bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical spectrum of acute abdominal pain in Turkish pediatric patients: A prospective study
Authors: Erkan Tülay , Çam Halit , Özkan Hilda Çerçi , Kiray Evrim , Erginoz Ethem , Kutlu Tufan , Tastan Yucel , Çullu Fugen 
Published: May 2004

Abstract
Background
: The aim of the present study was to determine the prevalence, associated symptoms, and clinical outcomes of children with acute abdominal pain who had been admitted to an emergency department.
Methods
: Children aged between 2 and 16 years who presented to the emergency department of Cerrahpaşa Medical School, Istanbul University between July 2001 and August 2002 with acute abdominal pain were enrolled in this study. A questionnaire was completed each patient admitted to our pediatric emergency unit for acute abdominal pain. Data collected included presenting signs and symptoms, the hospital follow up for all children who returned within 10 days, test results, and telephone follow up.
Results
: The number of children referred to the emergency department was 7442, with 399 (5.4%) of these having acute abdominal pain. The mean age of the study population was 6.9 ± 3.5 years, and 201 of the patients were male. The five most prevalent diagnoses were: (i) upper respiratory tract infection and/or complicated with otitis media or sinusitis (23.7%); (ii) abdominal pain with uncertain etiology (15.4%); (iii) gastroenteritis (15.4%); (iv) constipation (9.4%); and (v) urinary tract infection (8%). The most common associated symptoms were decreased appetite, fever and emesis. Because of follow‐up deficiency the progress of 28 patients was not obtained. Eighty‐two children were referred to the department of pediatric surgery, but only 17 of 82 (20.7%) required surgical intervention (15 of these 17 for appendicitis). Eleven patients returned within 10 days for re‐evaluation, but the initial diagnosis was not changed. The complaints of 57 patients with uncertain etiology were resolved within 2 days.
Conclusions
: An acute complaint of abdominal pain was usually attributed to a self‐limited disease. However, the percentage of surgical etiology is not negligible.
A questionnaire survey on the use of quick‐acting insulin analog in Japanese children and adolescents with type 1 diabetes
Authors: Urakami Tatsuhiko , Kawamura Tomoyuki , Sugihara Shigetaka , Miyamoto Shigeki , Amemiya Shin , Sasaki Nozomu , Matsuura Nobuo 
Published: May 2004

Abstract
Background
: The aim of this study was to investigate the actual condition of quick‐acting insulin analog (Q) in Japanese children and adolescents with type 1 diabetes.
Methods
: Forty‐seven physicians who managed 944 patients under 18 years of age with type 1 diabetes, were requested to complete questionnaires in May 2002 regarding the use of Q.
Results
: Q was administered to 417 out of 944 (44%) patients. The details of the daily insulin regimens were as follows: three doses of Q with basal insulin in 116 of 403 (29%), three doses of Q with more than twice the basal insulin in 69 of 403 (17%), and other modifications using either Q or regular insulin (R) depending on the patients’ lifestyles in 213 of 403 (53%). Q dose was equal to R after the change of insulin regimens in 232 of 290 (80%). After switching to Q from R, the basal insulin dosage increased in 113 of 341 (33%) and the number of basal insulin injections increased in 42 of 341 (12%). After the transfer to Q from R, glycemic control was judged to improve in 179 of 372 (48%), to have no significant change in 162 of 372 (44%), and to aggravate in 31 of 372 (8%). The majority of patients, (305/389; 78%), noted an improvement of quality of life (QOL) following the administration of Q.
Conclusions
: Q was considered to be useful in flexibility of daily insulin therapy and improvement of QOL in children and adolescents with type 1 diabetes. Insulin therapy for type 1 diabetes during childhood and adolescence should be tailored to meet individual needs.
Ineffective erythropoiesis underlies the clinical heterogeneity of congenital dyserythropoietic anemia type II (CDA II)
Authors: Kostaridou Stavroula , Polychronopoulou Sophia , Premetis Evangelos , Papassotiriou Ioannis , Stamoulakatou Alexandra , Haidas Stavros 
Published: May 2004

