bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Effective Is Melatonin as a Preventive Treatment for Hemicrania Continua? A Clinic‐Based Study
Authors: Rozen Todd D. 
Published: February 2015

ObjectiveTo assess the efficacy of melatonin as a preventive therapy for hemicrania continua in a larger population of patients than has previously been studied.BackgroundHemicrania continua is defined by its sensitivity to indomethacin. Rarely can patients be fully tapered off indomethacin without headache recurrence; thus, the risks associated with chronic indomethacin usage are substantial for these individuals. Melatonin, a pineal hormone with a similar chemical structure to indomethacin, has shown efficacy as a preventive agent for hemicrania continua in isolated case reports. Melatonin would be a preferential alternative prophylactic treatment to indomethacin because of its minimal side effect profile. How truly effective melatonin is as a preventive for hemicrania continua is unknown at present and needs further study.MethodsRetrospective analysis of all International Classification of Headache Disorders‐3 beta diagnosed hemicrania continua patients treated with both indomethacin and melatonin at the Geisinger Headache Center from July 2011 to January 2014.ResultsEleven patients were treated (9 women, 2 men). Two patients became pain free on melatonin, while partial relief was noted in 3 other patients; thus, they were able to lower their dose of indomethacin but could not achieve pain freedom with melatonin alone. Six patients had no response. Melatonin dosing needed for response ranged from 3 to 30 mg. In the partial relief responders, indomethacin dosing decreased by 50% to 75%.ConclusionFrom this single clinic investigation, only a small percent of subjects with hemicrania continua (less than 20%) will achieve pain freedom on melatonin, thus clearly not matching the effectiveness of indomethacin. However, the addition of melatonin to indomethacin may allow around 45% of patients to have complete or partial relief of their headache with the subsequent ability to reduce or eliminate their indomethacin dosage, which may lead to a decrease in medical morbidity over time secondary to less exposure to indomethacin.
Clinical and demographic factors associated with low viral load in early untreated HIV infection in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
Authors: Law MG , Achhra A , Deeks SG , Gazzard B , Migueles SA , Novak RM , Ristola M ,   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group
Published: February 2015

ObjectivesA small subset of HIV‐positive adults have low HIV RNA in the absence of therapy, sometimes for years. Clinical factors associated with low HIV RNA in early infection have not been well defined.MethodsWe assessed factors associated with low plasma HIV RNA level at study entry in the Strategic Timing of AntiRetroviral Treatment (START) trial. All START participants had a baseline HIV RNA assessment within 60 days prior to randomization. The key covariables considered for this analysis were race, and hepatitis B virus (HBV) and hepatitis C virus (HCV) status. We assessed factors associated with HIV RNA ≤ 50 and ≤ 400 HIV‐1 RNA copies/mL using logistic regression. Because of the strong association between region of randomization and baseline low HIV RNA, analyses were stratified by region.ResultsWe found that, of 4676 eligible participants randomized in START with a baseline HIV RNA assessment, 113 (2.4%) had HIV RNA ≤ 50 copies/mL at baseline, and a further 257 (5.5%) between 51 and 400 copies/mL. We found that HIV exposure routes other than male homosexual contact, higher high‐density lipoprotein (HDL) cholesterol levels, higher CD4 cell counts, and higher CD4:CD8 ratio were associated with increased odds of low HIV RNA. HCV antibody positivity was borderline statistically significantly associated with low HIV RNA. Race and HBV surface antigen positivity were not significantly associated with low HIV RNA.ConclusionsIn a modern cohort of individuals with early untreated HIV infection, we found that HIV exposure routes other than male homosexual contact and higher HDL cholesterol were associated with increased odds of low HIV RNA.
Transmission risk behaviour at enrolment in participants in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
Authors: Rodger AJ , Lampe FC , Grulich AE , Fisher M , Friedland G , Phanuphak N , Bogner JR , Pereira LC , Rietmeijer C , Burman W , Phillips AN ,   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group
Published: February 2015

