bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surveillance of active human cytomegalovirus infection in hematopoietic stem cell transplantation (HLA sibling identical donor): search for optimal cutoff value by real-time PCR
Authors: Peres Renata MB , Costa Cláudia RC , Andrade Paula D , Bonon Sandra HA , Albuquerque Dulcinéia M , de Oliveira Cristiane , Vigorito Afonso C , Aranha Francisco JP , de Souza Cármino A , Costa Sandra CB 
Published: June 2010

Abstract

Background
Human cytomegalovirus (CMV) infection still causes significant morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Therefore, it is extremely important to diagnosis and monitor active CMV infection in HSCT patients, defining the CMV DNA levels of virus replication that warrant intervention with antiviral agents in order to accurately prevent CMV disease and further related complications.

Methods
During the first 150 days after allogeneic HSTC, thirty patients were monitored weekly for active CMV infection by pp65 antigenemia, nested-PCR and real-time PCR assays. Receiver operating characteristic (ROC) plot analysis was performed to determine a threshold value of the CMV DNA load by real-time PCR.

Results
Using ROC curves, the optimal cutoff value by real-time PCR was 418.4 copies/104 PBL (sensitivity, 71.4%; specificity, 89.7%). Twenty seven (90%) of the 30 analyzed patients had active CMV infection and two (6.7%) developed CMV disease. Eleven (40.7%) of these 27 patients had acute GVHD, 18 (66.7%) had opportunistic infection, 5 (18.5%) had chronic rejection and 11 (40.7%) died - one died of CMV disease associated with GVHD and bacterial infection.

Conclusions
The low incidence of CMV disease in HSCT recipients in our study attests to the efficacy of CMV surveillance based on clinical routine assay. The quantification of CMV DNA load using real-time PCR appears to be applicable to the clinical practice and an optimal cutoff value for guiding timely preemptive therapy should be clinically validated in future studies.
Effect of obesity on constant workrate exercise in hyperinflated men with COPD
Authors: Laviolette Louis , Sava Francesco , O'Donnell Denis E , Webb Katherine A , Hamilton Alan L , Kesten Steven , Maltais François 
Published: June 2010

Abstract

Background
Chronic obstructive pulmonary disease (COPD) and a high body mass index (BMI) can both affect pulmonary volumes as well as exercise tolerance, but their combined effect on these outcomes is not well known. The aim of this study was to investigate the effects of increased BMI during constant workrate cycle ergometry in patients with COPD.

Methods
Men with COPD and hyperinflation were divided according to World Health Organization BMI classification: 84 normal BMI (NBMI), 130 overweight (OW) and 64 obese (OB). Patients underwent spirometric and lung volumes assessment and an incremental cycling exercise test. This was followed by a constant workrate exercise test (CET) at 75% of peak capacity. Inspiratory capacity and Borg dyspnea scores were measured at baseline, during and at the end of CET.

Results and discussion
FEV1 % predicted was not different across BMI classes. Total lung capacity and functional residual capacity were significantly lower in OB and OW compared to NBMI patients. Peak VO2 in L·min-1 was significantly higher in OB and OW patients than in NBMI patients. CET time was not different across BMI classes (p = 0.11). Changes in lung volumes and dyspnea during CET were not different between BMI categories.

Conclusions
OB and OW patients with COPD had a higher peak VO2 than their lean counterparts. Endurance time, dyspnea and changes in lung volumes during CET were similar between BMI categories.
US public opinion regarding proposed limits on resident physician work hours
Authors: Blum Alexander B , Raiszadeh Farbod , Shea Sandra , Mermin David , Lurie Peter , Landrigan Christopher P , Czeisler Charles A 
Published: June 2010

Abstract

Background
In both Europe and the US, resident physician work hour reduction has been a source of controversy within academic medicine. In 2008, the Institute of Medicine (IOM) recommended a reduction in resident physician work hours. We sought to assess the American public perspective on this issue.

Methods
We conducted a national survey of 1,200 representative members of the public via random digit telephone dialing in order to describe US public opinion on resident physician work hour regulation, particularly with reference to the IOM recommendations.

