bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness and Perceptions of Vermont’s Prescribed Product Gift Ban and Disclosure Law by Prescribers and Pharmacists
Authors: Kennedy Amanda G. , Possidente Carl J. , Pinckney Richard G. 
Published: August 2012

Purpose: Vermont law strictly regulates the interactions between pharmaceutical manufacturers and health care providers, including gifts, meals, and medication samples. The purpose of this study was to describe providers’ awareness and perceptions of current requirements. Methods: An online survey was completed by Vermont providers, including prescribers and pharmacists. The survey asked providers about their awareness of 15 different legal requirements and about their level of agreement with these requirements. Results: Four hundred and eleven providers completed the survey (61% male, mean age 52 years, and 71% physicians). Awareness of the 15 requirements ranged from 28.4% to 93.8%. Most providers agreed or had no strong opinions. Responses at significance levels of P < .001 were noted in 8 of 15 requirements when perceptions were stratified by providers who had any interactions with pharmaceutical representatives in the past year (N = 227, 55.4%) versus providers who reported no interactions (N = 183; 44.6%). Conclusions: A high proportion of Vermont providers are unaware of the current law. Most agreed or had no strong opinions about the requirements; however, at least a quarter disagreed with banning small gifts and meals. Having any interaction with pharmaceutical representatives changed how providers perceived the requirements. These data may be useful for other states considering similar laws.
Increased C1q, C4 and C3 deposition on platelets in patients with systemic lupus erythematosus – a possible link to venous thrombosis?
Authors: Lood C , Eriksson S , Gullstrand B , Jönsen A , Sturfelt G , Truedsson L , Bengtsson AA 
Published: August 2012

Objective: Patients with systemic lupus erythematosus (SLE) have an increased risk of developing vascular diseases (VD) such as myocardial infarction, stroke and venous thrombosis, which can only partly be explained by traditional risk factors. The role of platelets in this process has not been extensively studied. Platelet activation supports complement binding to the platelet surface, and increased C4d has been seen on platelets in SLE patients as well as in non-rheumatic patients with stroke. In this study we investigated in vivo platelet deposition of the classical complement pathway components C1q, C4d and C3d in relation to VD in SLE patients. Furthermore, the ability of serum to support in vitro complement deposition on fixed heterologous platelets was analyzed. Methods: Blood from 69 SLE patients and age- and sex-matched healthy individuals was collected in sodium-citrate tubes and platelets isolated by centrifugation. Complement deposition on platelets was detected by flow cytometry. Results: We could demonstrate that SLE patients had increased C1q, C3d and C4d deposition on platelets as compared to healthy controls ( p < 0.0001). SLE patients with a history of venous thrombosis had increased complement deposition on platelets as compared to SLE patients without this manifestation ( p < 0.05). In vitro studies demonstrated that serum from patients with lupus anticoagulant, venous thrombosis or antiphospholipid antibody syndrome supported increased platelet C4d deposition in vitro as compared to SLE patients without these manifestations ( p < 0.05). Our data support the hypothesis that platelet activation and the subsequent complement deposition on platelets are central in the development of venous thrombosis in SLE. Conclusions: Altogether we suggest that complement deposition on platelets could reflect important pathogenetic events related to the development of venous thrombosis in SLE and might be used as a marker for venous thrombosis in SLE.
Prospectively Surveying Health-Related Quality of Life and Symptom Relief in a Lot-Based Sample of Medical Cannabis-Using Patients in Urban Washington State Reveals Managed Chronic Illness and Debility
Authors: Aggarwal S. K. , Carter G. T. , Sullivan M. D. , Zumbrunnen C. , Morrill R. , Mayer J. D. 
Published: August 2012

