bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complementary and alternative asthma treatments and their association with asthma control: a population-based study
Authors: Chen Wenjia , FitzGerald J Mark , Rousseau Roxanne , Lynd Larry D , Tan Wan C , Sadatsafavi Mohsen 
Published: September 2013

ObjectivesMany patients with asthma spend time and resources consuming complementary and alternative medicines (CAMs). This study explores whether CAM utilisation is associated with asthma control and the intake of asthma controller medications.DesignPopulation-based, prospective cross-sectional study.SettingGeneral population residing in two census areas in the province of British Columbia, Canada. Recruitment was based on random-digit dialling of both landlines and cell phones.Participants486 patients with self-reported physician diagnosis of asthma (mean age 52 years; 67.3% woman).Primary and secondary outcome measuresWe assessed CAM use over the previous 12 months, level of asthma control as defined by the Global Initiative for Asthma and the self-reported intake of controller medications. Multivariate logistic regression was performed to study the relationship between any usage of CAMs (outcome), asthma control and controller medication usage, adjusted for potential confounders.ResultsA total of 179 (36.8%) of the sample reported CAM usage in the past 12 months. Breathing exercises (17.7%), herbal medicines (10.1%) and vitamins (9.7%) were the most popular CAMs reported. After adjustment, female sex (OR 1.66; 95% CI 1.09 to 2.52) and uncontrolled asthma (vs controlled asthma, OR 2.25, 95% CI 1.30 to 3.89) were associated with a higher likelihood of using any CAMs in the past 12 months. Controller medication use was not associated with CAM usage in general and in the subgroups defined by asthma control.ConclusionsClinicians and policy makers need to be aware of the high prevalence of CAM use in patients with asthma and its association with lack of asthma control.
Accessory Cells of the Microenvironment Protect Multiple Myeloma from T-Cell Cytotoxicity through Cell Adhesion-Mediated Immune Resistance
Authors: de Haart Sanne J. , van de Donk Niels W.C.J. , Minnema Monique C. , Huang Julie H. , Aarts-Riemens Tineke , Bovenschen Niels , Yuan Huipin , Groen Richard W.J. , McMillin Douglas W. , Jakubikova Jana , Lokhorst Henk M. , Martens Anton C. , Mitsiades Constantine S. , Mutis Tuna 
Published: September 2013

Abstract
Purpose: Cellular immunotherapy frequently fails to induce sustained remissions in patients with multiple myeloma, indicating the ability of multiple myeloma cells to evade cellular immunity. Toward a better understanding and effective therapeutic modulation of multiple myeloma immune evasion mechanisms, we here investigated the role of the tumor microenvironment in rendering multiple myeloma cells resistant to the cytotoxic machinery of T cells.
Experimental Design: Using a compartment-specific, bioluminescence imaging-based assay system, we measured the lysis of luciferase-transduced multiple myeloma cells by CD4+ or CD8+ CTLs in the presence versus absence of adherent accessory cells of the bone marrow microenvironment. We simultaneously determined the level of CTL activation by measuring the granzyme B release in culture supernatants.
Results: Bone marrow stromal cells from patients with multiple myeloma and healthy individuals, as well as vascular endothelial cells, significantly inhibited the lysis of multiple myeloma cells in a cell–cell contact-dependent manner and without substantial T-cell suppression, thus showing the induction of a cell adhesion-mediated immune resistance (CAM-IR) against CTL lysis. Further analyses revealed that adhesion to accessory cells downregulated Fas and upregulated the caspase-3 inhibitor survivin in multiple myeloma cells. Reconstitution of Fas expression with bortezomib enhanced the CTL-mediated lysis of multiple myeloma cells. Repressing survivin with the small-molecule YM155 synergized with CTLs and abrogated CAM-IR in vitro and in vivo.
Conclusion: These results reveal the cell adhesion-mediated induction of apoptosis resistance as a novel immune escape mechanism and provide a rationale to improve the efficacy of cellular therapies by pharmacologic modulation of CAM-IR. Clin Cancer Res; 19(20); 5591–601. ©2013 AACR.
Molecular Pathways: Targeting MALT1 Paracaspase Activity in Lymphoma
Authors: Fontán Lorena , Melnick Ari 
Published: September 2013

