bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chest computed tomography predicts microbiological burden and symptoms in pulmonary Mycobacterium xenopi
Authors: MARRAS THEODORE K. , WAGNETZ UTE , JAMIESON FRANCES B. , PATSIOS DEMETRIS A. 
Published: October 2012

ABSTRACTBackground and objective:  The development of computed tomography (CT) findings usually precedes the diagnosis of pulmonary nontuberculous mycobacterial infection. The utility of specific CT scan features, although often available long before respiratory sample cultures, is not fully understood. We sought to assess associations among CT features, symptoms and microbiological disease criteria in pulmonary Mycobacterium xenopi isolation.Methods:  We reviewed 70 consecutive immunocompetent patients with pulmonary M. xenopi isolation and classified them according to the American Thoracic Society (ATS) diagnostic criteria for disease. ‘Definite disease’ patients (n = 16) met modified ATS criteria. ‘Possible disease’ patients (n = 10) met microbiological criteria, had abnormal CT scans, but data regarding symptoms were unavailable. ‘No disease’ patients (n = 44) had only one positive sputum culture, or were asymptomatic or had no relevant CT findings. Two radiologists, without knowledge of the clinical or microbiological information, independently reviewed the scans.Results:  The mean (standard deviation) age of all patients was 63 (16) years, and 39% were women. Patients with ‘definite disease’ usually had nodules (88%) and cavities (63%), but less often bronchiectasis (50%) and tree‐in‐bud (50%). Patients with ‘possible’ or ‘no disease’, respectively, had nodules (100% or 80%), bronchiectasis (40% or 18%) or tree‐in‐bud (40% or 11%). Cavitation (P ≤ 0.0001) and nodules ≥5 mm (P = 0.0002) were associated with fulfilled microbiological criteria for disease. Bronchiectasis (P = 0.02) and nodules <5 mm (P = 0.002) were associated with symptoms of infection.Conclusions:  Among immunocompetent patients with pulmonary M. xenopi isolation, cavitation and large nodules predict fulfilling microbiological disease criteria, while bronchiectasis and small nodules predict symptoms.
Randomized and prospective trial comparing tract creation using plasma vaporization with balloon dilatation in percutaneous nephrolithotomy
Authors: Chiang Po Hui , Su Hsin Hao 
Published: October 2012

What's known on the subject? and What does the study add?
Use of balloon dilatation leads to less blood transfusion rates than metallic dilators. Plasma vaporization leads to less blood loss than balloon dilatation in this study.
The study evaluates a novel technique for the creation of a nephrostomy tract for PCNL. Compared with other techniques, plasma vaporization is a safer procedure that causes lesser blood loss, requires a shorter hospital stay, causes less radiation exposure, and enables easier nephrostomy tract creation for PCNL.
Objective
To evaluate the efficacy and safety of plasma vaporization for tract creation in percutaneous nephrolithotomy (PCNL).
Patients and Methods
In this randomized prospective trial we enrolled 65 patients and assigned each to one of two groups: 33 patients were randomly scheduled to undergo plasma vaporization and 32 were scheduled to undergo balloon dilatation for tract creation.
A bipolar resectoscope mounted with a plasma vaporization button electrode or a traditional balloon dilator were used to create the nephrostomy tract.
Results
The mean blood loss, mean length of hospital stay and mean operating time, stone‐free rates and postoperative complications in the two groups were compared using the t‐test or chi‐squared test (Fisher's exact test).
The plasma vaporization group had a significantly lower mean (SD) decrease in haematocrit level (3.5 [2.8]% vs 6.6 [3.3]%; P = 0.02) and a shorter mean (SD) hospital stay (2.6 [1.2] days vs 5.3 [3.4] days; P = 0.0).
There were no significant differences in the operating time, stone‐free rate or cases of postoperative fever between the two groups.
Conclusion
The plasma vaporization technique is safe, leads to less blood loss than the other techniques, and is a simple solution for creating the nephrostomy tract for PCNL.
The Party Politics of Englishness
Authors: Mycock Andrew , Hayton Richard 
Published: October 2012

