bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Testosterone and Vardenafil Treatment for Restoring Erectile Function in Hypogonadal Patients who Failed to Respond to Testosterone Therapy Alone
Authors: Yassin Dany-Jan , Yassin Aksam A. , Hammerer Peter G. 
Published: November 2013

Abstract

Introduction
The role of testosterone in erectile dysfunction (ED) is increasingly recognized. It is suggested that assessment of testosterone deficiency in men with ED and symptoms of hypogonadism, prior to first-line treatment, may be a useful tool for improving therapy.

Aim
In this prospective, observational, and longitudinal study, we investigated the effects of vardenafil treatment as adjunctive therapy to testosterone undecanoate in hypogonadal ED patients who failed to respond to testosterone treatment alone.

Methods
One hundred twenty-nine testosterone deficient (serum total testosterone ≤3.4 ng/mL) patients aged 56 ± 3.9 years received intramuscular injections of long-acting parenteral testosterone undecanoate at 3-month intervals for 8 months mean follow-up.

Main Outcome Measures
Scores on the International Index of Erectile Function Questionnaire-five items (IIEF-5) and partner survey scores were compared at baseline and posttreatment with testosterone therapy alone or in combination with vardenafil. Patient baseline demographics and concomitant disease were correlated with patients' IIEF-5 scores.

Results
Seventy one (58.2%) responded well to monotherapy within 3 months. Nonresponders had lower testosterone levels and higher rates of concomitant diseases and smoking. Thirty-four of the 51 nonresponders accepted the addition of 20 mg vardenafil on demand. Efficacy assessments were measured by the IIEF–erectile function domain (IIEF-EF, questions 1–5 plus 15, 30 points) and partner self-designed survey at baseline after 4–6 weeks and at study end point. Thirty out of 34 patients responded well to this combination. IIEF-EF Sexual Health Inventory for Men score improved from 12 to 24 (P &lt; 0.0001), and partner survey showed significantly higher satisfaction (P &lt; 0.001). These patients reported spontaneous or nocturnal and morning erections or tumescence. No changes in adverse effects were recorded.

Conclusions
These data suggest that combination therapy of testosterone and vardenafil is safe and effective in treating hypogonadal ED patients who failed to respond to testosterone monotherapy.
Public policy's bibliography: The use of research in US regulatory impact analyses
Authors: Desmarais Bruce A. , Hird John A. 
Published: November 2013

AbstractMajor US federal regulatory decisions are developed and justified using regulatory impact analyses (RIAs) mandated by executive order. We examine the scientific citation activity in RIAs, a unique effort that we believe holds significant potential for understanding the use of science in policymaking. This paper reports preliminary findings from collecting and examining scientific citations in 104 RIAs from 2008–2012. We present evidence indicating that some agencies make extensive use of science in RIAs, that there is substantial variation in use across agencies, and show variation across journals and disciplines cited by regulatory agencies. Finally, we present analysis showing that regulatory policymakers make greater use of research published in highly cited scholarly journals. We conclude by outlining several future directions for research using these data.
Simple Formula for Calculating Bias‐corrected AIC in Generalized Linear Models
Authors: Imori Shinpei , Yanagihara Hirokazu , Wakaki Hirofumi 
Published: November 2013

ABSTRACTIn real‐data analysis, deciding the best subset of variables in regression models is an important problem. Akaike's information criterion (AIC) is often used in order to select variables in many fields. When the sample size is not so large, the AIC has a non‐negligible bias that will detrimentally affect variable selection. The present paper considers a bias correction of AIC for selecting variables in the generalized linear model (GLM). The GLM can express a number of statistical models by changing the distribution and the link function, such as the normal linear regression model, the logistic regression model, and the probit model, which are currently commonly used in a number of applied fields. In the present study, we obtain a simple expression for a bias‐corrected AIC (corrected AIC, or CAIC) in GLMs. Furthermore, we provide an ‘R’ code based on our formula. A numerical study reveals that the CAIC has better performance than the AIC for variable selection.
Campaign Finance and Policymaking: PACs, Campaign Contributions, and Interest Group Influence in Congress
Authors: Peoples Clayton D. 
Published: November 2013

