bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced‐intensity conditioning haematopoietic cell transplantation for haemophagocytic lymphohistiocytosis: an important step forward
Authors: Marsh Rebecca A. , Jordan Michael B. , Filipovich Alexandra H. 
Published: June 2011

SummaryHaemophagocytic lymphohistiocytosis (HLH) is a life‐threatening immunodeficiency characterized by severe systemic hyper‐inflammatory responses to infectious or other triggers of the immune system. In many patients, the underlying cause of HLH is a genetic defect leading to defective CD8+ T cell and natural killer cell granule‐mediated cytotoxicity. The treatment of HLH consists principally of immune suppression followed by allogeneic haematopoietic cell transplantation (HCT) to cure the underlying defect and prevent relapse of HLH. Initial treatment regimens consist of steroids coupled with either etoposide or antithymocyte globulin, ± ciclosporin. Complete responses are observed in only 50–75% of patients and even after a complete response, relapse and death still occur. The only definitive, long‐term cure for patients with genetic forms of HLH is allogeneic HCT. Unfortunately, allogeneic HCT for patients with HLH is often complicated by critical illness, extensive organ involvement, active infections, or refractory HLH. For these reasons, patients are unusually prone to developing transplant‐related toxicities and complications. In recent years, great strides have been made with regard to the care and transplantation of patients with HLH. Here we review the current state of the treatment of patients with HLH with allogeneic HCT, highlighting the important steps forward that have been made with reduced‐intensity conditioning.
Biweekly rituximab, cyclophosphamide, vincristine, non‐pegylated liposome‐encapsulated doxorubicin and prednisone (R‐COMP‐14) in elderly patients with poor‐risk diffuse large B‐cell lymphoma and moderate to high ‘life threat’ impact cardiopathy
Authors: Corazzelli Gaetano , Frigeri Ferdinando , Arcamone Manuela , Lucania Anna , RosariaVilla Maria , Morelli Emanuela , Amore Alfonso , Capobianco Gaetana , Caronna Antonietta , Becchimanzi Cristina , Volzone Francesco , Marcacci Gianpaolo , Russo Filippo , De Filippi Rosaria , Mastrullo Lucia , Pinto Antonio 
Published: June 2011

SummaryThis Phase II study assessed feasibility and efficacy of a biweekly R‐COMP‐14 regimen (rituximab, cyclophosphamide, non‐pegylated liposome‐encapsulated doxorubicin, vincristine and prednisone) in untreated elderly patients with poor‐risk diffuse large B‐cell lymphoma (DLBCL) and moderate to high ‘life threat’ impact NIA/NCI cardiac comorbidity. A total of 208 courses were delivered, with close cardiac monitoring, to 41 patients (median age: 73 years, range: 62–82; 37% >75 years) at a median interval of 15·6 (range, 13–29) days; 67% completed all six scheduled courses. Response rate was 73%, with 68% complete responses (CR); 4‐year disease‐free survival (DFS) and time to treatment failure (TTF) were 72% and 49%, respectively. Failures were due to early death (n = 3), therapy discontinuations (no‐response n = 2; toxicity n = 6), relapse (n = 6) and death in CR (n = 3). Incidence of cardiac grade 3–5 adverse events was 7/41 (17%; 95% confidence interval: 8–31%). Time to progression and overall survival at 4‐years were 77% and 67%, respectively. The Age‐adjusted Charlson Comorbidity Index (aaCCI) correlated with failures (P = 0·007) with patients scoring ≤7 having a longer TTF (66% vs. 29%; P = 0·009). R‐COMP‐14 is feasible and ensures a substantial DFS to poor‐risk DLBCL patients who would have been denied anthracycline‐based treatment due to cardiac morbidity. The aaCCI predicted both treatment discontinuation rate and TTF.
Protective pathways against colitis mediated by appendicitis and appendectomy
Authors: Cheluvappa R , Luo A S , Palmer C , Grimm M C 
Published: June 2011