Research Highlights and Abstract provides one of the first assessments of how British multi-national and English political parties have responded to existing and emergent identity tensions in England whilst continuing to defend the concept of the post-devolution British union-state. extends debates about multi-level party political systems in multi-national states which have typically focused on Scotland, Wales and, to a lesser extent, Northern Ireland. considers the potential that debates about English national identity could morph into a party politics of Englishness. assesses the potential for nascent English nationalism to encourage divergent party political responses to questions of English governance, citizenship and nation identity. This article assesses how the main British multi-national parties, whilst retaining an attachment of one form or another to the concept of the Union-state, have responded to existing and emergent identity tensions. Through examination of Labour, the Conservatives and the Liberal Democrats, with brief discussion of the BNP, UKIP and the English Democrats, it will consider the impact of devolution and the threat of separatist nationalism on party approaches and policy choices concerning English identity construction and governance. It will also explore the extent to which devolution has compromised the ability of UK politicians to ‘speak of Britain’ (they rarely use the term UK) and the four composite nations. By comparing and contrasting the narratives articulated by parties at different levels of governance it will ask whether a nascent ‘party politics of Englishness’ has emerged which can accommodate these challenges.
Action Imitation at 1½ Years Is Better Than Pointing Gesture in Predicting Late Development of Language Production at 3 Years of Age
Authors: Zambrana Imac M. , Ystrom Eivind , Schjølberg Synnve , Pons Francisco 
Published: October 2012

This study examined whether poor pointing gestures and imitative actions at 18 months of age uniquely predicted late language production at 36 months, beyond the role of poor language at 18 months of age. Data from the Norwegian Mother and Child Cohort Study were utilized. Maternal reports of the children's nonverbal skills and language were gathered for 42,517 children aged 18 months and for 28,107 of the same children at 36 months. Panel analysis of latent variables revealed that imitative actions, language comprehension, and language production uniquely contributed to predicting late development of language production, while pointing gestures did not. It is suggested that the results can be explained by underlying symbolic representational skills at 18 months.
Living with side effects from cancer treatment – a challenge to target information
Authors: Pedersen Birgith , Koktved Dorte P. , Nielsen Lene L. 
Published: October 2012

BackgroundPatients with cancer experience side effects related to their antineoplastic treatment. Demands for efficiency limit the time patients spend with health professionals. This requires that professionals are able to offer adequate support to patients in coping with side effects of treatment in everyday life. However, it appears that the level of information about and support in living with side effects may be insufficient.ObjectiveTo explore patients' experiences of how side effects from chemotherapy and radiotherapy impact everyday life as well as the information needs in coping with these side effects.MethodsNine patients' experiences were analysed and interpreted using a phenomenological‐hermeneutical approach. Data were collected through semi‐structured interviews.FindingsThe patients are deeply impacted by side effects in their everyday life. They struggle to take power but experience loss of control. They feel inexperienced without knowledge in an ‘ongoing system', and because of lack of continuity, they do not come up with their real needs. To avoid pitfalls in the information, the patients need individualized support from the professionals.ConclusionIf the patients have to be supported during everyday life with side effects from cancer treatment in an individualized way, the professional must be aware that the patients risk adapting to the busy healthcare system. To empower the patient, the professional must be able to sense the patients' appeal for help and enter into caring relationships.Implications for practiceTo ensure targeted information, the relationship between nurse and patient must build on nursing values including the patients' illness – perspective. However, the professionals must take a critical look at how they provide information and how they act to empower the patients.
Diversity of mucosal immune responses in upper respiratory airways and the suitability of mucosal vaccines
Authors: Kurono Y. , Nagano H. , Umakoshi M. , Makise T. 
Published: October 2012

