bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Asian breast cancer patients have poorer survival than their western counterparts? A comparison between Singapore and Stockholm
Authors: Tan Benita Kiat Tee , Lim Gek Hsiang , Czene Kamila , Hall Per , Chia Kee Seng 
Published: January 2009

Abstract
Introduction
The difference in breast cancer incidence and prognosis between ethnic groups seeks an explanation. We have recently shown that Swedish women are two to three times more likely to be diagnosed with breast cancer compared with Singaporean women. In the present paper, we compare breast cancer survival in the two countries.

Methods
We compared the survival of 10,287 Singaporean women and 17,090 Swedish women with breast cancer. Relative survival ratios were used to describe the prognosis in the two populations. A Poisson regression model was used to calculate relative risks for different follow-up periods, age groups, time of diagnosis and disease stages.

Results
The majority of the Swedish women had local cancer (80%) compared with Singaporean women (51%). The overall 5-year relative survival of the Swedish women appeared better (80%) than that of the Singaporean women (70%). A similar survival pattern was observed, however, between the two countries in a stage-by-stage comparison. Survival improved for all women in Singapore over the two decades, but only in the premenopausal women in Stockholm. In 1980 to 1989, premenopausal Singaporean women had 27% increased risk of death compared with Swedish women, adjusted for stage and year of follow-up, while the postmenopausal women had 48% increased risk. In 1990 to 1999, this risk decreased by 19% and 22% for the premenopausal and postmenopausal Singaporean women compared with the Swedish women.

Conclusions
The stage-dependent prognosis was similar for Singaporean women and for Swedish women. Singaporean women, both premenopausal and postmenopausal, had pronounced improvement in prognosis over the calendar periods, probably contributed by marked economic improvement, leading to better medical facilities and management with increased awareness of patients to diagnosis and treatment, as well as improved treatment options. Improvement seen only in the premenopausal women in Stockholm was probably due to improved treatment options.
Benefits of intensive insulin therapy on neuromuscular complications in routine daily critical care practice: a retrospective study
Authors: Hermans Greet , Schrooten Maarten , Van Damme Philip , Berends Noor , Bouckaert Bernard , De Vooght Wouter , Robberecht Wim , Berghe Greet Van den 
Published: January 2009

Abstract
Introduction
Intensive insulin therapy (IIT) reduced the incidence of critical illness polyneuropathy and/or myopathy (CIP/CIM) and the need for prolonged mechanical ventilation (MV ≥ 14 days) in two randomised controlled trials (RCTs) on the effect of IIT in a surgical intensive care unit (SICU) and medical intensive care unit (MICU). In the present study, we investigated whether these effects are also present in daily clinical practice when IIT is implemented outside of a study protocol.

Methods
We retrospectively studied electrophysiological data from patients in the SICU and MICU, performed because of clinical weakness and/or weaning failure, before and after routine implementation of IIT. CIP/CIM was diagnosed by abundant spontaneous electrical activity on electromyography. Baseline and outcome variables were compared using Student's t-test, Chi-squared or Mann-Whitney U-test when appropriate. The effect of implementing IIT on CIP/CIM and prolonged MV was assessed using univariate analysis and multivariate logistic regression analysis (MVLR), correcting for baseline and ICU risk factors.

Results
IIT significantly lowered mean (± standard deviation) blood glucose levels (from 144 ± 20 to 107 ± 10 mg/dl, p < 0.0001) and significantly reduced the diagnosis of CIP/CIM in the screened long-stay patients (125/168 (74.4%) to 220/452 (48.7%), p < 0.0001). MVLR identified implementing IIT as an independent protective factor (p < 0.0001, odds ratio (OR): 0.25 (95% confidence interval (CI): 0.14 to 0.43)). MVLR confirmed the independent protective effect of IIT on prolonged MV (p = 0.002, OR:0.40 (95% CI: 0.22–0.72)). This effect was statistically only partially explained by the reduction in CIP/CIM.

