bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opiate users' knowledge about overdose prevention and naloxone in New York City: a focus group study
Authors: Worthington Nancy , Markham Piper Tinka , Galea Sandro , Rosenthal David 
Published: May 2012

Abstract

Background
Drug-induced and drug-related deaths have been increasing for the past decade throughout the US. In NYC, drug overdose accounts for nearly 900 deaths per year, a figure that exceeds the number of deaths each year from homicide. Naloxone, a highly effective opiate antagonist, has for decades been used by doctors and paramedics during emergency resuscitation after an opiate overdose. Following the lead of programs in Europe and the US who have successfully distributed take-home naloxone, the Overdose Prevention and Reversal Program at the Lower East Side Harm Reduction Center (LESHRC) has started providing a similar resource for opiate users in NYC. Participants in the program receive a prescription for two doses of naloxone, with refills as needed, and comprehensive training to reduce overdose risk, administer naloxone, perform rescue breathing, and call 911. As of September 2005, 204 participants have received naloxone and been trained, and 40 have revived an overdosing friend or family member. While naloxone accessibility stands as a proven life-saving measure, some opiates users at LESHRC have expressed only minimal interest in naloxone use, due to past experiences and common misconceptions.

Methods
In order to improve the naloxone distribution program two focus groups were conducted in December 2004 with 13 opiate users at LESHRC to examine knowledge about overdose and overdose prevention. The focus groups assessed participants' (i) experiences with overdose response, specifically naloxone (ii) understanding and perceptions of naloxone, (iii) comfort level with naloxone administration and (iv) feedback about increasing the visibility and desirability of the naloxone distribution program.

Results
Analyses suggest that there is both support for and resistance to take-home naloxone, marked by enthusiasm for its potential role in reviving an overdosing individual, numerous misconceptions and negative views of its impact and use.

Conclusion
Focus group results will be used to increase participation in the program and reshape perceptions about naloxone among opiate users, also targeting those already prescribed naloxone to increase their comfort using it. Since NYC is advancing toward a citywide naloxone distribution program, the LESHRC program will play an important role in establishing protocol for effective and wide-reaching naloxone availability.
Radical hysterectomy in the elderly
Authors: Mousavi Azamsadat , Zarchi Mojgan Karimi , Modares Gilani Mitra , Behtash Nadereh , Ghaemmaghami Fatemeh , Shams Maryam , Irvanipoor Maryam 
Published: May 2012

Abstract

Background
The considerable increase in life expectancy on one hand and an increase in cervical cancer among Iranian patients on the other, brings out the importance of investigating whether radical surgery can be performed safely and effectively on patients above 60 years of age.

Methods
In a study of historical cohort, all 22 patients 60 years and above who have undergone a Wertheim radical hysterectomy for cervical cancer from 1999 to 2005 were compared with 128 matched cases under 60 years of age who had undergone a Wertheim hysterectomy during the same calendar year. All patients were analyzed for preexisting medical comorbidities, length of postoperative stay, morbidity, and postoperative mortality.

Results
There was no operative mortality in either group, morbidity (minor, p = 0.91; major, p = 0.89) were statistically not different in the two groups despite the patient's above 60 years having significantly higher comorbidity prior to surgery than the younger cohort (minor, P < 0.05; major, P < 0.05). The mean postoperative hospital stay was significantly longer in the older patients (5 days vs. 3 days, P < 0.001).

Conclusion
Wertheim Radical hysterectomy is a safe surgical procedure in the selected population of patients 60 years and over. No differences in operative mortality or morbidity were found when compared to a cohort of patient's aged 60 years or younger.
Role of cervical dendritic cell subsets, co-stimulatory molecules, cytokine secretion profile and beta-estradiol in development of sequalae to Chlamydia trachomatis infection
Authors: Agrawal Tanvi , Vats Vikas , Wallace Paul K , Salhan Sudha , Mittal Aruna 
Published: May 2012

