bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term follow‐up of nevirapine‐treated patients in a single‐centre cohort
Authors: Colafigli M , Di Giambenedetto S , Bracciale L , Fanti I , Prosperi M , Cauda R , De Luca A 
Published: May 2009

Objectives
We reviewed the safety and efficacy of nevirapine (NVP)‐based therapy in all patients initiating NVP‐containing combined antiretroviral therapy [cART (≥3 drugs)] in our clinic since 1994.Methods
Patient characteristics and laboratory values from the start of the NVP‐based cART regimen to the last available follow‐up or to NVP discontinuation were retrieved from an observational database.Results
Five hundred and seventy‐three patients were treated with NVP‐based cART for a median of 18.4 (range 0.1–128.8) months. The 1‐year cumulative estimated probability of discontinuing NVP‐containing regimens for toxicity was 0.203. Only 1.9% developed a grade 3 alanine aminotransferase (ALT) elevation. Significant increases in high‐density lipoprotein cholesterol were observed up to month 12 except in treatment‐naïve patients, where the increase was limited to 3 months. Discontinuation because of cutaneous reaction was predicted independently by female gender [Hazard Ratio (HR) 3.21, P<0.001] and Centers for Disease Control class C (HR 0.50, P=0.012). Discontinuation because of liver toxicity was predicted independently by anti‐hepatitis C virus positivity (HR 3.84, P<0.001). In patients starting NVP‐containing cART with undetectable viral loads, the 5‐year estimated probability of viral load >400 HIV‐1 RNA copies/mL was 0.34.Conclusions
Long‐term follow‐up with an NVP‐containing cART showed a low rate of discontinuation caused by liver toxicity and the maintenance of virological suppression in patients switched with undetectable viral loads.
Tenofovir‐associated renal and bone toxicity
Authors: Woodward CLN , Hall AM , Williams IG , Madge S , Copas A , Nair D , Edwards SG , Johnson MA , Connolly JO 
Published: May 2009

Objectives
The aims of the study were to describe the clinical presentation and renal and bone abnormalities in a case series of HIV‐infected patients receiving treatment with tenofovir (TDF), and to recommend appropriate screening for toxicity related to TDF.Methods
Patients were identified from referrals to a specialist HIV renal clinic. Patients were included if treatment with TDF was assessed as the primary cause of the renal function impairment and clinical data were available prior to and following discontinuation of TDF treatment. Data were collected from case note review and clinic databases.Results
Twenty‐two patients (1.6% of all those who received TDF) were identified with TDF‐associated renal toxicity. All had normal serum creatinine prior to TDF therapy. All presented with proteinuria. On stopping TDF, renal function improved. Eight patients had confirmed Fanconi syndrome. Twelve patients presented with bone pain and osteomalacia was confirmed on an isotope bone scan in seven of these patients. The findings (in those patients tested) of tubular proteinuria, reduced tubular transport maximum of phosphate (TmP), and glycosuria were all consistent with the proximal tubule being the site of toxicity.Conclusion
Renal toxicity remains a concern in patients treated with TDF. Clinical presentation may be with renal dysfunction, Fanconi syndrome or osteomalacia. Our investigations suggest proximal tubular toxicity as a common pathogenic mechanism.
Trends in mortality and antibiotic resistance among HIV‐infected patients with invasive pneumococcal disease
Authors: Grau I , Ardanuy C , Liñares J , Podzamczer D , Schulze MH , Pallares R 
Published: May 2009