Abstract
MALT1 mediates the activation of NF-κB in response to antigen receptor signaling. MALT1, in association with BCL10 and CARD11, functions as a scaffolding protein to activate the inhibitor of IκB kinase (IKK) complex. In addition, MALT1 is a paracaspase that targets key proteins in a feedback loop mediating termination of the NF-κB response, thus promoting activation of NF-κB signaling. Activated B-cell subtype of diffuse large B-cell lymphomas (ABC-DLBCL), which tend to be more resistant to chemotherapy, are often biologically dependent on MALT1 activity. Newly developed MALT1 small-molecule inhibitors suppress the growth of ABC-DLBCLs in vitro and in vivo. This review highlights the recent advances in the normal and disease-related functions of MALT1. Furthermore, recent progress targeting MALT1 proteolytic activity raises the possibility of deploying MALT1 inhibitors for the treatment of B-cell lymphomas and perhaps autoimmune diseases that involve increased B- or T-cell receptor signaling. Clin Cancer Res; 19(24); 6662–8. ©2013 AACR.
Acquired haemophilia A: A 2013 update
Authors: Franchini Massimo , Mannucci Pier Mannuccio 
Published: September 2013

SummaryAcquired haemophilia A (AHA) is a rare but often severe bleeding disorder caused by autoantibodies against coagulation factor VIII (FVIII). AHA occurs more frequently in the elderly and in association with several conditions, such as the post-partum period, malignancies, autoimmune diseases or drug exposure; however, approximately 50% of reported cases are apparently idiopathic. Beside the elimination of the underlying disorder, the therapeutic approach to AHA should be directed toward the control of acute bleed and the eradication of FVIII autoantibody production. In this narrative review, we summarise the current knowledge on the epidemiology, diagnosis and clinical features of AHA, focusing in particular on advances in the management of this challenging bleeding disorder.
A Congolese Virus and Belgian Doctors? Postcolonial Perspectives on Migration and HIV1
Authors: Pezeril Charlotte , Kanyeba Dany 
Published: September 2013

Abstract
Based on collaborative research between a Congolese activist in HIV prevention in Belgium and a French anthropologist, this paper hopes to initiate a debate about the issue of HIV /AIDS in light of the postcolonial links between Belgium and its former colony Congo/Zaire. By exploring the social representations that HIV has generated in Francophone Belgium and the changing political management of the epidemic since the 1980s, the paper focuses on how Congolese HIV-­positive migrants have been viewed, treated and allowed (or not) to settle in Belgium. It analyzes how the HIV/AIDS epidemic was seen as an ‘African disease,’ and more precisely a ‘Congolese virus.’ It concludes that Achille Mbembe’s ‘postcolonial scoriae’ must be taken into account (without necessarily implying a linear passage from colonial to postcolonial relations) in order to understand European and international policies in Africa or policies concerning African migrants.
« Le Kivu, c’est notre Alsace-Lorraine, monsieur ! » : Femmes d’origine congolaise dans l’espace public belge et contraintes de la dénonciation en situation postcoloniale
Authors: Sinatu Césarine Bolya , Godin Marie , Grégoire Nicole 
Published: September 2013

Résumé
A partir d’une situation d’interpellation parlementaire mettant en scène une tribune de femmes d’origine congolaise dénonçant la situation de guerre et de violence sévissant à l’Est du Congo, cet article se penche sur la présence croissante de femmes d’origine congolaise dans l’espace public belge. Tout d’abord, l’article met en relation l’histoire de l’évolution des rapports sociaux de sexe au Congo et la socialisation politique de certaines femmes d’origine congolaise dans l’espace public belge à travers notamment le développement d’un tissu associatif congolais particulièrement féminisé. Ensuite, le cadre dans lequel la dénonciation faite par les femmes prend place est analysé par le biais d’un outillage théorique innovant, articulant des concepts de la sociologie pragmatique (Boltanski et al. 1984; Boltanski et al. 2007) et de la théorie des mouvements sociaux (Snow et al. 1986). L’analyse montre que les rapports postcoloniaux belges peuvent donner lieu, dans l’espace public, à des situations d’interaction paradoxales où l’histoire coloniale, alors qu’elle sous-tend l’ensemble des échanges, doit être gardée sous silence sous peine de grever la légitimité et la cohérence de la prise de parole en public. Cette stratégie d’évitement du cadre postcolonial permet aux femmes de faire entendre leurs voix.
Prognostic impact of vascular and lymphovascular invasion in early lung cancer
Authors: Al-Alao Bassel S , Gately Kathy , Nicholson Siobhan , McGovern Eilis , Young Vincent K , O'Byrne Kenneth J 
Published: September 2013