AbstractBackgroundChlamydia trachomatis infection of the female genital tract can lead to serious sequelae resulting in fertility related disorders. Little is known about the mechanism leading to Chlamydia induced pathology and factors responsible for it. As only some of the women develops reproductive disorders while majority of the women clears infection without any severe sequalae, mucosal immune response in women with or without fertility disorders was studied to identify factors which may lead to final clinical outcome of chlamydial infection.MethodsMyeloid DCs (mDCs) and plasmacytoid DCs (pDCs) populations in cervical mucosa and peripheral blood were analyzed in controls and Chlamydia positive women with or without fertility disorders with multicoloured flow cytometric analysis. Cervical cytokines (IL-6, IL-8, IL-10, IL-12, TNF-alpha and IFN-gamma), C-reactive protein levels and sex hormone levels in serum were quantified by ELISA.ResultsIn cervix of Chlamydia positive women with fertility disorders, significantly high (P < 0.05) numbers of pDCs were present with increased CD80 expression. pDCs correlated significantly with C-reactive protein levels, IL-6 and IFN-gamma levels in women with fertility disorders. In contrast, mDCs showed significant upregulation of CD1a during chlamydial infection and correlated significantly with IL-12 levels in Chlamydia positive fertile women. β-estradiol levels were significantly higher in women having fertility disorders as compared to fertile women and have significant correlations (r = 0.65; P < 0.05) with pDCs numbers, CD80 expression, IL-6 levels and IFN-gamma levels in these women.ConclusionThese results suggest that development of sequalae in some women can be a result of interplay of many factors including type of dendritic cell, co stimulatory molecule expression, cytokine secretion pattern and hormone levels.
Is satisfaction a direct predictor of nursing turnover? Modelling the relationship between satisfaction, expressed intention and behaviour in a longitudinal cohort study
Authors: Murrells Trevor , Robinson Sarah , Griffiths Peter 
Published: May 2012

Abstract

Background
The theory of planned behaviour states that attitudinal variables (e.g. job satisfaction) only have an indirect effect on retention whereas intentions have a direct effect. This study uses secondary data from a longitudinal cohort of newly qualified nurses to test for the direct and indirect effects of job satisfaction (client care, staffing, development, relationships, education, work-life interface, resources, pay) and intentions to nurse on working as a nurse during the 3 years after qualification.

Methods
A national sample (England) of newly qualified (1997/98) nurses (n = 3669) were surveyed at 6 months, 18 months and 3 years. ANOVA and MANOVA were used for comparison of mean job satisfaction scores between groups; intentions to nurse (very likely, likely vs. unlikely, very unlikely and unable to say at this stage); working (or not working as a nurse) at each time-point. Indirect and direct effects were tested using structural equation and logistic regression models.

Results
Intentions expressed at 6 months to nurse at 18 months were associated with higher scores on pay and relationships, and intentions at 3 years were associated with higher scores on care, development, relationships, work-life interface, resources, pay respectively. Intentions expressed at 18 months to nurse at 3 years were associated with higher scores on development, relationships, education and work-life interface. Associations with actual nursing were fewer. Those working as a nurse had higher satisfaction scores for development (18 months) and relationships (3 years). Regression models found significant associations between the pay and staffing factors and intentions expressed at 6 months to nurse at 18 months, and between pay and intentions to nurse at 3 years. Many of the associations between intentions and working as a nurse were significant. Development was the only job satisfaction factor significantly associated with working as a nurse and just at 18 months.

Conclusion
Results partially support the theory of planned behaviour. Intentions expressed by nurses are stronger predictors of working as a nurse than job satisfaction. Retention strategies should focus on identifying nurses showing early signs of departure with emphasis on developmental aspects, mentoring and support.
Development of avian influenza virus H5 DNA vaccine and MDP-1 gene of Mycobacterium bovisas genetic adjuvant
Authors: Jalilian Babak , Omar Abdul Rahman , Bejo Mohd Hair , Alitheen Noorjahan Banu , Rasoli Mehdi , Matsumoto Sohkichi 
Published: May 2012

