bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing Physician Knowledge, Attitudes, and Beliefs About Migraine: Evaluation of a New Educational Intervention
Authors: Patwardhan Meenal B. , Samsa Gregory P. , Lipton Richard B. , Matchar David B. 
Published: March 2006

Objective.—Use a presurvey of primary care providers (PCPs) enrolled in a continuing medical education (CME) program on headache management to ascertain their existing knowledge, attitudes, and beliefs regarding migraine and use a postsurvey to determine the extent to which the CME program has brought participant knowledge, attitudes, and skills closer to conformance with best evidence.Background.—Migraine is a common and debilitating condition, which PCPs may not always manage satisfactorily. In an effort to improve management, the American Headache Society has developed a CME program called BRAINSTORM that encourages PCPs to adopt the US Headache Consortium Guidelines for headache care.Methods.—A 20‐item questionnaire was developed that covered the essential elements of migraine care. The questionnaire was administered before and after a BRAINSTORM presentation to 254 consenting primary care clinicians attending a medical meeting at 1 of 6 sites. A control group of 112 comparable physicians who did not attend the presentation completed the same questionnaire. Prepresentation scores of attendees were compared to scores of nonattendees to assess the generalizability of results. Prepresentation scores on selected questions were used to assess participant baseline knowledge, attitudes, and beliefs. Pre‐ and postpresentation scores for attendees at all sites were compared using the Mantel‐Haenszel statistic to assess the effectiveness of the BRAINSTORM CME. Pre‐ and postpresentation scores were compared by site using the Breslow‐Day test to evaluate any differential impact based on CME location.Results.—Prepresentation scores of attendees and nonattendees were found to be similar. No significant difference in performance was noted across sites. A chi‐square analysis revealed a statistically significant difference between pre‐ and postpresentation scores for 16 of the test's 20 questions. In the pretest, all participants scored <66% on 2 questions related to prevalence, impact, and pathophysiology of migraine, 2 questions pertaining to history taking/physical examination, and 3 migraine management questions. Attendee scores improved to >66% posttest on all except 2 questions related to prevalence, impact, and pathophysiology of migraine.Conclusion.—Our results indicate that PCPs need to acquire greater understanding about the epidemiology and pathophysiology of migraine and may require guidance in history taking and physical examination of migraine patients. Improvement in scores posttest confirms that the BRAINSTORM program has a significant immediate impact on the knowledge, beliefs, and attitudes of participants. The program could be strengthened to improve emphasis in some areas where posttest scores showed no improvement.
The Impact of Intensive Patient Education on Clinical Outcome in a Clinic‐Based Migraine Population
Authors: Rothrock John Farr , Parada Victoria A. , Sims Cheryl , Key Kristin , Walters Naomi S. , Zweifler Richard M. 
Published: March 2006

Objective.—To determine whether the addition of patient education to routine medical management improves the clinical status of migraine patients and reduces their utilization of healthcare resources.Background.—Optimal migraine management typically requires effective patient education. Such education often is difficult to accomplish in the busy clinic setting.Methods.—One hundred consecutive patients with migraine presenting to an university‐based headache clinic were randomized to receive or not receive a standardized course of didactic instruction regarding migraine biogenesis and management. The course consisted of 3 classes taught by lay migraineurs who themselves previously had undergone intensive training. All patients were evaluated initially and at 1, 3, and 6 months by a neurologist blinded as to the results of randomization. Clinical variables examined included headache frequency/severity, migraine disability assessment (MIDAS) scores, patient compliance, presence versus absence of analgesic use/overuse, and headache‐related unscheduled visits or phone calls. Comparisons were made between baseline findings and findings at the 6‐month follow‐up visit, with the change in mean MIDAS score serving as the primary outcome variable.Results.—At 6 months the group randomized to receive intensive education exhibited a significantly greater reduction in mean MIDAS score than the group randomized to routine medical management only (24 vs. 14 points; P < .05). Those patients also experienced a reduction in mean headache days per month and a greater reduction in functionally incapacitating headache days per month, exhibited less analgesic overuse and need for abortive therapy, were more compliant with prophylactic therapy prescribed, and made fewer headache‐related calls to the clinic or unscheduled visits.Conclusion.—Intensive education of migraine patients by trained lay instructors may convey significant benefit to those patients and reduce their utilization of healthcare resources.
Migraine Prevention: What Patients Want From Medication and Their Physicians (A Headache Specialty Clinic Perspective)
Authors: Rozen Todd D. 
Published: March 2006

