bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring patterns of care coordination within services for older people
Authors: Chester Helen , Hughes Jane , Sutcliffe Caroline , Xie Chengqiu , Challis David 
Published: April 2015

Introduction Supporting frail older people at home is an international policy objective. This article explored variations in care coordination arrangements and their relationship with service level outcomes using England as a case study. Method Survey data and routinely generated data collected in 2006 from 119 local authorities responsible for social care were combined. Using cluster analysis, distinct groups were identified with regard to forms of care coordination. Results Considerable variation was evident both within and between different types of care coordination, reflecting implementation guidance. Links with service level outcomes were weak, the most notable being the provision of intensive home care, a component of intensive care management. Discussion Thus this study, using agency level data, confirmed the variability in care coordination arrangements and the relative absence of intensive care management, central to shifting the balance of care from residential and nursing provision to care at home.
Improving the quality of care delivered to people imminently dying in hospital by implementing a care bundle: an observational before and after feasibility study
Authors: Clark Katherine , Byfieldt Naomi 
Published: April 2015

Introduction Most Australians die predictably in acute hospital settings. Despite this, hospitals remain ill-equipped to care for dying patients with hospital deaths not uncommonly perceived as distressing by both patients and their families. A care bundle for the dying was developed with this aiming to report the feasibility of implementing this quality improvement strategy. Methods A before and after observational approach was used to compare whether there were changes in care delivery to imminently dying patients in two medical wards. Data were extracted retrospectively from their inpatient files. The main outcome of this work was the percentage compliance with the bundle elements and proportional change from baseline where comparative care processes had previously been in place. Results Over 6 months, 90 deaths occurred with the bundle in place for 74.5% (n = 70) with significant increases in regular symptom monitoring and monitoring of family distress seen ( p < 0.001, respectively). There was compliance with prescribing guideline for pain in 59.2% (29/49) charts and breathlessness in 53.1% (26/49). In the absence of previous prescribing guidelines it was not possible to comment on the significance of this latter observation. Discussion This work highlights that it is feasible to implement and assess a pilot project aimed at improving the quality of care delivered to people dying in acute hospitals. This preliminary work suggests that it is possible to integrate evidence-based care processes into the care of the dying by adopting a care paradigm more typically reserved for critical care. However, more work is required to confirm this in larger studies.
How I use bypassing therapy for prophylaxis in patients with hemophilia A and inhibitors
Authors: Leissinger Cindy A. , Singleton Tammuella , Kruse-Jarres Rebecca 
Published: April 2015

AbstractInhibitor development poses a significant challenge in the management of hemophilia because once an inhibitor is present, bleeding episodes can no longer be treated with standard clotting factor replacement therapy. Consequently, patients with inhibitors are at increased risk for difficult-to-control bleeding and complications, particularly arthropathy and physical disability. Three clinical trials in patients with inhibitors have demonstrated that prophylaxis with a bypassing agent reduces joint and other types of bleeding and improves health-related quality of life compared with on-demand bypassing therapy. In hemophilia patients without inhibitors, the initiation of prophylaxis with factor (F) VIII or FIX prior to the onset of recurrent hemarthroses can prevent the development of joint disease. Whether this is also true for bypassing agent prophylaxis remains to be determined.
The role of rituximab in adults with warm antibody autoimmune hemolytic anemia
Authors: Dierickx Daan , Kentos Alain , Delannoy André 
Published: April 2015

