bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary immunodeficiencies predisposed to Epstein‐Barr virus‐driven haematological diseases
Authors: Parvaneh Nima , Filipovich Alexandra H. , Borkhardt Arndt 
Published: June 2013

SummaryEpstein‐Barr virus (EBV), a ubiquitous human herpesvirus, maintains lifelong subclinical persistent infections in humans. In the circulation, EBV primarily infects the B cells, and protective immunity is mediated by EBV‐specific cytotoxic T cells (CTLs) and natural killer (NK) cells. However, EBV has been linked to several devastating diseases, such as haemophagocytic lymphohistiocytosis (HLH) and lymphoproliferative diseases in the immunocompromised host. Some types of primary immunodeficiencies (PIDs) are characterized by the development of EBV‐associated complications as their predominant clinical feature. The study of such genetic diseases presents an ideal opportunity for a better understanding of the biology of the immune responses against EBV. Here, we summarize the range of PIDs that are predisposed to EBV‐associated haematological diseases, describing their clinical picture and pathogenetic mechanisms.
‘Trifecta’ after radical prostatectomy: is there a standard definition?
Authors: Borregales Leonardo D. , Berg William T. , Tal Oded , Wambi Chris , Kaufman Sarah , Gaya Jose M. , Urzúa Cristian , Badani Ketan K. 
Published: June 2013

Objectives
To determine the extent of variability in the definitions of the ‘trifecta’ after radical prostatectomy (undetectable PSA, urinary continence and potency) to be found in the literature.
To establish a consensus definition of the trifecta in an effort to standardize criteria and reporting.
Materials and Methods
A systematic review of published articles found in the PubMed database for the period from January 2003 to March 2012 was performed.
The search queries included the keywords ‘radical prostatectomy,’ ‘prostatectomy outcome,’ and ‘trifecta’.
Results
A total of 86 publications were identified of which 14 were used for analysis.
Eight different definitions of biochemical recurrence were reported, the most common definition being PSA ≥0.2 ng/mL.
The definition of potency was the most variable. Ten different definitions of potency were found, with the most common being ‘having erections sufficient for intercourse with or without a phosphodiesterase‐5 inhibitor’.
Nine different definitions of continence were found. The most common definition of continence was ‘wearing no pads’.
Only six of the 14 articles used validated questionnaires in their outcome measures.
Conclusions
The definitions of trifecta reported in the literature are highly variable.
We propose the following consensus definition based on our analysis: (1) PSA >0.2 ng/mL with confirmatory value; (2) attainment of erections sufficient for intercourse with or without oral pharmacological agents; (3) wearing zero pads. This consensus definition should be considered when designing studies and reporting outcomes of radical prostatectomy.
Spatial distribution of positive cores improves the selection of patients with low‐risk prostate cancer as candidates for active surveillance
Authors: Abdollah Firas , Suardi Nazareno , Capitanio Umberto , Gallina Andrea , Sun Maxine , Villa Luca , Scattoni Vincenzo , Bianchi Marco , Tutolo Manuela , Fossati Nicola , Karakiewicz Pierre , Rigatti Patrizio , Montorsi Francesco , Briganti Alberto 
Published: June 2013

Objective
To test the hypothesis that spatial distribution of positive cores at biopsy is a predictor of unfavourable prostate cancer characteristics at radical prostatectomy (RP) in active surveillance (AS) candidates.
Patients and Methods
We examined the data of 524 patients treated with RP, between 2000 and 2012. All fulfilled at least one of four commonly used AS criteria.
Regression models tested the relationship between positive cores spatial distribution, defined as the number of positive zones at biopsy (PBxZ) and tumour laterality at biopsy and two endpoints: (i) unfavourable prostate cancer at RP (Gleason score ≥4 + 3, and/or pT3 disease), and (ii) clinically significant prostate cancer (tumour volume ≥2.5 mL).
Results
Unfavourable prostate cancer and clinically significant prostate cancer rates were 8 and 25%, respectively. Patients with more than one PBxZ had a 3.2‐fold higher risk of harbouring unfavourable prostate cancer, and a 2.3‐fold higher risk of harbouring clinically significant prostate cancer compared with their counterparts with one PBxZ (both P = 0.01).
Patients with bilateral tumour at biopsy had a 3.3‐fold higher risk of harbouring unfavourable prostate cancer and a 1.7‐fold higher risk of harbouring clinically significant prostate cancer compared with their counterparts with unilateral tumour at biopsy (both P ≤ 0.04).
Some of these results did not reach a statistically significant level, when the analyses were restricted to patients that fulfilled the most stringent AS criteria.
Conclusions
Positive cores spatial distribution at biopsy should be considered, when advising patients about AS.
The addition of this predictor to AS inclusion criteria can help identifying patients at a higher risk of progression, and reduce the rate of inappropriate surveillance of aggressive tumours. However, the most stringent AS criteria (namely John‐Hopkins criteria and Prostate Cancer Research International: Active Surveillance criteria) might not benefit from the addition of this predictor. This point warrants further investigation in future studies.
Activation-induced CD137 is a fast assay for identification and multi-parameter flow cytometric analysis of alloreactive T cells
Authors: Litjens N H R , de Wit E A , Baan C C , Betjes M G H 
Published: June 2013

