bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prescription medicines: decision‐making preferences of patients who receive different levels of public subsidy
Authors: Robertson Jane , Doran Evan , Henry David A. , Salkeld Glenn 
Published: August 2011

AbstractObjective  To compare the relative importance of medicine attributes and decision‐making preferences of patients with higher or lower levels of insurance coverage in a publicly funded health care system.Design and setting  Cross‐sectional telephone survey of randomly selected regular medicine users aged ≥18 years in the Hunter Valley, NSW, Australia.Main variables studied  Questions about 27 medicine attributes and active involvement in decisions to start a new medicine.Results  After adjustment, there were few differences between the 408 concession card holders (high insurance) and 410 general beneficiaries (low insurance) in their assessment of the importance of medicine attributes. For both groups, the explanation of treatment options, establishing the need for the medicine, and medicine efficacy and safety were the most important considerations. Medicine costs, the treatment burden and medicine familiarity were less important; the views of family and friends ranked lowest. There was a statistically significantly greater influence of the regular doctor for the concession card holders than general beneficiaries (93.6 vs. 84%, adjusted OR 2.80, 95% CI 1.31, 5.99). Concession card holders were more likely to favour doctors having more say in the decision‐making process (crude OR 1.69, 95% CI 1.28, 2.24), and more likely to report the most recent treatment decision being made by the doctor alone, compared with general beneficiaries (61.2 vs. 40.3%).Conclusion  Medicine need, efficacy and safety are viewed as paramount for most patients, irrespective of insurance status. While patients report the importance of participation in treatment decisions, delegation of decision making to the doctor was common in practice.
Physicians’ attitudes about communicating and managing scientific uncertainty differ by perceived ambiguity aversion of their patients
Authors: Portnoy David B. , Han Paul K. J. , Ferrer Rebecca A. , Klein William M. P. , Clauser Steven B. 
Published: August 2011

AbstractBackground  Medical interventions are often characterized by substantial scientific uncertainty regarding their benefits and harms. Physicians must communicate to their patients as part of the process of shared decision making, yet they may not always communicate scientific uncertainty for several reasons. One suggested by past research is individual differences in physicians’ tolerance of uncertainty. Relatedly, an unexplored explanation is physicians’ beliefs about their patients’ tolerance of uncertainty.Design  To test this possibility, we surveyed a sample of primary care physicians (N = 1500) and examined the association between their attitudes about communicating and managing scientific uncertainty and their perceptions of negative reactions to uncertainty by their patients. Physician perceptions were measured by their propensity towards pessimistic appraisals of risk information and avoidance of decision making when risk information is ambiguous – of uncertain reliability, credibility or adequacy, known as ‘ambiguity aversion’.Results  Confirming past studies, physician demographics (e.g. medical specialty) predicted attitudes toward communicating scientific uncertainty. Additionally, physicians’ beliefs about their patients’ ambiguity aversion significantly predicted these preferences. Physicians who thought that more of their patients would have negative reactions to ambiguous information were more likely to think that they should decide what is best for their patients (β = 0.065, P = 0.013), and to withhold an intervention that had uncertainty associated with it (β = 0.170, P < 0.001).Discussion  When faced with the task of communicating scientific uncertainty about medical tests and treatments, physicians’ perce‐ptions of their patients’ ambiguity aversion may be related to their attitudes towards communicating uncertainty.
Juvenile polyposis and other intestinal polyposis syndromes with microdeletions of chromosome 10q22–23
Authors: Dahdaleh FS , Carr JC , Calva D , Howe JR 
Published: August 2011

Dahdaleh FS, Carr JC, Calva D, Howe JR. Juvenile polyposis and other intestinal polyposis syndromes with microdeletions of chromosome 10q22–23.Juvenile polyposis (JP) is an autosomal dominant hamartomatous polyposis syndrome that carries a significant risk for the development of colorectal cancer. Microdeletions of one of the two predisposing genes to JP, BMPR1A, have been associated with a severe form of JP called juvenile polyposis of infancy. Many of these deletions have also been found to contiguously include PTEN, which is the gene responsible for the development of Cowden syndrome. The advent of molecular techniques that localize genomic copy number variations and others that target specific genes such as multiplex‐ligation probe analysis has allowed researchers to explore this area further for deletions. Here, we review the literature for microdeletions described on chromosome 10q22–23 in patients with JP and other intestinal polyposis syndromes.
Effects of Soil Salinity and Plant Density on Yield and Leaf Senescence of Field‐Grown Cotton
Authors: Zhang H. J. , Dong H. Z. , Li W. J. , Zhang D. M. 
Published: August 2011