Abstract
Warm antibody hemolytic anemia is the most common form of autoimmune hemolytic anemia. When therapy is needed, corticosteroids remain the cornerstone of initial treatment but are able to cure only a minority of patients (<20%). Splenectomy is usually proposed when a second-line therapy is needed. This classical approach is now challenged by the use of rituximab both as second-line and as first-line therapy. Second-line treatment with rituximab leads to response rates similar to splenectomy (∼70%), but rituximab-induced responses seem less sustained. However, additional courses of rituximab are most often followed by responses, at the price of reasonable toxicity. In some major European centers, rituximab is now the preferred second-line therapy of warm antibody hemolytic anemia in adults, although no prospective study convincingly supports this attitude. A recent randomized study strongly suggests that in first-line treatment, rituximab combined with steroids is superior to monotherapy with steroids. If this finding is confirmed, rituximab will emerge as a major component of the management of warm antibody hemolytic anemia not only after relapse but as soon as treatment is needed.
Activated protein C: biased for translation
Authors: Griffin John H. , Zlokovic Berislav V. , Mosnier Laurent O. 
Published: April 2015

AbstractThe homeostatic blood protease, activated protein C (APC), can function as (1) an antithrombotic on the basis of inactivation of clotting factors Va and VIIIa; (2) a cytoprotective on the basis of endothelial barrier stabilization and anti-inflammatory and antiapoptotic actions; and (3) a regenerative on the basis of stimulation of neurogenesis, angiogenesis, and wound healing. Pharmacologic therapies using recombinant human and murine APCs indicate that APC provides effective acute or chronic therapies for a strikingly diverse range of preclinical injury models. APC reduces the damage caused by the following: ischemia/reperfusion in brain, heart, and kidney; pulmonary, kidney, and gastrointestinal inflammation; sepsis; Ebola virus; diabetes; and total lethal body radiation. For these beneficial effects, APC alters cell signaling networks and gene expression profiles by activating protease-activated receptors 1 and 3. APC’s activation of these G protein–coupled receptors differs completely from thrombin’s activation mechanism due to biased signaling via either G proteins or β-arrestin-2. To reduce APC-associated bleeding risk, APC variants were engineered to lack >90% anticoagulant activity but retain normal cell signaling. Such a neuroprotective variant, 3K3A-APC (Lys191-193Ala), has advanced to clinical trials for ischemic stroke. A rich data set of preclinical knowledge provides a solid foundation for potential translation of APC variants to future novel therapies.
An official American Thoracic Society/European Respiratory Society statement: research questions in COPD
Authors: Celli Bartolome R. , Decramer Marc , Wedzicha Jadwiga A. , Wilson Kevin C. , Agustí Alvar , Criner Gerard J. , MacNee William , Make Barry J. , Rennard Stephen I. , Stockley Robert A. , Vogelmeier Claus , Anzueto Antonio , Au David H. , Barnes Peter J. , Burgel Pierre-Regis , Calverley Peter M. , Casanova Ciro , Clini Enrico M. , Cooper Christopher B. , Coxson Harvey O. , Dusser Daniel J. , Fabbri Leonardo M. , Fahy Bonnie , Ferguson Gary T. , Fisher Andrew , Fletcher Monica J. , Hayot Maurice , Hurst John R. , Jones Paul W. , Mahler Donald A. , Maltais François , Mannino David M. , Martinez Fernando J. , Miravitlles Marc , Meek Paula M. , Papi Alberto , Rabe Klaus F. , Roche Nicolas , Sciurba Frank C. , Sethi Sanjay , Siafakas Nikos , Sin Don D. , Soriano Joan B. , Stoller James K. , Tashkin Donald P. , Troosters Thierry , Verleden Geert M. , Verschakelen Johny , Vestbo Jorgen , Walsh John W. , Washko George R. , Wise Robert A. , Wouters Emiel F.M. , ZuWallack Richard L. 
Published: April 2015

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) research statement is to describe evidence related to diagnosis, assessment and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management.Clinicians, researchers, and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified.Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulatedviadiscussion and consensus.Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers, and patient advocates believe will have the greatest impact on patient-centred outcomes.
The involvement of follistatin-like protein 1 in osteoarthritis by elevating NF-κB-mediated inflammatory cytokines and enhancing fibroblast like synoviocyte proliferation
Authors: Ni Su , Miao Kaisong , Zhou Xianju , Xu Nanwei , Li Chenkai , Zhu Ruixia , Sun Rongbin , Wang Yuji 
Published: April 2015

Abstract
Introduction
Our previous work has revealed that expression of follistatin-like protein 1 (FSTL1) is elevated in the synovial tissues from osteoarthritis (OA) patients. The aim of this study was to elucidate the underlying molecular mechanisms by which FSTL1 plays a role in the pathogenesis of OA.

