bluuebunny/crossref_metadata_2025_split huggingface dataset:
The indications, efficacy and adverse events of rituximab in a large cohort of patients with juvenile-onset SLE
Authors: Watson L , Beresford M W , Maynes C , Pilkington C , Marks S D , Glackin Y , Tullus K 
Published: August 2014

Background B cells drive antibody formation and T cell activation. This study aimed to describe the clinical indications, efficacy and adverse events (AEs) for the B-cell depleting agent, rituximab, in a large cohort of children with lupus. Methods Prescribing records and the UK JSLE Cohort Study database identified rituximab use. Results Sixty-three patients received 104 courses of intravenous rituximab over a 10-year period. Patients were aged 12.2 (IQR 9.0–13.9) years at diagnosis and 50 (79%) were female. They had disease for 1.4 (0.2–3.0) years at the time of rituximab. Lupus nephritis was the most common indication (36% of first courses). Clinical biomarkers, 2.5 (1.6–4.3) months after treatment, demonstrated a statistically significant improvement in ESR, C3, C4, creatinine, albumin, haemoglobin, anti-dsDNA titres and urine albumin:creatinine ratio. IgG, IgA and IgM levels decreased ( p < 0.01). Oral corticosteroid dose significantly reduced after rituximab (dose before 0.26 (0.09–0.44) mg/kg, after 0.17 (0.09–0.30) mg/kg; p = 0.01)). AEs occurred in 19 (18%) of all courses including; delayed second dose (8%), Ig replacement (2%) and infusion reactions (6%; anaphylaxis 2%). The global BILAG score showed a trend toward improvement (before 4.5 (2.0–9.0), after 3.0 (2.0–5.0); p = 0.16). Conclusion Rituximab improves disease activity in children with lupus and serious AEs are infrequent. Controlled studies are required.
Systemic lupus erythematosus-associated acute transverse myelitis: manifestations, treatments, outcomes, and prognostic factors in 20 patients
Authors: Saison J , Costedoat-Chalumeau N , Maucort-Boulch D , Iwaz J , Marignier R , Cacoub P , Vital-Durand D , Hot A , Tebib J , Aumaitre O , Schleinitz N , Sarrot-Reynauld F , Broussolle C , Sève P 
Published: August 2014

Background Transverse myelitis is a rare complication of systemic lupus erythematosus (SLE). This retrospective multicentre study identifies the prognostic factors in a relatively large patient series. Patients and methods Twenty patients fulfilled the SLE criteria of the ACR classification and the Transverse Myelitis Consortium Working Group. A severe neurological flare was defined as muscle strength grade <3/5 in more than half the muscle groups at the motor neurological level. Inability to run or another significant ambulation-unrelated disability was considered as ‘unfavourable neurological outcome’. Results Myelitis was the first SLE symptom in 12 patients; in the eight others, it occurred 8.6 years (median delay) after SLE onset. Eleven patients presented severe neurological impairments. The treatment included corticosteroids in all patients associated with intravenous cyclophosphamide in 11 and/or hydroxychloroquine in 14. Unfavourable outcomes were observed in 53% of the patients at six months and in 28% at end of follow-up (median: 5.9 years). An initial severe neurological impairment and no cyclophosphamide use were associated with unfavourable neurological outcomes at six months and at end of follow-up, respectively. Conclusion Transverse myelitis may reveal SLE or occur more than 10 years after SLE diagnosis. The initial severity of the neurological flare (with paraplegia) is the main prognostic marker. The study provides arguments for cyclophosphamide use.
Thrombopoietin levels in systemic lupus erythematosus are linked to inflammatory cytokines, but unrelated to thrombocytopenia or thrombosis
Authors: Lu C , Nossent J 
Published: August 2014

