bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-monitoring of oral anticoagulation: does it work outside trial conditions?
Authors: Gardiner C , Longair I , Pescott M A , Erwin H , Hills J , Machin S J , Cohen H 
Published: January 2009

Background:Patient self-monitoring (PSM) of oral anticoagulation therapy (OAT) can improve anticoagulant control, but poor uptake and high dropout rates have prompted suggestions that PSM is suitable for only a minority of patients in the UK.Aims:To determine whether PSM could be a viable alternative to regular hospital anticoagulant clinic attendance, if offered from the start of treatment.Methods:318 consecutive patients referred, for the first time, to an anticoagulation clinic were assessed for eligibility using established criteria. Patients electing for PSM attended training and, following successful assessment, performed a capillary blood INR every two weeks or more frequently if directed to do so by the anticoagulation clinic. Primary outcome measures were uptake of PSM and the percentage time in target therapeutic INR range (TIR) compared to patients electing for routine clinic care.Results:Of 318 patients referred for OAT, 188 were eligible for PSM. 84 (26%) elected to self-monitor, of whom 72 (23%) remained self-monitoring or had completed their course of treatment at the end of the audit. Self-monitoring patients had significantly better anticoagulant control than those receiving routine hospital anticoagulation clinic care (TIR 71% vs 60%, p = 0.003) and significantly less time outside critical limits, ie, INR <1.5 or >5.0 (0.45% vs 2.04%, p = 0.008).Conclusions:Patients offered PSM from the start of treatment show increased uptake compared to previous UK studies and a level of oral anticoagulation control comparable to that reported in previous clinical trials.
CD105/endoglin expression in Gorham disease of bone
Authors: Franchi A , Bertoni F , Bacchini P , Mourmouras V , Miracco C 
Published: January 2009

Background:Gorham disease is a rare pathological condition characterised by a proliferation of vascular channels of haematic and lymphatic origin in bone and adjacent soft tissues, which results in a progressive destruction of the involved bone segment.Aim:To evaluate expression of the vascular endothelial cell marker CD105/endoglin in Gorham disease of bone.Methods:An immunohistochemical analysis was conducted on four cases of Gorham disease of bone, and for comparison on eight cases of conventional haemangioma of bone and on normal fetal and adult bone tissue specimens.Results:Diffuse and intense immunostaining of endothelial cells for CD105 was observed in the specimens of fetal bone in areas undergoing ossification and in the growth plate of young adults. In medullary bone, CD105 positivity was limited to sinusoids of haemopoietic marrow, while endothelial cells of capillaries and small arterioles and venules within fatty marrow were either negative or showed weak immunostaining. The mean percentage of positive vessels in Gorham disease was significantly higher than in osseous haemangioma (58.9 (SEM 14.9) vs 17.2 (SEM 12.0); p = 0.03, Mann–Whitney U test). A significant direct correlation was observed between the proliferative activity assessed by MIB-1 immunostaining, and the percentage of CD105 positive vessels in the entire series (r = 0.681; p = 0.01).Conclusions:Data indicate that the phenotype of proliferating endothelial cells of Gorham disease is similar to that of the endothelial lining of vessels of metabolically active bone characterised by high expression of CD105, while that of conventional haemangioma is more similar to that of metabolically quiescent bone tissue, such as fatty marrow, with low levels of expression of CD105. This may have potential therapeutic and diagnostic applications.
Holding personal information in a disease-specific register: the perspectives of people with multiple sclerosis and professionals on consent and access: Table 1
Authors: Baird W , Jackson R , Ford H , Evangelou N , Busby M , Bull P , Zajicek J 
Published: January 2009

Objective:To determine the views of people with multiple sclerosis (MS) and professionals in relation to confidentiality, consent and access to data within a proposed MS register in the UK.Design:Qualitative study using focus groups (10) and interviews (13).Setting:England and Northern Ireland.Participants:68 people with MS, neurologists, MS nurses, health services management professionals, researchers, representatives from pharmaceutical companies and social care professionals.Results:People with MS expressed open and altruistic views towards the use of their personal information to facilitate service provision and research, placing trust in responsible guardianship and legitimate use of their information. Participant’s proposed that people with MS should be able to select their individual level of involvement in a register using levels of consent. It was agreed that access to the register should be governed by a guardianship committee composed of a range of stakeholders. People with MS did not wish their details to be used by marketing agencies and did not consider this a legitimate use of their data. Whilst participants were positive of the role a register could play in promoting research, participants felt that access to data by pharmaceutical industries should be administered by the guardianship committee. People with MS are concerned should their employers be able to access their personal information. Professionals were more cautious than people with MS in their approach to the use of patient personal data within a register.Conclusions:Whilst all stakeholders were positive of the benefits of an MS register, development of such a resource must incorporate robust data security and guardianship measures in order to ensure that, whilst opportunities are maximised, risks to the privacy of individuals and legal challenges to professionals are avoided.
Cigarette affordability trends: an update and some methodological comments
Authors: Blecher E H , van Walbeek C P 
Published: January 2009