AbstractBackgroundStudies have shown that DNA vaccines can induce protective immunity, which demonstrated the high potential of DNA vaccines as an alternative to inactivated vaccines. Vaccines are frequently formulated with adjuvants to improve their release, delivery and presentation to the host immune system.MethodsThe H5 gene of H5N1 virus (A/Ck/Malaysia/5858/04) was cloned separately into pcDNA3.1 + vector. The immunogenicity of the cloned H5 DNA vaccine was tested on SPF chickens using two different approaches. First approach was using H5 DNA vaccine (pcDNA3.1/H5) and the second was using H5 DNA vaccine in addition to the pcDNA3.1/MDP1 vaccine. Ten days old chickens inoculated three times with two weeks intervals. The spleen and muscle samples from chickens immunized with H5 (pcDNA3.1/H5) and H5 + MDP1 (pcDNA3.1/H5 + pcDNA3.1/MDP1) vaccines were collected after sacrificing the chickens and successfully expressed H5 and MDP1 RNA transcripts. The sera of immunized chickens were collected prior to first immunization and every week after immunization; and analyzed using enzyme-linked immunosorbent assay (ELISA) and hemagglutination inhibition (HI) test.ResultsResults of competitive ELISA showed successful antibody responses two weeks post immunization. The HI test showed an increased in antibody titers during the course of experiment in group immunized with H5 and H5 + MDP1 vaccines. The result showed that the constructed DNA vaccines were able to produce detectable antibody titer in which the group immunized with H5 + MDP1 vaccine produced higher antibody comparing to H5 vaccine alone.ConclusionsThis study shows for the first time the usefulness of MDP1 as a genetic adjuvant for H5 DNA vaccine.
Overweight and obese adolescents: what turns them off physical activity?
Authors: Stankov Ivana , Olds Timothy , Cargo Margaret 
Published: May 2012

Abstract
A systematic review of qualitative studies was undertaken to understand the barriers to physical activity experienced by adolescents who were overweight or obese. From a search of electronic databases and ‘grey’ literature, published between 1950 and 2009, 15 studies met the inclusion criteria. Bronfenbrenner’s model of human development provided an ecological lens for identifying and synthesising barriers to physical activity. Two reviewers appraised study quality. Miles and Huberman’s cross-case analysis was integrated with thematic networking to synthesize the individual, interpersonal and environmental level barriers for boys and girls of different ethnicities and socioeconomic status, across school settings and generalised context. Thirty-five barriers were identified, 13 of which occurred in physical activity situations in the school setting, 18 were not linked to a specific setting, and the remainder were common across both contexts. The fact that these barriers emerged from studies that focused on topics such as victimisation and mental health is particularly poignant and reflects the potentially pervasive influence of adolescent’s excessive weight not only in relation to physical activity situations but other aspects of their lives. Furthermore, socioeconomic status and ethnicity was poorly considered, with only one study linking these participant characteristics to quotations and discussing the potential implications. At present, there are few qualitative studies with sufficiently thick description or interpretive validity that provide insight into this vulnerable group of adolescents, and give them a voice to influence policy and practice.
Role overload, pain and physical dysfunction in early rheumatoid or undifferentiated inflammatory arthritis in Canada
Authors: Mustafa Sally Sabry , Looper Karl Julian , Zelkowitz Phyllis , Purden Margaret ,   McGill Early Arthritis Research Group, Baron Murray 
Published: May 2012

Abstract

Background
Inflammatory arthritis impairs participation in societal roles. Role overload arises when the demands by a given role set exceed the resources; time and energy, to carry out the required tasks. The present study examines the association between role overload and disease outcomes in early inflammatory arthritis (EIA).

Methods
Patients (n = 104) of 7.61 months mean duration of inflammatory arthritis completed self-report questionnaires on sociodemographics, disease characteristics and role overload. Pain was assessed using the Short Form McGill Pain Questionnaire (MPQ) and physical functioning was measured with the Medical Outcomes Study Short Form 36 (SF-36) physical functioning score. Role overload was measured by the Role Overload Scale. Patients indicated the number of social roles they occupied from a total of the three typical roles; marital, parental and paid work.

Results
Participants’ mean age was 56 years and 70.2% were female. Role overload was not correlated to the number of social roles, however, it was positively associated with pain (p = 0.004) and negatively associated with physical functioning (p = 0.001). On multivariate analysis, role overload was negatively associated with physical functioning after controlling for the relevant sociodemographic variables.

Conclusion
This study identifies a possible reciprocal relationship between role overload and physical functioning in patients with EIA.
The role of estrogen receptor alpha in mediating chemoresistance in breast cancer cells
Authors: Jiang Zhinong , Guo Junlan , Shen Jianguo , Jin Mei , Xie Shuduo , Wang Linbo 
Published: May 2012

Abstract

Introduction
Previous studies suggested that estrogen receptor alpha (ERα) plays an important role in the chemoresistance of breast cancers. However, large random trials failed to demonstrate any benefit of the concurrent estrogen antagonist tamoxifen on the chemotherapy efficacy. Thus, in the present study, the importance of the role of ERα in the chemoresistance of breast cancer cells was investigated.

