bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Age on Outcome of Reduced-Intensity Hematopoietic Cell Transplantation for Older Patients With Acute Myeloid Leukemia in First Complete Remission or With Myelodysplastic Syndrome
Authors: McClune Brian L. , Weisdorf Daniel J. , Pedersen Tanya L. , Tunes da Silva Gisela , Tallman Martin S. , Sierra Jorge , DiPersio John , Keating Armand , Gale Robert P. , George Biju , Gupta Vikas , Hahn Theresa , Isola Luis , Jagasia Madan , Lazarus Hillard , Marks David , Maziarz Richard , Waller Edmund K. , Bredeson Chris , Giralt Sergio 
Published: March 2010

Purpose Acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) primarily afflict older individuals. Hematopoietic cell transplantation (HCT) is generally not offered because of concerns of excess morbidity and mortality. Reduced-intensity conditioning (RIC) regimens allow increased use of allogeneic HCT for older patients. To define prognostic factors impacting long-term outcomes of RIC regimens in patients older than age 40 years with AML in first complete remission or MDS and to determine the impact of age, we analyzed data from the Center for International Blood and Marrow Transplant Research (CIBMTR). Patients and Methods We reviewed data reported to the CIBMTR (1995 to 2005) on 1,080 patients undergoing RIC HCT. Outcomes analyzed included neutrophil recovery, incidence of acute or chronic graft-versus-host disease (GVHD), nonrelapse mortality (NRM), relapse, disease-free survival (DFS), and overall survival (OS). Results Univariate analyses demonstrated no age group differences in NRM, grade 2 to 4 acute GVHD, chronic GVHD, or relapse. Patients age 40 to 54, 55 to 59, 60 to 64, and ≥ 65 years had 2-year survival rates as follows: 44% (95% CI, 37% to 52%), 50% (95% CI, 41% to 59%), 34% (95% CI, 25% to 43%), and 36% (95% CI, 24% to 49%), respectively, for patients with AML (P = .06); and 42% (95% CI, 35% to 49%), 35% (95% CI, 27% to 43%), 45% (95% CI, 36% to 54%), and 38% (95% CI, 25% to 51%), respectively, for patients with MDS (P = .37). Multivariate analysis revealed no significant impact of age on NRM, relapse, DFS, or OS (all P > .3). Greater HLA disparity adversely affected 2-year NRM, DFS, and OS. Unfavorable cytogenetics adversely impacted relapse, DFS, and OS. Better pre-HCT performance status predicted improved 2-year OS. Conclusion With these similar outcomes observed in older patients, we conclude that older age alone should not be considered a contraindication to HCT.
Phase III Study of Carboplatin and Paclitaxel Alone or With Sorafenib in Advanced Non–Small-Cell Lung Cancer
Authors: Scagliotti Giorgio , Novello Silvia , von Pawel Joachim , Reck Martin , Pereira José Rodrigues , Thomas Michael , Abrão Miziara José Elias , Balint Beatrix , De Marinis Filippo , Keller Alan , Arén Osvaldo , Csollak Maria , Albert Istvan , Barrios Carlos Henrique , Grossi Francesco , Krzakowski Maciej , Cupit Lisa , Cihon Frank , DiMatteo Sandra , Hanna Nasser 
Published: March 2010

Purpose This phase III, multicenter, randomized, placebo-controlled trial assessed the efficacy and safety of sorafenib, an oral multikinase inhibitor, in combination with carboplatin and paclitaxel in chemotherapy-naïve patients with unresectable stage IIIB or IV non–small-cell lung cancer (NSCLC). Patients and Methods Nine hundred twenty-six patients were randomly assigned to receive up to six 21-day cycles of carboplatin area under the curve 6 and paclitaxel 200 mg/m2 (CP) on day 1, followed by either sorafenib 400 mg twice a day (n = 464, arm A) or placebo (n = 462, arm B) on days 2 to 19. The maintenance phase after CP consisted of sorafenib 400 mg or placebo twice a day. The primary end point was overall survival (OS); secondary end points included progression-free survival and tumor response. Results Overall demographics were balanced between arms; 223 patients (24%) had squamous cell histology. On the basis of a planned interim analysis, median OS was 10.7 months in arm A and 10.6 months in arm B (hazard ratio [HR] = 1.15; 95% CI, 0.94 to 1.41; P = .915). The study was terminated after the interim analysis concluded that the study was highly unlikely to meet its primary end point. A prespecified exploratory analysis revealed that patients with squamous cell histology had greater mortality in arm A than in arm B (HR = 1.85; 95% CI, 1.22 to 2.81). Main grade 3 or 4 sorafenib-related toxicities included rash (8.4%), hand-foot skin reaction (7.8%), and diarrhea (3.5%). Conclusion No clinical benefit was observed from adding sorafenib to CP chemotherapy as first-line treatment for NSCLC.
Risk-Adapted Dose-Dense Immunochemotherapy Determined by Interim FDG-PET in Advanced-Stage Diffuse Large B-Cell Lymphoma
Authors: Moskowitz Craig H. , Schöder Heiko , Teruya-Feldstein Julie , Sima Camelia , Iasonos Alexia , Portlock Carol S. , Straus David , Noy Ariela , Palomba Maria L. , O'Connor Owen A. , Horwitz Steven , Weaver Sarah A. , Meikle Jessica L. , Filippa Daniel A. , Caravelli James F. , Hamlin Paul A. , Zelenetz Andrew D. 
Published: March 2010