Summary
Appendicitis followed by appendectomy (AA) at a young age protects against inflammatory bowel disease (IBD). Using a novel murine appendicitis model, we showed that AA protected against subsequent experimental colitis. To delineate genes/pathways involved in this protection, AA was performed and samples harvested from the most distal colon. RNA was extracted from four individual colonic samples per group (AA group and double-laparotomy control group) and each sample microarray analysed followed by gene-set enrichment analysis (GSEA). The gene-expression study was validated by quantitative reverse transcription–polymerase chain reaction (RT–PCR) of 14 selected genes across the immunological spectrum. Distal colonic expression of 266 gene-sets was up-regulated significantly in AA group samples (false discovery rates &lt; 1%; P-value &lt; 0·001). Time–course RT–PCR experiments involving the 14 genes displayed down-regulation over 28 days. The IBD-associated genes tnfsf10, SLC22A5, C3, ccr5, irgm, ptger4 and ccl20 were modulated in AA mice 3 days after surgery. Many key immunological and cellular function-associated gene-sets involved in the protective effect of AA in experimental colitis were identified. The down-regulation of 14 selected genes over 28 days after surgery indicates activation, repression or de-repression of these genes leading to downstream AA-conferred anti-colitis protection. Further analysis of these genes, profiles and biological pathways may assist in developing better therapeutic strategies in the management of intractable IBD.
A concerted decline in insulin secretion and action occurs across the spectrum of fasting and postchallenge glucose concentrations
Authors: Sathananthan Airani , Man Chiara Dalla , Zinsmeister Alan R. , Camilleri Michael , Rodeheffer Richard J. , Toffolo Gianna , Cobelli Claudio , Rizza Robert A. , Vella Adrian 
Published: June 2011

SummaryAims/hypothesis  Individuals with impaired fasting glucose (IFG) are at increased risk of developing diabetes over the subsequent decade. However, there is uncertainty as to the mechanisms contributing to the development of diabetes. We sought to quantitate insulin secretion and action across the prediabetic range of fasting glucose.Methods  We studied a cohort of 173 individuals with a fasting glucose concentration <7·0 mm after an overnight fast using a 75‐g oral glucose tolerance test (OGTT). Insulin action (Si) was estimated using the oral glucose minimal model, and β‐cell responsivity indices (φ) were estimated using the oral C‐peptide minimal model. The disposition index (DI) for each individual was calculated. The relationship of DI, φ and Si with fasting and postchallenge glucose, as well as other covariates, was explored using a generalized linear regression model.Results  In this cross‐sectional study, Si and DI were inversely related to fasting glucose concentrations. On the other hand, φ was unrelated to fasting glucose concentrations. Si, φ and DI were all inversely related to area above basal glucose concentrations after glucose challenge. Multiple parameters including body composition and gender contributed to the variability of Si and DI at a given fasting or postchallenge glucose concentration.Conclusions/interpretation  Defects in insulin secretion and action interact with body composition and gender to influence postchallenge glucose concentrations. There is considerable heterogeneity of insulin secretion and action for a given fasting glucose likely because of patient subsets with isolated IFG and normal glucose tolerance.
Liver stiffness and 30‐day mortality in a cohort of patients admitted to hospital
Authors: Lindvig Kristoffer , Mössner Belinda K. , Pedersen Court , Lillevang Søren T. , Christensen Peer.B. 
Published: June 2011

Eur J Clin Invest 2011AbstractBackground  Transient elastography (TE) is a new noninvasive method to assess the degree of liver fibrosis by measuring liver stiffness. The objective of this study was to determine whether increased liver stiffness in patients admitted to medical wards was associated with increased 30‐day mortality.Materials and methods  A prospective cohort study at the medical admissions ward at Odense University Hospital, Denmark, covering a population of 300 000 inhabitants. Consecutive patients ≥ 18 years of age were examined by TE (Fibroscan) at admission. Outcome measure was 30‐day mortality.Results  Among 568 patients admitted during 24 days, 289 (50·8%) were included in the study, 212 (73·4%) with valid TE measurement. Increased liver stiffness (TE value > 8 kPa) was found in 22·6% (48/212). This was independently associated with cirrhosis of the liver (P < 0·001) and congestive heart failure (CHF) (P < 0·001). The estimated prevalence of cirrhosis was 7% (95% CI 4–11%). The 30‐day mortality among patients with TE value > 8 kPa was 20·8% (10/48, 95%CI 10·5–35·0%) compared to patients with TE value ≤ 8 kPa 3·7% (6/164, 95%CI 1·3–7·8%) (P < 0·001), and TE value > 8 kPa was an independent predictor of death.Conclusions  Elevated TE value at admission is associated with increased mortality, cirrhosis of the liver and CHF. This information may potentially be used to improve the outcome of high‐risk patients admitted to hospital.
Trade‐off between travel distance and prioritization of high‐reward sites in traplining bumblebees
Authors: Lihoreau Mathieu , Chittka Lars , Raine Nigel E. 
Published: June 2011

