bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative outcomes of elderly and non‐elderly patients receiving first‐line palliative chemotherapy for advanced biliary tract cancer
Authors: Kou Tadayuki , Kanai Masashi , Ikezawa Kenji , Ajiki Tetsuo , Tsukamoto Tadashi , Toyokawa Hideyoshi , Yazumi Shujiro , Terajima Hiroaki , Furuyama Hiroaki , Nagano Hiroaki , Ikai Iwao , Kuroda Nobukazu , Awane Masaaki , Ochiai Toshiya , Takemura Shigekazu , Miyamoto Atsushi , Kume Makoto , Ogawa Masao , Takeda Yutaka , Taira Kaoru , Ioka Tatsuya 
Published: July 2013

AbstractBackground and AimFew studies have reported the efficacy and safety of palliative chemotherapy in elderly patients with advanced biliary tract cancer. We aimed to investigate the clinical outcomes of palliative chemotherapy for advanced biliary tract cancer in elderly patients.MethodsWe retrospectively evaluated 403 consecutive patients who received palliative chemotherapy between April 2006 and March 2009 for pathologically confirmed unresectable or recurrent biliary tract cancer. Clinical outcomes of the elderly group (≥ 75 years old; n = 94) were compared with those of the non‐elderly group (< 75 years old; n = 309).ResultsExcept for the extent of disease, patient baseline characteristics were well balanced between both groups. The median overall survival was 10.4 months in the elderly group and 11.5 months in the non‐elderly group (hazard ratio, 1.14; 95% confidence interval, 0.89–1.45; P = 0.31). Although the frequency of adverse events between both groups was similar, interstitial pneumonitis was significantly more frequent in the elderly group than in the non‐elderly group (4.3% vs 0%, P < 0.01).ConclusionsIn advanced biliary tract cancer, overall survival of elderly patients receiving palliative chemotherapy is comparable with that of non‐elderly patients. To our knowledge, this is one of the largest studies that have reported the clinical outcomes of elderly patients following palliative chemotherapy.
Anti‐programmed cell death‐1 antibody as a new serological marker for type 1 autoimmune hepatitis
Authors: Matsumoto Kazuyuki , Miyake Yasuhiro , Matsushita Hiroshi , Ohnishi Atsuyuki , Ikeda Fusao , Shiraha Hidenori , Takaki Akinobu , Nouso Kazuhiro , Yamamoto Kazuhide 
Published: July 2013

AbstractBackground and AimRecently, the association of the dysfunction of programmed cell death (PD)‐1 expressed on activated lymphocytes with the pathogenesis of autoimmune hepatitis (AIH) has been speculated. This study aimed to investigate the association of serum anti‐PD‐1 antibodies with clinical characteristics of type 1 AIH.MethodsSerum samples before the initiation of prednisolone treatment were obtained from 52 type 1 AIH patients, 24 patients with drug‐induced liver injury (DILI), 30 patients with acute viral hepatitis (AVH), 11 patients with primary sclerosing cholangitis (PSC), and 62 healthy volunteers. Titers of serum anti‐PD‐1 antibodies were measured by indirect enzyme‐linked immunosorbent assay. The cutoff level was represented by a mean absorbance + 2 standard deviations in healthy volunteers.ResultsPrevalence of serum anti‐PD‐1 antibodies was 63% in type 1 AIH patients, 8% in DILI patients, 13% in AVH patients, 18% in PSC patients, and 3% in healthy volunteers. In type 1 AIH patients, titers of serum anti‐PD‐1 antibodies were correlated with serum levels of bilirubin (r = 0.31, P = 0.030) and alanine aminotransferase (r = 0.31, P = 0.027) but not serum immunoglobulin G levels. Positivity for serum anti‐PD‐1 antibodies was associated with the later normalization of serum alanine aminotransferase levels after the initiation of prednisolone and the disease relapse.ConclusionsSerum anti‐PD‐1 antibodies would be useful for the discrimination of type 1 AIH from DILI, AVH, and PSC as an auxiliary diagnostic marker. Furthermore, anti‐PD‐1 antibodies may be associated with clinical characteristics of type 1 AIH.
Promoter‐like sequences regulating transcriptional activity in neurexin and neuroligin genes
Authors: Runkel Fabian , Rohlmann Astrid , Reissner Carsten , Brand Stefan‐Martin , Missler Markus 
Published: July 2013

