bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility and efficacy of neoadjuvant sunitinib before nephron‐sparing surgery
Authors: Silberstein Jonathan L. , Millard Frederick , Mehrazin Reza , Kopp Ryan , Bazzi Wassim , DiBlasio Christopher J. , Patterson Anthony L. , Downs Tracy M. , Yunus Furhan , Kane Christopher J. , Derweesh Ithaar H. 
Published: April 2010

Study type – Therapy (case series) Level of Evidence 4OBJECTIVETo investigate efficacy of neoadjuvant tyrosine kinase‐inhibitor therapy (TKI) before imperative nephron‐sparing surgery (NSS), as NSS in patients with large locally advanced or centrally located tumours can be challenging, and TKI therapy might result in a reduction of primary tumour burden and increase the feasibility of NSS.PATIENTS AND METHODSThis was a multicentre retrospective review and prospective pilot study of patients undergoing neoadjuvant sunitinib before planned NSS from February 2006 to February 2009. All patients underwent confirmatory biopsy for clear cell renal cell carcinoma. Patients received two 28‐day cycles of sunitinib before NSS. Demographics/tumour characteristics, tumour response (by the Response Evaluation Criteria In Solid Tumors), outcomes and complications were analysed.RESULTSTwelve patients (seven men and five women; mean age 60.1 years, tumours on 14 renal units) were given TKI before NSS for imperative indications. The mean pretreatment tumour diameter was 7.1 cm; all patients had a decrease in size of the primary tumour after TKI, with a mean reduction in maximum diameter of 1.5 cm (21.1%). Four of 14 and 10 of 14 primary tumours had a partial response and stable disease after TKI. NSS was achievable in all 14 kidneys. Four patients had a concurrent metastasectomy. The mean warm ischaemia time was 22.5 min; postoperative dialysis was not required in any patients. Final pathology revealed negative tumour margins in all 14 tumours. The mean creatinine and estimated glomerular filtration rate (before/after NSS) were 1.34/1.40 mg/dL (P = 0.431) and 57.7/53.4 mL/min/1.73 m2 (P = 0.475), respectively. At a mean follow‐up of 23.9 months, 10 of the 12 patients were alive, one died from metastatic RCC and none required dialysis. Three of the 14 renal units developed delayed urinary leaks, all in patients who also received postoperative sunitinib. All leaks resolved with conservative measures.CONCLUSIONSNeoadjuvant TKI followed by NSS is safe and feasible, with all patients achieving a reduction in maximum tumour diameter, and with NSS being achievable with negative margins and with no requirement for postoperative dialysis. Further investigation is required.
Suppression of bladder overactivity by activation of somatic afferent nerves in the foot
Authors: Tai Changfeng , Shen Bing , Chen Mang , Wang Jicheng , Liu Hailong , Roppolo James R. , de Groat William C. 
Published: April 2010

What’s known on the subject? and What does the study add? It is known that electrical stimulation of the sacral root, pudendal nerve, or tibial nerve can inhibit bladder overactivity. These stimulation methods require surgery or repeated clinical visits that are expensive and inconvenient.This study shows for the first time that electrical stimulation of the foot can suppress bladder overactivity. Stimulation of the foot is non‐invasive, easily accessible, and convenient, which could be a widely acceptable treatment for bladder overactivity.OBJECTIVETo investigate the possibility of suppressing bladder overactivity by electrical activation of somatic afferent nerves in the foot.MATERIALS AND METHODSCats with an intact spinal cord were studied under α‐chloralose anaesthesia. Bladder pressure was recorded via a urethral catheter. Foot stimulation was applied via surface pad electrodes attached to the skin of the front or hind foot.RESULTSReflex micturition was inhibited by electrical stimulation of the hind foot at either low (5 Hz) or high (20 Hz) frequencies, but stimulation of the front foot was ineffective. The mean (sem) bladder capacity during a saline infusion cystometrogram (CMG) was significantly (P < 0.05) increased to 153.2 (18.2)% and 136.9 (14.3)% of the control bladder capacity by stimulation at frequencies of 5 Hz and 20 Hz, respectively. Intravesical infusion of 0.25% acetic acid (AA) induced bladder overactivity and reduced bladder capacity to 20.3 (8.9)% of the control capacity measured during saline infusion. Foot stimulation inhibited the AA‐induced bladder overactivity recorded under isovolumetric conditions, and significantly (P < 0.05) increased bladder capacity during AA infusion. However, it only restored the small bladder capacity caused by AA irritation to 40–50% of the control bladder capacity measured during saline infusion. The effect of foot stimulation did not persist after termination of stimulation during repeated CMG tests.CONCLUSIONSThis study shows the potential of noninvasive transcutaneous electrical stimulation of somatic nerves in the foot to inhibit reflex bladder activity and treat overactive bladder symptoms.
Dimensions of CEO–Board Relations
Authors: Boyd Brian K. , Haynes Katalin Takacs , Zona Fabio 
Published: April 2010

