bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum 25‐hydroxyvitamin D deficiency predicts poor outcome amongst acute ischaemic stroke patients with low high density lipoprotein cholesterol
Authors: Xu T. , Zhong C. , Peng Y. , Chen C.‐S. , Wang J. , Ju Z. , Li Q. , Geng D. , Sun Y. , Zhang D. , Zhang Y. , Chen J. , Xu T. , Zhang Y. , He J. 
Published: September 2016

Background and purposeCurrent observational studies indicate that a lower vitamin D level is associated with a higher risk of poor ischaemic stroke prognosis. Whether this association is affected by lipid levels is unclear. Our aim was to examine the effect of serum vitamin D especially its deficiency on the global outcome of ischaemic stroke stratified by individual lipid component level.MethodsA total of 3181 ischaemic patients from China Antihypertensive Trial in Acute Ischaemic Stroke were included in this study and their baseline serum 25‐hydroxyvitamin D levels were tested. They were prospectively followed up for death, major disability and vascular events for 3 months after acute ischaemic stroke. A multivariable logistic model was used to evaluate the association between serum 25‐hydroxyvitamin D levels and clinical outcomes of ischaemic stroke in the 3‐month period of follow‐up in all patients and in different lipid‐level subgroups.ResultsVitamin D deficiency was associated with poor clinical outcomes only in ischaemic stroke patients with high density lipoprotein cholesterol (HDLC) <1.04 mmol/l rather than all patients. The multivariable adjusted odds ratios (95% confidence intervals) of major disability and composite adverse events were 1.98 (1.08–3.63) and 2.24 (1.22–4.12), respectively. There was a significant interaction effect between vitamin D andHDLClevels on major disability and the composite outcome (Pfor interaction < 0.05 for both). A significant linear trend existed between 25‐hydroxyvitamin D and risk of poor prognosis (P= 0.03).ConclusionsVitamin D deficiency may be merely an independent risk factor of poor prognosis in ischaemic stroke patients with lowHDLClevel.
Epidemiological, clinical and genetic aspects of adult onset isolated focal dystonia in Ireland
Authors: Williams L. , McGovern E. , Kimmich O. , Molloy A. , Beiser I. , Butler J. S. , Molloy F. , Logan P. , Healy D. G. , Lynch T. , Walsh R. , Cassidy L. , Moriarty P. , Moore H. , McSwiney T. , Walsh C. , O'Riordan S. , Hutchinson M. 
Published: September 2016

BackgroundAdult onset idiopathic isolated focal dystonia presents with a number of phenotypes. Reported prevalence rates vary considerably; well‐characterized cohorts are important to our understanding of this disorder.AimTo perform a nationwide epidemiological study of adult onset idiopathic isolated focal dystonia in the Republic of Ireland.MethodsPatients with adult onset idiopathic isolated focal dystonia were recruited from multiple sources. Diagnosis was based on assessment by a neurologist with an expertise in movement disorders. When consent was obtained, a number of clinical features including family history were assessed.ResultsOn the prevalence date there were 592 individuals in Ireland with adult onset idiopathic isolated focal dystonia, a point prevalence of 17.8 per 100 000 (95% confidence interval 16.4−19.2). Phenotype numbers were cervical dystonia 410 (69.2%), blepharospasm 102 (17.2%), focal hand dystonia 39 (6.6%), spasmodic dysphonia 18 (3.0%), musician's dystonia 17 (2.9%) and oromandibular dystonia six (1.0%). Sixty‐two (16.5%) of 375 consenting index cases had a relative with clinically confirmed adult onset idiopathic isolated focal dystonia (18 multiplex and 24 duplex families). Marked variations in the proportions of patients with tremor, segmental spread, sensory tricks, pain and psychiatric symptoms by phenotype were documented.ConclusionsThe prevalence of adult onset idiopathic isolated focal dystonia in Ireland is higher than that recorded in many similar service‐based epidemiological studies but is still likely to be an underestimate. The low proportion of individuals with blepharospasm may reflect reduced environmental exposure to sunlight in Ireland. This study will serve as a resource for international comparative studies of environmental and genetic factors in the pathogenesis of the disorder.
Human papillomavirus 16 (HPV16) and HPV52 E6‐specific immunity in HIV‐infected adults on combination antiretroviral therapy
Authors: Leng CY , Low HC , Chua LL , Chong ML , Sulaiman H , Azwa I , Roberts JM , Kamarulzaman A , Rajasuriar R , Woo YL 
Published: September 2016

