bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epigenetic induction of adaptive immune response in multiple myeloma: sequential azacitidine and lenalidomide generate cancer testis antigen‐specific cellular immunity
Authors: Toor Amir A. , Payne Kyle K. , Chung Harold M. , Sabo Roy T. , Hazlett Allison F. , Kmieciak Maciej , Sanford Kimberly , Williams David C. , Clark William B. , Roberts Catherine H. , McCarty John M. , Manjili Masoud H. 
Published: July 2012

SummaryPatients with multiple myeloma (MM) undergoing high dose therapy and autologous stem cell transplantation (SCT) remain at risk for disease progression. Induction of the expression of highly immunogenic cancer testis antigens (CTA) in malignant plasma cells in MM patients may trigger a protective immune response following SCT. We initiated a phase II clinical trial of the DNA hypomethylating agent, azacitidine (Aza) administered sequentially with lenalidomide (Rev) in patients with MM. Three cycles of Aza and Rev were administered and autologous lymphocytes were collected following the 2nd and 3rd cycles of Aza‐Rev and cryopreserved. Subsequent stem cell mobilization was followed by high‐dose melphalan and SCT. Autologous lymphocyte infusion (ALI) was performed in the second month following transplantation. Fourteen patients have completed the investigational therapy; autologous lymphocytes were collected from all of the patients. Thirteen patients have successfully completed SCT and 11 have undergone ALI. Six patients tested have demonstrated CTA up‐regulation in either unfractionated bone marrow (n = 4) or CD138+ cells (n = 2). CTA (CTAG1B)‐specific T cell response has been observed in all three patients tested and persists following SCT. Epigenetic induction of an adaptive immune response to cancer testis antigens is safe and feasible in MM patients undergoing SCT.
Prescribing for pain – how do nurses contribute? A national questionnaire survey
Authors: Stenner Karen , Carey Nicola , Courtenay Molly 
Published: July 2012

Aims and objectives.  To provide information on the profile and practice of nurses in the UK who prescribe medication for pain.Background.  Pain is widely under‐reported and under‐treated and can have negative consequences for health and psychosocial well‐being. Indications are that nurses can improve treatment and access to pain medications when they prescribe. Whilst nurses working in many practice areas treat patients with pain, little is known about the profile, prescribing practice or training needs of these nurses.Design.  A descriptive questionnaire survey.Method.  An online questionnaire was used to survey 214 nurses who prescribed for pain in the UK between May and July 2010. Data were analysed using descriptive statistics and non‐parametric tests.Results.  Half the participants (50%) worked in primary care, 32% in secondary care and 14% worked across care settings. A range of services were provided, including general practice, palliative care, pain management, emergency care, walk‐in‐centres and out‐of‐hours. The majority (86%) independently prescribed 1–20 items per week. Non‐opioid and weak opioids analgesics were prescribed by most (95%) nurses, whereas fewer (35%) prescribed strong opioids. Training in pain had been undertaken by 97% and 82% felt adequately trained, although 28% had problems accessing training. Those with specialist training prescribed a wider range of pain medications, were more likely to prescribe strong opioids and were more often in pain management roles.Conclusion.  Nurses prescribe for pain in a range of settings with an emphasis on the treatment of minor ailments and acute pain. A range of medications are prescribed, and most nurses have access to training.Relevance to clinical practice.  The nursing contribution to pain treatment must be acknowledged within initiatives to improve pain management. Access to ongoing training is required to support nurse development in this area of practice to maximise benefits.
Implementation of complex adaptive chronic care: the Patient Journey Record system (PaJR)
Authors: Martin Carmel M. , Vogel Carl , Grady Deirdre , Zarabzadeh Atieh , Hederman Lucy , Kellett John , Smith Kevin , O’ Shea Brendan 
Published: July 2012