abstractInteractions between CEOs and their boards of directors are a prominent focus of management and strategy research. Despite the extensive literature on CEO–board relations, to date there has been limited integration of theoretical perspectives and measurement schemes. Through an extensive analysis of published studies, we hope to facilitate future research on CEO–board relations. We begin with a comparison of key theoretical approaches. Next, we conduct a content analysis of 51 empirical articles. We find that prior studies have an unbalanced focus regarding both topics and theoretical perspectives, and that there is limited consistency in the choice of measures. Based on this review, we lay out a number of promising directions for future research. We also find that, while there has been progress in international research on CEO–board relations, there are still many unanswered questions regarding the generalizability of governance theories across different geographic settings.
Predicting Placement Breakdown: Individual and Environmental Factors Associated with the Success or Failure of Community Residential Placements for Adults with Intellectual Disabilities
Authors: Phillips Neil , Rose John 
Published: April 2010

Background  Individuals with intellectual disabilities are more likely to experience a breakdown in their community residential placement if they display ‘challenging’ behaviour. However, some individuals with behaviour that poses a severe challenge live successfully in community services long‐term, indicating that other factors are also important. This study seeks to test the validity of a proposed framework for placement breakdown that incorporates elements of Weiner’s theory of helping behaviour, in particular, staff attributions of control about the causes of an individual’s challenging behaviour.Method  The study employed a between‐subjects design with two non‐experimental groups, controlling for the presence of challenging behaviour. One of these groups experienced a placement breakdown, whilst the other remained in the same placement. Staff completed questionnaires measuring a range of individual and service‐related factors.Results  No differences were found between the groups in overall levels of challenging behaviour, although the breakdown group displayed higher rates of ‘intentional’ antisocial behaviour. Breakdown was predicted by a combination of increased community self‐sufficiency skills, attributions of a greater degree of control by the most senior members of staff, and lower levels of interaction and help from staff. Services in which a breakdown occurred were also of poorer overall quality, particularly in terms of staff resources and energy levels, the physical environment and administrative systems. Individuals experiencing breakdown were more likely to have had at least one acute behavioural or psychiatric admission.Conclusions  Support was obtained for the proposed framework, indicating that staff attributions of control may play a mediating role between the challenging behaviour of an individual and the subsequent risk of placement breakdown. This has implications clinically in the identification of those at greater risk, given that this may not necessarily be those with the most severe challenging behaviour. Interventions to reduce this risk will need to address the way that staff think about challenging behaviour. Further research is required to test the validity of the framework.
Predictors of Job Satisfaction among Staff in Residential Settings for Persons with Intellectual Disabilities: A Comparison between Three Residential Models
Authors: Chou Yueh‐Ching , Kröger Teppo , Lee Yue‐Chune 
Published: April 2010