SummaryDetection and isolation of viable alloreactive T cells at the single-cell level requires a cell surface marker induced specifically upon T cell receptor activation. In this study, a member of the tumour necrosis factor receptor (TNFR)-family, CD137 (4-1BB) was investigated for its potential to identify the total pool of circulating alloreactive T cells. Optimal conditions for sensitive and specific detection of allogeneic-induced CD137 expression on circulating T cells were established. Thereafter, CD137+ alloreactive T cells were phenotypically and functionally characterized by multi-parameter flow cytometry. Alloantigen-induced CD137 expression identified both alloreactive CD8+ T cells (mean ± standard error of the mean: 0·21 ± 0·07%) and alloreactive CD4+ T cells (0·21 ± 0·05%). CD137+ alloreactive T cells were detected in different T cell subsets, including naive T cells, but were found preferentially in CD28+ T cells and not in the terminally differentiated T cell subset. Upon allogeneic (re-)stimulation, the cytokine-producing as well as proliferative capacity of T cells resided mainly within the CD137-expressing fraction. About 10% of the CD137+ alloreactive T cells produced any combination of interferon (IFN)-γ, interleukin (IL)-2 and TNF-α. Polyfunctional alloreactive T cells, defined by multiple cytokine expression, were observed infrequently. In conclusion, activation-induced CD137 expression is a fast assay allowing for detection and functional analysis of the total alloreactive T cell compartment at the single-cell level by multi-parameter flow cytometry.
Correlation between subjective and objective evaluation of peri‐implant soft tissue color
Authors: Paniz Gianluca , Bressan Eriberto , Stellini Edoardo , Romeo Eugenio , Lops Diego 
Published: June 2013

AbstractPurposeWhile extensive references are present in the literature dealing with the correlation between subjective and objective evaluation of tooth shade, there is a lack of information on this correlation regarding the soft tissue color. The purpose of this experimental study was to verify whether a correlation between the objective and subjective evaluation exists in analyzing soft tissue color.Material and methodsA total of 39 patients with at least one implant‐supported restoration in the anterior maxilla were included in the study. The shade of the peri‐implant mucosa was compared with the shade of the gingiva at the adjacent tooth in a subjective and in an objective manner. The subjective evaluation was performed by five dental professionals (prosthodontist, periodontist, general dentist, dental hygienist, and dental assistant) in a subjective scale (ranging from 1 to 4). The objective evaluation was obtained by means of a spectrophotometer in a CIELAB* Color Scale, and the differences were evaluated through formula . To correlate the subjective and the objective evaluation, for each arithmetical median value of the subjective evaluation, a mean value of objective evaluation has been calculated, and the Spearman's rank correlation coefficient has been used. The differences have been also analyzed for thin and thick tissue biotypes.ResultsThe mean ∆E value for the subjective evaluation between peri‐implant soft tissue and adjacent tooth gingival tissue was ∆E = 9.74. Also, mean ∆E values of 10.35 and 7.54 have been reported for thin and thick biotypes, respectively. Mean values of ∆E = 6.63, 8.54, and 15.54 were presented by median values of 1 (perfect matching), 2 (good matching), and 3 (clinically distinguishable), respectively. The threshold for the distinction of differences of mucosal color by the human eyes between perfect or good matching and distinguishable values has been calculated in ∆E = 8.74.ConclusionsWithin the limitation of this study, a correlation between the subjective and the objective evaluation of the peri‐implant soft tissue exists and the threshold for the distinction of mucosal color differences between perfect or good matching and distinguishable subjective values has been calculated in ∆E = 8.74 in the objective evaluation.
Ultrathin endoscope‐assisted self‐expandable metallic stent placement following initial unsuccessful attempt in malignant upper gastrointestinal obstruction
Authors: Park Se Woo , Lee Hyuk , Park Jun Chul , Shin Sung Kwan , Lee Sang Kil , Lee Yong Chan 
Published: June 2013