Methods
The ERα-transfected Bcap37 cells and natural ERα-positive T47D breast cancer cells were treated using chemotherapeutic agents with or without 17-beta estradiol (E2) pretreatment. Their viabilities were assessed using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assays. The dead cell rates were determined using propidium iodide dye exclusion tests, and the expression levels of Bcl-2 and Bax were detected through Western blot analysis. The effects of E2 on the growth of breast cancer cells were also determined via cell growth curve and cell cycle analysis.

Results
ERα activation by E2 increased the sensitivity of natural ERα-positive T47D breast cancer cells to chemotherapeutic agents. However, the increase in ERα expression in ERα-negative Bcap37 breast cancer cells also significantly increased their resistance. These phenomena cannot be explained by asserting that ERα mediated the chemoresistance of breast cancer cells by regulating the expression of Bcl-2 and Bax. Our findings show that ERα activation upregulated the expression of Bcl-2 in natural ERα-positive T47D breast cancer cells, whereas ERα activation by E2 downregulated and upregulated the Bcl-2 and Bax expression levels, respectively, in ERα-transfected Bcap37 cells. This phenomenon was due to the influence of ERα on the growth of breast cancer cells. Specifically, ERα activation enhanced the growth of natural ERα-positive breast cancer cells and thus increased their sensitivity to chemotherapeutic agents. However, ERα activation also inhibited the growth of ERα-transfected Bcap37 cells and increased the resistance of cancer cells to chemotherapeutic agents. Chemoresistance of ERα-transfected Bcap37 cells was only due to the specific growth inhibition by E2, which is not applicable to common ERα-positive breast cancer cells.

Conclusions
Although ERα was associated with chemoresistance of breast cancers, ERα itself did not mediate this resistance process.
Impact of intensive care unit admission during morning bedside rounds and mortality: a multi-center retrospective cohort study
Authors: de Souza IvensAugusto O , Karvellas Constantine J , Gibney RT Noel , Bagshaw Sean M 
Published: May 2012

Abstract
Introduction
Recent data have suggested that patient admission during intensive care unit (ICU) morning bedside rounds is associated with less favorable outcome. We undertook the present study to explore the association between morning round-time ICU admissions and hospital mortality in a large Canadian health region.

Methods
A multi-center retrospective cohort study was performed at five hospitals in Edmonton, Canada, between July 2002 and December 2009. Round-time ICU admission was defined as occurring between 8 and 11:59 a.m. Multivariable logistic regression analysis was used to explore the association between round-time admission and outcome.

Results
Of 18,857 unique ICU admissions, 2,055 (10.9%) occurred during round time. Round-time admissions were more frequent in community hospitals compared with tertiary hospitals (12.0% vs. 10.5%; odds ratio [OR] 1.16; 95% CI, 1.05-1.29, P < 0.004) and from the ward compared with the emergency department (ED) or operating theater (17.5% vs. 9.2%; OR 2.1; 95% CI, 1.9-2.3, P < 0.0001). Round-time admissions were more often medical than surgical (12.6% vs. 6.6%; OR 2.06; 95% CI, 1.83-2.31, P < 0.0001), had more comorbid illness (11.9% vs. 10.5%; OR 1.15; 95% CI, 1.04-1.27, P < 0.008) and higher APACHE II score (22.2 vs. 21.3, P < 0.001), and were more likely to have a primary diagnosis of respiratory failure (37.0% vs. 31.3%, P < 0.001) or sepsis (11.1% vs. 9.0%, P = 0.002). Crude ICU mortality (15.3% vs. 11.6%; OR 1.38; 95% CI, 1.21-1.57, P < 0.0001) and hospital mortality (23.9% vs. 20.6%; OR 1.21; 95% CI, 1.09-1.35, P < 0.001) were higher for round-time compared with non-round-time admissions. In multi-variable analysis, round-time admission was associated with increased ICU mortality (OR 1.19, 95% CI, 1.03-1.38, P = 0.017) but was not significantly associated with hospital mortality (OR 1.02; 95% CI, 0.90-1.16, P = 0.700). In the subgroup admitted from the ED, round-time admission showed significantly higher ICU mortality (OR 1.54; 95% CI, 1.21-1.95; P < 0.001) and a trend for higher hospital mortality (OR 1.22; 95% CI, 0.99-1.51, P = 0.057).

