bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of docetaxel plus oxaliplatin as a first‐line chemotherapy in patients with advanced or metastatic non‐small cell lung cancer
Authors: Ban Heejung , Kim Kyu‐Sik , Oh In‐Jae , Yoon Seong‐Hoon , Lee Boram , Yu Jinyeong , Kim Sunmin , Lee Ho‐Sung , Shin Hong‐Joon , Park Cheol‐Kyu , Kwon Yong‐Soo , Kim Yu‐Il , Lim Sung‐Chul , Kim Young‐Chul 
Published: April 2014

AbstractBackgroundPlatinum doublets are standard first‐line treatment for stage IV non‐small cell lung cancer (NSCLC) without targetable driver mutations. Oxaliplatin is more potent than cisplatin, requiring fewer DNA adducts to provide equivalent cytotoxicity. The objective of this study was to evaluate the efficacy and safety of oxaliplatin combined with docetaxel as a first‐line treatment for stage IV NSCLC.MethodsThis was a prospective, single‐center, phase II trial. Patients with chemotherapy‐naive NSCLC received 60 mg/m2 docetaxel (day 1) and 70 mg/m2 oxaliplatin (day 2) every three weeks for up to six cycles. The primary endpoint was objective response rate (ORR), and the secondary endpoints were progression‐free survival (PFS), overall survival (OS), and safety. Treatment response was evaluated according to Response Evaluation Criteria in Solid Tumors version 1.1.ResultsThirty‐three patients were enrolled and a response evaluation was available in 31 patients. There were 11 patients with a partial response, 15 with stable disease, and five with progressive disease. Two patients ceased further treatment after the first cycle of chemotherapy. Thus, the ORR was 33.3% in the 33 patients of the intention‐to‐treat population. Median PFS was 3.6 months (95% confidence interval [CI], 2.8–4.5), and median OS was 10.9 months (95% CI, 8.2–13.6). The most common hematologic toxicity was neutropenia. Grade 3–4 neutropenia occurred in 51.5% of patients.ConclusionThe results suggest that the combination of oxaliplatin and docetaxel is effective in patients with NSCLC with reasonable toxicity.
A retrospective review of the therapeutic response with remission in patients with newly diagnosed bullous pemphigoid
Authors: Chuah Sai Yee , Tan Suat Hoon , Chua Sze Hon , Tang Mark B.Y. , Lim Yen Loo , Neoh Ching Yin , Tan Audrey WH 
Published: April 2014

AbstractWe reviewed the clinical characteristics and therapeutic response in cases of newly diagnosed bullous pemphigoid at the National Skin Centre between June 2009 and December 2010. Most (76%, n = 68/90) achieved clinical remission within 6 months of commencement of therapy. Oral mucosal involvement was identified as a risk factor associated with a prolonged duration of treatment beyond 6 months.
The Responsibility Objection to Abortion: Rejecting the Notion that the Responsibility Objection Successfully Refutes a Woman's Right to Choose
Authors: McDaniel Ian 
Published: April 2014

AbstractThis article considers the objection to abortion that a woman who voluntarily engages in sexual activity is responsible for her fetus and so cannot have an abortion. The conclusion argued for is that the conceptions of responsibility that can ground the objection that are considered do not necessitate a requirement on the part of a pregnant woman to carry her pregnancy to term. Thus, the iterations of the responsibility objection presented cannot be used to curtail reproductive choice.
Comorbid Rat Model of Ischemia and β‐Amyloid Toxicity: Striatal and Cortical Degeneration
Authors: Amtul Zareen , Whitehead Shawn N. , Keeley Robin J. , Bechberger John , Fisher Alicia L. , McDonald Robert J. , Naus Christian C. , Munoz David G. , Cechetto David F. 
Published: April 2014