ObjectivesA proportion of HIV‐positive people have condomless sex. Antiretroviral treatment (ART) reduces infectiousness, but a substantial proportion of HIV‐diagnosed people are not yet on ART. We describe baseline self‐reported risk behaviours in ART‐naïve Strategic Timing of AntiRetroviral Treatment (START) trial participants.MethodsAll START participants completed a risk behaviour questionnaire. Data were collected on sociodemographics, lifestyle factors, health and wellbeing status and clinical status. Recent sexual behaviour and HIV transmission beliefs in the context of ART were also assessed. The primary interest was in condomless sex with serodifferent partners (CLS‐D) in the past two months.ResultsA total of 4601 of 4685 HIV‐positive participants (98%) completed the questionnaire [2559 men who have sex with men (MSM), 803 heterosexual men and 1239 women]. Region of recruitment was Europe/Israel, 33%; South America/Mexico, 25%; Africa, 22%; other, 21%. Median age was 36 years [interquartile range (IQR) 29, 44 years]. Forty‐five per cent reported white ethnicity and 31% black ethnicity. Two per cent had HIV viral load < 50 HIV‐1 RNA copies/mL. Seventeen per cent (767 of 4601) reported CLS‐D; 20% of MSM compared with 10% of heterosexual men and 14% of women. MSM were also more likely to report multiple CLS‐D partners. Possible risk limitation measures (reported by more than half of those who had CLS‐D) were seropositioning (receptive anal CLS‐D only) or withdrawal (insertive anal CLS‐D always without ejaculation). CLS‐D was more commonly reported by participants from South America/Mexico and North America compared with Europe; among heterosexual men and women CLS‐D was also more commonly reported among participants from Africa compared with Europe. Knowledge of ART impact on transmission risk was low.ConclusionsA substantial minority recruited to the START study reported CLS‐D at baseline. CLS‐D reporting was higher in MSM than heterosexuals and varied significantly according to region of recruitment. A substantial proportion of MSM reporting CLS‐D appear to take transmission risk limitation measures.
Baseline prevalence and predictors of liver fibrosis among HIV‐positive individuals: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
Authors: Matthews GV , Neuhaus J , Bhagani S , Mehta SH , Vlahakis E , Doroana M , Naggie S , Arenas‐Pinto A , Peters L , Rockstroh JK ,   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group
Published: February 2015

ObjectivesLiver disease is increasingly recognized in HIV‐positive individuals, even among those without viral hepatitis, partly as a result of the recent availability of noninvasive methods of liver fibrosis assessment. The objective of this substudy is to compare the effects of early versus deferred antiretroviral therapy (ART) on liver fibrosis progression.MethodsSites in the Strategic Timing of AntiRetroviral Treatment (START) study with access to FibroScan® were invited to participate in the Liver Fibrosis Progression Substudy. All substudy participants underwent FibroScan® at baseline, and two noninvasive serum algorithms, APRI and FIB‐4, were calculated. Demographic and liver‐related information was collected for all START participants at baseline.ResultsA total of 230 participants were enrolled in the substudy (11.5% with hepatitis B or C virus coinfection), of whom 221 had a valid transient elastography (TE) result. The median TE score was 4.9 kPa [interquartile range (IQR) 4.3–6.0 kPa]. Seventeen patients (7.8%) [95% confidence interval (CI) 5.1–12.1%] had a TE score of > 7.2 kPa, indicating significant liver fibrosis. Baseline factors associated with higher TE scores in multivariate analysis were higher alanine aminotransferase (ALT) per 10 U/L (P = 0.045), higher log10 HIV RNA (P < 0.001) and Hispanic/Latino ethnicity (P = 0.01). TE correlated weakly with noninvasive markers.ConclusionsAt baseline, significant liver fibrosis was observed in approximately 8% of participants, with higher ALT and HIV RNA the only clinical factors associated with increasing TE score. TE will be used annually to monitor fibrosis and evaluate the role of ART in further fibrosis progression.
The carbon‐conscious‐consumer? A causal model for the product carbon footprint of asparagus at the consumer stage
Authors: Lampert Paul , Soode Eveli , Menrad Klaus 
Published: February 2015

AbstractTools to measure climate impacts, such as a product carbon footprinting (PCF), have gained increasing attention in recent years. Our study shows that it is possible to develop a valid structural equation model for a PCF for the example of the use phase of asparagus on the basis of empirical data generated by a panel survey. The parameters considered in the model are environmental and sustainability‐related attitudes, sociodemographics and a technical component. The results show that the age of the technical component has effect on the PCF, an older technical component having an increasing impact, while a high degree of environmental concern has a decreasing effect.
p21‐activated kinase 1 predicts recurrence and survival in patients with non‐metastatic clear cell renal cell carcinoma
Authors: Zhu Yu , Xu Le , An Huimin , Liu Weisi , Wang Zhong , Xu Jiejie 
Published: February 2015

