bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blood transfusion usage among adults with sickle cell disease – a single institution experience over ten years
Authors: Drasar Emma , Igbineweka Norris , Vasavda Nisha , Free Matthew , Awogbade Moji , Allman Marlene , Mijovic Aleksandar , Thein Swee Lay 
Published: January 2011

SummaryTransfusion of red blood cells is a major therapeutic option in sickle cell disease (SCD). There is strong evidence for its efficacy, particularly in primary and secondary stroke prevention in children, however, its use in other areas remains controversial. This study assessed the patterns of transfusion in the adult cohort attending King’s College Hospital over a 10‐year period, from 2000 to 2009. Total blood usage has increased significantly (P = 0·006) during this time, with 78% of the blood received by only 6% of the patients. The increase is explained by increased automated red cell exchange and increased usage for planned and acute transfusions for sickle‐related complications.
Subclones with the t(9;22)/BCR‐ABL1 rearrangement occur in AML and seem to cooperate with distinct genetic alterations
Authors: Bacher Ulrike , Haferlach Torsten , Alpermann Tamara , Zenger Melanie , Hochhaus Andreas , Beelen Dietrich W. , Uppenkamp Michael , Rummel Mathias , Kern Wolfgang , Schnittger Susanne , Haferlach Claudia 
Published: January 2011

SummaryIn AML, cooperation of mutations suppressing differentiation (‘class‐II‐mutations’) with ‘class‐I‐mutations’ increasing cell proliferation is frequent. In rare cases of myeloid malignancies, the BCR‐ABL1 fusion was reported to cooperate as class‐I‐mutation with class‐II‐mutations, but most cases had to be classified as blast phase of chronic myeloid leukaemia (CML). We identified five cases of Philadelphia positive subclones in AML occurring in coincidence with other genetic lesions: 1:220 patients with inv(16)/CBFB‐MYH11 (0·5%), 2:272 AML cases with t(8;21)/RUNX1‐RUNX1T1 (0·7%), 1:1029 NPM1‐mutated AML (0·1%), and one patient with s‐AML following MDS with a 5q‐deletion. Four patients had m‐BCR (e1a2) BCR‐ABL1 transcripts; one case only had an M‐BCR (b3a2) breakpoint. These cases allow some interesting conclusions: The BCR‐ABL1 rearrangement apparently can cooperate with the NPM1 mutation similar to other class‐I‐mutations. The identification of Philadelphia positive subclones in <1% of patients with CBF‐leukaemias fits well with previous observations that most CBF‐AML are accompanied by activating mutations in genes enhancing proliferation. Since we observed the occurrence of the Philadelphia positive subclones at diagnosis, at relapse, or throughout the disease, the time point of the emergence of Philadelphia subclones seems variable in AML. Clinical research should further concentrate on Philadelphia positive subclones in AML to assess the clinical impact.
Children's views on attending a remedial class – because of concentration difficulties
Authors: Ljusberg A.‐L. 
Published: January 2011

AbstractBackground  An increasing number of segregating solutions (e.g. remedial classes) can be seen in Swedish schools. The aim of this article is to stress how children describe why they attend a remedial class and what it means to be a pupil in that setting.Methods  The data collection consists of semi‐structured interviews with 10 pupils between 10 and 12 years old attending 10 different remedial classes because they had been attributed with having concentration difficulties or diagnosed with attention deficit/hyperactivity disorder. The content of the interviews was described and analysed in relation to the classroom context. The socio‐cultural perspective is used as a screen to describe and understand the children's comments about attending remedial class.Results and conclusions  All interviews with the children indicate that they are carriers of their schools' compensatory perspective. This means that they are fully aware of the fact that they are regarded as difficult, with annoying and problematic behaviour, deviating from pupils' in general. The remedial class creates social difficulties for the children; they see themselves as deviant, they lose old friends and there are limited possibilities of establishing new friendship in remedial classes.
Association of leisure time physical activity and sports competition activities with high blood pressure levels: study carried out in a sample of portuguese children and adolescents
Authors: Gaya A. R. , Silva P. , Martins C. , Gaya A. , Ribeiro J. C. , Mota J. 
Published: January 2011

