bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Prognostic Value of Assessing Tumor Diameter Versus Tumor Volume at Diagnosis or in Response to Initial Chemotherapy in Rhabdomyosarcoma
Authors: Ferrari Andrea , Miceli Rosalba , Meazza Cristina , Casanova Michela , Favini Francesca , Morosi Carlo , Trecate Giovanna , Marchianò Alfonso , Luksch Roberto , Cefalo Graziella , Terenziani Monica , Spreafico Filippo , Polastri Daniela , Podda Marta , Catania Serena , Schiavello Elisabetta , Giannatempo Patrizia , Gandola Lorenza , Massimino Maura , Mariani Luigi 
Published: February 2010

Purpose In this study on a series of 205 patients with rhabdomyosarcoma, we investigated whether the prognostic effect of tumor size, at diagnosis or in terms of tumor response after induction chemotherapy, differed when tumor diameter or tumor volume were considered. Patients and Methods Tumor size was assessed radiologically at diagnosis and, for the 108 patients with measurable disease, after three courses of chemotherapy. The analysis was based on multivariable models (linear for association between size and patient/tumor characteristics, Cox for association with survival). The predictive performance of the Cox model (estimated by V measure) was compared for the tumor's diameter and volume. Results Initial tumor size was significantly larger in male or older patients and in T2 or alveolar tumors, but was not associated with the achievement of complete surgical resection. Initial tumor size significantly influenced overall survival. The risk of death was comparable for tumors 10 cm in maximum diameter and 194.0 cm3 in volume. The predictive performance of the Cox model was much the same when the tumor's diameter or volume was considered. Tumor response was a significant predictor of survival, again irrespective of the type of tumor measurement considered. Conclusion In our analysis, initial tumor size and tumor response were significant prognostic factors in rhabdomyosarcoma, regardless of whether tumor diameter or volume was considered. Three-dimensional tumor assessment was of no greater prognostic value than one-dimensional assessment, neither initially nor after induction treatment.
End-of-Life Discussions, Goal Attainment, and Distress at the End of Life: Predictors and Outcomes of Receipt of Care Consistent With Preferences
Authors: Mack Jennifer W. , Weeks Jane C. , Wright Alexi A. , Block Susan D. , Prigerson Holly G. 
Published: February 2010

Purpose Physicians have an ethical obligation to honor patients' values for care, including at the end of life (EOL). We sought to evaluate factors that help patients to receive care consistent with their preferences. Methods This was a longitudinal multi-institutional cohort study. We measured baseline preferences for life-extending versus symptom-directed care and actual EOL care received in 325 patients with advanced cancer. We also measured associated sociodemographic, health, and communication characteristics, including EOL discussions between patients and physicians. Results Preferences were assessed a median of 125 days before death. Overall, 68% of patients (220 of 325 patients) received EOL care consistent with baseline preferences. The proportion was slightly higher among patients who recognized they were terminally ill (74%, 90 of 121 patients; P = .05). Patients who recognized their terminal illness were more likely to prefer symptom-directed care (83%, 100 of 121 patients; v 66%, 127 of 191 patients; P = .003). However, some patients who were aware they were terminally ill wished to receive life-extending care (17%, 21 of 121 patients). Patients who reported having discussed their wishes for EOL care with a physician (39%, 125 of 322 patients) were more likely to receive care that was consistent with their preferences, both in the full sample (odds ratio [OR] = 2.26; P < .0001) and among patients who were aware they were terminally ill (OR = 3.94; P = .0005). Among patients who received no life-extending measures, physical distress was lower (mean score, 3.1 v 4.1; P = .03) among patients for whom such care was consistent with preferences. Conclusion Patients with cancer are more likely to receive EOL care that is consistent with their preferences when they have had the opportunity to discuss their wishes for EOL care with a physician.
Plain Dextrose 5% in Water or Hypotonic Saline Solutions Could Result in Acute Hyponatremia and Death in Healthy Children; Investigate and Clarify Requests for Missing Doses; Provera, Prozac, or Proscar?
Authors: Cohen Michael R. , Smetzer Judy L. 
Published: February 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site ( www.ismp.org ), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
The STanding Orders Protocol (STOP): A Pharmacy Driven Pneumococcal and Influenza Vaccination Program
Authors: Veltri Keith T. , Ferguson-Myrthil Nadia , Currie Brian 
Published: February 2010

