bluuebunny/crossref_metadata_2025_split huggingface dataset:
Older adults' alcohol consumption and late‐life drinking problems: a 20‐year perspective
Authors: Moos Rudolf H. , Schutte Kathleen K. , Brennan Penny L. , Moos Bernice S. 
Published: May 2009

ABSTRACTAims  The aim of this study was to identify changes in patterns of alcohol consumption over a 20‐year interval among older women and men, and to examine the associations between guideline‐defined excessive drinking and late‐life drinking problems.Design, participants and measures  A community sample of 719 adults between 55 and 65 years of age who consumed alcohol at or prior to baseline participated in a survey of alcohol consumption and drinking problems and was followed 10 years and 20 years later.Findings  The likelihood of excessive drinking declined over the 20‐year interval as adults matured into their 70s and 80s. However, at ages 75–85, 27.1% of women and 48.6% of men consumed more than two drinks per day or seven drinks per week. At comparable guideline levels of alcohol consumption, older men were more likely to have drinking problems than were older women. Consumption of more than two drinks per day or seven drinks per week was identified as a potential conservative guideline for identifying excessive drinking associated with an elevated likelihood of drinking problems.Conclusions  A substantial percentage of older adults who consume alcohol engage in guideline‐defined excessive drinking and incur drinking problems. The finding that older men may be more likely than older women to experience problems when they drink beyond guideline levels suggests that alcohol guidelines for men should not be set higher than those for women.
Anti‐tissue transglutaminase antibodies in the follow‐up of adult coeliac disease
Authors: DIPPER C. R. , MAITRA S. , THOMAS R. , LAMB C. A. , MCLEAN‐TOOKE A. P. C. , WARD R. , SMITH D. , SPICKETT G. , MANSFIELD J. C. 
Published: May 2009

SummaryBackground  The detection of auto antibodies directed against tissue transglutaminase (anti‐tTG antibodies) has a well‐established role in the diagnosis of coeliac disease, but the value of these antibodies in long‐term follow‐up is controversial.Aims  To determine if serial anti‐tTG antibody measurements could confirm adherence to a gluten‐free diet (GFD) and identify patients at risk of disease complications.Methods  In a 54‐month cohort follow‐up study, 182 adult patients were assessed. Data recorded included self‐assessment of GFD adherence; anti‐tTG antibody concentration and serum ferritin, vitamin B12 and folate. Where available, bone mineral density (BMD) and duodenal histology data were retrieved.Results  Persistently elevated anti‐tTG antibody levels were significantly associated with abnormal duodenal histology (P < 0.001), low ferritin (P < 0.01) and poor adherence to the GFD (P < 0.001). The specificity was >85% while the sensitivity was 39–60%. Anti‐tTG antibody concentrations fell rapidly following successful initiation of a GFD, and maintenance of normalization identified those who continued to be adherent to the diet.Conclusions  This study supports a strategy of using anti‐tTG antibody concentrations to monitor newly diagnosed and established patients with coeliac disease, and to target dietetic intervention to reduce the risk of complication.
Clinical Trial: High‐dose furosemide plus small‐volume hypertonic saline solutions vs. repeated paracentesis as treatment of refractory ascites
Authors: LICATA G. , TUTTOLOMONDO A. , LICATA A. , PARRINELLO G. , DI RAIMONDO D. , DI SCIACCA R. , CAMMÀ C. , CRAXÌ A. , PATERNA S. , PINTO A. 
Published: May 2009