Objectives
The aim of the study was to describe trends and risk factors for mortality and changes in antibiotic resistance, serotypes and clones among HIV‐infected patients with invasive pneumococcal disease (IPD).Methods
A prospective study of 199 episodes of IPD occurring in a cohort of 4011 HIV‐infected patients was carried out. Predictors of mortality included clinical and microbiological data. The 7‐valent pneumococcal conjugate vaccine (PCV7) for children was introduced in late 2001. Time periods were classified for mortality studies as pre‐ (1986–1996), early (1997–2001) and late (2002–2007) highly active antiretroviral therapy (HAART) era, and for serotype studies as pre‐PCV7 (1986–2001) and PCV7 (2002–2007) era.Results
Of 199 IPD episodes, 71 (36%) occurred in HIV‐infected patients with associated comorbidities (mainly liver cirrhosis; 52 of 71), which increased in recent years. The incidence of IPD decreased from the pre‐HAART era to the early HAART era and then remained stable in the late HAART era (24.1, 8.4 and 7.4 episodes per 1000 patient‐years, respectively). Rates of 30‐day mortality have risen over the three periods (8, 19 and 25%, respectively; P=0.017). In multiple logistic regression analysis, predictors of mortality were shock at presentation [odds ratio (OR) 7.01; 95% confidence interval (CI) 2.05–23.87] and associated comorbidities (OR 4.27; 95% CI 1.53–11.92). In the PCV7 era, IPD caused by non‐PCV7 serotypes increased, and resistance to betalactams decreased. The most frequent genotypes were Spain9V‐ST156, Spain23F‐ST81, ST8819F, Sweden1‐ST304 and Spain6B‐ST90.Conclusions
In the late HAART era, the incidence of IPD has not significantly decreased. Mortality from IPD has risen in association with an increase in comorbidities such as liver cirrhosis. New vaccination strategies are needed to diminish the burden of IPD in the HIV‐infected population.
Effects of feature types on proportion discrimination
Authors: TOKITA MIDORI , ISHIGUCHI AKIRA 
Published: May 2009

Abstract:  We investigated the effects of feature types on statistical description of relative frequency by testing the accuracy and precision in a proportion discrimination task. We used search symmetry pairs and search asymmetry pairs as the elements for comparison. In Experiment 1, we used sets of red and green dots and sets of parallel lines and converging lines as search symmetry pairs, and we used sets of circles and circles with lines as a search asymmetry pair. The results demonstrated that the proportion of pop‐out elements in the asymmetry pair was overestimated and that precision of proportion discrimination differed between pairs. In Experiment 2, to eliminate the possibility that the overestimation found in Experiment 1 was due to quantitative dominance, we used sets of circles with gaps and circles. In Experiment 3, we tested the effect of the exposure duration on the performance of proportion discrimination to determine the source of bias and of difference in precision. Overall, the findings show that the performance of the proportion discrimination depended on the types of features being compared.
Biogenic volatile organic compounds in the Earth system
Authors: Laothawornkitkul Jullada , Taylor Jane E. , Paul Nigel D. , Hewitt C. Nicholas 
Published: May 2009

SummaryBiogenic volatile organic compounds produced by plants are involved in plant growth, development, reproduction and defence. They also function as communication media within plant communities, between plants and between plants and insects. Because of the high chemical reactivity of many of these compounds, coupled with their large mass emission rates from vegetation into the atmosphere, they have significant effects on the chemical composition and physical characteristics of the atmosphere. Hence, biogenic volatile organic compounds mediate the relationship between the biosphere and the atmosphere. Alteration of this relationship by anthropogenically driven changes to the environment, including global climate change, may perturb these interactions and may lead to adverse and hard‐to‐predict consequences for the Earth system.

Contents

Summary
27

I.
Introduction
27

II.
Regulation of BVOC emission
30

III.
Roles of BVOCs in the Earth system
32

IV.
BVOCs in a changing global environment
36

V.
Synthesis
44

Acknowledgements
44

References
44
Family decision‐making in advanced dementia: narrative and ethics
Authors: Elliott Barbara A. , Gessert Charles E. , Peden‐McAlpine Cynthia 
Published: May 2009

Background:  Traditionally, family members become decision‐makers for ageing parents with cognitive impairment. Our understanding of how families negotiate the ethical issues in this decision‐making is still developing.Aim:  To describe and understand the ethical thinking used in end‐of‐life decision‐making by family surrogates on behalf of their cognitively impaired elders.Methods:  Qualitative research with eight focus groups that included 39 family members of severely impaired nursing home residents in Minnesota. Transcripts were analysed using a thematic approach.Findings:  The family surrogates described their decision‐making as a process based in the families’ stories and as extensions of the elders’ identities. Four themes emerged from the analysis of the families’ decision‐making: (i) acquisition of decision‐making authority, (ii) decision‐making for short‐term or long‐term time frames, (iii) justifying the decisions and (iv) advocacy for the elders.Conclusions:  The families in these focus groups used the elders’ life stories to frame their decisions for care. Providers working in primary care settings who work with families in making care decisions for cognitively impaired elderly patients may find narrative ethics more pertinent than principle‐based ethics in understanding families’ perspectives and priorities, while also recognizing their decision‐making transition from using the principle of autonomy to that of beneficence.
Primacy of existential pain and suffering in residents in chronic pain in nursing homes: a phenomenological study
Authors: Gudmannsdottir Gudrun Dora , Halldorsdottir Sigridur 
Published: May 2009

