bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lamivudine plus adefovir vs. entecavir in HBeAg‐positive hepatitis B with sequential treatment failure of lamivudine and adefovir
Authors: Son Chang Young , Ryu Han Jak , Lee Jung Min , Ahn Sang Hoon , Kim Do Young , Lee Myoung Ha , Han Kwang Hyub , Chon Chae Yoon , Park Jun Yong 
Published: March 2012

AbstractBackground and AimsFew studies have adequately examined the efficacy of lamivudine plus adefovir (LAM+ADV) combination therapy vs. entecavir (ETV) monotherapy in HBeAg‐positive hepatitis B patients who fail to respond to sequential treatment with LAM and ADV. We compared directly the efficacy of LAM+ADV vs. ETV in such patients and assessed prognostic factors associated with a virologic response at month 12.MethodsIn total, 72 HBeAg‐positive patients who showed resistance (n = 33) or a suboptimal virologic response (n = 39) to ADV monotherapy with resistance to LAM therapy underwent rescue therapy (31 LAM+ADV and 41 ETV). All patients were followed for at least 12 months.ResultsFollowing 12 months of treatment, in the LAM+ADV and ETV groups, a virologic response was observed in 7/31 (22.6%) and 8/41 (19.5%; P = 0.777) patients; ALT normalization occurred in 11/13 (84.6%) and 16/18 (88.9%; P = 0.566); HBeAg seroconversion in 1/31 (2.3%) and 4/41 (9.8%; P = 0.341) and a virologic breakthrough in 3/31 (9.0%) and 5/41 (12.1%; P = 0.452) respectively. Independent prognostic factors associated with a virologic response were the baseline HBV‐DNA level (OR = 0.37; 95% CI 0.17–0.80; P = 0.011) and the duration of prior ADV monotherapy (OR = 0.89; 95% CI 0.83–0.95; P = 0.044).ConclusionsNeither LAM+ADV nor ETV was adequately effective in patients with sequential LAM and ADV treatment failure. Thus, when chronic hepatitis B patients show resistance or suboptimal response to ADV monotherapy, early modification of treatment should be considered.
Cardiac Catheterization in the Dialysis Population in 2012: We Know More, but Much Remains Unknown
Authors: Costa Salvatore P. , Jayne John E. , Friedman Scott E. , Lentine Krista L. 
Published: March 2012

AbstractChronic kidney disease is now widely accepted as an independent risk factor for coronary disease and the dialysis population may represent the highest risk subgroup. Among all dialysis patients, a cardiac cause of mortality has been estimated at 40%. In addition, prior studies have demonstrated that when cardiac catheterization is obtained in a consecutive series of asymptomatic diabetic patients on dialysis the rates of coronary disease can approach 50%. However, the ability to define the problem continues to be greater than the ability to treat or prevent it. Coronary revascularization strategies have limitations in the general population which are amplified in the dialysis population. The ability to accurately diagnose an acute coronary syndrome is more difficult, clinical outcomes have a smaller margin of benefit, and technical challenges result in higher complication rates. Recent data demonstrate an inverse relationship between glomerular filtration rate and the risk of presenting with an acute myocardial infarction rather than unstable angina suggesting that patients with CKD may have a unique pathophysiologic profile that is more prone to plaque rupture. However, these “vulnerable” plaques typically are associated with stenoses <50% prior to rupture and are thus poor targets for revascularization and perhaps best treated with medical therapy. Although the benefits of revascularization may continue to outweigh the risks in the context of acute coronary syndromes, preventive strategies would have to overcome the lower margin of benefit and higher complication rates.
Sudden Cardiac Death in Dialysis: Do Current Guidelines for Implantable Cardioverter Defibrillator Therapy Apply to Patients with End‐stage Kidney Disease?
Authors: O’Shaughnessy Michelle M. , Lappin David W. , Reddan Donal N. 
Published: March 2012

