bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of anxiety and distress following diagnosis of multiple sclerosis: a two-year longitudinal study
Authors: Janssens A CJW , Buljevac D , van Doorn P A , van der Meché F GA , Polman C H , Passchier J , Hintzen R Q 
Published: December 2006

Objective: To investigate the course of anxiety, depression and disease-related distress of patients with multiple sclerosis (MS) and their partners in the first years after diagnosis. Methods: The Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale (IES) were completed at baseline, six-month, one-and two-year follow-up in 101 recently diagnosed patients and 78 partners. The Expanded Disability Status Scale (EDSS) was assessed annually. Results: Mean time since diagnosis at baseline was 7.8 (SD 6.5) months. Mean anxiety scores of patients and partners did not change during the two years of follow-up and remained higher than that observed in the general population at all assessments (P <0.05). The high levels of disease-related distress at baseline were lower at follow-up. Of the patients and partners with high anxiety scores at baseline (HADS anxiety ≥8), 69% also had high scores at any time during follow-up, compared to 26% in those with low baseline anxiety scores. For severe distress at follow-up, these percentages were 41 and 14%. The sensitivity and specificity of baseline anxiety screening for the prediction of high anxiety or distress scores at follow-up were 55 and 85%. Conclusion: MS patients and their partners continued to have high levels of anxiety and distress in the first years after diagnosis. Screening for anxiety after diagnosis can be used to predict levels of anxiety and distress during two-year follow-up.
Knowledge Use in Social Work Practice
Authors: Osmond Jennifer 
Published: December 2006

Summary: The enterprise of knowledge utilization in social work practice has to some extent remained elusive. To date, little empirical clarity has been provided that demystifies the ends to which knowledge is put. The reported qualitative study of 10 social workers explored the functional distinctions of knowledge use in practice. The paper offers a number of previously unreported insights into this important topic and, in doing so, offers a level of transparency about practice behaviour that illuminates the nature and shape of direct social work practice. Findings: The study underscored that knowledge is used for both conceptual and instrumental purposes, with ten primary functions delineated: awareness, prediction, alerting, comparison, generalization, direction of practice behaviour, promoting an attitude and/or ethical stance, education, rapport development and problem solving. Application: The presented findings offer human service professionals an insight into how practice knowledge is/can be used. Such insight could then be used as a strategy to critically recognize and assess their own knowledge use, determine both its negative and creative potential and assist in the recognition of their own knowledge needs.
The Assessment of Risk in the National Probation Service of England and Wales
Authors: Lancaster Elizabeth , Lumb Jeannie 
Published: December 2006

Summary: This article focuses on the National Probation Service of England and Wales and explores the dominance of a particular approach to risk assessment. Reference is made to other areas of social work practice. Findings: The article starts with a description of probation practice in relation to the assessment of risk using the current risk/needs assessment tool, the Offender Assessment System (OASys). The article explores the distinction between risk of reconviction and risk of harm and the use of static and dynamic factors in assessment. It then moves to a consideration of issues arising in two areas. The first of these is the relationship between risk and concepts of proportionality and fairness within the justice system. The second area for consideration is some implications of the dominance of a particular form of risk assessment in the National Probation Service specifically in respect of the knowledge base of assessment; motivation; and the distinction between defensible and defensive judgements about risk made by individual practitioners. Applications: A preoccupation with the technicalities of risk assessment has encouraged the overshadowing of proportionality and the erosion of the rights of ‘risky’ offenders. A rights-based, rather than a risk-based, emphasis in criminal justice innovations might redress the balance. An approach which explores protective factors, rather than risk factors, is worthy of consideration.
Can Telephone Support Improve Parent and Child Well-Being?
Authors: Ritchie Charlotte 
Published: December 2006

