bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening for autoantibodies in chronic hepatitis C patients has no effect on treatment initiation or outcome
Authors: Mauss S. , Berger F. , Schober A. , Moog G. , Heyne R. , John C. , Pape S. , Hueppe D. , Pfeiffer‐Vornkahl H. , Alshuth U. 
Published: October 2012

SummaryAutoantibodies in hepatitis C virus–infected patients may indicate autoimmune hepatitis or other immune‐mediated diseases. This may impact safety and efficacy of interferon‐based therapy of chronic hepatitis C. We investigated the association between a positive test result for a variety of autoantibodies and the initiation and efficacy of therapy for chronic hepatitis C. We analysed an observational cohort of 24 306 patients for an association between autoantibodies and treatment outcome. 8241 patients were tested simultaneously for antinuclear antibodies (ANA), liver kidney microsomal antibodies (LKM), smooth muscle antibodies (SMA) and antimitochondrial antibodies (AMA). Matched‐pair analysis was performed matching one autoantibody‐positive patient to three controls. Control patients had negative tests for all four antibodies. Analyses were performed for patients with a single positive autoantibody test and for patients with multiple positive autoantibody tests. A positive test result for ANA, LKM, SMA or AMA did not affect the physician's decision to initiate therapy with pegylated interferon and ribavirin. In addition, a positive test for one or multiple autoantibodies did not adversely affect sustained virologic response. There was no difference in fibrosis stage or alanine transaminase at baseline or during therapy irrespective of antibody status. Thyroid dysfunction was more frequent in patients with positive LKM antibodies (P = 0.004). Initiation of therapy for chronic hepatitis C and outcome were not affected by the presence of ANA, LKM, SMA or AMA. Routine testing of these autoantibodies seems not warranted. Determination of autoantibodies should be guided by individualized clinical decisions.
Factors associated with successful decrease and discontinuation of antegrade continence enemas (ACE) in children with defecation disorders: a study evaluating the effect of ACE on colon motility
Authors: Rodriguez L. , Nurko S. , Flores A. 
Published: October 2012

AbstractBackground  Antegrade continence enemas (ACE) have been used in the treatment of defecation disorders in children; little is known on their effect on colon motility and the utility of the colon manometry (CM) predicting long‐term ACE outcomes.Methods  Retrospective review of children with constipation undergoing CM before and after ACE to evaluate CM changes and their utility on predicting ACE outcome.Key Results  A total of 40 patients (mean age 8.8 SD 3 years and 53% female patients) were included; 39 of 40 responded to the ACE. Of these 39, 14 (36%) were dependent and 25 (64%) had decreased it (11 of those or 28% discontinued it). On repeat CM we found a significant increase in the fasting (P < 0.01) and postprandial (P = 0.03) motility index, number of bisacodyl‐induced high amplitude propagating contractions (HAPCs) (P = 0.03), and total HAPCs (P = 0.02). Gastrocolonic response to a meal, propagation and normalization of HAPCs improved in 28%, 58%, and 33%, respectively, with CM normalizing in 33% of patients. The baseline CM did not predict ACE outcome. The presence of normal HAPCs on the repeat CM was associated with ACE decrease. Progression and normalization of HAPCs (P = 0.01 and 0.02, respectively) and CM normalization (P = 0.01) on repeat CM were individually associated with ACE decrease. No CM change was associated with ACE discontinuation. Multivariate analysis showed that older age and HAPC normalization on CM predict ACE decrease and older age is the only predictor for ACE discontinuation.Conclusions & Inferences  Colon motility improves after ACE and the changes on the repeat CM may assist in predicting ACE outcome.
Recognition of the Different Structural Forms of the Capsid Protein Determines the Outcome following Infection with Porcine Circovirus Type 2
Authors: Trible Benjamin R. , Suddith Andrew W. , Kerrigan Maureen A. , Cino-Ozuna Ada G. , Hesse Richard A. , Rowland Raymond R. R. 
Published: October 2012