ObjectivesTo estimate the impact of p21‐activated kinase 1 expression on recurrence and survival of patients with non‐metastatic clear cell renal cell carcinoma after surgical resection.MethodsWe retrospectively enrolled 254 patients (187 in the training cohort and 67 in the validation cohort) with non‐metastatic clear cell renal cell carcinoma undergoing nephrectomy at a single institution. Clinicopathological features, overall survival and recurrence‐free survival were recorded. p21‐activated kinase 1 intensities were assessed by immunohistochemistry of patients' specimens. The Kaplan–Meier method was applied to compare survival curves. Cox regression models were used to analyze the impact of prognostic factors on overall survival and recurrence‐free survival. The concordance index was calculated to assess predictive accuracy.ResultsIn both cohorts, elevated p21‐activated kinase 1 expression in tumor tissues positively correlated with advanced T stage and Fuhrman grade. High p21‐activated kinase 1 expression indicated poor survival and early recurrence of patients with non‐metastatic clear cell renal cell carcinoma, especially with early T1–2 stage disease. After backward elimination, p21‐activated kinase 1 expression was identified as an independent adverse prognostic factor for survival and recurrence. The predictive accuracy of the traditional University of California Integrated Staging System and Mayo Clinic stage, size, grade and necrosis prognostic models was improved when p21‐activated kinase 1 expression was added.ConclusionsElevated expression of p21‐activated kinase 1 seems to be an independent adverse prognostic biomarker for recurrence and survival in patients with non‐metastatic clear cell renal cell carcinoma after nephrectomy.
Nurse‐led educational interventions on cancer pain outcomes for oncology outpatients: a systematic review
Authors: Zhou L. , Liu X.‐L. , Tan J.‐Y. , Yu H.‐P. , Pratt J. , Peng Y.‐Q. 
Published: February 2015

BackgroundCancer pain management is still unsatisfactory, although some effective guidelines exist. Educational interventions are reported to be useful in pain relief for oncology outpatients.AimThe aims of this systematic review were to evaluate the effects of nurse‐led educational interventions on improving cancer pain outcomes for oncology patients, and to establish an effective cancer pain protocol for clinical nursing practice in China.MethodsA three‐step search strategy was utilized. Eight databases were searched using the standards provided by the Joanna Briggs Institute that guided article selection, critical appraisal, data collection and data synthesis.ResultsA total of 1093 studies were identified through a literature search. Only six studies complied with the inclusion criteria and were found to be methodologically sound. In general, the included studies indicated positive results pertaining to patient's knowledge and attitudes towards analgesics and cancer pain management and decreased pain intensity. Studies reported minimal effects of intervention on anxiety, depression, satisfaction regarding cancer pain management and patient's quality of life.ConclusionsEducational interventions were reported as effective methods to improve cancer pain outcomes. Analysis of the six included studies demonstrated the overall positive effects of nurse‐led educational interventions for improving cancer pain management.Implications for nursing and health policyThe results suggest that an effective cancer pain protocol for improving cancer pain management can be established in China.
Ongoing challenges responding to behavioural and psychological symptoms of dementia
Authors: Ostaszkiewicz J. , Lakhan P. , O'Connell B. , Hawkins M. 
Published: February 2015

