactive protective effects against diarrhoea of exclusively using improved water sources and breastfeeding among children in rural Mali.Methods  Interviews were conducted with parents or guardians of children under 7 years of age in seven villages with access to a variety of water supplies. Water sources used, breastfeeding status, demographics and recent diarrhoea symptoms were determined for 1117 children. The cross‐sectional findings were used to compare diarrhoea prevalence among exclusive and non‐exclusive users of improved water sources. Variation in prevalence by age and exclusive breastfeeding status was evaluated using chi‐square and multivariate analyses.Results  Children whose water was drawn exclusively from wells had a significantly lower prevalence of diarrhoea as compared with children whose water was drawn from a spring or stream (5.9%vs. 8.7%; P = 0.04). The exclusive use of improved water sources had no impact on diarrhoea prevalence among children who were exclusively breastfed. Similarly, the strongest protective effect was observed among children who were not exclusively breastfed.Conclusions  Our results indicate that using surface water as a primary or secondary water source exposes children to greater risk of diarrhoeal disease than using only improved sources such as wells. It is particularly beneficial for young children who are not exclusively breastfed to be supplied with water drawn from improved sources.
Waiting too long: low use of maternal health services in Kalabo, Zambia
Authors: Stekelenburg J. , Kyanamina S. , Mukelabai M. , Wolffers I. , van Roosmalen J. 
Published: November 2004

SummaryObjective  To determine the level of use of maternal health services and to identify and assess factors that influence women's choices where to deliver in Kalabo District, Zambia.Methods  A cross‐sectional descriptive study conducted between 1998 and 2000, with 332 women interviewed using semi‐structured questionnaires. Focus group discussions were held and hospital data and registers were checked.Results  Although 96% of respondents would prefer to deliver in a clinic, only 54% actually did, because of long distances, lack of transport, user fees, lack of adequate health education given during antenatal clinic attendances, poorly staffed and ill‐equipped institutions with poorly skilled personnel.Conclusion  Unmarried women, women with higher education and women with formal employment, who are able to pay the user fees and live near a clinic are more likely to deliver in a clinic. This does not guarantee survival, however; maternal mortality is high in the district; health facilities are poorly staffed, poorly skilled and ill‐equipped.
Responsiveness to life‐threatening obstetric emergencies in two hospitals in Abidjan, Côte d'Ivoire
Authors: Gohou V. , Ronsmans C. , Kacou L. , Yao K. , Bohoussou K. M. , Houphouet B. , Bosso P. , Diarra‐Nama A. J. , Bacci A. , Filippi V. 
Published: November 2004

SummaryObjectives  To document the frequency of severe obstetric illness, and the intervals between admission or decision and life‐saving surgery and the factors contributing to delays, which were reported during case reviews in two hospitals in Abidjan, Côte d'Ivoire.Methods  The study was conducted in the teaching hospital in Cocody (CHUC) and the district hospital in Abobo (FSAS) in 2000–01. All severe obstetric cases were inventoried over a period of 1 year, and a subset of cases selected for in‐depth review. For the 23 audited cases requiring emergency surgery, the interval between admission/decision and surgery was determined and reasons for the delays examined.Findings  The yearly incidence of severe obstetric morbidity was 224.5 and 11.8 per 1000 live births in the CHUC and FSAS respectively. In CHUC, the decision‐to‐delivery time was extremely long (median 4.8 h) and this was largely determined by the time needed to obtain a complete surgical kit (median 2.8 h), either because the family had to pay for it in advance or because the kit lacked some essential components, which had to be bought separately. In FSAS, the decision‐to‐delivery time was much shorter (median 1.0 h).Conclusion  The interval between decision and emergency obstetric surgery substantially exceeded the 30 min generally advocated in industrialized countries. The reasons for the long delays were multiple and complex, but the main factors governing them were the huge case load of severe cases and the absence of any clear policy towards ensuring prompt and adequate treatment for life‐threatening emergencies. In‐depth reviews of cases of severe obstetric morbidity focusing in particular on the timing of emergency treatment could increase the responsiveness of the health system and providers to the needs of women requiring emergency obstetric care.
Indirect costs associated with accessing eye care services as a barrier to service use in Ethiopia
Authors: Melese Muluken , Alemayehu Wondu , Friedlander Eva , Courtright Paul 
Published: November 2004

