bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Nurse Practitioner Comanagement on the Care of Geriatric Conditions
Authors: Reuben David B. , Ganz David A. , Roth Carol P. , McCreath Heather E. , Ramirez Karina D. , Wenger Neil S. 
Published: June 2013

ObjectivesTo determine whether community‐based primary care physician (PCP)–nurse practitioner (NP) comanagement implementing the Assessing Care of Vulnerable Elders (ACOVE)‐2 model: (case finding, delegation of data collection, structured visit notes, physician and patient education, and linkage to community resources) can improve the quality of care for geriatric conditions.DesignCase study.SettingTwo community‐based primary care practices.ParticipantsPatients aged 75 and older who screened positive for at least one condition: falls, urinary incontinence (UI), dementia, and depression.InterventionThe ACOVE‐2 model augmented by NP comanagement of conditions.MeasurementsQuality of care according to medical record review using ACOVE‐3 quality indicators (QIs). Individuals receiving comanagement were compared with those who received PCP care alone in the same practices.ResultsOf 1,084 screened individuals, 658 (61%) screened positive for more than one condition; 485 of these were randomly selected for chart review and triggered a mean of seven QIs. A NP saw 49% for comanagement. Overall, individuals received 57% of recommended care. Quality scores for all conditions (falls, 80% vs 34%; UI, 66% vs 19%; dementia, 59% vs 38%) except depression (63% vs 60%) were higher for individuals who saw a NP. In analyses adjusted for sex and age of patient, number of conditions, site, and a NP estimate of medical management style, NP comanagement remained significantly associated with receiving recommended care (P < .001), as did NP estimate of medical management style (P = .02).ConclusionNP comanagement is associated with better quality of care for geriatric conditions in community‐based primary care than usual care using the ACOVE‐2 model.
An alternative short‐form Mini‐Nutritional Assessment for rating the risk of malnutrition in persons on haemodialysis
Authors: Tsai Alan C , Chang Tsui‐Lan , Chang Mei‐Zu 
Published: June 2013

Aims and objectivesTo improve the short‐form Mini‐Nutritional Assessment (MNA) to ameliorate under‐rating the risk of malnutrition in patients on haemodialysis.BackgroundThe full MNA was found to be appropriate for rating the risk of malnutrition in persons undergoing haemodialysis but the short‐form under‐rated the risk.DesignA cross‐sectional study with purposive sampling.MethodsThe study recruited 152 adult ambulatory patients on maintenance haemodialysis from one dialysis centre in Taiwan. Each subject was rated with the Subjective Global Assessment (SGA), the original and selected alternative short‐forms (by replacing better performing nonshort‐form items for lesser performing short‐form items) of a Taiwanese‐specific MNA (T1). Serum albumin and creatinine concentrations and the SGA were also used as referents. Results were evaluated with Pearson's correlation analysis, binary classification test and receiver operating characteristic (ROC) curves.ResultsThe full MNA showed good consistency with the SGA, but the original short‐form rated fewer patients at risk of malnutrition compared with the full MNA. Exchanging item O (self‐rated nutritional status) with item E (neuropsychological problems) produced the best results and restored the predictive ability of the short‐form. Replacing item P for E produced the next best results.ConclusionResults suggest that the predictive ability of the short‐form can be greatly restored by rearranging the component items of the short‐form without affecting the performance of the full MNA. The study is probably the first example of a disease‐specific version of the MNA.Relevance to clinical practiceThe revision makes short‐form MNA suitable for rating the risk of malnutrition in patients on haemodialysis in clinical practice.
Expression of PROX‐1 in oral Kaposi's sarcoma spindle cells
Authors: Benevenuto de Andrade Bruno Augusto , Ramírez‐Amador Velia , Anaya‐Saavedra Gabriela , Martínez‐Mata Guillermo , Fonseca Felipe P. , Graner Edgard , Paes de Almeida Oslei 
Published: June 2013