Abstract
Background
: Congenital dyserythropoietic anemia type II (CDA II) is an autosomal recessive disease, and is the most common CDA. The qualitative and quantitative defects of erythropoiesis in CDA II, as estimated by the hematological and biochemical parameters at the time of diagnosis, may not reflect the heterogeneity of the disease course of each patient.
Methods
: Three pediatric patients with CDA II are herein presented, having an heterogeneous clinical course. In addition to bone marrow morphology, Ham test and SDS‐PAGE of erythrocyte membrane protein, the present study also examined erythroid marrow activity, by measuring serum Erythropoietin (Epo), soluble Transferrin Receptors (sTfR) concentrations and Reticulocyte Production Index (RPI).
Results
: All patients demonstrated the same pattern of ineffective erythropoiesis, having increased Epo (350−389 IU/L), sTfR concentrations (6.2−7.8 mg/L) and low RPI values (0.8−1.3). Erythron expansion was expressed by RPI values nearly twofold higher than normal values in parallel to raised sTfR and high Epo production. Despite the same degree of ineffective erythropoiesis seen in all patients, the severity of the clinical course was diverse in terms of frequency and clinical relevance of transfusion needs.
Conclusion
: An analysis of the parameters expressing ineffective erythropoiesis in CDA II can provide a better understanding of the degree of dyserythropoiesis, however it is not useful for predicting the clinical course of disease in patients, because the underlying genetic heterogeneity of this disorder remains obscure.
Analysis of factors that influence body mass index from ages 3 to 6 years: A study based on the Toyama cohort study
Authors: Sugimori Hiroki , Yoshida Katsumi , Izuno Takashi , Miyakawa Michiko , Suka Machi , Sekine Michikazu , Yamagami Takashi , Kagamimori Sadanobu 
Published: May 2004

Abstract
Background
: The aim of the present study was to elucidate both environmental and behavioral factors that influence body mass index (BMI, kg/m2) among Japanese children from ages 3−6.
Methods
: In 1992 (at age 3) and 1995 (at age 6), 8170 6‐year‐old children (4176 boys and 3994 girls) were surveyed using a questionnaire on both body build (height and weight) and lifestyle. The correlation between BMI for 3‐year‐olds and for 6‐year‐olds were analyzed. From the temporal changes of body build between age 3 and 6 years, we categorized children into four groups: group 1, normal at both age 3 years and 6 years (normal/normal); group 2, overweight at age 3 years and normal at age 6 years (overweight/normal); group 3, normal at age 3 years and overweight at age 6 years (normal/overweight); and group 4, overweight at both age 3 years and 6 years (overweight/overweight). The authors compared the four groups with each other according to sex, concerning frequencies of children who matched the categories of environmental and behavioral factors. Each factor was tested using the χ2 test. Overweight children were defined as those whose BMI value was age‐sex specific in the 90th percentile or more.
Results
: A significant correlation was found between body builds for children aged 3 and 6 years in both genders (boys, r = 0.559, P < 0.01; girls, r = 0.584, P < 0.01). Significant factors associated with overweight children were diet (eating rice, green tea, eggs, meat, but less breads and juice), rapid eating, short sleep duration, early bedtime, long periods of television viewing, avoidance of physical activity, and frequent bowel movement.
Discussion
: Temporal changes in BMI from age 3 years to 6 years are significantly associated with both environmental and behavioral factors at age 6 years. The results of this study may be useful for health promotion programs designed to prevent obesity during the early stages of childhood.
Relation between predischarge auditory brainstem responses and clinical factors in high‐risk infants
Authors: Suzuki Naomitsu , Suzumura Hiroshi 
Published: May 2004

Abstract
Background
: Advances in perinatal medicine have increased the survival rate of infants admitted to neonatal intensive care units (NICU). Some of the infants will have health problems including hearing disorder and/or brainstem dysfunction, and may have associated communicative and cognitive difficulties and/or repeated apnea attacks that require therapy or care.
Methods
: In this study, the authors measured mean thresholds and mean I−V interpeak latencies in 56 high‐risk infants and 30 controls who were about to be discharged from NICU. The authors retrospectively investigated whether predischarge auditory brainstem response (ABR) data, which seem to be related to a number of clinical factors affecting neonates, are useful for detecting hearing disorder and/or brainstem dysfunction, and we investigated six clinical factors.
Results
: The results showed that the positive risk factors for hearing impairment in infants who are about to be discharged from the NICU are: receiving mechanical ventilation (including for a period of <1 day) and the administration of five or more different antibiotics, especially in extremely low‐birthweight (ELBW) infants. Another result showed that the high‐risk mature infants had a significant high risk factor for brainstem dysfunction.
Conclusions
: The findings of the study emphasize the importance of performing ABR examinations in high‐risk infants, even in infants who are about to be discharged from an NICU. ABR examinations are especially important in ELBW infants or mature infants who have received mechanical ventilation or who have received five or more different antibiotics.
Facilitation of visuo‐motor learning by transcranial direct current stimulation of the motor and extrastriate visual areas in humans
Authors: Antal Andrea , Nitsche Michael A. , Kincses Tamás Z. , Kruse Wolfgang , Hoffmann Klaus‐Peter , Paulus Walter 
Published: May 2004