Conclusions
Implementing IIT in routine daily practice in critically ill patients evoked a similar beneficial effect on neuromuscular function as that observed in two RCTs. IIT significantly improved glycaemic control and significantly and independently reduced the electrophysiological incidence of CIP/CIM. This reduction partially explained the beneficial effect of IIT on prolonged MV.
IL-21 ensures TGF-β1-induced IgA isotype expression in mouse Peyer’s patches
Authors: Seo Goo-Young , Youn Jeehee , Kim Pyeung-Hyeun 
Published: January 2009

AbstractIt is well established that TGF-β1 induces IgA and IgG2b class-switching recombination in murine B cells. In the present study, we assessed the activity of IL-21 along with TGF-β1 in Ig synthesis by murine spleen B cells. IL-21 showed antiproliferative activity on LPS-activated splenic B cells, comparable with that of TGF-β1. IL-21 alone had little effect on IgA secretion and decreased other isotypes. Likewise, IL-21 also did not alter the TGF-β1-induced IgA synthesis and concurrently diminished the syntheses of IgM and IgG2a, which were repressed by TGF-β1. Unexpectedly, IL-21 inhibited the TGF-β1-induced IgG2b production. This IL-21 effect was examined using B cells from IL-21R knockout mice, where the IgA production profile was paralleled by that seen in wild-type B cells. However, the inhibitory effect of IL-21 on TGF-β1-induced IgG2b synthesis was not seen in the IL-21R−/− mouse, suggesting that IL-21 causes TGF-β1-stimulated B cells to decrease IgG2b synthesis. Expression patterns of Ig germ-line α(GLα)/GLγ2b transcripts under the influence of TGF-β1 and IL-21 were paralleled by IgA/IgG2b secretion. This was also observed in the activities of GLα and GLγ2b promoters. These results indicate that IL-21 decreases IgG2b secretion mainly through inhibition of GLγ2b transcription and is ultimately associated with selective IgA secretion induced by TGF-β1. Our results showed that IL-21 was expressed in greater magnitude in Peyer’s patches (PP) than in spleen. These results suggest that IL-21 has an important effect on selective IgA+ B cell commitment in PP.
Evaluating Value-at-Risk Models with Desk-Level Data
Authors: Berkowitz Jeremy , Christoffersen Peter , Pelletier Denis 
Published: January 2009

We present new evidence on disaggregated profit and loss (P/L) and value-at-risk (VaR) forecasts obtained from a large international commercial bank. Our data set includes the actual daily P/L generated by four separate business lines within the bank. All four business lines are involved in securities trading and each is observed daily for a period of at least two years. Given this unique data set, we provide an integrated, unifying framework for assessing the accuracy of VaR forecasts. We use a comprehensive Monte Carlo study to assess which of these many tests have the best finite-sample size and power properties. Our desk-level data set provides importance guidance for choosing realistic P/L-generating processes in the Monte Carlo comparison of the various tests. The conditional autoregressive value-at-risk test of Engle and Manganelli (2004) performs best overall, but duration-based tests also perform well in many cases. This paper was accepted by John Birge, focused issue editor.
Comparison of Immunoassays for the Selective Measurement of Human High–Molecular Weight Adiponectin
Authors: Liu Dan , Schuster Tibor , Baumann Marcus , Roos Marcel , Sollinger Daniel , Lutz Jens , Heemann Uwe , von Eynatten Maximilian 
Published: January 2009

Abstract
Background: Adiponectin is an adipocyte-derived hormone circulating in different multimer complexes. The high–molecular-weight (HMW) complex is likely the active form of this protein and has been recognized as a risk marker for type 2 diabetes and coronary artery disease (CAD). Because quantification of HMW adiponectin by Western blot analysis is time-consuming, novel ELISAs have been developed to simplify measurements in clinical research. However, these enzyme immunoassays have not been cross-validated in larger patient groups. We evaluated 2 individual ELISA systems by comparison to Western blotting for measurement of the distribution of HMW adiponectin in healthy individuals and patients with CAD and type 2 diabetes.
Methods: We measured HMW adiponectin in 204 individuals (83 CAD patients, 81 type 2 diabetes patients, and 40 healthy controls). Correlations, range of agreement, and imprecision of HMW concentrations obtained using 2 commercial ELISAs (#1, ALPCO Diagnostics; #2, Millipore) were evaluated by comparison with quantitative Western blotting.
Result: Adiponectin results of the ELISAs were significantly correlated with those obtained by Western blotting (both r &gt; 0.75, P &lt; 0.001). Deming regression and Bland-Altman analyses indicated high agreement among the 3 immunoassays. The median difference between HMW adiponectin concentrations measured by ELISA and by Western blot was +0.4 mg/L for ELISA #1 and −0.4 mg/L for ELISA #2 with 95% of value differences &lt;3 mg/L.
Conclusions: Selective measurement of HMW adiponectin by ELISA is feasible; however, individual differences among immunoassays must be considered. The evaluated ELISAs exhibit analytical characteristics that allow their use as equivalent for Western blot analysis in larger clinical and epidemiological groups.
High-Sensitivity Chemiluminescence Immunoassays for Detection of Growth Hormone Doping in Sports
Authors: Bidlingmaier Martin , Suhr Jennifer , Ernst Andrea , Wu Zida , Keller Alexandra , Strasburger Christian J , Bergmann Andreas 
Published: January 2009