Summary1. Animals exploiting renewable resource patches are faced with complex multi‐location routing problems. In many species, individuals visit foraging patches in predictable sequences called traplines. However, whether and how they optimize their routes remains poorly understood.2. In this study, we demonstrate that traplining bumblebees (Bombus terrestris) make a trade‐off between minimizing travel distance and prioritizing the most rewarding feeding locations.3. Individual bees trained to forage on five artificial flowers of equal reward value selected the shortest possible route as a trapline. After introducing a single highly rewarding flower to the array, they re‐adjusted their routes visiting the most rewarding flower first provided the departure distance from the shortest possible route remained small (18%). When routes optimizing the initial rate of reward intake were much longer (42%), bees prioritized short travel distances.4. Under natural conditions, in which individual flowers vary in nectar productivity and replenish continuously, it might pay bees to prioritize highly rewarding locations, both to minimize the overall number of flowers to visit and to beat competitors.5. We discuss how combined memories of location and quality of resource patches could allow bees and other traplining animals to optimize their routing decisions in heterogeneous environments.
Tree architecture and life‐history strategies across 200 co‐occurring tropical tree species
Authors: Iida Yoshiko , Kohyama Takashi S. , Kubo Takuya , Kassim Abd Rahman , Poorter Lourens , Sterck Frank , Potts Matthew D. 
Published: June 2011

Summary1. Tree architecture is thought to allow species to partition horizontal and vertical light gradients in the forest canopy. Tree architecture is closely related to light capture, carbon gain and the efficiency with which trees reach the canopy. Previous studies that investigated how light gradients drive differentiation in tree architecture have produced inconsistent results, partially because of the differences in which tree species and ontogenetic stages were studied.2. We examined the relationship between stem diameter, tree height, foliage height, crown width and life‐history strategy over a broad size range of 200 randomly selected, co‐occurring tree species in a lowland rainforest in Peninsular Malaysia. We developed a hierarchical Bayesian model to account for both intra‐ and interspecific variation and describe the relationships among tree architectural variables. We analysed interspecific variation in tree architectural variables in relation to adult stature and light requirement for species regeneration as a function of tree size.3. There was little interspecific variation in architectural variables, this is partly because of large intraspecific variation in response to canopy heterogeneity, but it also suggests architectural convergence within this community. However, interspecific analyses showed that, for large‐statured species, small size classes had thinner stems with narrow and shallow crowns, whereas large‐size classes had wider crowns. Light‐demanding species (as indicated by high sapling mortality in shaded conditions) showed weak trends in tree architecture and were only characterized by wide crowns at intermediate sizes.4. In summary, tree architectural traits overlapped across the species community. This suggests that architectural convergence and equalizing effects occur in this diverse tropical forest and that community‐wide allometric equations can be used to describe forest height and carbon storage. Light resource partitioning also occurs, indicating stabilizing effects. Interspecific architectural variation in relation to adult stature supports the theory of the trade‐off between early reproduction and vegetative growth. In closed rainforests, adult stature imposes a stronger force on architectural differentiation of species than regeneration light requirements.
Compatibilisation of starch/poly(butylene adipate co‐terephthalate) blends in blown films
Authors: Olivato Juliana B. , Grossmann Maria V. E. , Yamashita Fabio , Nobrega Marcelo M. , Scapin Monica R. S. , Eiras Daniel , Pessan Luiz A. 
Published: June 2011