BackgroundMid‐ to late‐stage dementia is often characterized by behavioural and psychological symptoms, including, but not limited to physical and verbal aggression.IntroductionAlthough there is a considerable research about the prevalence, aetiology, and management of behavioural and psychological symptoms of dementia, there is limited research about the experience of caring for people with such symptoms in long‐term aged care facilities.AimThe aims of the study were to describe: (i) nurses' experiences of caring for people with behavioural and psychological symptoms of dementia in long‐term aged care facilities, and (ii) strategies nurses used to deal with these symptoms.MethodsA qualitative exploratory and descriptive design, involving focus group interviews with 30 nurses from three long‐term aged care units in Australia. The transcripts were analysed using inductive content analysis.ResultsThe findings revealed five interrelated themes: (i) working under difficult conditions, (ii) behavioural and psychological symptoms of dementia: an everyday encounter, (iii) making sense of behavioural and psychological symptoms of dementia, (iv) attempting to manage behavioural and psychological symptoms of dementia, and (v) feeling undervalued.ConclusionThis study highlighted the difficult conditions under which nurses worked and the complexity of caring for individuals who have behavioural and psychological symptoms of dementia.Implications for nursing and health policyOrganizational efforts to enhance the quality of care for individuals with behavioural and psychological symptoms of dementia in long‐term aged care facilities should extend beyond staff education to heed nurses' concerns about organizational barriers to interpersonal care.
Characterization of Pleural Effusion After Left Atrial Appendage Exclusion Using the Lariat Procedure
Authors: GUNDA SAMPATH , KANMANTHAREDDY ARUN , VALLAKATI AJAY , JANGA PRAMOD , AFZAL MUHAMMAD RIZWAN , PILLARISETTI JAYASREE , BOMMANA SUDHARANI , ATKINS DONITA , EARNEST MATTHEW , NATH JAYANT , HOSAKOTE NAGARAJ , DI BIASE LUIGI , NATALE ANDREA , REDDY MADHU , LEE RANDALL , LAKKIREDDY DHANUNJAYA 
Published: February 2015

Pleural Effusions After the Lariat ProcedureBackgroundThe Lariat procedure is increasingly used for the exclusion of the left atrial appendage (LAA) in atrial fibrillation (AF) patients. There are anecdotal reports of pleural effusions after the Lariat procedure. However, the incidence, demographics, and pathophysiology of these effusions are largely unknown.ObjectiveCharacterization of pleural effusions in patients who underwent LAA exclusion using the Lariat procedure.MethodsWe report the incidence, demographics, and clinical and laboratory characteristics of patients from a multicenter prospective registry who underwent the Lariat procedure and subsequently developed pleural effusions.ResultsA total of 10 out of 310 (3.2%) patients developed significant pleural effusions after the Lariat procedure. The mean age of these patients was 67 ± 9, ranging from 52 to 78 years and included 5 (50%) males. Nine patients had persistent AF with median CHADS2 score of 2.7 ± 1.2. The LAA was successfully ligated in all these patients. Post‐Lariat procedure, 6 patients developed bilateral and 4 patients developed left‐sided pleural effusions. Pleural tap revealed transudative in 2 and exudative in 6 patients. The remaining 2 patients responded to active diuresis and behaved clinically like transudative effusions. There is a statistically significant difference between the onset of pleural effusion after the Lariat procedure between tPLE versus ePLE groups (14 ± 1.2 vs. 6 ± 6, P = 0.05).ConclusionIncidence of clinically significant pleural effusion is uncommon after the Lariat procedure and can be either exudative or transudative in nature depending on the underlying mechanisms. More prospective studies are needed to study the pathophysiologic basis of development of pleural effusions after the Lariat procedure.
Molecular Phylogeny of Mobilid and Sessilid Ciliates Symbiotic in Eastern Pacific Limpets (Mollusca: Patellogastropoda)
Authors: Irwin Nicholas A. T. , Lynn Denis H. 
Published: February 2015

ABSTRACTThe phylogenetic relationships of the ciliate subclass Peritrichia, composed of the orders Mobilida and Sessilida, have recently come under debate as morphological and molecular analyses have struck contrasting conclusions as to the monophyly of the group. We provide additional molecular data to assess the monophyly of the Peritrichia by sequencing the small subunit ribosomal RNA genes of two symbiotic peritrichs, Urceolaria korschelti and Scyphidia ubiquita, found inhabiting the mantle cavity of limpets. Although phylogenetic analyses indicated a nonmonophyletic Peritrichia, approximately unbiased tests revealed that the monophyletic hypothesis could not be rejected. With regard to the Mobilida, our analysis showed divergence within the family Trichodinidae related to host taxa—a molluscan clade and a fish clade. For the Sessilida, the family Scyphidiidae was sister to the Astylozoidae. In our sampling of U. korschelti and S. ubiquita, both species showed significant genetic divergence among geographically isolated, yet morphologically indistinguishable populations. We hypothesize that cryptic speciation has produced these morphologically identical species and argue that more extensive genomic analyses are required to fully assess the monophyly, biogeography, and ultimately biodiversity of the peritrichs.
Enterocytozoon bieneusi in Dairy Cattle in the Northeast of China: Genetic Diversity of ITS Gene and Evaluation of Zoonotic Transmission Potential
Authors: Zhao Wei , Zhang Weizhe , Yang Fengkun , Zhang Longxian , Wang Rongjun , Cao Jianping , Shen Yujuan , Liu Aiqin 
Published: February 2015