AbstractPerformance of visuo‐motor tasks requires the transfer of visual data to motor performance and depends highly on visual perception and cognitive processing, mainly during the learning phase. The primary aim of this study was to determine if the human middle temporal (MT)+/V5, an extrastriate visual area that is known to mediate motion processing, and the primary motor cortex are involved in learning of visuo‐motor coordination tasks. To pursue this, we increased or decreased MT+/V5, primary contralateral motor (M1) and primary visual cortex excitability by 10 min of anodal or cathodal transcranial direct current stimulation in healthy human subjects during the learning phase of a visually guided tracking task. The percentage of correct tracking movements increased significantly in the early learning phase during anodal stimulation, but only when the left V5 or M1 was stimulated. Cathodal stimulation had no significant effect. Also, stimulation of the primary visual cortex was not effective for this kind of task. Our data suggest that the areas V5 and M1 are involved in the early phase of learning of visuo‐motor coordination.
GABAergic synapses of the suprachiasmatic nucleus exhibit a diurnal rhythm of short‐term synaptic plasticity
Authors: Gompf Heinrich S. , Allen Charles N. 
Published: May 2004

AbstractWe examined synaptic plasticity at intrasuprachiasmatic nucleus (SCN) γ‐aminobutyric acid (GABA)ergic synapses by measuring the paired‐pulse ratio between pairs of evoked inhibitory postsynaptic currents (IPSCs). Interstimulus intervals were chosen to represent the range of spontaneous action potential firing frequencies found in SCN neurons. A majority of synapses studied during the day exhibited paired‐pulse depression (PPD), whereas a majority of synapses studied during the night showed no PPD. Two types of PPD were found. Type 1 PPD expresses the greatest inhibition at shorter interstimulus intervals, is predominant in the early morning and is likely to be a result of vesicle depletion. Type 2 showed the greatest inhibition at interstimulus intervals between 175 and 225 ms, is found throughout the day yet rarely at night and is likely to be a result of a Ca2+‐dependent mechanism that is independent of pertussis toxin‐sensitive G‐proteins. Thus, multiple mechanisms of synaptic plasticity modulate intra‐SCN communication throughout the diurnal cycle.
Thapsigargin‐induced mobilization of dendritic dense‐cored vesicles in rat supraoptic neurons
Authors: Tobin Vicky A. , Hurst Gillian , Norrie Linda , Dal Rio Francesco P. , Bull Philip M. , Ludwig Mike 
Published: May 2004

AbstractDense‐cored vesicles (DCVs) containing oxytocin or vasopressin are secreted from both the nerve terminals in the posterior pituitary and dendrites in the hypothalamus of magnocellular supraoptic neurons. Dendritic secretion can be enhanced (primed) by pretreatment with either thapsigargin or oxytocin for subsequent activity‐dependent release. Here, we determined whether priming involves a translocation of DCV closer to the dendritic membrane. To reduce total vesicle content, rats were salt‐loaded for 24 h before application of thapsigargin or vehicle onto the ventrally exposed surface of the supraoptic nucleus in vivo. Tissues were then prepared for quantitative electron microscopic analysis of the total incidence of DCVs within supraoptic dendritic cross‐sections, and of the incidence and distance (within a 500‐nm margin) of each DCV to the dendritic plasma membrane. Salt loading per se did not alter the frequency distribution or average proportion of DCVs found in the 500‐nm margin but significantly decreased the average incidence of DCVs per dendrite by 30% (P < 0.05). However, thapsigargin treatment resulted in a significant increase in the total incidence of DCVs within the 500‐nm margins and a higher incidence of DCVs within the first 200 nm of the plasma membrane (P < 0.05), indicating that the thapsigargin‐induced priming involves a relocation of DCVs closer to sites of secretion.
Re‐visioning the spider woman archetype in Kiss of the Spider Woman
Authors: Wiegmann Mira 
Published: May 2004