SummaryReactive extrusion was utilised for starch/poly(butylene adipate co‐terephthalate) (PBAT) blown film production, using maleic anhydride (MA) and citric acid (CA), alone or combined, as compatibilisers. These compounds (2% w/w) were added to the starch/PBAT (55:45) mixture after dispersion on glycerol. More rigid films, with greater tensile strength (9.82 ± 0.45 MPa), were produced when 2.0% CA was used. The opposite, little homogeneity and poor tensile strength (0.77 ± 0.12 MPa) and elongation (2.67 ± 0.67%) were found in films produced using 2.0% MA. Barrier properties to water vapour were improved by compatibilisers. FTIR analysis showed that CA and MA were able to promote esterification/transesterification reactions. Blends containing CA also showed better phase compatibilisation in the scanning electron microscopic images. It was found that in mixtures containing MA, the process and the concentration of this reagent need to be adapted to produce films with improved properties.
Psychometric testing of the Spanish version of the Practice Environment Scale of the Nursing Work Index in a primary healthcare context
Authors: De Pedro‐Gómez Joan , Morales‐Asencio José Miguel , Sesé‐Abad Albert , Bennasar‐Veny Miquel , Pericas‐Beltran Jordi , Miguélez‐Chamorro Angélica 
Published: June 2011

de pedro‐gómez j., morales‐asencio j.m., sesé‐abad a., bennasar‐veny m., pericas‐beltran J. & miguélez‐chamorro a. (2012) Psychometric testing of the Spanish version of the Practice Environment Scale of the Nursing Work Index in a primary healthcare context. Journal of Advanced Nursing68(1), 212–221.AbstractAim.  This paper is a report of psychometric testing of the Spanish version of the Practice Environment Scale of the Nursing Work Index for use in a primary health care.Background.  The Practice Environment Scale of the Nursing Work Index has been widely used in different studies and contexts. However, there is no validated version for primary care nursing staff in Spain.Methods.  A descriptive, multicentre, cross‐sectional study for transcultural adaptation and psychometric validation purposes. Data were collected from October 2009 to January 2010. To test the reliability of the factors in the measurement model, Cronbach’s alpha was used. To study the measurement model, different structural models were tested, using exploratory and confirmatory factor analyses. 377 completed questionnaires were obtained from a total of 553 nurses working for the Public Health Service in the Balearic Islands (Spain). This represents a response rate of 68·2%.Results.  For overall reliability, a Cronbach alpha of 0·91 was obtained. The confirmatory analysis upholds the original five‐factor structure.Conclusion.  The excellent goodness of fit of the confirmatory analysis corroborates the validity of this adapted version in primary healthcare contexts.
Moderators of access and utilization of clinical preventive services in older adults
Authors: Garmon Bibb Sandra C. , Padden Diane L. , Ferguson Wakettia 
Published: June 2011

garmon bibb s.c., padden d.l. & ferguson w. (2012) Moderators of access and utilization of clinical preventive services in older adults. Journal of Advanced Nursing 68(2), 335–348.AbstractAim.  This paper reports a study exploring the relationships between potential moderators of access and utilization of clinical preventive services in a homogeneous sample of older adults with near universal health coverage.Background.  Advancements have occurred in eliminating financial and structural barriers to utilization of clinical preventive services (primary, secondary and tertiary prevention) in most developed countries, but variations in utilization continue. These variations may be attributed to non‐social determinants of health moderators that impact utilization in older adults.Methods.  Theorized relationships were explored using questions from the United States Behavioral Risk Factor Surveillance System Survey and a homogenous convenience sample of 202 older adults (mean age 84; sd 5·23) with near universal health coverage. Data collected across a 2 year period (2007–2009) were analysed using Chi‐square, Mann–Whitney U and Hierarchical Logistic Regression.Findings.  Several logistic regression models of personal access (advised to lose weight, high blood pressure, high cholesterol); moderators (gender, perceived health status, BMI ≥ 30 kg/m2); and clinical preventive services utilization (check‐up in last 12 months; ever had colonoscopy/sigmoidoscopy) showed statistically significant (P < 0·05) improvement in model fit by adding interaction terms (access X moderator).Conclusion.  Exploring the impact of moderators on utilization may yield more insight into variations than could be explained by measurement of the direct affect of having near universal health coverage alone.
Usefulness of Aggressive Behaviour Risk Assessment Tool for prospectively identifying violent patients in medical and surgical units
Authors: Kim Son Chae , Ideker Kristyn , Todicheeney‐Mannes Dale 
Published: June 2011