ObjectivesHuman papillomavirus (HPV)‐associated cancers disproportionately affect those infected with HIV despite effective combination antiretroviral therapy (cART). The primary aim of this study was to quantify HPV16 and HPV52 E6‐specific interferon (IFN)‐γ enzyme‐linked immunospot (ELISPOT) T‐cell responses, a correlate of protective immunity, in the first year following cART initiation and subsequently in those patients with suboptimal (sIR) and optimal (oIR) immune reconstitution.MethodsNinety‐four HIV‐infected patients were recruited to the study; a longitudinal cohort of patients recruited just prior to commencing cART and followed up for 48 weeks (n = 27), and a cross‐sectional cohort (n = 67) consisting of patients with sIR (CD4 T‐cell count < 350 cells/μL) and oIR (CD4 T‐cell count > 500 cells/μL) after a minimum of 2 years on cART. Controls (n = 29) consisted of HIV‐negative individuals. IFN‐γ ELISPOT responses against HPV16 and HPV52 E6 were correlated to clinical characteristics, anal and oral HPV carriage, T‐cell maturational subsets, markers of activation, senescence and T‐regulatory cells.ResultsHPV16 and HPV52 E6‐specific T‐cell responses were detected in only one of 27 patients (3.7%) during the initial phase of immune recovery. After at least 2 years of cART, those who achieved oIR had significantly higher E6‐specific responses (9 of 34; 26.5%) compared with those with sIR (2 of 32; 6.3%) (P = 0.029). Apart from higher CD4 T‐cell counts and lower CD4 T‐cell activation, no other immunological correlates were associated with the detection of HPV16 and HPV52 E6‐specific responses.ConclusionsHPV16 and HPV52 E6‐specific IFN‐γ T‐cell responses, a correlate of protective immunity, were detected more frequently among HIV‐infected patients who achieved optimal immune recovery on cART (26.5%) compared with those with suboptimal recovery (6.3%).
Feasibility, appropriateness, meaningfulness and effectiveness of patient participation at bedside shift reporting: mixed‐method research protocol
Authors: Malfait Simon , Eeckloo Kristof , Lust Elisa , Van Biesen Wim , Van Hecke Ann 
Published: September 2016

AbstractAimTo evaluate the feasibility, appropriateness, meaningfulness and effectiveness of bedside shift reporting in a minimum of five interventions and five control wards.BackgroundHospitals continually improve their quality of care. Next to improvements in clinical performance, more patient participation is stimulated through different methods. Methods to enhance patient participation such as bedside shift reporting lack rigorously performed research to determine their feasibility, appropriateness, meaningfulness and effectiveness. Small‐scale research and a previous pilot study indicate that bedside shift reporting improves patient participation, nurse–nurse communication and nurse–patient communication.DesignThe development, implementation and evaluation of bedside shift report are based on the Medical Research Council framework for complex interventions in health care. A matched, controlled, mixed‐method, longitudinal study design will be used. The Feasibility‐Appropriateness‐Meaningfulness‐Effectiveness framework will be applied for the quantitative and qualitative evaluation of bedside shift report.MethodsA tailored intervention and implementation process for bedside shift report will be developed using diagnostic interviews, co‐design and acceptability testing. The intervention will be evaluated before implementation and three times after implementation. Individual and focus group interviews will be performed. Questionnaires, observations and analysis of the medical records and administrative databases will be completed. This study was funded in October 2015. Research Ethics Committee approval was granted in March 2016.DiscussionThere is a pressing need for rigorous research into the effects of interventions for improving patient participation. This study addresses the significance of bedside shift report as an intervention to improve quality of care, communication and patient participation within a large‐scale, matched, controlled research design.
Moderators of treatment response to trauma‐focused cognitive behavioral therapy among youth in Zambia
Authors: Kane Jeremy C. , Murray Laura K. , Cohen Judith , Dorsey Shannon , Skavenski van Wyk Stephanie , Galloway Henderson Jennica , Imasiku Mwiya , Mayeya John , Bolton Paul 
Published: September 2016