Background Thrombopoietin (TPO) is a liver-produced protein that drives megakaryocyte maturation. TPO regulates platelet production and can increase platelet and endothelial reactivity. We investigated the relationship between TPO and the occurrence of thrombocytopenia and thrombosis in patients with systemic lupus erythematosus (SLE). Methods We undertook a cohort study of SLE patients ( n = 98) with clinical data collected simultaneously with sampling for TPO, inflammatory cytokines and autoantibody detection. TPO levels were measured by sandwich ELISA with patients with rheumatoid arthritis (RA) ( n = 100) and controls ( n = 79) as comparators. Disease associations were evaluated using non-parametric methods. Results TPO levels in SLE (median 8 pg/ml, mean 326, range 8992) were moderately increased compared with RA (median 8 pg/ml, mean 100, range 1659, p = 0.07) and controls (median 8, mean 94, range 2088, p = 0.1). Among SLE patients, TPO levels did not correlate with platelet count or levels of antiphospholipid antibodies. The prevalence of thrombocytopenic episodes, thrombotic events or active disease was not increased in patients with high TPO levels. TPO levels correlated with MIP-1α ( Rs 0.56, p < 0.001), IL6 ( Rs 0.26, p = 0.02) and IL4 ( Rs 0.29, p = 0.01), and inversely correlated to C4 ( Rs −0.23, p = 0.04). MIP-1α was the strongest independent predictor of increased TPO levels. Conclusion TPO levels are elevated in 20% of patients, but are not closely related to the occurrence of thrombocytopenia or thrombosis in SLE. MIP1-alpha is the main factor driving higher TPO levels among patients with SLE, likely through its inhibitory effect on megakaryocyte function.
Geographic Variation in Radiologist Capacity and Widespread Implementation of Lung Cancer CT Screening
Authors: Smieliauskas Fabrice , MacMahon Heber , Salgia Ravi , Shih Ya-Chen Tina 
Published: August 2014

Background Newly released United States Preventive Services Task Force (USPSTF) recommendations for lung cancer screening are expected to increase demand for low-dose computed tomography scanning, but health system capacity constraints might threaten the scale-up of screening. Objectives To estimate the prevalence of capacity constraints in the radiologist workforce and resulting potential disparities in access to lung cancer screening. Methods We combined information from health interview surveys to estimate the numbers of smokers who meet the USPSTF eligibility criteria, and information from administrative datasets to estimate the numbers of radiologists and the numbers of scans they currently interpret in Health Service Areas (HSAs) nationwide. We estimated and mapped the prevalence of capacity constrained HSAs – those having a greater than 5% or greater than 25% projected increase in scans over current levels from scaling up screening – and used descriptive statistics and logistic regressions to identify HSA characteristics associated with capacity constraints. Results Scaling up lung cancer screening would increase imaging procedures by an average of 4% across HSAs. Of the 9.6 million eligible smokers, 1,023,943 lived in HSAs with increases of at least 5%. HSAs that were rural, with many eligible smokers, and disproportionately Hispanic or low-income smokers had significantly higher odds of facing capacity constraints. Conclusions Disparities in access to lung cancer screening appear likely unless policy makers target HSAs with few radiologists for additional resources. Radiologists should be able to absorb the workload imposed by lung cancer screening in most areas of the country.
Co-inheritance of α-thalassaemia and β-thalassaemia in a prenatal screening population in mainland China
Authors: Li Jian , Xie Xing-Mei , Liao Can , Li Dong-Zhi 
Published: August 2014

Objective To determine the prevalence of α-thalassaemia in β-thalassaemia individuals in a Chinese population. Methods The standard diagnostic marker for β-thalassaemia was elevation of the Hb A2 level (>3.5%) with low mean corpuscular volume. The common α-thalassaemia mutations were studied by molecular analysis in all identified β-thalassaemia carriers. Results A prevalence rate of 3.3% for β-thalassaemia was found in our population; α- and β-thalassaemia interactions were found to co-exist in 17.8% of the β-thalassaemia carriers. The -SEA deletion was the most common α-thalassaemia mutation co-inherited with β-thalassaemia, followed by the -α3.7 deletion, the -α4.2 deletion, Hb Quong Sze, and Hb Constant Spring. Conclusion Our results suggest that it could be valuable to study co-existing α-globin mutations in subjects with β-thalassaemia trait in a prenatal screening programme, especially in populations with a high prevalence of haemoglobinopathies.
Outcome Results From Yo Veo
Authors: Chapman Mimi V. , Hall William J. 
Published: August 2014