Background The prognostic significance of vascular and lymphatic invasion in non-small-cell lung cancer is under continuous debate. We analyzed the effect of tumor aggressiveness (lymphatic and/or vessel invasion) on survival and relapse in stage I and II non-small-cell lung cancer. Methods We retrospectively analyzed prospectively collected data of 457 patients with stage I and II non-small-cell lung cancer from 1998 to 2008. Specimens were analyzed for intratumoral vascular invasion and lymphovascular space invasion. Overall survival and disease-free survival were estimated using the Kaplan-Meier method, and differences were determined by the logrank test. Cox regression analysis was performed to identify independent risk factors. Results The incidence of intratumoral vascular invasion was 23.4%, and this correlated significantly with grade of differentiation, visceral pleural involvement, lymphovascular space invasion, and N status. The incidence of lymphovascular space invasion was 5.5%, and this correlated significantly with grade of differentiation, lymph nodes involved, and intratumoral vascular invasion. On multivariate analyses, intratumoral vascular invasion proved to be an significant independent risk factor for overall survival but not for disease-free survival. Lymphovascular space invasion was associated significantly with early tumor recurrence but not with overall survival. Conclusions Vascular and lymphatic invasion can serve as independent prognostic factors in completely resected non-small-cell lung cancer. Intratumoral vascular invasion and lymphovascular space invasion in early stage non-small-cell lung cancer are important factors in overall survival and early tumor recurrence. Further large scale studies with more recent patient cohorts and refined histological techniques are warranted.
Initial large-dose administration of modified St. Thomas' solution
Authors: Hiraoka Arudo , Nakajima Kosuke , Kuinose Masahiko , Totsugawa Toshinori , Yoshitaka Hidenori 
Published: September 2013

Background We introduced an initial large dose of modified St. Thomas' Hospital cardioplegic solution with the aim of providing both myocardial protection as well as a smooth intraoperative process. Methods In 90 cases of isolated aortic valve replacement, we used the modified technique of cardioplegia in 45 (group S) and conventional administration of glucose-insulin-potassium solution in 45 (group G). The patients were selected at random. In group S, we added 4 mEq of potassium to the original St. Thomas' Hospital solution and administered 30 mL·kg−1 as an initial dose. The temperature was decreased to 2℃. Results The mean of reperfusion time after declamping in group S was significantly shorter (16.7 ± 6.4 vs. 21.5 ± 10.0 min; p = 0.007). The average of postoperative maximum creatine kinase-MB was significantly lower in group S (25.6 ± 9.5 vs. 40.6 ± 37.2 IU·L−1; p = 0.014). On multivariate analysis, use of the modified cardioplegia and aortic crossclamp time were significantly associated with creatine kinase-MB level and reperfusion time after declamping. Conclusions This modified technique was an acceptable option that provided a bloodless operative field and avoided multiple cardioplegic administrations.
MRI evaluation of the four tunnels of double-bundle ACL reconstruction
Authors: Kiekara Tommi , Järvelä Timo , Huhtala Heini , Paakkala Antti 
Published: September 2013

