bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracrystalline proteins and urolithiasis: a comparison of the protein content and ultrastructure of urinary calcium oxalate monohydrate and dihydrate crystals
Authors: Ryall Rosemary L. , Chauvet Magali C. , Grover Phulwinder K. 
Published: August 2005

OBJECTIVETo compare the ultrastructure and protein content, particularly prothrombin fragment 1 and osteopontin, of calcium oxalate monohydrate (COM) and calcium oxalate dihydrate (COD) crystals precipitated from human urine, and their susceptibility to proteolysis, to try to clarify the role of intracrystalline proteins in urolithiasis, as differences between these types of crystal may determine whether calcium oxalate crystals nucleated in urine progress to stone formation.MATERIALS AND METHODSSodium dodecyl sulphate gel electrophoresis and Western blotting were used to analyse demineralized extracts of COM and/or COD crystals deposited from the same centrifuged and filtered urine (which contains abundant urinary proteins) by adjusting the calcium concentration to 2 and 7 mmol/L, respectively. Similar analyses were performed on COM and COD crystals deposited from ultrafiltered urine (which contains only proteins of < 10 kDa) and then incubated in centrifuged and filtered urine, as well as crystals generated in the presence of increasing concentrations of proteins derived from the organic matrix of urinary calcium oxalate crystals. Field‐emission scanning electron microscopy was used to assess effects of proteinase K and cathepsin D on internal and superficial crystal structure.RESULTSOsteopontin was undetectable in COM extracts, but clearly visible in COD. Prothrombin fragment 1 was abundant in COM, but present in COD in lesser amounts than osteopontin. The selectivity was also the same with crystals from ultrafiltered urine that were incubated in centrifuged and filtered urine: prothrombin fragment 1 binding was favoured by low calcium concentration, while osteopontin bound at higher levels. Scanning electron microscopy of COM and COD digested with proteinase K and cathepsin D revealed superficial and internal texture, as wells as surface erosion, in crystals from centrifuged and filtered urine, thus confirming the presence of intracrystalline proteins. Such features were absent from crystals precipitated from ultrafiltered urine.CONCLUSIONBinding of osteopontin and prothrombin fragment 1 to calcium oxalate is dictated primarily by ambient calcium concentration. Each protein may inhibit urolithiasis by inhibiting crystallization of its preferred crystal habit, and by facilitating the intracellular disintegration and dissolution of crystals attached to and internalized by renal epithelial cells.
A tissue‐engineered suburethral sling in an animal model of stress urinary incontinence
Authors: Cannon Tracy W. , Sweeney Danielle D. , Conway Deidre A. , Kamo Izumi , Yoshimura Naoki , Sacks Michael , Chancellor Michael B. 
Published: August 2005

OBJECTIVETo create and evaluate the functional effects of a tissue‐engineered sling in an animal model of stress urinary incontinence (SUI).MATERIALS AND METHODSTwenty female Sprague‐Dawley rats were divided into four equal groups: a control group (C) had no intervention before the leak‐point pressure (LPP) was measured; a denervated group (D) had bilateral proximal sciatic nerve transection (PSNT) and periurethral dissection with no sling placed; group S had concomitant bilateral PSNT and a suburethral sling of small intestinal submucosa (SIS) placed; and group (M) had concomitant bilateral PSNT with implantation of a tissue‐engineered sling. The suburethral sling was placed via a transabdominal approach with the sling sutured to the pubic bone. Tissue‐engineered slings were prepared with muscle‐derived cells obtained via the pre‐plate technique and subsequently seeded for 2 weeks on a SIS scaffold. Suburethral slings were implanted 2 weeks before LPP testing, using the vertical‐tilt method.RESULTSSurgically placing a suburethral sling is feasible in the female rat, with few complications. LPPs from both sling groups (S and M) were not significantly different from untreated controls (C). The S, M and C groups all had significantly higher LPPs than group D. Importantly, no rat from either sling group (S and M) had signs of urinary retention.CONCLUSIONSPlacing tissue‐engineered slings in an animal model of SUI resulted in LPP values that were not significantly different from those in untreated control or SIS (S) groups. These data show that incorporating muscle stem cells into SIS slings does not adversely alter the advantageous mechanical properties of the SIS sling in a model of SUI, and provide the basis for future functional studies of tissue‐engineered sling materials with long‐term retention.
Alterations in connexin expression in the bladder of patients with urge symptoms
Authors: Neuhaus Jochen , Pfeiffer Friederike , Wolburg Hartwig , Horn Lars‐Christian , Dorschner Wolfgang 
Published: August 2005

