bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of blood supplies during an influenza pandemic
Authors: Kamp Christel , Heiden Margarethe , Henseler Olaf , Seitz Rainer 
Published: December 2009

BACKGROUND: Blood supplies are delicate resources, particularly vulnerable to incidents affecting the health of donors. The critical impact of a pandemic on the availability of red blood cells (RBCs) has been demonstrated in previous research; however, a detailed estimate of the expected deficit is missing. This has become a priority issue in the face of the current influenza pandemic.STUDY DESIGN AND METHODS: Data from several major blood donation services were used to analyze management of blood supplies in Germany. Routine management of RBCs was extrapolated to epidemic and pandemic situations using computer simulations with a mathematical model that allows for analysis of deficits in blood supplies.RESULTS: Routine management and distribution of RBCs are driven by supply, which has marked fluctuations but does not appear to have seasonality. There seems to be a remarkable elasticity in the demand for RBCs that helps to mitigate minor crises in supply, but this is likely to be overstretched during a severe pandemic.CONCLUSION: The supply‐driven management of RBCs in Germany implies that assessment of severity of shortages due to a pandemic depends on detailed knowledge about the fraction of transfusions that do not allow for postponement. Pandemic preparedness should include criteria for prioritization of transfusions.
Activity‐based costs of blood transfusions in surgical patients at four hospitals
Authors: Shander Aryeh , Hofmann Axel , Ozawa Sherri , Theusinger Oliver M. , Gombotz Hans , Spahn Donat R. 
Published: December 2009

BACKGROUND: Blood utilization has long been suspected to consume more health care resources than previously reported. Incomplete accounting for blood costs has the potential to misdirect programmatic decision making by health care systems. Determining the cost of supplying patients with blood transfusions requires an in‐depth examination of the complex array of activities surrounding the decision to transfuse.STUDY DESIGN AND METHODS: To accurately determine the cost of blood in a surgical population from a health system perspective, an activity‐based costing (ABC) model was constructed. Tasks and resource consumption (materials, labor, third‐party services, capital) related to blood administration were identified prospectively at two US and two European hospitals. Process frequency (i.e., usage) data were captured retrospectively from each hospital and used to populate the ABC model.RESULTS: All major process steps, staff, and consumables to provide red blood cell (RBC) transfusions to surgical patients, including usage frequencies, and direct and indirect overhead costs contributed to per‐RBC‐unit costs between $522 and $1183 (mean, $761 ± $294). These exceed previously reported estimates and were 3.2‐ to 4.8‐fold higher than blood product acquisition costs. Annual expenditures on blood and transfusion‐related activities, limited to surgical patients, ranged from $1.62 to $6.03 million per hospital and were largely related to the transfusion rate.CONCLUSION: Applicable to various hospital practices, the ABC model confirms that blood costs have been underestimated and that they are geographically variable and identifies opportunities for cost containment. Studies to determine whether more stringent control of blood utilization improves health care utilization and quality, and further reduces costs, are warranted.
Recent Caffeine Ingestion Reduces Adenosine Efficacy in the Treatment of Paroxysmal Supraventricular Tachycardia
Authors: Cabalag Miguel S. , Taylor David McDonald , Knott Jonathan C. , Buntine Paul , Smit DeVilliers , Meyer Alastair 
Published: December 2009