Background The double-bundle (DB) reconstruction of the anterior cruciate ligament (ACL) has gained popularity in recent years. The positioning of anteromedial (AM) and posterolateral (PL) tunnels is aimed at the anatomic femoral and tibial attachments of AM and PL bundles of the native ACL. Purpose To use magnetic resonance imaging (MRI) to evaluate the tunnel locations and tunnel findings in DB ACL reconstruction. Material and Methods Sixty-six patients with DB ACL reconstruction were evaluated with 1.5-T MRI 2 years postoperatively. Two musculoskeletal radiologists separately measured the locations and the diameters of the tunnels. Inter-observer agreements were estimated according to the method of Bland and Altman. Results In the femur, the mean AM tunnel location was 32% from the proximal condylar surface and 18% from the notch roof. The mean PL tunnel location was 42% and 43%, respectively. In the tibia, the mean AM tunnel location was 54% of the lateral-to-medial tibial width and 42% of the anterior-to-posterior tibial depth. The mean PL tunnel location was 54% and 56%, respectively. The mean tunnel enlargement was 3.8 mm (56%). Tunnel communication was seen in seven patients (11%) in the femur and in 19 patients (29%) in the tibia. Greater femoral AM tunnel distance from the proximal condylar surface was associated with more tunnel enlargement, and more posterior tibial PL tunnel location was associated with less tunnel enlargement. Conclusion The tunnel locations of DB ACL reconstruction can be evaluated with MRI. Tunnel location was associated with tunnel enlargement that in turn was associated with tunnel communication.
Explanations for the heterogeneity of splenic enhancement derived from blood flow kinetic measurements using dynamic contrast-enhanced CT (DCE-CT)
Authors: Sauter Alexander W , Spira Daniel , Schulze Maximilian , Horger Marius S 
Published: September 2013

Background The heterogeneity of splenic computed tomography (CT) attenuation is still not fully understood. A differentiation of these enhancement patterns and other conditions such as diffuse spleen infiltration can be challenging. Purpose To understand the underlying physiological mechanisms of flow heterogeneity in normal and cirrhosis patients by quantifying perfusion parameters such as blood flow (BF), blood volume (BV), time to peak (TTP), flow extraction product (Ktrans), and mean transit time (MTT) using dynamic contrast-enhanced CT (DCE-CT). Material and Methods Sixteen patients without splenic or hepatic disease and 16 patients with liver cirrhosis were retrospectively analyzed. Perfusion assessment included rapidly and slowly enhancing areas of the spleen, the entire splenic volume, as well as intra- and inter-observer reliability analysis. Results Significant differences between rapidly and slowly enhancing areas were found in controls for BF (109.8 mL/100 mL/min vs. 63.5 mL/100 mL/min), BV (37.1 mL/100 mL vs. 18.9 mL/100 mL), MTT (10.1 s vs. 13.0 s), but not for TTP (17.6 s vs. 18.6 s) and Ktrans (40.3 mL/100 mL/min vs. 44.7 mL/100 mL/min). In cirrhotic patients, differences proved significant for BF (90.5 mL/100 mL/min vs. 58.7 mL/100 mL/min), BV (17.5 mL/100 mL vs. 8.8 mL/100 mL), but not for Ktrans (60.9 mL/100 mL/min vs. 50.5 mL/100 mL/min), TTP (18.8 s vs. 20.0 s), and MTT (11.4 s vs. 14.2 s). Differences between rapidly enhancing areas in controls and cirrhotic patients reached a significant level for BV and Ktrans. Conclusion Preliminary results suggest that DCE-CT-based splenic perfusion measurements enable detection of different blood flow kinetics presumed to represent the complex and characteristic architecture of splenic vascular channels. It is the separate analysis of flow kinetics through the rapidly enhancing channels that allow for additional differentiation between controls and patients with portal hypertension.
Early Controlled Tension Improves the Material Properties of Healing Human Achilles Tendons After Ruptures
Authors: Schepull Thorsten , Aspenberg Per 
Published: September 2013

Background: Weightbearing in a fixed brace after acute Achilles tendon ruptures does not necessarily lead to mechanical tension in the tendon. Early motion has a positive effect on the clinical outcome, but it is not clear if this is because of effects on tendon strength or unspecific effects. The aim of this study was to examine if tensional loading leads to an improvement in the mechanical properties of the healing Achilles tendon. Hypothesis: The elastic modulus of the tendon callus is increased by early tensional loading. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Thirty-five patients with an acute Achilles tendon rupture were recruited consecutively. They underwent surgery with a single suture and received metal markers in the distal and proximal parts of the tendon. After surgery, the patients were randomized to either cast immobilization for 7 weeks or tensional loading. The latter group wore a cast for 2 weeks and then a removable foam walker boot for 5 weeks. They were instructed to remove the boot twice daily and push a special training pedal to produce a predetermined, gradually increasing tensional load on the healing tendon. At 7, 19, and 52 weeks postoperatively, the patients were investigated with roentgen stereophotogrammetric analysis under different loading conditions and computed tomography. The collected data allowed calculation of the modulus of elasticity. At 52 weeks, the clinical outcome was also examined using the Achilles tendon Total Rupture Score (ATRS) and the heel-raise index. Results: The elastic modulus at 19 and 52 weeks was higher in the tensional loading group. There was no significant difference in the ATRS or heel-raise index at 52 weeks. As in previous studies, there was a significant correlation between the modulus at 7 weeks and the heel-raise index at 52 weeks. There were no signs of tendon elongation. Conclusion: Early tensional loading improves the mechanical properties of the healing Achilles tendon.
A Comparison of the Responsiveness of 4 Commonly Used Patient-Reported Outcome Instruments at 5 Years After Matrix-Induced Autologous Chondrocyte Implantation
Authors: Ebert Jay R. , Smith Anne , Wood David J. , Ackland Timothy R. 
Published: September 2013