Summary: This article reports on a study of 196 parents who received telephone support over a period of 6 weeks. Children’s well-being was assessed using the Strengths and Difficulties Questionnaire (SDQ) and parental well-being was assessed using the General Health Questionnaire (GHQ). Findings: The study showed that parents who used telephone support had children with high levels of need as measured by the SDQ. Parents experienced a range of barriers to accessing support for their children with corresponding high scores on the GHQ. Parents reported that telephone support had improved their parenting over a range of domains. Those who had received support also had significantly lower scores on the GHQ, suggesting that they were less distressed. Applications: The study suggests that telephone support may be a cost-effective way of supporting and signposting parents.
Fluconazole for empiric antifungal therapy in cancer patients with fever and neutropenia
Authors: Yu Donghui T , Seger Diane L , Peterson Josh F , Kumar Ritesh N , Bates David W 
Published: December 2006

Abstract

Background
Several clinical trials have demonstrated the efficacy of fluconazole as empiric antifungal therapy in cancer patients with fever and neutropenia. Our objective was to assess the frequency and resource utilization associated with treatment failure in cancer patients given empiric fluconazole antifungal therapy in routine inpatient care.

Methods
We performed a retrospective cohort study of cancer patients treated with oral or intravenous fluconazole between 7/97 and 6/01 in a tertiary care hospital. The final study cohort included cancer patients with neutropenia (an absolute neutrophil count below 500 cells/mm3) and fever (a temperature above 38°C or 100.4°F), who were receiving at least 96 hours of parenteral antibacterial therapy prior to initiating fluconazole. Patients' responses to empiric therapy were assessed by reviewing patient charts.

Results
Among 103 cancer admissions with fever and neutropenia, treatment failure after initiating empiric fluconazole antifungal therapy occurred in 41% (95% confidence interval (CI) 31% – 50%) of admissions. Patients with a diagnosis of hematological malignancy had increased risk of treatment failure (OR = 4.6, 95% CI 1.5 – 14.8). When treatment failure occurred the mean adjusted increases in length of stay and total costs were 7.4 days (95% CI 3.3 – 11.5) and $18,925 (95% CI 3,289 – 34,563), respectively.

Conclusion
Treatment failure occurred in more than one-third of neutropenic cancer patients on fluconazole as empiric antifungal treatment for fever in routine clinical treatment. The increase in costs when treatment failure occurs is substantial.
Transcriptional profiling of degraded RNA in cryopreserved and fixed tissue samples obtained at autopsy
Authors: Haller Andrew C , Kanakapalli Deepa , Walter Rosemarie , Alhasan Samir , Eliason James F , Everson Richard B 
Published: December 2006

Abstract

Background
Traditional multiplexed gene expression methods require well preserved, intact RNA. Such specimens are difficult to acquire in clinical practice where formalin fixation is the standard procedure for processing tissue. Even when special handling methods are used to obtain frozen tissue, there may be RNA degradation; for example autopsy samples where degradation occurs both pre-mortem and during the interval between death and cryopreservation. Although specimens with partially degraded RNA can be analyzed by qRT-PCR, these analyses can only be done individually or at low levels of multiplexing and are laborious and expensive to run for large numbers of RNA targets.

Methods
We evaluated the ability of the cDNA-mediated Annealing, Selection, extension, and Ligation (DASL) assay to provide highly multiplexed analyses of cryopreserved and formalin fixed, paraffin embedded (FFPE) tissues obtained at autopsy. Each assay provides data on 1536 targets, and can be performed on specimens with RNA fragments as small as 60 bp.

Results
The DASL performed accurately and consistently with cryopreserved RNA obtained at autopsy as well as with RNA extracted from formalin-fixed paraffin embedded tissue that had a cryopreserved mirror image specimen with high quality RNA. In FFPE tissue where the cryopreserved mirror image specimen was of low quality the assay performed reproducibly on some but not all specimens.

Conclusion
The DASL assay provides reproducible results from cryopreserved specimens and many FFPE specimens obtained at autopsy. Gene expression analyses of these specimens may be especially valuable for the study of non-cancer endpoints, where surgical specimens are rarely available.
Physicians' communication with patients about adherence to HIV medication in San Francisco and Copenhagen: a qualitative study using Grounded Theory
Authors: Barfod Toke S , Hecht Frederick M , Rubow Cecilie , Gerstoft Jan 
Published: December 2006

