bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinician awareness of tetanus-diphtheria vaccination in trauma patients: a questionnaire study
Authors: Yoon Young-Hoon , Moon Sung-Woo , Choi Sung-Hyuk , Cho Young-Duck , Kim Jung-Youn , Kwak Young Ho 
Published: May 2012

Abstract

Background
Most trauma patients visit the hospital via the emergency department. They are at high risk for tetanus infection because many trauma patients are wounded. Tetanus immunity in the Korean population has been revealed to be decreased in age groups over 20 years old. It is important for emergency physicians to vaccinate patients with the tetanus booster in wound management.

Methods
Questionnaires were sent to the directors of the emergency departments of resident training hospitals certified by the Korean Society of Emergency Medicine.

Results
Two thirds of the emergency department directors surveyed reported applying tetanus prophylaxis guidelines to more than 80% of wounded patients. However, about 45% of clinicians in the emergency departments considered giving less than half of the wounded patient tetanus booster vaccinations, and there were no distinct differences in tetanus booster vaccination rates among different age groups. Most emergency physicians are familiar with tetanus prophylaxis guidelines for wound management. However, more than half of the emergency department directors reported that the major reason for not considering tetanus-diphtheria vaccination was due to assumptions that patients already had tetanus immunity.

Conclusion
Attitude changes should be encouraged among emergency physicians regarding tetanus prophylaxis. As emergency physicians are frequently confronted with patients that are at a high risk for tetanus infection in emergency situations, they need to be more informed regarding tetanus immunity epidemiology and encouraged to administer tetanus booster vaccines.
Noninvasive mechanical ventilation may be useful in treating patients who fail weaning from invasive mechanical ventilation: a randomized clinical trial
Authors: Trevisan Cristiane E , Vieira Silvia R ,   the Research Group in Mechanical Ventilation Weaning
Published: May 2012

Abstract
Introduction
The use of noninvasive positive-pressure mechanical ventilation (NPPV) has been investigated in several acute respiratory failure situations. Questions remain about its benefits when used in weaning patients from invasive mechanical ventilation (IMV). The objective of this study was to evaluate the use of bi-level NPPV for patients who fail weaning from IMV.

Methods
This experimental randomized clinical trial followed up patients undergoing IMV weaning, under ventilation for more than 48 hours, and who failed a spontaneous breathing T-piece trial. Patients with contraindications to NPPV were excluded. Before T-piece placement, arterial gases, maximal inspiratory pressure, and other parameters of IMV support were measured. During the trial, respiratory rate, tidal volume, minute volume, rapid shallow breathing index, heart rate, arterial blood pressure, and peripheral oxygen saturation were measured at 1 and 30 minutes. After failing a T-piece trial, patients were randomly divided in two groups: (a) those who were extubated and placed on NPPV and (b) those who were returned to IMV. Group results were compared using the Student t test and the chi-square test.

Results
Of 65 patients who failed T-piece trials, 28 were placed on NPPV and 37 were placed on IMV. The ages of patients in the NPPV and IMV groups were 67.6 ± 15.5 and 59.7 ± 17.6 years, respectively. Heart disease, post-surgery respiratory failure, and chronic pulmonary disease aggravation were the most frequent causes of IMV use. In both groups, ventilation time before T-piece trial was 7.3 ± 4.1 days. Heart and respiratory parameters were similar for the two groups at 1 and 30 minutes of T-piece trial. The percentage of complications in the NPPV group was lower (28.6% versus 75.7%), with lower incidences of pneumonia and tracheotomy. Length of stay in the intensive care unit and mortality were not statistically different when comparing the groups.

Conclusion
The results suggest that NPPV is a good alternative for ventilation of patients who fail initial weaning attempts. NPPV reduces the incidence of pneumonia associated with mechanical ventilation and the need for tracheotomy.