SummaryBackground  In patients with cirrhosis, ascites is defined as refractory when it cannot be mobilized or recurs early in standard diuretic therapy.Aim  To compare the safety and efficacy of intravenous high‐dose furosemide + hypertonic saline solutions (HSS) with repeated paracentesis in patients with cirrhosis and refractory ascites.Patients and methods  Eighty‐four subjects (59/25 M/F) with cirrhosis, mostly of viral aetiology, admitted for refractory ascites, were randomly assigned to receive furosemide (250–1000 mg/bid i.v.) plus HSS (150 mL H2O with NaCl 1.4–4.6% or 239–187 mEq/L) (60 patients, Group A) or to repeated paracentesis and a standard diuretic schedule (24 patients, Group B).Results  During hospitalization, Group A patients had more diuresis (1605 ± 131 mL vs. 532 ± 124 mL than Group B patients; P < 0.001) and a greater loss of weight at discharge (−8.8 ± 4.8 kg vs. −4.5 ± 3.8 kg, P < 0.00). Control of ascites, pleural effusions and/or leg oedema was deemed significantly better in Group A.Conclusions  This randomized pilot study suggests that HHS plus high‐dose furosemide is a safe and effective alternative to repeated paracentesis when treating hospitalized patients with cirrhosis and refractory ascites. Larger studies will be needed to evaluate long‐term outcomes such as readmission and mortality.
Effect of mesalazine on mucosal immune biomarkers in irritable bowel syndrome: a randomized controlled proof‐of‐concept study
Authors: CORINALDESI R. , STANGHELLINI V. , CREMON C. , GARGANO L. , COGLIANDRO R. F. , DE GIORGIO R. , BARTESAGHI G. , CANOVI B. , BARBARA G. 
Published: May 2009

SummaryBackground  Intestinal immune infiltration contributes to symptoms in patients with irritable bowel syndrome (IBS).Aim  To assesses the effect of mesalazine (mesalamine) on mucosal immune cells in patients with IBS, through a pilot study.Methods  A randomized, double‐blind, placebo‐controlled trial in 20 patients with IBS in tertiary care setting. Patients were randomized to receive placebo or 800 mg mesalazine three times daily for 8 weeks. The primary endpoint was a significant reduction in total colonic immune cells on biopsies obtained at the end of treatment compared to baseline. Secondary endpoints included effects on subsets of immune cells, inflammatory mediators and symptom severity. Intention‐to‐treat analysis was performed.Results  Mesalazine markedly reduced immune cells as compared with placebo (P = 0.0082); this effect was ascribed to a marked inhibition of mast cells (P = 0.0014). Mesalazine significantly increased general well‐being (P = 0.038), but had no significant effects on abdominal pain (P = 0.084), bloating (P = 0.177) or bowel habits. No serious drug‐related adverse events were reported during the study.Conclusions  Mesalazine is an effective and safe approach to reduce mast cell infiltration and may improve general well‐being in patients with IBS. These results support the hypothesis that immune mechanisms represent potential therapeutic targets in IBS.
A role of Gab2 association in Flt3 ITD mediated Stat5 phosphorylation and cell survival
Authors: Masson Kristina , Liu Tao , Khan Rasheed , Sun Jianmin , Rönnstrand Lars 
Published: May 2009

SummaryThe haematopoietic growth factor receptor Flt3 has been implicated as major cause of transformation in acute myeloid leukaemia. Intracellular signals mediated by wild‐type Flt3 are involved in cell differentiation and survival whereas signalling via the mutant Flt3 ITD (internal tandem duplication) promotes enhanced cell growth. In this study, we identified tyrosines 768, 955 and 969 of Flt3 as phosphorylation sites and mediators of growth factor receptor binding protein 2 (Grb2) interaction, leading to the association of Grb2 associated binder 2 (Gab2) and contributing to proliferation and survival. Ba/F3 cells were transfected with either the wild‐type Flt3 or the ITD, with or without a triple mutation of the Grb2 binding sites, and characterised in terms of proliferation and viability. Interestingly, the Flt3 ITD promoted increased survival but after introducing the triple mutation, this phenotype was lost. When looking into different downstream pathways, this effect was mainly caused by decreased phosphoinositide 3‐kinase and Stat5 signalling, and the Flt3 ITD carrying the Grb2 binding mutations showed less Akt and Stat5 activation compared to the regular Flt3 ITD receptor. These findings not only reveal novel phosphorylation sites in Flt3 but contribute to the understanding of the molecular mechanism by which Flt3 ITD functions in pathological conditions.
Outcomes for patients who fail high dose chemoradiotherapy and autologous stem cell rescue for relapsed and primary refractory Hodgkin lymphoma
Authors: Moskowitz Alison J. , Perales Miguel‐Angel , Kewalramani Tarun , Yahalom Joachim , Castro‐Malaspina Hugo , Zhang Zhigang , Vanak Jill , Zelenetz Andrew D. , Moskowitz Craig H. 
Published: May 2009