SummaryMucosal vaccines are considered to be a promising strategy for preventing upper airway infections. As immunization routes to induce mucosal immune responses, oral, intranasal and sublingual immunizations have been proposed for clinical application. Recently, it was reported that transcutaneous immunization (TC) is also capable of inducing mucosal as well as systemic immune responses. However, it remains unclear which route is most effective for inducing mucosal immune responses in upper respiratory airways. In this study, the mucosal immune responses against phosphorylcholine (PC), a structural component of a wide variety of Gram‐positive and ‐negative bacteria, were investigated after intranasal, sublingual, or TC. Female BALB/c mice were immunized intranasally, sublingually, or transcutaneously with PC and cholera toxin. For the TC, the dorsal region was shaved and a cotton patch soaked with the antigen was attached. Nasal wash, saliva and serum samples were collected at 7 days after the final immunization, and examined for their PC‐specific antibody activities using ELISA. Phosphorylcholine‐specific antibodies in serum and PC‐specific IgA in nasal washes and saliva were detected in mice after intranasal and sublingual immunization with PC. Although salivary IgA was higher following intranasal immunization, nasal wash IgA was significantly higher after sublingual immunization. Furthermore, significantly increased IgA in vaginal washes and remarkably decreased serum IgE production were observed after sublingual immunization. TC increased PC‐specific IgA in faecal samples, but not in saliva. The PC antigen can induce mucosal as well as systemic immune responses when administered via intranasal, sublingual and transcutaneous routes. Sublingual immunization is superior to intranasal immunization in terms of safety for inducing mucosal immune responses. Although TC might be an alternative way to induce mucosal immune responses, further investigation is needed for its application as a vaccine route to prevent upper airway infection.
New approach for improving the safety of oral immunotherapy for food allergy
Authors: Urisu A. , Tanaka K. , Ogura K. , Naruse N. , Hirata N. , Nakajima Y. , Inuo C. , Suzuki S. , Ando H. , Kondo Y. , Tsuge I. , Yamada K. , Kimura M. 
Published: October 2012

SummaryAvoidance of causative foods is the mainstay of therapy for food allergy. This therapy places a burden, to a greater or lesser extent, on food‐allergic patients and their parents if they are children. They always face the probable risk of an unexpected accident resulting from intake of a causative food. Allergen‐specific immunotherapy for pollinosis and bee‐venom allergy has been proven efficient and common in clinical practice. Recently, reports on oral immunotherapy (OIT) for food allergy have been increasing, and OIT has drawn attention as a therapy with the possibility of providing a cure for food allergy. Initially, we review the present status of oral antigen‐specific immunotherapy for food allergy. Overall, OIT for food allergy is promising with regard to an increase in tolerance to causative foods. However, several concerns regarding safety remain. Subsequently, we review new approaches for improving the safety of OIT, including sublingual immunotherapy and modified antigens for OIT. We briefly summarize our study on OIT using heated and ovomucoid‐reduced egg white as an example of a hypoallergenic antigen for safer OIT.
Biology of Asphondyliini (Diptera: Cecidomyiidae)
Authors: TOKUDA Makoto 
Published: October 2012

AbstractThe family Cecidomyiidae (Diptera) including about 6100 described species displays diverse feeding habits. The tribe Asphondyliini is a well‐circumscribed monophyletic group of Cecidomyiidae and all species are known as gall inducers. Species belonging to this tribe exhibit fascinating ecological traits such as host alternation, polyphagy, extended diapause, induction of dimorphic galls and association with fungal symbionts. For these reasons, biogeographical and phylogenetic studies of Asphondyliini are of interest in elucidating the evolution of these traits, and particularly the processes of host‐range expansion, host‐plant shift and shifts in gall‐bearing organs. In order to facilitate further evolutionary studies of Asphondyliini, I review studies of systematics, biogeography, phylogeny, speciation, cytology, behavior, ecology, physiology, biological interaction and economic importance in this tribe.
Assessment of Undergraduate Clinical Reasoning in Geriatric Medicine: Application of a Script Concordance Test
Authors: Piovezan Ronaldo D. , Custódio Osvladir , Cendoroglo Maysa S. , Batista Nildo A. , Lubarsky Stuart , Charlin Bernard 
Published: October 2012