BackgroundThe effectiveness of mental health interventions such as trauma‐focused cognitive behavioral therapy (TF‐CBT) may vary by client, caregiver, and intervention‐level variables, but few randomized trials in low‐ and middle‐income countries (LMIC) have conducted moderation analyses to investigate these characteristics. This study explores moderating factors to TF‐CBT treatment response among a sample of orphans and vulnerable children (OVC) in Zambia.MethodsData were obtained from a completed randomized trial of TF‐CBT among 257 OVC in Zambia. Trauma symptoms and functioning were measured at baseline and following the end of treatment. Mixed effects regression models were estimated for each moderator of interest: gender, age, number of trauma types experienced, history of sexual abuse, orphan status, primary caretaker, school status, and parental involvement in treatment.ResultsTreatment effectiveness was moderated by history of sexual abuse with greater reductions in both outcomes (trauma, p < .05; functioning, p < .01) for those that experienced sexual abuse. Primary caretaker was also a moderator with greater trauma reductions in those who identified their mother as the primary caretaker (p < .01), and better functioning in those that identified their father as the primary caretaker (p < .05). Nonorphans and single orphans (mother alive) showed greater reduction in functional impairment (p < .01) compared with double orphans. There was no significant moderator effect found by gender, age, number of trauma types, school status, or caregiver participation in treatment.ConclusionsThis study suggests that TF‐CBT was effective in reducing trauma symptoms and functional impairment among trauma‐affected youth overall and that it may be particularly effective for survivors of child sexual abuse and children whose primary caretaker is a biological parent. Scale‐up of TF‐CBT is warranted given the wide range of effectiveness and prevalence of child sexual abuse. Future randomized trials of interventions in LMIC should power for moderation analyses in the study design phase when feasible.
Technological and Sensory Properties of Calcium‐Enriched Dry Fermented Sausages: A Study of the Calcium Bioavailability
Authors: Soto Ana Maria , Garcia Maria Luisa , Selgas Maria Dolores 
Published: September 2016

AbstractDry fermented sausages (DFS) were enriched with calcium (Ca) to determine its bioavailability. Three Ca salts (gluconate, lactate and citrate‐malate) were tested in sufficient amounts to assure that 100 g of DFS gave 20–40% of the Ca RDA. Technological and sensory properties of enriched DFS were similar to the control batch without Ca. The batches with Ca gluconate exhibited the lowest sensory quality and were, thus, discarded. Neither the type nor the amount of salt tested had an influence on the growth of the microbiota. Calcium bioavailability of the experimental sausages was determined by an in vitro assay. Both Ca lactate and citrate‐malate salts showed values of close to 10%, which lies within the average absorption limits established for other Ca‐enriched foods. In view of the results, either of the later mentioned Ca salts could be used for the enrichment of the type of meat product studied.Practical ApplicationsIn recent years, the dry fermented sausage industry has been focused on the development of newer and healthier products by improving their nutritional value. Calcium (Ca) is essential for the correct functioning of the human organism. It plays important roles within several physiological activities, among those which include the ossification process. The calcium daily allowance recommended by international health organizations is between 800 and 1000 mg. The fortification of dry fermented sausages offers a good alternative source for increasing Ca intake. The products showing good sensory quality and a good Ca bioavailability could be considered as a source of calcium. If the Ca bioavailability is similar to that described for other Ca‐enriched foods, these new meat products could help to expand the range of healthy products in the market. The investigation described in continuation has been carried out with this aim.
Kidney Function and Disability‐Free Survival in Older Women
Authors: Cavanaugh Alyson M. , LaCroix Andrea Z. , Kritz‐Silverstein Donna , Rillamas‐Sun Eileen , Rifkin Dena E. 
Published: September 2016