AbstractSynapse function requires the cell‐adhesion molecules neurexins (Nrxn) and neuroligins (Nlgn). Although these molecules are essential for neurotransmission and prefer distinct isoform combinations for interaction, little is known about their transcriptional regulation. Here, we started to explore this important aspect because expression of Nrxn1‐3 and Nlgn1‐3 genes is altered in mice lacking the transcriptional regulator methyl‐CpG‐binding protein2 (MeCP2). Since MeCP2 can bind to methylated CpG‐dinucleotides and Nrxn/Nlgn contain CpG‐islands, we tested genomic sequences for transcriptional activity in reporter gene assays. We found that their influence on transcription are differentially activating or inhibiting. As we observed an activity difference between heterologous and neuronal cell lines for distinct Nrxn1 and Nlgn2 sequences, we dissected their putative promoter regions. In both genes, we identify regions in exon1 that can induce transcription, in addition to the alternative transcriptional start points in exon2. While the 5′‐regions of Nrxn1 and Nlgn2 contain two CpG‐rich elements that show distinct methylation frequency and binding to MeCP2, other regions may act independently of this transcriptional regulator. These data provide first insights into regulatory sequences of Nrxn and Nlgn genes that may represent an important aspect of their function at synapses in health and disease.
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Neurexins and neuroligins constitute large families of synaptic cell‐surface molecules that play essential roles in neurotransmission and are linked to autism spectrum disorders and schizophrenia. To better understand their gene regulation, we analyze putative promoter regions for transcriptional activity. Expression involves the brain‐specific regulator MeCP2 and methylation frequency, suggesting an unexpected pathway for regulating their distribution, splicing or activity‐dependent plasticity.
Effects of VMAT2 inhibitors lobeline and GZ‐793A on methamphetamine‐induced changes in dopamine release, metabolism and synthesis in vivo
Authors: Meyer Andrew C. , Neugebauer Nichole M. , Zheng Guangrong , Crooks Peter A. , Dwoskin Linda P. , Bardo Michael T. 
Published: July 2013

AbstractVesicular monoamine transporter‐2 (VMAT2) inhibitors reduce methamphetamine (METH) reward in rats. The current study determined the effects of VMAT2 inhibitors lobeline (LOB; 1 or 3 mg/kg) and N‐(1,2R‐dihydroxylpropyl)‐2,6‐cis‐di(4‐methoxyphenethyl)piperidine hydrochloride (GZ‐793A; 15 or 30 mg/kg) on METH‐induced (0.5 mg/kg, SC) changes in extracellular dopamine (DA) and its metabolite dihydroxyphenylacetic acid (DOPAC) in the reward‐relevant nucleus accumbens (NAc) shell using in vivo microdialysis. The effect of GZ‐793A (15 mg/kg) on DA synthesis in tissue also was investigated in NAc, striatum, medial prefrontal cortex and orbitofrontal cortex. In NAc shell, METH produced a time‐dependent increase in extracellular DA and decrease in DOPAC. Neither LOB nor GZ‐793A alone altered extracellular DA; however, both drugs increased extracellular DOPAC. In combination with METH, LOB did not alter the effects of METH on DA; however, GZ‐793A, which has greater selectivity than LOB for inhibiting VMAT2, reduced the duration of the METH‐induced increase in extracellular DA. Both LOB and GZ‐793A enhanced the duration of the METH‐induced decrease in extracellular DOPAC. METH also increased tissue DA synthesis in NAc and striatum, whereas GZ‐793A decreased synthesis; no effect of METH or GZ‐793A on DA synthesis was found in medial prefrontal cortex or orbitofrontal cortex. These results suggest that selective inhibition of VMAT2 produces a time‐dependent decrease in DA release in NAc shell as a result of alterations in tyrosine hydroxylase activity, which may play a role in the ability of GZ‐793A to decrease METH reward.
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We determined if inhibition of the vesicular monoamine transporter (VMAT2) alters METH‐induced changes in dopamine (DA) release, metabolism, and synthesis in vivo. Our results suggest that selective inhibition of VMAT2 produces a time‐dependent decrease in DA release as a result of alterations in tyrosine hydroxylase (TH) activity, which may play a role in the ability of the VMAT2 inhibitor GZ‐793A to decrease METH reward.
TRPC6 channel‐mediated neurite outgrowth in PC12 cells and hippocampal neurons involves activation of RAS/MEK/ERK, PI3K, and CAMKIV signaling
Authors: Heiser Jeanine H. , Schuwald Anita M. , Sillani Giacomo , Ye Lian , Müller Walter E. , Leuner Kristina 
Published: July 2013

