bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Burkitt lymphoma in equatorial Africa using a simple three‐drug combination followed by a salvage regimen for patients with persistent or recurrent disease
Authors: Ngoma Twalib , Adde Melissa , Durosinmi Muheez , Githang'a Jessie , Aken'Ova Yetunde , Kaijage Jane , Adeodou Oluwagbemiga , Rajab Jamilla , Brown Biobele J. , Leoncini Lorenzo , Naresh Kikkeri , Raphael Martine , Hurwitz Nina , Scanlan Patricia , Rohatiner Ama , Venzon David , Magrath Ian 
Published: July 2012

SummaryPrior to the introduction of the International Network for Cancer Treatment and Research (INCTR) protocol INCTR 03‐06, survival of patients with Burkitt lymphoma at four tertiary care centres in equatorial Africa was probably no more than 10–20%. The results reported here for 356 patients have demonstrated marked improvement in survival through the use of a uniform treatment protocol consisting of cyclophosphamide, methotrexate, vincristine, and intrathecal therapy, and the introduction of non‐cross resistant second‐line (salvage) therapy, consisting of ifosfamide, mesna, etoposide and cytarabine, when patients failed to achieve a complete response to first‐line therapy or relapsed early. Overall survival rates of 67% and 62% were observed at 1 and 2 years (relapse is rare after 1 year of remission). Of interest was the small impact of cerebrospinal fluid (CSF) and bone marrow involvement on outcome. However, the presence or absence of abdominal involvement clearly defined two prognostic groups. An additional finding was the association between CSF pleocytosis and orbital tumours, suggesting that spread of tumour cells to the central nervous system may sometimes occur via direct involvement of cranial nerves in the orbit. Survival rates may be increased in patients with abdominal involvement by combining first‐ and second‐line therapy, but verification will require a further clinical study.
The rationale and pilot study of a new paediatric dental patient request form to improve communication and outcomes of dental appointments
Authors: Jones L. M. , Huggins T. J. 
Published: July 2012

AbstractBackgroundChildren's unhappy visits to the dentist can negatively impact lifelong oral health. A possible intervention is to enhance empathy in the child patient–dental practitioner relationship through communication. The present paper presents a new instrument, the Survey of Anxiety and Information for Dentists (SAID), which targets children's dental anxiety, coping preferences and dental neglect, and offers children a change to request information and engage in treatment planning.MethodFive children's focus groups pilot tested the content, wording and response format of a prototype patient request form, the SAID. Participants were 34 10‐ to 13‐year‐old children who individually completed the form then discussed it item by item in their small groups.ResultsChildren had no difficulty completing most items. They identified ambiguities, and items that were meaningless to them, and proposed a new item asking the dentist about their job. Children were polarized over the response format, but they were emphatic about passing the form directly to the dentist, and not to a receptionist or assistant, stressing the importance of having a conversation with their dentist.ConclusionsBefore the pilot, dentists had expressed concerns about the potential for words in the SAID‐provoking negative feelings. Children, however, wanted and needed facts, so requested that dentists use plain language, not euphemisms, to describe problems and treatment options. We report their selected practical suggestions. SAID‐informed negotiated care may promote more patient cooperation and satisfaction at appointments, and more attention to oral hygiene between appointments.
Molecular diagnosis on tissues and cells: how it affects training and will affect practice in the future
Authors: Boyd C. , Boyle D. P. 
Published: July 2012