Purpose In studies of diffuse large B-cell lymphoma, positron emission tomography with [18F]fluorodeoxyglucose (FDG-PET) performed after two to four cycles of chemotherapy has demonstrated prognostic significance. However, some patients treated with immunochemotherapy experience a favorable long-term outcome despite a positive interim FDG-PET scan. To clarify the significance of interim FDG-PET scans, we prospectively studied interim FDG-positive disease within a risk-adapted sequential immunochemotherapy program. Patients and Methods From March 2002 to November 2006, 98 patients at Memorial Sloan-Kettering Cancer Center received induction therapy with four cycles of accelerated R-CHOP (rituximab + cyclophosphamide, doxorubicin, vincristine, and prednisone) followed by an interim FDG-PET scan. If the FDG-PET scan was negative, patients received three cycles of ICE (ifosfamide, carboplatin, and etoposide) consolidation therapy. If residual FDG-positive disease was seen, patients underwent biopsy; if the biopsy was negative, they also received three cycles of ICE. Patients with a positive biopsy received ICE followed by autologous stem-cell transplantation. Results At a median follow-up of 44 months, overall and progression-free survival were 90% and 79%, respectively. Ninety-seven patients underwent interim FDG-PET scans; 59 had a negative scan, 51 of whom are progression free. Thirty-eight patients with FDG-PET–positive disease underwent repeat biopsy; 33 were negative, and 26 remain progression free after ICE consolidation therapy. Progression-free survival of interim FDG-PET–positive/biopsy-negative patients was identical to that in patients with a negative interim FDG-PET scan (P = .27). Conclusion Interim or post-treatment FDG-PET evaluation did not predict outcome with this dose-dense, sequential immunochemotherapy program. Outside of a clinical trial, we recommend biopsy confirmation of an abnormal interim FDG-PET scan before changing therapy.
Comparison of Resistivity and Time Domain Reflectometry Sensors for Assessing Moisture Content in Bioreactor Landfills
Authors: Jonnalagadda Sreeram , Kumar Dinesh , Jain Pradeep , Gawande Nitin , Townsend Timothy G. , Reinhart Debra R. 
Published: March 2010

Abstract
Instruments that can monitor the in situ moisture content of landfilled waste would be of great benefit to landfill operators, especially those operating their facilities as bioreactor landills (wet landfills). Two instrumentation technologies for measuring in situ moisture content (resistivity sensors and time domain reflectometry (TDR)) in landfills were examined and compared. Resistivity and TDR instruments were installed in close proximity at multiple locations in a leachate recirculation well field at a bioreactor landfill in Florida, and resulting moisture content measurements were assessed. The resistivity instruments were less expensive, easier to install, and found more reliable over time than TDR sensors. Both technologies predicted transient moisture changes in the landfill. The magnitudes of the moisture content values obtained using the two technologies were much higher compared to values estimated using mass balance, suggesting that accurate calibration to field conditions is difficult.
Moderate energy restriction-induced weight loss affects circulating IGF levels independent of dietary composition
Authors: Belobrajdic Damien P , Frystyk Jan , Jeyaratnaganthan Nilani , Espelund Ulrick , Flyvbjerg Allan , Clifton Peter M , Noakes Manny 
Published: March 2010