AbstractBackgroundThe Patient Journey Record system (PaJR) is an application of a complex adaptive chronic care model in which early detection of adverse changes in patient biopsychosocial trajectories prompts tailored care, constitute the cornerstone of the model.AimsTo evaluate the PaJR system's impact on care and the experiences of older people with chronic illness, who were at risk of repeat admissions over 12 months.DesignCommunity‐based cohort study – random assignment into intervention and usual care group, with process and outcome evaluation.Study populationAdult and older patients with multiple morbidity, one or more chronic diseases with one or more overnight hospitalizations, and seven or more general practice visits in the past 6 months.Complex interventionPaJR lay care guides/advocates call patients and their caregivers. The care guides summarize their semi‐structured conversations about health concerns and well‐being. Predictive modelling and rules‐based algorithms trigger alerts in relation to online call summaries. Alerts are acted upon according to agreed guidelines.AnalysisDescriptive and comparative statistics.OutcomesImpact on unplanned emergency ambulatory care sensitive admissions (ACSC) with an overnight stay; sensitivity of alerts and predictions; rates of care guides‐supported activities.FindingsFive part‐time lay care guides and a care manager monitored 153 intervention patients for 500 person months with 5050 phone calls. The 153 patients in the intervention group were comparable to the 61 controls. The intervention group reported in 50% of calls that their health limited their social activities; and one‐third of calls reported immediate health concerns. Predictive analytics were highly sensitive to risk of hospitalization. ACSC admissions were reduced by 50% compared to controls across the sites.DiscussionThe initial implementation of a complex patient‐centred adaptive chronic care model using lay care guides, supported by machine learning, appeared sensitive to risk of hospitalization and capable of stabilizing illness journeys in older patients with multi‐morbidity.ConclusionActions based on alerts produced in this study appeared to significantly reduce hospitalizations. This paves the way for further testing of the model.
Seed–litter–position drives seedling establishment in grassland species under recurrent drought
Authors: Wellstein C. 
Published: July 2012

AbstractChanges in land use and climate interfere with grassland ecosystem processes. Here I experimentally investigated the combined effects of land‐use change related litter cover and contrasting water supply on seedling emergence. In this context, the role of the initial relative position of seeds,i.e. seeds on top of the litterversusseeds beneath the litter in interaction with water supply has not been investigated so far. I hypothesised that facilitative effects of litter on seedling emergence occur when seeds are covered by litter and deteriorate when litter covers the ground and seeds fall on it (seeds on top of the litter). Further, I hypothesised that the importance of seed position for seedling emergence will increase under conditions of recurrent drought. I performed a controlled pot experiment on seedling emergence of three common European grassland species (Pimpinella saxifraga,Leontodon autumnalis,Sanguisorba officinalis) by experimental manipulations of litter and water availability. Seedling emergence under moist conditions showed no significant differences between each litter position compared to the control across species. In contrast, under recurrent drought, seedling emergence was significantly higher below the litter compared to seeds on top of the litter and the control (i.e. no litter). In abandoned land, seedling emergence may be limited when seeds fall on ground‐covering litter. In contrast, in grasslands with regular low‐intensity land use, seedling emergence may be enhanced when a moderate level of litter covers seeds at the end of the growing season. Protective mechanisms that occur with seeds positioned beneath litter are particularly important under recurrent drought.
Pollen dispersal and fruit production in Vaccinium oxycoccos and comparison with its sympatric congener V. uliginosum
Authors: Van Rossum F. , Vereecken N. J. , Brédat E. , Michez D. 
Published: July 2012