AbstractLevels of cerebral amyloid, presumably β‐amyloid (Abeta), toxicity and the incidence of cortical and subcortical ischemia increases with age. However, little is known about the severe pathological condition and dementia that occur as a result of the comorbid occurrence of this vascular risk factor and Abeta toxicity. Clinical studies have indicated that small ischemic lesions in the striatum are particularly important in generating dementia in combination with minor amyloid lesions. These cognitive deficits are highly likely to be caused by changes in the cortex. In this study, we examined the viability and morphological changes in microglial and neuronal cells, gap junction proteins (connexin43) and neuritic/axonal retraction (Fer Kinase) in the striatum and cerebral cortex using a comorbid rat model of striatal injections of endothelin‐1 (ET1) and Abeta toxicity. The results demonstrated ventricular enlargement, striatal atrophy, substantial increases in β‐amyloid, ramified microglia and increases in neuritic retraction in the combined models of stroke and Abeta toxicity. Changes in connexin43 occurred equally in both groups of Abeta‐treated rats, with and without focal ischemia. Although previous behavioral tests demonstrated impairment in memory and learning, the visual discrimination radial maze task did not show significant difference, suggesting the cognitive impairment in these models is not related to damage to the dorsolateral striatum. These results suggest an insight into the relationship between cortical/striatal atrophy, pathology and functional impairment.
Meta‐Analysis of the Effects of Forest Fragmentation on Interspecific Interactions
Authors: MAGRACH AINHOA , LAURANCE WILLIAM F. , LARRINAGA ASIER R. , SANTAMARIA LUIS 
Published: April 2014

AbstractForest fragmentation dramatically alters species persistence and distribution and affects many ecological interactions among species. Recent studies suggest that mutualisms, such as pollination and seed dispersal, are more sensitive to the negative effects of forest fragmentation than antagonisms, such as predation or herbivory. We applied meta‐analytical techniques to evaluate this hypothesis and quantified the relative contributions of different components of the fragmentation process (decreases in fragment size, edge effects, increased isolation, and habitat degradation) to the overall effect. The effects of fragmentation on mutualisms were primarily driven by habitat degradation, edge effects, and fragment isolation, and, as predicted, they were consistently more negative on mutualisms than on antagonisms. For the most studied interaction type, seed dispersal, only certain components of fragmentation had significant (edge effects) or marginally significant (fragment size) effects. Seed size modulated the effect of fragmentation: species with large seeds showed stronger negative impacts of fragmentation via reduced dispersal rates. Our results reveal that different components of the habitat fragmentation process have varying impacts on key mutualisms. We also conclude that antagonistic interactions have been understudied in fragmented landscapes, most of the research has concentrated on particular types of mutualistic interactions such as seed dispersal, and that available studies of interspecific interactions have a strong geographical bias (arising mostly from studies carried out in Brazil, Chile, and the United States).Meta‐Análisis de los Efectos de la Fragmentación del Bosque sobre las Interacciones Interespecíficas
Implants and contact allergy: are sensitizing metals released as haptens from coronary stents?
Authors: Svedman Cecilia , Möller Halvor , Gruvberger Birgitta , Gustavsson Carl‐Gunnar , Dahlin Jakob , Persson Lena , Bruze Magnus 
Published: April 2014

SummaryBackgroundThe possible impact of metal release from coronary artery stents has, with their increased use, become a concern.ObjectivesTo study in vitro metal release in biologically relevant milieu from coronary stents made of different alloys.Materials and methodCoronary stents in common use in a department of cardiology at the time of the study were tested. A previously described in vitro technique was used, whereby the stents were kept in the extraction media for a week. Two different extraction media were used to show the necessity of studying the actual biological surrounding of the implant when metal release is investigated. Metal release was determined with atomic absorption spectrometry.ResultsIn this study, we show metal release from stents after immersion in extraction media of artificial sweat and cysteine solution, as illustrative media.ConclusionMetal release from coronary stents is shown. The magnitude of release is influenced by several factors. The extent to which metal release in vitro has potential biological effects, in terms of elicitation of an allergic reaction or induction of sensitization, in vivo needs to be explored. However, as metal release from an implant in a biologically appropriate medium has been established, better risk assessments in relation to delayed hypersensitivity may be undertaken.
The acute effect of moderate intensity aquatic exercise on coagulation factors in haemophiliacs
Authors: Beltrame Luis Gustavo Normanton , Abreu Laurinda , Almeida Jussara , Boullosa Daniel Alexandre 
Published: April 2014