AbstractBackgroundPoor adherence is the main barrier to the effectiveness of HIV medication. The objective of this study was to explore and conceptualize patterns and difficulties in physicians' work with patients' adherence to HIV medication. No previous studies on this subject have directly observed physicians' behavior.MethodsThis is a qualitative, cross-sectional study. We used a Grounded Theory approach to let the main issues in physicians' work with patients' adherence emerge without preconceiving the focus of the study. We included physicians from HIV clinics in San Francisco, U.S.A. as well as from Copenhagen, Denmark. Physicians were observed during their clinical work and subsequently interviewed with a semi-structured interview guide. Notes on observations and transcribed interviews were analyzed with NVivo software.ResultsWe enrolled 16 physicians from San Francisco and 18 from Copenhagen. When we discovered that physicians and patients seldom discussed adherence issues in depth, we made adherence communication and its barriers the focus of the study. The main patterns in physicians' communication with patients about adherence were similar in both settings. An important barrier to in-depth adherence communication was that some physicians felt it was awkward to explore the possibility of non-adherence if there were no objective signs of treatment failure, because patients could feel "accused." To overcome this awkwardness, some physicians consciously tried to "de-shame" patients regarding non-adherence. However, a recurring theme was that physicians often suspected non-adherence even when patients did not admit to have missed any doses, and physicians had difficulties handling this low believability of patient statements. We here develop a simple four-step, three-factor model of physicians' adherence communication. The four steps are: deciding whether to ask about adherence or not, pre-questioning preparations, phrasing the question, and responding to the patient's answer. The three factors/determinants are: physicians' perceptions of adherence, awkwardness, and believability.ConclusionCommunication difficulties were a main barrier in physicians' work with patients' adherence to HIV medication. The proposed model of physicians' communication with patients about adherence – and the identification of awkwardness and believability as key issues – may aid thinking on the subject for use in clinical practice and future research.
Quality and effectiveness of different approaches to primary care delivery in Brazil
Authors: Harzheim Erno , Duncan Bruce B , Stein Airton T , Cunha Carlo RH , Goncalves Marcelo R , Trindade Thiago G , Oliveira Mônica MC , Pinto Maria Eugênia B 
Published: December 2006

AbstractBackgroundSince 1994, Brazil has developed a primary care system based on multidisciplinary teams which include not only a physician and a nurse, but also 4–6 lay community health workers. This system now consists of 26,650 teams, covering 46% of the Brazilian population. Yet relatively few investigations have examined its effectiveness, especially in contrast with that of the traditional multi-specialty physician team approach it is replacing, or that of other existing family medicine approaches placing less emphasis on lay community health workers.Primary health care can be defined through its domains of access to first contact, continuity, coordination, comprehensiveness, community orientation and family orientation. These attributes can be ascertained via instruments such as the Primary Care Assessment Tool (PCATool), and correlated with the effectiveness of care. The objectives of our study are to validate the adult version of this instrument in Portuguese, identify the extent (quality) of primary care present in different models of primary care services, and correlate this extent with measures of process and outcomes in patients with diabetes, hypertension and coronary heart disease (CHD).Methods/DesignWe are conducting a population-based cross-sectional study of primary care in the municipality of Porto Alegre. We will interview a random sample totaling 3000 adults residing in geographic areas covered by four distinct models of primary care of the Brazilian national health system or, alternatively, by one nationally prominent complementary health care service, as well as the physicians and nurses of the health teams of these services. Interviews query perceived quality of care (PCATool-Adult Version), patient satisfaction, and process indicators of management of diabetes, hypertension and known CHD. We are measuring blood pressure, anthropometrics and, in adults with known diabetes, glycated hemoglobin.DiscussionWe hope to contribute not only by validating the PCATool-Adult Version for use in Brazil, but also by furnishing ample data concerning the appropriate mix of health care professionals in the primary care team, a question of international import. Once validated, future use of this instrument should help direct advances aiming at improving the quality of primary care in Brazil.
Kinetic studies of HIV-1 and HIV-2 envelope glycoprotein-mediated fusion
Authors: Gallo Stephen A , Reeves Jacqueline D , Garg Himanshu , Foley Brian , Doms Robert W , Blumenthal Robert 
Published: December 2006

Abstract

Background
HIV envelope glycoprotein (Env)-mediated fusion is driven by the concerted coalescence of the HIV gp41 N-helical and C-helical regions, which results in the formation of 6 helix bundles. Kinetics of HIV Env-mediated fusion is an important determinant of sensitivity to entry inhibitors and antibodies. However, the parameters that govern the HIV Env fusion cascade have yet to be fully elucidated. We address this issue by comparing the kinetics HIV-1IIIB Env with those mediated by HIV-2 from two strains with different affinities for CD4 and CXCR4.