AbstractThe non‐selective cationic transient receptor canonical 6 (TRPC6) channels are involved in synaptic plasticity changes ranging from dendritic growth, spine morphology changes and increase in excitatory synapses. We previously showed that the TRPC6 activator hyperforin, the active antidepressant component of St. John's wort, induces neuritic outgrowth and spine morphology changes in PC12 cells and hippocampal CA1 neurons. However, the signaling cascade that transmits the hyperforin‐induced transient rise in intracellular calcium into neuritic outgrowth is not yet fully understood. Several signaling pathways are involved in calcium transient‐mediated changes in synaptic plasticity, ranging from calmodulin‐mediated Ras‐induced signaling cascades comprising the mitogen‐activated protein kinase, PI3K signal transduction pathways as well as Ca2+/calmodulin‐dependent protein kinase II (CAMKII) and CAMKIV. We show that several mechanisms are involved in TRPC6‐mediated synaptic plasticity changes in PC12 cells and primary hippocampal neurons. Influx of calcium via TRPC6 channels activates different pathways including Ras/mitogen‐activated protein kinase/extracellular signal‐regulated kinases, phosphatidylinositide 3‐kinase/protein kinase B, and CAMKIV in both cell types, leading to cAMP‐response element binding protein phosphorylation. These findings are interesting not only in terms of the downstream targets of TRPC6 channels but also because of their potential to facilitate further understanding of St. John's wort extract‐mediated antidepressant activity.
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Alterations in synaptic plasticity are considered to play an important role in the pathogenesis of depression. Beside several other proteins, TRPC6 channels regulate synaptic plasticity. This study demonstrates that different pathways including Ras/MEK/ERK, PI3K/Akt, and CAMKIV are involved in the improvement of synaptic plasticity by the TRPC6 activator hyperforin, the antidepressant active constituent of St. John's wort extract.
Quantitative analysis of microscopicX‐ray computed tomography imaging: Japanese quail embryonic soft tissues with iodine staining
Authors: Tahara Rui , Larsson Hans C. E. 
Published: July 2013

AbstractRapid three‐dimensional imaging of embryos to better understand the complex process of morphogenesis has been challenging. Recently introduced iodine staining protocols (I2KIand alcoholic iodine stains) combined with microscopic X‐ray computed tomography allows visualization of soft tissues in diverse small organisms and tissue specimens.I2KIprotocols have been developed specifically for small animals, with a limited number of quantitative studies of soft tissue contrasts. To take full advantage of the low X‐ray attenuation of ethanol and retain bound iodine while dehydrating the specimen in ethanol, we developed an ethanolI2KIprotocol. We present comparative microscopic X‐ray computed tomography analyses of ethanolI2KIand I2KIstaining protocols to assess the performance of this new protocol to visualize soft tissue anatomy in late stage Japanese quail embryos using quantitative measurements of soft tissue contrasts and sample shrinkage. Both protocols had only 5% shrinkage compared with the original harvested specimen, supporting the use of whole mounts to minimize tissue shrinkage effects. Discrimination within and among the selected organs with each staining protocol and microscopic X‐ray computed tomography imaging were comparable to those of a gray scale histological section. Tissue discrimination was assessed using calibratedcomputed tomographyvalues and a newdiscriminationindex to quantify the degree ofcomputed tomographyvalue overlaps between selected soft tissue regions. Tissue contrasts were dependent on the depth of the tissue within the embryos before the embryos were saturated with each stain solution, and optimal stain saturations for the entire embryo were achieved at 14 and 28 days staining forI2KIand ethanolI2KI, respectively. EthanolI2KIprovided superior soft tissue contrasts by reducing overstaining of fluid‐filled spaces and differentially modulating staining of some tissues, such as bronchial and esophageal walls and spinal cord. Delineating the selected soft tissues using optimal threshold ranges derived from the quantitative analyses of the contrast enhancement in optimally stained embryos is possible. The protocols presented here are expected to be applicable to other organisms with modifications to staining time and contribute toward rapid and more efficient segmentation of soft tissues for three‐dimensional visualization.
‘Safe enough in here?’: patients' expectations and experiences of feeling safe in an acute psychiatric inpatient ward
Authors: Stenhouse Rosemary C 
Published: July 2013