A challenging aspect of geriatric practice is that it often requires decision‐making under conditions of uncertainty. The Script Concordance Test (SCT) is an assessment tool designed to measure clinical data interpretation, an important element of clinical reasoning under uncertainty. The purpose of this study was to develop and analyze the validity of results of an SCT administered to undergraduate students in geriatric medicine. An SCT consisting of 13 cases and 104 items covering a spectrum of common geriatric problems was designed and administered to 41 undergraduate medical students at a medical school in São Paulo, Brazil. A reference panel of 21 practicing geriatricians contributed to the test's score key. The responses were analyzed, and the psychometric properties of the tool were investigated. The test's internal consistency and discriminative capacity to distinguish students from experienced geriatricians supported construct validity. The Cronbach alpha for the test was 0.84, and mean scores for the experts were found to be significantly higher than those of the students (80.0 and 70.7, respectively; P < .001). This study demonstrated robust evidence of reliability and validity of an SCT developed for use in geriatric medicine for assessing clinical reasoning skills under conditions of uncertainty in undergraduate medical students. These findings will be of interest to those involved in assessing clinical competence in geriatrics and will have important potential application in medical school examinations.
Chewing Ability and Tooth Loss: Association with Cognitive Impairment in an Elderly Population Study
Authors: Lexomboon Duangjai , Trulsson Mats , Wårdh Inger , Parker Marti G. 
Published: October 2012

ObjectivesTo determine whether there is an association between tooth loss, chewing ability, and cognitive function in a general elderly population.DesignData from the Panel Study of Living Conditions of the Oldest Old in 2002 were analyzed. Stepwise logistic regression analyses were used to examine the relationship between cognitive function and tooth loss and chewing ability.ParticipantsFive hundred fifty‐seven persons who were nationally representative of the Swedish population aged 77 and older.MeasurementsCognitive function was measured using the abridged version of the Mini‐Mental State Examination. Information on dental status and chewing difficulty was obtained according to self‐assessment.ResultsPersons with multiple tooth loss and persons with difficulty chewing hard food had significantly higher odds of cognitive impairment. When adjusted for sex, age, and education, the odds of cognitive impairment were not significantly different between persons with natural teeth and with multiple tooth loss, but the odds of impairment remained significantly higher for persons with chewing difficulty even when adjusted for sex, age, education, depression, and mental illness.ConclusionSex, age, education, and certain illnesses do not explain the association between cognition and chewing ability. Whether elderly persons chew with natural teeth or prostheses may not contribute significantly to cognitive impairment as long as they have no chewing difficulty. The results add to the evidence of the association between chewing ability and cognitive impairment in elderly persons.
Older Adults with Biliary Tract Cancer: Treatment and Prognosis
Authors: Lee Ban S. , Hwang Jin‐Hyeok , Lee Sang H. , Jang Sang E. , Ahn Dong‐Won , Hwang Dae W. , Cho Jai Y. , Yoon Yoo‐Seok , Han Ho‐Seong , Ahn Soyeon 
Published: October 2012

ObjectivesTo compare survival in older (≥65) and younger (<65) individuals with biliary tract cancer (BTC) and to determine whether treatment efficacy varies according to age.DesignRetrospective cohort study and nested case–control study.SettingTertiary referral center in Korea.ParticipantsFive hundred thirty–one individuals diagnosed with BTC from 2003 to 2011.MeasurementsDemographic and clinical characteristics of 326 older (≥65) and 205 younger (<65) individuals with BTC were compared. Differences in survival were also assessed after matching according to propensity score.ResultsThere were no significant differences in sex, symptoms and signs, tumor histology, stage, or surgery between the two groups, but older participants had more comorbidities and poorer performance status and underwent less chemotherapy and radiotherapy (P < .05). Survival of the two groups was compared. After adjustment for baseline characteristics using the propensity score method, survival was still comparable (P = .72). When survival of older participants in the treatment group (TG, those who underwent surgery, chemotherapy, or radiotherapy) was compared with that of those in the supportive care group (SCG, those who received only supportive care), those in the TG had a longer survival time than those in the SCG (P < .001). This result was confirmed in the propensity analysis (including individuals undergoing surgery, P < .001; excluding individuals undergoing surgery, P < .001). In the multivariable Cox analysis, surgical resection and chemotherapy were significantly associated with longer survival, and advanced tumor stage, lower baseline serum albumin level, and greater comorbidity were found to significantly predict poor survival. Age was not associated with survival in individuals with BTC (P = .33).ConclusionOlder age was not associated with poor survival in BTC, and treated individuals had longer survival in the older BTC population. Therefore, treatment should not be restricted on the basis of age.
Effect of Coexisting Chronic Obstructive Pulmonary Disease and Cognitive Impairment on Health Outcomes in Older Adults
Authors: Chang Sandy S. , Chen Shu , McAvay Gail J. , Tinetti Mary E. 
Published: October 2012