Objective.—To document the results of a migraine patients survey, from a headache specialty clinic, in which patients were asked to rank, in order of importance, certain characteristics of migraine preventive treatment.Methods.—A 10‐question survey was completed by 150 patients (114 females and 36 males) with a history of migraine who presented to the Michigan Head Pain & Neurological Institute. The patients were asked to rank, in order of importance, characteristics of migraine preventive treatment. Each characteristic was rated individually on a 1 to 10 scale (1 being of little importance and 10 being extremely important). The mean rating of each characteristic was then calculated and the results analyzed.Results/Discussion.—From this migraine preventive treatment survey, the most important thing to migraineurs, from a headache specialty clinic population, is that the prescribing physician involves them in the decision making of choosing a preventive agent. The physician taking time to explain the possible medication side effects is the second most highly ranked characteristic. Migraine preventives with published efficacy in the medical literature are also deemed very important. Migraineurs do not mind using more than 1 preventive agent at one time if greater efficacy can be achieved. Agents that may affect weight and /or cause sedation may be important factors as to why patients (especially females) may not want to take a preventive medication. Natural therapies and once‐daily dosing are ranked lower overall but still are important characteristics of preventive treatment. Some gender differences are noted in the ranking of migraine preventive characteristics.
Migraine Headaches and Preeclampsia: An Epidemiologic Review
Authors: Adeney Kathryn L. , Williams Michelle A. 
Published: March 2006

Objective.—To summarize and evaluate available empirical research on the relationship between migraines and gestational hypertension or preeclampsia and to provide direction for future research in this area.Background.—Migraines affect a substantial proportion of reproductive‐aged women and have been associated with cardiovascular risk factors and ischemic disease in this population. Preeclampsia is a vascular disorder of pregnancy, also linked to adverse cardiovascular outcomes.Methods.—Publications were identified by a MEDLINE search using keywords “migraine,”“preeclampsia,” and “gestational hypertension,” and by examination of the reference lists of identified articles.Results.—The literature review yielded 10 studies addressing the association between migraines and preeclampsia or gestational hypertension. Of the 10 studies, 8 reported a positive association between the syndromes.Conclusions.—Available evidence suggests that migraines and preeclampsia may reflect an underlying predisposition toward ischemic injury. More rigorous epidemiologic research is warranted, after consideration of several important methodologic issues.
Recent Canadian experience with targeted hepatitis C virus lookback
Authors: Goldman Mindy , Patterson Lindsay , Long Anne 
Published: March 2006

BACKGROUND:  Targeted hepatitis C virus (HCV) lookback studies have been performed in Canada since 1995. The yield of HCV lookback has not been reassessed since the introduction of improved HCV screening tests.STUDY DESIGN AND METHODS:  Data were combined from the two Canadian blood suppliers to determine the yield of targeted HCV lookback performed on donors found to be HCV‐positive by antibody screening and/or nucleic acid testing (NAT) from the introduction of NAT in 1999 until January 1, 2005.RESULTS:  Lookback was performed on 498 donations from 176 HCV‐seropositive and two NAT‐only‐positive donors; 494 components had been transfused, and 160 components were traced to living recipients who underwent HCV testing. Seventy‐two percent of recipients of components derived from donations given before the introduction of second‐generation enzyme immunoassay (EIA) testing were HCV‐seropositive. Four recipients of components derived from donations tested by second‐ or third‐generation EIA, with or without NAT, were HCV‐seropositive. Two of these recipients tested HCV‐seropositive before transfusion, and a third was probably infected by transfusions before the introduction of HCV testing. The fourth recipient likely received a noninfectious transfusion, since five other recipients of components from subsequent donations made by this donor were seronegative.CONCLUSION:  When previous donations had been tested by second‐ or third‐generation EIA, the yield of HCV lookback was likely zero. Because HCV infection is relatively common in the general population and patients in Canada do not undergo pretransfusion testing, coincident infections in recipients may be erroneously attributed to transfusion. The regulatory requirement for HCV lookback should be reassessed.
Evaluation of the performance of 44 assays used in countries with limited resources for the detection of antibodies to hepatitis C virus
Authors: Scheiblauer Heinrich , El‐Nageh Mohamed , Nick Sigrid , Fields Howard , Prince Alfred , Diaz Susan 
Published: March 2006