AbstractObjectives: Caffeine, an adenosine receptor blocker, should theoretically reduce adenosine efficacy in the treatment of paroxysmal supraventricular tachycardia (SVT). We aimed to determine the effect of recent caffeine ingestion on the likelihood of reversion of SVT with adenosine.Methods: This was a multicenter, case–control study of adult patients with SVT treated with adenosine between September 2007 and July 2008. The primary endpoint was reversion to sinus rhythm (SR) after a 6‐mg adenosine bolus, as a function of recent (within 2, 4, 6, and 8 hours) caffeine ingestion. Caffeine ingestion data were collected using a self‐administered questionnaire.Results: Of 68 patients enrolled, 52 (76.5%, 95% confidence interval [CI] = 64.4% to 85.6%) reverted after a 6‐mg adenosine bolus. There were no significant differences in age, sex, or daily caffeine ingestion between patients who did and did not revert (p > 0.05). However, as a group, patients who did not revert had recently ingested significantly more caffeine (p < 0.05). If caffeine had been ingested less than 2 or 4 hours before the adenosine bolus, the odds of reversion to SR were significantly reduced (odds ratio [OR] = 0.18, 95% CI = 0.04 to 0.93; and OR = 0.14, 95% CI = 0.04 to 0.49, respectively). If caffeine had been ingested less than 6 or 8 hours before the adenosine, the odds of reversion were not reduced (OR = 0.31, 95% CI = 0.09 to 1.02; and OR = 0.31, 95% CI = 0.09 to 1.08, respectively).Conclusions: Ingestion of caffeine less than 4 hours before a 6‐mg adenosine bolus significantly reduces its effectiveness in the treatment of SVT. An increased initial adenosine dose may be indicated for these patients.ACADEMIC EMERGENCY MEDICINE 2010; 17:44–49 © 2009 by the Society for Academic Emergency Medicine
Validation of the Wong‐Baker FACES Pain Rating Scale in Pediatric Emergency Department Patients
Authors: Garra Gregory , Singer Adam J. , Taira Breena R. , Chohan Jasmin , Cardoz Hiran , Chisena Ernest , Thode Henry C. 
Published: December 2009

AbstractObjectives:  The Wong‐Baker FACES Pain Rating Scale (WBS), used in children to rate pain severity, has been validated outside the emergency department (ED), mostly for chronic pain. The authors validated the WBS in children presenting to the ED with pain by identifying a corresponding mean value of the visual analog scale (VAS) for each face of the WBS and determined the relationship between the WBS and VAS. The hypothesis was that the pain severity ratings on the WBS would be highly correlated (Spearman’s rho > 0.80) with those on a VAS.Methods:  This was a prospective, observational study of children ages 8–17 years with pain presenting to a suburban, academic pediatric ED. Children rated their pain severity on a six‐item ordinal faces scale (WBS) from none to worst and a 100‐mm VAS from least to most. Analysis of variance (ANOVA) was used to compare mean VAS scores across the six ordinal categories. Spearman’s correlation (ρ) was used to measure agreement between the continuous and ordinal scales.Results:  A total of 120 patients were assessed: the median age was 13 years (interquartile range [IQR] = 10–15 years), 50% were female, 78% were white, and six patients (5%) used a language other than English at home. The most commonly specified locations of pain were extremity (37%), abdomen (19%), and back/neck (11%). The mean VAS increased uniformly across WBS categories in increments of about 17 mm. ANOVA demonstrated significant differences in mean VAS across face groups. Post hoc testing demonstrated that each mean VAS was significantly different from every other mean VAS. Agreement between the WBS and VAS was excellent (ρ = 0.90; 95% confidence interval [CI] = 0.86 to 0.93). There was no association between age, sex, or pain location with either pain score.Conclusions:  The VAS was found to have an excellent correlation in older children with acute pain in the ED and had a uniformly increasing relationship with WBS. This finding has implications for research on pain management using the WBS as an assessment tool.ACADEMIC EMERGENCY MEDICINE 2010; 17:50–54 © 2009 by the Society for Academic Emergency Medicine
Analysis of humoral immune responses in rhesus macaques vaccinated with attenuated SIVmac239Δnef and challenged with pathogenic SIVmac251
Authors: Freißmuth Doris , Hiltgartner Alexander , Stahl‐Hennig Christiane , Fuchs Dietmar , Tenner‐Racz Klara , Racz Paul , Überla Klaus , Strasak Alexander , Dierich Manfred P. , Stoiber Heribert , Falkensammer Barbara 
Published: December 2009

AbstractBackground  To determine the correlation between protection and humoral immune response against simian immunodeficiency virus (SIVmac251), 11 macaques were immunized with live‐attenuated SIVmac239Δnef either intravenously or via the tonsils and exposed to SIVmac251 after either 6 or 15 months along with unvaccinated controls.Results  Independent of the route of vaccine application, viremia was significantly reduced in vaccinees compared with controls 2 weeks post‐challenge. Concomitantly, viremia correlated inversely with SIV‐specific IgG, complement‐mediated lysis and neutralizing antibodies and these parameters seemed to contribute to reduced viremia. During chronic infection, six monkeys controlled viremia in the circulation (two or fewer infectious units per 106 PBMCs) and showed no signs of trapping in lymphatic tissues (Appendix S1).Conclusions  As no significant differences were observed throughout the study, with respect to the humoral immune response and viremia control, between the two vaccinated cohorts, mucosal immunization strategies are recommended due to more simplified application.
Choices for People With Intellectual Disabilities: Official Discourse and Everyday Practice
Authors: Antaki Charles , Finlay W. M. L. , Walton Chris 
Published: December 2009