ABSTRACT
Porcine circovirus type 2 (PCV2) capsid protein (CP) is the only protein necessary for the formation of the virion capsid, and recombinant CP spontaneously forms virus-like particles (VLPs). Located within a single CP subunit is an immunodominant epitope consisting of residues 169 to 180 [CP(169–180)], which is exposed on the surface of the subunit, but, in the structural context of the VLP, the epitope is buried and inaccessible to antibody. High levels of anti-CP(169–180) activity are associated with porcine circovirus-associated disease (PCVAD). The purpose of this study was to investigate the role of the immune response to monomer CP in the development of PCVAD. The approach was to immunize pigs with CP monomer, followed by challenge with PCV2 and porcine reproductive and respiratory syndrome virus (PRRSV). To maintain the CP immunogen as a stable monomer, CP(43–233) was fused to ubiquitin (Ub-CP). Size exclusion chromatography showed that Ub-CP was present as a single 33-kDa protein. Pigs immunized with Ub-CP developed a strong antibody response to PCV2, including antibodies against CP(169–180). However, only low levels of virus neutralizing activity were detected, and viremia levels were similar to those of nonimmunized pigs. As a positive control, immunization with baculovirus-expressed CP (Bac-CP) resulted in high levels of virus neutralizing activity, small amounts of anti-CP(169–180) activity, and the absence of viremia in pigs following virus challenge. The data support the role of CP(169–180) as an immunological decoy and illustrate the importance of the structural form of the CP immunogen in determining the outcome following infection.
Narrative synthesis of health service accreditation literature
Authors: Hinchcliff Reece , Greenfield David , Moldovan Max , Westbrook Johanna Irene , Pawsey Marjorie , Mumford Virginia , Braithwaite Jeffrey 
Published: October 2012

AimsTo systematically identify and synthesise health service accreditation literature.MethodsA systematic identification and narrative synthesis of health service accreditation literature published prior to 2012 were conducted. The search identified 122 empirical studies that examined either the processes or impacts of accreditation programmes. Study components were recorded, including: dates of publication; research settings; levels of study evidence and quality using established rating frameworks; and key results. A content analysis was conducted to determine the frequency of key themes and subthemes examined in the literature and identify knowledge-gaps requiring research attention.ResultsThe majority of studies (n=67) were published since 2006, occurred in the USA (n=60) and focused on acute care (n=79). Two thematic categories, that is, ‘organisational impacts’ and ‘relationship to quality measures’, were addressed 60 or more times in the literature. ‘Financial impacts’, ‘consumer or patient satisfaction’ and ‘survey and surveyor issues’ were each examined fewer than 15 times. The literature is limited in terms of the level of evidence and quality of studies, but highlights potential relationships among accreditation programmes, high quality organisational processes and safe clinical care.ConclusionsDue to the limitations of the literature, it is not prudent to make strong claims about the effectiveness of health service accreditation. Nonetheless, several critical issues and knowledge-gaps were identified that may help stimulate and inform discussion among healthcare stakeholders. Ongoing effort is required to build upon the accreditation evidence-base by using high quality experimental study designs to examine the processes, effectiveness and financial value of accreditation programmes and their critical components in different healthcare domains.
Personalised performance feedback reduces narcotic prescription errors in a NICU
Authors: Sullivan Kevin M , Suh Sanghee , Monk Heather , Chuo John 
Published: October 2012

ObjectiveNeonates are at high risk for significant morbidity and mortality from medication prescribing errors. Despite general awareness of these risks, mistakes continue to happen. Alerts in computerised physician order entry intended to help prescribers avoid errors have not been effective enough. This improvement project delivered feedback of prescribing errors to prescribers in the neonatal intensive care unit (NICU), and measured the impact on medication error frequency.MethodsA front-line multidisciplinary team doing multiple Plan Do Study Act cycles developed a system to communicate prescribing errors directly to providers every 2 weeks in the NICU. The primary outcome measure was number of days between medication prescribing errors with particular focus on antibiotic and narcotic errors.ResultsA T-control chart showed that the number of days between narcotic prescribing errors rose from 3.94 to 22.63 days after the intervention, an 83% improvement. No effect in the number of days between antibiotic prescribing errors during the same period was found.ConclusionsAn effective system to communicate mistakes can reduce some types of prescribing errors.
Characteristics of femur fractures in ambulatory young children
Authors: Capra Louise , Levin Alex V , Howard Andrew , Shouldice Michelle 
Published: October 2012