BackgroundThe histogenesis of neoplastic spindle cells of Kaposi's sarcoma is still uncertain, but some studies consider it a lymphatic vessel differentiation. Prox‐1 is a nuclear transcription factor that plays a major role during embryonic lymphangiogenesis, and it has been considered a specific and sensitive lymphatic endothelial cell marker. The aim of this study was to determine the expression of Prox‐1 in oral Kaposi's sarcoma comparing the results with oral benign vascular tumors including capillary hemangiomas and pyogenic granulomas.MethodsExpression of Prox‐1 and HHV‐8 was evaluated by immunohistochemistry in 30 oral Kaposi's sarcoma, 5 oral capillary hemangiomas, and 10 oral pyogenic granulomas. The labeling index was expressed as the percentage of positive cells for each case studied. Statistical comparison was performed using the Wilcoxon–Mann–Whitney rank sum test.ResultsTwenty‐eight (93.3%) and 30 oral Kaposi's sarcoma cases were positive for Prox‐1 and HHV‐8, respectively, while all oral benign vascular tumors were negative for these markers. The number of Prox‐1 and HHV‐8 oral Kaposi's sarcoma‐positive cells increased significantly from patch/plaque to nodular histological stages.ConclusionThe expression of Prox‐1 in the neoplastic spindle cells supports the view of a lymphatic differentiation in oral Kaposi's sarcoma. Prox‐1 may also be involved in the pathogenesis of oral Kaposi's sarcoma as the number of positive spindle cells increased progressively from patch to nodular stages and could be eventually useful as an additional diagnostic tool for differential diagnosis between oral Kaposi's sarcoma and benign oral vascular lesions.
β‐Aminobutyric Acid Primed Expression of WRKY and Defence Genes in Brassica carinata Against Alternaria Blight
Authors: Chavan Vinodkumar , Kamble Avinash 
Published: June 2013

AbstractFoliar spray with BABA led to a significant reduction of lesion development in Brassica carinata caused by Alternaria brassicae. To get better insight into molecular mechanisms underlying priming of defence responses by BABA, expression pattern of BcWRKY genes and marker genes for the SA and JA pathway namely PR‐1 and PDF 1.2 was examined. Q‐RT‐PCR analysis revealed priming of BcWRKY70, BcWRKY11 and BcWRKY53 gene expression in BABA‐pretreated Brassica plants challenged with pathogen. However, the expression of BcWRKY72 and BcWRKY18 remained unchanged. Furthermore, BcWRKY7 gene was found to be upregulated in water‐treated plants in response to pathogen indicating its role in susceptibility. In addition, BABA application potentiated expression of defence genes PR‐1, PDF1.2 and PAL in response to the pathogen. In conclusion, BABA‐primed expression of BcWRKY70, BcWRKY11 and BcWRKY53 genes is strongly correlated with enhanced expression of PR‐1, PDF1.2 and PAL hence suggesting their role in BABA‐induced resistance.
Contribution of temporal floral closure to reproductive success of the spring‐flowering Tulipa iliensis
Authors: ABDUSALAM Aysajan , TAN Dun‐Yan 
Published: June 2013

AbstractTemporal flower closure is a non‐morphological floral character of adaptive significance for growth of some species in extreme environments, and it has important implications for plant reproductive success. Flowers of Tulipa species responded to changes in temperature and closed temporarily at low temperatures, but they reopened when temperatures increased. In this study, we determined the effects of temporal flower closure of Tulipa iliensis Regel. on mating pattern, flower microenvironmental temperature, and sexual organ functions during exposure to low temperatures, rainfall, and wind. First, flowers of T. iliensis were incompletely herkogamous with stamens longer than the pistil. Floral closure resulted in the contact of dehisced anthers with the stigma and auto‐pollen deposition on the stigma, thus facilitating automatic self‐pollination. Second, floral closure maintained the temperature inside the flower, providing a stable microenvironment that promoted pollen germination and avoided a decline in stigma receptivity. Third, flower closure of T. iliensis before rainstorms avoided flushing of pollen from anthers and helped maintain both pollen viability and stigma receptivity during exposure to rain. Finally, flower closure maintained pollen clumping in the anthers during exposure to wind, thereby enhancing pollination efficiency by pollinators and/or automatic selfing. Therefore, temporal flower closure of T. iliensis is an important floral strategy in facilitating automatic selfing, extending the functional period of male and female organs, and it thus ensures reproductive success in the unpredictable early spring environment.
Transfusion of 28‐day‐old leucoreduced or non‐leucoreduced stored red blood cells induces an inflammatory response in healthy dogs
Authors: Callan M. B. , Patel R. T. , Rux A. H. , Bandyopadhyay S. , Sireci A. N. , O'Donnell P. A. , Ruane T. , Sikora T. , Marryott K. , Sachais B. S. , Hod E. A. 
Published: June 2013