SummaryMost patients with Hodgkin lymphoma (HL) are cured with first and second‐line treatment; however, the outcome is unknown for those who fail high dose chemoradiotherapy with autologous stem cell transplant (HDT‐ASCT). This report is an analysis of patients with relapsed and primary refractory HL who were treated with HDT‐ASCT and failed due to progression of disease (POD). Two hundred and two patients received HDT‐ASCT at Memorial Sloan Kettering Cancer Center for relapsed or refractory HL between December 1994 and 2005 and 71 failed due to POD. The median survival following HDT‐ASCT failure was 25 months. Only 16 (23%) of the 71 patients are currently alive, nine of whom are in remission. Multivariate analysis revealed two factors associated with poor outcome: relapse within 6 months of HDT‐ASCT and primary refractory disease. The only factor associated with improved survival was the ability to receive a second transplant, in particular, reduced intensity allogeneic transplant (RIT). Novel therapies are needed for patients who fail HDT‐ASCT, particularly those with primary refractory disease and those who relapse within 6 months of HDT‐ASCT. Future studies should focus on prospectively evaluating RIT following HDT‐ASCT failure in patients with remission duration from HDT‐ASCT of >6 months.
Low plasma HDL‐c, a vascular risk factor in high risk patients independent of LDL‐c
Authors: Hajer G. R. , Van Der Graaf Y. , Bots M. L. , Algra A. , Visseren F. L. J. ,   on behalf of the SMART Study Group
Published: May 2009

AbstractBackground  High concentrations of high density lipoprotein‐cholesterol (HDL‐c) are associated with lower cardiovascular risk, but it is not known whether this is also the case in the presence of intensive low density lipoprotein‐cholesterol (LDL‐C) therapy. In this study, we determined the relationship between HDL‐c and new non‐fatal or fatal vascular events in patients with various manifestations of clinical evident vascular disease and evaluated whether this relationship is modified by LDL‐c levels.Materials and methods  Prospective single centre, cohort study of 3837 patients with a history or recent diagnosis of clinical manifest vascular disease (coronary, cerebrovascular, peripheral arterial disease or abdominal aortic aneurysm) The relationship between HDL‐c quintiles and time to a new event (myocardial infarction, ischaemic stroke, vascular death) was quantified with Cox‐regression models and adjusted for potential confounders (age, gender, body mass index, type 2 diabetes, triglycerides, smoking, use of alcohol and lipid‐lowering therapy). Effect modification of LDL‐c was assessed with interaction terms.Results  During a median follow up of 3·3 (range 0·1–9·5) years, a total of 465 first new events occurred. Compared with the lowest quintile, the upper quintile of HDL‐c levels was associated with a lower risk for new events; Hazard Ratio 0·61 (95% CI 0·43–0·86) irrespective of the localisation of vascular disease and use of lipid‐lowering medication. Higher HDL‐c levels were associated with comparably lower risks for vascular events in patients with LDL‐c levels above and below 2·5 mmol L−1 (P‐values for interaction > 0·05).Conclusions  Patients with various clinical manifestations of vascular diseases in the highest HDL‐c quintile have a lower risk for vascular events compared with patients in the lowest HDL‐c quintile. Further, the current results expand the evidence by showing that also in a cohort of patients with various localisations of clinical evident vascular disease, in which statins were widely used, higher HDL‐c levels confer a lower risk for developing new vascular events, irrespective of the localisation of vascular disease, use of lipid‐lowering medication and plasma LDL‐c concentration.
Toward a full multiscale approach to interpret potential fields
Authors: Cella Federico , Fedi Maurizio , Florio Giovanni 
Published: May 2009