AbstractArrhythmic mechanisms account for one in four deaths in end‐stage kidney disease. Large‐scale randomized controlled trials have demonstrated a mortality benefit from implantable cardioverter defibrillator therapy in carefully selected patient groups at high risk for sudden cardiac death. Unfortunately, patients with end‐stage kidney disease were systematically excluded from these trials. Consequently, the applicability of American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Rhythm Society (HRS) guidelines on implantable cardioverter defibrillator therapy to dialysis patients remains uncertain. Observational data suggest that secondary preventative implantable cardioverter defibrillator therapy following resuscitated cardiac arrest prolongs the lives of dialysis patients. This intervention may also offer a survival advantage as a primary preventative strategy in end‐stage kidney disease. However, competing risk from co‐morbidity can negate any perceived benefit. Device‐related complications also negatively impact outcome. The recommendation that primary preventative device implantation be reserved for patients with severely impaired left ventricular function may be excessively restrictive in this high‐risk population. Trials of implantable cardioverter defibrillator therapy that include dialysis patients are required to validate existing device eligibility criteria in this unique population. Novel indications for this intervention in dialysis patients should also be identified.
Development of a Public Health Nursing Data Infrastructure
Authors: Monsen Karen A. , Bekemeier Betty , P. Newhouse Robin , Scutchfield F. Douglas 
Published: March 2012

AbstractAn invited group of national public health nursing (PHN) scholars, practitioners, policymakers, and other stakeholders met in October 2010 identifying a critical need for a national PHN data infrastructure to support PHN research. This article summarizes the strengths, limitations, and gaps specific to PHN data and proposes a research agenda for development of a PHN data infrastructure. Future implications are suggested, such as issues related to the development of the proposed PHN data infrastructure and future research possibilities enabled by the infrastructure. Such a data infrastructure has potential to improve accountability and measurement, to demonstrate the value of PHN services, and to improve population health.
Conceptual Models for Population‐focused Public Health Nursing Interventions and Outcomes: The State of the Art
Authors: Bigbee Jeri L. , Issel L. Michele 
Published: March 2012

AbstractThe conceptual basis of public health nursing (PHN) has evolved particularly over the past three decades. InOctober 2010, a national research agenda setting conference was held with grant support from theAgency forHealthcareResearch andQuality. From the conference, public health nursing intervention models emerged as one of four top priorities. The need for a stronger theoretic base that can guide population‐focused nursing practice and research was strongly emphasized. The purpose of this review, in concert with this priority, is to analyze the current status ofPHNconceptual models. Based on the review, a set of recommendations is presented related to future conceptual development and testing, with an emphasis onPHNinterventions and outcomes. A key recommendation is the refinement of the existing conceptual models with perhaps some consolidation of models, thereby establishing strong grand, middle‐range and practice theories that include explicitPHNintervention and outcome components. Another recommendation calls for rigorous comparative analysis and testing. Professional support from thePHNcommunity along with funding agencies will be needed to implement the recommendations related toPHNtheory development and testing.
Single‐Lead Percutaneous Peripheral Nerve Stimulation for the Treatment of Hemiplegic Shoulder Pain: A Case Series
Authors: Chae John , Wilson Richard D. , Bennett Maria E. , Lechman Tina E. , Stager Kathryn W. 
Published: March 2012

AbstractObjective:  Previous studies demonstrated the efficacy of Intramuscular Nerve (IMN) therapy with a 4‐lead percutaneous, peripheral nerve stimulation (PNS) system in reducing hemiplegic shoulder pain (HSP). This case series investigates the feasibility of a less complex, single‐lead approach in reducing HSP.Methods:  Eight participants received one percutaneous intramuscular lead in the hemiparetic deltoid muscle and were then treated 6 hours/day for 3 weeks. The primary outcome measure was the Brief Pain Inventory (Short‐Form) Question 3 (BPI3), which queries worst pain in the last week on a 0 to 10 numeric rating scale. Secondary outcomes included pain interference (BPI9) and Medical Outcomes Study Short‐Form 36 (SF‐36v2). Primary and secondary outcomes were assessed at the end of treatment (EOT) and 1 and 4 weeks after the EOT.Results:  All participants tolerated the treatment well with 96% compliance. All leads remained infection‐free and were removed intact at the EOT. On average, participants exhibited 70% reduction in BPI3 at the EOT and 61% reduction at 4 weeks after the EOT. All participants satisfied the success criterion of at least a 2‐point reduction in BPI3 at the EOT. Longitudinal analysis revealed significant treatment effect for BPI3 (F = 14.0, P < 0.001), BPI9 (F = 5.9, P < 0.01), and the bodily pain domain of SF‐36v2 (F = 12.8, P < 0.001).Conclusion:  This case series demonstrates the feasibility of a single‐lead, 3‐week IMN therapy for the treatment of chronic HSP. Additional studies are needed to further demonstrate safety, efficacy, and long‐term benefit, define optimal prescriptive parameters and dose, and expand clinical indications.
Yoga Spinal Flexion Positions and Vertebral Compression Fracture in Osteopenia or Osteoporosis of Spine: Case Series
Authors: Sinaki Mehrsheed 
Published: March 2012

