bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensitization to contact allergens and bronchial hyper‐responsiveness
Authors: Schnabel Eva , Schoefer Yvonne , Chen Chih‐Mei , Schäfer Torsten , Behrendt Heidrun , Ring Johannes , Wichmann H.‐Erich , Heinrich Joachim ,   for the KORA study group
Published: October 2015

Background: Exposure to contact allergens and specific allergic sensitization to them are common, but possible related health effects have been rarely studied. Objectives: We aimed to analyse possible associations between contact sensitization to nickel sulfate and fragrance mix I and lung function parameters or bronchial hyper‐responsiveness. Methods: Within a population‐based study in Augsburg, 1052 adults performed lung function tests, including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and bronchial hyper‐responsiveness (BHR). Patch tests were performed, and information was assessed by medical examinations and interviews. Logistic regression models were applied to study associations between contact allergies and lung function parameters. Results: Women were sensitized significantly more often than men to nickel [odds ratio (OR) 3.97, 95% confidence interval (CI) 2.50–6.29] and fragrance mix I (OR 2.28, 95% CI 1.50–3.46). Patch test results for nickel and fragrance mix I did not influence mean FEV1 and FVC % predicted values. However, in women, a higher rate of BHR was associated with positive patch test reactions to fragrance mix I (OR 2.24, 95% CI 1.11–4.52). Conclusions: Contact sensitization to fragrance mix I is associated with a higher rate of BHR in women. Thus, in women with contact allergy to fragrances, airway obstruction should be considered as a possible co‐morbidity.
The development and psychometric testing of a theory‐based instrument to evaluate nurses’ perception of clinical reasoning competence
Authors: Liou Shwu‐Ru , Liu Hsiu‐Chen , Tsai Hsiu‐Min , Tsai Ying‐Huang , Lin Yu‐Ching , Chang Chia‐Hao , Cheng Ching‐Yu 
Published: October 2015

AbstractAimThe purpose of the study was to develop and psychometrically test the Nurses Clinical Reasoning Scale.BackgroundClinical reasoning is an essential skill for providing safe and quality patient care. Identifying pre‐graduates’ and nurses’ needs and designing training courses to improve their clinical reasoning competence becomes a critical task. However, there is no instrument focusing on clinical reasoning in the nursing profession.DesignCross‐sectional design was used. This study included the development of the scale, a pilot study that preliminary tested the readability and reliability of the developed scale and a main study that implemented and tested the psychometric properties of the developed scale.MethodThe Nurses Clinical Reasoning Scale was developed based on the Clinical Reasoning Model. The scale includes 15 items using a Likert five‐point scale. Data were collected from 2013–2014. Two hundred and fifty‐one participants comprising clinical nurses and nursing pre‐graduates completed and returned the questionnaires in the main study. The instrument was tested for internal consistency and test–retest reliability. Its validity was tested with content, construct and known‐groups validity.ResultsOne factor emerged from the factor analysis. The known‐groups validity was confirmed. The Cronbach's alpha for the entire instrument was 0·9.ConclusionThe reliability and validity of the Nurses Clinical Reasoning Scale were supported. The scale is a useful tool and can be easily administered for the self‐assessment of clinical reasoning competence of clinical nurses and future baccalaureate nursing graduates. Study limitations and further recommendations are discussed.
Reconciling evidence‐based medicine and patient‐centred care: defining evidence‐based inputs to patient‐centred decisions
Authors: Weaver Robert R. 
Published: October 2015

AbstractEvidence‐based and patient‐centred health care movements have each enhanced the discussion of how health care might best be delivered, yet the two have evolved separately and, in some views, remain at odds with each other. No clear model has emerged to enable practitioners to capitalize on the advantages of each so actual practice often becomes, to varying degrees, an undefined mishmash of each. When faced with clinical uncertainty, it becomes easy for practitioners to rely on formulas for care developed explicitly by expert panels, or on the tacit ones developed from experience or habit. Either way, these tendencies towards ‘cookbook’ medicine undermine the view of patients as unique particulars, and diminish what might be considered patient‐centred care. The sequence in which evidence is applied in the care process, however, is critical for developing a model of care that is both evidence based and patient centred. This notion derives from a paradigm for knowledge delivery and patient care developed over decades by Dr. Lawrence Weed. Weed's vision enables us to view evidence‐based and person‐centred medicine as wholly complementary, using computer tools to more fully and reliably exploit the vast body of collective knowledge available to define patients’ uniqueness and identify the options to guide patients. The transparency of the approach to knowledge delivery facilitates meaningful practitioner–patient dialogue in determining the appropriate course of action. Such a model for knowledge delivery and care is essential for integrating evidence‐based and patient‐centred approaches.
Motivating Action and Maintaining Change: The Time‐Varying Role of Homework Following a Brief Couples' Intervention
Authors: Hawrilenko Matt , Eubanks Fleming C. J. , Goldstein Alana S. , Cordova James V. 
Published: October 2015