Results
Respondents estimated that resident physicians currently work 12.9-h shifts (95% CI 12.5 to 13.3 h) and 58.3-h work weeks (95% CI 57.3 to 59.3 h). They believed the maximum shift duration should be 10.9 h (95% CI 10.6 to 11.3 h) and the maximum work week should be 50 h (95% CI 49.4 to 50.8 h), with 1% approving of shifts lasting >24 h (95% CI 0.6% to 2%). A total of 81% (95% CI 79% to 84%) believed reducing resident physician work hours would be very or somewhat effective in reducing medical errors, and 68% (95% CI 65% to 71%) favored the IOM proposal that resident physicians not work more than 16 h over an alternative IOM proposal permitting 30-h shifts with ≥5 h protected sleep time. In all, 81% believed patients should be informed if a treating resident physician had been working for >24 h and 80% (95% CI 78% to 83%) would then want a different doctor.

Conclusions
The American public overwhelmingly favors discontinuation of the 30-h shifts without protected sleep routinely worked by US resident physicians and strongly supports implementation of restrictions on resident physician work hours that are as strict, or stricter, than those proposed by the IOM. Strong support exists to restrict resident physicians' work to 16 or fewer consecutive hours, similar to current limits in New Zealand, the UK and the rest of Europe.
Early uptake and continuous accumulation of thallium-201 chloride in a benign mixed tumor of soft tissue: Case Report
Authors: Nagata Shigenori , Jin Yu-Fen , Yoshizato Katsuhiko , Kitamura Masanori , Iizuka Norishige , Song Misa , Tomoeda Miki , Yuki Michiko , Kubo Chiaki , Yoshizawa Hidenori , Outani Hidetatsu , Hamada Kenichiro , Araki Nobuhito , Funauchi Masahiro , Tomita Yasuhiko 
Published: June 2010

Abstract
A case of benign mixed tumor of the soft tissue in a 64-year-old Japanese male is presented. He noticed a painless, elastic hard mass sized 3 cm in the right knee, which gradually grew larger and harder in the last 5 years. Magnetic resonance imaging demonstrated a mass lesion embedded in the subcutaneous tissue with low and high signal intensity at T1- and T2-weighted images, respectively. Tl-201 scintigraphy showed an early uptake of Tl-201 within the lesion at 10 minutes after injection, which was slightly decreased but still continued at 2 hours later. The patient underwent a resection of tumor, and the pathological diagnosis was a benign mixed tumor of soft tissue without high vascularity, characterized by histological features similar to pleomorphic adenomas in the salivary glands. Immunohistochemical study proved expression of Na+/K+-ATPase of tumor cells. Overexpression of Na+/K+-ATPase of the tumor might be responsible for the early uptake of Tl-201, and poor vascular structure in this tumor might lead to continuous accumulation. The Tl-201 scintigraphic features of mixed tumor of soft tissue are assessed to resemble those of malignant soft tissue tumors.
The differential effects of core stabilization exercise regime and conventional physiotherapy regime on postural control parameters during perturbation in patients with movement and control impairment chronic low back pain
Authors: Muthukrishnan Ramprasad , Shenoy Shweta D , Jaspal Sandhu S , Nellikunja Shankara , Fernandes Svetlana 
Published: June 2010

Abstract

Background
The purpose of the present study was to examine the differential effect of core stability exercise training and conventional physiotherapy regime on altered postural control parameters in patients with chronic low back pain (CLBP). As heterogeneity in CLBP population moderates the effect of intervention on outcomes, in this study, interventions approaches were used based on sub-groups of CLBP.

Methods
This was an allocation concealed, blinded, sequential and pragmatic control trial. Three groups of participants were investigated during postural perturbations: 1) CLBP patients with movement impairment (n = 15, MI group) randomized to conventional physiotherapy regime 2) fifteen CLBP patients with control impairment randomized to core stability group (CI group) and 3) fifteen healthy controls (HC).

Results
The MI group did not show any significant changes in postural control parameters after the intervention period however they improved significantly in disability scores and fear avoidance belief questionnaire work score (P < 0.05). The CI group showed significant improvements in Fx, Fz, and My variables (p < 0.013, p < 0.006, and p < 0.002 respectively with larger effect sizes: Hedges's g > 0.8) after 8 weeks of core stability exercises for the adjusted p values. Postural control parameters of HC group were analyzed independently with pre and post postural control parameters of CI and MI group. This revealed the significant improvements in postural control parameters in CI group compared to MI group indicating the specific adaptation to the core stability exercises in CI group. Though the disability scores were reduced significantly in CI and MI groups (p < 0.001), the post intervention scores between groups were not found significant (p < 0.288). Twenty percentage absolute risk reduction in flare-up rates during intervention was found in CI group (95% CI: 0.69-0.98).