BackgroundObesity is associated with major changes in the circulating IGF system. However, it is not clear to what extent the IGF system is normalized following diet, and the possible role of different types of diet is also unknown.ObjectiveTo compare changes in the circulating IGF system following 12 weeks of moderate energy restriction (7000 kJ/day) in overweight or obese males on a high protein high red meat diet (HP) or a high carbohydrate diet (HC).DesignSeventy-six men (mean age, 51±1.0 years; body mass index, 32.8±0.5 kg/m2) were allocated to matched groups treated with isocaloric diets of HP (n=34) or HC (n=42). Outcome measures were weight, body composition, IGF-related peptides, homoeostasis model assessment of insulin resistance (HOMA1-IR) and adipokines.ResultsWeight loss did not differ between diets (HP 8.5±0.6 kg; HC 8.2±0.6 kg,P>0.05). IGF-related peptides increased total IGF1 (HP 23%; HC 18%,P<0.0001), bioactive IGF1 (HP 18%; HC 15%,P<0.002), IGF1:IGF-binding protein-3 (IGFBP-3; HP 29%; HC 22%,P<0.0001) and IGFBP-1 (HP 24%; HC 25%,P<0.01). By contrast, decreases were observed in IGFBP-3 (HP −4%; HC −3%,P<0.01), pro-IGF2 (HP −3%; HC −6%,P=0.001), total IGF2 (HP −7%; HC −3%,P=0.001) and sIGF2R (HP −10%; HC −6%,P<0.005). Only IGFBP-2 increased differentially by diet (HP 34%; HC 50%,P<0.0001, dietP<0.05). Adiponectin increased in both diets, but leptin and HOMA-IR decreased (P<0.001).ConclusionsWeight loss induced by moderate energy restriction modulated the IGF system independent of dietary protein or red meat content. The effect of diet on IGFBP-2 appeared to have limited biological effect as total IGF2 and pro-IGF2 did not change.
Music Training Improves Pitch Perception in Prelingually Deafened Children With Cochlear Implants
Authors: Chen Joshua Kuang-Chao , Chuang Ann Yi Chiun , McMahon Catherine , Hsieh Jen-Chuen , Tung Tao-Hsin , Li Lieber Po-Hung 
Published: March 2010

OBJECTIVE:
The comparatively poor music appreciation in patients with cochlear implants might be ascribed to an inadequate exposure to music; however, the effect of training on music perception in prelingually deafened children with cochlear implants remains unknown. This study aimed to investigate whether previous musical education improves pitch perception ability in these children.

METHODS:
Twenty-seven children with congenital/prelingual deafness of profound degree were studied. Test stimuli consisted of 2 sequential piano tones, ranging from C (256 Hz) to B (495 Hz). Children were asked to identify the pitch relationship between the 2 tones (same, higher, or lower). Effects of musical training duration, pitch-interval size, current age, age of implantation, gender, and type of cochlear implant on accuracy of pitch perception were evaluated.

RESULTS:
The duration of musical training positively correlated with the correct rate of pitch perception. Pitch perception performance was better in children who had a cochlear implant and were older than 6 years than in those who were aged ≤6 years (ie, preschool). Effect of pitch-interval size was insignificant on pitch perception, and there was no correlation between pitch perception and the age of implantation, gender, or type of cochlear implant.

CONCLUSIONS:
Musical training seems to improve pitch perception ability in prelingually deafened children with a cochlear implant. Auditory plasticity might play an important role in such enhancement. This suggests that incorporation of a structured training program on music perception early in life and as part of the postoperative rehabilitation program for prelingually deafened children with cochlear implants would be beneficial. A longitudinal study is needed to show whether improvement of music performance in these children is measurable by use of auditory evoked potentials.
State Variation in Underinsurance Among Children With Special Health Care Needs in the United States
Authors: Kogan Michael D. , Newacheck Paul W. , Blumberg Stephen J. , Heyman Kathleen M. , Strickland Bonnie B. , Singh Gopal K. , Zeni Mary Beth 
Published: March 2010

OBJECTIVE:
National attention has focused on providing health insurance coverage for children. Less awareness has been given to underinsurance, particularly for children with special health care needs (CSHCN). Defined as having inadequate benefits, underinsurance may be a particular problem for CSHCN because of their greater needs for medical care.

METHODS:
We used the 2005–2006 National Survey of Children With Special Health Care Needs, a nationally representative study of &gt;40 000 CSHCN, to address state variations in underinsurance. CSHCN with health insurance were considered underinsured when a parent reported that the child's insurance did not usually or always cover needed services and providers or reasonably cover costs. We calculated the unadjusted prevalence of underinsurance for each state. Using logistic regression, we estimated state-specific odds and prevalence for underinsurance after adjusting for poverty level, race/ethnicity, gender, family structure, language use, insurance type, and severity of child's health condition. We also conducted multilevel analyses incorporating state-level contextual data on Medicaid and the State Children's Health Insurance Program.