Objective: This study reports results from the outcome evaluation of Yo Veo, a visual intervention with schoolteachers, which structures conversations about challenges that teachers face teaching Latino/Latina immigrant students. Method: The intervention was delivered to teachers at two middle schools in the southeastern United States, one with a large and another with a growing proportion of Latino/Latina students. Questionnaire data were collected from 46 teachers at baseline, posttest, and 9-month follow-up. Measures were adapted at the second school as part of the pilot process. Results: Results show improvements in teachers’ scores on cultural competency, multicultural teaching practices, positive classroom management strategies, beliefs about parental involvement, mental health competency, knowledge of barriers to mental health service access, and attitudes toward undocumented immigrants. Measures on which there was no change or changes in the negative direction are also discussed. Conclusions: Yo Veo is a promising approach for promoting awareness, attitudes, and understanding among teachers working with Latino/Latina immigrant students and families. Further research is required to prepare the intervention for wider testing and dissemination.
Addressing Parental Mental Health Within Interventions for Children
Authors: Acri Mary C. , Hoagwood Kimberly Eaton 
Published: August 2014

Purpose: Untreated parent mental health problems have deleterious effects upon the family, yet caregivers are unlikely to receive services for their emotional health. We conducted a review of treatments and services for children and adolescents that also offered services to parents. Methods: Child treatment and service studies were included in the present study if they analyzed parent symptoms or diagnoses over time, and the intervention contained a parent component. Results: Of 200 studies reviewed, 20 contained a component for the parent and assessed the parent’s emotional health at multiple time points. Depression and anxiety were the most commonly studied parental mental health problem; most parent components consisted of behavioral strategies in service of the child’s psychological health. Conclusion: Major shifts in health care policy affecting mental health services provide an opportunity to create integrated and coordinated health and behavioral health systems. Attention must be given to ensure that the workforce of providers, the administrative structures, and the reimbursement strategies are strengthened and connected to serve the needs of parents/caregivers and children in order to enhance family outcomes.
Evaluation of a Pet-Assisted Living Intervention for Improving Functional Status in Assisted Living Residents With Mild to Moderate Cognitive Impairment
Authors: Friedmann Erika , Galik Elizabeth , Thomas Sue A. , Hall P. Sue , Chung Seon Yoon , McCune Sandra 
Published: August 2014

Background: In older adults with cognitive impairment (CI), decreased functional status and increased behavioral symptoms require relocation from assisted living (AL) to nursing homes. Studies support positive effects of pets on health/function. Purpose: Evaluate the effectiveness of the Pet AL (PAL) intervention to support physical, behavioral, and emotional function in AL residents with CI. Methods: Cognitively impaired AL residents randomized to 60-90 minute sessions [PAL (n = 22) or reminiscing (n = 18)] twice/week for 12 weeks. PAL interventionist encourages residents to perform skills with the visiting dog; reminiscing interventionist encourages residents to reminisce. Monthly assessment of physical (energy expenditure, activities of daily living), emotional (depression, apathy), and behavioral (agitation) function. Results: In linear mixed models, physical activity depressive symptoms improved more with PAL. Conclusion: Evidence supports that the PAL program helps preserve/enhance function of AL residents with CI. Additional study is required to evaluate the duration and predictors of effectiveness of the PAL intervention.
Results of intravesical botulinum toxin A in men with idiopathic overactive bladder symptoms
Authors: Hobbs Catherine P , Henderson John M , Foley Steve J 
Published: August 2014

Objective: The objective of this article is to determine treatment outcomes and risk factors for urinary retention in men with idiopathic overactive bladder (OAB) symptoms treated with intravesical botulinum toxin A (BTXA). Patients and methods: All men undergoing intravesical BTXA treatment from 2009 to 2013 at the Royal Berkshire Hospital were identified. Pre-treatment urodynamics and outcomes of treatment were determined. Results: A total of 35/43 men were deemed to have idiopathic OAB. Symptomatic improvement was seen in six of 13 (46%) dry OAB and 12/22 (55%) wet OAB irrespective of proven detrusor overactivity. Catheterisation rates were dose dependent with an overall rate of 16/35 (46%). Four of nine (44%) with bladder outflow obstruction required catheterisation, as did eight of 17 (47%) without. Twelve of 25 (48%) men with a Bladder Contractility Index (BCI) ⩽120 required catheterisation, as did four of 10 (40%) with a BCI >120. Conclusion: BTXA is a successful treatment in males with idiopathic wet and dry OAB, irrespective of detrusor overactivity. One hundred units is an appropriate dose at which to begin treatment. Surprisingly, presence of bladder outflow obstruction and weak bladder contractility did not demonstrate an increased risk for catheterisation although further study should be conducted with larger numbers of patients.
Genetic studies reveal an unexpected negative regulatory role for Jak2 in thrombopoiesis
Authors: Meyer Sara C. , Keller Matthew D. , Woods Brittany A. , LaFave Lindsay M. , Bastian Lennart , Kleppe Maria , Bhagwat Neha , Marubayashi Sachie , Levine Ross L. 
Published: August 2014