Studies regarding the effectiveness of homework assignments in cognitive‐behavioral treatments have demonstrated mixed results. This study investigated predictors of compliance with homework recommendations and the time‐varying relationship of recommendation completion with treatment response in a brief couples' intervention (N = 108). More satisfied couples and couples with more motivation to change completed more recommendations, whereas couples with children completed fewer. The association between recommendation completion and treatment response varied with the passage of time, with the strongest effect observed 6 months after the intervention, but no discernible differences at 1 year postintervention. Couples that completed more recommendations experienced more rapid treatment gains, but even those couples doing substantially fewer recommendations ultimately realized equivalent treatment effects, although they progressed more slowly. Implications are discussed.
Innovative quantitative testing of hand function in Charcot‐Marie‐Tooth neuropathy
Authors: Alberti Maria A. , Mori Laura , Francini Luca , Poggi Ilaria , Monti Bragadin Margherita , Bellone Emilia , Grandis Marina , Maggi Giovanni , Reni Lizia , Sormani Maria P. , Tacchino Andrea , Padua Luca , Prada Valeria , Bove Marco , Schenone Angelo 
Published: October 2015

AbstractTo describe a new test to quantitatively evaluate hand function in patients affected by Charcot‐Marie‐Tooth neuropathy (CMT). The sensor‐engineered glove test (SEGT) was applied to CMT patients (N: 26) and compared with a cohort of healthy controls (HC, N: 26). CMT patients were further divided into subjects with clinically normal (group 1) or impaired hand (group 2) function. The SEGT parameters evaluated were touch duration, inter‐tapping interval, and movement rate parameters of two different sequences: finger tapping (FT) and index‐medium‐ring‐little (IMRL) performed at self‐paced mode (SPM) and maximum velocity (MV). Hand function and strength were assessed by the 9‐hole peg test (9HPT) and dynamometry. Disability of patients was measured by the CMT neuropathy score. CMT patients had significantly worst performances at SEGT than controls regarding the rate of execution of both FT (at MV) and IMRL sequences (at SPM and MV). The rate parameter at MV in IMRL sequence showed a significant trend of decreasing in its average between HC (n: 26, rate = 3.08 ± 0.52 Hz), group 1 (n: 9, rate = 2.64 ± 0.66 Hz) and group 2 (n: 17, rate = 2.19 ± 0.45 Hz) (p for trend <0.001). No correlations were found with either 9HPT, dynamometry, electrophysiology, and the CMT neuropathy score. The SEGT test is sensitive to show hand dysfunction in CMT patients, with and without clinically impaired hands.
Periodontitis contributes to aberrant metabolism in type 2 diabetes mellitus rats by stimulating the expression of adipokines
Authors: Luo S. , Yang X. , Wang D. , Ni J. , Wu J. , Xu Z. , Xuan D. , Zhang J. 
Published: October 2015