AbstractOfficial policy talk of “choice” for people with intellectual impairments tends toward fundamental life choices (e.g., who to marry, what job to work at) at the expense of the minor but more frequent concerns of daily living (when to wash, what to eat, where to go in the evening). Statutes and mission statements are unspecific about how any such choices, big or small, are, or should be, offered. They are also silent on the relation of exercising “choices” to institutional imperatives. To examine these particulars the authors undertook an examination of how choice policies are actualized in day‐to‐day activities in two group homes. Data were drawn from a broader ethnographic study of residential services for people with intellectual disabilities serviced by National Health Service Trust in the United Kingdom. Conversation analysis, used to explicate the interactions, showed how staff, although undoubtedly well‐meaning, use the discourse of choice to promote institutional managerial objectives, thus demonstrating a gap between practice and overarching policy theory and recommendations.
Developing an Education Intervention for Staff Supporting Persons With an Intellectual Disability and Advanced Dementia
Authors: Fahey‐McCarthy Elizabeth , McCarron Mary , Connaire Kevin , McCallion Philip 
Published: December 2009

AbstractGenerally, staff working in settings that provide care for adults with intellectual disabilities (ID) have not received specific education with respect to extended care for terminal illnesses or late‐stage dementia. Equally, staff working in specialist palliative care often are not familiar with the unique issues of supporting persons with intellectual disabilities affected by dementia. To understand care concerns with respect to supporting persons with ID and advanced dementia, and to develop, deliver, and evaluate an educational intervention with staff in ID settings and specialist palliative care services, 14 focus group interviews were conducted with staff across six ID services and one specialist palliative care provider in the greater Dublin (Ireland) area. Qualitative descriptive analysis resulted in the emergence of key themes and formed the development of an educational intervention. Pre‐ and posttest questionnaires assessed responses to a pilot delivery of the educational intervention. Formal feedback from staff indicated that the educational intervention was highly valued and addressed key training concerns. They agreed that the training supported “aging in place,” and the preparation for a “good death” including support for staff, peers, and family in their grief and bereavement. An educational intervention in the form of a trainer manual was produced to support cross‐service system in‐service training on issues of addressing advanced dementia in persons with ID.
“Pachyostosis” in aquatic amniotes: a review
Authors: HOUSSAYE Alexandra 
Published: December 2009

AbstractDuring the course of amniote evolution, numerous taxa secondarily adapted to an aquatic life. It appears that many of these taxa primitively display “pachyostosis,” an osseous specialization characterized by an increase in bone compactness and/or volume. The term “pachyostosis” is used in morphological and histological descriptions to describe what in fact corresponds to different patterns. The aim of this paper is to present the current state of knowledge relative to this adaptation among aquatic amniotes. All the taxa that have returned to an aquatic environment are listed. Moreover, their degree of adaptation to the marine environment, their life environment, and the nature of their “pachyostotic” pattern, when present, are described. This inventory enables the evaluation of the current quality of the data relative to this specialization and provides an indication of the work that remains to be done. The functional consequences of “pachyostosis,” and notably its importance for buoyancy control in the context of hydrostatic regulation of the body trim, are discussed and opposed to the requirement of improved swimming abilities in the case of a hydrodynamic mode of trim regulation. Questions are posed about the signification of the polymorphism displayed by this specialization between different taxa, different specimens of the same taxon and different bones of the same specimen, and the problem of quantification of pachyostosis is discussed.
Physiological adaptations of small mammals to desert ecosystems
Authors: SCHWIMMER Hagit , HAIM Abraham 
Published: December 2009