AbstractThe response of cotton to constant salinity has been well documented under controlled conditions, but its response to changing salinity under field conditions is poorly understood. Using a split‐plot design, we conducted a 2‐year field experiment to determine the effects of soil salinity and plant density on plant biomass, boll load, harvest index and leaf senescence in relation to cotton yield in three fields with similar fertility but varying salinity. The main plots were assigned to weak (electrical conductivity of soil saturated paste extract, ECe = 5.5 dS m−1), moderate (ECe = 10.1 dS m−1) and strong (ECe = 15.0 dS m−1) soil salinity levels, while plant density (3.0, 4.5 and 7.5 plants m−2) was assigned to the subplots. Soil salinity had a negative effect on seedcotton yield, but the negative effect was compensated for by increased plant density under strong‐salinity conditions. Seedcotton yield under weak salinity changed little with varying plant density, but the medium plant density yielded better than the low or high plant density under moderate salinity. Plants accumulated 49 and 112 % more Na+ in leaves under moderate and strong salinity than under weak salinity. Strong salinity also led to higher boll load and early leaf senescence. Plant density had no effect on Na+ accumulation in leaves, but greatly reduced boll load and delayed leaf senescence. Plant biomass, maximum leaf area index and harvest index were greatly affected by salinity, plant density and their interaction. Accelerated leaf senescence under strong salinity was attributed to the high boll load and increased accumulation of toxic ions like Na+ in leaves, while delayed leaf senescence with increased plant density was attributed to the reduced boll load. Optimal yield can only be obtained with proper coordination of total biomass and harvest index by modification of plant density based on salinity levels.
Tripterygium wilfordii bioactive compounds as anticancer and anti‐inflammatory agents
Authors: Wong Kwong‐Fai , Yuan Yi , Luk John M 
Published: August 2011

Summary1. Bioactive compounds from medicinal plants with anticancer and anti‐inflammatory effects have become key resources in drug discovery fields for the treatment of various malignancies and immunological disorders.2. Tripterygium wilfordii (TW) is a medicinal plant that exhibits profound immunosuppressive effects and has been used in herbal regimens for the treatment of immunological diseases for thousand years in China.3. Procedures for the isolation and characterization of TW bioactive compounds have been well established. Over the past three decades, more than 46 diterpenoids, 20 new triterpenoids, 26 alkaloids and other small molecules have been identified from TW.4. Triptolide, celastrol and tripchlorolide are among the bioactive compounds conferring the immunosuppressive and anticancer activities of TW. Accumulated evidence suggests that the TW bioactive compounds exert their pharmacological actions by modulating the transcriptional activity of nuclear factor‐κB signalling molecule.5. Triptolide derivatives with improved water solubility have emerged as promising drug candidates. Clinical trials are being conducted on the derivatives to provide encyclopaedic knowledge on triptolide pharmacokinetics in patients.
Factors predicting continence recovery 1 month after radical prostatectomy: Results of a multicenter survey
Authors: Gacci Mauro , Carini Marco , Simonato Alchiede , Imbimbo Ciro , Gontero Paolo , Briganti Alberto , De Cobelli Ottavio , Fulcoli Vittorio , Martorana Giuseppe , Nicita Giulio , Mirone Vincenzo , Carmignani Giorgio 
Published: August 2011