C. Boyd and D. P. Boyle  Molecular diagnosis on tissues and cells: how it affects training and will affect practice in the futureOn 25th November 2011, a symposium organized by the Royal College of Pathologists, entitled ‘Molecular diagnosis on tissues and cells’, took place in London. As trainees in histopathology and cytopathology, we were stimulated to consider the role that molecular biology is likely to play in future practice and how this is addressed by our own training. The symposium provided a basis for this article. Routine samples requiring molecular analysis are equally relevant to histopathologists and cytopathologists, and molecular biology laboratories are now using cytological as well as histological material for diagnostic testing, allowing different specimen types to be used as and when they are most appropriate. The most widely used types of molecular analysis in routine cellular pathology are EGFR testing in lung cancer, molecular testing of thyroid nodules, fluorescence in situ hybridization testing of urine samples, clonality analysis in lymphoma testing, HER2 testing in breast and gastric cancer, KRAS testing in colorectal cancer, intraoperative assessment of breast cancer sentinel nodes, molecular testing of gastrointestinal stromal tumours and mismatch repair protein analysis. Of these, the majority in the UK are carried out on histopathology samples, although many are applicable to cytological samples if adequate material is obtained. We are particularly encouraged by the potential of molecular diagnostic cytology in traditionally difficult areas, such as intraoperative assessment. We believe that increasing reliance on molecular diagnostic techniques will also herald changes in training.
Nutrient reduction and climate change cause a potential shift from pelagic to benthic pathways in a eutrophic marine ecosystem
Authors: Lindegren Martin , Blenckner Thorsten , Stenseth Nils C. 
Published: July 2012

AbstractThe degree to which marine ecosystems may support the pelagic or benthic food chain has been shown to vary across natural and anthropogenic gradients for e.g., in temperature and nutrient availability. Moreover, such external forcing may not only affect the flux of organic matter but could trigger large and abrupt changes, i.e., trophic cascades and ecological regime shifts, which once having occurred may prove potentially irreversible. In this study, we investigate the state and regulatory pathways of the Kattegat; a eutrophied and heavily exploited marine ecosystem, specifically testing for the occurrence of regime shifts and the relative importance of multiple drivers, e.g., climate change, eutrophication and commercial fishing on ecosystem dynamics and trophic pathways. Using multivariate statistics and nonlinear regression on a comprehensive data set, covering abiotic factors and biotic variables across all trophic levels, we here propose a potential regime shift from pelagic to benthic regulatory pathways; a possible first sign of recovery from eutrophication likely triggered by drastic nutrient reductions (involving both nitrogen and phosphorus), in combination with climate‐driven changes in local environmental conditions (e.g., temperature and oxygen concentrations).
Persistence and production of perennial grasses under water deficits and extreme temperatures: importance of intraspecific vs. interspecific variability
Authors: Poirier Magalie , Durand Jean‐Louis , Volaire Florence 
Published: July 2012

AbstractExtreme climatic events are expected to increase in frequency and magnitude as a consequence of global warming. Grasslands cover a large proportion of the European continent and contribute to both agricultural production and ecosystem services through inter and intraspecific genetic variability. This study analysed the effects of summer droughts and heat waves on the persistence and production of perennial forage grasses. Mediterranean and temperate populations of Dactylis glomerata L. and Festuca arundinacea (Schreb.) were compared at both Mediterranean and temperate sites in France. By manipulating canopy temperatures and water availability, grass swards in the field were subjected to cumulative summer and spring water deficits (CSSWD) ranging from 329 to 707 mm to test different projected climatic conditions and extreme summer events. Under controlled summer heat waves (6–21 days at a mean daily canopy temperature higher than 30–35 °C), there was no increase in membrane damage to surviving aerial tissues. Plant stress was thus mainly generated through greater soil water deficit. Under the greatest CSSWD, annual biomass production was reduced on average by 60% and 30% with temperate and Mediterranean populations, respectively. Thresholds for a significant increase in summer tiller mortality were seen at CSSWD higher than 450 mm for temperate populations and 550 mm for Mediterranean populations. The latter displayed lower predawn leaf water potentials in summer and recovered through intense tillering in the subsequent seasons. Under the most extreme CSSWD, fewer than 20% of tillers of temperate populations survived and their nitrogen uptake ability was drastically altered. The higher potential productivity of Mediterranean populations in winter was associated with greater frost sensitivity. The identification of thresholds for vulnerability and the determination of the role of genetic diversity will improve the management of plant resilience and the design of new plant material to cope with climate change.
Effects of written plus oral information vs. oral information alone on precolonoscopy anxiety
Authors: Luo Yuan‐Yuan 
Published: July 2012