AbstractObjective:  The objective of this report is to raise awareness of the effect of strenuous yoga flexion exercises on osteopenic or osteoporotic spines. We previously described subjects with known osteoporosis in whom vertebral compression fractures (VCFs) developed after spinal flexion exercise (SFE) and recommended that SFEs not be prescribed in patients with spinal osteoporosis.Methods:  This report describes 3 healthy persons with low bone mass and yoga‐induced pain or fracture.Results:  All 3 patients had osteopenia, were in good health and pain‐free, and had started yoga exercises to improve their musculoskeletal health. New pain and fracture areas occurred after participation in yoga flexion exercises.Conclusions:  The development of pain and complications with some flexion yoga positions in the patients with osteopenia leads to concern that fracture risk would increase even further in osteoporosis. Although exercise has been shown to be effective for improving bone mineral density and decreasing fracture risk, our subjects had development of VCFs and neck and back pain with yoga exercises. This finding suggests that factors other than bone mass should be considered for exercise counseling in patients with bone loss. The increased torque pressure applied to vertebral bodies during SFEs may be a risk. Exercise is effective and important for treatment of osteopenia and osteoporosis and should be prescribed for patients with vertebral bone loss. Some yoga positions can contribute to extreme strain on spines with bone loss. Assessment of fracture risk in older persons performing SFEs and other high‐impact exercises is an important clinical consideration.
Transdermal Opioid Patches for Pain Treatment in Ancient Greece
Authors: Harrison Adrian P. , Hansen Steen H. , Bartels Else M. 
Published: March 2012

Abstract:  Pain treatment in ancient Greece, and through the middle ages in Europe, was to a great extent based on the expertise of the Greek physician Galen (c. 129–200 A.D.). Galen makes particular reference to “Olympic Victor’s Dark Ointment” (OVDO), which is listed with a number of collyria. Galen states that OVDO can be useful for treating extreme pain and swellings, forming one of the best eye salves.Olympic Victor’s Dark Ointment, an opium‐based treatment, forms a “patch” when applied externally as an ointment, because it quickly dries to cover a localized region but still retains its elastic properties.This study has recreated OVDO and applied the ointment to abdominal mouse skin, in vitro. To assess the efficacy of OVDO, the transdermal transfer of morphine was measured when given as OVDO and compared to morphine administered in the form of a solution of Opium + PBS (ringer).Olympic Victor’s Dark Ointment showed a transdermal transfer of morphine over time comparable to 25% of the most efficient modern transdermal opioid patches, while hardly any morphine was able to penetrate the skin when applied mixed in PBS.We conclude that OVDO is very efficient in its composition and may carry some forgotten abilities in terms of drug delivery, which could be transferred to modern medicine. Indeed, this may lead to a better choice of morphine use and controlled management in individual patient cases, taking both pain relief and anti‐inflammatory aspects into account.
Preventing transfusion‐transmitted babesiosis: preliminary experience of the first laboratory‐based blood donor screening program
Authors: Young Carolyn , Chawla Anjulika , Berardi Victor , Padbury James , Skowron Gail , Krause Peter J. ,   the Babesia Testing Investigational Containment Study Group
Published: March 2012