Key Points
Jak2 deletion in PLTs and MKs leads to thrombocytosis due to dysregulated TPO turnover. Jak2 loss in PLTs/MKs induces non-autonomous expansion of stem/progenitors, and specifically of MK-primed hematopoietic stem cells (HSCs).
KIR B haplotype donors confer a reduced risk for relapse after haploidentical transplantation in children with ALL
Authors: Oevermann Lena , Michaelis Sebastian U. , Mezger Markus , Lang Peter , Toporski Jacek , Bertaina Alice , Zecca Marco , Moretta Lorenzo , Locatelli Franco , Handgretinger Rupert 
Published: August 2014

Key Points
KIR haplotype B donors and high KIR B content score confer better protection against relapse after HLA-haploidentical transplantation in pediatric acute lymphoblastic leukemia. Haploidentical donor selection criteria for childhood acute lymphoblastic leukemia should include KIR haplotype and KIR B-content score.
A staging system for renal outcome and early markers of renal response to chemotherapy in AL amyloidosis
Authors: Palladini Giovanni , Hegenbart Ute , Milani Paolo , Kimmich Christoph , Foli Andrea , Ho Anthony D. , Rosin Marta Vidus , Albertini Riccardo , Moratti Remigio , Merlini Giampaolo , Schönland Stefan 
Published: August 2014

Key Points
A staging system based on proteinuria and glomerular filtration rate discriminates patients at different risk of progression to dialysis. Changes in proteinuria and glomerular filtration rate allow early assessment of renal response to therapy.
The exosome complex establishes a barricade to erythroid maturation
Authors: McIver Skye C. , Kang Yoon-A , DeVilbiss Andrew W. , O’Driscoll Chelsea A. , Ouellette Jonathan N. , Pope Nathaniel J. , Camprecios Genis , Chang Chan-Jung , Yang David , Bouhassira Eric E. , Ghaffari Saghi , Bresnick Emery H. 
Published: August 2014

Key Points
Exosome complex components are endogenous suppressors of erythroid cell maturation. GATA-1 and Foxo3 transcriptionally repress exosome complex components, thus abrogating the erythroid maturation blockade.
Advanced biliary tract carcinomas: a retrospective multicenter analysis of first and second-line chemotherapy
Authors: Fiteni Frédéric , Jary Marine , Monnien Franck , Nguyen Thierry , Beohou Eric , Demarchi Martin , Dobi Erion , Fein Francine , Cleau Denis , Fratté Serge , Nerich Virginie , Bonnetain Franck , Pivot Xavier , Borg Christophe , Kim Stefano 
Published: August 2014

Abstract

Background
Gemcitabine/Cisplatin (Gem/CDDP) combination has demonstrated a clear survival advantage over gemcitabine alone and has become a new standard in advanced Biliary Tract Carcinoma (aBTC). However, Gemcitabine/Oxaliplatin (GEMOX) combination and Gemcitabine/Carboplatin (Gem/Carb) combination regimens have shown efficacy in phase II trials and there is no comparative study between different platinum salts.
We assessed the efficacy and safety of different platinum-based chemotherapies at first line in aBTC patients. We also analysed the second-line chemotherapy.

Methods
Sixty-four consecutive patients with aBTC diagnosed between 1998 and 2010 were included for analysis. At first line chemotherapy, 44 patients received one day GEMOX regimen (gemcitabine 1000 mg/m2 and oxaliplatin 100 mg/m2 Day 1, every 2 weeks), and 20 patients received Gem/Carb regimen (gemcitabine at 1000 mg/m2 Days 1 and 8 with carboplatin delivered according to an area-under-the-curve (AUC) 5 at day 1, every 3 weeks). At second line, a total of 16 patients received a fluoropyrimidine-based chemotherapy.