Background: Patient-reported outcome (PRO) instruments are employed to assess outcomes after matrix-induced autologous chondrocyte implantation (MACI), although the PRO most responsive to change after surgery remains unknown. Purpose: To compare the responsiveness of 4 commonly used PRO instruments at 5 years after MACI. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The Knee Injury and Osteoarthritis Outcome Score (KOOS), the Lysholm score, the Tegner activity scale, and the 36-item Short Form Health Survey (SF-36) were administered to 104 patients before and at 5 years after MACI knee surgery. The Self-administered Patient Satisfaction Scale was employed at 5 years to investigate each patient’s overall level of satisfaction as well as satisfaction with relieving pain and improving the ability to perform daily activities, partake in recreational activities, and participate in sport. The effect size (ES) and standardized response mean (SRM) were used to compare PRO responsiveness. A receiver operating characteristic (ROC) curve analysis was performed to evaluate the extent to which PRO changes were associated with satisfaction. The minimal clinically important difference (MCID) according to the criterion of patient satisfaction was identified as the PRO instrument change score maximizing classification accuracy. Results: The most responsive PRO measures were the KOOS sport/recreation (ES, 1.63; SRM, 1.43) and quality of life (QOL) (ES, 1.37; SRM, 1.18) subscales. The least responsive were the SF-36 mental component summary (MCS) (ES, 0.38; SRM, 0.40) and the Tegner activity scale (ES, 0.91; SRM, 0.59). Of the 104 patients, 54 (51.9%) reported being “very satisfied,” 38 (36.5%) “somewhat satisfied,” 8 (7.7%) “somewhat dissatisfied,” and 4 (3.9%) “very dissatisfied.” A ROC curve analysis was performed using “very satisfied” as the responder criterion. The strongest association was between the change in KOOS sport/recreation with satisfaction in improving the ability to perform recreational activities (area under the curve, 0.756; 95% confidence interval, 0.663-0.849), and the change score maximizing prediction accuracy (MCID) was 40 (sensitivity, 69%; specificity, 76%). Conclusion: The KOOS sport/recreation and QOL subscales were the most responsive PRO measures and were most predictive of satisfaction. This information will provide a guide as to the improvements required in pertinent PRO measures to produce a satisfied patient, while allowing researchers to better structure trials in these patients using the most relevant PRO instruments.
Unveiling the Work–Life System
Authors: Munn Sunny L. 
Published: September 2013

The Problem Individuals, organizations, and government are the primary forces studied in a work–life scenario. Too often these forces are studied independently of one another when they should instead be examined as a system. The most frequently discussed piece of the work–life system is work–life balance. Understanding how concepts of work–life balance are intertwined with meaningful work is important to individual and organizational development in human resource development (HRD). The Solution This article introduces the work–life system as a means to examine the three forces, individuals, organizations, and government, and the three work–life dimensions, balance, initiatives, and policy. The first force and the first dimension, individuals and work–life balance, are discussed to demonstrate connections between work–life balance, meaningful work, and organizational culture. Using data from the 2008 National Study of the Changing Workforce, a preliminary ordinary least squares regression analysis illustrates these relationships and provides insight for future research. The Stakeholders Work–life balance is increasingly relevant to HRD researchers and practitioners. This discussion seeks to illuminate key facets of the work–life dialogue and their impact on meaningful work to encourage further integration of the work–life system within HRD research and practice in the United States.