BACKGROUND: Babesiosis is the most common transfusion‐transmitted infection reported to the Food and Drug Administration (FDA). We developed and implemented the first laboratory‐based blood donor screening program for Babesia microti to help reduce and prevent transfusion‐transmitted babesiosis (TTB) and report results for the initial year.STUDY DESIGN AND METHODS: Selective B. microti donor screening was performed using real‐time polymerase chain reaction (PCR) and indirect immunofluorescence assay (IFA) to reduce the incidence of TTB in neonates and pediatric sickle cell and thalassemia patients under an FDA‐approved investigational new drug application. We compared the reports of TTB in these patients in the first 12 months of the study with those of patients who received unscreened blood from 2005 to 2010.RESULTS: There were 2113 units tested with 2086 negative results, 26 positive IFA results (1.23%), and one indeterminate PCR result (0.05%). No reported case of TTB occurred with any B. microti–screened unit transfused to the targeted patients (0/787 units) or to any patient who received the screened units (0/2086 units). Before screening, there were seven cases of TTB in neonates, sickle cell, and thalassemia patients from 6500 unscreened units (one case/929 units) and 24 cases in the total transfused population from 496,545 units distributed (one case/20,686 units).CONCLUSION: Implementation of B. microti IFA and PCR screening is compatible with blood center operations to provide tested units. While the results after 1 year are not powered to demonstrate a change in the rate of TTB after testing, they are encouraging.
Do Shareholders Really Prefer Their Executives to Maximize the Equity Value? A Newsvendor Case*
Authors: Berman Oded , Sanajian Nima , Abouee‐Mehrizi Hossein 
Published: March 2012

ABSTRACTIn this article, we study how the operational decisions of a firm manager depend on her own incentives, the capital structure, and financial decisions in the context of the newsvendor framework. We establish a relationship between the firm’s cost of raising funds and the riskiness of the inventory decisions of the manager. We consider four types of managers, namely, profit, equity, firm value, and profit‐equity maximizers, and initially assume that they may raise funds to increase the inventory level only by issuing debt. We show that the shareholders are indifferent between the different types of managers when the coefficient of variation (CV) of demand is low. However, this is not the case when the CV of demand is high. Based on the demand and the firm’s specific characteristics such as profitability, leverage, and bankruptcy costs, the shareholders might be better off with the manager whose compensation package is tied to the firm value as opposed to the equity value. We, then, extend our model by allowing the manager to raise the required funds by issuing both debt and equity. For this case we focus on the equity and firm value maximizer managers and show that our earlier results (for the debt only case) still hold subject to the cost of issuing equity. However the benefit of the firm value maximizer manager over the equity maximizer manager for shareholders is considerably less in this case compared to the case where the manager can only issue debt. The Board of Directors can take these factors into consideration when establishing/modifying the right incentive package for the managers. We also incorporate the notion of the asymmetric information to capture its impact on the board of directors’ decision about the managers’ incentive package.
Adverse Effects of Long‐Term Right Ventricular Apical Pacing and Identification of Patients at Risk of Atrial Fibrillation and Heart Failure
Authors: SISTI ANTONIO DE , MÁRQUEZ MANLIO F. , TONET JOELCI , BONNY AIM , FRANK ROBERT , HIDDEN‐LUCET FRANÇOISE 
Published: March 2012

In patients needing a pacemaker (PM) for bradycardia indications, the amount of right ventricular (RV) apical pacing has been correlated with atrial fibrillation (AFib) and heart failure (HF) in both DDD and VVI mode. RV pacing was linked with left ventricular (LV) dyssynchrony in almost 50% of patients with PM implantation and atrioventricular (AV) node ablation for AFib. In patients with normal systolic function needing a PM, apical RV pacing resulted in LV ejection fraction (LVEF) reduction. These negative effects were prevented by cardiac resynchronization therapy (CRT). Algorithms favoring physiological AV conduction are possible useful tools able to maintain both atrial and ventricular support and limit RV pacing. However, when chronic RV pacing cannot be avoided, it appears necessary to reconsider the cut‐off value of basic LVEF for CRT.In HF patients, RV pacing can induce greater LV dyssynchrony, enhanced by underlying conduction diseases. In this context, a more deleterious effect of RV pacing in implantable cardioverter‐defibrillator (ICD) patients with low LVEF can be expected. In some major ICD trials, DDD mode was correlated with increased mortality/HF. This negative impact was attributed to unnecessary RV pacing >40–50%, virtually absent in VVI‐40 mode. However, some data suggest that avoiding RV pacing may also not be the best option for patients requiring an ICD. In patients with impaired LV function, AV synchrony should therefore be ensured. The best pacing mode in ICD patients with HF should be defined on an individual basis.(PACE 2012; 35:1035–1043)
Radiofrequency and Cryoablation Therapies for Supraventricular Arrhythmias in the Young: Five‐Year Review of Efficacies
Authors: BUDDHE SUJATHA , SINGH HARINDER , DU WEI , KARPAWICH PETER P. 
Published: March 2012