OBJECTIVETo compare the formation of gap junctions between detrusor smooth muscle cells in situ and the distribution of connexin (Cx)40, Cx43 and Cx45 expressions in bladder biopsies from a control group (with bladder tumour) and from patients with urge symptoms, as smooth muscle cells of the human detrusor muscle communicate via gap junctions and express several connexin subtypes, alterations of which may be involved in the causes of lower urinary tract symptoms.MATERIALS AND METHODSConnexin expression is prominent in myofibroblast‐like cells, supposedly involved in afferent signalling pathways of the bladder. Their strategic position directly beneath the urothelium suggests they are a link between urothelial ATP signalling during bladder filling and afferent Aδ‐fibre stimulation for co‐ordination of bladder tonus and initialization of the micturition reflex. Modification of their coupling characteristics may have profound impact on bladder sensation. Bladder tissue probes of patients undergoing cystectomy or transurethral tumour resection for bladder cancer were used as controls. Tissue samples from patients with severe idiopathic urge symptoms were taken for exclusion diagnostics of interstitial cystitis (IC) and carcinoma in situ. The formation of functional syncytia between detrusor smooth muscle cells were examined in dye‐coupling experiments by injecting with Lucifer Yellow. The morphology and structure of gap junctions were assessed by transmission electron microscopy and immunogold labelling of Cx43 and Cx45. The expression of connexin subtypes Cx40, Cx43 and Cx45 was compared by indirect immunofluorescence, and confocal laser scanning microscopy used for semiquantitative analysis.RESULTSThere was dye coupling between smooth muscle cells of the detrusor in situ. Electron microscopy and immunogold labelling showed very small gap junctional plaques. These findings were confirmed by confocal immunofluorescence. Semiquantitative analyses showed significantly higher Cx43 expression in the detrusor muscle, and a tendency to higher Cx45 expression in the suburothelial layer associated with urge symptoms, whereas Cx40 expression was unaffected.CONCLUSIONSSmooth muscle cells of the human detrusor muscle are coupled by classical gap junctions, forming limited local functional syncytia. Both Cx43 and Cx45 are expressed at low levels in normal detrusor. Up‐regulation of Cx43 in patients with urge incontinence supports the possibility of functional changes in the syncytial properties of detrusor smooth muscle cells in this condition. In addition, the observed increase of Cx45 in the myofibroblast cell layer supports the idea that alterations in sensory signalling are also involved. Comparison with previous reports implies that the pathophysiology of urgency is distinct from that of the unstable bladder and other forms of incontinence.
A Tale of Two Towns: Social Structure, Integration and Crime in Rural New South Wales
Authors: Jobes Patrick C. , Donnermeyer Joseph F. , Barclay Elaine 
Published: August 2005

AbstractThis paper examines social factors that are associated with crime in two rural Australian communities with high proportions of Aboriginal people. It draws upon the theoretical contributions of Braithwaite (1989) to explain how levels of community integration and cohesion affect the presence of crime. Data for the case studies are derived from secondary statistics, surveys, observation and in‐depth interviews. Existing literature on crime in Australia emphasises the disproportionate representation of Aboriginal people within the criminal justice system. Yet, by comparing and contrasting the two communities, the analysis demonstrated that social structural and perceptual characteristics, rather than Indigenous status, account for high levels of crime in one community and low levels in the other. The analyses demonstrate that communities with high levels of social cohesion can ameliorate the affects of social disorganisation, division, and disadvantage in communities with high Aboriginal populations. It further demonstrates that rural crime is a complex and multi‐faceted phenomenon.
Visions in Agriculture
Authors: Gundelach Peter 
Published: August 2005