Abstract
Background: Recombinant human growth hormone (rhGH) is abused in sports, but adequate routine doping tests are lacking. Analysis of serum hGH isoform composition has been shown to be effective in detecting rhGH doping. We developed and validated selective immunoassays for isoform analysis with potential utility for screening and confirmation in doping tests.
Methods: Monoclonal antibodies with preference for pituitary hGH (phGH) or rhGH were used to establish 2 pairs of sandwich-type chemiluminescence assays with differential recognition of rhGH (recA and recB) and phGH (pitA and pitB). We analyzed specimens from volunteers before and after administration of rhGH and calculated ratios between the respective rec- and pit-assay results.
Results: Functional sensitivities were &lt;0.05 μg/L, with intra- and interassay imprecision ≤8.4% and ≤13.7%, respectively. In 2 independent cohorts of healthy subjects, rec/pit ratios (median range) were 0.84 (0.09–1.32)/0.81 (0.27–1.21) (recA/pitA) and 0.68 (0.08–1.20)/0.80 (0.25–1.36) (recB/pitB), with no sex difference. In 20 recreational athletes, ratios (median SD) increased after a single injection of rhGH, reaching 350% (73%) (recA/pitA) and 400% (93%) (recB/pitB) of baseline ratios. At a moderate dose (0.033 mg/kg), mean recA/pitA and recB/pitB ratios remained significantly increased for 18 h (men) and 26 h (women). After high-dose rhGH (0.083 mg/kg), mean rec/pit ratios remained increased for 32 h (recA/pitA) and 34 h (recB/pitB) in men and were still increased after 36 h in women.
Conclusions: Using sensitive chemiluminescence assays with preferential recognition of phGH or rhGH, detection of a single injection of rhGH was possible for up to 36 h.
Reducing Routine Ionized Calcium Measurement
Authors: Baird Geoffrey S , Rainey Petrie M , Wener Mark , Chandler Wayne 
Published: January 2009

Abstract
Background: Ionized calcium (iCa) is measured frequently in hospitalized patients, and hypocalcemia is frequently found, seemingly supporting the practice.
Methods: We retrieved the results of 58 040 iCa tests and records of intravenous (IV) and oral calcium supplementation from laboratory and hospital information systems and evaluated them for frequency of testing, frequency of hypocalcemia, and effects of calcium supplementation.
Results: Serial and daily iCa testing was common and responsible for a substantial fraction of all iCa tests ordered. Half of all patients tested had iCa values below the reference interval. IV, but not oral, calcium therapy increased mean iCa concentrations, but the effect of calcium administration was small compared with the spontaneous increase in iCa that occurred in similar patients who received no calcium treatment. A retrospective analysis suggested that a low total calcium (tCa) concentration (&lt;2.00 mmol/L, &lt;8 mg/dL) could identify most patients with low iCa (&lt;1.0 mmol/L). Introduction of a reflexive strategy reduced iCa testing by 72%–76% and reduced IV calcium gluconate therapy by 45%–81%.
Conclusions: Testing for iCa and IV calcium supplementation were significantly reduced with a reflexive calcium testing strategy that provided iCa testing only to patients with low tCa. Adverse clinical outcomes possibly associated with hypocalcemia did not increase.
Prime Time for Enzymatic Creatinine Methods in Pediatrics
Authors: Cobbaert Christa M , Baadenhuijsen Henk , Weykamp Cas W 
Published: January 2009