ABSTRACTThe way potential fields convey source information depends on the scale at which the field is analysed. In this sense a multiscale analysis is a useful method to study potential fields particularly when the main field contributions are caused by sources with different depths and extents. Our multiscale approach is built with a stable transformation, such as depth from extreme points. Its stability results from mixing, in a single operator, the wavenumber low‐pass behaviour of the upward continuation transformation of the field with the enhancement high‐pass properties of n‐order derivative transformations. So, the complex reciprocal interference of several field components may be efficiently faced at several scales of the analysis and the depth to the sources may be estimated together with the homogeneity degrees of the field. In order to estimate the source boundaries we use another multiscale method, the multiscale derivative analysis, which utilizes a generalized concept of horizontal derivative and produces a set of boundary maps at different scales. We show through synthetic examples and application to the gravity field of Southern Italy that this multiscale behaviour makes this technique quite different from other source boundary estimators.The main result obtained by integrating multiscale derivative analysis with depth from extreme points is the retrieval of rather effective information of the field sources (horizontal boundaries, depth, structural index). This interpretative approach has been used along a specific transect for the analysis of the Bouguer anomaly field of Southern Apennines. It was set at such scales, so to emphasize either regional or local features along the transect. Two different classes of sources were individuated. The first one includes a broad, deep source with lateral size of 45∼50 km, at a depth of 13 km and having a 0.5 structural index. The second class includes several narrower sources located at shallowest depths, ranging from 3–6 km, with lateral size not larger than 5 km and structural indexes ranging from 1–1.5. Within a large‐scale geological framework, these results could help to outline the mean structural features at crustal depths.
The utility of rapid application development in large‐scale, complex projects
Authors: Berger Hilary , Beynon‐Davies Paul 
Published: May 2009

AbstractThis paper describes an investigation into the utility of an agile development approach known as rapid application development (RAD) within a large‐scale development project conducted within the public sector in the UK. Features of RAD as an ‘agile’ information systems development method (ISDM) are discussed and previous research identifying properties of development environments most conducive to its application are described. A case study is then presented based upon a long‐term qualitative investigation of the ‘unbundling’ of a commercial RAD‐like ISDM. The evidence from this case leads us to question established wisdom in relation to appropriate adoption and application of agile development within large‐scale and complex development environments.
Silence, power and communication in the operating room
Authors: Gardezi Fauzia , Lingard Lorelei , Espin Sherry , Whyte Sarah , Orser Beverley , Baker G. Ross 
Published: May 2009

AbstractTitle.  Silence, power and communication in the operating room. Aim.  This paper is a report of a study conducted to explore whether a 1‐ to 3‐minute preoperative interprofessional team briefing with a structured checklist was an effective way to support communication in the operating room.Background.  Previous research suggests that nurses often feel constrained in their ability to communicate with physicians. Previous research on silence and power suggests that silence is not only a reflection of powerlessness or passivity, and that silence and speech are not opposites, but closely interrelated.Methods.  We conducted a retrospective study of silences observed in communication between nurses and surgeons in a multi‐site observational study of interprofessional communication in the operating room. Over 700 surgical procedures were observed from 2005–2007. Instances of communication characterized by unresolved or unarticulated issues were identified in field notes and analysed from a critical ethnography perspective.Findings.  We identified three forms of recurring ‘silences’: absence of communication; not responding to queries or requests; and speaking quietly. These silences may be defensive or strategic, and they may be influenced by larger institutional and structural power dynamics as well as by the immediate situational context.Conclusions.  There is no single answer to the question of why ‘nobody said anything’. Exploring silences in relation to power suggests that there are multiple and complex ways that constrained communication is produced in the operating room, which are essential to understand in order to improve interprofessional communication and collaboration.
The sequences of Arabidopsis GA‐INSENSITIVE RNA constitute the motifs that are necessary and sufficient for RNA long‐distance trafficking
Authors: Huang Nien‐Chen , Yu Tien‐Shin 
Published: May 2009

SummaryIn higher plants a number of physiological processes are regulated by systemic RNA signaling molecules. This phloem‐mediated remote‐control system provides specific and efficient regulation to fine‐tune many plant developmental programs. However, the molecular mechanism underlying long‐distance movement of RNA remains to be elucidated. To this end, we examined the long‐distance movement of GA‐insensitive (GAI) RNA by Arabidopsis inflorescence grafting and RT‐PCR analysis. Our results demonstrated that long‐distance movement of RNA only occurred in specific transcripts. In addition, the sequences of GAI RNA are necessary and sufficient to target GREEN FLUORESCENT PROTEIN (GFP) RNA for long‐distance movement, which indicates that the trafficking of GAI RNA is mediated by specific RNA motifs. Further analyses revealed that the motifs at coding sequences and 3′ untranslated regions of GAI RNA play important roles during RNA movement. In addition, the structure of the RNA rather than its specific sequence may also be important in GAI RNA trafficking. However, the secondary structure of GAI RNA is not the only factor to target RNA for long‐distance movement, because recovery of the secondary structure of movement‐defective GAI RNA only partially rescued RNA movement. Taken together, our results show that long‐distance movement of non‐cell autonomous RNA operates by specific RNA mobile elements.
Comparison of conventional and molecular detection of respiratory viruses in hematopoietic cell transplant recipients
Authors: Kuypers J. , Campbell A.P. , Cent A. , Corey L. , Boeckh M. 
Published: May 2009