Background and ObjectivesStudies in mice suggest that rapid transfusions of red blood cells (RBCs), refrigerator stored for longer durations, induce a pro‐inflammatory cytokine response. Studies in human neonates confirm these findings; however, to date, adult human studies have failed to replicate these findings. We used healthy research dogs to begin to examine the factors affecting the cytokine response to transfusion.Materials and MethodsIn a prospective study, healthy dogs were randomized for two autologous packedRBCtransfusions after 7 (i.e. ‘fresh’) and 28 (i.e. ‘old’) days of storage, or after 28 and 7 days of storage, with or without prestorage leucoreduction (LR).ResultsNo significant differences were observed betweenLRand non‐LRtransfusions for all circulating analytes measured following transfusion. A pro‐inflammatory cytokine response, exemplified by monocyte chemoattractant protein‐1, was observed 6 h after only oldRBCtransfusions, irrespective of infusion rate (P < 0·001). This response was accompanied by increased neutrophil counts (P < 0·001) and decreased platelet counts (P < 0·001).ConclusionIn healthy dogs, oldRBCtransfusions induce inflammation, which is unaffected by infusion rate.
Complete Genome Sequence of a Rabies Virus Isolate from a Ferret Badger (
Melogale moschata
) in Jiangxi, China
Authors: Zhao Jinghui , Zhang Shoufeng , Liu Ye , Zhang Fei , Hu Rongliang 
Published: June 2013

ABSTRACT
The genome of ferret badger rabies virus JX09-17(fb), isolated in Jiangxi Province, China, in 2009 has been completely sequenced. The genomic length is 11, 923 nucleotides (nt) with an overall organization similar to that of other rabies virus isolates. JX09-17(fb) is closely related to Chinese epidemic canine isolates in clade I.
Individual performance review in hospital practice: the development of a framework and evaluation of doctors’ attitudes to its value and implementation
Authors: Trebble T M , Cruickshank L , Hockey P M , Heyworth N , Powell T , Clarke N 
Published: June 2013

BackgroundAppraisal, or independent performance review (IPR) is used in human resources management in the commercial and public sectors to evaluate the performance of an employee against agreed local organisational expectations and objectives, and to identify their requirements for development and effective management. IPR for NHS consultants may provide essential information for job planning, contribute towards medical appraisal for revalidation, and facilitate productivity and quality improvement.AimsTo develop a framework for IPR for consultants, and to determine attitudes on its value, process and content.MethodInformation from commercial, public and voluntary sector models and published and other literature sources were used to develop an IPR framework. This was assessed through a three-cycle action research methodology involving qualitative interviews with 22 consultants (predominantly with medical management roles).ResultsThe domains of the IPR framework included: (1) performance against objectives; (2) behaviour and leadership; (3) talent management; (4) agreed future objectives. A number of themes were identified from the consultant interviews including: ineffective current appraisal systems reflecting a lack of valid performance data and allotted time; a lack of empowerment of medical managers to address performance issues; IPR as a more explicit system, offering value in evaluating doctors performance; and the dependence of successful implementation on the engagement of the Trust executive.ConclusionsIPR may have value for performance evaluation of consultants, contributing toward job planning and complementing medical appraisal. Support by their employing organisation and engagement with medical managers in design and implementation is likely to be essential.
Discontinuity of care at end of life: a qualitative exploration of OOH end of life care
Authors: Leydon Geraldine M , Shergill Narinder K , Campion-Smith Charles , Austin Helen , Eyles Caroline , Baverstock Jenny , Addington-Hall Julia , Sloan Richard , Davis Carol , Moore Michael V 
Published: June 2013