AbstractBackground  A better understanding of the different domains and characteristics of children's and adolescent's physical activity (PA) could be a strategy to clarify the association of this behaviour with the early development of cardiovascular risk factors.Objectives  To examine the relationship between leisure time physical activity (LTPA) and sports competition activities (SCA) with high blood pressure (HBP) levels in a sample of children and adolescents from Porto, Portugal.Study design  This is a cross‐sectional study, which comprised 503 boys and 572 girls, aged 8–17 years old. LTPA and SCA were assed by self‐reported. Students were assigned as active and non‐active in SCA or LTPA according to their self‐reported participation. Participants were classified as HBP when they are above of the last quartile for systolic and/or diastolic BP adjusted for gender and age.Results  Do not be engaged in LTPA (OR: 1.47; 95% CI: 1.12; 1.93) and SCA (OR: 1.36; 95% CI: 1.02; 1.81) was significantly associated with the likelihood of being HBP. However, when cardiorespiratory fitness (CRF) (OR: 1.23; 95% CI: 0.91; 1.67) and body mass index (BMI) (OR: 1.31; 95% CI: 0.98; 1.75) were included on SCA model, the association between SCA with HBP did not showed significant results.Conclusion  Children and adolescents who are not engaged in SCA or LTPA are more likely to be classified as having HBP; however, the relationship between SCA and HBP was dependent of CRF and BMI. Further, PA strategies should take these differences on the relationship between HBP, SCA and LTPA.
The substance and sources of young children's healthy eating and physical activity knowledge: implications for obesity prevention efforts
Authors: Lanigan J. D. 
Published: January 2011

AbstractBackground  The prevalence of overweight among young children is increasing at an alarming rate. Global efforts to address the issue can benefit from understanding how young children's experiences across multiple contexts shape their perspectives of healthy weight.Methods  This qualitative study examines the substance and sources of young American children's knowledge related to healthy eating, physical activity and media practices. Role play and semi‐structured interviews were conducted in child‐care settings with 81 children aged 3–5 who represented diverse socio‐economic statuses and ethnic backgrounds.Results  Children demonstrated better understanding of the benefits of healthy eating compared with physical activity. Snacks and beverages consumed outside mealtime were less likely to be healthy even among the 40% of children who demonstrated an understanding of healthy nutrition. The majority of children's leisure activity selections involved media and minimally active pursuits. Three quarters of the children were unable to articulate reasons for healthy choices or identify the sources of their health understandings. The media was listed as source of health information more frequently than adults.Conclusion  Obesity prevention efforts targeting young children need to use consistent messaging across all contexts in which children develop in order to increase their understanding that physical activity and eating choices support health. Efforts need to counter inaccurate information and address the rationale for health practices. Key gaps in young children's understanding include: the importance of drinking water, that snacks are part of nutritional intake and the benefits of engaging in physical activities.
Chemical ecology of tannins and other phenolics: we need a change in approach
Authors: Salminen Juha‐Pekka , Karonen Maarit 
Published: January 2011

Summary 1. Tannins are one of the most studied groups of plant secondary metabolites in research related to chemical ecology. They are traditionally thought to form an important factor of plant defence against herbivorous insects. 2. For a long time, tannins’ anti‐herbivore activity was thought to derive from their protein precipitation capacity that rendered plant tissues non‐nutritious and unpalatable for herbivores. Recent evidence suggests that tannin activity cannot be explained quite this simply, as tannin oxidation should also be taken into account as a defence mechanism for plants. 3. Tannins show very high variability in their structures with several hundred unique molecules detected in plants. These molecules are unevenly distributed in the plant kingdom and only very seldom—if ever—do two plant species share the same tannin pool. In many cases tannin composition varies even within organs of the same plant species and individual. Still, the overall tannin composition of many plant species is as of yet unknown. 4. Chemical ecology of tannins is challenging due to its multi‐disciplinary nature. To facilitate research on tannins, we must provide ecologists and chemists with methodological and collaborative alternatives that enable the true and holistic investigation of all important questions that may arise from the field. So far this has not been possible with the tannin oxidation hypothesis, since simple and widely usable methods have not been available. 5. The aim of this review is to give a clear but detailed view of the chemical ecology of tannins and the methodology used to study them. In addition, we introduce a new method to estimate the oxidative activity of all types of tannins and other phenolics that might cause oxidative stress to herbivores. Hopefully our arguments and method will lead to clear changes in the approaches we take to tannins and their exciting biological activities, and we will witness a new era of flourishing and productive research in the chemical ecology of tannins.
The development of fruit‐based functional foods targeting the health and wellness market: a review
Authors: Sun‐Waterhouse Dongxiao 
Published: January 2011