Background  This cross‐sectional study aims to assess whether there are differences in staff job satisfaction, including organizational and individual characteristics, between three residential models for adults with intellectual disabilities (small residential home, group home and institution) and to investigate the organizational and individual variables associated with staff job satisfaction.Methods  A standardized self‐administered questionnaire (Job Satisfaction Survey) was distributed together with demographic questions between April 2007 and June 2007. In total, 1301 staff members completed the questionnaire.Results  We found that staff working at small homes had a significantly higher level of job satisfaction than staff from the other two models. Logistic regression revealed that the characteristics of the organizations at which they were employed rather than the staff’s individual characteristics were strongly associated with job satisfaction.Conclusion  This study suggests that the residential model and the provider sector of the residential setting are the factors of concern when ensuring staff job satisfaction.
A Comparison of Quality of Life Outcomes for People with Intellectual Disabilities in Supported Employment, Day Services and Employment Enterprises
Authors: Beyer Stephen , Brown Tony , Akandi Rachel , Rapley Mark 
Published: April 2010

Background  Policy objectives for people with intellectual disabilities include day service modernization and the promotion of paid employment and quality of life. Quality of life is under represented as an outcome measure in vocational research. This research compares subjective and objective quality of life, and quality of work environment for adults with intellectual disabilities in supported employment, employment enterprises and day services with non‐disabled workers in community employment.Methods  Comprehensive Quality of Life Scale, and Work Environment Scale were collected for people with intellectual disabilities: 17 supported employees; 10 employment enterprise workers; 10 day service attendees; and 17 non‐disabled work colleagues of supported employees.Results  Supported employees reported higher objective quality of life than employment enterprise workers and day service attendees. Non‐disabled co‐workers reported higher objective quality of life and autonomy at work than the three groups of people with intellectual disabilities. Supported employees reported higher subjective quality of life than non‐disabled co‐workers.Conclusions  The findings support the utility of supported employment as a means to provide constructive occupation and enhanced quality of life to people with intellectual disabilities. However, closing the gap with respect to non‐disabled co‐workers on objective quality of life measures represents a challenge and will require improving the quality of job finding and workplace support and the training provided.
An Investigation of Nursing Staff Attitudes and Emotional Reactions Towards Patients with Intellectual Disability in a General Hospital Setting
Authors: Lewis Sharna , Stenfert‐Kroese Biza 
Published: April 2010

Background  It has been suggested that inequalities in health care for people with intellectual disabilities may be partly explained by negative attitudes of health professionals. This study aimed to investigate the attitudes and emotional reactions reported by nursing staff working in general hospitals towards caring for patients with intellectual disabilities.Method  Attitudes and emotional reactions were measured using a self‐report, vignette style questionnaire, tested for validity and reliability. Attitudes towards patients with physical disabilities were also assessed to act as a comparison.Results  Nursing staff reported less positive attitudes, more negative emotions and fewer positive emotions, in response to caring for a patient with an intellectual disability compared to a patient with a physical disability. Occupational status (registered general nurse, student nurse, nursing assistant) had no effect upon respondents reported attitudes or emotions. Finally, attitudinal and emotional variables were significantly correlated, with positive emotions being associated with more favourable attitudes.Conclusions  Although caution needs to be exercised when inferring actual behaviour from attitudes expressed, it is suggested that the presence of less positive attitudes and feelings amongst nursing staff towards patients with intellectual disabilities may affect the quality of care. Recommendations for future research and service development includes: the need to focus upon improving attitudes of nursing staff through training, and increased joint working between acute care services and Community Intellectual Disability Teams.
The Subjective Experiences of People with an Intellectual Disability and Diagnosis of Schizophrenia Who are Detained in a Medium Secure Unit
Authors: Cookson Alex , Dickson Joanne M. 
Published: April 2010