Conclusions
Approximately 1 in 10 patients is admitted during morning rounds. These patients are more commonly admitted from the ward and are burdened by comorbidities, are non-operative, and have higher illness severity. These patients admitted during morning rounds have higher observed ICU mortality but no difference in hospital mortality.
Clinical implementation of kilovoltage cone beam CT for the verification of sequential and integrated photon boost treatments for breast cancer patients
Authors: Donovan E M , Castellano I , Eagle S , Harris E 
Published: May 2012

Objective
The objective of this study was to formulate a practical method for the use of cone beam CT (CBCT) for the verification of sequential and integrated tumour bed boosts for early breast cancer patients.

Methods
Partial arc scan geometries were assessed on a treatment unit. Imaging dose measurements on an Elekta Synergy CBCT system were made in a CT dose phantom for scan parameters 100 kV, 25 mA and 40 ms with an S20 collimator. The protocol was used to verify the setup of a cohort of 38 patients, all of whom had surgical clips inserted in the tumour bed. Setup errors with and without an extended no action level (eNAL) protocol were calculated.

Results
Arcs from 260° to 85° (left breast) and 185° to 15° (right breast) were found sufficient to image fiducial markers and anatomy whilst accounting for the physical limits of the equipment. A single treatment and imaging isocentre was found by applying simple constraints: isocentre &lt;8 cm from midline and isocentre–couch distance &lt;30 cm. Contralateral breast doses were ∼2 mGy per scan (right breast) and ∼12 mGy (left breast). Both mean population systematic error and mean population random error were 3 mm prior to correction. The systematic error reduced to 1.5 mm using an eNAL correction protocol, implying that a 5-mm setup margin could be achieved.

Conclusion
An image-guided verification protocol using CBCT for breast cancer boost plans was implemented successfully. Setup errors were reduced with an acceptable imaging dose to the contralateral breast.
A gestural account of the velar fricative in Navajo
Authors: Iskarous Khalil , McDonough Joyce , Whalen D. H. 
Published: May 2012

AbstractUsing the framework of Articulatory Phonology, we offer a phonological account of the allophonic variation undergone by the velar fricative phoneme in Navajo, a Southern or Apachean Athabaskan language spoken in Arizona and New Mexico. The Navajo velar fricative strongly co-articulates with the following vowel, varying in both place and manner of articulation. The variation in this velar fricative seems greater than the variation of velars in many well-studied languages. The coronal central fricatives in the inventory, in contrast, are quite phonetically stable. The back fricative of Navajo thus highlights 1) the linguistic use of an extreme form of coarticulation and 2) the mechanism by which languages can control coarticulation. It is argued that the task dynamic model underlying Articulatory Phonology, with the mechanism of gestural blending controlling coarticulation, can account for the multiplicity of linguistically-controlled ways in which velars coarticulate with surrounding vowels without requiring any changes of input specification due to context. The ability of phonological and morphological constraints to restrict the amount of coarticulation argues against strict separation of phonetics and phonology.
Tetraphenylpyridinium pertechnetate: a promising salt for the immobilization of technetium
Authors: Mausolf Edward , Droessler J. , Poineau Frédéric , Hartmann T. , Czerwinski Kenneth R. 
Published: May 2012

AbstractIn the context of the immobilization of technetium, as pertechnetate, from spent nuclear fuel from reprocessing activies, or potentially a scavenger for pertechnetate in repository conditions, the compound tetraphenylpyridinium pertechnetate (TPPy-TcO4) has been synthesized, structurally characterized and its solubility investigated. The compound TPPy-TcO4has been prepared by metathesis from ammonium pertechnetate and 1,2,4,6-tetraphenylpyridinium tetrafluoroborate from a water/acetone media. Diffraction measurements show that the compound crystallizes in the orthorhombic space group (Pbca) witha= 16.1242(10)Å,b= 16.7923(10)Å, andc= 17.6229(11)Å. The solubility of the salt has been investigated at room temperature in aqueous media at pH 2.22, 6.91, and 9.81 where solubility products were determined as 6.16 × 10−12, 4.13 × 10−12, and 1.16 × 10−11, respectively. The compound TPPy-TcO4is not the most insoluble pertechnetate salt reported so far, but comparatively has a lower solubility than that of most other pertechnetate salts.