The study’s rationale: Chronic pain is a major health problem among the elderly, both in the community and within nursing homes.Aims and objectives: The purpose of the study was to examine the essentials of the experience of residents in chronic pain in nursing homes.Methodological design and methods: The research approach was interpretive phenomenology. Data were collected in 23 dialogues with 12 residents, ages 74–97. Mean age was 86 years.Results: The main finding is theprimacy of existential pain and sufferingin residents in chronic pain in nursing homes. Indeed they recounted aculminationof existential pain and suffering, e.g. loss of loved ones, loss of former home, health and independence, as well as loss of connectedness. Many seemed to be in some kind of grief and theirwork towards reconciliationto their life and circumstances seemed an ongoing process with successful results while others seemed more haltering or even stuck. Living with chronic pain in a nursing home is indeeda challengeand manyblocks to successful pain managementwere identified. The main sources of strength were loved ones who were seen aslifelines. Nurses seemed distant in their narratives of pain management.Study limitations: Frailty of residents is a limitation as a few were starting to forget from one interview to the other and some were actually in pain at the time of our dialogue.Conclusions: It is important to support ahealthy process of grieving and reconciliationin elderly people who live with chronic pain in nursing homes. Those who suffer in silence with their pain and discomforts and do not seek help should be identified and cared for. The residents’ own sources of strength should be identified and supported. Multi‐professional collaboration with educational thrust is needed towards quality pain management of elderly people in nursing homes where existential pain and suffering is not excluded.
Practice Location Choice by New Physicians: The Importance of Malpractice Premiums, Damage Caps, and Health Professional Shortage Area Designation
Authors: Chou Chiu‐Fang , Lo Sasso Anthony T. 
Published: May 2009

Objective. To understand the factors affecting the choice of initial practice location by new physicians.Data Sources/Study Setting. A unique survey of exiting medical residents in New York State from 1998 to 2003.Study Design. We estimate conditional logit models to examine the factors affecting the choice of initial practice location by new physicians.Data Collection/Extraction Methods. We identify all physicians completing their training in obstetrics/gynecology or surgery and primary care physicians (PCPs) (general internal medicine, pediatrics, and family medicine) who had accepted a job in patient care and who provided the location (zip code) of their job. This resulted in 3,758 physicians in our sample.Principal Findings. Our results indicate that malpractice insurance premiums are a significant deterrent for surgeons, but they do not appear to deter OB/GYNs or PCPs from locating in particular areas. In addition, caps on malpractice damage awards attract surgeons to areas. Shortage area designations attract PCPs without education debt yet deter PCPs with debt, suggesting that subsidies do not outweigh the perceived costs of locating in underserved areas.Conclusions. In general our results highlight that new physicians are sensitive to the characteristics of the locations in which they could potentially locate when beginning their careers in patient care.
Racial Segregation and Disparities in Health Care Delivery: Conceptual Model and Empirical Assessment
Authors: Vaughan Sarrazin Mary S. , Campbell Mary E. , Richardson Kelly K. , Rosenthal Gary E. 
Published: May 2009

Objective. This study examines two dimensions of racial segregation across hospitals, using a disease for which substantial disparities have been documented.Data Sources. Black (n=32,289) and white (n=244,042) patients 67 years and older admitted for acute myocardial infarction during 2004–2005 in 105 hospital markets were identified from Medicare data. Two measures of segregation were calculated: Dissimilarity (i.e., dissimilar distribution by race across hospitals), and Isolation (i.e., racial isolation within hospitals). For each measure, markets were categorized as having low, medium, or high segregation.Study Design. The relationship of hospital segregation to residential segregation and other market characteristics was evaluated. Cox proportional hazards regression was used to evaluate disparities in the use of revascularization within 90 days by segregation level.Results. Agreement of segregation category based on Dissimilarity and Isolation was poor (κ=0.12), and the relationship of disparities in revascularization to segregation differed by measure. The hazard of revascularization for black relative to white patients was lowest (i.e., greatest disparity) in markets with low Dissimilarity, but it was unrelated to Isolation.Conclusions. Significant racial segregation across hospitals exists in many U.S. markets, although the magnitude and relationship to disparities depends on definition. Dissimilar distribution of race across hospitals may reflect divergent cultural preferences, social norms, and patient assessments of provider cultural competence, which ultimately impact utilization.
Characterization of ZK 245186, a novel, selective glucocorticoid receptor agonist for the topical treatment of inflammatory skin diseases
Authors: Schäcke H , Zollner TM , Döcke WD , Rehwinkel H , Jaroch S , Skuballa W , Neuhaus R , May E , Zügel U , Asadullah K 
Published: May 2009