AbstractInvestigating plant–pollinator interactions and pollen dispersal are particularly relevant for understanding processes ensuring long‐term viability of fragmented plant populations. Pollen dispersal patterns may vary strongly, even between similar congeneric species, depending on the mating system, pollinator assemblages and floral traits. We investigated pollen dispersal and fruit production in a population of Vaccinium oxycoccos, an insect‐pollinated shrub, and compared the pollen dispersal pattern with a co‐flowering, sympatric congener, V. uliginosum. We examined whether they share pollinators (through interspecific fluorescent dye transfers) and may differently attract pollinators, by comparing their floral colour as perceived by insects. Fluorescent dyes were mainly dispersed over short distances (80% within 40.4 m (max. 94.5 m) for V. oxycoccos and 3.0 m (max. 141.3 m) for V. uliginosum). Dye dispersal in V. oxycoccos was not significantly affected by plant area, floral display or the proximity to V. uliginosum plants. Interspecific dye transfers were observed, indicating pollinator sharing. The significantly lower dye deposition on V. oxycoccos stigmas suggests lower visitation rates by pollinators, despite higher flower density and local abundance. The spectral reflectance analysis indicates that bees are unlikely to be able to discriminate between the two species based on floral colour alone. Fruit production increased with increasing floral display, but was not affected by proximity to V. uliginosum plants. Our study highlights that fragmented populations of V. oxycoccos, when sympatric with co‐flowering V. uliginosum, might incur increased competition for the shared pollinators in the case of pollination disruption, which might then reduce outcrossed seed set.
Andromonoecy in an Old World Papilionoid legume, Erophaca baetica
Authors: Casimiro‐Soriguer R. , Herrera J. , Talavera S. 
Published: July 2012

AbstractAndromonoecy (i.e. the occurrence on individual plants of hermaphroditic and male flowers) is a rare sexual system among the angiosperms, regarded by some authors as a transitional stage from hermaphroditism to monoecy. Having discovered the occurrence of andromonoecy in Erophaca baetica (a Mediterranean shrubby legume with two subspecies), a novelty for Old World papilionoid legumes, we investigated the morpho‐functional correlates and the geographical distribution of this phenomenon in the species. The relative frequencies of hermaphrodite and male flowers were determined in two field and 111 herbarium populations. Biomass allocation within flowers, pollen production and viability, pollen tube growth, nectar production and the temporal pattern of male flower production were also studied in two nearby southern Spanish populations. Virtually all of the studied populations were andromonoecious. Male flowers tended to appear at apical positions within the inflorescence, and became more abundant by the end of the flowering season. Male flowers were externally similar to hermaphroditic flowers (although with less biomass and smaller parts) and released equivalent amounts of pollen and nectar; however, their pollen germinated significantly better. Erophaca is the first example of an andromonecious Papilionoid in the Old World. Since the main difference among floral morphs in this species is functional (i.e. pollen germination rate) rather than morphological, andromonoecy is not readily noticeable, and very careful inspection may be required to reveal it. The potential effect of andromonoecy in enhancing outcrossing rate in this species is discussed.
Plant‐mediated effects of drought on aphid population structure and parasitoid attack
Authors: Aslam T. J. , Johnson S. N. , Karley A. J. 
Published: July 2012

AbstractThe effects of predicted climate change on aphid–natural enemy interactions have principally considered the effects of elevated carbon dioxide concentration and air temperature. However, increased incidence of summer droughts are also predicted in Northern Europe, which could affect aphid–plant interactions and aphid antagonists. We investigated how simulated summer drought affected the bird cherry–oat aphid,
Rhopalosiphum padi
L., and its natural enemy the parasitoid wasp
Aphidius ervi. Drought and, to a greater extent, aphids reduced barley (
Hordeum vulgare) dry mass by 33% and 39%, respectively. Drought reduced leaf and root nitrogen concentrations by 13% and 28%, respectively, but foliar amino acid concentrations and composition remained similar. Aphid numbers were unaffected by drought, but population demography changed significantly; adults constituted 41% of the population on drought‐treated plants, but only 26% on those receiving ambient irrigation. Nymphs constituted 56% and 69% of the population on these plants, respectively, suggesting altered aphid development rates on drought‐stressed plants. Parasitism rates were significantly lower on drought‐stressed plants (9 attacks h−1 compared with 35 attacks h−1 on ambient‐irrigated plants), most likely because of lower incidence of nymphs and more adults, the latter being more difficult to parasitize. Any physiological changes in individual aphids did not affect parasitoid preferences, suggesting that attacks were postponed because of drought‐induced changes in aphid demography. This study demonstrates the potential for sporadic climate change events, such as summer drought, to be disruptive to herbivore–antagonist interactions.
Is chest tube insertion with ultrasound guidance safe in patients using clopidogrel?
Authors: ABOUZGHEIB WISSAM , SHWEIHAT YOUSEF R. , MEENA NIKHIL , BARTTER THADDEUS 
Published: July 2012

