bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phase I trial of low dose decitabine targeting DNA hypermethylation in patients with chronic lymphocytic leukaemia and non‐Hodgkin lymphoma: dose‐limiting myelosuppression without evidence of DNA hypomethylation
Authors: Blum Kristie A. , Liu Zhongfa , Lucas David M. , Chen Ping , Xie Zhiliang , Baiocchi Robert , Benson Donald M. , Devine Steven M. , Jones Jeffrey , Andritsos Leslie , Flynn Joseph , Plass Christoph , Marcucci Guido , Chan Kenneth K. , Grever Michael R. , Byrd John C. 
Published: April 2010

SummaryTargeting aberrant DNA hypermethylation in chronic lymphocytic leukaemia (CLL) and non‐Hodgkin lymphoma (NHL) with decitabine may reverse epigenetic silencing in B‐cell malignancies. Twenty patients were enrolled in two phase I trials to determine the minimum effective pharmacological dose of decitabine in patients with relapsed/refractory CLL (n = 16) and NHL (n = 4). Patients received 1–3 cycles of decitabine. Dose‐limiting toxicity (DLT) was observed in 2 of 4 CLL and 2 of 2 NHL patients receiving decitabine at 15 mg/m2 per d days 1–10, consisting of grade 3–4 thrombocytopenia and hyperbilirubinaemia. Six patients with CLL received decitabine at 10 mg/m2 per d days 1–10 without DLT; however, re‐expression of methylated genes or changes in global DNA methylation were not observed. Therefore, a 5‐day decitabine schedule was examined. With 15 mg/m2 per d decitabine days 1–5, DLT occurred in 2 of 6 CLL and 2 of 2 NHL patients, consisting of grade 3–4 neutropenia, thrombocytopenia, and febrile neutropenia. Eight patients had stable disease. In 17 patients, there were no significant changes in genome‐wide methylation or in target gene re‐expression. In conclusion, dose‐limiting myelosuppression and infectious complications prevented dose escalation of decitabine to levels associated with changes in global methylation or gene re‐expression in CLL and NHL.
Stable long‐term risk of leukaemia in patients with severe congenital neutropenia maintained on G‐CSF therapy
Authors: Rosenberg Philip S. , Zeidler Cornelia , Bolyard Audrey A. , Alter Blanche P. , Bonilla Mary A. , Boxer Laurence A. , Dror Yigal , Kinsey Sally , Link Daniel C. , Newburger Peter E. , Shimamura Akiko , Welte Karl , Dale David C. 
Published: April 2010

SummaryIn severe congenital neutropenia (SCN), long‐term therapy with granulocyte colony‐stimulating factor (G‐CSF) has reduced mortality from sepsis, revealing an underlying predisposition to myelodysplastic syndrome and acute myeloid leukaemia (MDS/AML). We have reported the early pattern of evolution to MDS/AML, but the long‐term risk remains uncertain. We updated a prospective study of 374 SCN patients on long‐term G‐CSF enrolled in the Severe Chronic Neutropenia International Registry. Long‐term, the annual risk of MDS/AML attained a plateau (2·3%/year after 10 years). This risk now appears similar to, rather than higher than, the risk of AML in Fanconi anaemia and dyskeratosis congenita.
Quantifying soil organic carbon in complex landscapes: an example of grassland undergoing encroachment of woody plants
Authors: LIU FENG , WU X. BEN , BAI E. , BOUTTON THOMAS W. , ARCHER STEVEN R. 
Published: April 2010