Objectives: To characterize health-related quality of life (HRQoL) in medical cannabis patients. Methods: Short Form 36 (SF-36) Physical Health Component Score and Mental Health Component Score (MCS) surveys as well has CDC (Centers for Disease Control) HRQoL-14 surveys were completed by 37 qualified patients. Results: Mean SF-36 PCS and MCS, normalized at 50, were 37.4 and 44.2, respectively. Eighty percent of participants reported activity/functional limitations secondary to impairments or health problems. Patients reported using medical cannabis to treat a wide array of symptoms across multiple body systems with relief ratings consistently in the 7-10/10 range. Conclusion: The HRQoL results in this sample of medical cannabis-using patients are comparable with published norms in other chronically ill populations. Data presented provide insight into medical cannabis-using patients’ self-rated health, HRQoL, disease incidences, and cannabis-related symptom relief.
Global Talent Management
Authors: Kim Sehoon , McLean Gary N. 
Published: August 2012

The Problem Despite increasing attention in business, talent management in global contexts has not been explored adequately in HRD. Most studies related to global talent management explain only part of it and do not provide an integrative understanding of what is going on globally in talent management in an HRD perspective. The Solution This article proposed an integrative conceptual framework for global talent management that involves the necessity, challenges, and roles of HRD. Considering cross-cultural viewpoints and multinational enterprise issues in HRD, the study analyzed why talent management is necessary and the challenges of developing talent. Finally, proposals were made for developing global talent and roles for HRD researchers and practitioners. The Stakeholders The results of this study will provide insights or guides for researchers interested in talent management/development and HR practitioners involved in a multinational enterprise.
Creating a Flexible Organizational Culture to Attract and Retain Talented Workers Across Generations
Authors: Eversole Barbara A. W. , Venneberg Donald L. , Crowder Cindy L. 
Published: August 2012

The Problem One of the most important emerging issues in the field of human resource development is how to effectively help organizations deal with the shifting demographics in the workforce. The largest generational cohort is nearing retirement, which will result in a loss of talent, experience, and expertise. The newest generation entering the workforce is substantively different. The next 20 years will likely see a shift to new ways of working, reflecting the values of the younger generation. The Solution Organizational cultures that will be able to retain employees across generations need to be developed. Each generation seems to be alike in one crucial area: their desire for workplace flexibility. Middle managers need to be incented and trained to accept a culture where they maintain accountability without power and control. The Stakeholders Human resource development practitioners and researchers have a role in developing interventions to change organizational culture to be more flexible, thereby potentially increasing retention of valued workers across the generations.
Driven to Distraction
Authors: Williams Edie 
Published: August 2012

The Problem An uncertain economy with a highly mobile workforce compels employers to rely heavily on HRD research for empirically based selection criteria and proven predictors of job performance. One of those predictors is the ability to think analytically and critically. Evidence is mounting that heavy use of electronic media may impact the ability to think critically because of increased distractibility and inattention to work related tasks. The Solution Collaborative research with medical and educational communities is needed to correlate impacts of heavy electronic media usage to critical thinking and, if confirmed, develop critical thinking measures and curricula that strengthen critical thinking skills in children and young adults entering the workforce. The Stakeholders Confirming the effects of heavy electronic media on critical thinking will increase the body of research for medical professionals about brain functioning, inform education researchers about trends in student populations experiencing lower test scores, and provide HRD researchers information about developing engaged and productive employees.
Addressing methodological challenges in implementing the nursing home pain management algorithm randomized controlled trial
Authors: Ersek Mary , Polissar Nayak , Pen Anna Du , Jablonski Anita , Herr Keela , Neradilek Moni B 
Published: August 2012