Trial registration
CEP HCPA (02–114).
Phase II Trial of Vorinostat With Idarubicin and Cytarabine for Patients With Newly Diagnosed Acute Myelogenous Leukemia or Myelodysplastic Syndrome
Authors: Garcia-Manero Guillermo , Tambaro Francesco Paolo , Bekele Nebiyou B. , Yang Hui , Ravandi Farhad , Jabbour Elias , Borthakur Gautam , Kadia Tapan M. , Konopleva Marina Y. , Faderl Stefan , Cortes Jorge E. , Brandt Mark , Hu Yumin , McCue Deborah , Newsome Willie Mae , Pierce Sherry R. , de Lima Marcos , Kantarjian Hagop M. 
Published: May 2012

PurposeTo evaluate the safety and efficacy of the combination of the histone deacetylase inhibitor vorinostat with idarubicin and ara-C (cytarabine) in patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS).Patients and MethodsPatients with previously untreated AML or higher-risk MDS age 15 to 65 years with appropriate organ function and no core-binding factor abnormality were candidates. Induction therapy was vorinostat 500 mg orally three times a day (days 1 to 3), idarubin 12 mg/m2intravenously (IV) daily × 3 (days 4 to 6), and cytarabine 1.5 g/m2IV as a continuous infusion daily for 3 or 4 days (days 4 to 7). Patients in remission could be treated with five cycles of consolidation therapy and up to 12 months of maintenance therapy with single-agent vorinostat. The study was designed to stop early if either excess toxicity or low probability of median event-free survival (EFS) of more than 28 weeks was likely.ResultsAfter a three-patient run-in phase, 75 patients were treated. Median age was 52 years (range, 19 to 65 years), 29 patients (39%) were cytogenetically normal, and 11 (15%) had FLT-3 internal tandem duplication (ITD). No excess vorinostat-related toxicity was observed. Induction mortality was 4%. EFS was 47 weeks (range, 3 to 134 weeks), and overall survival was 82 weeks (range, 3 to 134 weeks). Overall response rate (ORR) was 85%, including 76% complete response (CR) and 9% in CR with incomplete platelet recovery. ORR was 93% in diploid patients and 100% in FLT-3 ITD patients. Levels of NRF2 and CYBB were associated with longer survival.ConclusionThe combination of vorinostat with idarubicin and cytarabine is safe and active in AML.
Sex Differences in Fertility-Related Information Received by Young Adult Cancer Survivors
Authors: Armuand Gabriela M. , Rodriguez-Wallberg Kenny A. , Wettergren Lena , Ahlgren Johan , Enblad Gunilla , Höglund Martin , Lampic Claudia 
Published: May 2012

Purpose The aim was to investigate male and female cancer survivors' perception of fertility-related information and use of fertility preservation (FP) in connection with cancer treatment during reproductive age. Methods The study sample consisted of cancer survivors diagnosed from 2003 to 2007 identified in population-based registers in Sweden. Inclusion criteria included survivors who were age 18 to 45 years at diagnosis and had lymphoma, acute leukemia, testicular cancer, ovarian cancer, or female breast cancer treated with chemotherapy. Of 810 eligible participants, 484 survivors (60% response rate) completed a postal questionnaire. Results The majority of male participants reported having received information about treatment impact on fertility (80%) and FP (68%), and more than half of the men banked frozen sperm (54%). Among women, less than half (48%) reported that they received information about treatment impact on fertility, and 14% reported that they received information about FP. Only seven women (2%) underwent FP. Predictors for receiving information about treatment impact on fertility were a pretreatment desire to have children (odds ratio [OR], 3.5), male sex (OR, 3.2), and being ≤ 35 years of age at diagnosis (OR, 2.0). Predictors for receiving information about FP included male sex (OR, 14.4), age ≤ 35 at diagnosis (OR, 5.1), and having no children at diagnosis (OR, 2.5). Conclusion Our results show marked sex differences regarding the receipt of fertility-related information and use of FP. There is an urgent need to develop fertility-related information adapted to female patients with cancer to improve their opportunities to participate in informed decisions regarding their treatment and future reproductive ability.
Prospective Study of Falls and Risk Factors for Falls in Adults With Advanced Cancer
Authors: Stone Carol A. , Lawlor Peter G. , Savva George M. , Bennett Kathleen , Kenny Rose Anne 
Published: May 2012