SummaryFunctional foods and their health benefits beyond individual nutrients present challenges to the traditional ‘nutrition’ approach to foods. Epidemiological studies suggest that regular or increased consumption of fruits may promote general health and well‐being as well as reduce the risk of chronic diseases. Therefore, a broad range of research amongst academic, industry and government institutes has been stimulated in attempts to add the goodness of fruits into popular consumer foods. This article provides a brief overview of the research opportunities in the emerging functional foods area, with an emphasis on fruit‐derived products. Based on recent research in the fruit‐based functional food area, a structured approach for designing and developing functional finished products is presented. Included are the technical challenges and their associated solutions during food design, formulation, processing and storage. A consumer‐oriented food product development process is highlighted. Controlling the interactions among the targeted bioactives and other food components during food processing, handling and storage is the key to ensure that a stable and appealing functional food is produced. Manipulating the beneficial synergies among food ingredients, and among food formulation and processing methods, has the potential to lead to substantial food innovations.
Flow regulation reduces native plant cover and facilitates exotic invasion in riparian wetlands
Authors: Catford Jane A. , Downes Barbara J. , Gippel Christopher J. , Vesk Peter A. 
Published: January 2011

Summary 1. River regulation and exotic plant invasion threaten riverine ecosystems, and the two often co‐occur. By altering water regimes, flow regulation can facilitate plant invasion by providing conditions that directly benefit invading species, or by reducing competition from native species unsuited to the modified conditions. Integrating water and weed management has the potential to limit riparian plant invasion and maximize the ecological benefit of environmental flows. 2. We surveyed plant communities and modelled flood histories of 24 riparian wetlands along the regulated River Murray, south‐eastern Australia. There were no suitable control rivers, so we compared modelled pre‐ and post‐regulation hydrological data to quantify hydrological change in the study wetlands. Regression analyses revealed relationships between hydrological modification and cover of native non‐weed, native weed and exotic weed groups and 10 individual species. 3. Exotic cover was highest and native non‐weed cover lowest in wetlands that had experienced the greatest change in hydrology – a reduction in peak flow. Native weeds did not respond to hydrological modification indicating that exotic species’ success was not reliant on their generalist characteristics. 4. By altering habitat filters, hydrological modification caused a decline in amphibious native non‐weed species cover and simultaneously provided drier conditions that directly favoured the exotic species group dominated by terrestrial species. Exotic species were potentially further assisted by human‐mediated dispersal. 5. Species and functional diversity was inversely related to exotic cover. By shifting the balance between native and exotic taxa and changing community functional composition, flow regulation may disrupt the ecological function and ecosystem services of floodplain wetlands. 6. Synthesis and applications. Worldwide, flow regulation has led to riverine ecosystems becoming more terrestrial. The success of most introduced plants relies on minimal inundation. In this study, flood magnitude was more important than frequency, timing, or duration for wetland flora because it reflects spatial extent and depth of flooding. Augmenting natural spring floods with environmental flows will kill terrestrial weeds and facilitate native macrophyte growth. Combined with strategies for managing particular amphibious weeds, we recommend flows of 117 000–147 000 ML day−1 for at least 2 days every 10 years for River Murray wetland weed management.
Evidence‐based medicine training in a resource‐poor country, the importance of leveraging personal and institutional relationships
Authors: Tomatis Cristina , Taramona Claudia , Rizo‐Patrón Emiliana , Hernández Fiorela , Rodríguez Patricia , Piscoya Alejandro , Gonzales Elsa , Gotuzzo Eduardo , Heudebert Gustavo , Centor Robert M. , Estrada Carlos A. 
Published: January 2011

AbstractRationale, aims and objectives  Efforts to implement evidence‐based medicine (EBM) training in developing countries are limited. We describe the results of an international effort to improve research capacity in a developing country; we conducted a course aimed at improving basic EBM attitudes and identified challenges.Method  Between 2005 and 2009, we conducted an annual 3‐day course in Perú consisting of interactive lectures and case‐based workshops. We assessed self‐reported competence and importance in EBM using a Likert scale (1 = low, 5 = high).Results  Totally 220 clinicians participated. For phase I (2005–2007), self‐reported EBM competence increased from a median of 2 to 3 (P < 0.001) and the perceived importance of EBM did not change (median = 5). For phase II (2008–2009), before the course, 8–72% graded their competence very low (score of 1–2). After the course, 67–92% of subjects graded their increase in knowledge very high (score of 4–5). The challenges included limited availability of studies relevant to the local reality written in Spanish, participants' limited time and lack of long‐term follow‐up on practice change. Informal discussion and written evaluation from participants were universally in agreement that more training in EBM is needed.Conclusions  In an EBM course in a resource‐poor country, the baseline self‐reported competence and experience on EBM were low, and the course had measurable improvements of self‐reported competence, perceived utility and readiness to incorporate EBM into their practices. Similar to developed countries, translational research and building the research capacity in developing countries is critical for translating best available evidence into practice.
Implementation of a simple age‐based strategy in the prevention of cardiovascular disease: the Polypill approach
Authors: Wald David S. , Wald Nicholas J. 
Published: January 2011