Background Unrelieved pain among nursing home (NH) residents is a well-documented problem. Attempts have been made to enhance pain management for older adults, including those in NHs. Several evidence-based clinical guidelines have been published to assist providers in assessing and managing acute and chronic pain in older adults. Despite the proliferation and dissemination of these practice guidelines, research has shown that intensive systems-level implementation strategies are necessary to change clinical practice and patient outcomes within a health-care setting. One promising approach is the embedding of guidelines into explicit protocols and algorithms to enhance decision making. Purpose The goal of the article is to describe several issues that arose in the design and conduct of a study that compared the effectiveness of pain management algorithms coupled with a comprehensive adoption program versus the effectiveness of education alone in improving evidence-based pain assessment and management practices, decreasing pain and depressive symptoms, and enhancing mobility among NH residents. Methods The study used a cluster-randomized controlled trial (RCT) design in which the individual NH was the unit of randomization. The Roger’s Diffusion of Innovations theory provided the framework for the intervention. Outcome measures were surrogate-reported usual pain, self-reported usual and worst pain, and self-reported pain-related interference with activities, depression, and mobility. Results The final sample consisted of 485 NH residents from 27 NHs. The investigators were able to use a staggered enrollment strategy to recruit and retain facilities. The adaptive randomization procedures were successful in balancing intervention and control sites on key NH characteristics. Several strategies were successfully implemented to enhance the adoption of the algorithm. Limitations/Lessons The investigators encountered several methodological challenges that were inherent to both the design and implementation of the study. The most problematic issue concerned the measurement of outcomes in persons with moderate to severe cognitive impairment. It was difficult to identify valid, reliable, and sensitive outcome measures that could be applied to all NH residents regardless of the ability to self-report. Another challenge was the inability to incorporate advances in implementation science into the ongoing study Conclusions Methodological challenges are inevitable in the conduct of an RCT. The need to optimize internal validity by adhering to the study protocol is compromised by the emergent logistical issues that arise during the course of the study.
Stopping a trial early – and then what?
Authors: Wittes Janet 
Published: August 2012

Background This article addresses a problem arising when a trial shows such strong evidence of benefit of the tested intervention that it stops early with an observed effect size for the experimental treatment that is statistically significantly better than the control. Within the classical frequentist framework of group sequential trials, the observed estimated effect size, the associated naïve confidence interval, and the p-value are all biased estimates of the true values. The bias is in the direction of the overestimation of the treatment effect, creation of narrower confidence intervals than appropriate, and a p-value that is too small. Purpose To discuss methods for correcting the bias in observed effect sizes, confidence intervals, and p-values for trials stopped early and to show the extent to which such correction would have modified the conclusions of the Randomized Aldactone Evaluation Study (RALES). Results In RALES, the effect of not correcting for bias is negligible. Limitations This article does not show general results; it only explores a few examples that use conservative methods for early stopping. It does not consider sequential methods that allow a relatively high probability of stopping early. Conclusions This article points out that there is no unique solution to the correction of the p-value, but it recommends stagewise ordering, which states that earlier stopping of a trial is ipso facto stronger evidence of effect than later stopping so long as the stopping is governed by a monitoring boundary that preserves the Type I error rate. Associated with stagewise ordering is a method for calculating the estimated effect size and its confidence interval. In the RALES trial, which stopped at 50% information time, the corrections to the estimated values are small.
The issue of multiplicity in noninferiority studies
Authors: Ke Chunlei , Ding Beiying , Jiang Qi , Snapinn Steven M 
Published: August 2012

Background In a clinical study to evaluate noninferiority (NI) of an experimental drug relative to an established therapy, it is common to further test superiority of the experimental drug after NI is established. It has been shown that no multiplicity issue exists between NI and superiority tests of the primary endpoint. However, when there is an additional, or secondary, endpoint that will be tested for superiority in a hierarchical fashion to the NI testing of the primary endpoint, it is not clear whether the overall type I error rate is strictly controlled among all the tests. Purpose In this article, our goal is to evaluate if the family-wise type I error rate is strictly controlled in this setting. We also evaluate a multiplicity adjustment procedure based on the Hochberg procedure. Methods We use the closed testing principle to evaluate the family-wise type I error rate. Some simulations are performed to appreciate the magnitude of the potential inflation of the type I error rate. Results It is demonstrated that the family-wise type I error rate is not controlled and an appropriate multiplicity adjustment procedure must take into account the NI and superiority tests of the two endpoints. When the test statistic used for superiority testing of the primary endpoint is the same as that for the NI testing, a multiplicity adjustment method using the popular Hochberg procedure is shown to be potentially conservative. Limitation The assessment is based on a simplified set-up where there is only one secondary endpoint tested for superiority in addition to the primary endpoint. Conclusion It is necessary to evaluate the issue of multiplicity in non-inferiority studies to assure strict control of the family-wise type I error rate.
In Vivo MRI Tracking of Polyethylenimine-Wrapped Superparamagnetic Iron Oxide Nanoparticle–Labeled BMSCs for Cartilage Repair
Authors: Chen Jiarong , Wang Fuyou , Zhang Yi , Jin Xuhong , Zhang Lin , Feng Yong , Yang Liu 
Published: August 2012