Aims and objectives:  To determine the effect of written plus oral information vs. oral information alone on precolonoscopy anxiety.Background:  Information provision has been considered to reduce precolonoscopy anxiety. However, the best means to provide information before colonoscopy has not yet been determined as there is inconsistency in the outcomes of the clinical trials.Design:  A two‐group, pretest, post‐test, prospective, quasi‐experimental design with non‐random assignment.Methods:  Participants were assigned to group 1 or 2 in the study. In the enrolment all the participants completed the questionnaires to collect personal characteristics data and assessed subjects’ anxiety level by the Chinese version of the State Scale of State‐Trait Anxiety Inventory as baseline data. After that, subjects in group 1 received written plus oral information before colonoscopy, while those in group 2 received oral information before colonoscopy. On the day for colonoscopy all subjects completed the Chinese version of the State Scale of State‐Trait Anxiety Inventory again.Results:  There was no difference in state anxiety and personal characteristic between the two groups at enrolment. After the intervention, although the state anxiety scores were dropped, there were no statistical significant differences between two groups or within groups 1 and 2.Conclusions:  Information provision before colonoscopy did not reduce the anxiety level in patients directly before colonoscopy.Relevance to clinical practice:  There was a trend that information had a positive effect on patients’ state anxiety. Future information provision studies may need to add more interactive methods appropriately and take patients’ gender, educational level and coping style into consideration.
The quality of clinical practice guidelines in China: a systematic assessment
Authors: Hu Jing , Chen Ru , Wu Shanshan , Tang Jinling , Leng Gillian , Kunnamo Ilkka , Yang Zhirong , Wang Weiwei , Hua Xinyang , Zhang Yuelun , Xie Yanming , Zhan Siyan 
Published: July 2012

AbstractBackgroundClinical guidelines are an important tool for improving service quality, the benefits of guidelines depend on their quality. In China, there has been a great increase in production of guidelines. However, little is known about their quality.MethodWe identified Chinese guidelines published between 2006 and 2010 by searching three Chinese full‐text databases, major Chinese guidelines websites and Google. Three appraisers independently evaluated each guideline by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Subgroup analyses were performed according to source, title, version, aspect of care and developer of guidelines.ResultsA total of 327 guidelines were eligible and 57 were excluded for their lacking of any account of the guideline development methodology. Of the 270 guidelines, 77 (28.5%) can be recommended, 6 (2.2%) were evidence‐based guidelines. Sixteen (5.9%) guidelines described the methods used to search for evidence, 61 (22.6%) appraised the quality of evidence and 53 (19.6%) graded the strength of recommendations. Two guidelines declared the involvement of methodological experts and none reported considering patients’ values. 29 (10.7%) guidelines received drug company sponsorship but only two declared the views of the funding bodies did not influence the recommendations, 259 (95.9%) didn't declare the interest conflicts of guideline developers. Guidelines downloaded from Internet and with updated versions yielded higher quality than the rest.ConclusionsAlthough numerous guidelines were produced in China, the quality was generally low. Focusing on improving the quality of Chinese guidelines, rather than continuing to produce them in great quantity, is urgently needed.
Stigma, public awareness about intellectual disability and attitudes to inclusion among different ethnic groups
Authors: Scior K. , Addai‐Davis J. , Kenyon M. , Sheridan J. C. 
Published: July 2012