AbstractBased on theories of social movements, this article is an analysis of the visions of the Presidium of the Danish Agricultural Council, the umbrella organisation for farmers' organisations in Denmark. The research is inspired by Alain Touraine's interventionist sociology. The research shows that the presidium was strongly committed to a productivist worldview, i.e. that the objective is to increase production, lower production costs and get as high prices as possible. The co‐operative history of Danish farming still played a role for the Presidium's worldview. They cherished the democratic procedures and institutions, but when there was an international merge the presidium did not wish to expand the privileges of membership to farmers in other countries. For Danish farmers the Presidium felt that the co‐operative way of organising was superior both democratically and economically. The analysis of the Presidium's narratives showed that it can clearly state a problematic situation ‐ the financial situation of the farmers ‐ but because it cannot attribute this injustice to specific groups it is unable to create a strong narrative about the opponents and hence about how the unfair situation might be improved.
The Role of Consultation Clinics in Services for Children and Young People with Learning Disabilities and/or Autism
Authors: Cheseldine Sally , Manders Duncan , McGowan Clare 
Published: August 2005

Background:  Consultation and supervision are familiar to many professionals, and their relevance to those working with children with learning disabilities and autism is discussed.Method:  Consultation Clinics for Community Learning Disability Nurses and others were set up by a specialist Child and Adolescent Mental Health team servicing an area with a general population of 750,000. They were provided by a clinical psychologist and a psychiatrist, and data on their use were collected over a 16 month period.Results:  There were differences in frequency of use between nurses based in more rural teams and those in city teams. The number of children discussed increased over time, and approximately half continued to be supported by the discussant, rather than being referred to the Tier 3 service.Conclusions:  Suggestions are made as to the possible impact and benefits, with discussion also considering the role of professional responsibilities in consultative services.
Psychiatrists’ Use of Melatonin with Children
Authors: Bramble David , Feehan Cathy 
Published: August 2005

Background:  Melatonin is gaining popularity as a sedative agent with children. This study sought to characterise this practice more precisely as well as examine aspects of its safety and efficacy in order to develop treatment guidelines.Method:  Postal surveys of two groups of psychiatrists: generic child psychiatrists and psychiatrists who regularly treat learning disabled children.Results:  Both groups (all of the specialists and 81% of the non‐specialists) reported regular but not frequent use of melatonin in their usual practice, mostly for night‐settling sleep problems refractory to behavioural modification strategies, commonly in the context of neurodevelopmental disability (especially autism). Treatment was described as being ‘usually successful’ and side‐effects were highly infrequent and mild in nature. Variations in most prescribing practices were identified (dosage, timing).Conclusions:  Melatonin appears to represent a useful and relatively safe drug when used in specific circumstances; however, the evidence‐base underpinning its use, particularly over the long‐term, remains modest. Thus caution and clinical audit of practice is required.
Dementia and Alzheimer's Disease Incidence in Relationship to Cardiovascular Disease in the Cardiovascular Health Study Cohort
Authors: Newman Anne B. , Fitzpatrick Annette L. , Lopez Oscar , Jackson Sharon , Lyketsos Constantine , Jagust William , Ives Diane , DeKosky Steven T. , Kuller Lewis H. 
Published: August 2005