AbstractThe invasion of woody plants into grass‐dominated ecosystems has occurred worldwide during the past century with potentially significant impacts on soil organic carbon (SOC) storage, ecosystem carbon sequestration and global climate warming. To date, most studies of tree and shrub encroachment impacts on SOC have been conducted at small scales and results are equivocal. To quantify the effects of woody plant proliferation on SOC at broad spatial scales and to potentially resolve inconsistencies reported from studies conducted at fine spatial scales, information regarding spatial variability and uncertainty of SOC is essential. We used sequential indicator simulation (SIS) to quantify spatial uncertainty of SOC in a grassland undergoing shrub encroachment in the Southern Great Plains, USA. Results showed that both SOC pool size and its spatial uncertainty increased with the development of woody communities in grasslands. Higher uncertainty of SOC in new shrub‐dominated communities may be the result of their relatively recent development, their more complex above‐ and belowground architecture, stronger within‐community gradients, and a greater degree of faunal disturbance. Simulations of alternative sampling designs demonstrated the effects of spatial uncertainty on the accuracy of SOC estimates and enabled us to evaluate the efficiency of sampling strategies aimed at quantifying landscape‐scale SOC pools. An approach combining stratified random sampling with unequal point densities and transect sampling of landscape elements exhibiting strong internal gradients yielded the best estimates. Complete random sampling was less effective and required much higher sampling densities. Results provide novel insights into spatial uncertainty of SOC and its effects on estimates of carbon sequestration in terrestrial ecosystem and suggest effective protocol for the estimating of soil attributes in landscapes with complex vegetation patterns.
Cerebral palsy: experiences of mothers after learning their child’s diagnosis
Authors: Huang Yu‐Ping , Kellett Ursula M. , St John Winsome 
Published: April 2010

huang y.‐p., kellett u.m. & st john w. (2010) Cerebral palsy: experiences of mothers after learning their child’s diagnosis. Journal of Advanced Nursing 66(6), 1213–1221.AbstractTitle.  Cerebral palsy: experiences of mothers after learning their child’s diagnosis. Aim.  This study is a report of a study describing mothers’ experience of learning that their child has been diagnosed with cerebral palsy.Background.  Learning a child’s diagnosis of disability is a crisis for parents. Their reactions include shock, refusal to accept the diagnosis, anger, fear, and uncertainty about the extent of disability and associated impairment. Knowledge about parental reactions is based on studies conducted in western countries, many of which do not apply to Taiwan where Confucianism strongly influences cultural perspectives of family and disability.Method.  In this phenomenological study, data were collected in 2005–2006 using in‐depth interviews and journaling with 15 Taiwanese mothers of children diagnosed with cerebral palsy. Hermeneutic analysis was undertaken of interview transcripts and journal notes.Findings.  Four shared meanings associated with learning of their child’s diagnosis were revealed: feeling out of control and powerless, mistrusting healthcare professionals, release and confirmation, and feeling blamed for not following traditional practices. Mothers experienced a loss of their ‘ideal’ child when their child was diagnosed with cerebral palsy. Expectations of ‘normal’ motherhood and fulfilling societal anticipation of giving birth to a healthy child were lost. Maintaining their husband’s family honour and prosperity, as well as saving face in their community were threatened. Mixed feelings of disbelief, rejection, self‐blame and sadness were compounded by uncertainty about their child’s future.Conclusion.  To promote better understanding of the child’s condition, emotional support and information should be provided to the mother and family, both when informing them of the diagnosis and in the period after diagnosis.
Effectiveness of cutaneous warming systems on temperature control: meta‐analysis
Authors: Galvão Cristina Maria , Liang Yuanyuan , Clark Alexander M. 
Published: April 2010

galvão c.m., liang y. & clark a.m. (2010) Effectiveness of cutaneous warming systems on temperature control: meta‐analysis. Journal of Advanced Nursing 66(6), 1196–1206.AbstractTitle.  Effectiveness of cutaneous warming systems on temperature control: meta‐analysis. Aim.  This paper is a report of a meta‐analysis to identify the effectiveness of different types of cutaneous warming systems in temperature control for patients undergoing elective surgery.Background.  Hypothermia is a common and serious complication of surgery. Different cutaneous warming systems are used to prevent hypothermia during surgery but there have been no previous meta‐analyses of the effectiveness of different warming systems in controlling temperature.Data sources.  We conducted a search of the CINAHL (2000 to April 2009), Medline (2000 to April 2009), Embase (2000 to April 2009) and the Cochrane Register of Controlled Trials (2000 to April 2009) databases for randomized controlled trials published in English, Spanish and Portuguese. The primary outcome measure of interest was core body temperature.Methods.  A systematic review incorporating meta‐analysis was carried out.Results.  From 329 papers, 23 trials compared warming systems. Forced‐air warming systems had a strong tendency towards superior temperature control over passive insulation via cotton blankets (mean difference: 0·29°C; 95% confidence interval: −0·02 to 0·59, three trials 292 patients) and radiant warming systems (mean difference: 0·16°C; 95% confidence interval: −0·01 to 0·33, three trials, 161 patients). However, circulating water garments tended to be more effective than forced‐air warming systems (mean difference: −0·73°C; 95% confidence interval: −1·51 to 0·05, I2 = 97%; four trials, 198 patients). Pooled results approached statistical significance and indicated clinically meaningful differences in temperature control.Conclusion.  Current evidence suggests that circulating water garments offer better temperature control than forced‐air warming systems, and both are more effective than passive warming devices.
Forage quantity, quality and depletion as scale‐dependent mechanisms driving habitat selection of a large browsing herbivore
Authors: Van Beest Floris M. , Mysterud Atle , Loe Leif E. , Milner Jos M. 
Published: April 2010

