bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thiopurine Methyltransferase Enzyme Activity Determination before Treatment of Inflammatory Bowel Disease with Azathioprine: Effect on Cost and Adverse Events
Authors: Sayani Farzana A , Prosser Connie , Bailey Robert J , Jacobs Philip , Fedorak Richard N 
Published: March 2016

BACKGROUND: Azathioprine (AZA), used to treat inflammatory bowel disease (IBD), is metabolized by thiopurine methyltransferase (TPMT). The accumulation of individual metabolites varies because humans display genetic polymorphism for TPMT expression. Deficiencies in TPMT result in accumulation of toxic metabolites, followed by neutropenia and hepatic inflammation. Concern over acute toxicity frequently leads to under dosing and frequent monitoring tests and visits.OBJECTIVE: To determine whether assessment of TPMT activity before the administration of AZA would predict acute toxicity and, thus, allow for reductions in health care costs related to biochemical screening for, and management of, AZA-induced adverse events.METHODS: Before AZA treatment, 29 patients with IBD were prospectivelyrandomized to one of two groups: group 1, in which no TPMT assay was performed, was started on AZA at 1 mg/kg/day and then titrated every two weeks to a target dose of 2.5 mg/kg/day; and group 2, in which TPMT assays were performed, was started on AZA at the target dose of 2.5 mg/kg/day. For both groups, complete blood count and liver enzymes were monitored weekly for six weeks and at monthly intervals thereafter. Additional tests and health care interventions were undertaken at the discretion of the attending physicians.RESULTS: Of the 29 patients in the study, 15 were randomly assigned to group 1 and 14 to group 2. Demographics and disease activity were similar for both groups. Mean follow-up time was 7.1 months (range 3.5 to 10.7 months). Eight patients from group 1 and six patients from group 2 withdrew as a result of AZA-induced adverse events. There was no correlation between the TPMT activity and the development of AZA-induced adverse events. The direct health care costs for group 1 ($300.11 per patient) were lower than in group 2 ($348.87 per patient).CONCLUSION: The prospective assessment of TPMT enzyme activity before initiating AZA therapy in IBD patients incurred additional cost and did not predict AZA-induced toxicity.
The Role of Gemcitabine in the Treatment of Cholangiocarcinoma and Gallbladder Cancer: A Systematic Review
Authors: Dingle Brian H , Rumble R Bryan , Brouwers Melissa C 
Published: March 2016

BACKGROUND: Cholangiocarcinoma and gallbladder cancer are difficult to treat curatively. The treatment of choice is surgery, dependent on detection at a resectable stage. No chemotherapy or radiotherapy options have shown substantial activity. Gemcitabine has demonstrated response in similar cancers. Considering the lack of treatment options for cholangiocarcinoma and gallbladder cancer, a systematic review of the evidence on gemcitabine use for these indications was performed.OBJECTIVE: To perform a systematic review to evaluate the role of gemcitabine in the treatment of cholangiocarcinoma and gallbladder cancer.METHODS: The MEDLINE database was searched (1996 to March 2005) using the medical subject headings 'gemcitabine' and 'gallbladder neoplasms' with results limited to English only. Proceedings from the 1998 to 2004 meetings of the American Society of Clinical Oncology, including the 2004 Gastrointestinal Cancers Symposium, were searched for relevant abstracts. The Canadian Medical Association infobase and the National Guidelines Clearinghouse were also searched for practice guideline reports. Reports were selected and reviewed by two reviewers, and the reference lists from those were searched for additional trials.RESULTS: A total of 13 single-arm phase II trial reports were obtained.CONCLUSIONS: In appropriate patients with gallbladder cancer or cholangiocarcinoma, surgery offers the best chance for survival and should remain the first treatment of choice. For patients not considered candidates for surgery, but willing and able to tolerate chemotherapy alone or in combination with a fluoropyrimidine (such as 5-fluorouracil or capecitabine), gemcitabine appears to be a reasonable alternative to best supportive care, although this conclusion has not been confirmed with a randomized controlled trial.
Validation of a Short Questionnaire in English and French for Use in Patients with Persistent Upper Gastrointestinal Symptoms Despite Proton Pump Inhibitor Therapy: The Pass (Proton Pump Inhibitor Acid Suppression Symptom) Test
Authors: Armstrong David , van Zanten Sander JO Veldhuyzen , Chung Sharon A , Shapiro Colin M , Dhillon Sukhjeet , Escobedo Sergio , Chakraborty Bijan K , Mann Vijay , Tanser Lisa , Nevin Krista 
Published: March 2016