Conclusions
In this study core stability exercise group demonstrated significant improvements after intervention in ground reaction forces (Fz, Mz; g > 0.8) indicating changes in load transfer patterns during perturbation similar to HC group.

Trial registration
UTRN095032158-06012009423714
5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention: summary of key research and implications for policy and practice – Biomedical prevention
Authors: Mascolinli Mark , Kort Rodney 
Published: June 2010

No major findings were reported at the 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2009) on currently enrolled microbicides, pre‐exposure prophylaxis (PrEP) or vaccine trials, although important findings in all three areas of biomedical prevention research are expected within the next few years.A study found that daily acyclovir did not reduce HIV transmission, but was a factor in modest reductions in viral load, which could confer some clinical benefit. Research demonstrating rapid viral replication in mucosal tissue and subsequent dissemination throughout the body suggested that research priorities should shift towards a mucosal vaccine. Findings reported in Track C indicated that, in addition to reducing vertical transmission, antiretroviral therapy (ART) also lowers the risk of prematurity, stillbirth and abortion.Challenging concerns about the potential “disinhibiting” effect of ART as prevention, a Kenyan study found that widespread ART encourages greater use of condoms and does not increase the rate of risky sex. Another Kenyan study found that pregnancy increases the risk of HIV transmission in a cohort of serodiscordant couples. Although three randomized trials have conclusively demonstrated that circumcision reduces HIV transmission among heterosexual men, research presented at IAS 2009 found no evidence of a preventive impact for women.19‐22 July 2009, 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2009), Cape Town, South Africa
Laura Carruth
Authors: Hoopes Laura L. Mays 
Published: June 2010

Note from the Editor Educator Highlights for CBE—LSE show how professors at different kinds of institutions educate students in life sciences with inspiration and panache. If you have a particularly creative teaching portfolio yourself, or if you wish to nominate an inspiring colleague to be profiled, please e-mail Laura Hoopes at lhoopes@pomona.edu .
Cigarette smoking and depression: tests of causal linkages using a longitudinal birth cohort
Authors: Boden Joseph M. , Fergusson David M. , Horwood L. John 
Published: May 2010

BackgroundResearch on the comorbidity between cigarette smoking and major depression has not elucidated the pathways by which smoking is associated with depression.AimsTo examine the causal relationships between smoking and depression via fixed-effects regression and structural equation modelling.MethodData were gathered on nicotine-dependence symptoms and depressive symptoms in early adulthood using a birth cohort of over 1000 individuals.ResultsAdjustment for confounding factors revealed persistent significant (P<0.05) associations between nicotine-dependence symptoms and depressive symptoms. Structural equation modelling suggested that the best-fitting causal model was one in which nicotine dependence led to increased risk of depression. The findings suggest that the comorbidity between smoking and depression arises from two routes; the first involving common or correlated risk factors and the second a direct path in which smoking increases the risk of depression.ConclusionsThis evidence is consistent with the conclusion that there is a cause and effect relationship between smoking and depression in which cigarette smoking increases the risk of symptoms of depression.
An early improvement threshold to predict response and remission in first-episode schizophrenia
Authors: Schennach-Wolff R. , Seemüller F. H. , Mayr A. , Maier W. , Klingberg S. , Heuser I. , Klosterkötter J. , Gastpar M. , Häfner H. , Sauer H. , Schneider F. , Gaebel W. , Jäger M. , Möller H.-J. , Riedel M. 
Published: May 2010

BackgroundEarly improvement with treatment is thought to be important in patients with first-episode schizophrenia, yet a valid definition is still outstanding.AimsTo develop a valid definition of early improvement and test its predictive validity regarding response and remission.MethodWe examined 188 in-patients with first-episode schizophrenia. Early improvement was defined as improvement in Positive and Negative Syndrome Scale (PANSS) total score at week 2, response as a 40% PANSS total score improvement at end-point, and remission according to consensus criteria.ResultsReasonable predictive validity of early improvement was found for a 46% PANSS total score improvement at week 2 and a 50% improvement for remission (area under the curve: response 0.707, remission 0.692). Estimated confidence intervals ranged from 26 to 62% PANSS reduction for response and remission.ConclusionsPatients with a first episode of schizophrenia should improve by at least 30% in PANSS total score at week 2 to achieve response and remission.
Discriminating levels of alcohol use associated with self-harm in individuals presenting to a district general hospital
Authors: Holdsworth Nicholas , Griffiths Hugh , Crawford David 
Published: May 2010