ObjectivesTo determine and identify the characteristics and circumstances of femur fractures in ambulatory young children.Design and settingRetrospective review of 203 ambulatory children, between 1 and 5 years old, presenting with femur fractures to an urban paediatric hospital over a 10-year period. χ2And Student's t test were employed for statistical analysis.ResultsThe mean age was 36.6 months, with 155 (76.2%) being male. The most frequent mechanism of injury was fall from a height (n=62, 30.5%). The highest number of injuries occurred in 2–3-year-olds. The most common history in 1–2-year-olds was stumbling on/over something causing a fall. For 4–5 year olds it was road traffic accidents. Other additional physical findings were infrequent (14.3%) and not suspicious of inflicted injury. Child protective services concluded three of the cases to be likely non-accidental, and four cases were inconclusive but requiring close follow-up. Of these seven children, six occurred in 1–2-year-olds. No distinguishing feature was noted in fracture type or location.ConclusionsFemur fractures can occur with low velocity injury whether from a short fall or twisting/stumbling injury in young healthy ambulatory children.
Pointers and pitfalls of mycophenolate-associated colitis
Authors: Lee Stephen , de Boer W Bastiaan , Subramaniam Kavitha , Kumarasinghe M Priyanthi 
Published: October 2012

AimsMycophenolate-associated colitis has been previously reported to show patterns of colonic mucosal injury mimicking a host of conditions, including graft-versus-host disease, ischaemia and inflammatory bowel disease (IBD). The aim of this study is to characterise, semiquantitatively, pathological changes of mycophenolate mofetil (MMF) mucosal injury.MethodsSeven transplant patients receiving MMF who underwent colonoscopic examination and biopsy were identified retrospectively over a 2-year period. Multiple histologic parameters, including architectural distortion, cryptitis, stromal active inflammation, individual damaged crypts (IDC) and crypt apoptotic figures were evaluated in the biopsies semiquantitatively. Where biopsy site was identified, the parameters were assessed separately in biopsies from right and left colon.ResultsAll cases showed mixed patterns of mucosal injury. All seven cases showed focal architectural distortion (in 58% of fragments per case), focal cryptitis (mean 3.0 foci per case), increased crypt apoptosis (mean 26.5/100 crypts) and IDC (mean 3.0 foci). Focal changes resembling acute self-limited colitis were noted in three cases. Possible proximal accentuation of some changes was noted with right side biopsies tending to show greater crypt apoptotic activity and more foci of architectural distortion. Three cases showed dual pathology (two with cytomegalovirus (CMV) infection and one with IBD).ConclusionsAlthough a wide spectrum of changes may be seen in MMF-associated colitis, important microscopic clues include a mixed pattern of injury (typically a combination of crypt apoptosis, isolated crypt damage and architectural distortion), and possible proximal accentuation of pathologic changes. The need for clinical correlation and follow-up is emphasised by the occurrence of dual pathology in patients treated with MMF.
Point of Care INR testing devices: performance of the Roche CoaguChek XS and XS Plus in the UK NEQAS BC external quality assessment programme for healthcare professionals: four years’ experience
Authors: Kitchen Dianne Patricia , Kitchen Steven , Jennings Ian , Woods Timothy AL , Fitzmaurice David A , Murray Ellen T , Walker Isobel D 
Published: October 2012

BackgroundVitamin K antagonists have been used for many decades and have been traditionally monitored by the measurement of the International Normalised Ratio (INR) in the laboratory. Introduction of Point of Care (POC) testing devices to measure INR has resulted in many tests being undertaken in primary care. External Quality Assessment (EQA) of these POC devices is recommended to ensure accuracy and reliability of INR results outside a laboratory setting.AimTo assess the quality of INR results for users of two POC devices (CoaguChek XS and CoaguChek XS Plus) over a four-year period.MethodsFour surveys (two samples) were sent in each 12-month period. The median INR value of each sample was calculated and the percentage deviation from this median determined. Any results greater than 15% from the median were considered to be outside consensus which indicated a possible problem within the testing system.ResultsVariability of INR results in this UK National External Quality Assessment Scheme (NEQAS) programme was comparable to that in the UK NEQAS EQA programme for laboratory INR testing. Occurrence of persistent problems was lower in the POC programme than the laboratory programme.ConclusionsUtilisation of an EQA programme for POC devices in primary care is feasible and necessary. Our data suggest for those health professionals using EQA, the reliability and accuracy of INR testing matches the quality of laboratory testing.
Reovirus: A Targeted Therapeutic—Progress And Potential
Authors: Maitra Radhashree , Ghalib Mohammad H. , Goel Sanjay 
Published: October 2012