BACKGROUND: The management of persistent symptoms during acid suppression therapy in patients with gastroesophageal reflux disease or dyspepsia might be improved if patient-physician communication regarding the presence and character of these persistent symptoms were facilitated.AIM: To validate a short, simple questionnaire (the Proton pump inhibitor [PPI] Acid Suppression Symptom [PASS] test), in English and French, to identify patients with persistent acid-related symptoms during PPI therapy and document their response to a change in therapy.METHODS: Patients with persistent acid-related symptoms on PPI therapy were interviewed to produce a draft, five-item questionnaire; content validity was evaluated by focus groups comprising English- and French-speaking patients. Psychometric validity was subsequently evaluated in a multicentre, family practice-based study of English- and French-speaking patients with persistent acid-related upper gastrointestinal symptoms despite PPI therapy. The PASS test, Global Overall Symptom scale, Gastrointestinal Symptom Rating Scale (GSRS), Quality of Life in Reflux and Dyspepsia questionnaire and Reflux Disease Questionnaire were completed at baseline and repeated after one week while patients continued their original PPI therapy. All patients then received esomeprazole 40 mg once daily for four weeks, after which all questionnaires and an evaluation of overall treatment effect were completed.RESULTS: Content validity was established in 20 English- and 16 French-speaking patients. Psychometric validation in 158 English- and 113 French-speaking patients revealed good-to-excellent test-retest reliability coefficients: 0.76 for English; 0.68 for French. For construct validity, the PASS test showed moderate-to-high correlation with the GSRS scale (0.51 for English; 0.43 for French). After four weeks of therapy, the PASS test score fell to zero in 30% of English- and 33% of French-speaking patients, while the Global Overall Symptom score fell to one (no symptoms) in 32% of patients (English- and French-speaking); the PASS test demonstrated good responsiveness in comparison with the GSRS, Reflux Disease Questionnaire and Quality of Life in Reflux and Dyspepsia questionnaire.CONCLUSION: The five-item PASS test is a valid tool for the evaluation of persistent acid-related symptoms in patients receiving PPI therapy. It demonstrates good content validity, test-retest reliability, responsiveness and construct validity in both English and French forms. The PASS test is a simple, clinically applicable tool for the identification of patients with persistent acid-related symptoms during therapy and the assessment of their responses to a change in therapy.
Pegylated-Interferon Alpha 2b and Ribavirin for Recurrent Hepatitis C after Liver Transplantation: From a Canadian Experience to Recommendations for Therapy
Authors: Babatin Mohamed , Schindel Lynn , Burak Kelly W 
Published: March 2016