BACKGROUND:  This study was conducted by the International Consortium for Blood Safety (ICBS) and its Collaborating Center, the Paul Ehrlich Institute, to identify high‐quality, affordable assays for the detection of hepatitis C virus (HCV) antibodies and make available information on their performance for the benefit of developing countries.STUDY DESIGN AND METHODS:  Forty‐four assays were evaluated for their sensitivity and specificity. The assays’ sensitivity was evaluated on a characterized panel of 200 anti‐HCV‐positive samples comprising major HCV genotypes 1 through 6. Three seroconversion panels were used to estimate sensitivity in the early infectious phase. Specificity was evaluated with a characterized ICBS‐negative panel of 181 verified negative samples.RESULTS:  Sensitivity was 100 percent for 15 assays, 99.5 percent for 11 assays, 99.0 percent for 6 assays, and less than 99.0 percent for 12 assays. The false‐negative results found were not linked to the genotype. Anti‐HCV detection in the early infectious phase was, on average, 16.7 days later than for tests licensed in the European Union. Specificity in 25 tests was 100 percent, whereas 11 assays showed 1 false‐positive result (99.45%) and the other assays were nonspecific in 2 or more samples. Two assays were not supplied in sufficient quantity to test for specificity.CONCLUSIONS:  On applying criteria for highest sensitivity (100%) and high specificity (≥99.5%), 11 tests met the criteria. An additional 19 tests reached a performance comparable to WHO’s criteria for human immunodeficiency virus antibody assays. The genotype diversity of HCV was found not to influence sensitivity of the assays.
Platelets photochemically treated with amotosalen HCl and ultraviolet A light correct prolonged bleeding times in patients with thrombocytopenia
Authors: Slichter Sherrill J. , Raife Thomas J. , Davis Kathryn , Rheinschmidt Margaret , Buchholz Donald H. , Corash Laurence , Conlan Maureen G. 
Published: March 2006

BACKGROUND:  Photochemical treatment (PCT) with amotosalen HCl with ultraviolet A illumination inactivates pathogens and white blood cells in platelet (PLT) concentrates.STUDY DESIGN AND METHODS:  In a Phase II crossover study, 32 patients with thrombocytopenia received one transfusion of PCT and/or one transfusion of untreated (reference) apheresis PLTs. Hemostatic efficacy was assessed with the cutaneous template bleeding time and clinical observations.RESULTS:  Paired bleeding time data for PCT and reference transfusions were available for 10 patients. Mean pretransfusion bleeding times were 29.2 ± 1.6 minutes in the PCT group and 28.7 ± 2.5 minutes in the reference group. After transfusion of a dose of PLTs of at least 6.0 × 1011, mean 1‐hour posttransfusion template bleeding times corrected to 19.3 ± 9.5 minutes in the PCT group and 14.3 ± 6.5 minutes in the reference group (p = 0.25). In 29 patients receiving paired PCT and reference transfusions, mean 1‐hour posttransfusion PLT count increments were 41.9 × 109 ± 20.8 × 109 and 52.3 × 109 ± 18.3 × 109 per L for PCT and reference, respectively (p = 0.007), and mean 1‐hour posttransfusion PLT corrected count increments (CCIs) were 10.4 × 103 ± 4.9 × 103 and 13.6 × 103 ± 4.3 × 103 for PCT and reference, respectively (p < 0.001). The time to next PLT transfusion was 2.9 ± 1.2 days after PCT transfusions versus 3.4 ± 1.3 days after reference transfusions (p = 0.18). Clinical hemostasis was not significantly different after PCT and reference transfusions.CONCLUSION:  PCT PLTs provided correction of prolonged bleeding times and transfusion intervals not significantly different than reference PLTs despite significantly lower PLT count increments and CCIs.
Prevalence of HLA antibodies in transfused patients with and without red cell antibodies
Authors: Buetens Orin , Shirey R. Sue , Goble‐Lee Mary , Houp Julie , Zachary Andrea , King Karen E. , Ness Paul M. 
Published: March 2006