Background:

Cryoablation (Cryo) has augmented radiofrequency (RF) as the ablation energy choice for most supraventricular tachycardias (SVT). Although initial acute results and more recent, but limited, 3–36‐month follow‐up studies have been reported, more longer follow‐up information is required to determine actual efficacy.
Methods:

Data from patients with structurally normal hearts who underwent reentrant forms of SVT ablation at our institution from January 2005 to December 2009 were reviewed. These included demographics, clinical and electrophysiologic findings, and ablative energies used. Following apparent acute success, all patients were then reevaluated for any potential recurrences of SVT or preexcitation up to 5 years later.
Results:

A total of 155 patients (83 male) were reviewed (mean age 13.4 ± 3.7 years). Ablations were predominantly right‐sided (75%). Atrioventricular reciprocating tachycardia was seen in 74% and atrioventricular node reciprocating tachycardia (AVNRT) in 17% of patients. For concerns of atrioventricular node integrity, Cryo ± RF was user‐preferred for anteroseptal accessory fiber locations and AVNRT. Acute success rate was 98% and chronic 83.2% over the next 5 years. Among patients with accessory pathways, recurrence was pathway number and location dependent: significantly higher (P < 0.05) if they were right anterior‐anteroseptal, multiple, or with a broad‐distribution pattern. There were no significant differences in recurrence rates with use of RF or its combination with Cryo.
Conclusion:

Radiofrequency ablation and Cryo are both effective therapies for pediatric patients. Although use of Cryo with RF in combination may enhance safety while affording comparable success, risk of recurrence still persists in the current era among patients depending on accessory pathways connection location and characteristics. (PACE 2012; 35:711–717)
Questionnaire Survey of Cardiologists’ Knowledge, Attitudes, and Guideline Application of Implantable Cardioverter Defibrillator Therapy
Authors: SADARMIN PRAVEEN P. , WONG KELVIN C. K. , RAJAPPAN KIM , BASHIR YAVER , BETTS TIMOTHY R. 
Published: March 2012

Introduction:

There are little data on cardiologists’ knowledge and application of current implantable cardioverter defibrillator (ICD) guidelines, attitudes to risk, and how these may influence ICD prescription.
Methods:

A questionnaire survey was sent to UK cardiologists to test their knowledge and application of ICD guidelines and their estimate of the clinical benefits gained in different clinical scenarios. They were questioned on the minimum absolute risk reduction (ARR) required to justify an ICD implant and factors that influenced their decision making.
Results:

Sixty responses from 23 implanters and 37 nonimplanters were obtained. Eighty‐three percent implanters and 43% nonimplanters were fully aware of UK ICD National Institute of Clinical Excellence guidelines. Only 7% responders had a screening program to identify primary prevention (PP) candidates. Although the mean estimate of ARR in PP scenarios was similar to trial data, the range of estimates was very wide. The benefit in secondary prevention (SP) scenarios was overestimated by both implanters and nonimplanters. Three‐year ARR believed to justify PP and SP ICDs were heavily influenced by patients’ age but in patients <80 years, age was compatible with trial results. Implanters and nonimplanters correctly applied guidelines in SP scenarios with younger patients but often withheld an ICD in elderly patients. Correct application did not correlate with full awareness of guidelines.
Conclusion:

Lack of knowledge of guidelines (particularly in nonimplanters), failure of nonimplanters to offer ICDs to appropriate PP patients, age bias, and a lack of screening programs appear to be the greatest barriers to uptake of ICDs in the United Kingdom, rather than financial concerns. (PACE 2012; 35:672–680)