Objective: To evaluate the feasibility of tracking polyethylenimine (PEI)-wrapped superparamagnetic iron oxide (SPIO) nanoparticle–labeled, bone marrow–derived mesenchymal stem cells (BMSCs) by in vivo magnetic resonance imaging (MRI) in articular cartilage repair in a minipig model. Methods: Eighteen Guizhou minipigs were randomly divided into three groups (groups A, B, and C). In group A, PEI-wrapped SPIO nanoparticle (PEI/SPIO) and green fluorescent protein (GFP) colabeled, autologous BMSCs seeded in type II collagen gel were transplanted into the articular cartilage defects of the minipig model. In group B, GFP-labeled, autologous BMSCs seeded in type II collagen gel were transplanted. In group C, no treatment was applied for cartilage defects. All minipigs underwent clinical 3.0-T MR imaging at 4, 8, 12, and 24 weeks postsurgery. The findings were compared histologically. Results: Prussian staining and transmission electron microscope showed that BMSCs were efficiently labeled by PEI/SPIO. Cell viability, proliferation, and differentiation were comparable between labeled and unlabeled cells. MRI SET2WI sequence revealed that marked hypointense signal void areas representing the transplanted labeled BMSCs could be observed for at least 24 weeks. Histochemical staining confirmed the presence of Prussian blue–positive cells and GFP-positive cells at the hypointense signal void areas. At 24 weeks postsurgery, both MR signals and histologic staining of minipigs in groups A and B at the cartilage defect were close to the normal cartilage. Conclusions: 3.0-T MRI in vivo tracking of PEI/SPIO-labeled BMSCs seeded in type II collagen gel on cartilage repair following transplantation is feasible in minipigs.
Methemoglobinemia and ascorbate deficiency in hemoglobin E β thalassemia: metabolic and clinical implications
Authors: Allen Angela , Fisher Christopher , Premawardhena Anuja , Bandara Dayananda , Perera Ashok , Allen Stephen , St Pierre Timothy , Olivieri Nancy , Weatherall David 
Published: August 2012

AbstractDuring investigations of the phenotypic diversity of hemoglobin (Hb) E β thalassemia, a patient was encountered with persistently high levels of methemoglobin associated with a left-shift in the oxygen dissociation curve, profound ascorbate deficiency, and clinical features of scurvy; these abnormalities were corrected by treatment with vitamin C. Studies of erythropoietin production before and after treatment suggested that, as in an ascorbate-deficient murine model, the human hypoxia induction factor pathway is not totally dependent on ascorbate levels. A follow-up study of 45 patients with HbE β thalassemia showed that methemoglobin levels were significantly increased and that there was also a significant reduction in plasma ascorbate levels. Haptoglobin levels were significantly reduced, and the high frequency of the 2.2 haptoglobin genotype may place an additional pressure on ascorbate as a free-radical scavenger in this population. There was, in addition, a highly significant correlation between methemoglobin levels, splenectomy, and factors that modify the degree of globin-chain imbalance. Because methemoglobin levels are modified by several mechanisms and may play a role in both adaptation to anemia and vascular damage, there is a strong case for its further study in other forms of thalassemia and sickle-cell anemia, particularly when splenic function is defective.
Prevention of hyperoxia-mediated pulmonary inflammation in neonatal rats by caffeine
Authors: Weichelt Ulrike , Cay Ruhuye , Schmitz Thomas , Strauss Evelyn , Sifringer Marco , Bührer Christoph , Endesfelder Stefanie 
Published: August 2012