BACKGROUND:  Multiply transfused patients are at increased risk of developing red cell (RBC) antibodies, as well as antibodies to HLA. Although pretransfusion testing screens for RBC antibodies, no such testing is routinely performed for HLA antibodies. Determining which patients are more likely to make HLA antibodies may be important for patients undergoing elective surgery where platelets (PLTs) may be required. It is hypothesized that patients with RBC alloantibodies may be more likely to have HLA antibodies than previously transfused patients without RBC antibodies.STUDY DESIGN AND METHODS:  Blood was collected from 53 adult male surgical patients with RBC alloantibodies and a control group of 69 similar male patients with a history of previous transfusions but no evidence of RBC alloimmunization. The samples were tested for the presence of immunoglobulin G Class I HLA antibodies by enzyme‐linked immunosorbent assay.RESULTS:  Of the 53 samples from patients with RBC alloantibodies, 12 (22.6%) also had HLA antibodies, whereas only 7 (10.1%) of the 69 patients in the control group had HLA antibodies (p < 0.03).CONCLUSIONS:  There is a significant difference between the rates of HLA alloimmunization in male patients with RBC antibodies versus multiply transfused patients without RBC antibodies. Screening for HLA antibodies may be warranted in patients with RBC alloantibodies who might require PLT transfusion support for elective surgery.
Platelet function in variable platelet split products intended for neonatal transfusion
Authors: Strasser Erwin F. , Stachel Daniel K. , Schwarzkopf Peter , Ringwald Jürgen , Weisbach Volker , Zimmermann Robert , Zingsem Jürgen , Eckstein Reinhold 
Published: March 2006

BACKGROUND:  Only a few systematic studies have examined the effect of variable produced small platelet (PLT) aliquots on PLT function before transfusion to neonates. Although neonatal transfusion could be critical, no standardization of production or systematic quality controls have been introduced so far.STUDY DESIGN AND METHODS:  PLT split products were prepared in three different ways (30‐ or 60‐mL bag, syringe aliquot) at different times from the parent unit (Days 1‐4) and stored for 2 or 4 hours. The measures of PLT function include pH, lactate, P‐selectin expression, and cytokines (β‐thromboglobulin [β‐TG], PLT‐derived growth factor AB [PDGF‐AB]). Additionally, syringe passage (0.5 mL/min) was assessed.RESULTS:  High product variability of PLT content was found (40% deviation of PLT content from programmed target, 13%‐19% PLT loss by product distribution), which resulted in PLT concentrations of split units between 0.94 × 109 and 1.66 × 109 PLTs per mL. Different gas transfer rates (pCO2) of PLT containers caused different pH values of the product (Trima 7.47 ± 0.09 vs. COM.TEC 7.33 ± 0.08; p < 0.0001), but acceptable results of PLT metabolism were found in all split units (minimum pH, 7.09; maximum lactate content, 13.1 mmol/L). P‐selectin expression on PLTs increased by factor of 2 in the parent units stored for 4 days (16.9 ± 8.6% 32.2 ± 13.4%; p = 0.02). After Day 3, β‐TG and PDGF‐AB increased by twofold. PLTs stored during passage for 100 minutes in syringes dropped pO2 by 50 percent and caused 15 percent higher lactate levels.CONCLUSION:  High variability of PLT content in split units requires at least additional PLT counts before transfusion in critical preterm or neonatal infants.
TheRHCEalleleceSL: the second example for D antigen expression without D‐specific amino acids
Authors: Chen Qing , Hustinx Hein , Flegel Willy A. 
Published: March 2006