Purpose A Medical Board-approved pharmacy-based inpatient STanding Orders Protocol (STOP) for influenza and pneumococcal vaccination was designed and implemented at Montefiore Medical Center in response to federal and state regulations put in place in 2006. This vaccination program aims to improve historically poor vaccination rates in a complex, urban patient population. Developing this initiative in a large health care system with high turnover and a diverse (many non-English speaking) population represented a formidable challenge. Methods In 2006 the institution initiated a program to improve patient care. The program involved a clinical pharmacist rounding on patient care units specifically to encourage the acceptance of the pneumococcal and influenza vaccine in patients at least 65 years of age at 1 of the 2 campus sites in the Bronx, New York. Medical residents were also employed to facilitate the pharmacist and achieve national standards. Registered nurses and licensed practical nurses are authorized to administer standing orders for vaccines and anaphylaxis treatment agents as needed under this protocol without direct physician examination. Vaccine information sheets (VIS) and gender- and ethnicity-specific patient teaching aids provide statistical information regarding disease and mortality rates. Language barriers are reduced by providing VIS in both Spanish and English, and telephone translation in most languages are utilized when necessary. Documentation of refusal of, previously received, or a newly ordered vaccination is placed in the patient's chart and in the central database. Discussion Prior to the STOP program, the total in-hospital vaccination encounter rates according to various Center for Medicare and Medicaid Services (CMS) audits was approximately 18% for pneumococcal and 27% for influenza vaccinations, respectively. The institution's current encounter rates have dramatically increased to more than 85% for pneumococcal and 55% for influenza vaccine. Conclusion The cooperative efforts of physicians, pharmacists, and nursing staff have led to the creation of a successful inpatient-based vaccine standing orders protocol. As a result, in 2007 the institution approved a second clinical pharmacist to allow for coverage at both of Montefiore's hospital sites. The hospital's goal is to ultimately decrease pneumococcal disease and its severity, increase and maintain the highest vaccination rates in New York City, and comply with national standards. The implication for decreasing morbidity and readmission of patients is promising. Future plans include the development of an ambulatory-based program with a similar design model.
Vaccine with 2 Components; Kapidex and Casodex Confusion; Valtrex(Valacyclovir) and Valcyte (Valganciclovir) Confusion
Authors: Cohen Michael R. , Smetzer Judy L. 
Published: February 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site ( www.ismp.org ), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Smoothing the Path for Intravenous (IV) to Oral (PO) Conversion: Where Have We Come in 11 Years?
Authors: Banko Heidi , Goldwater Shannon H. , Adams Erin 
Published: February 2010

Purpose The objectives of this study were to determine how many hospitals have active programs for converting patients from intravenous (IV) to oral (PO) therapy and obtain details of their conversion policies and documented cost savings and clinical impact from the IV to PO programs. In addition, the perceived benefits of these types of pharmacy programs will be highlighted. Methods Surveys were sent via e-mail to approximately 7,905 pharmacy managers and clinical pharmacists throughout the United States, which were obtained from American Society of Health-System Pharmacists (ASHP) and American College of Clinical Pharmacy (ACCP) by working through various list-serves that target this group of practitioners. The survey questioned participants regarding their hospital's policies for IV to PO conversion programs, including demographics, criteria, process, medications involved in the switches, clinical outcomes, and cost savings of such programs. Results Of 276 surveys completed and returned, 42% of responders were from the south; 81% had an active IV to PO program (larger hospital systems were more likely to have a program in existence for a longer period of time); and 82% identified patients via a computer-generated list of target patients and drugs for pharmacists to intervene. The majority of medications involved in IV to PO switches included antibiotics, GI, and antifungal drug classes. Fifty-four percent of responders indicated pharmacy manpower was the largest barrier to implementation and continuation of IV to PO conversion programs. Sixty-seven percent of responders documented cost savings and 47% of the 81 facilities that specified savings had saved at least $50,000 annually. Conclusion There was no change in the percent of facilities with IV to PO conversion programs (81%). There were minimal differences in the types of medications involved in conversion programs between 1996 and 2007. The policy and procedures supporting these type of programs have become more defined in the 11 years between surveys. In addition, methods of conversions have become more automatic since the first survey. Financial impact of IV to PO conversion programs were documented in both surveys.
Tolvaptan
Authors: Cada Dennis J. , Levien Terri L. , Baker Danial E. 
Published: February 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent in print and are also available online. Monographs can be customized to meet the needs of a facility. Subscribers to The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The November 2009 monograph topics are telavancin, pitavastatin, asenapine, colchicine, and indacaterol. The DUE is on telavancin.
Rapid methods for extracting high-quality DNA from shell-boring “Conchocelis”
Authors: Wang Jinfeng , Jiang Peng , Zhou Wei , Cui Yulin , Qin Song 
Published: February 2010