Aims and objectivesTo understand the experience of being a patient on an acute psychiatric inpatient ward.BackgroundAcute psychiatric inpatient care is an integral part of the mental health system. A key driver for admission to acute wards is risk. Previous research indicates that people do not always feel safe when in an acute ward. Understanding the patient experience of safety can influence nursing practice, as well as policy and service development.DesignA qualitative approach was used. Patient experience was conceptualised as represented through narrative as data. Sociolinguistic theories linking narrative structure with meaning informed the development of the analytic framework.MethodsThirteen patients with a variety of diagnoses were recruited from an acute ward. Unstructured interviews were carried out in participants' homes two and six weeks postdischarge. Holistic analysis of each individual's data set was undertaken. Themes running across these holistic analyses were then identified and developed.ResultsParticipant narratives were focused around themes of help, safety and power. This study presents findings relating to the experience of safety. Participants expected to be safe from themselves and from others. Initially, they experienced a sense of safety from the outside world. Lack of knowledge of their fellow patients made them feel vulnerable. Participants expected the nurses to keep them safe, and felt safer when there were male nurses present.ConclusionsParticipants talk about safety in terms of psychological and physical safety. A key issue was the perception of threat from other patients, highlighting the need to consider patient safety as more than physical safety.Relevance to practiceNurses need to be sensitive to the possibility that patients feel unsafe in the absence of obvious threat. Institutional structures that challenge patients' sense of safety must be examined.
The performance of an online osteoporosis detection system a sensitivity and specificity analysis
Authors: Chang Shu Fang , Hong Chin Ming , Yang Rong Sen 
Published: July 2013

Aims and objectivesTo develop an online system for the detection of osteoporosis risk and to test its accuracy.BackgroundOsteoporosis is a silent killer; usually, there are no symptoms, such as pain, until bone erosion and fracture occur. The risks of osteoporosis have been underestimated and neglected; as a result, osteoporosis can be as dangerous as heart diseases and cancers that lead to a healthcare crisis.DesignCross‐sectional study.MethodsThe study participants were individuals presenting for routine health examinations at a medical centre in Taiwan from 2006–2007. Women over 30 years of age who underwent dual‐energy X‐ray absorptiometry scanning for measurement of bone mineral density were eligible for this study. The system for osteoporosis detection and health risk, which was developed in this study, was analysed.ResultsThe findings indicated a high sensitivity of 75%, specificity of 75%, positive predictive value of 75% and negative predictive value of 75%. In addition, the online osteoporosis detective system had a higher predictive power (24·2% vs. 11%) and a similar cut‐off point (33% vs. 27%) compared with the tool designed by the International Osteoporosis Foundation.ConclusionThe online system for detection of osteoporosis risk had excellent reliability and validity. It performed well in predicting osteoporosis and the cut‐off point used for identifying the risk among women at risk of developing osteoporosis. Therefore, it is suitable for the Asian women and can help women achieve the goals of early detection and health promotion.Relevance to clinical practiceEarly detection is the only way to prevent osteoporosis. Professional nurses should apply effective technology to promote health care in community‐dwelling people.
Psychometric properties of the self‐efficacy for clinical evaluation scale in Turkish nursing students
Authors: Zengin Neriman , Pınar Rukiye , Akinci Ayse Cil , Yildiz Hicran 
Published: July 2013

Aims and objectivesTo examine psychometric properties of the Self‐Efficacy for Clinical Evaluation Scale (SECS) in a nursing student sample.BackgroundSelf‐efficacy is a good choice to be used in order to make a prediction of nursing students' performance in clinical practice. TheSECS, consisting of perceived self‐efficacy and importance subscales, seems to be suitable to evaluate self‐efficacy regarding care skills for patients with chronic diseases. However, there is not a valid tool to evaluate the perception of self‐efficacy for Turkish nursing students.DesignCross‐sectional methodological design.MethodsThe sample included 400 Turkish nursing students who attended practicum at a hospital. Content of theSECSwas evaluated by content validity index (CVI). Reliability was evaluated with internal consistency, item–total correlation and test–retest reliability. Confirmatory factor analysis (CFA) and convergent and divergent validity were used to test the validity.ResultsTheCVIresults were satisfactory. We found satisfactory evidence for internal consistency and item–total correlations. Intraclass correlation coefficients showed stability of subscales. TheCFAreplicated two‐factor structure for theSECS. This was reflected in all fit indices. All factor loadings were positive and were above the perfect level. The convergent validity was supported by the correlation betweenSECSand General Self‐Efficacy Scale. The divergent validity findings demonstrated thatSECSdifferentiated between students with various levels of general point average, which is an indicator of academic success.ConclusionIn conclusion,SECSis a reliable and valid tool used in clinical nursing education settings.Relevance to clinical practiceMeasuring students' self‐efficacy in a clinical environment can provide an insight for students into what they have learned. Nurse educators can also use theSECSto spot nursing students with weaknesses in care activities and create educational strategies to help them to enhance their academic performance. Using theSECScan yield an insight both for students and for nursing educators.
Sexual lives of women with diabetes mellitus (type 2) and impact of culture on solution for problems related to sexual life
Authors: Kaya Erten Zeliha , Zincir Handan , Özkan Filiz , Selçuk Alime , Elmali Ferhan 
Published: July 2013