Abstract
Background: The literature regarding the nonspecificity of applications of the Jaffe (alkaline picrate) reaction for creatinine is generally outdated. We conducted a specificity study to update the nonspecificity information for current Jaffe and enzymatic creatinine assays.
Methods: Two serum pools with creatinine concentrations within the pediatric reference interval were spiked with albumin, IgG, unconjugated bilirubin, adult hemoglobin (Hb A), and fetal hemoglobin (Hb F) to produce 1 unspiked and 5 spiked samples per pool. The 35 laboratories participating in the survey used a total of 14 method–analyzer combinations. Measurements were performed in triplicate in a single run in accordance with manufacturer instructions. Absolute differences in creatinine concentration between spiked and unspiked samples were calculated per laboratory. Mixed ANOVA was used to quantify the interferent-related CV component for the Jaffe and enzymatic methods.
Results: The interference by bilirubin and Hb A on serum creatinine measurements was &lt;10% for most of the Jaffe and enzymatic methods. Obvious interference was observed among the Jaffe methods in samples spiked with Hb F, albumin, and IgG, but not among the enzymatic methods. The within-laboratory interferent-related CVs for the Jaffe method–analyzer combinations ranged from 8.0%–27% at a creatinine concentration of 40.4 μmol/L (0.46 mg/dL) and from 5.4%–15% at 73.4 μmol/L (0.83 mg/dL). Enzymatic methods had within-laboratory interferent-related CVs of &lt;4% at both concentrations.
Conclusions: Albumin, IgG, and Hb F interfered with Jaffe creatinine assays, leading to inaccuracies in estimated glomerular filtration rates that are clinically important, especially in children and neonates. Because protein error and Hb F interference do not occur with any of the enzymatic methods tested, we conclude that enzymatic creatinine methods are preferred for evaluation of kidney function in pediatric cases.
Automated Determination of Serum α1-Antitrypsin by Antitryptic Activity Measurement
Authors: Roche Denis , Mesner Alexandra , Al Nakib Malik , Leonard Frederic , Beaune Philippe 
Published: January 2009

AbstractBackground: α1-Antitrypsin (A1AT) deficiency is currently detectable by protein immunoassay, phenotyping, and genotyping of the S and Z mutations, but no fully automated method for standard biochemical analyzers is yet available. Here, we present a method that measures the antitryptic activity in serum. This method is rapid, automated, and allows the easy evaluation of a large cohort of patients.Methods: Our automated assay involves determining serum antitryptic capacity on the Olympus AU 400 autoanalyzer by using trypsin and succinylated gelatin as substrate in the presence of trinitrobenzene sulfonic acid. The results are expressed as a percentage of inhibition of the reaction of trypsin with succinylated gelatin. After we performed analytical validation studies and reference-interval determination based on serum samples from 120 healthy persons, we tested the assay on deidentified samples from 120 patients with various pathologies (primarily pulmonary) of unexplained origin and normal A1AT concentrations and phenotypes.Results: The analysis rate was up to 120 samples per hour. Intraassay CVs ranged from 3.1%–16.2%, and interassay CV was 7.5%. The reference population showed mean (SD) 58.4 (6.7)% inhibition. The detection limit was 9.5% inhibition. The 120 studied patients displayed significantly lower mean activity than 120 healthy individuals (P &lt; 0.0001).Conclusion: This assay is stable, reliable, and easily automated by use of open-system analyzers, allowing for the rapid evaluation of patients. After further validation on a larger randomized cohort, this new approach should function as a useful method to explore A1AT deficiency, especially in large-scale studies.
Apolipoprotein B and Cardiovascular Disease Risk: Position Statement from the AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices
Authors: Contois John H , McConnell Joseph P , Sethi Amar A , Csako Gyorgy , Devaraj Sridevi , Hoefner Daniel M , Warnick G Russell 
Published: January 2009

AbstractBackground: Low-density lipoprotein cholesterol (LDL-C) has been the cornerstone measurement for assessing cardiovascular risk for nearly 20 years.Content: Recent data demonstrate that apolipoprotein B (apo B) is a better measure of circulating LDL particle number (LDL-P) concentration and is a more reliable indicator of risk than LDL-C, and there is growing support for the idea that addition of apo B measurement to the routine lipid panel for assessing and monitoring patients at risk for cardiovascular disease (CVD) would enhance patient management. In this report, we review the studies of apo B and LDL-P reported to date, discuss potential advantages of their measurement over that of LDL-C, and present information related to standardization.Conclusions: In line with recently adopted Canadian guidelines, the addition of apo B represents a logical next step to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) and other guidelines in the US. Considering that it has taken years to educate physicians and patients regarding the use of LDL-C, changing perceptions and practices will not be easy. Thus, it appears prudent to consider using apo B along with LDL-C to assess LDL-related risk for an interim period until the superiority of apo B is generally recognized.
Evaluation of the VITROS 5,1 FS analyzer in a large clinical laboratory: comparison of methods using different specimens and chemistry systems / Evaluation des Systems VITROS 5,1 FS in einem großen klinischen Laboratorium: Methodenvergleiche mit verschiedenen Probenmaterialien und Systemen
Authors: Aufenanger Johannes , Sonntag Oswald 
Published: January 2009