ObjectiveThis study aimed to understand the experiences of palliative care patients when accessing or making decisions about out of hours (OOH) services. It also aimed to illuminate barriers and enablers to accessing appropriate and timely care following the introduction of the 2004 New General Medical Services Contract.MethodLongitudinal prospective qualitative study using semi-structured interviews and telephone interviews over 6 months and analysed for thematic content. 32 patients defined as receiving palliative care in six General Practices and three hospices selected on the basis of size and rural/urban location in Southern England were recruited.ResultsContinuity of care was highly valued. Participants described the importance of being known by the healthcare team, and the perceived positive implications continuity could have for the quality of care they received and the trust they had in their care. Various factors prevented participants from seeking help or advice from OOH services, despite having health concerns that may have benefitted from medical assistance. Prior poor experience, limited knowledge of services and knowing who to call and, indeed, when to call were all factors that reportedly shaped participants’ use of OOH services.ConclusionsInterpersonal or relationship continuity and management continuity are vital to the process of optimising the patient experience of OOH palliative care. While recent service innovations are tackling some of the issues highlighted, this research reinforces the value patients with palliative care needs places on continuity and the need to improve this aspect of care management.
A randomised, double-blind, placebo-controlled study to assess the safety and efficacy of methoxyflurane for procedural pain of a bone marrow biopsy
Authors: Spruyt Odette , Westerman David , Milner Alvin , Bressel Mathias , Wein Simon 
Published: June 2013

ContextPain during bone marrow biopsy (BMB) under local anaesthesia (LA) is reported in 70% of patients, of whom 35% rate the pain as severe. Pain is experienced during both the biopsy and the marrow aspiration. Many medical centres use conscious sedation involving benzodiazepines and/or opioids administered orally or intravenously for BMB analgesia. Methoxyflurane (MEOF) is self-administered by a handheld device (the Penthrox inhaler), which is licensed in Australia for the relief of pain associated with short surgical procedures.ObjectivesTo evaluate the efficacy and safety of MEOF analgesia in patients with cancer undergoing BMB.MethodsPatients received LA plus either MEOF or placebo. The primary endpoint was worst pain intensity measured with the Numerical Rating Scale. Anxiety was assessed with the State Trait Anxiety Inventory (STAI-Y-1). Patients, operators and the research nurse rated global medication performance using a 5-point Likert scale.ResultsForty-nine of the 50 patients randomised to MEOF and 48 of the 50 patients randomised to placebo effectively received the allocated intervention. Mean±SD worst pain overall was 4.90±2.07 in MEOF group and 6.0±2.24 in placebo group (p=0.011). Worst pain during the aspiration was 3.3±2.0 in MEOF group and 5.0±2.4 in placebo group (p<0.001). 49% of patients treated with MEOF rated the medication as very good or excellent compared with 16.5% of the patients treated with placebo (p=0.005). 20.4% of patients treated with MEOF had an adverse event (AE) compared with 4.2% in the placebo arm (p=0.028). All AEs were grade 1.ConclusionsMEOF was safe and performed better than placebo for analgesia in BMB procedures.
Multi-analyte profiling and pathway analysis of plasma for proteins associated with cancer-related fatigue syndrome in disease-free breast cancer patients after primary treatment
Authors: Minton O , Coulton G R , Stone P 
Published: June 2013

ContextA significant number of women treated for breast cancer develop long-term fatigue afterwards. Previous research has suggested that fatigue may be due to a prolonged inflammatory response. However, there are conflicting results and the exact nature of the disturbance remains unclear.ObjectivesTo identify inflammatory markers associated with fatigue.MethodsWe recruited women from a breast cancer follow-up clinic and categorised them on the basis of a diagnostic interview as to whether they met the criteria for cancer-related fatigue syndrome (cases) or not (controls). We took plasma samples from each participant to analyse subsequently using a panel of 88 biological markers.Results90 samples were analysed in total (45 cases and 45 controls). A factorial analysis of variance (using age as a fixed factor) demonstrated a number of differences in inflammatory cytokines. There were 28 significantly different analytes in total. Granulocyte colony stimulating factor was the most significantly different analyte (p<0.001). Many of the significant analytes were chemokine ligands found to be linked through an inflammatory pathway promoting T-cell and granulocyte production and activation.ConclusionsOur results add further weight to the hypothesis that cancer-related fatigue syndrome is associated with an increased pro-inflammatory immune response. Our findings indicate that these cytokine changes could underpin the subjective symptoms, such as perceived muscle weakness and concentration difficulties, experienced by women who feel fatigued after treatment.
Clinico-pathological characteristics and clinical outcome of different histological types of pancreatic cancer in a large Middle European series
Authors: Stotz Michael , Eisner Florian , Szkandera Joanna , Absenger Gudrun , Kornprat Peter , Lackner Carolin , Samonigg Hellmut , Gerger Armin , Pichler Martin 
Published: June 2013