AbstractBackground  Attitudes to the inclusion of people with intellectual disabilities (IDs) have been studied extensively, yet evidence on public awareness about ID and stigma is limited. The relationship between attitudes, knowledge and stigma associated with ID is poorly understood. The present study examined these factors and the relationships between them in the context of a multicultural society.Method  UK residents of working age (n = 1002) were presented with a diagnostically unlabelled vignette of someone with a mild ID. They were asked to label the difficulties presented and to complete measures of social distance and attitudes to the inclusion of people with IDs.Results  While attitudes to the inclusion of people with IDs were relatively positive overall, social contact was viewed with ambivalence. Inclusion attitudes and social distance were only moderately correlated. Across the whole sample 28% recognised typical symptoms of mild ID. Recognition of ID was associated with lower stigma and more positive attitudes than attribution of the difficulties presented to other causes. White Westerners showed increased knowledge, lower stigma and favoured inclusion more than participants from ethnic minorities. Among the latter group, Asians showed lower stigma and attitudes more in line with inclusion policies than participants of Black African/Caribbean backgrounds. Once a host of contextual factors were considered jointly, only contact was consistently associated with the variables measured.Conclusions  Stigma associated with ID is of concern across all ethnic groups, although it appears to be increased among the public from ethnic minorities. Given that contact and awareness are associated with reduced stigma, they should be considered as prime foci for efforts to tackle ID stigma. The current findings serve as baseline for attempts to increase public awareness and tackle stigma.
The content validity of the Behaviour Support Plan Quality Evaluation tool (BSP‐QEII) and its potential application in accommodation and day‐support services for adults with intellectual disability
Authors: McVilly K. , Webber L. , Sharp G. , Paris M. 
Published: July 2012

AbstractBackground  The quality of support provided to people with disability who show challenging behaviour could be influenced by the quality of the behaviour support plans (BSPs) on which staff rely for direction. This study investigated the content validity of the Behaviour Support Plan Quality Evaluation tool (BSP‐QEII), originally developed to guide the development of BSPs for children in school settings, and evaluated its application for use in accommodation and day‐support services for adults with intellectual disability.Method  A three‐round Delphi study involving a purposive sample of experienced behaviour support practitioners (n = 30) was conducted over an 8‐week period. The analyses included deductive content analysis and descriptive statistics.Results  The 12 quality domains of the BSP‐QEII were affirmed as valid for application in adult accommodation and day‐support service settings. Two additional quality domains were suggested, relating to the provision of detailed background on the client and the need for plans to reflect contemporary service philosophy. Furthermore, the results suggest that some issues previously identified in the literature as being important for inclusion in BSPs might not currently be a priority for practitioners. These included: the importance of specifying replacement or alternative behaviours to be taught, descriptions of teaching strategies to be used, reinforcers, and the specification of objective goals against which to evaluate the success of the intervention programme.Conclusions  The BSP‐QEII provides a potentially useful framework to guide and evaluate the development of BSPs in services for adults with intellectual disability. Further research is warranted to investigate why practitioners are potentially giving greater attention to some areas of intervention practice than others, even where research has demonstrated these others areas of practice could be important to achieving quality outcomes.
The experience of working on a locked acute psychiatric ward
Authors: JOHANSSON I. M. , SKÄRSÄTER I. , DANIELSON E. 
Published: July 2012

Accessible summary
Acute psychiatric wards, many of which are locked, are challenging work environments. This study explores the experience of health‐care staff working on such a ward.
The study shows that the health‐care staff have to manage a changing and demanding work environment. A need for security and control is indicated.
Some positive experiences from work are described, such as meaningfulness and personal development, which counterbalance the burden of working in this environment.
The forces that drive health‐care staff and their motivation for working on acute psychiatric wards need to be studied further.
AbstractThis study's aim was to elucidate health‐care staff experience of working on a locked acute psychiatric ward. In many countries changes in health care has contributed to fewer beds available in inpatient care, and a concentration of patients with severe psychiatric conditions. This implies a changing work environment in acute psychiatric care. Qualitative interviews with health‐care staff (n= 10) were carried out on a ward for patients with affective disorder and eating disorder in a Swedish hospital. Qualitative content analysis was used. Four themes were identified from the data: ‘undergoing changes in care delivery’, ‘feeling a need for security and control’, ‘managing the demands at work’ and ‘feeling a sense of responsibility’. This study adds to earlier research into how a sense of responsibility can place a significant burden on health‐care staff working on a locked psychiatric ward and also contribute to increased control of patients. This study also shows that relationships and power structures among health‐care staff need to be addressed when organizational changes are made in care delivery. Further research is needed to reach a comprehensive understanding of care on locked acute psychiatric wards, including a development of nursing and medicine as knowledge domains in one common context.
Quantitative electroencephalography during rapid eye movement (REM) and non‐REM sleep in combat‐exposed veterans with and without post‐traumatic stress disorder
Authors: COHEN DANIEL J. , BEGLEY AMY , ALMAN JENNIE J. , CASHMERE DAVID J. , PIETRONE REGINA N. , SERES ROBERT J. , GERMAIN ANNE 
Published: July 2012