AbstractBackground  A combination of medications that simultaneously reduce several cardiovascular risk factors in people above a specified age, without selection based on risk factor measurement, has been proposed as a simple strategy for reducing the risk of cardiovascular disease and shown to be effective in randomized trials (the Polypill approach).Aims  To assess acceptance of the Polypill approach and adherence to preventive treatment among individuals taking part in a cardiovascular disease prevention service.Methods  Daily treatment with simvastatin (40 mg), amlodipine (2.5 mg), bendroflumethiazide (1.25 mg), lisinopril (5 mg) [or candesartan (4 mg) if cough was reported] and folic acid (0.8 mg) was offered, as separate components, to people ≥ 55 years with no history of cardiovascular, renal or liver disease. An audit of adverse effects, adherence and requests for blood pressure and cholesterol measurement was determined by telephone consultation.Results  Between 2006 and 2010, 269 participants started treatment with the Polypill components. Follow‐up ranged from 3 to 48 months (mean 20). A total of 222 participants (83%) adhered to treatment, including 30 (11%) who switched from the angiotensin‐converting enzyme inhibitor (lisinopril) to the angiotensin receptor blocker (candesartan) because of cough. Ten participants (4%) continued to take treatment but stopped taking one or more drugs because of other symptoms, and 37 (14%) stopped all treatment, eight because of adverse effects and 29 for non‐medical reasons. No one requested a blood pressure or cholesterol measurement.Conclusion  This is the first demonstration of the application of the Polypill approach in practice. The method was accepted and the Polypill components were well tolerated, with good adherence and no demand for information about risk factors.
Evaluation of the agreement between guidelines and initial antihypertensive drug treatment using a national health care reimbursement database
Authors: Meneton Pierre , Ricordeau Philippe , Weill Alain , Tuppin Philippe , Samson Solène , Allemand Hubert , Durieux Pierre , Ménard Joël 
Published: January 2011

AbstractRationale, aims and objectives  To test the agreement between guidelines for the management of hypertension and medical practices while avoiding frequent limitations such as the use of non‐representative samples of practitioners and self‐reporting of their practices over a short period of time.Methods  The characteristics of initial antihypertensive drug treatment in a large representative sample of the French population aged 50–80 (n = 17 855) were collected from a national health care reimbursement database and compared with national guidelines over a 5‐year period.Results  Major discrepancies are observed including the use of non‐recommended drug classes such as loop and potassium sparing diuretics alone or in association and the absence of distinction between patients according to their age. More minor discrepancies are the preferential use of mono‐therapies over drug combinations and of some bi‐therapies among those recommended. Some degree of concordance with the guidelines is also observed including the specific characteristics of the treatment of diabetics compared with other categories of patients and the preferential use of long‐acting dihydropyridine calcium antagonists and of low‐dose thiazide diuretics when these drug classes are chosen. Several of these discrepancies or concordances, which mainly reflect general practitioner (GP) activity, show time trends over the entire follow‐up period with no significant effect of the guideline released during this period.Conclusions  At the French national level, the agreement between initial antihypertensive drug treatment and guidelines varies considerably depending on the characteristics of the treatment that are considered. The GPs who delivered the treatment do not seem to have been influenced by the guidelines released over the last decade.
Evidence‐based medical practice in developing countries: the case study of Iran
Authors: Mozafarpour Sarah , Sadeghizadeh Atefeh , Kabiri Payam , Taheri Hajar , Attaei Manizheh , Khalighinezhad Nima 
Published: January 2011

AbstractRationale, aims and objectives  Attitude towards and knowledge of various groups of health care providers regarding evidence‐based medicine (EBM) have been assessed worldwide. Also, barriers to practising EBM have been found to be different in different countries. However, there is little evidence on the place of EBM among some developing countries, like Iran. The aim of this study was to explore the current status of EBM among different medical specialists in Iran.Methods  This cross‐sectional study was conducted from August 2007 until March 2009 on a sample of 181 doctors in different medical specialties practising in Isfahan, Iran, not including faculty members. Attitude towards EBM and the barriers in practice and awareness of technical terms were investigated through a self‐administered questionnaire.Results  Less than half (41%) of the doctors reported they use EBM in their practice. They believed EBM improves the quality of health care services (70%); however, their understanding of the technical terms used in EBM was poor. The barrier to practising EBM identified by most respondents (74.3%) was the lack of EBM training courses in their academic curriculum.Conclusion  Despite the general welcoming attitude of all groups of specialists, they had insufficient knowledge and inadequate use of EBM in their practice. Designing and conducting EBM training courses and its integration into the general practitioners' training curriculum should be considered.