Methods
Cultured fibroblast-like synoviocytes (FLSs) from synovial tissues of OA patients were stimulated with human recombinant FSTL1, and then the expression of inflammatory cytokines in FLS and their concentrations in the cell supernatants were measured by real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. Nuclear factor kappa B (NF-κB) activation was examined by western blot and chromatin immunoprecipitation (ChIP) assay at the p65 binding site. Finally, the proliferation of FLSs and the expression level of the proliferation-related tumor suppressors (p53 and p21) were determined by MTS assay kit and western blot in the presence or absence of FSTL1, respectively.

Results
FSTL1 remarkably promoted expression levels of several inflammatory cytokines (tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6)) in vitro. Western blot analysis showed that FSTL1 activated the inflammatory-related NF-κB signaling pathway, as validated by ChIP assay detecting p65-binding level on the cytokine promoter region. Moreover, FSTL1 promoted the proliferation of OA FLS by downregulating the expression of p53 and p21. Interestingly, the concentration of synovial fluid IL-6 was remarkably elevated in OA patients, and was correlated with synovial fluid and serum FSTL1 levels.

Conclusions
These findings show that FSTL1 functions as an important proinflammatory factor in the pathogenesis of OA by activating the canonical NF-κB pathway and enhancing synoviocytes proliferation, suggesting that FSTL1 may be a promising target for the treatment of OA.
Gout and risk of chronic kidney disease and nephrolithiasis: meta-analysis of observational studies
Authors: Roughley Matthew J , Belcher John , Mallen Christian D , Roddy Edward 
Published: April 2015

Abstract
Introduction
To determine the prevalence of chronic kidney disease and nephrolithiasis in people with gout, and the association between gout and prevalent or incident chronic kidney disease and nephrolithiasis.

Methods
Systematic review and meta-analysis of epidemiological studies. Data sources; MEDLINE, EMBASE and CINAHL databases, hand-searched reference lists, citation history and contact with authors. Eligibility criteria: cohort, case–control or cross-sectional studies which examined the occurrence of chronic kidney disease or nephrolithiasis amongst adults with gout (with or without a non-gout comparator group) in primary care or general population samples. Prevalence and risk estimate meta-analyses were performed using a random-effects model.

Results
Seventeen studies were included in the meta-analysis (chronic kidney disease n = 7, nephrolithiasis n = 8, both n = 2). Pooled prevalence estimates of chronic kidney disease stage ≥3 and self-reported lifetime nephrolithiasis in people with gout were 24% (95% confidence interval 19% to 28%) and 14% (95% CI 12% to 17%) respectively. Gout was associated with both chronic kidney disease (pooled adjusted odds ratio 2.41, 95% confidence interval 1.86 to 3.11) and self-reported lifetime nephrolithiasis (1.77, 1.43 to 2.19).

Conclusions
Chronic kidney disease and nephrolithiasis are commonly found amongst patients with gout. Gout is independently associated with both chronic kidney disease and nephrolithiasis. Patients with gout should be actively screened for chronic kidney disease and its consequences.
Gender differences in outcomes in people with schizophrenia in
rural China: 14-year follow-up study
Authors: Ran Mao-Sheng , Mao Wen-Jun , Chan Cecilia Lai-Wan , Chen Eric Yu-Hai , Conwell Yeates 
Published: April 2015