Purpose Retrospective studies of inpatients with cancer suggest that a cancer diagnosis confers a high risk of falls. In adults with advanced cancer, we aimed to prospectively document the incidence of falls, identify the risk factors, and determine if falls in this population occur predominantly in older patients. Patients and Methods Patients admitted consecutively to community and inpatient palliative care services with metastatic or locoregionally advanced cancer who were mobile without assistance were recruited. Risk-factor assessment was conducted on initial encounter. Patients underwent follow-up via weekly telephone contact for 6 months or until time of fall or death. Relationship between covariates and time to fall was examined using hazard ratios (HRs) derived from univariate and multivariate Cox proportional hazards models. Results Of 185 participants (52.4% men; mean age 68 ± standard deviation of 12.6 years), 50.3% fell; 35 (53%) of 66 participants age < 65 years and 58 (48.7%) of 119 age ≥ 65 years fell; 61.3% of falls occurred in the community; 42% resulted in injury. Median time to fall was 96 days (95% CI, 64.66 to 127.34). Primary brain tumor or brain metastasis (HR 2.5; P = .002), number of falls in the preceding 3 months (HR, 1.27; P = .005), severity of depression (HR, 1.12; P = .012), benzodiazepine dose (HR, 1.05; P = .004), and cancer-related pain (HR, 1.96; P = .024) were independently associated with time to fall in multivariate analysis. Conclusion Fifty percent of adults with advanced cancer, regardless of age, will experience a fall associated with high risk of physical injury. There is a compelling need to assess the efficacy of assessment and management of modifiable fall risk factors in patients with advanced cancer.
Differential Gene Expression by Oxyphil and Chief Cells of Human Parathyroid Glands
Authors: Ritter Cynthia S. , Haughey Bruce H. , Miller Brent , Brown Alex J. 
Published: May 2012

Abstract

Context:
Parathyroid oxyphil cells, whose function is unknown, are thought to be derived from chief cells. Oxyphil cells increase in number in parathyroid glands of patients with chronic kidney disease (CKD) and are even more abundant in patients receiving treatment for hyperparathyroidism with calcitriol and/or the calcimimetic cinacalcet.

Objective:
We examined oxyphil and chief cells of parathyroid glands of CKD patients for differential expression of genes important to parathyroid function.

Design/Setting/Participants:
Parathyroid tissue from CKD patients with refractory hyperparathyroidism was immunostained for gene expression studies.

Main Outcome Measure:
Immunostaining for PTH, PTHrP, calcium-sensing receptor, glial cells missing 2, vitamin D receptor, 25-hydroxyvitamin D-1α-hydroxylase, and cytochrome c was quantified and expression reported for oxyphil and chief cells.

Results:
Expression of all proteins analyzed, except for the vitamin D receptor, was higher in oxyphil cells than in chief cells.

Conclusion:
Human parathyroid oxyphil cells express parathyroid-relevant genes found in the chief cells and have the potential to produce additional autocrine/paracrine factors, such as PTHrP and calcitriol. Additional studies are warranted to define the secretory properties of these cells and clarify their role in parathyroid pathophysiology.
Epistemische Gerechtigkeit. Sozialempirie und Perspektivenpluralismus in der Angewandten Ethik
Authors: Schicktanz Silke 
Published: May 2012

Abstract
To demonstrate the necessity of (certain kinds of) social-empirical research in practical-moral judgment, I will present three interrelated arguments. Firstly, skepticism towards ethical expertise; secondly, the normative meaning of being affected; and thirdly, epistemic justice. Epistemic justice will be at the center of my contribution as it can be regarded to constitute the normative and epistemic basic condition for the other two arguments. Taken together they provide a conclusive argument for the necessity of the inclusion of certain perspectives, namely those of affected persons. Relying on Miranda Frickers concept of epistemic justice and Donna Haraways idea of situated knowledge, I will argue that these perspectives should be granted an ethically exclusive place in practical-moral judgment.
Genetic and Environmental Influences on Infant Sleep
Authors: Fisher Abigail , van Jaarsveld Cornelia H. M. , Llewellyn Clare H. , Wardle Jane 
Published: May 2012