BackgroundPeriodontitis has been associated with type 2 diabetes mellitus. We investigated the effects of local aberrant secretion of adipokines in diabetic rats on systemic metabolism.Material and MethodsOtsuka Long‐Evans Tokushima Fatty (OLETF) and non‐diabetic Long‐Evans Tokushima Otsuka rats were used as a diabetic model and associated control, respectively. Periodontitis was induced using a silk ligature for 36 wk. Rats were grouped into OLETF with (OP+) or without (OP−) periodontitis and Long‐Evans Tokushima Otsuka with (LP+) or without (LP−) periodontitis. Alveolar bone resorption and destruction were evaluated by micro‐computed tomography and hematoxylin and eosin staining. After 20 wk of periodontitis induction, lipids, insulin, interleukin‐1, leptin and plasminogen activator inhibitor‐1 were analyzed, and mRNA expressions of NF‐κB, Mark8, TLR2 and ‐4, IKBKB and Nampt were evaluated by quantitative polymerase chain reaction in adipose tissue.ResultsAfter ligation, OLETF rats exhibited typical periodontitis lesions with the clinical features of type 2 diabetes mellitus. When compared with the OP(−) group, the area under curve of the oral glucose tolerance test and homeostatic model assessment–insulin resistance values were significantly higher in the OP(+) group. Micro‐computed tomography showed that the OP(+) group had more bone resorption than the OP(−) group. When compared with the OP(−) group, the OP(+) group also exhibited higher total cholesterol (p < 0.05), leptin (p < 0.05), insulin (p > 0.05) and higher expression of Nampt (p < 0.05) and IKBKB (p < 0.05). The LP(+) group had a trend towards higher bone resorption when compared with the LP(−) group. Additionally, no difference in white adipose tissues or adipokines was found between LP(+) and LP(−) rats.ConclusionsChronic periodontitis can alter lipid profiles in affected rats, elevate adipose tissue expression of Nampt and affect the metabolism of adipose tissue through the NF‐κB pathway to inflame diabetes.
Transcription factor ART1 mediates starch hydrolysis and mycotoxin production in Fusarium graminearum and F. verticillioides
Authors: Oh Mira , Son Hokyoung , Choi Gyung Ja , Lee Chanhui , Kim Jin‐Cheol , Kim Hun , Lee Yin‐Won 
Published: October 2015

SummaryMolecular mechanisms underlying the responses to environmental factors, such as nitrogen, carbon and pH, involve components that regulate the production of secondary metabolites, including mycotoxins. In this study, we identified and characterized a gene in the FGSG_02083 locus, designated as FgArt1, which was predicted to encode a Zn(II)2Cys6 zinc finger transcription factor. An FgArt1 deletion mutant of Fusarium graminearum exhibited impaired starch hydrolysis as a result of significantly reduced α‐amylase gene expression. The deletion strain was unable to produce trichothecenes and exhibited low Tri5 and Tri6 expression levels, whereas the complemented strain showed a similar ability to produce trichothecenes as the wild‐type strain. In addition, FgArt1 deletion resulted in impairment of germination in starch liquid medium and reduced pathogenicity on flowering wheat heads. To investigate the roles of the FgArt1 homologue in F. verticillioides, we deleted the FVEG_02083 gene, and the resulting strain showed defects in starch hydrolysis, similar to the FgArt1 deletion strain, and produced no detectable level of fumonisin B1. Fum1 and Fum12 expression levels were undetectable in the deletion strain. However, when the FvArt1‐deleted F. verticillioides strain was complemented with FgArt1, the resulting strain was unable to recover the production of fumonisin B1, although FgArt1 expression and starch hydrolysis were induced. Thus, our results suggest that there are different regulatory pathways governed by each ART1 transcription factor in trichothecene and fumonisin biosynthesis. Taken together, we suggest that ART1 plays an important role in both trichothecene and fumonisin biosynthesis by the regulation of genes involved in starch hydrolysis.
Gastrointestinal mucormycosis in immunocompromised hosts
Authors: Dioverti M. Veronica , Cawcutt Kelly A. , Abidi Maheen , Sohail M. Rizwan , Walker Randall C. , Osmon Douglas R. 
Published: October 2015

SummaryInvasive mucormycosis is a rare fungal infection in immunocompromised hosts, but it carries a high mortality rate. Primary gastrointestinal disease is the least frequent form of presentation. Early diagnosis and treatment are critical in the management; however, symptoms are typically non‐specific in gastrointestinal disease, leading to delayed therapy. To describe the clinical presentation, diagnosis, treatment and outcomes of gastrointestinal mucormycosis in immunocompromised hosts, we reviewed all cases of primary gastrointestinal mucormycosis in immunocompromised hosts reported in English literature as well as in our Institution from January 1st 1991 to December 31st 2013 for a total of 31 patients. About 52% of patients underwent solid organ transplant (SOT), while the rest had an underlying haematologic malignancy. Abdominal pain was the most common presenting symptom, followed by gastrointestinal bleeding and fever. Gastric disease was more common in SOT, whereas those with haematologic malignancy presented with intestinal disease (P = 0.002). Although gastrointestinal mucormycosis remains an uncommon condition in immunocompromised hosts, it carries significant morbidity and mortality, particularly in cases with intestinal involvement. A high index of suspicion is of utmost importance to institute early and appropriate therapy and improve outcomes.
Comparing the efficacy of continuous erythropoietin receptor activator and darbepoetin Alfa treatments in Japanese patients with chronic kidney disease during the predialysis period: A propensity‐matched analysis
Authors: Koibuchi Kiyoto , Miyagi Moriatsu , Arai Taichi , Aoki Toshiyuki , Aikawa Atsushi , Sakai Ken 
Published: October 2015