Abstract
The genome DNA required for molecular studies of Porphyra has generally been extracted from either blades or free-living “Conchocelis”. However, the main disadvantages are complicated procedures, high cost, and DNA contamination. In this study, we developed a strategy for pure DNA extraction from shell-boring “Conchocelis” and a single-step technique to prepare PCR templates. The results show that contamination of free-living “Conchocelis” with microalgae was eliminated after the filaments had bored into shells. The electrophoretic banding patterns and intensities were similar between materials obtained from free-living “Conchocelis” and shell-boring “Conchocelis”, suggesting that total DNA extraction from the latter was efficient. Molecular evidence demonstrated additional bands in PCR products of internal transcribed spacer (ITS) amplifications prepared from cultures of free-living “Conchocelis” contaminated with microalgae. The additional bands appeared in all three Porphyra yezoensis replicates and one out of three Porphyra haitanensis replicates, but were not detectable in preparations from shell-boring “Conchocelis”. The DNA extracted from shell-boring “Conchocelis” reduced the risk of microalgal contamination and the single-step technique reduced the time required for the preparation of DNA for molecular studies of Porphyra. The single-step method should be useful for PCR amplification of small amounts of materials, large sample sizes, or samples contaminated with microalgae. The technique may also be suitable for other genera of Bangiaceae, providing that shell-boring “Conchocelis” stages are present in their life cycles.
Coexistence of Ulva rigida and Ulva laetevirens (Ulvales, Chlorophyta) in Venice Lagoon and other Italian transitional and marine environments
Authors: Sfriso Adriano 
Published: February 2010

Abstract
There is confusion about the identity of laminar Ulva thalli in Italian and Mediterranean transitional systems and on the open coasts. Although some authors report the presence of both U. rigida and U. laetevirens, systematic revisions for the Adriatic and Mediterranean Seas recognise only the presence of U. laetevirens. This paper uses anatomical and environmental analyses to provide evidence for the presence of both species. The only diagnostic character that distinguishes the two is cell shape in cross section of rhizoidal and basal regions. Therefore, identification of floating thalli in these regions is not possible. The species grow and coexist in the same environments and on the same substrata, but analysis of environmental data suggests that U. rigida occurs preferentially in eutrophic environments, especially lagoon areas rich in phosphate, ammonium and phytoplankton, whereas U. laetevirens is more abundant in areas where nutrient levels are low.
Questionnaire-Based Case Finding of Celiac Disease in a Population of 8- to 9-Year-Old Children
Authors: Toftedal Peter , Hansen Dorte Gilså , Nielsen Christian , Lillevang Søren Thue , Hansen Tine Plato , Husby Steffen 
Published: February 2010

OBJECTIVE:
Antibody screenings and diagnosis of celiac disease (CD) among children with type 1 diabetes have suggested that a considerable proportion of children with CD may, in fact, have preclinical (undiagnosed) symptoms. We aimed to test if a questionnaire would lead to significant case finding in an unselected population of 8- to 9-year-old children.

PATIENTS AND METHODS:
The study population included 9880 children aged 8 to 9 years. Before the study, 13 children from the study population were known to have CD. We developed a questionnaire on the basis of 5 simple items suggestive of CD and mailed the questionnaire to the families of all children in the study population who resided in the County of Funen, Denmark. In total, 7029 respondents returned the questionnaire (70%); among them, 2835 children had 1 or more symptoms. These children were invited for a blood test to determine their human serum immunoglobulin A (IgA) anti–tissue transglutaminase antibody (anti-tTG) levels.