Abstract:The article examines the transformation of spider woman archetype from Manuel Puig's adaptation of his novel to a play, and other adaptations into a film and a musical. The paper examines how the archetype's image and function shift when ‘re‐visioned’ by various artists and performed in disparate social contexts.
Knowing What You Don’t Know? Discourses and Contradictions in Knowledge Management Research
Authors: Schultze Ulrike , Stabell Charles 
Published: May 2004

ABSTRACTEven though knowledge management scholars generally advocate explicit management of knowledge, there is research that cautions against the unintended consequences of such efforts. Some researchers go as far as arguing that knowledge and management are contradictory concepts (Alvesson and Kärreman, 2001). This paper explores the apparent double‐edged nature of knowledge management by developing a theory‐based framework that highlights different fundamental assumptions about knowledge and its management. This framework, which is an adaptation of Burrell and Morgan's four paradigms of social and organizational inquiry, distinguishes among a neo‐functionalist, a constructivist, a critical and a dialogic discourse.We use the contradiction of managing tacit knowledge, which has been highlighted in the knowledge management literature, as an analytical device to explore the four discourses in more detail. We show how notions of knowledge, and what it means to manage knowledge, vary across the four discourses. We conclude that all four discourses need to be appreciated, understood and represented in knowledge management research for this area of inquiry to deal with the rich and problematic nature of managing knowledge in practice.
The Problem of Abortion: Essentially Contested Concepts and Moral Autonomy
Authors: Gibson Susanne 
Published: May 2004

ABSTRACTWhen one thinks about the ethics of abortion, one inevitably thinks about rights, since it is in terms of the concept of rights that much of the debate has been conducted. This is true of overtly feminist as well as non‐feminist accounts. Indeed, some early feminist writers – Judith Jarvis Thomson and Mary Ann Warren, for example – employ a model of rights that is indistinguishable, or virtually indistinguishable, from that of their non‐feminist counterparts. However, more recent feminist writers have developed a different understanding of ‘a woman's right to choose.’In this paper, I will begin by outlining the non‐feminist debate over the moral permissibility of abortion. I will suggest that this debate is irresolvable, since at its heart is an ‘essentially contested concept’, that of personhood. I will then consider the way in which some feminist writers have attempted to reconceive the terms of the abortion debate and suggest an expanded account of women's right to abortion, drawing on the work of Susan Sherwin. Finally, I will argue that there is a further element to a ‘woman's right to choose’ that expands on and provides a conceptual link between the feminist and non‐feminist understanding of abortion.
Adequate Conscious Life and Age‐Related Need: F.M. Kamm's Approach to Patient Selection
Authors: Waring Duff 
Published: May 2004

AbstractKamm's approach to patient selection qualifies the notion that fairness makes need for scarce, transplantable organs inversely proportional to age. She defines need as how much adequate conscious life a person will have had before death. Length of adequate conscious life correlates highly with age. If so, then younger persons are usually needier than older ones. Since Kamm allows for past periods of non‐adequate conscious life, I argue that this correlation may be neither as close, nor as easy to apply, as she wants it to be. Fairness should require assessment of experiential content in determining how long one's life has been adequately conscious. I argue that such assessments involve some of the goods of experience and quality of life judgements that Kamm thinks a reliance on adequate conscious life will avoid.
What Happened to the Japanese Model?
Authors: Schaede Ulrike 
Published: May 2004

AbstractJapan's steep postwar growth was nested in a political economy built around producer‐oriented policies: by fostering the growth of large firms using the tools of industrial policy, the government could jumpstart development. Many large firms, and their employees, benefited indirectly from this growth program, and very small firms and industries not included in the growth model were compensated through preferential policies or subsidies. Japan's social contract evolved around this system, having as its centerpiece lifetime employment. The government spent more resources on supporting exporting industries and compensating domestic ones than on building a forward‐looking welfare system. Japan's decade‐long economic downturn marks a structural transition towards a postindustrial society. While excelling in producing tangibles, Japan has fallen behind in fostering modern industries, including services; the country also lacks a welfare system to handle increasing structural unemployment that this transition brings about. Without a commitment towards a welfare system and a welfare society, and a reorientation of the social contract towards citizens, Japan is unlikely to transition successfully.
Choice of designs and doses for early phase trials
Authors: Zhou Yinghui 
Published: May 2004