Objectives: To determine whether coronary artery disease, peripheral arterial disease (PAD), or noninvasive markers of cardiovascular disease (CVD) predict the onset of dementia and Alzheimer's disease (AD).Design: Longitudinal cohort study.Setting: Four U.S. communities.Participants: Men and women (N=3,602) with a brain magnetic resonance imaging (MRI) scan but no dementia were followed for 5.4 years. Participants with stroke were excluded.Measurements: Neurologists and psychiatrists classified incident cases of dementia and subtype using neuropsychological tests, examination, medical records and informant interviews. CVD was defined at the time of the MRI scan. Noninvasive tests of CVD were assessed within 1 year of the MRI. Apolipoprotein E allele status, age, race, sex, education, Mini‐Mental State Examination score, and income were assessed as potential confounders.Results: The incidence of dementia was higher in those with prevalent CVD, particularly in the subgroup with PAD. The rate of AD was 34.4 per 1,000 person‐years for those with a history of CVD, versus 22.2 per 1,000 person‐years without a history of CVD (adjusted hazard ratio (HR)=1.3, 95% confidence interval (CI)=1.0–1.7). Rates of AD were highest in those with PAD (57.4 vs 23.7 per 100 person‐years, adjusted HR=2.4, 95% CI=1.4–4.2). Results were similar with further exclusion of those with vascular dementia from the AD group. A gradient of increasing risk was noted with the extent of vascular disease.Conclusion: Older adults with CVD other than stroke had a higher risk of dementia and AD than did those without CVD. The risk was highest in people with PAD, suggesting that extensive peripheral atherosclerosis is a risk factor for AD.
Relationship Between Patient Age and Duration of Physician Visit in Ambulatory Setting: Does One Size Fit All?
Authors: Lo Agnes , Ryder Kathryn , Shorr Ronald I. 
Published: August 2005

Objectives: To determine whether patient age, the presence of comorbid illness, and the number of prescribed medications influence the duration of a physician visit in an ambulatory care setting.Design: A cross‐sectional study of ambulatory care visits made by adults aged 45 and older to primary care physicians.Setting: A probability sample of outpatient follow‐up visits in the United States using the National Ambulatory Medical Care Survey (NAMCS) 2002 database.Participants: Of 28,738 physician visits in the 2002 NAMCS data set, there were 3,819 visits by adults aged 45 and older included in this study for analysis.Measurements: The primary endpoint was the time that a physician spent with a patient at each visit. Covariates included for analyses were patient characteristics, physician characteristics, visit characteristics, and source of payment. Visit characteristics, including the number of diagnoses and the number of prescribed medications, the major diagnoses, and the therapeutic class of prescribed medications, were compared for different age groups (45–64, 65–74, and ≥75) to determine the complexity of the patient's medical conditions. Endpoint estimates were computed by age group and were also estimated based on study covariates using univariate and multivariate linear regression.Results: The mean time±standard deviation spent with a physician was 17.9±8.5 minutes. There were no differences in the duration of visits between the age groups before or after adjustment for patient covariates. Patients aged 75 and older had more comorbid illness and were prescribed more medications than patients aged 45 to 64 and 65 to 74 (P<.001). Patients aged 75 and older were also prescribed more medications that require specific monitoring and counseling (warfarin, digoxin, angiotensin‐converting enzyme inhibitors, diuretics, and levothyroxine) than were patients in other age groups (P<.001). Hypertension, coronary artery disease, atrial fibrillation, congestive heart failure, cerebrovascular disease, and transient ischemic attack were more common in patients aged 75 and older than in other age groups (P<.001). Despite these differences, there were no differences in unadjusted or adjusted duration of physician visit between the age groups.Conclusion: Although patients aged 75 and older had more medical conditions and were at higher risk for drug‐related problems than younger patients, the duration of physician visits was similar across the age groups. These findings suggest that elderly patients may require a multidisciplinary approach to optimize patient care in the ambulatory setting.
Mobility Limitations in the Medicare Population: Prevalence and Sociodemographic and Clinical Correlates
Authors: Shumway‐Cook Anne , Ciol Marcia A. , Yorkston Kathryn M. , Hoffman Jeanne M. , Chan Leighton 
Published: August 2005

Objectives: To examine the prevalence of and clinical markers associated with mobility limitations in Medicare Current Beneficiary Community Survey (MCBS) respondents.Design: Cross‐sectional analysis of a community survey.Setting: Community.Participants: Twelve thousand seven hundred sixty‐nine respondents from the 2001 MCBS, aged 65 and older.Measurements: Four questions from the MCBS were used to create four levels of mobility limitation: none, mild, moderate, and severe. Sampling weights were used to calculate estimates of means and proportions of the entire Medicare population for each mobility limitation category. A polytomous logistic regression analysis was used to model the association between four levels of mobility limitation and sociodemographic and clinical variables.Results: Prevalence of mobility limitations ranged from 9.5 million (mild) to 1.2 million (severe). Increasing severity of mobility limitation was associated with older age, being female, reporting fair or poor health, being overweight, smoking, having a greater number of comorbidities, having an annual income below $25,000, having less than a high school education, being unmarried, and living with others.Conclusion: National prevalence estimates suggest that functional mobility limitation is a significant problem for many older adults and is associated with some potentially modifiable characteristics.
Bachmann's Bundle: Does It Play a Role in Atrial Fibrillation?
Authors: KHAJA AZAMUDDIN , FLAKER GREG 
Published: August 2005