Results
HIV-1 and HIV-2 Env-mediated cell fusion occurred with half times of about 60 and 30 min, respectively. Binding experiments of soluble HIV gp120 proteins to CD4 and co-receptor did not correlate with the differences in kinetics of fusion mediated by the three different HIV Envs. However, escape from inhibition by reagents that block gp120-CD4 binding, CD4-induced CXCR4 binding and 6-helix bundle formation, respectively, indicated large difference between HIV-1 and HIV-2 envelope glycoproteins in their CD4-induced rates of engagement with CXCR4.

Conclusion
The HIV-2 Env proteins studied here exhibited a significantly reduced window of time between the engagement of gp120 with CD4 and exposure of the CXCR4 binding site on gp120 as compared with HIV-1IIIB Env. The efficiency with which HIV-2 Env undergoes this CD4-induced conformational change is the major cause of the relatively rapid rate of HIV-2 Env mediated-fusion.
The molecular epidemiology of Foot-and-Mouth Disease virus serotypes A and O from 1998 to 2004 in Turkey
Authors: Klein Joern , Parlak Ünal , Özyörük Fuat , Christensen Laurids S 
Published: December 2006

Abstract

Background
Foot-and-Mouth Disease (FMD) causes significant economic losses in Turkish livestock.
We have analysed the genetic diversity of the 1D sequences, encoding the hypervariable surface protein VP1, of Turkish isolates of serotype A and O collected from 1998 to 2004 in order to obtain epidemiological and immunological information.

Results
The 1D coding region of 33 serotype O and 20 serotype A isolates, obtained from outbreaks of FMD between 1998 and 2004, was sequenced.
For serotype A, we confirmed the occurrence of the two subtypes IRN99 and IRN96. These subtypes are most divergent within the region encoding the immuno-dominant GH-loop. Also a close relationship to Foot-and-Mouth Disease virus (FMDV) serotype A isolates obtained from outbreaks in Iraq and Iran were detected and a clustering of isolates collected during the same period of time were found.
The analysis of the deduced amino-acid sequences of these subtypes revealed evidence of positive selection in one site and one deletion, both within the GH-loop region. By inferring the ancestral history of the positively selected codon, two potential precursors were found. Furthermore, the structural alignment of IRN99 and IRN96 revealed differences between the tertiary structures of these subtypes.
The similarity plot of the serotype O isolates suggested a more homogeneous group than the serotype A isolates. However, phylogenetic analysis revealed two major groups, each further divided in subgroups, of which some only consisted of Turkish isolates.
Positively selected sites and structural differences of the Turkish isolates analysed, were not found.

Conclusion
The sequence and structural analysis of the IRN99 strains is indicative of positive selection suggesting an immunological advantage compared to IRN96. However, results of antigenic comparison reported elsewhere do not substantiate such a conclusion. There is evidence that IRN99 was introduced to Turkey, in all probability from Iran.
Since, a member of the IRN96 lineage was included as a component of the FMDV vaccine produced since 2000, the outbreaks caused by IRN96 strains in 2004 could be due to incomplete vaccine coverage.
The Turkish type O strains, all with a VP1 structure similar to the O1/Manisa/69 vaccine, appear in several sublineages. Whether these sublineages reflect multiple samplings from a limited number of outbreaks, or if they reflect cross-boundary introductions is not clear.
Estimate of overdiagnosis of breast cancer due to mammography after adjustment for lead time. A service screening study in Italy
Authors: Paci Eugenio , Miccinesi Guido , Puliti Donella , Baldazzi Paola , De Lisi Vincenzo , Falcini Fabio , Cirilli Claudia , Ferretti Stefano , Mangone Lucia , Finarelli Alba Carola , Rosso Stefano , Segnan Nereo , Stracci Fabrizio , Traina Adele , Tumino Rosario , Zorzi Manuel 
Published: December 2006

Abstract
Introduction
Excess of incidence rates is the expected consequence of service screening. The aim of this paper is to estimate the quota attributable to overdiagnosis in the breast cancer screening programmes in Northern and Central Italy.