AbstractAimErythropoiesis‐stimulating agent (ESA) treatment during the predialysis period can be a strategy to reduce cardiac mortality soon after initiation of dialysis. In this study, we compared the efficacy of continuous erythropoietin receptor activator (CERA) and darbepoetin alfa (DA) in patients with chronic kidney disease (CKD) over 6 months prior to initiation of dialysis.MethodsThis study was a retrospective propensity score‐matched study conducted at a single center in Japan that analyzed the effects of CERA and DA therapy on haemoglobin (Hb) changes, ESA resistance index (ERI) changes, and interval of ESA administration during a 6‐month observation period prior to initiation of dialysis. Propensity scores were used for matching the patients included in the CERA and DA groups.ResultsAmong 680 screened, 74 pairs of patients (one in each group) were included in the present analysis after propensity score matching. Mean Hb significantly decreased over 6 months in the DA group compared to that in the CERA group (−0.70 ± 0.23 vs. –0.33 ± 0.22). In the DA group, mean ERI was significantly increased at 4, 3, 2, and 1 month before dialysis and initiation of dialysis, while in the CERA group, mean ERI was significantly increased only at 1 month before dialysis and initiation of dialysis. Moreover, patients administered CERA were required to visit the hospital significantly less frequently for ESA administration than those administered DA.ConclusionOur study showed that CERA may be more effective than DA for management of anaemia during the predialysis period in CKD patients.
Anaemia and early phase cardiovascular events on haemodialysis
Authors: Hayashi Toshihide , Joki Nobuhiko , Tanaka Yuri , Hase Hiroki 
Published: October 2015

AbstractAlthough the mechanism of the cardio‐renal anaemia syndrome (CRAS) has been elucidated in considerable detail over the past decade, cardiovascular disease (CVD) remains a leading cause of death among patients with end‐stage kidney disease (ESKD) undergoing haemodialysis, and these patients' cardiovascular mortality is greater than that of the general population. Recent studies have reported that the CVD risk increases with advancing chronic kidney disease (CKD) stage. Furthermore, the incidence of cardiovascular events is highest during the first week after dialysis initiation, with increased risk in incident haemodialysis patients. This accumulated evidence demonstrates that how patients are managed during the pre‐dialysis phase may have important implications on long‐term outcomes in ESKD. Anaemia, a non‐traditional risk factor for CVD, advances exponentially along with declining kidney function due to insufficient erythropoietin production. Anaemia causes functional abnormalities of the heart, as represented by cardiac hypertrophy, which results from increased cardiac workload induced by an increased preload. Left ventricular hypertrophy (LVH), a traditional risk factor for CVD, is especially associated with advanced CKD stage and could be a major risk factor for cardiovascular complications such as ischaemic heart disease, heart failure, and sudden cardiac death. In ESKD, anaemia develops more severely and requires a higher amount of erythropoiesis‐stimulating agent (ESA) therapy before dialysis initiation. This suggests that improvement in anaemia management during the pre‐dialysis phase may have a beneficial effect on cardiac hypertrophy and contribute to reducing the CVD risk after initiating haemodialysis.
Treatment of renal anaemia with erythropoiesis‐stimulating agents in predialysis chronic kidney disease patients: Haemoglobin profile during the 6 months before initiation of dialysis
Authors: Kawahara Kazuhiko , Minakuchi Jun , Yokota Narushi , Suekane Hiroto , Tsuchida Kenji , Kawashima Shu 
Published: October 2015