ObjectivesTo examine the prospective association between kidney function and three outcomes: survival to age 85 with functional independence, survival to age 85 with disability, and death before age 85.DesignProspective study.SettingWomen's Health Initiative, conducted at 40 U.S. clinical centers.ParticipantsPostmenopausal women enrolled between 1993 and 1998 with baseline biomarker assessments who had the potential to reach age 85 before September 2013 (N = 7,178).MeasurementsKidney function was measured according to estimated glomerular filtration rate (eGFR) calculated from serum creatinine collected at baseline. Outcomes were survival to age 85 with functional independence, survival with disability, or death before age 85. Disability was defined as mobility or activity of daily living limitations measured by questionnaire.ResultseGFR was greater than 90 mL/min per 1.73 m2 in 22.7% of women, 60 to 89 mL/min per 1.73 m2 in 66.5%, 45 to 59 mL/min per 1.73 m2 in 8.7%, and less than 45 mL/min per 1.73 m2 in 2.0%. Median follow‐up was 15 years. Of 4,953 survivors, 3,155 reported no physical disability at age 85. Two thousand two hundred twenty‐five participants died before age 85. Women with an eGFR of 90 mL/min per 1.73 m2 or greater had 2.71 times greater odds of survival to age 85 with functional independence than of dying before 85 (95% confidence interval (CI) = 1.62–4.51) than those with an eGFR less than 45 mL/min per 1.73 m2, women with an eGFR of 60 to 89 mL/min per 1.73 m2 had 3.04 times (95% CI = 1.85–5.00) greater odds, and women with an eGFR of 45 to 59 mL/min per 1.73 m2 had 2.22 times (95% CI = 1.31–3.76) greater odds. Similar, but slightly weaker odds were seen for survival to age 85 with disability. Better kidney function was not significantly associated with greater likelihood of survival to age 85 with independent function than of surviving with disability.ConclusionBetter kidney function was associated with greater likelihood of survival to age 85 with and without disability.
Development of real‐time PCR for quantitation of simian immunodeficiency virus 2‐LTR circles
Authors: Lee Michael , Kim Woong‐Ki , Kuroda Marcelo J. , Pal Ranajit , Chung Hye Kyung 
Published: September 2016

AbstractBackgroundNon‐human primates infected with simian immunodeficiency virus (SIV) represent a robust model to evaluate pre‐clinical efficacy of HIV‐1 preventive strategies and to determine the size of reservoir.MethodsWe developed a real‐time qPCR assay to specifically quantify episomal 2‐LTR circular DNA in peripheral blood mononuclear cells and brain tissues from SIV‐infected macaques.ResultsThis assay has sensitivity, accuracy and reproducibility over seven orders of magnitude. High copy numbers of SIV 2‐LTR circles were correlated to high proviral DNA levels in brains of two SIV encephalitic animals. In contrast, no 2‐LTR circles were detectable in two SIV‐infected animals with no sign of encephalitis or two animals that had mild encephalitis with low levels of proviral DNA.ConclusionsThese results suggest that simultaneous application of total proviral DNA and 2‐LTR circle assays provides quantitative evaluation of pathogenesis and outcome of SIV infection in macaques.
The comparison between intradermal injection of abobotulinumtoxinA and normal saline for face‐lifting: a split‐face randomized controlled trial
Authors: Wanitphakdeedecha Rungsima , Ungaksornpairote Chanida , Kaewkes Arisa , Rojanavanich Viboon , Phothong Weeranut , Manuskiatti Woraphong 
Published: September 2016

SummaryBackgroundBotulinum toxin type A (BTA) has been approved for the treatment of strabismus, blepharospasm, muscle spasm, cervical dystonia, pain syndrome, glabella wrinkles, and severe primary axillary hyperhidrosis. Intradermal injection of BTA has been used off‐label by many clinicians for the purpose of face‐lifting effect. Few studies on onabotulinumtoxinA (ONA) demonstrated no clinical efficacy on face‐lifting effect when comparing to normal saline solution (NSS). So far, there is no split‐face comparison study on face‐lifting effect of abobotulinumtoxinA (ABO).ObjectiveTo determine the face‐lifting effect of ABO intradermal injection and NSS.MethodsTwenty‐two subjects with symmetrical faces on both facial expression and expressionless were randomly injected with ABO at 1:7 cc dilution (500 unit or one vial in 7 cc of NSS) on one side and NSS on the other side using intradermal injection technique. Standardized photographic documentation was obtained at baseline, and at 2 weeks after treatment. The face‐lifting effect was graded by two blinded dermatologists using photographic comparison and rated by the patients. Side effects were also recorded at the end of the study.ResultsFace‐lifting effect was demonstrated in 40.9% and 4.5% of patients with ABO and NSS, respectively. There was a statistically significant difference in face‐lifting effect when comparing between ABO and NSS (P = 0.021). The face‐lifting was reported in 50.0% of patients receiving ABO injection. The patients with oval‐face shape tended to respond better with ABO (P = 0.046). The odd of face‐lifting effect for patients aged younger than 32 was higher than patients aged older than 32 with the odds ratio of 7.9 and 95% confidence interval of 1.1–56.1. Facial asymmetry was found in 22.7% of subjects.ConclusionsThis study demonstrated the face‐lifting effect of ABO intradermal injection. Patients with oval‐face shape and aged younger than 32 tended to respond better. Therefore, patient selection should be emphasized to improve efficacy of this technique.
The patient–provider discordance in patients’ needs assessment: a qualitative study in breast cancer patients receiving oral chemotherapy
Authors: Wei Chunlan , Nengliang Yao , Yan Wang , Qiong Fang , Yuan Changrong 
Published: September 2016