In preterm human infants, briefly elevated concentrations of oxygen are associated with a prolonged increase in blood chemokine concentrations and the development of bronchopulmonary dysplasia (BPD). Caffeine given to preterm infants for the prevention or treatment of apnoea has been shown to reduce the rate of BPD.We tested the hypotheses that infant rats exposed to a combination of caffeine and hyperoxia would be less susceptible to lung injury than those exposed to hyperoxia alone and that caffeine decreases the pulmonary tissue expression of chemokines and leukocyte influx following hyperoxia.Using 6-day-old rat pups, we demonstrated that 24 h of 80% oxygen exposure caused pulmonary recruitment of neutrophils and macrophages. High levels of oxygen upregulated the expression of: the CXC chemokines, cytokine-induced neutrophil chemoattractant-1 and macrophage inflammatory protein-2; the CC-chemokine monocyte chemoattractant protein-1; the pro-inflammatory cytokines tumour necrosis factor-α and interleukin-6, as measured by realtime PCR after the administration of caffeine (10 mg·kg−1body weight); and attenuated chemokine and cytokine upregulation, as well as the influx of CD11b+, ED-1+and myeloperoxidase+leukocytes.These experiments suggest that protective effects of caffeine in the neonatal lung are mediated, at least in part, by reduction of pulmonary inflammation.
The impact of depressive symptoms on recovery and outcome of hospitalised COPD exacerbations
Authors: Papaioannou Andriana I. , Bartziokas Konstantinos , Tsikrika Stamatoula , Karakontaki Foteini , Kastanakis Emmanouil , Banya Winston , Haniotou Aikaterini , Papiris Spyros , Loukides Stelios , Polychronopoulos Vlassis , Kostikas Konstantinos 
Published: August 2012

The impact of depressive symptoms on outcomes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) has not been thoroughly evaluated in prospective studies.We prospectively enrolled 230 consecutive patients hospitalised for AECOPD, without previous diagnosis of depression. Depressive symptoms were evaluated with Beck's depression inventory. Pulmonary function tests, arterial blood gases, COPD assessment test (CAT) and Borg dyspnoea scale were recorded on admission and on days 3, 10 and 40. Patients were evaluated monthly for 1 year.Patients with depressive symptoms required longer hospitalisation (mean±sd11.6±3.7versus5.6±4.1 days, p<0.001). Clinical variables improved during the course of AECOPD, but depressive symptoms on admission had a significant impact on dyspnoea (p<0.001) and CAT score (p=0.012) improvement. Patients with depressive symptoms presented more AECOPD (p<0.001) and more hospitalisations for AECOPD (p<0.001) in 1 year. In multivariate analysis, depressive symptoms were an independent predictor of mortality (hazard ratio 3.568, 95% CI 1.302–9.780) and risk for AECOPD (incidence rate ratio (IRR) 2.221, 95% CI 1.573–3.135) and AECOPD hospitalisations (IRR 3.589, 95% CI 2.319–5.556) in 1 year.The presence of depressive symptoms in patients admitted for AECOPD has a significant impact on recovery and is related to worse survival and increased risk for subsequent COPD exacerbations and hospitalisations in 1 year.
Short-form Sun-style t’ai chi as an exercise training modality in people with COPD
Authors: Leung Regina Wai Man , McKeough Zoe J. , Peters Matthew J. , Alison Jennifer A. 
Published: August 2012

The aims of the study were to determine the effect of short-form Sun-style t’ai chi (SSTC) (part A) and investigate exercise intensity of SSTC (part B) in people with chronic obstructive pulmonary disease (COPD).Part A: after confirmation of eligibility, participants were randomly allocated to either the t’ai chi group or control group (usual medical care). Participants in the t’ai chi group trained twice weekly for 12 weeks. Part B: participants who had completed training in the t’ai chi group performed a peak exercise test (incremental shuttle walk test) and SSTC while oxygen consumption (VO2) was measured. Exercise intensity of SSTC was determined by the per cent ofVO2reserve.Of 42 participants (mean±sdforced expiratory volume in 1 s 59±16% predicted), 38 completed part A and 15 completed part B. Compared to control, SSTC significantly increased endurance shuttle walk time (mean difference 384 s, 95% CI 186–510); reduced medial-lateral body sway in semi-tandem stand (mean difference -12.4 mm, 95% CI -21– -3); and increased total score on the chronic respiratory disease questionnaire (mean difference 11 points, 95% CI 4–18). The exercise intensity of SSTC was 53±18% ofVO2reserve.SSTC was an effective training modality in people with COPD achieving a moderate exercise intensity which meets the training recommendations.