kim s.c., ideker k. & todicheeney‐mannes d. (2012) Usefulness of Aggressive Behaviour Risk Assessment Tool for prospectively identifying violent patients in medical and surgical units. Journal of Advanced Nursing 68(2), 349–357.AbstractAim.  The aim of this study is to evaluate the usefulness of the Aggressive Behaviour Risk Assessment Tool for prospectively identifying violent patients in medical‐surgical units.Background.  Although patient violence against nurses is a serious occupational hazard, there is a lack of simple screening tools with acceptable sensitivity and specificity for identifying potentially violent patients in medical‐surgical units.Methods.  A prospective cohort study involving patients admitted to six medical‐surgical units at an acute care hospital was conducted from August 2009 to December 2009. Primary nurses completed the 17‐item checklist within 24 hours of admission. A second identical checklist was completed by another nurse to assess the inter‐rater reliability. Following a violent event or just prior to discharge, the violent event outcome section was completed to collect information about violent event, if any. A multivariate logistic regression model with backward elimination was used to select a set of parsimonious items that best predict violent behaviours.Results.  Fifty‐six patients out of 2063 (2·7%) had one or more violent events. A parsimonious set of ten items were selected for the tool. Receiver Operating Characteristics analysis of Aggressive Behaviour Risk Assessment Tool showed that the area under the curve was 0·82 (95% Confidence Interval, 0·75–0·90). The sensitivity and specificity at the cut‐off score of 1 were 70·9% and 89·3%, respectively. The Cohen’s Kappa for inter‐rater reliability was 0·647.Conclusion.  The Aggressive Risk Assessment Tool is a simple, easy‐to‐use assessment tool with acceptable inter‐rater reliability, sensitivity and specificity that may be useful for prospectively identifying violent patients in medical‐surgical units.
Transcultural spirituality: the spiritual journey of hospitalized patients with schizophrenia in Taiwan
Authors: Yang Chun‐Tien , Narayanasamy Aru , Chang Sung‐Ling 
Published: June 2011

Yang
C.‐T., Narayanasamy A. & Chang S.‐L. (2012) Transcultural spirituality: the spiritual journey of hospitalized patients with schizophrenia in Taiwan. Journal of Advanced Nursing 68(2), 358–367.AbstractAim.  The aim of this study was to explore how hospitalization and the diagnosis of schizophrenia have an impact on Taiwanese patients’ spiritual life.Background.  Psychiatric nurses tend to construe patients’ spiritual issues as pathological problems and consequently are reluctant to address patient’s spirituality, which results in spirituality being overlooked in mental illness. An individual’s spiritual journey is dependent upon their cultural background and beliefs; however, the professional’s preconceived ideas suppress the voice of patients with schizophrenia to share their experiences of their spiritual journey. The lack of research exploring spirituality in mental illness in Taiwan means that spiritual care is overlooked in practice. This study sets out to explore spirituality from the perspectives of patients in two mental hospitals in Taiwan.Methods.  Using a qualitative approach, 22 long‐term hospitalized patients diagnosed with schizophrenia were interviewed. Several themes from the data were identified using Ritchie and Spencer’s (1994) five stages analytical framework. The study was carried out from 2006 to 2008.Results.  Patients revealed spiritual distress as a consequence of prolonged hospitalization. They used referents consistent with traditional Chinese philosophical perspectives derived from Taoism and Confucianism to describe various features of their spiritual distress and their longing for spiritual revival, transcendence and to be accepted as normal persons.Conclusions.  In this age of globalization, nurses need to be fully cognisant of the cultural aspects of patients to respond to a mental health patient’s spirituality. Clinical and educational guidelines and policies could be developed for spiritual care in Taiwan.