Aims and methodAlthough alcohol is reported as commonly associated with self-harm, there is nothing in the literature that bases the association on validated screening tools. We sought to discern the different types of alcohol use as discriminated by the Alcohol Use Disorders Identification Test (AUDIT). Completed AUDITs from a 2-year period were analysed, all relating to people who had presented to a district general hospital in Northumberland following self-harm.ResultsThe proportion of dependent, harmful and hazardous drinkers identified using AUDIT was many times higher than previously estimated in similar studies that had not used a validated alcohol screening tool.Clinical implicationsThe routine use of an alcohol screening tool should be part of any standard psychosocial assessment of self-harm, to guide appropriate interventions for problematic alcohol use that might otherwise be overlooked.
Pharmacy-based intervention in Wernicke's encephalopathy
Authors: Day Ed , Callaghan Rhiannon , Kuruvilla Tarun , George Sanju , Webb Kerry , Bentham Peter 
Published: May 2010

Aims and methodClinical audit methodology was used to compare the treatment of alcohol misusers at risk of Wernicke's encephalopathy in an acute medical setting, and to assess the impact of providing information about best practice to prescribing doctors. All patients prescribed thiamine during an admission to an acute hospital trust over a 6-month period were identified, and data about their treatment episode were collected retrospectively. Hospital pharmacists then provided all prescribers with a flowchart summarising current prescribing guidelines, and prescribing patterns were re-audited 6 months later.ResultsOver two audit periods, half of the patients prescribed thiamine whose case notes we examined had symptoms suggestive of Wernicke's encephalopathy, and another 30% were at high risk. Prescribing adhered to hospital guidelines only in 14% of cases, with the pharmacy-led intervention associated with a small but significant increase in the number of patients receiving adequate treatment for Wernicke's encephalopathy.Clinical implicationsWernicke's encephalopathy is relatively common in alcohol-dependent individuals admitted to hospital, and it is easily and cheaply managed. However, even when potential cases are identified, prescribing guidelines are followed in a minority of cases, even with prompting by a hospital pharmacist. This may be related to the limited research base concerning the optimum dosing schedule of thiamine, or fears about possible anaphylaxis when using parenteral preparations.
Newly introduced deprivation of liberty safeguards: anomalies and concerns
Authors: Shah Ajit , Heginbotham Chris 
Published: May 2010

SummaryThe European Court of Human Rights found that the care and treatment of HL in the ‘Bournewood case’ constituted infringement, in the form of deprivation of liberty, of his rights under Articles 5 (1) and 5 (4) of the European Convention on Human Rights. To prevent the infringement, the Deprivation of Liberty Safeguards were introduced into the Mental Capacity Act 2005 via the Mental Health Act 2007. The recent implementation of the Deprivation of Liberty Safeguards on 1 April 2009 has exposed some anomalies and higlighted some difficulties in its implemention and application, and these are described in the paper.
Effectiveness and confusion of the Time to Change anti-stigma campaign
Authors: Abraham Abu , Easow Joby M. , Ravichandren Palanisamy , Mushtaq Salman , Butterworth Linda , Luty Jason 
Published: May 2010

Aims and methodSeveral national anti-stigma campaigns have been devised in the UK, including the current Time to Change campaign in England. Our aim was to assess whether the campaign promotional materials were likely to have any effect on public attitudes towards mental illness. Postcards, leaflets and bookmarks promoting the campaign were posted to 250 participants recruited from a representative panel of members of the public. Two weeks later a questionnaire was sent to assess the impact the campaign materials had.ResultsThe response rate was 78%. Only 23% of participants recognised the Time to Change logo after 2 weeks and only 20% correctly reported that one in four people were affected by mental health problems when presented with five alternative responses. Almost as many participants thought the campaign was promoting a British political party rather than discrimination against mental illness.Clinical implicationsA single exposure to Time to Change campaign materials is unlikely to be effective. The title of the campaign is likely to be confused with political campaigning in Britain.
Intramolecular Chirality Transfer in trans-5,6-Diaryl-5,6-dihydro-1,10-phenanthroline-5,6-diols: Solvato- and Halochromic Responses by Circular Dichroism
Authors: Suzuki Takanori , Miura Youhei , Nehira Tatsuo , Kawai Hidetoshi , Fujiwara Kenshu 
Published: May 2010