AbstractAimErythropoiesis‐stimulating agents (ESAs) are all effective for renal anaemia in patients with chronic kidney disease (CKD). However, it was reported that the haemoglobin (Hb) concentration decreases to 8.4 g/dL during the initial phase of dialysis despite treatment with recombinant human erythropoietin (rHuEPO). This study compared Hb at the initiation of dialysis among patients treated with three different ESAs (rHuEPO, darbepoetin alfa [DA], and a continuous erythropoietin receptor activator [CERA]).MethodsThe subjects were 82 CKD patients who started dialysis at Kawashima Hospital between 1 January 2009 and 28 February 2015 and who received only one kind of ESA for at least 6 months before initiation of dialysis. Baseline characteristics and laboratory data at initiation of dialysis were compared among the three groups. Then changes of the Hb, ESA dose, and erythropoiesis resistance index were assessed over time during the 6 months before initiation of dialysis. Differences of Hb at the initiation of dialysis were also assessed.ResultsAmong the 82 patients, 36 received rHuEPO, 13 received DA, and 33 received CERA. Baseline characteristics and laboratory data of the patients showed no significant differences among the three groups. The monthly Hb decreased gradually during the 6‐month period before initiation of dialysis in all three groups. Hb was significantly higher in the CERA group than the rHuEPO group at the initiation of dialysis.ConclusionLong‐acting ESAs may be more useful for predialysis patients with CKD because they do not attend hospital frequently, unlike haemodialysis patients.
Quality of life of family caregivers of children with orofacial clefts in Nigeria: a mixed‐method study
Authors: Awoyale T , Onajole AT , Ogunnowo BE , Adeyemo WL , Wanyonyi KL , Butali A 
Published: October 2015

BackgroundOrofacial clefts (OFCs) are common birth defects that may impose a large burden on the health and psychosocioeconomic well‐being of affected individuals and families. This study aims to identify qualitative factors that affect the quality of life (QOL) of family caregivers of children with OFCs.MethodsA mixed‐method study in which family caregivers of OFCs children were consecutively recruited from cleft clinics over a 3‐month period. Quantitative data were analyzed using SPSS version 17 and focus group discussion by framework analysis.ResultsA total of 107 caregivers participated in the entire study, and 24 caregivers participated in the focus group discussions. About 50% of the children had cleft lip and palate (CLP), 28% with cleft lips only (CL) and 23.4% with cleft palate only (CP). Poor access to specific information and lack of empathy of professionals affected the quality of life and delivery of family‐centered care.ConclusionsTo improve the quality of life of family caregivers, individual‐focused counseling sessions should be organized for caregivers soon after birth. This will provide an opportunity to discuss the laid out plans for supportive care. It will also be as an avenue to address the arising social issues by health professionals and counselors.
Childhood relapsed acute lymphoblastic leukemia: Biology and recent treatment progress
Authors: Goto Hiroaki 
Published: October 2015

AbstractAcute lymphoblastic leukemia (ALL) is the most frequent cancer in children. Despite remarkable improvement in the prognosis of childhood ALL over the past few decades, the treatment of relapsed ALL is still challenging. The prognosis of first ALL relapse is associated with time of relapse after initial therapy, sites of relapse, and immunophenotype. More recently, response to treatment, which is evaluated by assessment of minimal residual disease (MRD), has been found to be clinically significant in relapsed ALL as well as in the initially diagnosed disease. Utilizing these factors, risk‐oriented treatment stratification for first ALL relapse has been established. In the standard‐risk group for first ALL relapse, intensification of conventional ALL‐type therapy can provide a cure in approximately 70% of patients. It is important to assess MRD after reinduction therapy to determine the indications for stem cell transplantation in the standard‐risk group. In contrast, no standardized therapy has been established for the high‐risk group, which accounts for more than half of relapsed ALL patients. Recent studies have shed light on the clonal origin of relapsed ALL, which usually exists as a minor subclone at the time of initial diagnosis. Clonal selection and evolution take place during chemotherapy, resulting in distinct genetic and epigenetic characteristics of relapsed ALL, some of which are linked to drug resistance, a common and problematic feature of ALL after relapse. To overcome resistance to standard ALL‐type therapy, and considering the heterogeneous biological background of high‐risk relapsed ALL, innovative therapies using new agents are necessary.