Background: Cardiac anatomists have known the presence of a group of specialized fibers connecting the right and left atrium for years. However, only recently have clinical cardiologists come to recognize the potential importance of this specialized conduction system. Anatomical and microscopic studies have shown that the Bachmann's bundle (BB) represents a distinct structure similar to the atrio‐ventricular node and the His‐Purkinje conduction system but without any insulating tissue.
Results: BB cells have specialized electrophysiological properties like supernormal excitability and faster longitudinal conduction that can facilitate more rapid impulse transmission compared to the normal atrial tissue. Experimental blockage of this pathway causes prolongation and widening of the P wave, which is associated with an increased incidence of atrial fibrillation. Atrial pacing is effective in reducing the incidence of atrial fibrillation by preventing bradycardia, synchronizing the atria, limiting anisotropy and reducing the dispersion of refractoriness. Various animal and human studies have shown pacing near the right atrial insertion of BB to have a beneficial effect in patients with interatrial conduction delay and atrial tachyarrhythmias. This mode of atrial septal pacing is convenient, safe, reliable, and clinically as effective as multisite pacing.
Conclusion: This article is an effort to define the special properties of BB and its possible role in prevention of atrial fibrillation by permanent pacemakers.
Impact of Duration of Cryothermal Application on Clinical Efficacy of Pulmonary Vein Isolation Using Transvenous Cryoablation
Authors: TSE HUNG‐FAT , LAU CHU‐PAK 
Published: August 2005

Background: Recent studies have demonstrated that transvenous cryoablation is a safe and feasible method for pulmonary vein (PV) isolation for treatment of atrial fibrillation (AF). However, this technique is limited by a much longer ablation time than conventional radiofrequency ablation. The aim of this study was to determine the effect of duration of cryoablation application with double freeze‐thaw cycles on clinical efficacy for PV isolation for treatment of AF.
Materials and Results: We compared the clinical efficacy and procedural time of cryoablation (CryoCorTM, San Diego, CA, USA) for segmental PV isolation in 30 patients (mean age 51 ± 13, 20 men) with paroxysmal AF using either double 5‐minute (n = 15) or double 2.5‐minute (n = 15) freeze‐thaw cycle delivered with a 10 F deflectable transvenous catheter. Clinical recurrence of AF and the occurrence of PV stenosis as determined by computer tomography of the thorax were performed at 3‐ and 12‐month follow‐up. Acute successful electrical isolation of PV was achieved with cryoablation in 96 of 98 (98%) targeted PVs in 30 patients (mean: 3.2 ± 0.8 PVs per patient). There were no significant differences between the baseline characteristics, the number of PV isolated per patient, the total number and percentage of effective cryoablation and the acute clinical efficacy between using double 5‐minute and double 2.5‐minute freezes (P > 0.05). However, the fluoroscopy time (107 ± 43 vs 138 ± 113 minutes, P = 0.06) and the procedural time (360 ± 113 vs 510 ± 115 minutes, P = 0.01) of using double 2.5‐minute freezes was reduced by ∼30% compared with double 5‐minute freezes. At a mean of 20 ± 8 month follow‐up, there was no significant difference in the chronic clinical efficacy of cryoablation in terms of freedom from AF in the absence of antiarrhythmic drug therapy between using double 5‐minute (6/15, 40%) and double 2.5‐minute freezes (7/15, 46%, P = 0.98).
Conclusion: As compared with double 5‐minute freeze, the use of a shorter double 2.5‐minute freeze protocol significantly reduces the procedural time without affecting the acute and long‐term clinical efficacy of cryoablation to isolate PV for treatment of AF.