Background and purpose: Glucocorticoids are highly effective in the therapy of inflammatory diseases. Their value, however, is limited by side effects. The discovery of the molecular mechanisms of the glucocorticoid receptor and the recognition that activation and repression of gene expression could be addressed separately opened the possibility of achieving improved safety profiles by the identification of ligands that predominantly induce repression. Here we report on ZK 245186, a novel, non‐steroidal, low‐molecular‐weight, glucocorticoid receptor‐selective agonist for the topical treatment of inflammatory dermatoses.Experimental approach: Pharmacological properties of ZK 245186 and reference compounds were studied in terms of their potential anti‐inflammatory and side effects in functional bioassaysin vitroand in rodent modelsin vivo.Key results: Anti‐inflammatory activity of ZK 245186 was demonstrated inin vitroassays for inhibition of cytokine secretion and T cell proliferation.In vivo, using irritant contact dermatitis and T cell‐mediated contact allergy models in mice and rats, ZK 245186 showed anti‐inflammatory efficacy after topical application similar to the classical glucocorticoids, mometasone furoate and methylprednisolone aceponate. ZK 245186, however, exhibits a better safety profile with regard to growth inhibition and induction of skin atrophy after long‐term topical application, thymocyte apoptosis, hyperglycaemia and hepatic tyrosine aminotransferase activity.Conclusions and implications: ZK 245186 is a potent anti‐inflammatory compound with a lower potential for side effects, compared with classical glucocorticoids. It represents a promising drug candidate and is currently in clinical trials.This article is part of a themed issue on Mediators and Receptors in the Resolution of Inflammation. To view this issue visithttp://www3.interscience.wiley.com/journal/121548564/issueyear?year=2009
Effects of indomethacin‐loaded nanocapsules in experimental models of inflammation in rats
Authors: Bernardi A , Zilberstein ACCV , Jäger E , Campos MM , Morrone FB , Calixto JB , Pohlmann AR , Guterres SS , Battastini AMO 
Published: May 2009

Background and purpose:  The effects of systemic treatment with indomethacin‐loaded nanocapsules (IndOH‐NC) were compared with those of free indomethacin (IndOH) in rat models of acute and chronic oedema.Experimental approach:  The following models of inflammation were employed: carrageenan‐induced acute oedema (measured between 30 min and 4 h), sub‐chronic oedema induced by complete Freund's adjuvant (CFA) (determined between 2 h and 72 h), and CFA‐induced arthritis (oedema measured between 14 and 21 days).Key results:  IndOH or IndOH‐NC produced equal inhibition of carrageenan‐elicited oedema. However, IndOH‐NC was more effective in both the sub‐chronic (33 ± 4% inhibition) and the arthritis (35 ± 2% inhibition) model of oedema evoked by CFA, when compared with IndOH (21 ± 2% and 14 ± 3% inhibition respectively) (P < 0.01). In the CFA arthritis model, treatment with IndOH‐NC markedly inhibited the serum levels of the pro‐inflammatory cytokines tumour necrosis factor α and IL‐6 (by 83 ± 8% and 84 ± 11% respectively), while the levels of the anti‐inflammatory cytokine IL‐10 were significantly increased (196 ± 55%). The indices of gastrointestinal damage in IndOH‐NC‐treated animals were significantly less that those after IndOH treatment (58 ± 16%, 72 ± 6% and 69 ± 2%, for duodenum, jejunum and ileum respectively).Conclusions and implications:  IndOH‐NC produced an increased anti‐inflammatory efficacy in long‐term models of inflammation, allied to an improved gastrointestinal safety. This formulation might represent a promising alternative for treating chronic inflammatory diseases, with reduced undesirable effects.This article is part of a themed issue on Mediators and Receptors in the Resolution of Inflammation. To view this issue visit http://www3.interscience.wiley.com/journal/121548564/issueyear?year=2009
Detection of exhaled hydrogen sulphide gas in rats exposed to intravenous sodium sulphide
Authors: Insko Michael A , Deckwerth Thomas L , Hill Paul , Toombs Christopher F , Szabo Csaba 
Published: May 2009