AbstractThe general public is skeptical of our current system of campaign finance and feels that members of Congress are corrupt. Although the scholarly literature on campaign contribution influence is mixed, there is growing consensus that Political Action Committees (PACs) and interest groups do, indeed, have a powerful influence on policymaking in Congress. In this article, the author reviews this literature and discusses how influence occurs. Findings reveal that influence is only very rarely an explicit quid pro quo exchange. Instead, it is typically an ongoing, implicit, reciprocal exchange that impacts multiple stages of the legislative process and yields contributors many dividends, such as softer regulations, lower taxes, and lucrative contracts – none of which are explicitly promised (except in rare cases of full‐blown bribery) but are, nonetheless, regularly granted. The social relationships between contributors and lawmakers are central to this process, as is the ability to get legislators to sway their colleagues.
Disasters and Social Inequalities
Authors: Reid Megan 
Published: November 2013

AbstractIn this article, I review recent research on the relationship between social inequalities and disasters, focusing on the areas of social vulnerability to disaster and social inequalities in disaster recovery. I highlight how race, class, and gender structure the disaster experience such that marginalized populations are most vulnerable to the negative consequences of a disaster and face significant challenges in recovery. Then, I discuss the next steps for advancing disaster studies. First, scholars should work to develop improved methodologies for disaster research. Second, theoretical work on defining, theorizing, and classifying disasters is needed. Finally, the field should incorporate other intersectional dimensions of social inequality into the study of disasters.
Cost‐effectiveness of blood donor screening for Babesia microti in endemic regions of the United States
Authors: Simon Matthew S. , Leff Jared A. , Pandya Ankur , Cushing Melissa , Shaz Beth H. , Calfee David P. , Schackman Bruce R. , Mushlin Alvin I. 
Published: November 2013

BackgroundBabesia microti is the leading reported cause of red blood cell (RBC) transfusion‐transmitted infection in the United States. Donor screening assays are in development.Study Design and MethodsA decision analytic model estimated the cost‐effectiveness of screening strategies for preventing transfusion‐transmitted babesiosis (TTB) in a hypothetical cohort of transfusion recipients in Babesia‐endemic areas of the United States. Strategies included: 1) no screening; 2) Uniform Donor Health History Questionnaire (UDHQ), “status quo”; 3) recipient risk targeting using donor antibody and polymerase chain reaction (PCR) screening; 4) universal endemic donor antibody screening; and 5) universal endemic donor antibody and PCR screening. Outcome measures were TTB cases averted, costs, quality‐adjusted life‐years (QALYs), and incremental cost‐effectiveness ratios (ICERs; $/QALY). We assumed a societal willingness to pay of $1 million/QALY based on screening for other transfusion‐transmitted infections.ResultsCompared to no screening, the UDHQ avoids 0.02 TTB cases per 100,000 RBC transfusions at an ICER of $160,000/QALY whereas recipient risk–targeted strategy using antibody/PCR avoids 1.62 TTB cases per 100,000 RBC transfusions at an ICER of $713,000/QALY compared to the UDHQ. Universal endemic antibody screening avoids 3.39 cases at an ICER of $760,000/QALY compared to the recipient risk–targeted strategy. Universal endemic antibody/PCR screening avoids 3.60 cases and has an ICER of $8.8 million/QALY compared to universal endemic antibody screening. Results are sensitive to blood donor Babesia prevalence, TTB transmission probability, screening test costs, risk and severity of TTB complications, and impact of babesiosis diagnosis on donor quality of life.ConclusionAntibody screening for Babesia in endemic regions is appropriate from an economic perspective based on the societal willingness to pay for preventing infectious threats to blood safety.
Second language errors and features of world Englishes
Authors: HAMID M. OBAIDUL , BALDAUF RICHARD B. 
Published: November 2013