SummaryThe objective of this cross‐sectional study was to analyse the acute effect of aquatic exercise on haemostasis in persons with haemophilia. Ten adult haemophiliacs (8 type A, 2 type B) familiarized with aquatic training performed a 20‐min exercise session in a swimming pool at an intensity of ~70% maximum heart rate (HR). Blood samples were collected immediately after the training session. The haemostatic parameters selected for analyses were factor VIII (FVIII), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen. There were unclear effects of the exercise bout on FVIII and APTT, with a possibly beneficial effect on PT (−11·4%; 90% confidence interval: −26·1;3·3%), and a trivial change on fibrinogen levels. It was found an association between the mean rise in HR during exercise and the decrement in PT after exercise (r = 0·729; P = 0·026). The greater changes were observed in the patients diagnosed with a moderate level of haemophilia. It is concluded that a short bout of moderate intensity of aquatic exercise may have a positive influence on PT in adults with haemophilia with greater changes in those individuals exhibiting a greater rise in HR during exercise. This may be an important issue to the haemostatic control of haemophiliacs in clinical settings. Further studies are warranted for testing the influence of different aquatic exercise intensities on haemostasis.
The prognostic value of D‐dimer in lung cancer
Authors: İnal Tuba , Anar Ceyda , Polat Gülru , Ünsal İpek , Halilçolar Hüseyin 
Published: April 2014

AbstractBackground and AimActivation of coagulation and fibrinolysis is frequently encountered among cancer patients. Such tumors are supposed to be associated with higher risk of invasion, metastases and eventually worse outcome. The aim of this study is to explore the prognostic value of blood coagulation tests for lung cancer patients.MethodsBetween 2009 and 2012, 72 newly diagnosed patients with lung cancer and 40 healthy subjects as control group were included in this prospective study. Patients were staged according to the seventh edition of the tumor, node, metastasis (TNM) classification. The treatment responses of patients were evaluated according to the World Health Organization (WHO) criteria. We measured plasma D‐dimer level, activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), lactate dehhydrogenase (LDH), hemoglobin (Hb), platelet (Plt), white blood cells (WBC) count before, during and after chemotherapy. We investigated association of the results with stage and histologic type of the disease, as well as with response to therapy and survival in lung cancer patients.ResultsThe median D‐dimer, PT and INR levels of the patients with lung cancer were significantly higher than in the control group (P = 0,000). D‐dimer, APTT, PT, INR, LDH levels after four cycles of treatment were significantly lower in responders than in nonresponders (P = 0,000). Plasma D‐dimer levels were evaluated according to histopathological type and stage of diseases; D‐dimer level was found significantly higher in metastatic disease (P < 0,5) and significantly lower in small cell lung cancer (SCLC) (P < 0,05). The mean follow‐up was 574,14 ± 463,48 days. The mean survival was 750 866 ± 74 857 days (95% CI: 604 147 – 897 586). After second and fourth cycles of treatment, the plasma D‐dimer, APTT, and LDH levels were higher in mortality group than in survival group (P = 0,000). After four cycles of treatment, the mean survival of the patients with serum D‐dimer level above and below 1900 ng/mL was found to be significantly different (P = 0,000).ConclusionThe results suggest that determination of D–dimer plasma levels that is an inexpensive, easy and non invasive method may be useful in predicting clinical outcome, survival and treatment response of patients with lung cancer.
Physical fitness and amount of asthma and asthma‐like symptoms from childhood to adulthood
Authors: Guldberg–Møller Jørgen , Hancox Bob , Mikkelsen Dennis , Hansen Henrik Steen , Rasmussen Finn 
Published: April 2014