SummaryBackground  The prevalence of blindness and visual impairment are high in Ethiopia and use of services is limited. Determining the barriers to use of eye care services is critical for planning strategies to prevent blindness.Methods  A population‐based survey of the magnitude and causes of blindness and visual impairment in adults 40 years and older in the Gurage Zone, central Ethiopia was conducted. Among those individuals who had binocular or monocular vision <6/18, an interview to assess use of eye care services and reasons for a failure to use such services was undertaken.Results  Of 850 adults with visual impairment or blindness, 802 were interviewed. Cataract surgery accounted for the primary service currently needed by the blind, followed by trichiasis surgery; service needs were higher for women than for men. Use of services (27.8% of sample) was associated with being male, binocular vision loss, and blindness. The primary reason for a failure to use eye care services were indirect costs (overall, reported by 40% of respondents) associated with accessing the service. There were significant differences between men and women in the reasons for not using the services and between cataract and trichiasis cases but not when comparing binocular vs. monocular conditions, or patients with visual impairment vs. blindness.Conclusion  The majority of the causes of visual impairment and blindness are treatable (cataract) or preventable (trachomatous trichiasis). The main barrier for seeking service is related to the indirect medical costs of the service. This suggests that efforts are needed to create mechanisms that ‘bridge’ communities and eye care facilities. A holistic approach that deals both with the organization of services and the sociocultural factors in communities that affect use is needed. The organization of trichiasis surgery at peripheral health centres and screening programmes which identify and facilitate transport to hospital for cataract patients is one approach. The indirect burden of accessing eye care on the family may be lessened by encouraging patients to have surgery earlier (before they require assistance to reach the hospital), and by improving the efficiency of existing services. Promotion of services must be gender‐sensitive, ensuring that specific characteristics of the sociocultural roles of women be considered in order to improve uptake among women. Training and placement of cataract surgeons in rural hospitals would also enhance provision of eye care for the rural population.
Evaluation of the sensitivity of Aedes aegypti and Anopheles gambiae complex mosquitoes to two insect repellents: DEET and KBR 3023
Authors: Badolo Athanase , Ilboudo‐Sanogo Edith , Ouédraogo Albert Patoin , Costantini Carlo 
Published: November 2004

SummaryWe conducted laboratory tests to assess the sensitivity to the insect repellent 1‐piperidinecarboxylic acid, 2‐(2‐hydroxyethyl)‐, 1‐methylpropylester (known as KBR 3023 or Picaridin, trade name Bayrepel®) of West African strains of the yellow fever mosquito Aedes aegypti and of malaria vectors of the Anopheles gambiae complex, in comparison with the standard repellent N,N‐diethyl‐3‐methyl‐benzamide (DEET). Test mosquitoes were exposed according to a ‘separate arms’ protocol to logarithmic dose increments applied on one arm of human subjects to evaluate the relative potency, and the median effective dosages (ED50 and ED90). According to a logistic regression model fitted to the experimental data, the dose–response relationship for the two repellents was the same within each species, thus pooled ED values were assessed for each mosquito separately. The median ED of KBR 3023 and DEET was estimated at 0.78 (95% confidence limits (CI): 0.57–1.04) and at 0.018 μg/cm2 (0.004–0.052) for mosquitoes of the An. gambiae complex and Ae. aegypti, respectively. ED90 values were 125.6 (81.4–201.3) and 24.0 μg/cm2 (5.7–208.5) for An. gambiae s.l. and Ae. aegypti, respectively. The relative potency of KBR 3023 was not significantly different from that of DEET for An. gambiae s.l. (95% confidence limits 0.7–1.0), whereas in the case of Ae. aegypti it was with 95% probability 1.1–2.0 times more potent than DEET. On the basis of available evidence, KBR 3023 represents a promising alternative to DEET for personal protection against bites of these important vectors of disease in the Afrotropical region.