AbstractEnterocytozoon bieneusi is the most frequently diagnosed microsporidian species in humans. It has been found in a wide range of animals and is considered an important zoonotic pathogen. To date, little information is available on the role that cattle play in the epidemiology of human microsporidiosis caused by E. bieneusi in China. In this study, 133 fecal specimens from dairy cattle were collected in Heilongjiang Province, China. Enterocytozoon bieneusi was identified and genotyped by nested PCR analysis of the internal transcribed spacer (ITS) region of the rRNA gene, with 30.1% positive. Nine ITS genotypes were identified: six known genotypes—O (n = 26), EbpA (n = 2), I (n = 2), J (n = 2), D (n = 1) and BEB4 (n = 1)—and three novel genotypes named as CC‐I to CC‐III (two each). Genotype O was identified in cattle for the first time. The observation of all the six known genotypes here reported previously in humans, and also the fact of all the three novel genotypes (CHN‐DC1 to CHN‐DC3) falling into zoonotic group 1, indicate the possibility of cattle in the transmission of E. bieneusi to humans.
Molecular Phylogeny of the Family Ophryscolecidae (Ciliophora, Litostomatea) Inferred from 18S rDNA Sequences
Authors: Rossi Mariana F. , Dias Roberto Júnio. P. , Senra Marcus V. X. , Martinele Isabel , Soares Carlos A. G. , D'Agosto Marta 
Published: February 2015

AbstractThe 18S rDNA was used to infer oral ciliature patterns of evolution within the family Ophryoscolecidae, with the addition of five new sequences of ciliates from the genus Ostracodinium. Our data confirmed the monophyly of the subfamilies Entodiniinae and Ophryoscolecinae, but more analysis would be required for the definition of the status of the subfamily Diplodiniinae. The oral infraciliature patterns reflect evolutionary divergence in the family Ophryscolecidae, observing monophyly on Entodinium‐type, Diplodinium‐type, Ostracodinium‐type, Epidinium‐type, and Ophryoscolex‐type. The ancestral infraciliature of Entodinium‐type cannot be proven, however, the position of Entodinium‐type showed closer of Diplodinium‐type than Ophryoscolex‐type, corroborating previous studies using morphological characters. The observed inconsistencies reflect the need to increase the number of 18S rDNA sequences to family Ophryoscolecidae and investigate the evolution of this group using other molecular markers.
Trading Land: A Review of Approaches to Accounting for Upstream Land Requirements of Traded Products
Authors: Schaffartzik Anke , Haberl Helmut , Kastner Thomas , Wiedenhofer Dominik , Eisenmenger Nina , Erb Karl‐Heinz 
Published: February 2015

SummaryLand use is recognized as a pervasive driver of environmental impacts, including climate change and biodiversity loss. Global trade leads to “telecoupling” between the land use of production and the consumption of biomass‐based goods and services. Telecoupling is captured by accounts of the upstream land requirements associated with traded products, also commonly referred to as land footprints. These accounts face challenges in two main areas: (1) the allocation of land to products traded and consumed and (2) the metrics to account for differences in land quality and land‐use intensity. For two main families of accounting approaches (biophysical, factor‐based and environmentally extended input‐output analysis), this review discusses conceptual differences and compares results for land footprints. Biophysical approaches are able to capture a large number of products and different land uses, but suffer from a truncation problem. Economic approaches solve the truncation problem, but are hampered by the limited disaggregation of sectors and products. In light of the conceptual differences, the overall similarity of results generated by both types of approaches is remarkable. Diametrically opposed results for some of the world's largest producers and consumers of biomass‐based products, however, make interpretation difficult. This review aims to provide clarity on some of the underlying conceptual issues of accounting for land footprints.