BackgroundConventional endoscopy for self‐expandable metallic stent (SEMS) placement may be technically limited in long and tortuous strictures. Therefore, we analyzed the feasibility, safety and usefulness of ultrathin endoscopy (UTE)‐guided SEMS placement.Patients and MethodsThis study involved 24 patients with upper gastrointestinal obstruction and unsuccessful initial attempts to place SEMS using conventional endoscopy. After completely passing a UTE across the stricture, the UTE was withdrawn, leaving a guidewire placed via the working channel. Through‐the‐scope SEMS placement was done using a conventional endoscope inserted along the guidewire. The primary endpoints were assessed by technical/clinical success and stent patency duration.ResultsStents were successfully placed at target locations in all but one case with a long tortuous stricture, with 95.8% (23/24) technical success. One week after stent placement, mean gastricoutlet obstruction score improved significantly from baseline (1.74 ± 0.62 and 0.33 ± 0.48, respectively; P < 0.001). Stent migration, restenosis, and fracture occurred in four (17.4%), six (26.1%), and one (4.3%) of 23 stents, respectively. Median stent patency duration was 79 days. Mean stent patency was significantly longer in patients who received palliative chemotherapy than in those who did not (122.9 ± 11.0 and 38.3 ± 4.6, respectively; P < 0.001).ConclusionsUTE guidance SEMS delivery can be a feasible and safe rescue treatment method for malignant upper gastrointestinal obstruction in cases of failed attempts to place SEMS using conventional endoscopy. Our result warrants a further study to define the efficacy of this method in difficult SEMS placement cases.
Provision of long‐term care in relation to needs in urban and rural municipalities in Japan and Sweden
Authors: Lagergren Mårten , Kurube Noriko 
Published: June 2013

AimThe aim of the study was to establish whether there are differences in long‐term care (LTC) provision with regard to needs between rural and urban municipalities in Japan and Sweden, and we propose possible causes for these differences.MethodsUsing comparable datasets from Japan (n = 20 699) and Sweden (n = 17 576), the care systems have been compared on an individual level. The datasets each contain information from nine large urban, midsize urban and rural municipalities regarding disability levels and the LTC services provided.ResultsLTC users in the large urban municipalities in both countries are, on average, less disabled than users in the midsize urban and rural municipalities. In both countries, per capita costs for LTC were lower in the large urban municipalities than in the rural municipalities (10% and 14%, respectively). However, when standardized for the level of disability, the per capita costs were higher in the large urban municipalities (4% in both cases). Multivariate analysis showed that there were significant per capita cost differences between the large urban and the rural municipalities in Japan. In Sweden, there were no significant per capita cost differences between the different types of municipality when age, sex and disability differences were accounted for.ConclusionThe findings seem to reflect the effect of differences in household structure, which in the large urban municipalities result in less access to informal LTC, thereby influencing the propensity to apply for formal, public LTC – especially for those with lesser needs. In Japan, where the number of extended family households is decreasing, this gives an idea of the future challenges facing LTC provision. Geriatr Gerontol Int 2014; 14: 315–327..
Underweight/overweight and the risk of long‐term care: Follow‐up study using data of the Japanese long‐term care insurance system
Authors: Honda Akiko , Tanabe Naohito , Seki Nao , Ogawa Yoshiko , Suzuki Hiroshi 
Published: June 2013