AbstractThis paper reviews state‐of‐art statistical designs for dose‐escalation procedures in first‐into‐man studies. The main focus will be on studies in oncology, as most statistical procedures for phase I trials have been proposed in this context. Extensions to situations such as the observation of bivariate outcomes and healthy volunteer studies are also discussed. The number of dose levels and cohort sizes used in early phase trials are considered. Finally, this paper raises some practical issues for dose‐escalation procedures.
Assessment of patient‐reported outcomes in clinical trials: the example of health‐related quality of life
Authors: Wiklund Ingela 
Published: May 2004

AbstractAs the patient is the primary recipient of treatment, there is a need to recognize and value the patient's perception of change in response to treatment in clinical trials. A new outcomes classification, patient‐reported outcomes (PROs), has been proposed by regulators. The PROs are used as an umbrella term and include, for example measures of subjective symptoms, health‐related quality of life (HRQL) and treatment satisfaction. In this sense, the PROs are unique and complementary indicators of disease activity as well as of treatment efficacy. Frequently, pharmaceutical companies desire to include PRO benefits in the product label in order to reach a broad range of customers, including prescribers as well as patients. Therefore such information must be based on results that are scientifically valid. The measurement strategy, i.e. the thinking about and decision‐making related to PRO and HRQL evaluations, needs to be explicit for clinical trials. First of all it is necessary to specify and provide the rationale for measuring the PROs. Similarly, the reason for selecting particular instruments should be stated and, for the selected instruments, the psychometric evidence should be summarized. The key PRO domains must be prespecified and evidence of their importance to patients should be provided. The research question under study and potential claims need to be clearly delineated. Hence, instrument selection is a key initial step for planning successful and scientifically adequate clinical trials intended to support labelling and promotional claims of PRO benefits to patients. The scientific criteria and design issues of clinical trials are the same for clinical and PRO endpoints. However, important issues of particular relevance to PRO assessments, such as missing values, multiple outcomes, and the statistical analysis, require careful attention. The thinking and planning involved in developing the PRO component of the clinical trial need to be articulated. Successful evaluation of PROs in clinical trials relies on careful planning provided the treatment shows sufficient effectiveness.
Effects of differential blockade of the renin‐angiotensin system in postinfarcted rats
Authors: Lacour Colette , Roccon Alain , Galindo Gérard , Canals Françoise , Hogie Manuela , Segondy Danielle , Briand Danielle , Roque Claude , Herbert Jean‐Marc , Nisato Dino 
Published: May 2004

AbstractThe present study compared short‐term effects of the AT1‐receptor antagonist, irbesartan with the angiotensin‐converting enzyme (ACE) inhibitor, enalapril on systemic haemodynamics and cardiac remodelling in post‐myocardia‐infarcted (MI) rats. MI Sprague–Dawley rats were orally treated for 4 weeks with irbesartan (50 mg/kg/day) or enalapril (10 mg/kg/day). Then, cardiac and systemic haemodynamics were measured. Compared with the sham‐operated group, left ventricular end‐diastolic pressure (LVEDP), diastolic pressure (LVDP), heart weight to body weight ratio were all significantly increased in the MI group while the LV contractility (dP/dt) and pulsatile arterial pressure were significantly reduced. Both drugs reduced the elevated LVEDP and LVDP and prevented cardiac hypertrophy. Furthermore, irbesartan attenuated the right shift of the pressure–volume curves, prevented postinfarction‐induced increase in urinary cyclic guanosine monophosphate and reduced urinary aldosterone excretion. Although both drugs were able to prevent further cardiac hypertrophy and improved cardiac filling pressure, only irbesartan limited LV dilatation. These data indicate that blockade of the renin‐angiotensin system at the level of AT1 receptors may have a better cardioprotective benefit than reducing angiotensin II levels by ACE inhibition.