Abstract
Medical therapy of patients with malignancy requires a paradigm shift through development of new drugs with a good safety record and novel mechanisms of activity. While there is no dearth of such molecules, one particular agent, “reovirus” is promising by its ability to target cancer cells with aberrant signaling pathways. This double-stranded RNA virus has been therapeutically formulated and has rapidly progressed from preclinical validation of anticancer activity to a phase III registration study in platinum refractory metastatic squamous cell carcinoma of the head and neck. During this process, reovirus has shown safety both as a single agent when administered intratumorally and intravenously, as well as in combination therapy, with multiple chemotherapeutics such as gemcitabine, carboplatin/paclitaxel, and docetaxel; and similarly with radiation. The scientific rationale for its development as an anticancer agent stems from the fact that it preferentially replicates in and induces lyses of cells with an activated Kras pathway. As documented in many previous studies, the initial observation of greater tropism in Kras-compromised situation might certainly not be the sole and possibly not even the predominant reason for enhanced virulence. All the same, scientists have emphasized on Kras optimistically due to its high prevalence in various types of cancers. Incidence of Kras mutation has been found to be highest in pancreatic cancer (85%–90%) followed by colorectal (35–45%) and lung (25–30%). Reovirus, in fact has the potential not only as a therapy but also as a tool to unravel the aberrant cellular pathway leading to carcinogenicity. Mol Cancer Res; 10(12); 1514–25. ©2012 AACR.
Association between Ambient Ultraviolet Radiation and Risk of Epithelial Ovarian Cancer
Authors: Tran Bich , Jordan Susan J. , Lucas Robyn , Webb Penelope M. , Neale Rachel 
Published: October 2012

Abstract
Evidence is accumulating to suggest that higher exposure to solar ultraviolet radiation (UVR) is associated with decreased risk of internal cancers, but data for ovarian cancer are unclear. We aimed to examine the association between lifetime ambient UVR and ovarian cancer in a population-based-case–control study. The study included women aged 18 to 79 years with a new diagnosis of invasive (n = 1,215) or borderline (n = 285) epithelial ovarian cancer identified through a network of clinics and state cancer registries throughout Australia. Controls (n = 1,459), frequency matched to cases by age (5-year groups) and state of residence, were randomly selected from the National Electoral Roll. We asked participants to report where they had lived at different periods of their life and assigned an estimate of UVR using data from NASA's Total Ozone Mapping Spectrometer database (1997–2003). We estimated the association between ambient UVR and risk of ovarian cancer using conditional logistic regression adjusted for potential confounders. Women in the highest third of average daily ambient UVR over their lifetime were at significantly lower risk of all epithelial ovarian cancers than those in the lowest third [OR, 0.70; 95% confidence interval (CI), 0.56–0.88]. The inverse association was stronger for borderline tumors (0.47, 0.31–0.71) than invasive tumors (0.78, 0.61–1.00). The effect sizes for overall and borderline tumors were unchanged after adjusting for confounders, whereas the inverse association for invasive tumors was attenuated. These data suggest that exposure to ambient UVR may reduce the risk of ovarian cancer. Cancer Prev Res; 5(11); 1330–6. ©2012 AACR.
Effects of Vertical Wind Shear on the Predictability of Tropical Cyclones
Authors: Zhang Fuqing , Tao Dandan 
Published: October 2012