BACKGROUND: Recurrent hepatitis C (HCV) after liver transplantation (LT) is often more aggressive and treatments tend to be less successful. Pegylated-interferon and ribavirin are the standard of care for the treatment of HCV; however, there is limited published experience of its use after LT.OBJECTIVE: To report the results of pegylated-interferon alpha 2b (PEG-IFN) plus ribavirin for the treatment of recurrent HCV after LT and compare the results with published data.METHODS: Thirteen patients with recurrent HCV were treated with PEG-IFN plus ribavirin. Liver biopsies demonstrated early-stage disease in eight patients and advanced fibrosis in five patients. The average starting dose of PEG-IFN was 0.91 µg/kg (range 0.5 µg/kg to 1.1 µg/kg) per week and ribavirin was started at 662 mg (range 0 mg to 1200 mg) per day. PEG-IFN treatment began an average of 24 months after LT (range six to 73 months). The dose of PEG-IFN was increased in four patients but only two reached 1.5 µg/kg. The ribavirin dose was increased in four, reduced in six and only seven patients reached a ribavirin dose greater than 10.6 mg/kg.RESULTS: A sustained virological response was seen in four of 13 (30.7%) patients and in four of eight (50%) patients with early-stage disease compared with zero of five patients with advanced fibrosis (P=0.1). Cytopenias were common and therapy was poorly tolerated in four of five patients with advanced fibrosis, including acute cellular rejection in three, renal failure in two, liver decompensation in four and death in three.CONCLUSIONS: Although a reasonable sustained virological response can be achieved with the use of PEG-IFN and ribavirin, the treatment is very poorly tolerated by patients with advanced-stage recurrent HCV. Treatment should be instituted before the development of significant fibrosis after LT.
Antimicrobial Therapy in Patients with Acute Variceal Hemorrhage
Authors: Wilbur Kerry , Sidhu Kiran 
Published: March 2016

BACKGROUND: Acute variceal hemorrhage is a serious complication of liver disease and hospital outcome is closely related to infection. Patients with cirrhosis are at greater risk for developing bacterial infection, which is associated with failure to control bleeding and higher rates of hospital mortality. Many clinical practice guidelines endorse antimicrobial prophylaxis as standard of care for cirrhotic patients.OBJECTIVE: The present study was performed to characterize the use of antimicrobial therapy for patients hospitalized with acute variceal hemorrhage.METHODS: Medical records of 98 patients hospitalized with suspected variceal hemorrhage were retrospectively reviewed.RESULTS: One-half of the patients received antimicrobials at any time during their hospital admission, and in very few (24%) could prescribed therapy be considered prophylactic. Seventy-seven per cent of patients undergoing endoscopy did not receive an antimicrobial within 24 h of the procedure. Those who received antimicrobial therapy had more severe liver disease (model for end-stage liver disease scores of 19.5±10 versus 12.9±8, P<0.05; Child-Pugh class C 78% versus 65%, not significant) and worse in-hospital outcome (length of stay 17 versus 6.5 days, P<0.05; mortality 15 versus two, P<0.05). Cephalosporins were the most widely prescribed agents (45%), followed by fluoroquinolone (40%). Regimens ranged in length from single-dose administration to two weeks.CONCLUSIONS: Patients with liver disease admitted with variceal hemorrhage were often not prescribed antimicrobial therapy to reduce the risk of bacterial infection. These results imply that published practice guidelines are not being consistently observed. A large, well-designed study with mortality outcome may be required for clinical guidelines to be successfully implemented in practice.
Treatment of Chronic Hepatitis C in Canadian Prison Inmates
Authors: Farley John D , Wong Victor K , Chung Henry V , Lim Elizabeth , Walters Gavin , Farley Theresa A , Yoshida Eric M 
Published: March 2016

PURPOSE: To assess sustained viral response rate and adherence to standard interferon alpha-2b and ribavirin therapy in inmates with chronic hepatitis C (HCV) in Canadian penitentiaries in the Pacific region.OBJECTIVE: A retrospective chart review of all inmates with chronic HCV who were treated with standard interferon alpha-2b and ribavirin therapy between March 2001 and October 2002.RESULTS: A total of 90 male inmates were treated. The mean age at time of treatment was 40 years. There were 49 inmates with HCV genotype 1, 11 with HCV genotype 2 and 30 with HCV genotype 3. Eight inmates discontinued treatment because of intolerance to side effects. Nine inmates were stopped by the physician because of nonresponse at an average of 27 weeks. All inmates achieved at least 80% adherence of interferon and ribavirin therapy. The overall sustained virological response (SVR) was 55.9%. SVR was 31.6% for genotype 1, 100% for genotype 2 and 71.4% for genotype 3.CONCLUSION: There was excellent SVR and adherence to treatment with interferon and ribavirin. This experience highlights an important opportunity to treat a population with a high prevalence of HCV-positive persons who may otherwise not seek treatment.
Questões metodológicas em Guerra e paz: causação, agência e refiguração
Authors: Nunes Jordão Horta 
Published: March 2016