Abstract
The clinical chemical analysis system Vitros 5,1 FS (Ortho Clinical Diagnostics, Neckargemünd, Germany) combines on one platform multilayer film technology with a newly developed technology based on conventional wet chemistry. We report the first extensive evaluation of this novel analyzer, establishing precision data, accuracy, and linearity of MicroSlide technology analytes and analytes using the newly developed MicroTip technology. For comparison, measurements with the analysis systems Beckman-Coulter DXC800 and Immage or Siemens Healthcare Diagnostics Dimension Xpand, and plasma, serum, urine and cerebrospinal fluid (CSF) samples as well as blood from routine operations were employed, respectively. For within-run imprecision, coefficients of variation between 0.2% and 5.5% were calculated. Coefficients of variation for quality control materials from day-to-day ranged from 0.6% to 7.1%. In all examined analytes, except hemoglobin A1c, calculated inaccuracies were within the acceptable ranges of the national directives for quality assurance (RiliBÄK, directives issued by the German Medical Association). Method comparison demonstrated good agreement between MicroSlide assays and wet chemistry methods with correlation coefficients ranging from 0.872 to 0.998. For the MicroTip assays, the calculated correlation coefficients ranged from 0.968 to 0.994. In conclusion, the Vitros 5,1 FS analyzer is a reliable analysis system which can be easily integrated into clinical chemical routine and which can also be applied for analysis of CSF, urine, and blood samples.
Therapiemonitoring der Multiplen Sklerose / Therapy monitoring of multiple sclerosis
Authors: Deisenhammer Florian 
Published: January 2009

Zusammenfassung
Die Therapie der Multiplen Sklerose (MS) hat sich in den letzten Jahren um eine beträchtliche Zahl an verschiedenen Medikamenten erweitert, welche sich durch verschiedene Wirkmechanismen unterscheiden. Der Haupteffekt dieser medikamentösen Therapien liegt in der Reduktion der klinischen Schubrate, welche im Schnitt unter einer Attacke pro Jahr liegt und damit ein relativ seltenes Ereignis darstellt. Somit ist die Bewertung des Therapieerfolges aufgrund der rein klinischen Beobachtung schwierig und ein laborgestütztes Therapiemonitoring wäre hilfreich und ist in manchen Fällen auch möglich. Die Mehrzahl der Medikamente ist auch mit laborchemischen Nebenwirkungen behaftet, weshalb auch diesbezügliche Verlaufskontrollen mitunter notwendig sind.
In diesem Artikel werden die laborgestützten Möglichkeiten der Therapieüberwachung in Hinblick auf Wirksamkeit und Sicherheit der MS-Therapien besprochen.
Inadequacies of glucocorticoid replacement and improvements by physiological circadian therapy
Authors: Debono Miguel , Ross Richard J , Newell-Price John 
Published: January 2009

Patients with adrenal insufficiency need lifelong glucocorticoid replacement, but many suffer from poor quality of life, and overall there is increased mortality. Moreover, it appears that use of glucocorticoids at the higher end of the replacement dose range is associated with increased risk for cardiovascular and metabolic bone disease. These data highlight some of the inadequacies of current regimes.The cortisol production rate is estimated to be equivalent to 5.7–7.4 mg/m2per day, and a major difficulty for replacement regimes is the inability to match the distinct circadian rhythm of circulating cortisol levels, which are low at the time of sleep onset, rise between 0200 and 0400 h, peaking just after waking and then fall during the day. Another issue is that current dose equivalents of glucocorticoids used for replacement are based on anti-inflammatory potency, and few data exist as to doses needed for equivalent cardiovascular and bone effects. Weight-adjusted, thrice-daily dosing using hydrocortisone (HC) reduces glucocorticoid overexposure and represents the most refined regime for current oral therapy, but does not replicate the normal cortisol rhythm. Recently, proof-of-concept studies have shown that more physiological circadian glucocorticoid therapy using HC infusions and newly developed oral formulations of HC have the potential for better biochemical control in patients with adrenal insufficiency. Whether such physiological replacement will have an impact on the complications seen in patients with adrenal insufficiency will need to be analysed in future clinical trials.