ABSTRACTWhile exocentric norms (e.g. British and American English) informed by a second language acquisition (SLA) perspective are prevalent in the Outer Circle, there is a growing recognition of local varieties of Englishes belonging to the world Englishes (WE) paradigm. However, what constitutes an error or a varietal feature is hard to decide, particularly in the absence of codification of non‐native Englishes in many Outer Circle contexts. Yet, distinguishing between errors and varietal features is a pedagogical requirement for correcting learners’ errors and nurturing their linguistic creativity. Although the WE literature suggests criteria to determine the status of neologisms, these have their limitations. On the other hand, insufficient attention has been given to the agency of English teachers who are in a critical position to mediate language standards and their variations. Against this background, this paper reports a small‐scale study involving practising English teachers in Bangladesh to provide a pedagogical perspective on error/innovation issues. Acknowledging the underlying complexity, we argue that understanding teachers’ perspectives should be seen as an important research agenda to address learner English/L2 variety issues in L2 pedagogy.
Healthcare professionals’ perspectives on delivering end-of-life care within acute hospital trusts: a qualitative study
Authors: Reid Colette , Gibbins Jane , Bloor Sophia , Burcombe Melanie , McCoubrie Rachel , Forbes Karen 
Published: November 2013

ObjectiveThe quality of end-of-life (EOL) care in acute hospitals is variable and interventions to improve this care, such as EOL care pathways, are not always used. The underlying reasons for this variability are not fully understood. We explored healthcare professionals’ views on delivering EOL care within an acute hospital trust in the South West of England.MethodsWe employed qualitative methods (focus groups, in-depth interviews and questerviews) within a study investigating the impact of a simple EOL tool on the care of dying patients. We invited a range of staff of all grades with experience in caring for dying patients from medicine, surgery and care of the elderly teams to participate.ResultsSix focus groups, seven interviews and five questerviews were conducted. Two main themes emerged: (a) delays (difficulties and avoidance) in diagnosing dying and (b) the EOL tool supporting staff in caring for the dying. Staff acknowledged that the diagnosis of dying was often made late; this was partly due to prognostic uncertainty but compounded by a culture that did not acknowledge death as a possible outcome until death was imminent. Both the medical and nursing staff found the EOL tool useful as a means of communicating ceilings of care, ensuring appropriate prescribing for EOL symptoms, and giving nurses permission to approach the bedside of a dying patient.ConclusionsThe culture of avoiding death and dying in acute hospitals remains a significant barrier to providing EOL care, even when EOL tools are available and accepted by staff.
Uncertainty and anxiety in the cancer of unknown primary patient journey: a multiperspective qualitative study
Authors: Richardson A , Wagland R , Foster R , Symons J , Davis C , Boyland L , Foster C , Addington-Hall J 
Published: November 2013

BackgroundPatients with cancer of unknown primary (CUP) have metastatic malignant disease without an identifiable primary site; it is the fourth most common cause of cancer death.ObjectivesTo explore patients’ informal and professional carers’ experiences of CUP to inform development of evidence-based, patient-centred care.MethodsQualitative study involving development of multiple exploratory case studies, each comprising a patient and nominated informal and professional carers, with contextual data extracted from medical records.Results17 CUP patients, 14 informal and 13 professional carers participated in the study. Two inter-related themes distinct to CUP emerged: uncertainty and continuity of care. In the absence of a primary diagnosis, patients and informal carers experienced uncertainty regarding prognosis, possible recurrence and the primary's hereditary potential. Professional carers experienced difficulty communicating uncertainty to patients, ambiguity in deciding optimal treatment plans in the absence of trial data and atest or treatdilemma: when to discontinue seeking the primary and start treatment. Common problems with care continuity were amplified for CUP patients relating to coordination, accountability and timeliness of care. The remit of multidisciplinary teams (MDTs) often excluded CUP, leading to “MDT tennis” where patients were “bounced” between MDTs.ConclusionsThe experience of those with CUP is distinctive and it can serve to amplify some of the issues encountered by people with cancer. The clinical uncertainties related to CUP compound existing shortcomings in continuity of care, increasing the likelihood of a disrupted patient journey. However, while little can be done to overcome uncertainty, more could be done to address issues regarding continuity of care.
Unilateral and bilateral acute pyelonephritis: differences in clinical presentation, progress and outcome
Authors: Lee Yu-Ji , Cho Seong , Kim Sung Rok 
Published: November 2013

Abstract

Purpose
Acute pyelonephritis (APN) generally involves a single kidney, but it can be bilateral. The aim of the present study was to evaluate differences in clinical presentation, progress and outcome for bilateral APN compared with unilateral APN.

Study design
The medical records of all patients over 19 years of age, hospitalised for APN and who underwent abdominal enhanced CT at Samsung Changwon Hospital between January 2009 and August 2012 were retrospectively reviewed. Patients were divided into two groups according to whether unilateral or bilateral lesions were identified on the CT scan.