Background  This paper examines the experiences of people with intellectual disabilities, in secure care, with a diagnosis of schizophrenia. The paper specifically looks at the perceptions of the participants in relation to their diagnosis and experience of psychosis.Method  Eleven adults with intellectual disabilities in a medium secure unit were interviewed about their experiences and understanding of their diagnosis of schizophrenia and symptoms of psychosis. The transcripts were analysed using Interpretative Phenomenological Analysis (IPA).Results  Three Superordinate themes were evident within the data as well as several subthemes; (i) reality of symptoms (voices as controlling/malevolent, symptoms as a real lived experience); (ii) making sense/a search for meaning (normalization, religious/spiritual explanation, psychotic symptoms as a sign of illness) and (iii) Perceptions of being labelled.Conclusion  The results highlighted that people with intellectual disabilities hold multiple frameworks in understanding both their diagnosis of schizophrenia and the associated symptoms of psychosis. The findings provide further insight into the experiences of people with intellectual disabilities, specifically those detained within a medium secure unit. The clinical implications are discussed in terms of developing services and therapeutic approaches.
Impact of cytomegalovirus (CMV) antibody reflex testing in the transfusion service on management of CMV‐seronegative blood inventory
Authors: Fontaine Magali J. , Jurado Christine , Miller Evelyn , Viele Maurene , Goodnough Lawrence T. 
Published: April 2010

BACKGROUND: Our goal is to minimize unnecessary cytomegalovirus (CMV)‐seronegative blood transfusion to preserve the CMV‐seronegative blood inventory for patients who are identified as CMV seronegative.STUDY DESIGN AND METHODS: We implemented a CMV antibody reflex testing protocol for patients who require CMV‐compatible blood but in whom a CMV serostatus is unknown (coded as CMVT in our computer system). A solid‐phase red blood cell (RBC) adherence antibody detection system was validated to detect CMV antibodies in plasma samples (received for ABO/Rh type and RBC antibody screen) with acceptable sensitivity and specificity. We evaluated the impact of this CMV antibody reflex testing on the management of RBC and platelet (PLT) inventory for patients requiring CMV‐compatible blood.RESULTS: Over a 16‐month period, implementation of CMV antibody reflex testing identified 361 (34%) of 1063 previously CMV‐untested patients who required CMV‐compatible blood and who were CMV seronegative. We observed a 75% decrease in the number of CMVT patients in our data base from 190 per month before implementation to 57 at 16 months postimplementation. Consequently we reevaluated the percentage in our blood inventory of CMV‐seronegative units required while potentially saving 1234 CMV‐seronegative blood products (835 RBCs and 399 PLTs) each month.CONCLUSION: A strategy of performing CMV antibody reflex testing in the transfusion service allows more effective blood inventory management and control in maintaining a CMV‐seronegative blood inventory dedicated for patients who truly require it.
Transfusion of antibody‐opsonized red blood cells results in a shift in the immune response from the red blood cell to the antibody in a murine model
Authors: Brinc Davor , Le‐Tien Hoang , Crow Andrew R. , Semple John W. , Freedman John , Lazarus Alan H. 
Published: April 2010

BACKGROUND:It is well known that infusion of immunoglobulin (Ig)G‐coated cells results in an inhibited antigen‐specific humoral immune response compared to the cells themselves, a phenomenon termed antibody‐mediated immune suppression (AMIS). Although this AMIS effect has been well described with many different types of cells as well as vaccines and insoluble antigens, the mechanisms behind this effect remain unresolved.STUDY DESIGN AND METHODS:To study AMIS in a broad context, three different models of AMIS were studied. In the first, mice were transfused with sheep red blood cells (SRBCs) versus IgG‐coated SRBCs. In the second, SRBCs expressing the antigen hen egg white lysozyme (HEL) were studied, and the third model consisted of the diphtheria/tetanus vaccine in the absence versus presence of anti‐tetanus IgG. The antibody responses to the SRBCs and HEL‐SRBCs, as well as the vaccine, were analyzed for up to 4 weeks after challenge.RESULTS:In these mouse models of immunization, the IgG‐coated RBCs or HEL‐RBCs induced an antibody response against the IgG, rather than against the RBCs. The decreased response to the RBCs was directly related to the increase of the response against the IgG. The inhibitory AMIS effect using the vaccine strategy again showed an immune response against the IgG, concurrent with a decrease in the immune response against the specific vaccine component targeted.CONCLUSIONS:This work demonstrates that, under AMIS conditions, the IgG itself becomes the focus of B cells in the immune system, suggesting a potential mechanism of B‐cell regulation.
A virally inactivated platelet‐derived growth factor/vascular endothelial growth factor concentrate fractionated from human platelets
Authors: Burnouf Thierry , Kuo Ya Po , Huang Chun Ting , Tseng Yu Hung , Lin Che Tong , Su Chen Yao 
Published: April 2010