Results
With GEMOX regimen, median progression-free survival (PFS) was 3.7 months (95%CI, 2.4 to 5) and median overall survival (OS) was 10.5 months (95%CI, 6.4 to14.7). The main toxicity was peripheral neuropathy (20% grade 2 and 7% grade 3). Grade 3/4 haematological toxicities were rare.
With Gem/Carb regimen, PFS was 2.5 months (95%CI, 2.1 to 3.7) and OS was 4.8 months (95%CI, 3.7 to 5.8). The main grade 3/4 toxicities were haematological: anaemia (45%), thrombocytopenia (45%), and neutropenia (40%).
At second-line, fluoropyrimidine-based chemotherapy was feasible in only a fourth of the patients. The median OS was 5.3 months (95%CI, 4.1 to 6.6), and median PFS was 4.0 months (95%CI, 2.6 to 5.5).

Conclusions
One day GEMOX regimen has a favourable toxicity profile and could be an alternative to standard Gem/CDDP regimen, in particular in unfit patients for CDDP.
At second-line, selective patients may benefit from fluoropyrimidine-based chemotherapy.
The prevalence of general and abdominal obesity according to sasang constitution in Korea
Authors: Baek Younghwa , Park Kihyun , Lee Siwoo , Jang Eunsu 
Published: August 2014

Abstract

Background
Obesity is an important risk factor for cardiovascular and metabolic diseases and could affect mortality rates. Body mass index (BMI) and waist circumference (WC) have been used to classify obesity, and waist-to-hip ratio (WHR) has recently emerged as a discriminator of cardiovascular disease. Sasang constitution (SC) is a kind of well-known traditional Korean medicine: Tae-eumin (TE), Soeumin (SE), Taeyangin (TY) and Soyangin (SY) carrying a different level of susceptibility to chronic diseases. We aimed to examine the prevalence in general and abdominal obesity (AO) using BMI, WC and WHR according to SC in the Korean population.

Methods
A total of 3,348 subjects were recruited from 24 Korean medicine clinics. Obesity was divided into three categories: general obesity by BMI, abdominal obesity by waist circumference (WC AO) and abdominal obesity by waist-to-hip ratio (WHR AO). A Chi-square test was performed to compare prevalence, and logistic regression was conducted to generate odds ratios (ORs) according to SC (p < .05).

Results
The prevalence of general obesity was significantly higher in males than in females. The highest prevalence of general obesity, WC AO and WHR AO were all observed in the TE type, and the SY and SE types were followed in order, for both males and females respectively.
The TE type was highly associated with increased risk of general obesity (OR = 20.2, 95% CI: 12.4-32.9 in males and OR = 14.3, 95% CI: 10.1-20.2 in females), of WC AO (OR = 10.7, 95% CI: 7.2-15.9 in males and OR = 7.5, 95% CI: 5.8-9.6 in females), and of WHR AO (OR = 4.6, 95% CI: 3.3-6.4 in males and OR = 3.8, 95% CI: 2.9-4.9 in females) compared with the SE type. In addition, after controlling for age, social status and eating habits, the ORs were similar to the crude model according to gender and SC.

Conclusions
This study shows that the prevalence of obesity varies according to SC in the Korean population. In particular, the TE type was highly associated with increased ORs for general obesity, WC AO and WHR AO in both genders.
Temperature dependence of electronic behaviors in quantum dimension junctionless thin-film transistor
Authors: Cheng Ya-Chi , Chen Hung-Bin , Han Ming-Hung , Lu Nan-Heng , Su Jun-Ji , Shao Chi-Shen , Wu Yung-Chun 
Published: August 2014

Abstract
The high temperature dependence of junctionless (JL) gate-all-around (GAA) poly-Si thin-film transistors (TFTs) with 2-nm-thick nanosheet channel is compared with that of JL planar TFTs. The variation of SS with temperature for JL GAA TFTs is close to the theoretical value (0.2 mV/dec/K), owing to the oxidation process to form a 2-nm-thick channel. The bandgap of 1.35 eV in JL GAA TFTs by fitting experimental data exhibits the quantum confinement effect, indicating greater suppression of Ioff than that in JL planar TFTs. The measured

∂

V
th

∂
T

of −1.34 mV/°C in JL GAA nanosheet TFTs has smaller temperature dependence than that of −5.01 mV/°C in JL planar TFTs.
Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case–control study
Authors: Eliason Sebastian , Awoonor-Williams John K , Eliason Cecilia , Novignon Jacob , Nonvignon Justice , Aikins Moses 
Published: August 2014

Abstract

Background
Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district.

Methods
A case–control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15–49 years were interviewed using structured questionnaires. A logistic regression was fitted.

Results
Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives.

Conclusion
While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.