AbstractAdaptations of animals to the xeric environment have been studied in various taxonomic groups and across several deserts. Despite the impressive data that have been accumulated, the focus in most of these studies is mainly on the significance of one variable at a time. Here, we attempt to integrate between responses of several physiological systems, challenged by increasing diet and water salinity and extreme temperatures, acquired in different studies of thermo and osmo‐regulatory adaptations, of small rodents, to the xeric environment. Studies have shown differential thermoregulatory responses to increased dietary salinity, which were attributed to habitat and habits of the relevant species. In the thermoregulatory studies, a potential adaptive significance of low metabolic rate was demonstrated. From an evolutionary point of view, the most important adaptation is in the timing of reproduction, as it enables the transfer of genetic properties to the next generation in an unpredictable ecosystem, where reproduction might not occur every year. Results in this aspect show that increased dietary salinity, through an increase in vasopressin plasma levels, plays an important role as a regulator of the reproductive system. We assume that the amount of food existing in the habitat and the amount of reserves in the animal in the form of white adipose tissue are important for reproduction. Photoperiod affects all studied physiological responses, emphasizing the importance of pre‐acclimation to seasonal characteristics. We summarize the existing data and suggest neuro‐endocrine pathways, which have a central role in these adaptations by affecting thermoregulation, osmoregulation and reproduction to create the optimal response to xeric conditions. These hypotheses can be used as the basis for future studies.
Management and survival of patients admitted with an exacerbation of COPD: Comparison of two Danish patient cohorts
Authors: Eriksen Nanna , Vestbo Jørgen 
Published: December 2009

AbstractIntroduction:  The aim of this study was to describe the management and prognosis related to a hospital admission for acute exacerbation of chronic obstructive pulmonary disease and to compare results to an earlier study.Objectives and Methods:  This is a retrospective study of 300 consecutively discharged patients admitted in 2006–2007 with an exacerbation of chronic obstructive pulmonary disease from three respiratory departments. Data were collected from patient charts and compared with a replicate study done in 2001.Results:  The mean age was 72.1 years; 61.7% were women. Mean forced expiratory volume in 1 s was 37.6% of predicted. On admission, 11.3% were treated with non‐invasive ventilation, and 84.3% were given systemic corticosteroids. In‐hospital mortality was 4.7%. At discharge, treatment with inhaled corticosteroids or at least one long‐acting bronchodilator was given to 86.7% and 89% of patients, respectively, which was significantly higher than for similarly sampled patients in 2001. Mortality in 30 days and 1 year after discharge was 4.5% and 25.5%, respectively, compared with 5.5% and 30.3% in 2001, the 12‐month mortality being significantly lower (P = 0.03). Readmission rate in the 12 months following discharge was 42.3%. Long‐term oxygen treatment, treatment with anti‐dysrhythmic drugs and lack of outpatient follow‐up were independent predictors of 1‐year mortality. Risk of readmission was increased with dependence in self‐care activities, previous admissions and treatment with strong analgesics.Conclusions:  Over a period of 6 years, a significantly higher number of patients are being treated according to guidelines. Survival following discharge increased over the same period.Please cite this paper as: Eriksen N and Vestbo J. Management and survival of patients admitted with an exacerbation of COPD: comparison of two Danish patient cohorts. The Clinical Respiratory Journal 2010; 4: 208–214.
Pneumococcal carriage is more common in asthmatic than in non‐asthmatic young men
Authors: Jounio Ulla , Juvonen Raija , Bloigu Aini , Silvennoinen‐Kassinen Sylvi , Kaijalainen Tarja , Kauma Heikki , Peitso Ari , Saukkoriipi Annika , Vainio Olli , Harju Terttu , Leinonen Maija 
Published: December 2009

AbstractIntroduction:  The aim was to investigate the prevalence of oropharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitidis and beta‐haemolytic streptococci among asthmatic and non‐asthmatic young Finnish men and to identify putative risk factors.Objectives:  A total of 224 asthmatics and 668 non‐asthmatic men (mean age 19.6 years) from two intakes of conscripts to the Kainuu Brigade, Finland in July 2004 and January 2005 were enrolled upon entering military service.Methods:  Oropharyngeal specimens were examined for bacteria by routine culture methods. All the participants filled in questionnaires concerning risk factors for asthma and respiratory infections.Results:  S. pneumoniae (48 cases, 5.4%), Group A streptococci (16, 1.8%), H. influenzae (45, 5.0%), M. catarrhalis (24, 2.7%) and N. meningitidis (20, 2.2%) were isolated from the 892 participants. Ten putative risk factors for oropharyngeal colonization (asthma, atopy, allergic rhinitis, smoking, current use of asthma medication, history of adeno/tonsillectomy, level of highly sensitive C‐reactive protein, peak expiratory flow, results of a 12‐min running test and body mass index) were evaluated. The only significant risk factor for S. pneumoniae carriage was asthma (OR, 2.04; 95% CI 1.12 to 3.72).Conclusions:  Pneumococcal carriage is more common in asthmatic than in non‐asthmatic young men.Please cite this paper as: Jounio U, Juvonen R, Bloigu A, Silvennoinen‐Kassinen S, Kaijalainen T, Kauma H, Peitso A, Saukkoriipi A, Vainio O, Harju T and Leinonen M. Pneumococcal carriage is more common in asthmatic than in non‐asthmatic young men. The Clinical Respiratory Journal 2010; 4: 222–229.
Immune Stimulatory Receptor CD40 Is Required for T-Cell Suppression and T Regulatory Cell Activation Mediated by Myeloid-Derived Suppressor Cells in Cancer
Authors: Pan Ping-Ying , Ma Ge , Weber Kaare J. , Ozao-Choy Junko , Wang George , Yin Bingjiao , Divino Celia M. , Chen Shu-Hsia 
Published: December 2009