Methods
All patients with breast cancer diagnosed between 50 and 74 years who were resident in screening areas in the six years before and five years after the start of the screening programme were included. We calculated a corrected-for-lead-time number of observed cases for each calendar year. The number of observed incident cases was reduced by the number of screen-detected cases in that year and incremented by the estimated number of screen-detected cases that would have arisen clinically in that year.

Results
In total we included 13,519 and 13,999 breast cancer cases diagnosed in the pre-screening and screening years, respectively. In total, the excess ratio of observed to predicted in situ and invasive cases was 36.2%. After correction for lead time the excess ratio was 4.6% (95% confidence interval 2 to 7%) and for invasive cases only it was 3.2% (95% confidence interval 1 to 6%).

Conclusion
The remaining excess of cancers after individual correction for lead time was lower than 5%.
Phase I/II Study of Continuous-Infusion Troxacitabine in Refractory Acute Myeloid Leukemia
Authors: Roboz Gail J. , Giles Francis J. , Ritchie Ellen K. , Allen-Bard Sandra , Curcio Tania J. , Wilkes Meredith A. , Park S. Lani , Kantarjian Hagop M. , Faderl Stefan , Ravandi Farhad , Kelner Michael J. , Feldman Eric J. 
Published: December 2006

Purpose Troxacitabine is a non-natural nucleoside analog with unique structural and metabolic features. Bolus intravenous (IV) troxacitabine regimens have shown significant activity in patients with refractory acute myeloid leukemia (AML) and preclinical data suggest that administration via continuous infusion may result in enhanced antitumor activity. Patients and Methods Patients with refractory AML initially received troxacitabine 10.1 mg/m2 by continuous IV infusion (CIVI) for 48 hours. Infusion duration and daily dose were increased in subsequent patient cohorts. Results Forty-eight patients, median age 58 years (range, 21 to 81 years), were treated. Dose-limiting toxicities were mucositis and hand-foot syndrome, and 12.0 mg/m2/d for 5 days was established as the maximum-tolerated dose. Seven patients (15%) achieved complete remission (CR) or CR with incomplete platelet recovery (CRp), with a median survival among responders of 12 months. Steady-state concentrations of troxacitabine were found to be linearly and inversely proportionally related to calculated creatinine clearance at doses of 10.1 and 12.0 mg/m2/d. All patients responding to troxacitabine had steady-state serum drug concentration of more than approximately 80 ng/mL. In 27 patients achieving target troxacitabine plasma concentrations (ie, approximately 80 ng/mL) the CR + CRp rate was 26%. Conclusion Troxacitabine administered as a CIVI allows a significant increase in dose-intensity in comparison to IV bolus regimens, has antileukemic activity, and warrants additional investigation in patients with refractory AML. The recommended phase II study dose is 12.0 mg/m2 daily CIVI for 5 days.
Three-dimensionally Ordered Array of Nanoporous Starburst Carbon Spheres
Authors: Nakamura Tadashi , Yamada Yuri , Yano Kazuhisa 
Published: December 2006

Abstract
A three-dimensionally ordered array consisting of highly monodispersed nanoporous carbon spheres with a novel starburst structure was successfully fabricated via the self-assembly of mesoporous silica/carbon composite spheres and the subsequent dissolution of the silica templates.
Five decades of mechanistic and exploratory organic photochemistry
Authors: Zimmerman Howard E. 
Published: December 2006

Abstract
This exposition summarizes a personal perspective on past and current developments in organic photochemistry. It comprises three portions. The first section describes the beginnings of our photochemical studies and how it was possible to relate photochemical reactivity to excited-state electronic structures. The second selectively relates some of the reactions and concepts developed in the intermediate years. Finally, the third portion describes our recent research.