AbstractObjectiveThe potential benefits of physical activity on the development of respiratory symptoms are not well known. The present study investigated the longitudinal association between physical fitness and the development of asthma‐like symptoms from childhood to adulthood in a longitudinal community‐based study.MethodsParticipants were assessed at ages 9, 15, 20 and 29 years. Asthma‐like symptoms and physical fitness was assessed at each age.ResultsTracking for physical fitness was high from age 9 to 29 years. Using logistic regression, high physical fitness at age 9 predicted a lower prevalence of asthma‐like symptoms at ages 9, 20 and 29 years. Asthma at age 9 and female sex and smoking at any age were also independently associated with the presence of asthma‐like symptoms. Our findings suggest that the risk for the development of asthma is reduced by 3% and of asthma‐like symptoms reduced by 2% from early adolescence to young adulthood (ages 9–29 years) by increasing the maximal workload with 1 W/kg.ConclusionThis finding provide further evidence of a possible beneficial effect of physical activity in childhood on the development of respiratory symptoms in adulthood and supports the notion that the lower levels of physical activity in recent decades may have contributed to an increase in the prevalence of asthma and asthma‐like symptoms.
Usefulness of over‐the‐scope clipping system for closing digestive fistulas
Authors: Mercky Pascale , Gonzalez Jean‐Michel , Aimore Bonin Eduardo , Emungania Olivier , Brunet Julie , Grimaud Jean‐Charles , Barthet Marc 
Published: April 2014

Background and AimTherapeutic endoscopy has recently evolved into the treatment of complex gastrointestinal (GI) postoperative leakage, especially with over‐the‐scope clips (OTSC). We describe our 2‐year experience of 30 patients treated for digestive fistulas using the OTSC device.MethodsThis was a retrospective study conducted on patients referred for GI fistulas in two French hospitals. Technical aspects, clinical outcomes and closure rates were recorded.ResultsThirty patients were treated for GI leaks: 19 (63%) had a gastric fistula after laparoscopic sleeve gastrectomy (LSG); the others had rectovaginal, urethrorectal, rectovesical, gastrogastric, gastrocutaneous, esophagojejunal fistulas and colorectal anastomotic leak. Average follow up was 10.4 months. Eighteen (60%) had undergone previous endoscopic or surgical treatment. Orifice size was 3–20 mm (average 7.2 mm). Successful OTSC placement was achieved in 30 out of 34 attempts. There were four intraoperative undesired events (13.3%) but these were successfully managed. Overall success rate was 71.4% and 16 patients (53%) recovered with primary efficacy. Six patients (20%) required a subsequent endoscopic treatment. Eight patients (26.7%) required surgery for failure. In nine cases, we used one or more additional endoscopic procedures concomitantly with the OTSC combining self‐expandable metal stents, standard clips and glue injection. Healing rate after LSG fistula was 88.9%, which was significantly higher than the overall rate (P = 0.01).ConclusionOTSC placement seems to be safe and effective for the treatment of GI fistulas. Better results were seen in leaks after LSG.
Perceived Quality of Informed Refusal Process: A Cross‐Sectional Study from Iranian Patients' Perspectives
Authors: Farzandipour Mehrdad , Sheikhtaheri Abbas , Sadeqi Jabali Monireh 
Published: April 2014

AbstractPatients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider‐patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure (9.6 ± 6.4 out of 22 points) was perceived to be moderate, however, comprehension (2.3 ± 1.4 out of 4 points), voluntariness (8.7 ± 1.5 out of 12 points) and provider–patient relationship (10.2 ± 5.2 out of 16 points) were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow‐ups after refusal. Developing more informative refusal forms is needed.
Effect of hyperglycaemia on muscarinic M3 receptor expression and secretory sensitivity to cholinergic receptor activation in islets
Authors: Hauge‐Evans A. C. , Reers C. , Kerby A. , Franklin Z. , Amisten S. , King A. J. , Hassan Z. , Vilches‐Flores A. , Tippu Z. , Persaud S. J. , Jones P. M. 
Published: April 2014