Summary 1. Mechanisms that affect the spatial distribution of animals are typically scale‐dependent and may involve forage distribution. Forage quality and quantity are often inversely correlated and a much discussed trade‐off is whether or not to select for high‐quality forage at the expense of forage abundance. This discussion has rarely involved scale‐dependence or been applied to Northern browsing herbivores. At small spatial scales, browsers are assumed to select for the best quality forage. But, as high‐quality forage resources are often scarce and may become depleted, coarse‐scale habitat selection is assumed to be driven by forage availability. 2. To evaluate if moose selection for forage quantity and quality is scale‐dependent we modelled summer and winter habitat selection of 32 GPS‐marked female moose (Alces alces) at two spatial scales (landscape‐scale vs. within‐home range‐scale). We used mixed‐effects resource selection functions (RSFs) and landscape‐scale forage availability models of six tree species of varying quality for moose. We considered silver birch (Betula pendula), downy birch (Betula pubescens.), Scots pine (Pinus sylvestris) as low quality browse species and rowan (Sorbus aucuparia), aspen (Populus tremula), willow (Salix spp.) as high‐quality species. 3. As expected, the overall selection patterns for available browse biomass and quality varied across spatiotemporal scales. At the landscape‐scale, moose selected for habitat with high available browse biomass of low quality species while at the within‐home range‐scale moose selected for sites with the highest quality browse species available. Furthermore, selection patterns during summer remained fairly stable, while during winter, selection at the within‐home range‐scale switched from sites with high quality to sites with lower quality browse species which suggests depletion of high‐quality species. Consistent with expectations from seasonal resource depletion, site fidelity (bimonthly home range overlap) was much lower in winter than in summer. 4. Coarse‐scale habitat selection by moose as a function of forage variability revealed a scale‐dependent trade‐off between available browse quantity and browse quality. Moreover, resource depletion changed the winter selection criteria of free‐ranging moose and we demonstrate how the behavioural response to such a dynamic process can be inferred from RSFs.
Prerequisites for implementing cardiovascular absolute risk assessment in general practice: a qualitative study of Australian general practitioners' and patients' views
Authors: Wan Qing , Harris Mark F. , Zwar Nicholas , Vagholkar Sanjyot , Campbell Terry 
Published: April 2010

AbstractBackground  Although recommended in clinical practice guidelines, cardiovascular absolute risk (CVAR) assessment is still used infrequently in Australian general practice. One reason is the lack of an implementation strategy. Given the lack of published reports on the implementation of CVAR worldwide, the aim of this study was to explore the views of general practitioners (GPs) and patients on prerequisites for successfully implementing CVAR assessment in general practice.Methods  Multiple data involving GPs and patients were collected using focus groups (FGs) in three divisions of General Practice in Sydney between 2005 and 2006. Both GPs' and patients' opinions were analysed using thematic analysis.Results  Twenty‐two GPs participated in three GP FGs and 26 patients in three patient FGs. Many GPs thought that an initial cardiovascular risk screening could start from 40 years old while some patients thought it should start even younger. Targeting patients with known risk factors was supported by most GPs although some also stressed the importance of reaching those of unknown risk. For new patients or patients presenting for other problems, another visit for CVAR risk assessment and discussion was preferred by most GPs. A strong GP–patient relationship, common ground on priorities between GPs and their patients, patient awareness of cardiovascular risk and motivation were seen as important by both GPs and patients to the implementation of CVAR assessment.Conclusions  Addressing the appropriate selection of patients and time for implementing CVAR assessment requires a consideration of multiple factors. GPs see it as a process that may need to be staged over more than one consultation and requiring appropriate strategies.
The treatment effect of exercise programmes for chronic low back pain
Authors: Smith Caroline , Grimmer‐Somers Karen 
Published: April 2010