ABSTRACTBackground and objective:  Drainage of the pleural space is a common procedure. The safety of chest tube insertion in patients using clopidogrel has not been investigated.Methods:  Ultrasound‐guided chest tube insertions performed on 24 patients who were being actively treated with clopidogrel were retrospectively reviewed.Results:  No excessive bleeding occurred in any of these patients.Conclusions:  Given the known effects of clopidogrel on platelet function, these results were interpreted as indicating that clopidogrel therapy is a relative but not an absolute contraindication to chest tube insertion, if an experienced operator places a small‐bore tube under ultrasound guidance.
Development and external validation of lymph node density cut‐off points in prospective series of radical cystectomy and pelvic lymph node dissection
Authors: Simone Giuseppe , Papalia Rocco , Ferriero Mariaconsiglia , Guaglianone Salvatore , Naselli Angelo , Collura Devis , Introini Carlo , Puppo Paolo , Muto Giovanni , Gallucci Michele 
Published: July 2012

Objective:  To identify lymph node density thresholds and their prognostic role in patients who underwent radical cystectomy and pelvic lymph node dissection, and to validate findings in an external series.Methods:  Between May 2001 and September 2009, data from 750 radical cystectomies carried out at “Regina Elena” National Cancer Institute (Rome, Italy) were collected in a prospectively‐maintained database. Once patients who had undergone neoadjuvant treatments and those who had undergone salvage radical cystectomy were excluded from the 210 pN+ patients, 156 patients with urothelial carcinoma were selected for analysis. Optimal cut‐off points for age, lymph node count and lymph node density were identified by considering these variables as continuous. External validation of findings was carried out by using data of 154 pN+ patients selected from two prospective series.Results:  The optimal identified cut‐off points were 11% and 30% for lymph node density, nine and 30 nodes for lymph node count, and 73 years for age. Median cancer‐specific survival of patients were significantly different in patients with lymph node density <12%, between 12% and 30%, and >30% (71 months, 24 months and 11 months, respectively; P < 0.001). Cancer‐specific survival was independently predicted by lymph node density cut‐off points (12–30% vs <12%: hazard ratio 1.51, P = 0.047; >30% vs <12%: hazard ratio 2.89, P < 0.001). In the external series, the prognostic effect of lymph node density according to tertiary distribution of risk based on these lymph node density cut‐off points was confirmed at Cox multivariable analysis (12–30% vs <12%: hazard ratio 1.5, P = 0.048; >30% vs <12%: hazard ratio 2.5, P = 0.004).Conclusions:  Lymph node density is the strongest predictor of cancer‐specific survival. Identified lymph node density thresholds have shown to be independent predictors of cancer‐specific survival in the external validation series.
Correlation between cognitive ability measured by response time of 1‐back task and changes of SpO2 by supplying three different levels of oxygen in the elderly
Authors: Choi Mi‐Hyun , Kim Hyun‐Joo , Kim Ji‐Hye , Kim Hyung‐Sik , Choi Jin‐Seung , Yi Jeong‐Han , Tack Gye‐Rae , Chung Young‐Sun , Son Ina , Chung Soon‐Cheol 
Published: July 2012