BACKGROUND:Sleep duration is attracting increasing attention in relation to chronic disease risk, but few large-scale studies have investigated the determinants of sleep characteristics in early life. In this study we used data from a large, population-based twin study to examine genetic and environmental influences on sleep duration and sleep difficulties in infancy.METHODS:Participants were 1931 pairs of young twins (3862 children) from the Gemini twin birth cohort. Sleep patterns were assessed at 15 months by using a modification of the Brief Infant Sleep Questionnaire completed by parents. Outcomes included nighttime and daytime sleep duration and frequency of night waking.RESULTS:Twin analyses showed that nighttime sleep duration was predominantly influenced by the shared environment (66%, confidence interval [CI] 63%–70%) with a modest genetic effect (26%, CI 22%–30%). A similar pattern was observed for daytime nap duration (shared environment: 57%, CI 53%–62%; genetic effect: 37%, CI 33%–41%) and sleep disturbance (shared environment: 55%, 44%–64%) with a genetic effect of 40% (30%–51%). These estimates were similar for boys and girls.CONCLUSIONS:These results indicate an important contribution of the shared family environment as well as genes to children’s sleep behavior. There is a need for research to identify specific environmental determinants that could provide targets for interventions to improve sleep quality.
Postsecondary Education and Employment Among Youth With an Autism Spectrum Disorder
Authors: Shattuck Paul T. , Narendorf Sarah Carter , Cooper Benjamin , Sterzing Paul R. , Wagner Mary , Taylor Julie Lounds 
Published: May 2012

OBJECTIVES:
We examined the prevalence and correlates of postsecondary education and employment among youth with an autism spectrum disorder (ASD).

METHODS:
Data were from a nationally representative survey of parents, guardians, and young adults with an ASD. Participation in postsecondary employment, college, or vocational education and lack of participation in any of these activities were examined. Rates were compared with those of youth in 3 other eligibility categories: speech/language impairment, learning disability, and mental retardation. Logistic regression was used to examine correlates of each outcome.

RESULTS:
For youth with an ASD, 34.7% had attended college and 55.1% had held paid employment during the first 6 years after high school. More than 50% of youth who had left high school in the past 2 years had no participation in employment or education. Youth with an ASD had the lowest rates of participation in employment and the highest rates of no participation compared with youth in other disability categories. Higher income and higher functional ability were associated with higher adjusted odds of participation in postsecondary employment and education.

CONCLUSIONS:
Youth with an ASD have poor postsecondary employment and education outcomes, especially in the first 2 years after high school. Those from lower-income families and those with greater functional impairments are at heightened risk for poor outcomes. Further research is needed to understand how transition planning before high school exit can facilitate a better connection to productive postsecondary activities.
High ERK Protein Expression Levels Correlate with Shorter Survival in Triple-Negative Breast Cancer Patients
Authors: Bartholomeusz Chandra , Gonzalez-Angulo Ana M. , Liu Ping , Hayashi Naoki , Lluch Ana , Ferrer-Lozano Jaime , Hortobágyi Gabriel N. 
Published: May 2012

Abstract
The mitogen-activated protein kinase (MAPK) signaling pathway is known to be activated in triple-negative breast cancer (TNBC). Extracellular signal–related kinase (ERK), a member of the MAPK pathway, promotes cell proliferation, angiogenesis, cell differentiation, and cell survival. To assess the prognostic impact of ERK in TNBC patients, relative quantities of ERK (ERK-2 and pMAPK) and direct targets of the ERK pathway (MAPK/ERK kinase 1, phospho-enriched protein in astrocytes [PEA]-15, phosphorylated (p)PEA-15, tuberous sclerosis protein 2, p70S6 kinase, and p27) were measured using reverse-phase protein arrays in tumor tissue from patients with TNBC (n = 97) and non-TNBC (n = 223). Protein levels in patients with TNBC were correlated with clinical and tumor characteristics and outcome. The median age of patients with TNBC was 55 years (range, 27–86 years). Disease stage was I in 21%, II in 60%, and III in 20% of the patients. In a multivariate analysis, among patients with TNBC, those with ERK-2–overexpressing tumors had a lower overall survival rate than those with low ERK-2–expressing tumors (hazard ratio [HR], 2.76; 95% confidence interval [CI], 1.19–6.41). However, high pMAPK levels were associated with a significantly higher relapse-free survival rate (HR, 0.66; 95% CI, 0.46–0.95). In conclusion, ERK-2 and pMAPK are valuable prognostic markers in TNBC. Further studies are justified to elucidate ERK's role in TNBC tumorigenicity and metastasis.
High Let-7a MicroRNA Levels in KRAS-Mutated Colorectal Carcinomas May Rescue Anti-EGFR Therapy Effects in Patients with Chemotherapy-Refractory Metastatic Disease
Authors: Ruzzo Annamaria , Graziano Francesco , Vincenzi Bruno , Canestrari Emanuele , Perrone Giuseppe , Galluccio Nadia , Catalano Vincenzo , Loupakis Fotios , Rabitti Carla , Santini Daniele , Tonini Giuseppe , Fiorentini Giammaria , Rossi David , Falcone Alfredo , Magnani Mauro 
Published: May 2012