RESULTS:
Of the 1720 children who were tested for the human serum IgA anti-tTG, 24 participants had a positive result (range: 20 to &gt;150 U). Seventeen of these children underwent an upper endoscopy procedure. Fourteen children had histologic signs of CD (Marsh classification stage III). Fourteen children met the diagnostic criteria for CD. The prevalence proportion of patients who were newly diagnosed with CD was 0.14% (95% CI: 0.08–0.24) (14 of 9967), and the estimate of the minimum total prevalence proportion of children with CD was 0.27% (95% CI: 0.18–0.39) (27 of 9980). The maximal prevalence proportion of patients with newly diagnosed CD was 1.22% (95% CI: 0.76–1.90) (21 of 1720), including those participants who had a positive anti-tTG result but not a final diagnosis of CD. The ratio of known to minimally symptomatic CD was ∼1:1.

CONCLUSION:
A number of preclinical and low-grade symptomatic patients with CD may be identified by their responses to a mailed questionnaire.
The Course of Inattention and Hyperactivity/Impulsivity Symptoms After Foster Placement
Authors: Linares L. Oriana , Li MinMin , Shrout Patrick E. , Ramirez-Gaite Marta , Hope Stephanie , Albert Andrea , Castellanos Francisco Xavier 
Published: February 2010

BACKGROUND:
It is largely unknown whether symptoms of inattention and hyperactivity/impulsivity of foster children decline over time after placement and what the role of the quality and stability of the foster placement is on the course of attention-deficit hyperactivity disorder (ADHD) symptom trajectories. Longitudinal studies of normative trajectories of symptom types in nonreferred children may assist in appropriately diagnosing ADHD and designing the clinical treatment for foster children.

OBJECTIVE:
We described average level and slope of inattention and hyperactivity/impulsivity symptoms over time and examined parental (biological and foster) warmth and hostility and placement stability (number of foster-home moves and discharge from care) as reported by 3 informants (biological parent, foster parent, and classroom teacher) after considering maltreatment risks (child age, gender, sibling ADHD, and comorbidity) and use of ADHD medication.

METHODS:
We studied 252 maltreated children in 95 families during 4 yearly waves, beginning shortly after placement; children were assessed whether they remained in or were discharged from foster care.

RESULTS:
Average level of inattention declined according to the biological parent, whereas hyperactivity/impulsivity symptoms declined according to both biological and foster parents. Higher inattention was associated with lower parental warmth (foster parent), higher parental hostility (biological, foster, and teacher), and discharge from care (biological parent). Higher hyperactivity was also associated with lower parental warmth (foster parent) and higher parental hostility (biological and foster parent), higher (average) number of foster-home moves, and discharge from care (biological report). Higher teacher-derived hyperactivity symptoms were associated with a history of child abuse (versus neglect); however, abused children showed a steeper decline of hyperactivity over time than those with neglect histories. Unexpected interactions were found for the impact over time of parental (foster) warmth and number of foster-home moves.

CONCLUSION:
Findings point to the clinical usefulness of attending to the parenting quality and placement stability as malleable factors affecting symptom reduction subsequent to placement.
Association Between Parents' and Children's Use of Oral Health Services
Authors: Isong Inyang A. , Zuckerman Katharine E. , Rao Sowmya R. , Kuhlthau Karen A. , Winickoff Jonathan P. , Perrin James M. 
Published: February 2010

OBJECTIVE:
Several parental factors influence children's use of oral health services. Some localized studies have shown that children's dental use patterns correlate positively with those of their parents. The objective of this study was to investigate associations between parents' and children's oral health–seeking behaviors among a representative sample of US children.

METHODS:
We used the 2007 National Health Interview Survey to analyze a sample of children aged 2 to 17 years, matched with 1 parent. Using logistic regression, we examined associations between parents' and children's use of dental services and deferred dental care because of cost.

RESULTS:
The sample included 6107 child–parent pairs. Overall, 77% of children and 64% of parents had a dental visit in the previous 12 months. Adjusting for sociodemographic and use variables, children were more likely to have a dental visit when their parents also had a dental visit (adjusted odds ratio: 3.36 [95% confidence interval: 2.71–4.18]), compared with children of parents who did not have a dental visit. In addition, compared with children of parents who did not defer seeking dental care, children of parents who deferred their dental care because of cost were more likely to have care deferred because of cost as well (adjusted odds ratio: 12.47 [95% confidence interval: 9.09–17.11]).

CONCLUSIONS:
Parental oral health–seeking behaviors for themselves may have an important effect on oral health–seeking behaviors on behalf of their children, regardless of the child's insurance status. Comprehensive strategies to eliminate barriers that target parents and not just children may help to address children's underuse of oral health services.