Objectives:  To assess the factors associated with continence recovery 1 month after radical prostatectomy (RP) and to identify the correlation between these factors.Methods:  In total, 2408 men treated with RP for prostate cancer (PCa) were enrolled in the present multicenter prospective study. Clinical (age, body mass index) and urological (catheterization or transurethral resection of the prostate) records, quality of life (QOL) scores determined using various instruments (including the International Index of Erectile Function [IIEF] and University of California Los Angeles, Prostate Cancer Index [UCLA‐PCI]), PCa characteristics (clinical stage [cT], prostate‐specific antigen, biopsy Gleason score), surgical features (surgical approach, nerve and bladder neck sparing, catheterization), and pathologic outcomes (pT, pN+, Gleason score, positive surgical margins) were recorded. Continence status prior to surgery and at 1 month after RP was assessed and classified as followed: (i) full continence; (ii) 0–1 pads/day; or (iii) >1 pad/day. Only patients determined to have full continence prior to surgery were included in the analysis. Data were evaluated using Spearman's correlation analysis and multivariate logistic regression.Results:  Data from 1972 patients with full continence preoperatively and complete postoperative data were analyzed. At 1 month after RP, 644 patients (32.7%) were fully continent, 810 (41.1%) were using 0–1 pads/day, and 518 (26.3%) were using >1 pad/day. Univariate analysis indicated that clinical and urological data, QOL, PCa characteristics, surgical features, and pathologic outcomes were determinants for continence recovery. Multivariate analysis indicated that preoperative sexual activity (UCLA‐PCI Sexual Function P = 0.005; IIEF P = 0.040), bladder neck sparing (P = 0.003), catheterization time (P = 0.007), and catheter diameter (P = 0.046) were associated with 1 month continence recovery.Conclusions:  Age and nerve sparing are not significant predictors of continence recovery 1 month after RP. Preoperative erectile function can predict post‐prostatectomy incontinence. Bladder neck preservation has a significant effect on early continence recovery after RP.
Insertion of laryngeal mask airway does not increase the intraocular pressure in children with glaucoma
Authors: Bhardwaj Neerja , Yaddanapudi Sandhya , Singh Swati , Pandav Surinder S. 
Published: August 2011

SummaryObjectives: It is hypothesized that in children with glaucoma, the insertion of laryngeal mask airway (LMA) will cause lesser rise in intraocular pressure (IOP) than tracheal tube (TT).Aim: To compare the IOP response to LMA and TT insertion in children with glaucoma.Methods/Materials: A prospective, randomized, single‐blind study was conducted in 30 glaucomatous ASA‐1 children, aged 1–10 years scheduled to undergo trabeculectomy. Anesthesia was induced with halothane and maintained for 5 min with 1 MAC of halothane after administering atracurium 0.5 mg·kg−1 following which LMA or TT was introduced. IOP was measured in both the eyes before and after insertion of airway device for 5 min.Results: The IOP increased significantly from 27.3 ± 5.2 to 31.2 ± 5.4 mmHg (P < 0.001) after tracheal intubation but returned to baseline within 5 min. The IOP did not change from the baseline after insertion of LMA. The IOP was significantly higher in group TT compared to group LMA at 2 min (P = 0.004) and 5 min (P = 0.01) after the device insertion. The heart rate (HR) increased significantly after tracheal intubation and returned to baseline 4 min after intubation. The HR increase was significantly more in TT group compared to LMA group at all times of observation. Both systolic blood pressure (SBP; P = 0.01) and diastolic blood pressure (DBP; P = 0.02) showed an increase at 1 min in children in group TT.Conclusion: Insertion of LMA in glaucomatous children is not associated with an increased IOP response or cardiovascular changes.
Role of biopsies in patients with residual rectal cancer following neoadjuvant chemoradiation after downsizing: can they rule out persisting cancer?
Authors: Perez R. O. , Habr‐Gama A. , Pereira G. V. , Lynn P. B. , Alves P. A. , Proscurshim I. , Rawet V. , Gama‐Rodrigues J. 
Published: August 2011