Results
Of the 296 patients, 99 had bilateral APN. Only 64/86 (74.4%) patients with clear tenderness in the bilateral APN group had bilateral tenderness. Patients with bilateral APN had more severe abnormalities, based on the results of laboratory tests. Leukocytosis, thrombocytopenia, bacteraemia, acute kidney injury, shock and death occurred more frequently in bilateral than in unilateral APN. In the bilateral APN group, broad spectrum antibiotics were used more frequently as an initial antibiotic treatment. A history of stroke or diabetes mellitus, and duration of symptoms before admission, were independent risk factors associated with bilateral APN.

Conclusions
Patients with bilateral APN experienced more severe clinical and laboratory manifestations and had a poorer outcome than those with unilateral APN. Early imaging tests can be considered to discriminate unilateral from bilateral APN, especially in those with a history of stroke or diabetes and with a longer duration of symptoms. Moreover, initial use of broader spectrum antibiotics can be considered in patients with bilateral APN.
Shenqi Fuzheng Injection Alleviates the Transient Worsening Caused by Steroids Pulse Therapy in Treating Myasthenia Gravis
Authors: Qi Guo-Yan , Liu Peng , Gao Bu-Lang 
Published: November 2013

Purpose. To evaluate the treatment effect and side effect of Shenqi Fuzheng Injection (SFI) on alleviating transient worsening of myasthenia gravis (MG) symptoms caused by high-dose steroids pulse therapy.Methods. Sixty-six consecutive patients with MG were randomly divided into two groups: the treatment group treated with SFI and methylprednisolone pulse therapy (MPT) and the control group treated with MPT alone. The severity of MG before, during, and after MPT and the duration of transient worsening (TW) were evaluated and compared with the clinical absolute scoring (AS) and relative scoring (RS) system.Results. Twenty-nine patients experienced TW in each group. At TW, the AS was significantly increased (P<0.000) in both groups compared with baseline data, with the AS increase in the treatment group (16.8 ± 2) significantly smaller (P<0.05) than in the control group (24.9 ± 2.5). At the end of the treatment course, the AS for the treatment group was significantly decreased (7.5 ± 0.9) compared with at TW, although no significant difference compared with the control (9.7 ± 1.1). The TW lasted 1–6 days (mean 3.7) for the treatment group, significantly shorter (P<0.05) than 2–12 days (mean 7.8) for the control. The RS for the treatment group at the end of treatment was 43.8%–100% (mean 76.8% ± 2.6%), significantly better than the control group: 33.3%–100% (mean 67.2 ± 3.6%). Slight side effects (18.75%) included maldigestion and rash in the treatment group.Conclusion. SFI has a better treatment effect and few side effects and can alleviate the severity and shorten the duration of the transient worsening of MG during steroids pulse therapy.Erratum to “Shenqi Fuzheng Injection Alleviates the Transient Worsening Caused by Steroids Pulse Therapy in Treating Myasthenia Gravis”
Circadian Regulation of mTOR by the Ubiquitin Pathway in Renal Cell Carcinoma
Authors: Okazaki Hiroyuki , Matsunaga Naoya , Fujioka Takashi , Okazaki Fumiyasu , Akagawa Yui , Tsurudome Yuuya , Ono Mayumi , Kuwano Michihiko , Koyanagi Satoru , Ohdo Shigehiro 
Published: November 2013

Abstract
Circadian clock systems regulate many biologic functions, including cell division and hormone secretion in mammals. In this study, we explored the effects of circadian control on the pivot cell growth regulatory mTOR, the activity of which is deregulated in tumor cells compared with normal cells. Specifically, we investigated whether the antitumor effect of an mTOR inhibitor could be improved by changing its dosing schedule in RenCa tumor-bearing mice. Active, phosphorylated mTOR displayed a 24-hour rhythm, and levels of total mTOR protein (but not mRNA) also showed a circadian rhythm in RenCa tumor masses. Through investigations of the oscillation mechanism for mTOR expression, we identified the ubiquitination factor Fbxw7 as an mTOR regulator that oscillated in its expression in a manner opposite from mTOR. Fbxw7 transcription was regulated by the circadian regulator D-site–binding protein. Notably, administration of the mTOR inhibitor everolimus during periods of elevated mTOR improved survival in tumor-bearing mice. Our findings demonstrate that the circadian oscillation of mTOR activity is regulated by circadian clock systems, which influence the antitumor effect of mTOR inhibitors. Cancer Res; 74(2); 543–51. ©2013 AACR.
Prognostic Impact of Cigarette Smoking on the Survival of Patients with Established Nasopharyngeal Carcinoma
Authors: OuYang Pu-Yun , Su Zhen , Mao Yan-Ping , Liang Xue-Xia , Liu Qing , Deng Wuguo , Xie Fang-Yun 
Published: November 2013