BACKGROUND: The example of ceRT proved that the expression of some D epitopes does not require D‐specific amino acids. This allele denoted asRHce(R154T) caused the “false‐positive” reactions that were observed in ccddee blood donors who typed positive for the D antigen with some monoclonal anti‐D. No other example exposing a similar molecular mechanism was known.STUDY DESIGN AND METHODS: Eleven donor and 1 patient ccddee samples were collected in Switzerland that typed “false‐positive” with some monoclonal anti‐D in bromelain technique. TheirRHCEalleles were determined by nucleotide sequencing from genomic DNA and by a polymerase chain reaction with sequence‐specific priming. The D epitope profile was compared to ceRT. The population frequencies were estimated in Switzerland and Germany by serology or at the molecular level, respectively.RESULTS: The “false‐positive” reactions were caused by theRHCEalleleRHce(S122L) occurring in thecdehaplotype. Its ceSL phenotype expressed few D epitopes that belonged to the D epitope 6 group. The frequency of ceSL among D– donors was about 1:675 in the region of Bern, Switzerland. No ceSL donors were found elsewhere in Switzerland or in southwestern Germany.CONCLUSION: ceSL represented the second molecular mechanism for D antigen expression without any D‐specific amino acids. ceSL and ceRT were useful to delineate the molecular mechanisms of D expression by RhCE proteins carrying amino acids not representative for the RhD proteins. The ceSL population frequencies differed significantly among three Swiss and German populations.
ABO blood group in Kuwaitis: detailed allele frequency distribution and identification of novel alleles
Authors: Yip Shea Ping , Choi Pik Shan , Lee Sau Yin , Leung Kim Hung , El‐Zawahri Mokhtar M. , Luqmani Yunus A. 
Published: March 2006

BACKGROUND:  The ABO blood group is clinically the most important blood group system and can now be genotyped easily by DNA‐based methods without family studies.STUDY DESIGN AND METHODS:  Samples (n = 166) from a Kuwaiti population were phenotyped by standard serologic techniques for the ABO blood group and genotyped for the ABO locus by an established multiplex polymerase chain reaction protocol followed by single‐strand conformation polymorphism (SSCP) analysis. Nonstandard SSCP patterns were investigated by DNA sequencing of exons 6 and 7 and, if necessary intron 6.RESULTS:  Standard SSCP patterns identified six classical alleles in this population: A101 (0.1115), A102 (0.0181), A201 (0.0301), B101 (0.1627), O101 (0.3103), and O201 (0.2500). One A, 1 B, and 8 O variant alleles were identified (total frequency, 0.1175). All variant alleles were each present in one or two chromosomes (≤0.0060) in our samples except O109 (0.0813). Three of these 10 variant alleles were novel alleles defined by newly identified single‐nucleotide polymorphisms in exon 7 (527G>A, 687C>T, and 1116G>A). One new base substitution result in amino acid change.CONCLUSIONS:  This is the first study reporting the detailed distribution of ABO alleles and genotypes in Kuwaitis. Sixteen alleles were identified, including 3 novel alleles.
Encounters between aphids and their predators: the relative frequencies of disturbance and consumption
Authors: Nelson Erik H. , Rosenheim Jay A. 
Published: March 2006

AbstractEcologists may wish to evaluate the potential for predators to suppress prey populations through the costs of induced defensive behaviors as well as through consumption. In this paper, we measure the ratio of non‐consumptive, defense‐inducing encounters relative to consumptive encounters (henceforth the ‘disturbed : consumed ratio’) for two species of aphids and propose that these disturbed : consumed ratios can help evaluate the potential for behaviorally mediated prey suppression. For the pea aphid, Acyrthosiphon pisum (Harris) (Homoptera: Aphididae), the ratio of induced disturbances to consumption events was high, 30 : 1. For the cotton aphid, Aphis gossypii (Glover) (Homoptera: Aphididae), the ratio of induced disturbances to consumption events was low, approximately 1 : 14. These results indicate that the potential for predators to suppress pea aphid populations through induction of defensive behaviors is high, whereas the potential for predators to suppress cotton aphid populations through induced behaviors is low. In measuring the disturbed : consumed ratios of two prey species, this paper makes two novel points: it highlights the variability of the disturbed : consumed ratio, and it offers a simple statistic to help ecologists draw connections between predator–prey behaviors and predator–prey population dynamics.
Do I Contribute More When I Trust More? Differential Effects of Cognition- and Affect-Based Trust
Authors: Ng Kok-Yee , Chua Roy Y.J. 
Published: March 2006

AbstractThis study investigates the relationship between level of trust and cooperative behaviours in a social dilemma. We argue that this relationship should depend on the basis of trust (cognition- versus affect-based) and on beliefs about the equality of resource endowments. Results supported our prediction that increasing affect-based trust increases cooperation, but increasing cognition-based trust to a certain level can reduce cooperation because of free-riding tendency. Moreover, these effects of trust are stronger for individuals who believed that other group members had more resources than they did. Thus, our study demonstrates that higher levels of trust do not necessarily encourage cooperation. Implications of these findings are discussed.