AimsIslets are innervated by parasympathetic nerves which release acetylcholine (ACh) to amplify glucose‐induced insulin secretion, primarily via muscarinic M3 receptors (M3R). Here we investigate the consequence of chronic hyperglycaemia on islet M3R expression and secretory sensitivity of mouse islets to cholinergic receptor activation.MethodsThe impact of hyperglycaemia was studied in (i) islets isolated from ob/ob mice, (ii) alginate‐encapsulated mouse islets transplanted intraperitoneally into streptozotocin‐induced diabetic mice and (iii) mouse and human islets maintained in vitro at 5.5 or 16 mmol/l glucose. Blood glucose levels were assessed by a commercial glucose meter, insulin content by RIA and M3R expression by qPCR and immunohistochemistry.ResultsM3R mRNA expression was reduced in both ob/ob islets and islets maintained at 16 mmol/l glucose for 3 days (68 and 50% control, respectively). In all three models of hyperglycaemia the secretory sensitivity to the cholinergic receptor agonist, carbachol, was reduced by 60–70% compared to control islets. Treatment for 72 h with the irreversible PKC activator, PMA, or the PKC inhibitor, Gö6983, did not alter islet M3R mRNA expression nor did incubation with the PI3K‐inhibitor, LY294002, although enhancement of glucose‐induced insulin secretion by LY294002 was reduced in islets maintained at 16 mmol/l glucose, as was mRNA expression of the PI3K regulatory subunit, p85α.ConclusionsCholinergic regulation of insulin release is impaired in three experimental islet models of hyperglycaemia consistent with reduced expression of M3 receptors. Our data suggest that the receptor downregulation is a PKC‐ and PI3K‐independent consequence of the hyperglycaemic environment, and they imply that M3 receptors could be potential targets in the treatment of type 2 diabetes.
Association between first‐line monotherapy with sulphonylurea versus metformin and risk of all‐cause mortality and cardiovascular events: a retrospective, observational study
Authors: Morgan C. Ll. , Mukherjee J. , Jenkins‐Jones S. , Holden S. E. , Currie C. J. 
Published: April 2014

AbstractAimsTo evaluate the risk of all‐cause mortality and major adverse cardiovascular events (MACE) for patients exposed to first‐line monotherapy with sulphonylurea or metformin.MethodsData were from the Clinical Practice Research Datalink (CPRD). Patients with type 2 diabetes were selected if initiated with metformin or sulphonylurea monotherapy as their first‐line glucose‐lowering regimen 2000–2012. The primary endpoint was all‐cause mortality; the secondary endpoint was MACE (myocardial infarction or stroke). Times to endpoints were compared using Cox proportional hazards models. Additional analyses were performed on subsets matched directly on key characteristics and by propensity score.ResultsIn the main analysis, 76 811 patients were prescribed metformin monotherapy (mean follow‐up 2.9 years) and 15 687 sulphonylurea monotherapy (mean follow‐up 3.1 years). A total of 2604 patients were included in each arm of the directly matched cohorts and 8836 in the propensity‐matched. With respect to all‐cause mortality, using all three analytical approaches the hazard ratio (HR) was significantly increased for sulphonylurea compared with metformin: adjusted HR = 1.580 (95% CI 1.483–1.684) for the main analysis, 1.902 (1.733–2.088) for those matched on propensity score, and 1.272 (1.021–1.584) for the directly matched cohort analysis. For MACE, the respective HRs were 1.196 (1.090–1.313), 1.202 (1.001–1.442) and 0.814 (0.578–1.148), respectively.ConclusionsAll‐cause mortality was significantly increased in patients prescribed sulphonylurea compared with metformin monotherapy. Whilst residual confounding and confounding by indication may remain, this study indicates that first‐line treatment with sulphonylurea monotherapy should be reconsidered.