Abstract
Background: Cigarette smoking is associated with the etiology of nasopharyngeal carcinoma; however, the influence of smoking on survival in patients with established nasopharyngeal carcinoma remains unknown.
Methods: We retrospectively analyzed 1,849 patients with nasopharyngeal carcinoma who were categorized as never, former, and current smokers. Cumulative effect of smoking was defined in terms of pack-years. Associations between cigarette exposure and survival were estimated by Cox proportional hazards model.
Results: The risks of death, progression, locoregional relapse, and distant metastasis were significantly higher for former and current smokers (all P ≤ 0.002) than never smokers. Heavy smokers with high pack-years had HRs for death of 3.31 [95% confidence interval (CI), 2.58–4.26; P &lt; 0.001], for progression of 2.53 (95% CI, 2.03–3.16; P &lt; 0.001), and for distant metastasis of 2.65 (95% CI, 1.89–3.70; P &lt; 0.001). Specifically, in the cohort of 495 patients treated with intensity-modulated radiotherapy/three-dimensional conformal radiotherapy, we obtained similarly significant results. All of the survival outcomes remained significant in multivariate analyses.
Conclusions: Pretreatment cigarette smoking is an independent, poor prognostic factor for patients with nasopharyngeal carcinoma, which is associated with increased risk of death, progression, locoregional relapse, and distant metastasis, with the risk increasing with pack-years.
Impact: It is clear that cigarette smoking not only promotes carcinogenesis in the normal nasopharyngeal epithelium, but also affects the survival of patients with nasopharyngeal carcinoma. Cancer Epidemiol Biomarkers Prev; 22(12); 2285–94. ©2013 AACR.
Cognitive Factors Associated with Adherence to Oral Antiestrogen Therapy: Results from the Cognition in the Study of Tamoxifen and Raloxifene (Co-STAR) Study
Authors: Klepin Heidi D. , Geiger Ann M. , Bandos Hanna , Costantino Joseph P. , Rapp Stephen R. , Sink Kaycee M. , Lawrence Julia A. , Atkinson Hal H. , Espeland Mark A. 
Published: November 2013

AbstractLittle is known about the cognitive factors associated with adherence to antiestrogen therapy. Our objective was to investigate the association between domain-specific cognitive function and adherence among women in a clinical prevention trial of oral antiestrogen therapies. We performed a secondary analysis of Co-STAR, an ancillary study of the STAR breast cancer prevention trial in which postmenopausal women at increased breast cancer risk were randomized to tamoxifen or raloxifene. Co-STAR enrolled nondemented participants ≥65 years old to compare treatment effects on cognition. The cognitive battery assessed global cognitive function (Modified Mini-Mental State Exam), and specific cognitive domains of verbal knowledge, verbal fluency, figural memory, verbal memory, attention and working memory, spatial ability, and fine motor speed. Adherence was defined by a ratio of actual time taking therapy per protocol ≥80% of expected time. Logistic regression was used to evaluate the association between cognitive test scores and adherence to therapy. The mean age of the 1,331 Co-STAR participants was 67.2 ± 4.3 years. Mean 3MS score was 95.1 (4.7) and 14% were nonadherent. In adjusted analyses, the odds of nonadherence were lower for those with better scores on verbal memory [OR (95% confidence interval): 0.75 (0.62–0.92)]. Larger relative deficits in verbal memory compared with verbal fluency were also associated with nonadherence [1.28 (1.08–1.51)]. Among nondemented older women, subtle differences in memory performance were associated with medication adherence. Differential performance across cognitive domains may help identify persons at greater risk for poor adherence. Cancer Prev Res; 7(1); 161–8. ©2013 AACR.