AimsPancreatic cancer (PC) is a heterogeneous disease in terms of histological and molecular subtypes. The aim of this study was to evaluate the prognostic impact of different histological subtypes on cancer-specific survival (CSS) in a large single-centre Middle European cohort.MethodsWe retrospectively studied the records of 400 consecutive PC patients who were treated from 2004 to 2010 at a single tertiary academic centre. The association of histological subtypes and parameters such as tumour stage, tumour grade, levels of tumour markers carcinoembryonic antigen and CA19-9 at diagnosis, was studied. CSS was calculated using the Kaplan-Meier method, and the influence of each parameter on CSS was assessed with univariate and multivariable Cox proportional models.ResultsThe survival time was significantly shorter in the ductal adenocarcinoma and acinar histological subtypes compared to neuroendocrine differentiation (p<0.001). No survival difference was observed between ductal adenocarcinomas and patients with a histological variant of ductal adenocarcinoma, namely, mucinous non-cystic adenocarcinoma (p=0.7). In multivariable analysis, ductal adenocarcinoma (HR=3.1, CI 1.6 to 6.1, p=0.001) and acinar carcinoma (HR=3.2, CI 1.3 to 8.5, p=0.016) were identified as independent predictors for CSS.ConclusionsOur findings suggest that the main histological subtype is an independent predictor of CSS in patients with PC. Thus, our data underline the importance of routine assessment of histological type in PC for individual risk assessment. However, no clinical rationale for the subdivision of ductal adenocarcinoma and mucinous non-cystic adenocarcinoma can be supported by our study.
Health impacts of free bus travel for young people: evaluation of a natural experiment in London
Authors: Edwards Phil , Steinbach Rebecca , Green Judith , Petticrew Mark , Goodman Anna , Jones Alasdair , Roberts Helen , Kelly Charlotte , Nellthorp John , Wilkinson Paul 
Published: June 2013

BackgroundWe used the introduction of free bus travel for young people in London in 2005 as a natural experiment with which to assess its effects on active travel, car use, road traffic injuries, assaults, and on one measure of social inclusion, total number of trips made.MethodsA controlled before–after analysis was conducted. We estimated trips by mode and distances travelled in the preintroduction and postintroduction periods using data from London Travel Demand Surveys. We estimated rates of road traffic injury and assault in each period using STATS19 data and Hospital Episode Statistics, respectively. We estimated the ratio of change in the target age group (12–17 years) to the change in adults (ages 25–59 years), with 95% CIs.ResultsThe proportion of short trips travelled by bus by young people increased postintroduction. There was no evidence for an increase in the total number of bus trips or distance travelled by bus by young people attributable to the intervention. The proportion of short trips by walking decreased, but there was no evidence for any change to total distance walked. Car trips declined in both age groups, although distance travelled by car decreased more in young people. Road casualty rates declined, but the pre–post ratio of change was greater in young people than adults (ratio of ratios 0.84; 95% CI 0.82 to 0.87). Assaults increased and the ratio of change was greater in young people (1.20; 1.13 to 1.27). The frequency of all trips by young people was unchanged, both in absolute terms and relative to adults.ConclusionsThe introduction of free bus travel for young people had little impact on active travel overall and shifted some travel from car to buses that could help broader environmental objectives.
Double-lumen arterial balloon catheter technique for Onyx embolization of dural arteriovenous fistulas: initial experience
Authors: Chiu Albert Ho Yuen , Aw Grace , Wenderoth Jason David 
Published: June 2013

BackgroundDural arteriovenous fistulas are vascular malformations with variable clinical symptoms that range in severity from completely asymptomatic to seizures, dementia, loss of vision and intracranial hemorrhage. Historically, surgical obliteration was the treatment of choice but, more recently, endovascular embolization has become the first-line treatment. The liquid embolic agent Onyx (ethyl vinyl copolymer) has become the agent of choice, but problems with reflux around the delivery microcatheter and inadvertent venous penetration have arisen.Methods and resultsWe present six cases in which the double-lumen balloon microcatheter was used to transarterially embolize dural arteriovenous fistulas via injection of Onyx through the wire lumen. Depending on the individual pathology a venous balloon was also used in some cases. The advantages and disadvantages of the use of these devices are discussed.ConclusionsWe consider that the use of the double-lumen balloon technique for fistula embolization has the potential for reducing overall procedural times, procedural failures and catheter retention in certain situations. In such cases we would advocate this as a first-line technique. When lower profile, more navigable balloon catheters become available, this may become the standard of care.