AimBoth being underweight and overweight can lead to reduced activity of daily living, which subsequently can require long‐term care. The aim of the present study was to clarify the association between underweight/overweight and the subsequent risk of long‐term care introduction.MethodsWe tracked the data of long‐term care insurance for 1580 men and women aged ≥65 years who had participated in the official population‐based health check‐up program in 2001 in Tsunan town and Sekikawa village, Japan. The health check‐up data and medical expenditure data for the fiscal year 2001 were used as baseline data. Participants were classified into underweight (body mass index (BMI) <18.5 kg/m2), normal range (BMI = 18.5 to <25.0 kg/m2) and overweight (BMI ≥25.0 kg/m2); the normal range was used as a reference category in Cox proportional hazards models.ResultsDuring the average 5.8 years of follow up, 156 participants were identified to start using long‐term care services. Among the young‐old elderly (65–74 years‐of‐age), underweight was significantly associated with the risk of long‐term care introduction (multivariable‐adjusted HR 4.26, 95% CI 1.69–10.72), whereas overweight was not (multivariable‐adjusted HR 1.45, 95% CI 0.69–3.06). Neither underweight nor overweight were significantly associated with long‐term care introduction among the old‐old elderly (≥75 years‐of‐age).ConclusionsUnderweight could be a good predictor of long‐term care introduction in the young‐old elderly. We should pay attention to underweight in the elderly, as it might be a manifestation of some physical or mental problems related to future long‐term care introduction. Geriatr Gerontol Int 2014; 14: 328–335.
Consequences of switching from prophylactic treatment to on‐demand treatment in late teens and early adults with severe haemophilia A: the TEEN/TWEN study
Authors: Manco‐Johnson M. J. , Sanders J. , Ewing N. , Rodriguez N. , Tarantino M. , Humphries T. ,   TEEN/TWEN Study Group
Published: June 2013

SummaryAlthough many people with haemophilia discontinue prophylaxis in their late teens or early adulthood, the consequences of this decision are largely not known. This 18‐month, observational, case‐controlled, multicentre study evaluated long‐term prophylaxis and the consequences of switching from prophylaxis to on‐demand treatment in late teens and young adults with severe haemophilia A. Participants with haemophilia (aged 14–29 years) on prophylaxis ≥60% of the time for the 5 years before study entry were enrolled into 1 of 2 prospective or 1 retrospective group. Group 1 was prophylaxis, group 2 had voluntarily discontinued prophylaxis ≤12 months before study entry and group 3 had voluntarily discontinued prophylaxis ≥13 months before study entry. Assessments included bleeding frequency (primary endpoint), Haemo‐QoL‐A health‐related quality of life (HRQoL) scores, Gilbert score, development of target joints, Haemophilia Activities List, Godin Leisure‐Time, treatment satisfaction and State‐Trait Anxiety Inventory (secondary and exploratory endpoints). Descriptive statistics were provided for all variables. Thirty‐eight participants (group 1, n = 22; group 2, n = 5; group 3, n = 11; median age, 19.5 years) were enrolled. The median annualized number of bleeding events was 0, 4.8 and 24 in groups 1, 2 and 3 respectively. HRQoL was lower in participants who discontinued prophylaxis vs. those who remained on prophylaxis. Changes in the remaining secondary and exploratory variables were small, but were generally worse in participants who discontinued prophylaxis. Following a switch from prophylaxis to on‐demand therapy, the number of bleeding events increased and HRQoL worsened in late teens and young adults with severe haemophilia A.
Indices of initial hepatitis C virus RNA reduction rate to predict efficacy of interferon‐beta followed by peginterferon plus ribavirin for genotype 1b high viral load
Authors: Okushin Hiroaki , Yamamoto Takeharu , Kishida Hiroshi , Morii Kazuhiko , Uesaka Koichi 
Published: June 2013

AimInitial hepatitis C virus (HCV) RNA reduction was investigated as a potential index for sustained virological response (SVR) in the treatment of interferon (IFN)‐β followed by peginterferon plus ribavirin (PEG IFN/RBV).MethodsThe treatment course was retrospectively analyzed in 64 genotype 1b patients with a HCV RNA level of 5.0 logIU/mL or higher. IFN‐β was administrated twice a day for 2 weeks followed by 24 or 48 weeks of PEG IFN/RBV. The serum HCV RNA level was measured by real‐time polymerase chain reaction before administration and at 1, 2 and 4 weeks of therapy.ResultsBy the duration of PEG IFN administration, the SVR rates were 11% (2/18, <19 weeks), 64% (23/36, 20–24 weeks) and 40% (4/10, 25–72 weeks) (P = 0.0011, χ2‐test). The SVR rate was high in patients in whom the HCV RNA level had decreased by 2.5 logIU/mL or greater at 1 week of IFN‐β (29/55 [53%] vs 0/9 [0%], P = 0.0029, χ2‐test). Among these patients, the SVR rate was even higher in those with continuous reduction in the first 2 weeks after the switch to PEG IFN/RBV (27/45 [60%] vs 2/10 [20%], P = 0.0048). Age below 65 years, no previous IFN course and good initial HCV RNA reduction were significantly associated with SVR on multivariate analysis, and the SVR rate was 95% (18/19) among these patients.ConclusionThe 2.5 logIU/mL reduction in HCV RNA at 1 week of IFN‐β and the continuous reduction just after the switch to PEG IFN/RBV are important SVR‐predictive indices.
Integration of pharmacists into general practice clinics in Australia: the views of general practitioners and pharmacists
Authors: Tan Edwin C K , Stewart Kay , Elliott Rohan A , George Johnson 
Published: June 2013