Abstract
Immune tolerance to tumors is often associated with accumulation of myeloid-derived suppressor cells (MDSC) and an increase in the number of T-regulatory cells (Treg). In tumor-bearing mice, MDSCs can themselves facilitate the generation of tumor-specific Tregs. In this study, we demonstrate that expression of the immune stimulatory receptor CD40 on MDSCs is required to induce T-cell tolerance and Treg accumulation. In an immune reconstitution model, adoptive transfer of Gr-1+CD115+ monocytic MDSCs derived from CD40-deficient mice failed to recapitulate the ability of wild-type MDSCs to induce tolerance and Treg development in vivo. Agonistic anti-CD40 antibodies phenocopied the effect of CD40 deficiency and also improved the therapeutic efficacy of IL-12 and 4-1BB immunotherapy in the treatment of advanced tumors. Our findings suggest that CD40 is essential not only for MDSC-mediated immune suppression but also for tumor-specific Treg expansion. Blockade of CD40-CD40L interaction between MDSC and Treg may provide a new strategy to ablate tumoral immune suppression and thereby heighten responses to immunotherapy. Cancer Res; 70(1); 99–108
Chemosensitivity Profiles Identify Polymorphisms in the p53 Network Genes 14-3-3τ and CD44 That Affect Sarcoma Incidence and Survival
Authors: Vazquez Alexei , Grochola Lukasz F. , Bond Elisabeth E. , Levine Arnold J. , Taubert Helge , Müller Thomas H. , Würl Peter , Bond Gareth L. 
Published: December 2009

Abstract
The p53 regulatory network responds to cellular stresses by initiating processes such as cell cycle arrest and apoptosis. These responses inhibit cellular transformation and mediate the response to many forms of cancer therapies. Functional variants in the genes comprising this network could help identify individuals at greater risk for cancer and patients with poorer responses to therapies, but few such variants have been identified as yet. We use the NCI60 human tumor cell line anticancer drug screen in a scan of single nucleotide polymorphisms (SNP) in 142 p53 stress response genes and identify 7 SNPs that exhibit allelic differences in cellular responses to a large panel of cytotoxic chemotherapeutic agents. The greatest differences are observed for SNPs in 14-3-3τ (YWHAQ; rs6734469, P = 5.6 × 10−47) and CD44 (rs187115, P = 8.1 × 10−24). In soft-tissue sarcoma patients, we find that the alleles of these SNPs that associate with weaker growth responses to chemotherapeutics associate with poorer overall survival (up to 2.89 relative risk, P = 0.011) and an earlier age of diagnosis (up to 10.7 years earlier, P = 0.002). Our findings define genetic markers in 14-3-3τ and CD44 that might improve the treatment and prognosis of soft-tissue sarcomas. Cancer Res; 70(1); 172–80
Adult-Type Granulosa Cell Tumors and FOXL2 Mutation
Authors: Köbel Martin , Gilks C. Blake , Huntsman David G. 
Published: December 2009

Abstract
Little is known about the pathogenesis of ovarian granulosa cell tumors. Recently, we reported the identification of a somatic FOXL2 402C→G mutation that is present in virtually all adult-type granulosa cell tumors, but not in a wide range of other tumor types. This finding has important implications for the diagnosis and classification of ovarian sex cord-stromal tumors, provides insight into the pathogenesis of adult-type granulosa cell tumors, and opens possibilities for the development of targeted therapies. [Cancer Res 2009;69(24):9160–2]