AbstractRationale  This paper summarizes evidence of long‐term effectiveness of physiotherapy exercise therapy for chronic low back pain (LBP).Methods  A literature search was undertaken for experimental studies (2001–2007), which reported any post‐intervention (follow‐up) outcomes. Studies were critically appraised using the PEDro instrument. Comparative statistics were calculated, relative to the type of follow‐up outcome data.Results  Fifteen moderate quality trials were included [mean PEDro score 7.7, SD 1.3 (range 5–10)]. Nine trials reported pain scales, and six reported LBP reoccurrence. Trials which reported on pain scales at 6‐month follow‐up found significant differences in favour of exercise [standardized mean differences −0.57, 95%CI −0.75 to −0.39 (555 participants)]. At 12‐month follow‐up, a small pain scale benefit from exercise persisted [standardized mean differences −0.25, 95%CI −0.44 to 0.06 (434 participants)]. There was unconvincing evidence of exercise effectiveness on pain scales after this time. Three of the four trials which reported dichotomous outcomes at 6‐month follow‐up demonstrated large clinical benefits of exercise (relative risk reduction of reoccurrence 45–246%, absolute risk reduction of reoccurrence 36–42 for every 100 patients; and number needed to treat approximating 3, to prevent one patient suffering a LBP recurrence). The effect of exercise on LBP reoccurrence was variably reported beyond 6 months.Conclusion  Exercise programmes are effective for chronic LBP up to 6 months after treatment cessation, evidenced by pain score reduction and reoccurrence rates. The way in which follow‐up data are reported assists clinical interpretation of research findings.
Socio‐economic drivers of overnutrition in China
Authors: Shankar B. 
Published: April 2010

AbstractBackground:  Overnutrition has emerged as a major problem in China. Measuring the associations of socio‐economic variables with energy intake and its fat density is important, particularly at the upper tail ‘overnutrition’ areas of their distributions. The present study aimed to estimate such associations, with an emphasis on overnutrition areas.Methods:  The study used data on individuals aged 20–45 years from the 2006 China Health and Nutrition Survey (n = 3407). Quantile regression methods were employed to determine associations with key drivers at various parts of the conditional distributions of energy intake and its fat density.Results:  Household income was found to have little association with energy intake, and only a poor one with fat density of intake (a 1000 Yuan increase in household income was associated with a 0.1–0.3% point increase in fat density across the distribution). Although women had lower energy intakes than men, their energy intake was more fat dense at 1.5% points on average. Urban residents not only had lower energy intakes than rural residents (a 300 kJ difference at the lower tail, rising to a 600 kJ difference at the upper tail), but also more fat‐dense intakes (a 2.7% point difference on average).Conclusions:  The small income relationships estimated indicate that dietary excess may no longer only be a problem of the rich in China. A lower energy intake but higher fat density of intake associated with men compared to women and rural compared to urban residents indicates a need for flexible nutrition policy targeting.
Vital status of pre‐ART and ART patients defaulting from care in rural Malawi
Authors: McGuire Megan , Munyenyembe Tamika , Szumilin Elisabeth , Heinzelmann Annette , Le Paih Mickael , Bouithy Nenette , Pujades‐Rodríguez Mar 
Published: April 2010

SummaryObjectives  To ascertain the outcome of pre‐Antiretroviral therapy (ART) and ART patients defaulting from care and investigate reasons for defaulting.Methods  Patients defaulting from HIV care in Chiradzulu between July 2004 and September 2007 were traced at last known home address. Deaths and moves were recorded, and patients found alive were interviewed. Defaulting was defined as missed last appointment by more than 1 month among patients of unknown vital status.Results  A total of 1637 individuals were traced (54%–88% of eligible), 981 pre‐ART and 656 ART patients. Of 694 pre‐ART patients found, 49% had died (51% of adults and 38% of children), a median of 47 days after defaulting, and 14% had moved away. Of 451 ART patients found, 54% had died (54% of adults and 50% of children), a median of 52 days after defaulting, and 20% had moved away. Overall, 221 patients were interviewed (90% of those found alive), 42% had worked outside the district in the previous year; 49% of pre‐ART and 19% of ART patients had not disclosed their HIV status to other household members. Main reasons for defaulting were stigma (43%), care dissatisfaction (34%), improved health (28%) and for ART discontinuation, poor understanding of disease or treatment (56%) and drug side effects (42%).Conclusion  This study in a rural African HIV programme reveals the dynamics related to health service access and use, and it provides information to correct programme mortality estimates for adults and children.
Early active follow‐up of patients on antiretroviral therapy (ART) who are lost to follow‐up: the ‘Back‐to‐Care’ project in Lilongwe, Malawi
Authors: Tweya Hannock , Gareta Dickman , Chagwera Fredrick , Ben‐Smith Anne , Mwenyemasi Justin , Chiputula Fred , Boxshall Matthew , Weigel Ralf , Jahn Andreas , Hosseinipour Mina , Phiri Sam 
Published: April 2010