Background and purpose:  Sodium sulphide (Na2S) disassociates to sodium (Na+) hydrosulphide, anion (HS‐) and hydrogen sulphide (H2S) in aqueous solutions. Here we have established and characterized a method to detect H2S gas in the exhaled breath of rats.Experimental approach:  Male rats were anaesthetized with ketamine and xylazine, instrumented with intravenous (i.v.) jugular vein catheters, and a tube inserted into the trachea was connected to a pneumotach connected to a H2S gas detector. Sodium sulphide, cysteine or the natural polysulphide compound diallyl disulphide were infused intravenously while the airway was monitored for exhaled H2S real time.Key results:  Exhaled sulphide concentration was calculated to be in the range of 0.4–11 ppm in response to i.v. infusion rates ranging between 0.3 and 1.1 mg·kg−1·min−1. When nitric oxide synthesis was inhibited with Nω‐nitro‐L‐arginine methyl ester the amount of H2S exhaled during i.v. infusions of sodium sulphide was significantly increased compared with that obtained with the vehicle control. An increase in circulating nitric oxide using DETA NONOate [3,3‐bis(aminoethyl)‐1‐hydroxy‐2‐oxo‐1‐triazene] did not alter the levels of exhaled H2S during an i.v. infusion of sodium sulphide. An i.v. bolus of L‐cysteine, 1 g·kg−1, and an i.v. infusion of the garlic derived natural compound diallyl disulphide, 1.8 mg·kg−1·min−1, also caused exhalation of H2S gas.Conclusions and implications:  This method has shown that significant amounts of H2S are exhaled in rats during sodium sulphide infusions, and the amount exhaled can be modulated by various pharmacological interventions.
Socioeconomic deprivation independent of ethnicity increases status epilepticus risk
Authors: Chin Richard F.M. , Neville Brian G.R. , Peckham Catherine , Wade Angie , Bedford Helen , Scott Rod C. ,   for the NLSTEPSS Collaborative Group
Published: May 2009

SummaryBackground:  A higher incidence of convulsive status epilepticus (CSE) has been reported in nonwhite compared to white populations. Socioeconomic factors can be intricately involved in observed ethnic “effects,” and the importance of socioeconomic status on health conditions is widely recognized. Understanding the effect of socioeconomic factors on CSE would provide insights into etiology and management, leading to the development of novel prevention strategies.Methods:  From a population‐based UK study on childhood CSE, we tested the hypothesis that socioeconomic deprivation independent of ethnicity increases the risk of childhood CSE. Home postal codes were used to measure the socioeconomic status of the neighborhood in which patients lived relative to that of the borough in which the neighborhood was located. The child’s ethnicity was reported by parent(s). Relationships between socioeconomic status, ethnicity, and incidence were investigated using Poisson regression analysis.Results:  A total of 176 children were enrolled. The incidence of CSE in nonwhite children [18.5, 95% confidence interval (CI) 13.7–23.3/100,000/year] was 1.8 (95% CI 1.3–2.4) times greater than for white children (10.5, 95% CI 7.9–13.1/100,000/year) (p < 0.0005). Socioeconomic deprivation and Asian ethnicity were independently associated with increased incidence. For each point increase in Index of Multiple Deprivation (IMD) 2004, there was a 1.03 cumulative increased relative risk (95% CI 1.01–1.06, p = 0.007). Asian children were 5.7 times (95% CI 1.7–18.9) more likely than white children to have a first‐ever episode of CSE (p = 0.004). Socioeconomic and ethnicity effects were related to etiology of CSE.Interpretation:  Ethnic and socioeconomic factors independently affect risk for prolonged febrile seizures and acute symptomatic CSE, but not for other types of childhood CSE.