ObjectivesTo determine the extent to which the co‐occurrence of chronic obstructive pulmonary disease (COPD) and cognitive impairment affect adverse health outcomes in older adults.DesignMulticenter longitudinal cohort study.SettingCalifornia, Pennsylvania, Maryland, and North Carolina.ParticipantsThree thousand ninety‐three community‐dwelling adults aged 65 and older from the Cardiovascular Health Study. Four hundred thirty‐one had chronic obstructive pulmonary disease (COPD) at study baseline.MeasurementsFollow‐up began at the second CHS visit and continued for 3 years. Spirometric criteria for airflow limitation served to establish COPD using the Lambda‐Mu‐Sigma method, which accounts for age‐related changes in lung function. Cognitive impairment was evaluated using the modified Mini‐Mental State Examination and claims data. Outcomes were respiratory‐related and all‐cause hospitalizations and death.ResultsParticipants with coexisting COPD and cognitive impairment had the highest rates of respiratory‐related (adjusted hazard ratio (aHR) = 4.10, 95% confidence interval (CI) = 1.86–9.05) and all‐cause hospitalizations (aHR = 1.34, 95% CI = 1.00–1.80) and death (aHR = 2.29, 95% CI = 1.18–4.45). In particular, individuals with both conditions had a 48% higher rate of all‐cause hospitalizations (adjusted synergy index (aSI) = 1.48, 95% CI = 0.19–11.31) and a rate of death nearly three times as high (aSI = 2.74, 95% CI = 0.43–17.32) as the sum of risks for each respective outcome associated with having COPD or cognitive impairment alone. Nevertheless, tests for interaction were not statistically significant for the presence of synergism between the two conditions contributing to each of the outcomes. Therefore, it cannot be concluded that the combined effect of COPD and cognitive impairment is greater than additive.ConclusionCoexisting COPD and cognitive impairment have an additive effect on respiratory‐related and all‐cause hospitalizations and death. Optimizing outcomes in older adults with COPD and cognitive impairment will require that how to improve concurrent management of both conditions be determined.
A mathematical modeling approach to quantify the role of phlebotomy losses and need for transfusions in neonatal anemia
Authors: Rosebraugh Matthew R. , Widness John A. , Nalbant Demet , Veng‐Pedersen Peter 
Published: October 2012

BACKGROUND: Very preterm infants commonly develop anemia requiring multiple red blood cell transfusions (RBCTx). This is in part attributable to heavy laboratory phlebotomy loss. Quantification of the extent to which laboratory blood loss contributes to anemia sufficient to prompt RBCTx has not been examined.STUDY DESIGN AND METHODS: Twenty‐six preterm infants weighing less than 1500 g at birth requiring ventilator support who received one or more RBCTx were intensively studied during the first month of life. Hemoglobin (Hb) loss via laboratory blood loss and RBC senescence and Hb gain from RBCTx were precisely accounted for in a Hb mass balance mathematical model developed to assess the impact of phlebotomy on RBCTx when restrictive RBCTx criteria were applied.RESULTS: Study subjects had a birth weight of 880 ± 240 g (mean ± SD) and a Hb level of 14.4 ± 2.4 g/dL at birth and received 3.81 ± 2.15 RBCTx during the study period. Modeling indicated that even with the total elimination of laboratory phlebotomy loss, a reduction of 41% to 48% in RBCTx was achievable.CONCLUSION: The present modeling results indicate that while phlebotomy reduction can significantly decrease the number of RBCTx administered to preterm infants, total elimination of all RBCTx will likely require other approaches, for example, stimulation of erythropoiesis with erythropoiesis‐stimulating agents.