BACKGROUND: Human platelet concentrates (PCs) may be a source material to produce purified growth factors (GFs) for clinical use or cell therapy. However, no fractionation process of therapeutic‐grade GF from PCs has ever been developed.STUDY DESIGN AND METHODS: PCs were virally inactivated by solvent/detergent (S/D) treatment, subjected to oil extraction to remove part of the S/D agents, and fractionated on a SP‐Sepharose (SP) chromatographic column equilibrated in a phosphate‐buffered saline (PBS) buffer, pH 7.5. The breakthrough was recovered, and the column was washed with the PBS buffer and then eluted by a 0.7 mol/L NaCl‐PBS buffer pH 7.5 (SP‐eluate). The SP‐breakthrough and SP‐eluate were characterized for their content in GF, proteins, lipids, and S/D agents. The MTS value of three cell lines cultivated in a medium containing 10% fetal bovine serum supplemented with 1% to 3% of SP‐eluate or recombinant human (rHu) platelet‐derived growth factor (PDGF)‐BB was compared.RESULTS: The SP‐eluate contained a mean of 47, 17, and 6 ng/mL PDGF‐AB, ‐BB, and ‐AA, respectively, and 0.26 ng/mL vascular endothelial growth factor (VEGF). It was largely depleted of transforming growth factor‐β1 (2.33 ng/mL), epidermal growth factor (0.09 ng/mL), insulin‐like growth factor (3.40 ng/mL), albumin, immunoglobulin (Ig)G, IgM, IgA, and fibrinogen, which were mostly in the breakthrough. tri‐n‐butyl phosphate and Triton X‐45 were less than 2 ppm. Cell growth–promoting activity of the SP‐eluate was at least as good as that of rHu‐PDGF‐BB.CONCLUSION: Human PC can be fractionated into a purified, virally inactivated PDGF and VEGF concentrate, opening perspectives for the development of a new range of blood products for clinical use and cell therapy procedures.
Demographic correlates of low hemoglobin deferral among prospective whole blood donors
Authors: Mast Alan E. , Schlumpf Karen S. , Wright David J. , Custer Brian , Spencer Bryan , Murphy Edward L. , Simon Toby L. ,   for the NHLBI Retrovirus Epidemiology Donor Study‐II
Published: April 2010

BACKGROUND: Approximately 10% of attempted blood donations are not allowed because of low hemoglobin (Hb) deferral.STUDY DESIGN AND METHODS: Low Hb deferrals were tracked in more 715,000 whole blood donors at six blood centers across the United States. A multivariable logistic regression model was developed to comprehensively assess demographic correlates for low Hb deferral.RESULTS: Demographic factors significantly associated with low Hb deferral include female sex (11 times greater odds than males), increasing age in men (men over 80 have 29 times greater odds than men under 20), African American race (2‐2.5 times greater odds than Caucasians), Hispanic ethnicity in women (1.29 times greater odds than Caucasian women), and weight in men (men under 124 pounds have 2.5 times greater odds than men over 200 pounds). Interestingly, increasing donation frequency is associated with decreased odds for low Hb deferral (women with one donation in the previous 12 months have two times greater odds than those with six donations).CONCLUSIONS: Low Hb deferral is associated with female sex, older age, African American race/ethnicity, and lower body weight in men. An inverse association with donation frequency suggests a selection bias in favor of donors able to give more frequently. These data provide useful information that can be utilized to manage blood donors to limit low Hb deferrals and assist in policy decisions such as changing the Hb cutoff or permissible frequency of donation. They also generate hypotheses for new research of the causes of anemia in defined groups of donors.