Abstract
Through cloud-resolving simulations, this study examines the effect of vertical wind shear and system-scale flow asymmetry on the predictability of tropical cyclone (TC) intensity during different stages of the TC life cycle. A series of ensemble experiments is performed with varying magnitudes of vertical wind shear, each initialized with an idealized weak TC-like vortex, with small-scale, small-amplitude random perturbations added to the initial conditions. It is found that the environmental shear can significantly affect the intrinsic predictability of tropical cyclones, especially during the formation and rapid intensification stage. The larger the vertical wind shear, the larger the uncertainty in the intensity forecast, primarily owing to the difference in the timing of rapid intensification.
In the presence of environmental shear, initial random noise may result in changes in the timing of rapid intensification by as much as 1–2 days through the randomness (and chaotic nature) of moist convection. Upscale error growth from differences in moist convection first alters the tilt amplitude and angle of the incipient tropical storms, which leads to significant differences in the timing of precession and vortex alignment. During the precession process, both the vertical tilt of the storm and the effective (local) vertical wind shear are considerably decreased after the tilt angle reaches 90° to the left of the environmental shear. The tropical cyclone intensifies immediately after the tilt and the effective local shear reach their minima. In some instances, small-scale, small-amplitude random noise may also limit the intensity predictability through altering the timing and strength of the eyewall replacement cycle.
Tidal, Riverine, and Wind Influences on the Circulation of a Macrotidal Estuary
Authors: Bolaños Rodolfo , Brown Jennifer M. , Amoudry Laurent O. , Souza Alejandro J. 
Published: October 2012

Abstract
The effect of tides, river, wind and Earth’s rotation on the three-dimensional circulation in the Dee, a macrotidal estuary, are investigated using a fine-resolution model. The interactions of the large tidal amplitude, currents, river, and wind-generated circulation require baroclinic and unsteady studies to properly understand the estuarine dynamics. Assessment of the model skill has been carried out by model–observation comparisons for salinity, which is the main control for density, surface elevation, current, and turbulence. Stationary nondimensional numbers were only partially able to characterize the dynamics in this (real) complex macrotidal estuary. At low water, tidal straining and constrained river flow cause stratification. Large spatial variability occurs in the current and residual patterns, with flood-dominated maximum values occurring within the tidal channels. The tides control residual circulation by modulating stratification through tidal straining and bathymetric constraint on river flow. Tide–stratification–river interaction causes an unsteady pattern of residual circulation and tidal pulses. River-induced pulses are enhanced near low tide–inducing density-driven circulation. Wind effects are concentrated near the surface, mainly occurring at high tide because of increased fetch. Even though Coriolis has, overall, a small contribution it produces tidal pulses modifying the current and salinity distribution.
Acute psychiatric inpatient care: A cross-cultural comparison between two hospitals in Germany and Japan
Authors: Moriwaki Kumi , Neuner Tanja , Hübner-Liebermann Bettina , Hausner Helmut , Wittmann Markus , Horiuchi Toshihiro , Watanabe Hiromi , Kato Hideyuki , Hirakawa Junich , Iwai Kazumasa 
Published: October 2012

Background: Intercultural differences influence acute inpatient psychiatric care systems. Aims: To evaluate characteristics of acute inpatient care in a German and a Japanese hospital. Method: Based on a sample of 465 admissions to the Psychiatric State Hospital Regensburg (BKR) and 91 admissions to the Hirakawa Hospital (HH) over a six-month period in 2008, data from the psychiatric basic documentation system (BADO) were analysed with regard to socio-demographic characteristics, treatment processes and outcome indicators. Results: Schizophrenia and related psychosis was the most common diagnosis in both hospitals. Cases at the BKR were admitted more quickly after onset of the present episode. Global Assessment of Psychosocial Functioning (GAF) ratings at admission were lower at the HH. Most admissions to both hospitals received psychopharmacological treatment, but more at the HH received psychotherapy. Length of stay was significantly longer at the HH (75 days) than at the BKR (28 days). Admissions to the HH were more improved with regard to GAF and clinical global impression (CGI). Conclusions: Acute admissions in Germany provide intensive care with short hospitalization as crisis intervention. For acute admissions in Japan, comprehensive care for severe mental illness precedes emergency admissions and achieves greater improvement with longer hospitalization.