RESULTS:
Bivariate and multivariate analyses indicated that CSHCN′s state of residence had a strong association with insurance adequacy. State-level unadjusted underinsurance rates ranged from 24% (Hawaii) to 38% (Illinois). After multivariate adjustments, the range was largely unchanged: 23% (Hawaii) to 38% (New Jersey). Multilevel analyses indicated that Medicaid income eligibility levels were inversely associated with the odds of being underinsured.

CONCLUSIONS:
The individual-level and macro-level factors examined only partly explain state variations in underinsurance. Furthermore, the macro-level factors explained only a small portion of the variance; however, other macro-level factors may be relevant for the observed patterns.
An Intervention to Reduce Environmental Tobacco Smoke Exposure Improves Pregnancy Outcomes
Authors: El-Mohandes Ayman A. E. , Kiely Michele , Blake Susan M. , Gantz Marie G. , El-Khorazaty M. Nabil 
Published: March 2010

OBJECTIVE:
We tested the efficacy of a cognitive-behavioral intervention in reducing environmental tobacco smoke exposure (ETSE) and improving pregnancy outcomes among black women.

METHODS:
We recruited 1044 women to a randomized, controlled trial during 2001–2004 in Washington, DC. Data on 691 women with self-reported ETSE were analyzed. A subset of 520 women with ETSE and salivary cotinine levels (SCLs) of &lt;20 ng/mL were also analyzed. Individually tailored counseling sessions, adapted from evidence-based interventions for ETSE and other risks, were delivered to the intervention group. The usual-care group received routine prenatal care as determined by their provider. Logistic regression models were used to predict ETSE before delivery and adverse pregnancy outcomes.

RESULTS:
Women in the intervention were less likely to self-report ETSE before delivery when controlling for other covariates (odds ratio [OR]: 0.50 [95% confidence interval (CI): 0.35–0.71]). Medicaid recipients were more likely to have ETSE (OR: 1.97 [95% CI: 1.31–2.96]). With advancing maternal age, the likelihood of ETSE was less (OR: 0.96 [95% CI: 0.93–0.99]). For women in the intervention, the rates of very low birth weight (VLBW) and very preterm birth (VPTB) were significantly improved (OR: 0.11 [95% CI: 0.01–0.86] and OR: 0.22 [95% CI: 0.07–0.68], respectively). For women with an SCL of &lt;20 ng/mL, maternal age was not significant. Intimate partner violence at baseline significantly increased the chances of VLBW and VPTB (OR: 3.75 [95% CI: 1.02–13.81] and 2.71 [95% CI: 1.11–6.62], respectively). These results were true for mothers who reported ETSE overall and for those with an SCL of &lt;20 ng/mL.

CONCLUSIONS:
This is the first randomized clinical trial demonstrating efficacy of a cognitive-behavioral intervention targeting ETSE in pregnancy. We significantly reduced ETSE as well as VPTB and VLBW, leading causes of neonatal mortality and morbidity in minority populations. This intervention may reduce health disparities in reproductive outcomes.
Gaps in Hospital Policies and Practices to Prevent Perinatal Transmission of Hepatitis B Virus
Authors: Willis Bayo C. , Wortley Pascale , Wang Susan A. , Jacques-Carroll Lisa , Zhang Fan 
Published: March 2010

OBJECTIVE:
The objective of this study was to examine hospital policies and practices to prevent perinatal transmission of hepatitis B virus (HBV) in the United States and to and identify gaps.

METHODS:
In March 2006, a nationally representative sample of 242 delivery hospitals in the 50 states, District of Columbia, and Puerto Rico (with at least 100 annual births) were surveyed about hospital perinatal hepatitis B prevention policies and asked to review paired maternal–infant medical records for 25 consecutive live births. Main outcome measures were hospital policies related to the prevention of perinatal transmission of hepatitis B and the proportion of infants who received recommended care.

RESULTS:
A total of 190 of 242 hospitals responded to the survey and completed medical record reviews for 4762 mothers and 4786 infants. The proportion of hospitals that reported each of the 6 policies examined ranged from 63.0% to 80.6%. Among infants who were born to the 18 hepatitis B surface antigen (HBsAg)-positive women with documented prenatal test results, 62.1% received both hepatitis B vaccine and hepatitis B immunoglobulin within 12 hours, but 13.7% were unvaccinated and 19.7% did not receive hepatitis B immunoglobulin before hospital discharge. Among infants who were born to the 320 women with unknown HBsAg status, only 52.4% were vaccinated within 12 hours of birth and 20.1% were unvaccinated before discharge. Among infants who were born to HBsAg-negative mothers, 69.1% received the hepatitis B vaccine before hospital discharge. The strongest predictor of vaccine administration was having a written hospital policy for newborn hepatitis B vaccination.