AbstractAim  The study aimed to determine the value of postchemoradiation biopsies, performed after significant tumour downsizing following neoadjuvant therapy, in predicting complete tumour regression in patients with distal rectal cancer.Method  A retrospective comparative study was performed in patients with rectal cancer who achieved an incomplete clinical response after neoadjuvant chemoradiotherapy. Patients with significant tumour downsizing (> 30% of the initial tumour size) were compared with controls (< 30% reduction of the initial tumour size). During flexible proctoscopy carried out postchemoradiation, biopsies were performed using 3‐mm biopsy forceps. The biopsy results were compared with the histopathological findings of the resected specimen. UICC (Union for International Cancer Control) ypTNM classification, tumour differentiation and regression grade were evaluated. The main outcome measures were sensitivity and specificity, negative and positive predictive values, and accuracy of a simple forceps biopsy for predicting pathological response after neoadjuvant chemoradiotherapy.Results  Of the 172 patients, 112 were considered to have had an incomplete clinical response and were included in the study. Thirty‐nine patients achieved significant tumour downsizing and underwent postchemoradiation biopsies. Overall, 53 biopsies were carried out. Of the 39 patients who achieved significant tumour downsizing, the biopsy result was positive in 25 and negative in 14. Only three of the patients with a negative biopsy result were found to have had a complete pathological response (giving a negative predictive value of 21%). Considering all biopsies performed, only three of 28 negative biopsies were true negatives, giving a negative predictive value of 11%.Conclusion  In patients with distal rectal cancer undergoing neoadjuvant chemoradiation, post‐treatment biopsies are of limited clinical value in ruling out persisting cancer. A negative biopsy result after a near‐complete clinical response should not be considered sufficient for avoiding a radical resection.
The incidence and outcome of brain metastases after liver resection for colorectal cancer metastases
Authors: Byrne B. E. , Geddes T. , Welsh F. K. S. , John T. G. , Chandrakumaran K. , Rees M. 
Published: August 2011

AbstractAim  Brain metastases from colorectal cancer are rare, with an incidence of 0.6–4%. The risk and outcome of brain metastases after hepatic and pulmonary metastasectomy have not been previously described. This study aimed to determine the incidence, predictive factors, treatment and survival of patients developing colorectal brain metastases, who had previously undergone resection of hepatic metastases.Method  A retrospective review was carried out of a prospectively maintained database of patients undergoing liver resection for colorectal metastases.Results  Fifty‐two (4.0%) of 1304 patients were diagnosed with brain metastases. The annual incidence rate was 1.03% per person‐year. In the majority of cases brain metastases were found as part of multifocal disease. Median survival was 3.2 months (95% CI: 2.3–4.1), but was best for six patients treated with potentially curative resection [median survival = 13.2 (range, 4.9–32.1) months]. Multivariate analysis showed that a lymph node‐positive primary tumour [hazard ratio (HR) = 2.7, 95% CI: 1.8–6.19; P = 0.019], large liver metastases (> 6 cm) [HR = 2.23, 95% CI: 1.19–2.33; P = 0.012] and recurrent intrahepatic and extrahepatic disease [HR = 2.11, 95% CI: 1.2–4.62; P = 0.013] were independent predictors for the development of brain metastases.Conclusion  The annual risk of developing brain metastases following liver resection for colorectal metastases is low, but highest for patients presenting with a Dukes’ C primary tumour, large liver metastases or who subsequently develop disseminated disease. The overall survival from colorectal brain metastases is poor, but resection with curative intent offers patients their best chance of medium‐term survival.
Measurement of insulin action: a tribute to Sir Harold Himsworth
Authors: Kim S. H. 
Published: August 2011

Diabet. Med. 28, 1487–1493 (2011)AbstractSir Harold Himsworth was a renowned clinician and researcher. Among his myriad of accomplishments, he was the first to differentiate diabetes mellitus into ‘insulin‐sensitive’ and ‘insulin‐insensitive’ forms. To help distinguish these two types, he developed the first test to measure insulin sensitivity, the insulin–glucose test. This article reviews Himsworth’s pioneer methods and subsequent advances in the measurement of insulin action. The advantages and limitations of commonly used methods to assess insulin sensitivity are also examined.
The current status of diabetes professional educational standards and competencies in the UK—a Position Statement from the Diabetes UK Healthcare Professional Education Competency Framework Task and Finish Group
Authors: Walsh N. , George S. , Priest L. , Deakin T. , Vanterpool G. , Karet B. , Simmons D. 
Published: August 2011