Abstract

Background
Pharmacists working collaboratively with general practitioners (GPs) in primary-care settings can improve patient outcomes; however, there are challenges to the implementation of collaborative services. A possible solution is the co-location of pharmacists within general practice clinics.

Objective
To elicit the views of GPs and pharmacists on the integration of pharmacists into general practice in Australia.

Methods
Semi-structured, individual interviews with a sample of 11 GPs and 16 pharmacists.

Key findings
Four major themes emerged: the current GP–pharmacist relationship; the role of the general practice pharmacist; the pros and cons of integration; and the barriers to and facilitators for integration. Most participants had experienced positive inter-professional relationships, though there were limitations in the collaborative services currently provided. Various methods of integration were discussed, including the co-location of pharmacists within practices. The potential roles for practice pharmacists were deemed to be multifaceted and in some cases allowed for role expansion. Although these roles were thought to offer potential benefits to practice staff, patients and pharmacists, they were also perceived to be potentially disadvantageous. The integration of pharmacists into general practice was believed to be hindered by limited funding and infrastructure and by practitioner perceptions. Various facilitating factors were proposed that could help ensure viability of the role.

Conclusions
Various roles and methods of integration were identified for pharmacists in general practice; however, a number of barriers and facilitators to integration would need to be considered to ensure viability of services. Future research should explore different methods of collaboration and trial their implementation.
Systemic perspective of violence and aggression in mental health care: Towards a more comprehensive understanding and conceptualization: Part 2
Authors: Cutcliffe John R. , Riahi Sanaz 
Published: June 2013

AbstractThis is the second of a two part paper which seeks to explore a wide range of phenomena that have been found to have an association with aggression and violence (A/V) in inpatient mental health care, synthesize these propositions according to fit or congruence into a systemic model of A/V, explore the empirical evidence pertaining to these propositions, and begin to consider application of this model to better inform our individual and/or organizational responses to A/V in mental health care. The systemic model is comprised of four thematic categories with part two of the paper focusing on the final two categories: mental health‐care system‐related phenomena and clinician‐related phenomena. The paper then discusses a number of implications arising out of embracing a more systemic model of A/V in mental health care. In broadening our understanding to include all the phenomena that contribute increased risk of A/V incidents, we are able to move away from inaccurate views that disproportionately assign ‘responsibility’ to clients for causing A/V when the evidence indicates that the client‐related phenomena may only account for a small portion of these incidents.
Rentensysteme und ihre Reformen auf der ganzen Welt: Ursachen, Trends und Herausforderungen
Authors: Holzmann Robert 
Published: June 2013

AuszugDie Rentensysteme und ihre Reformen befinden sich aufgrund sich verschiebender Schwerpunkte, verändertem Reformbedarf und sich wandelnder Umfeldfaktoren auf der ganzen Welt in stetigem Wandel. Diese Veränderungen widerspiegeln einerseits objektive Ereignisse und andererseits Veränderungen der Überzeugungen und Wahrnehmungen. Aufgrund der anhaltenden globalen Finanzkrise und der Anpassung an eine noch ungewisse „neue Normalität“ werden sich die Rentensysteme der Zukunft von denen der Vergangenheit unterscheiden. In diesem Artikel unterbreiten wir: i) eine Zusammenfassung der wichtigsten aktuellen Veränderungen, die zu Reformen führen, ii) eine Übersicht über die wesentlichen Reformtrends bei den unterschiedlichen Rentensäulen in den letzten zwei Jahrzehnten und iii) einen Überblick über die wichtigsten Aspekte, auf die sich die Verantwortlichen bei Rentenreformen konzentrieren müssen, um ihre Ziele zu erreichen.