CONCLUSIONS:
These findings indicate that significant gaps persist in hospital policies and practices to prevent perinatal HBV transmission in the United States. Efforts to avoid medical errors through appropriate implementation and monitoring of hospital practices are needed to eliminate perinatal HBV transmission.
Efficacy of Amoxicillin and Metronidazole Combination for the Management of Generalized Aggressive Periodontitis
Authors: Yek Emine Cifcibasi , Cintan Serdar , Topcuoglu Nursen , Kulekci Guven , Halim İssever  , Kantarci Alpdogan 
Published: March 2010

Background: The aim of this study is to evaluate the effects of metronidazole–amoxicillin combination on clinical and microbiologic parameters in patients with generalized aggressive periodontitis.Methods: Twenty‐eight patients were randomly included. The test group (n = 12) received amoxicillin–metronidazole combination and scaling and root planing; the control group (n = 16) received scaling and root planing alone. In addition to the clinical examinations, subgingival plaque samples were analyzed for total cultivable bacteria and the presence of Porphyromonas gingivalis, Tannerella forsythia (previously T. forsythensis), Treponema denticola, Prevotella intermedia, Prevotella nigrescens, Prevotella pallens, and Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) using polymerase chain reaction.Results: All clinical parameters improved significantly compared to baseline (P <0.05) in both groups. There was a statistically significant reduction of pockets and clinical attachment gain in the combined group compared to the control group (P <0.05). Total counts of bacteria also decreased significantly at 3 and 6 months in both groups (P <0.05). T. denticola and T. forsythia were the most prevalent bacteria throughout the study. T. denticola showed a continuous decrease over 6 months in the test group, whereas no change was seen in the control group beyond 3 months. P. gingivalis decreased significantly at 3 months (P <0.05), whereas T. forsythia was the only pathogen decreased below detection limits by the combination therapy with a significant difference compared to the control group (P <0.05).Conclusions: The results from this study suggest that combined amoxicillin and metronidazole use as an adjunct to scaling and root planing leads to better clinical healing compared to mechanical treatment alone. The polypharmaceutical approach used results in a significant and substantial decrease in T. forsythia and prevents its recolonization for 6 months, suggesting that T. forsythia may determine the long‐term stability of periodontal treatment outcomes.
Effect of Initial Periodontal Therapy on Oral Health–Related Quality of Life in Patients With Periodontitis in Japan
Authors: Saito Atsushi , Hosaka Yasuo , Kikuchi Momomi , Akamatsu Mayako , Fukaya Chie , Matsumoto Shinya , Ueshima Fumie , Hayakawa Hiroki , Fujinami Koushu , Nakagawa Taneaki 
Published: March 2010

Background: It is becoming increasingly important for periodontists and dental hygienists to take a biopsychosocial approach to care when considering periodontal interventions. However, information on how patients perceive periodontitis and its treatment is limited. The purpose of the present study is to gain insight into the patient perception of oral health and the impact that periodontitis and treatment have on self‐assessed quality of life (QoL).Methods: This was a prospective, two‐center, clinical study in Japan. Patients with periodontitis were assessed for their perceptions of oral health by using an instrument for oral health–related QoL (OHRQL) before and after initial periodontal therapy.Results: A total of 58 patients (mean age: 53.6 years; 23 male and 35 female) participated in the study and completed initial periodontal therapy. At baseline, 97% of the patients perceived that their oral health status impacted on their QoL in one or more ways. Pain, eating and chewing, and psychologic function were identified as compromised OHRQL domains. More than one‐half of the patients rated their overall oral health as poor. Initial periodontal therapy, consisting mainly of oral hygiene instructions and scaling and root planing, significantly improved OHRQL scores (P = 0.0027). The effect size was calculated to be 0.51, indicating a moderate improvement. Compared with baseline, a significantly higher proportion of patients reported rarely or never having a problem regarding OHRQL domains such as pain (P = 0.0049) and eating and chewing (P = 0.0145) after treatment. No significant difference in the OHRQL improvement was found with respect to disease severity.Conclusions: Periodontitis negatively affected QoL in this population of Japanese patients with periodontitis. Conventional non‐surgical periodontal therapy has a potential to ameliorate patient perceptions of oral health.