Diabet. Med. 28, 1501–1507 (2011)AbstractDiabetes is a significant health concern, both in the UK and globally. Management can be complex, often requiring high levels of knowledge and skills in order to provide high‐quality and safe care. The provision of good, safe, quality care lies within the foundations of healthcare education, continuing professional development and evidence‐based practice, which are inseparable and part of a continuum during the career of any health professional. Sound education provides the launch pad for effective clinical management and positive patient experiences.This position paper reviews and discusses work undertaken by a Working Group under the auspices of Diabetes UK with the remit of considering all health professional educational issues for people delivering care to people with diabetes. This work has scoped the availability of education for those within the healthcare system who may directly or indirectly encounter people with diabetes and reviews alignment to existing competency frameworks within the UK’s National Health Service.
Outcome of patients with diabetes with negative percutaneous bone biopsy performed for suspicion of osteomyelitis of the foot
Authors: Senneville E. , Gaworowska D. , Topolinski H. , Devemy F. , Nguyen S. , Singer B. , Beltrand E. , Legout L. , Caillaux M. , Descamps D. , Canonne J. P. , Yazdanpanah Y. 
Published: August 2011

Diabet. Med. 29, 56–61 (2012)AbstractAims  To assess the outcome of patients with diabetes with suspicion of osteomyelitis of the foot who had undergone a percutaneous bone biopsy that yielded negative microbiological results, with focus on the occurrence of osteomyelitis at the biopsied site.Methods  Medical charts of adult patients with diabetes with a negative percutaneous bone biopsy were reviewed. Patients’ outcome was evaluated at least 2 years after the initial bone biopsy according to wound healing, the results of a new bone biopsy and bone imaging evaluation when applicable.Results  From January 2001 to January 2008, 41 patients with diabetes (30 men/11 women; mean age 58.1 ± 9.6 years; mean diabetes duration 15.8 ± 6.7 years) met study criteria. Osteomyelitis was suspected based on combined clinical and imaging diagnostic criteria. On follow‐up at a mean duration of 41.2 ± 22.5 months post‐bone biopsy, 16 patients had complete wound healing (39.0%). Of the 25 other patients, 15 had a new bone biopsy performed, six of which yielded positive microbiological results, and among the 10 patients who neither healed nor underwent bone biopsy, comparative radiography of the foot showed a stable aspect of the biopsied site in six of them, for whom the data were available. Finally, osteomyelitis of the foot at the site where the initial bone biopsy had been performed was confirmed during follow‐up in six patients (14.6%) and was suspected in four additional patients (9.7%).Conclusions  The results of the present study suggest that, of patients with diabetes with the suspicion of osteomylelitis and a negative percutaneous bone biopsy, only one out of four will develop osteomyelitis within 2 years of the biopsy.
The impact of hypoglycaemia on quality of life and related patient‐reported outcomes in Type 2 diabetes: a narrative review
Authors: Barendse S. , Singh H. , Frier B. M. , Speight J. 
Published: August 2011

Diabet. Med. 29, 293–302 (2012)AbstractAs a common side effect of insulin treatment for diabetes, hypoglycaemia is a constant threat and can have far‐reaching and potentially devastating consequences, including immediate physical injury as well as more pervasive cognitive, behavioural and emotional effects. Moreover, as a significant limiting factor in achieving optimal glycaemic control, exposure to hypoglycaemia can influence diabetes self‐management.Although hypoglycaemia is known to occur in Type 2 diabetes, its morbidity and impact on the individual are not well recognized. The aim of the current review is to examine published evidence to achieve a synthesis of the scope and significance of the potential detriment caused by hypoglycaemia to individuals with Type 2 diabetes. The implications of these observations for treatment and research have also been considered.A narrative review was performed of empirical papers published in English since 1966, reporting the effect of hypoglycaemia on quality of life and related outcomes (including generic and diabetes‐specific quality of life, emotional well‐being and health utilities) in Type 2 diabetes.Research demonstrates the potential impact of hypoglycaemia on the lives of people with Type 2 diabetes, from an association with depressive symptoms and heightened anxiety, to impairment of the ability to drive, work and function in ways that are important for quality of life. Few studies consider hypoglycaemia as an explanatory variable in combination with quality of life or related primary endpoints. As a consequence, there is a pressing need for high‐quality research into the overall impact of hypoglycaemia on the lives of people with Type 2 diabetes.