BackgroundLittle is known about gender differences in the long-term outcomes of
people with schizophrenia living in the community.AimsTo explore gender differences in the 14-year outcome of people with
schizophrenia in rural China.MethodA 14-year follow-up study among a 1994 cohort (n = 510)
of participants with schizophrenia was conducted in Xinjin County,
Chengdu, China. All participants and their informants were followed up in
2004 and 2008 using the Patients Follow-up Schedule.ResultsCompared with female participants, male participants were significantly
younger, had significantly higher rates of mortality, suicide and
homelessness, and poorer family and social support. There was no
significant gender difference in Positive and Negative Syndrome Scale
scores, previous suicide attempts, those never treated, previous hospital
admission or inability to work. Longer duration of illness was associated
with functional decline and comparatively poorer family economic
status.ConclusionsThe long-term outcomes of men with schizophrenia is worse than those of
women with the disorder in rural China. Higher mortality, suicide and
homelessness rates in men may contribute partly to the higher prevalence
of schizophrenia in women in China. Policies on social and family support
and gender-specific intervention strategies for improving long-term
outcomes should be developed for people with this disorder.
Technological innovations in mental healthcare: harnessing the digital revolution
Authors: Hollis Chris , Morriss Richard , Martin Jennifer , Amani Sarah , Cotton Rebecca , Denis Mike , Lewis Shôn 
Published: April 2015

SummaryDigital technology has the potential to transform mental healthcare by connecting patients, services and health data in new ways. Digital online and mobile applications can offer patients greater access to information and services and enhance clinical management and early intervention through access to real-time patient data. However, substantial gaps exist in the evidence base underlying these technologies. Greater patient and clinician involvement is needed to evaluate digital technologies and ensure they target unmet needs, maintain public trust and improve clinical outcomes.
Lessons from export to New Zealand of the second opinion appointed doctor scheme
Authors: Dawson John , Glue Paul , Ellis Pete M. , Lenagh-Glue Jessie , Goldsmith David , Smith Don A. R. 
Published: April 2015

Aims and methodWe compared findings of an audit of New Zealand's version of the second opinion appointed doctor (SOAD) scheme with published information on the equivalent scheme for England and Wales, to consider what might be learnt from the different jurisdictions' experience.ResultsStrong similarities exist between the two schemes in the demographic profile of individuals subject to the SOAD process and rates of approval of compulsory treatment. The clearer legal framework for the English scheme and its supervision by an independent national agency may offer significant advantages in terms of consistency and transparency, compared with the informal, decentralised structure of New Zealand's scheme.Clinical implicationsClinicians may not always favour greater formality or elaborate national structures for administering the Mental Health Act, but there are advantages in promoting clarity and consistency in a mandatory statutory process designed to protect compulsory patients' rights.
Advance care planning and palliative medicine in advanced dementia: a literature review
Authors: Jethwa Ketan Dipak , Onalaja Oluwademilade 
Published: April 2015

Aims and methodTo assess the factors that affect the clinical use of advanced care planning and palliative care interventions in patients with dementia. A literature search of Medline, Embase and PsycINFO was performed to identify themes in advanced care planning and palliative care in dementia.ResultsIn total, 64 articles were found, including 12 reviews, and three key areas emerged: barriers to advanced care planning, raising awareness and fostering communication between professionals and patients, and disease-specific interventions.Clinical implicationsMost of the studies analysed were carried out in the USA or Continental Europe. This narrative review aims to help guide future primary research, systematic reviews and service development in the UK.
Low Serum Vitamin D Levels Are Associated With Inferior Survival in Follicular Lymphoma: A Prospective Evaluation in SWOG and LYSA Studies
Authors: Kelly Jennifer L. , Salles Gilles , Goldman Bryan , Fisher Richard I. , Brice Pauline , Press Oliver , Casasnovas Olivier , Maloney David G. , Soubeyran Pierre , Rimsza Lisa , Haioun Corinne , Xerri Luc , LeBlanc Michael , Tilly Hervé , Friedberg Jonathan W. 
Published: April 2015