Guerra e Paz, obra magna de Tolstói, transcende o âmbito literário e suscita questões filosóficas e metodológicas. O objetivo aqui é tomá-la como ponto de partida para a discussão de questões como as da causalidade e da agência e de questões contemporâneas como as da linguagem e da escrita, na metodologia das ciências sociais. Numa primeira parte, procura-se mostrar como a discussão sobre as causas da invasão napoleônica elaborada por Tolstói em seu romance histórico traz elementos que prefiguram o debate sobre explicação e compreensão na filosofia analítica a partir de meados do sec. XX. A seguir discute-se, sob influência das práticas composicionais de Tolstói e da ideia de circularidade tempo-narrativa de Ricoeur, o potencial metodológico da refiguração narrativa para interpretar as relações entre arte, sociedade e história.
Supplementary Artistic Education Centers Development Drawing on the Example of «Sergei Andriaka’s Moscow Academy of Watercolour Painting and Fine Art»
Authors: Быкова  , Bykova Elena 
Published: March 2016

This article considers the development of one of the centers of continuous further education in the field of fine art, intended for primary
school children. Today supplementary education centers in Russian in legal and organizational conditions due to the relative freedom of the
implementation of educational programs can successfully coordinate the educational work, solve the problem of perfection of modern art
education in the framework of the territorial units.
ZONA PERI-URBAN SEMARANG METROPOLITAN: PERKEMBANGAN DAN TIPOLOGI SOSIAL EKONOMI
Authors: Rudiarto Iwan , Handayani Wiwandari , Pigawati Bitta , Pangi P 
Published: March 2016

<span style="font-size: 11.0pt; mso-bidi-font-size: 10.0pt; font-family: 'Amasis MT','serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-AU; mso-fareast-language: IN; mso-bidi-language: AR-SA;" lang="EN-AU">Peri-urban can be understood as an area mostly rural located in the surrounding urban center which also has obvious urban character. This paper aims to assess the socio-economic development of Peri-Urban Areas (PUA) of the Metropolitan Semarang in 1990-2011. Study area covers 295 villages that are included in the delineation of the Metropolitan area of Semarang. They are distributed in four cities/districts, i.e.: Semarang city, Semarang regency, Kendal regency, and Demak regency. Satellite imaginary analysis and Geographic Information System (GIS) analysis including overlay analysis, buffer and distance analysis, and descriptive spatial analysis were applied for the analysis. The analysis results show that the PUA of metropolitan Semarang has undergone changes and shifts in socio-economic conditions of rural significant to urban areas. In conclusion, the existence of PUA has led to the blurring of the distinction between rural and urban areas which are not simply dichotomized. Integrated development policies are very essential for more balanced urban development in Semarang Metropolitan region. </span>
MODEL KONSEPTUAL ADAPTASI RUANG KAMPUNG KOTA SEBAGAI AKIBAT KEBERADAAN SEKTOR PERDAGANGAN FORMAL (KAMPUNG SEKAYU KOTA SEMARANG)
Authors: Purnamasari Wulan Dwi 
Published: March 2016

<span style="font-size: 11.0pt; mso-bidi-font-size: 10.0pt; font-family: 'Amasis MT','serif'; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-AU; mso-fareast-language: IN; mso-bidi-language: AR-SA;" lang="EN-AU">The Growing up of Informal Sector is slowly affected space use and the morphological forms Kampung Sekayu, views of the circulation or movement changes and changes in space for. The model changes of Kampung Sekayu shown in matrix form, diagrams, and mapping by using symbols was adapted from Zahnd theory (2008) which were previously done uantitative analysis to know the category changes.Based on the theory of Lazarus (1984) about the adjustment, the results of this study shows that the activities of people in Kampung Sekayu is an adaptation because people trying to be part of the formal trade sector that grows rapidly. Each activity requires space as a container. In this case, the changes is happening in Kampung Sekayu is a form of adjustment due to some space available (such as public space) is intended to support the work done by street vendors and parking attendants.</span>
The Journey Metaphor in Mediatized Political Discourse
Authors: Dávid Gyula , Furkó Bálint Péter 
Published: March 2016