SummarySleep disturbances are a hallmark feature of post‐traumatic stress disorder (PTSD), and associated with poor clinical outcomes. Few studies have examined sleep quantitative electroencephalography (qEEG), a technique able to detect subtle differences that polysomnography does not capture. We hypothesized that greater high‐frequency qEEG would reflect ‘hyperarousal’ in combat veterans with PTSD (n = 16) compared to veterans without PTSD (n = 13). EEG power in traditional EEG frequency bands was computed for artifact‐free sleep epochs across an entire night. Correlations were performed between qEEG and ratings of PTSD symptoms and combat exposure. The groups did not differ significantly in whole‐night qEEG measures for either rapid eye movement (REM) or non‐REM (NREM) sleep. Non‐significant medium effect sizes suggest less REM beta (opposite to our hypothesis), less REM and NREM sigma and more NREM gamma in combat veterans with PTSD. Positive correlations were found between combat exposure and NREM beta (PTSD group only), and REM and NREM sigma (non‐PTSD group only). Results did not support global hyperarousal in PTSD as indexed by increased beta qEEG activity. The correlation of sigma activity with combat exposure in those without PTSD and the non‐significant trend towards less sigma activity during both REM and NREM sleep in combat veterans with PTSD suggests that differential information processing during sleep may characterize combat‐exposed military veterans with and without PTSD.
In situ hybridization for the detection of hepatitis C virus RNA in human liver tissue
Authors: Li G. , Li K. , Lea A. S. , Li N. L. , Abdulla N. E. , Eltorky M. A. , Ferguson M. R. 
Published: July 2012

SummaryIn situ hybridization (ISH) enables visualization of specific nucleic acid in morphologically preserved cells and tissue sections. Detection of the HCV genomes in clinical specimens is useful for differential diagnosis, particularly between recurrent HCV infection and acute cellular rejection in transplant specimens. We optimized an ISH protocol that demonstrated sensitivity and specificity for detecting genomic and replicative form of HCV RNA in tissue biopsies. Digoxigenin (Dig)‐labelled sense and anti‐sense riboprobes were synthesized using a plasmid containing a fragment of the highly conserved HCV noncoding region as a template. The efficiency of the Dig‐labelled riboprobes in detecting genomic and replicative‐intermediate HCV RNA was analysed in 30 liver biopsies from patients infected or uninfected with HCV in a blinded study. A Huh7 cell line that stably replicates genome‐length HCV RNA was developed to be used as a positive control. Negative control riboprobes were used in parallel to evaluate and control for background staining. The anti‐sense probe detected HCV RNA in 20/21 specimens from HCV‐infected liver tissues obtained from patients and in 0/9 samples from patients with non‐HCV‐related liver diseases, resulting in a sensitivity and specificity of 95% and 100%, respectively. HCV genomic RNA was variably distributed in tissue sections and was located primarily in the perinuclear regions in hepatocytes. Detection of HCV RNA by our optimized ISH protocol appears to be a sensitive and specific method when processing clinical specimens. It may also be revealing when exploring the pathophysiology of HCV infection by verifying the presence of viral genetic material within heptocytes and other cellular elements of diseased liver tissue. This methodology might also evaluate the response to antiviral therapies by demonstrating the absence or alteration of genetic material in clinical specimens from successfully treated patients.