Aim:  This study investigated the correlation between response time of the 1‐back task and changes of blood oxygen saturation (SpO2) by supplying three different levels of oxygen (21%, 1 L/min; 93%, 1 L/min; 93%, 5 L/min) in the elderly.Methods:  A total of 17 older adults (mean age 72.9 ± 4.7 years) participated in the experiment. A 1‐back task was used as a cognitive task. The experiment consisted of three phases, which included the adaptation phase (3 min) after oxygen administration, the control phase (2 min) that maintained a stable condition before the task, and the task phase (2 min) where the 1‐back task was carried out. SpO2 was measured during each phase.Results:  As concentration level and supply of oxygen increased, SpO2 increased and response time of the 1‐back task decreased.Conclusion:  Highly concentrated oxygen administration can increase SpO2 in the elderly and an increase in cognitive performance, such as a decrease in response time, can be observed. Geriatr Gerontol Int 2013; 13: 384–387.
Risk factors for unexpected death from suffocation in elderly patients hospitalized for pneumonia
Authors: Komiya Kosaku , Ishii Hiroshi , Okabe Eiji , Iwashita Tomohiko , Miyajima Hajime , Tsubone Tetsuo , Ohama Minoru , Kushima Hisako , Matsumoto Bunroku , Kadota Jun‐ichi 
Published: July 2012

Aim:  Unexpected death from suffocation as a result of ortholaryngeal mucinous secretions or vomitus during recovery from pneumonia is devastating for patients, their families and medical professionals. This study aimed to determine the risk factors for unexpected death from suffocation in elderly patients hospitalized for pneumonia.Methods:  This study was carried out with patients aged 65 years and older that were hospitalized for pneumonia and died of any cause. Unexpected death from suffocation was defined as: (i) being in the recovery stage of pneumonia; (ii) presenting stable vital signs a week before death; (iii) dying within 24 h after suffocation; and (iv) aspiration confirmed by transtracheal suction. The clinical features and courses, and methods of feeding were retrospectively analyzed.Results:  A total of 11 patients that had an unexpected death from suffocation and 62 patients who died of other causes were enrolled. There were significantly more patients that received tube feeding after admission (continuation and introduction) among the patients who had died of suffocation (63.6%) than in those who had died of other causes (12.9%; P < 0.001). A multiple logistic regression analysis showed that tube feeding after admission was strongly associated with unexpected death from suffocation (adjusted odds ratio 9.536, P = 0.047) after adjusting for sex, age, level of serum albumin, PaO2/FIO2 ratio, the pneumonia severity score and performance status.Conclusion:  A continuation of tube feeding after admission is thus considered to be a significant predictor of unexpected death from suffocation in elderly patients with pneumonia. Geriatr Gerontol Int 2013; 13: 388–392.
Short‐term effect of low‐intensity, pulsed, electromagnetic fields on gait characteristics in older adults with low bone mineral density: A pilot randomized‐controlled trial
Authors: Giusti Andrea , Giovale Massimo , Ponte Marco , Fratoni Francesco , Tortorolo Umberto , De Vincentiis Armando , Bianchi Gerolamo 
Published: July 2012

Aim:  To evaluate the short‐term effects of a 10‐min exposure to low‐intensity, pulsed, electromagnetic fields (PEF) on gait characteristics in older adults with low bone mineral density.Methods:  In a single‐center, double‐blind, randomized‐controlled trial, community‐dwelling older adults aged ≥70 years were randomized (3:2 ratio) to receive a 10‐min treatment with PEF (mean intensity 1.5 mW) or placebo. The following gait parameters were assessed at baseline and just after the intervention/placebo with the GAITRite Portable Walkway system: self‐selected gait speed (cm/s), stride length (cm), support base (cm) and double support phase (s).Results:  In the intervention group (25 patients), both self‐selected gait speed and stride length increased significantly from baseline, whereas the double support phase decreased. In the placebo group, all gait parameters except for support base remained unchanged. The mean percent increase (±standard deviation) of self‐selected gait speed was significantly (P = 0.010) greater in the intervention group (20.1 ± 15.6) compared with the placebo group (10.5 ± 13.1), whereas no significant difference in the mean percent variation of the other parameters was found between the two groups. During the intervention, no adverse event was observed. A similar proportion of patients in the two groups reported one fall in the 30 days after the intervention/placebo.Conclusions:  This is the first randomized‐controlled trial showing the potential beneficial effects of PEF on gait characteristics in older adults. Further phase III randomized trials are warranted to establish their potential benefits (e.g. fall prevention) on fall‐related health outcomes in elderly patients. Geriatr Gerontol Int 2013; 13: 393–397.