SummaryObjectives  To determine the proportion of patients returning to antiretroviral treatment (ART) and factors associated with their return in a resource‐limited setting.Methods  Between September 2006 and March 2009, at two ART‐providing facilities in Lilongwe, Malawi, we identified patients who had missed clinic appointments by more than 3 weeks and therefore would have run out of antiretroviral drugs. We traced these individuals, documented reasons for missed appointments and, where appropriate, arranged another ART clinic appointment.Results  Between April 2006 and March 2009, 2653 patients on ART had missed 3098 scheduled appointments. We successfully traced 85%, of whom 30% had died. Of the 1580 patients found alive, 25% had transferred to another ART clinic, 21% had collected drugs from other sources, 11% had treatment gaps; 40% had stopped taking drugs, 1% had not started taking drugs despite collecting them and 2% refused to be interviewed. Of the 1158 LTFU patients who had not died, transferred out or declined to be interviewed, 89% promised to return to their ART clinic and 74% actually did. The probability of returning to the clinic was significantly associated with being women, aged over 39 at ART initiation and having either treatment gaps or uninterrupted therapy. The B2C project reduced the proportion of patients finally classified as LTFU by 59%.Conclusion  Early active follow‐up of LTFU patients resulted in marked improvement in known patient outcomes and improved retention in the treatment programme.
Patient‐reported barriers and drivers of adherence to antiretrovirals in sub‐Saharan Africa: a meta‐ethnography
Authors: Merten Sonja , Kenter Elise , McKenzie Oran , Musheke Maurice , Ntalasha Harriet , Martin‐Hilber Adriane 
Published: April 2010

SummaryThis meta‐ethnography aims at providing a synthesis and an interpretation of the findings of recent social science research on the questions of retention in antiretroviral therapy (ART) programmes in sub‐Saharan Africa (SSA). The literature reviewed comprises ethnographic studies of the barriers to adherence to ART in various cultural settings. The results show that the quality of services, treatment‐related costs, as well as the need to maintain social support networks – which can be negatively affected by HIV‐related stigma – are important barriers to adherence. In addition, they show how African concepts of personhood are incompatible with the way services are conceived and delivered, targeting the individual. In SSA, individuals must balance physical health with social integrity, which is sometimes achieved by referring to traditional medicine. The ability of local concepts of illness to address social relations in addition to health, together with a historically grounded distrust in Western medicine, explains why traditional medicine is still widely used as an alternative to ART.
REVIEW: Cognitive effects of nicotine: genetic moderators
Authors: Herman Aryeh I. , Sofuoglu Mehmet 
Published: April 2010

ABSTRACTCigarette smoking is the main preventable cause of death in developed countries, and the development of more effective treatments is necessary. Cumulating evidence suggests that cognitive enhancement may contribute to the addictive actions of nicotine. Several studies have demonstrated that nicotine enhances cognitive performance in both smokers and non‐smokers. Genetic studies support the role of both dopamine (DA) and nicotinic acetylcholine receptors (nAChRs) associated with nicotine‐induced cognitive enhancement. Based on knockout mice studies, β2 nAChRs are thought to be essential in mediating the cognitive effects of nicotine. α7nAChRs are associated with attentional and sensory filtering response, especially in schizophrenic individuals. Genetic variation in D2 type DA receptors and the catechol‐O‐methyltransferase enzyme appears to moderate cognitive deficits induced by smoking abstinence. Serotonin transporter (5‐HTT) gene variation also moderates nicotine‐induced improvement in spatial working memory. Less is known about the contribution of genetic variation in DA transporter and D4 type DA receptor genetic variation on the cognitive effects of nicotine. Future research will provide a clearer understanding of the mechanism underlying the cognitive‐enhancing actions of nicotine.