Abstract
The present paper will analyse manifestations of the journey metaphor from a critical discourse analytical perspective in order to observe how the journey metaphor is used as a discourse strategy in mediatized political speeches and interviews whereby political actors manipulate the second-frame interactional participants (the audience) into sharing a (spurious) sense of solidarity with them. There are three hypotheses that will be tested in the course of the analysis: the first is that a wide-variety of realjourney elements are exploited for the political metaphor of journey, and there is a concrete correspondence between journey vehicles and political scenarios. The second hypothesis is that journey metaphors that are used in political speeches, celebrity interviews and confrontational political interviews are of different types and complexity. The third hypothesis is that the manipulative intent behind the use of metaphors is exposed in the latter types of mediatized political discourse to varying degrees as a result of the different degrees of pragmatic accountability adhered to in the two subgenres. We argue that the first two hypotheses are confirmed on the basis of the qualitative analysis presented in the paper, whereas the third hypothesis is not borne out by the data.
Dilemmas of Cultural Mediation: A Case Study of Tourism
Authors: Ajtony Zsuzsanna 
Published: March 2016

Abstract
Travelling implies the encounter and, in certain cases, the clash of cultures. By interpreting translation as a means of transfer between languages and cultures, the present study looks into the different views on translating culture-specific realia. Through a close analysis of texts with the purpose of informing foreign tourists it offers ways of how to carry out this mediation. The study calls for further research into closely related issues, such as the translator’s cultural awareness of and sensitivity to similarity and difference, identity and alterity in culture.
Unpacking the geography of tourism innovation in Western Cape Province, South Africa
Authors: Booyens Irma , Rogerson Christian M. 
Published: March 2016

Abstract
This paper interrogates the geography of tourism innovation in the Western Cape, South Africa. In particular, innovations by tourism firms are mapped and local tourism innovation networks are analysed. Networking behaviour is examined since it is regarded as indispensable for accessing knowledge and learning for innovation purposes. The analysis draws on a broader investigation of tourism innovation and networking within the Western Cape province. It is revealed that the main tourist regions in the Western Cape are also the most innovative. Whilst external networking relations are observed to be highly significant for tourism innovation, local embeddedness remains critical for stimulating path creation and exploiting local core competencies for the competitiveness and survival of tourism firms and destinations.
Differentiation of reproductive behaviour of the population of the Kraków Metropolitan Area in the light of survey research
Authors: Gałka Jadwiga , Kurek Sławomir , Wójtowicz Mirosław 
Published: March 2016

Abstract
Metropolitan areas are the poles of economic growth of regions and countries. These areas are characterized by specific development cycles, which are related to the direction of population migrations. Accordingly, there is a phase of urbanisation, suburbanisation, disurbanisation and re-urbanisation. Studies show that most Polish metropolitan areas are undergoing the process of suburbanisation, which means the movement of population from the central city to its suburban area. This process entails a number of demographic, social and economic consequences. One of the main demographic consequences of suburbanisation is the change in the structure of the central city and its suburban area. The reason for this is the fact that migrations from the centre are usually undertaken by young people. Thus, the number of inhabitants of the central city declines and the population is ageing. Migrants from the city bring new patterns of social and demographic behaviour, which may be shown in, among others, the tendencies of indigenous people to change the traditional family model.
This paper attempts to determine the reproductive behaviour patterns of the population of the Krakow Metropolitan Area (KMA) in the light of the survey. The surveys were conducted in selected KMA municipalities in 2013. The analysis of qualitative data, divided into two categories of respondents: immigrant and indigenous inhabitants, will give an answer to the question, what are the reproductive attitudes of the population and how they may affect the further development of these areas?