Purpose Recent literature reports a potential association between high vitamin D and improved lymphoma prognosis. We evaluated the impact of pretreatment vitamin D on follicular lymphoma (FL) outcome. Patients and Methods SWOG participants were previously untreated patients with FL enrolled onto SWOG clinical trials (S9800, S9911, or S0016) involving CHOP chemotherapy plus an anti-CD20 antibody (rituximab or iodine-131 tositumomab) between 1998 and 2008. Participants included in our second independent cohort were also previously untreated patients with FL enrolled onto the Lymphoma Study Association (LYSA) PRIMA trial of rituximab plus chemotherapy (randomly assigned to rituximab maintenance v observation) between 2004 and 2007. Using the gold-standard liquid chromatography–tandem mass spectrometry method, 25-hydroxyvitamin D was measured in stored baseline serum samples. The primary end point was progression-free survival (PFS). Results After a median follow-up of 5.4 years, the adjusted PFS and overall survival hazard ratios for the SWOG cohort were 1.97 (95% CI, 1.10 to 3.53) and 4.16 (95% CI, 1.66 to 10.44), respectively, for those who were vitamin D deficient (< 20 ng/mL; 15% of cohort). After a median follow-up of 6.6 years, the adjusted PFS and overall survival hazard ratios for the LYSA cohort were 1.50 (95% CI, 0.93 to 2.42) and 1.92 (95% CI, 0.72 to 5.13), respectively, for those who were vitamin D deficient (< 10 ng/mL; 25% of cohort). Conclusion Although statistical significance was not reached in the LYSA cohort, the consistent estimates of association between low vitamin D levels and FL outcomes in two independent cohorts suggests that serum vitamin D might be the first potentially modifiable factor to be associated with FL survival. Further investigation is needed to determine the effects of vitamin D supplementation in this clinical setting.
MiR-22/Sp-1 Links Estrogens With the Up-Regulation of Cystathionine γ-Lyase in Myocardium, Which Contributes to Estrogenic Cardioprotection Against Oxidative Stress
Authors: Wang Long , Tang Zhi-Ping , Zhao Wei , Cong Bing-Hai , Lu Jian-Qiang , Tang Xiao-Lu , Li Xiao-Han , Zhu Xiao-Yan , Ni Xin 
Published: April 2015

Abstract
Hydrogen sulfide, generated in the myocardium predominantly via cystathionine-γ-lyase (CSE), is cardioprotective. Our previous study has shown that estrogens enhance CSE expression in myocardium of female rats. The present study aims to explore the mechanisms by which estrogens regulate CSE expression, in particular to clarify the role of estrogen receptor subtypes and the transcriptional factor responsible for the estrogenic effects. We found that either the CSE inhibitor or the CSE small interfering RNA attenuated the protective effect of 17β-estradiol (E2) against H2O2- and hypoxia/reoxygenation-induced injury in primary cultured neonatal cardiomyocytes. E2 stimulates CSE expression via estrogen receptor (ER)-α both in cultured cardiomyocytes in vitro and in the myocardium of female mice in vivo. A specificity protein-1 (Sp-1) consensus site was identified in the rat CSE promoter and was found to mediate the E2-induced CSE expression. E2 increases ERα and Sp-1 and inhibits microRNA (miR)-22 expression in myocardium of ovariectomized rats. In primary cardiomyocytes, E2 stimulates Sp-1 expression through the ERα-mediated down-regulation of miR-22. It was confirmed that both ERα and Sp-1 were targeted by miR-22. In the myocardium of ovariectomized rats, the level of miR-22 inversely correlated to CSE, ERα, Sp-1, and antioxidant biomarkers and positively correlated to oxidative biomarkers. In summary, this study demonstrates that estrogens stimulate Sp-1 through the ERα-mediated down-regulation of miR-22 in cardiomyocytes, leading to the up-regulation of CSE, which in turn results in an increase of antioxidative defense. Interaction of ERα, miR-22, and Sp-1 may play a critical role in the control of oxidative stress status in the myocardium of female rats.