Aims and objectivesTo examine sexual lives of women with diabetes mellitus (type 2) (DM) and impact of culture on solution for problems related to sexual life.BackgroundDM has long been considered a risk factor for sexual dysfunction in men and women, although the evidence in women is less clear. This study was conducted to emphasise the effect of DM and culture on sexual life.DesignA descriptive and qualitative study.MethodsPlanned as descriptive and qualitative, this study was conducted with 38 women who matched with the following inclusion criterion: living in a neighbourhood with low socio‐economic status in the province of Kayseri, Turkey. The Participant Information Form, Diabetes Control Form, the Arizona Sexual Experiences Scale (ASEX), Sexual Life Definition Form and Semi‐Structured Interview Form for revealing problems lived in sexual life, besides the results of laboratory tests, were used for data collection.ResultsMean age of the participating women was 51·34 ± 5·85 years. Total score of ASEX was found to be correlated with the type of DM treatment, duration of DM diagnosis, complications of DM, relation with her husband, level of HbA1c and systolic–diastolic blood pressure (p < 0·05). Of the participating women, 47·4% expressed that they had problems with sexual relation.ConclusionMost of the women with DM were determined to have problems in sexual functions besides the disease, and the impact of culture on the solution for problems lived within sexual life was effective.Relevance to clinical practiceThese findings can help guide to raise the health of Turkish women with diabetes and to plan appropriate nursing interventions.
Evaluation of the currency of the Davies and Oberle (1990) model of supportive care in specialist and specialised palliative care settings in England
Authors: Newton Jenni , McVicar Andrew 
Published: July 2013

Aims and objectivesTo evaluate the extent to which the Davies and Oberle (1990) model of supportive nursing has currency across specialist and specialised care settings in England.BackgroundThe model describes attributes of palliative nursing for practice and associated educational curricula. It is influential but predates introduction of specialist/specialised care. Its applicability in contemporary care settings has not been evaluated.DesignEvaluation was undertaken using sequential mixed methods, predominantly qualitative. Data collected during 2008–2009.MethodsFour stages: (1) focus groups involving hospital and community palliative clinical nurse specialists and nurses from three hospice settings (total = 25) to identify setting‐specific characteristics, (2) survey of nurses (n = 48 respondents/31%) with follow‐up interviews (n = 25) to identify congruence with the model, (3) interviews with patients (n = 6) and carers (n = 13) for practice evidence and (4) reconvened focus groups (n = 19 nurses) for confirmation.ResultsAll major dimensions were evidenced. ‘Connecting’ had reduced emphasis in the hospital setting where specialist nurses spend limited time with patients, but diminishing time to ‘connect’ with patients and carers as service develops could potentially become problematic across all settings. Two new dimensions (‘Displaying expertise’ and ‘Influencing other professionals’) with subdimensions (e.g. ‘Advanced communication skills’) are proposed as additions to reflect advanced practice. Further new subdimensions (‘Making the assessment’, ‘Prioritising’, ‘Agreeing the plan’) are suggested to be best aligned with the existing dimension ‘Connecting’.ConclusionsA revised model of supportive care incorporating dimensions of advanced nursing has currency in contemporary specialist/specialised care settings, although evaluation is required as to the actual impact of the model on care outcomes. ‘Connecting’ is currently being affected by pace of work and lateness of referrals.Implications for practice‘Spending time’ is increasingly difficult to sustain so challenging nurses as to how they may continue to ‘connect’ with patients as service delivery continues to change.