Background. Sensitive detection of respiratory viruses is important for early diagnosis of infection in patients following hematopoietic cell transplantation (HCT). To evaluate the relative sensitivity of respiratory virus detection in specimens from HCT recipients, we compared the results of conventional and quantitative molecular methods.Methods. We tested 688 nasal wash samples collected prospectively from 131 patients during the first 100 days after HCT by viral culture, fluorescent antibody staining (FA), and real‐time quantitative reverse transcription‐polymerase chain reaction (PCR) assay for detection of respiratory syncytial virus (RSV), influenza virus types A (FluA) and B (FluB), and parainfluenza virus types 1 (PIV1) and 3 (PIV3). Testing for human metapneumovirus (MPV) was performed only by PCR. Data regarding 10 respiratory symptoms were collected with each sample.Results. By any method 37 specimens were positive for a respiratory virus; 34 were positive by PCR, 15 by culture, and 6 by FA. Four specimens were positive by all 3 methods (3 RSV, 1 FluA). One specimen was positive for PIV1, and 2 were positive for rhinovirus by culture alone. Specimens positive by PCR alone included 2 RSV, 2 PIV1, 8 PIV3, and 8 MPV. In 10 specimens positive for RSV, PIV, or influenza virus collected from patients reporting no respiratory symptoms, 9, 4, and 1 specimen were positive by PCR, culture, and FA, respectively. Overall, specimens positive only by PCR had significantly fewer viral copies/mL (mean log10=4.32) than specimens positive by both PCR and culture (mean log10=5.75; P=0.002) or PCR and FA (mean log10=6.83; P<0.001).Conclusions. FA testing alone did not detect a significant proportion of respiratory virus‐positive samples in HCT recipients, especially in patients with no respiratory symptoms and patients with PIV detection. PCR increased the yield of positive specimens 2 times relative to culture and more than 4 times relative to FA. Detection of respiratory viruses by PCR alone was associated with lower virus quantities and with fewer reported respiratory symptoms compared with concomitant detection by both PCR and conventional methods, indicating that PCR may be important to detect asymptomatic or mildly symptomatic stages of respiratory viral infections.
A randomized study of buffy coat platelets in platelet additive solution stored 1–5 versus 6–7 days prior to prophylactic transfusion of allogeneic haematopoietic progenitor cell transplant recipients
Authors: Diedrich B. , Ringdén O. , Watz E. , Shanwell A. 
Published: May 2009

Background and Objective  Storage of platelets > 5 days provides improved availability, logistical management and decreased outdating. Promising results on in vitro parameters and on in vivo post‐transfusion recovery and survival of autologous platelets in healthy volunteers have earlier been shown. To provide additional verification, randomized patient transfusion studies are needed.Materials and Methods  Sixty allogeneic haematopoietic progenitor cell transplant recipients were randomized to receive buffy‐coat (BC) platelets stored in platelet additive solution (PAS) for 1–5 days the first time a prophylactic transfusion was needed after transplantation, followed the second time by platelets stored for 6–7 days or vice versa. The corrected count increment (CCI) for 1 and 24 h were calculated.Results  CCI 1 h and CCI 24 h were higher for platelets stored 1–5 days as compared to 6–7 days, 10·4 ± 5·1 vs. 7·4 ± 3·8 (P < 0·001) and 5·4 ± 4·1 vs. 2·6 ± 2·6 (P < 0·001), respectively. Time to next platelet transfusion was significantly longer after a transfusion of platelets stored for 1–5 days as compared to platelets stored for 6–7 days: 2·2 ± 1·1 vs. 1·6 ± 0·8 days, respectively (P < 0·005). No differences in bleeding events and no transfusion reaction were recorded.Conclusion  The advantage of an extension of platelet storage time beyond day 5 should be balanced against the increased need for platelet transfusions that may occur and the conceivable risk of transfusion failure.