Abstract
Not only the configuration at the C5 and C6 stereocenters but also the intra/intermoleculer hydrogen-bonding mode are determinant for the sense of mobile helicity of the dihydrophenanthroline unit in the title diols in solution. Thus, drastic changes in chiroptical signals are induced through conformational switching of 1 upon addition of protic solvent and/or acid.
Photoluminescence via Two Different Excited States in a Mononuclear Europium(III) Complex with Tetradentate Schiff Base Ligands
Authors: Ebato Shouta , Watanabe Masayuki , Nakajima Kiyohiko , Tsuchimoto Masanobu 
Published: May 2010

Abstract
A europium(III) complex with tetradentate Schiff base ligands (C2H5)3NH[Eu(3,5Clsalen)2] was prepared, and its structure was determined by X-ray crystal structure analysis. The complex has an eight-coordinate mononuclear structure with two Schiff base ligands in a meridional form. The complex displays emission bands resulting from f–f transitions by excitation at 357 or 234 nm in acetonitrile.
Arthroscopic treatment of the snapping iliopsoas tendon through the central compartment of the hip
Authors: Contreras M. E. K. , Dani W. S. , Endges W. K. , De Araujo L. C. T. , Berral F. J. 
Published: May 2010

We undertook a prospective pilot study to determine whether arthroscopic surgery through the central compartment of the hip was effective in the management of a snapping iliopsoas tendon. Seven patients were assessed pre-operatively and at three, six, 12 and 24 months after operation. This included the assessment of pain on a visual analogue scale (VAS) and function using the modified Harris hip score.All the patients had resolution of snapping post-operatively and this persisted at follow-up at two years. The mean VAS score for pain fell from 7.7 (6 to 10) pre-operatively to 4.3 (0 to 10) by three months (p = 0.051), and to 3.6 (1 to 8) (p = 0.015), 2.4 (0 to 8) (p = 0.011) and 2.4 (0 to 8) (p = 0.011) by six, 12 and 24 months, respectively. The mean modified Harris hip score increased from 56.1 (13.2 to 84.7) pre-operatively to 88.4 (57.2 to 100) at one year (p = 0.018) and to 87.9 (49.5 to 100) at two years (p = 0.02). There were no complications and no weakness occurred in the musculature around the hip.Our findings suggest that this treatment is effective and would support the undertaking of a larger study comparing this procedure with other methods of treatment.
One-stage revision for patients with a chronically infected reverse total shoulder replacement
Authors: Beekman P. D. A. , Katusic D. , Berghs B. M. , Karelse A. , De Wilde L. 
Published: May 2010

We retrospectively reviewed 11 consecutive patients with an infected reverse shoulder prosthesis. Patients were assessed clinically and radiologically, and standard laboratory tests were carried out. Peroperative samples showed Propionbacterium acnes in seven, coagulase-negative Staphylococcus in five, methicillin-resistant staphylococcus aureus in one and Escherichia coli in one. Two multibacterial and nine monobacterial infections were seen. Post-operatively, patients were treated with intravenous cefazolin for at least three days and in all antibiotic therapy was given for at least three months. Severe pain (3 of 11) or severe limitation of function (3 of 11) are not necessarily seen. A fistula was present in eight, but function was not affected. All but one patient were considered free of infection after one-stage revision at a median follow-up of 24 months, and without antibiotic treatment for a minimum of six months. One patient had a persistent infection despite a second staged revision, but is now free of infection with a spacer. Complications included posterior dislocation in one, haematoma in one and a clavicular fracture in one. At the most recent follow-up the median post-operative Constant-Murley score was 55, 6% adjusted for age, gender and dominance. A one-stage revision arthroplasty reduces the cost and duration of treatment. It is reliable in eradicating infection and good functional outcomes can be achieved.