Aims and objectivesTo explore the differing perspectives of patients and providers and their assessment of supportive care needs in breast cancer patients receiving oral chemotherapy.BackgroundThe patient–provider concordance in patients’ needs assessment is critical to the effective management of cancer. Self‐administered oral chemotherapy greatly shifts responsibilities for side‐effect monitoring, symptom management and dose adjustments from the provider to the patient. Home‐based care plans will be central to the effective management of these patients.DesignA descriptive qualitative design was used.MethodsA purposive sample of nine breast cancer patients, four oncologists and four oncology nurses were recruited in Shanghai, China. Semi‐structured and in‐depth interviews were conducted to collect data. A qualitative content analysis aimed at finding manifest and latent meanings of data was applied to analyse the information.ResultsFour themes of needs emerged from the interviews with patients and providers: information/knowledge, communication, social support and symptom management, but patients and providers only agreed on the assessment of symptom and side‐effects management needs. Patients want more positive encouraging information from providers, but providers think patients need more information of efficacy and safety. Patients appreciate support from other peer patients with similar experiences, but providers think the support from families and friends are readily available to them. Patients discussed their spiritual needs, while oncologists see the need to improve patient adherence to medication.ConclusionBreast cancer patients differed from their providers in assessment of healthcare needs. Further investigation of the relationships between patient–provider discordance and patient outcomes may guide interventions to improve care for cancer patients receiving oral chemotherapy.Relevance to clinical practiceOncology nurses should develop a holistic home‐based care plan by exploring and integrating the discordance of needs assessment of both patients and health providers.
Translating research findings to clinical nursing practice
Authors: Curtis Kate , Fry Margaret , Shaban Ramon Z , Considine Julie 
Published: September 2016

Aims and objectivesTo describe the importance of, and methods for, successfully conducting and translating research into clinical practice.BackgroundThere is universal acknowledgement that the clinical care provided to individuals should be informed on the best available evidence. Knowledge and evidence derived from robust scholarly methods should drive our clinical practice, decisions and change to improve the way we deliver care. Translating research evidence to clinical practice is essential to safe, transparent, effective and efficient healthcare provision and meeting the expectations of patients, families and society. Despite its importance, translating research into clinical practice is challenging. There are more nurses in the frontline of health care than any other healthcare profession. As such, nurse‐led research is increasingly recognised as a critical pathway to practical and effective ways of improving patient outcomes. However, there are well‐established barriers to the conduct and translation of research evidence into practice.DesignThis clinical practice discussion paper interprets the knowledge translation literature for clinicians interested in translating research into practice.MethodsThis paper is informed by the scientific literature around knowledge translation, implementation science and clinician behaviour change, and presented from the nurse clinician perspective. We provide practical, evidence‐informed suggestions to overcome the barriers and facilitate enablers of knowledge translation. Examples of nurse‐led research incorporating the principles of knowledge translation in their study design that have resulted in improvements in patient outcomes are presented in conjunction with supporting evidence.ConclusionsTranslation should be considered in research design, including the end users and an evaluation of the research implementation. The success of research implementation in health care is dependent on clinician/consumer behaviour change and it is critical that implementation strategy includes this.Relevance to practiceTranslating best research evidence can make for a more transparent and sustainable healthcare service, to which nurses are central.