Abstract
Preclinical and experimental data in vivo indicate that Lethal-7 (Let-7) microRNA downregulates KRAS with antitumor effects in the presence of activating KRAS mutations. We quantified the Let-7a isoform in KRAS-mutated colorectal carcinomas from patients who received salvage cetuximab plus irinotecan. The study population was retrospectively identified among metastatic colorectal cancer patients who underwent third-line therapy with cetuximab plus irinotecan in a period when only epidermal growth factor receptor (EGFR) expression was required for anti-EGFR therapy. In 59 patients harboring KRAS mutations, Let-7a levels were analyzed for association with overall survival (OS) and progression-free survival (PFS) times. An exploratory subgroup analysis was performed using the rs61764370 (LCS6 T&gt;G) polymorphism that experimentally impairs Let-7 binding to KRAS mRNA. In the whole group, higher Let-7a levels were significantly associated with better survival outcomes. For the primary OS endpoint, the multivariate hazard ratio was 0.82 (95% confidence interval, 0.73–0.91; p = .01). The same findings with an accentuated positive effect of high Let-7a levels on both OS and PFS times were observed in an exploratory analysis of the 45 wild-type LCS6 patients (excluding 14 carriers of the LCS6 G allele variant). All survival associations were confirmed after excluding patients with KRAS codon 13 mutations. Among the clinicopathologic features, high Let-7a levels were associated with grade 2–3 skin toxicity (p = .002). In patients with KRAS mutations, Let-7a analysis may serve to identify subgroups of patients who may still benefit from EGFR inhibition and this may open up new perspectives for alternative treatment strategies.
Pharmacists and Harm Reduction: A Review of Current Practices and Attitudes
Authors: Watson Tyler , Hughes Christine 
Published: May 2012

Background: Injection drug use and other high-risk behaviours are the cause of signifcant morbidity and mortality and thus have been the focus of many health promotion strategies. Community pharmacists are considered underutilized health providers and are often thought to be more accessible than other health professionals. The purpose of this review is to provide an overview of community pharma cists' practices as well as pharmacists' attitudes and identified barriers toward providing harm reduction services. We will highlight the major harm reduction services being offered through community pharmacies, as well as identify barriers to implementing these services. Methods: A review of the literature from 1995 to 2011 was conducted using the electronic databases MEDLINE, PubMed and Scopus, encompassing pharmacists' involvement in harm reduction services. Keywords included pharmacist, harm reduction, disease prevention, health promotion, attitudes, competence and barriers. References of included articles were examined to identify further relevant literature. Results: Pharmacists are primarily involved in providing clean needles to injection drug users, as well as opioid substitution. Pharmacists generally have a positive attitude toward providing health promotion and harm reduction programs and express some interest in increasing their role in this area. Common barriers to expanding harm reduction strategies in community pharmacists' practice include lack of time and training, insufficient remuneration, fear of attracting unruly clientele and inadequate communication between health providers. Conclusion: As one of the most accessible health care providers, community pharmacists are in an ideal position to provide meaningful services to injection drug users. However, in order to do so, pharmacists require additional support in the form of better health team and system integration, as well as remuneration models.