Objectives:To calculate cigarette affordability for a number of countries using different techniques and data, to investigate trends since 1990 and to assess the appropriateness of different measures of affordability.Design:Two existing measures were specified. Relative income price (RIP) uses per capita gross domestic product (GDP) as the measure of income, while “minutes of labour” is based on a Union Bank of Switzerland (UBS) survey of earnings.Subjects:RIP (1990–2006) is calculated for 32 high-income and 45 low-income and middle-income countries. The “minutes of labour” measure is calculated for 29 high-income and 23 low-income and middle-income countries.Results:In high-income countries cigarettes are significantly more affordable than in low-income and middle-income countries, but have become less affordable since 1990. Among low-income and middle-income countries, cigarettes have become more affordable since 1990 and at an increasingly rapid rate since 2000. In 33 of 34 countries where cigarette affordability decreased since 1990, the real price increased. In 20 of 37 countries where cigarettes became more affordable, real price decreased.When measuring affordability in low-income and middle-income countries, a broad income measure, such as per capita GDP, is most appropriate. For high-income countries, the choice of income measure is not important.Conclusions:In international comparisons, cigarette prices should not only be viewed in monetary terms but also in terms of their affordability. Fast-growing countries face greater tobacco control challenges since rising incomes increase the affordability of cigarettes. The fact that cigarettes have become increasingly affordable in a majority of low-income and middle-income countries is a major tobacco control failure.
Elusive isotopic properties of deglacial meltwater spikes into the North Atlantic: example of the final drainage of Lake AgassizThis article is one of a series of papers published in the Special Issue on the theme Polar Climate Stability Network.
Authors: Hillaire-Marcel C. , Hélie J.-F. , McKay J. , de Vernal A. 
Published: January 2009

The impact of the final drainage of Lake Agassiz, some 8.4 ka ago on the Atlantic Meridional Overturning Circulation is still debated. The lack of isotopic response in planktic foraminifer records at the outlet of the drainage channel constitutes a puzzling element in this debate. To estimate the response of the 18O–salinity relationship in ocean surface waters to drainage, we use a core raised from southeast Hudson Bay to document δ18O values of lake waters, immediately prior to drainage. Valves of Candona sp. (an ostracod) from lacustrine varved-sediments underlying marine clays, yielded δ18O values clustered around –20.5‰ (versus VPDB (Vienna PeeDee Belemnite)). Assuming a lake bottom temperature of about 0 °C, an isotopic composition of –25‰ (versus VSMOW (Vienna standard mean ocean water)) is calculated for paleolake waters, not unlike values reported for earlier stages of Lake Agassiz. This value is only slightly more negative than those estimated for Laurentide Ice Sheet (LIS) meltwaters during the last glacial maximum (∼ –21‰), or for the “apparent” freshwater end member diluting modern northwest Atlantic surface waters (–20.3‰ ± 0.4‰). The estimated ∼ –0.1‰ shift of the 18O–salinity relationship of ocean surface waters, in the salinity domain (>34) characterizing the only planktic foraminifer ( Neogloboquadrina pachyderma , Np) then abundant off the drainage outlet, seems barely distinguishable from background noise of Np δ18O records from such environments. Most other similar LIS deglacial events have probably not left any clear isotopic records in deep-sea cores from surrounding basins.
Geochemical reconstruction of Pacific decadal variability from the eastern North Pacific during the HoloceneThis article is one of a series of papers published in this Special Issue on the themePolar Climate Stability Network.
Authors: Ivanochko Tara S. , Calvert Stephen E. , Thomson Richard E. , Pedersen Thomas F. 
Published: January 2009

Determining climate variations over the Holocene requires high-resolution records with well-developed age models. A 40 m long marine sediment core raised from Effingham Inlet, an anoxic fjord on the west coast of Vancouver Island, British Columbia, Canada, yields such a record. Forty six14C accelerator mass spectrometry (AMS) dates determined from terrestrial plant material form the age model. Downcore sampling at both 5 cm (20 year) and 1.5 cm (7 year) resolution indicates that high-frequency oceanographic variability has prevailed at this site over the last 10 000 years. Spectral analysis of wt.% opal, a proxy for diatom productivity in the basin, reveals the bidecadal and pentadecadal periods of the Pacific decadal oscillation (PDO) – North Pacific index (NPI) that are related to changes in the strength of the Aleutian Low. Coherence analysis between the Effingham Inlet data and δ18O records from Jellybean Lake (a high elevation site in southwest Yukon) indicates regional coherence at periods of 45, 70, and 510 years between productivity in Effingham Inlet and changes in the Aleutian Low strength. Over the entire Holocene, the strength of decadal variability has changed. Both 20- and 50-year periods are present to some degree in the early Holocene, and only the 50 year period is evident in the late Holocene. These data imply that regime shifts would have been more frequent in the early Holocene relative to the last several thousand years.
210Pb–226Ra–230Th systematics in very low sedimentation rate sediments from the Mendeleev Ridge (Arctic Ocean)This article is one of a series of papers published in this Special Issue on the theme Polar Climate Stability Network.GEOTOP Publication 2008-0031.
Authors: Not Christelle , Hillaire-Marcel Claude , Ghaleb Bassam , Polyak Leonid , Darby Dennis 
Published: January 2009

U-series isotope behaviour in subsurface sediment of the Arctic Ocean is investigated based on high resolution measurements of natural radionuclides (210Pb, 226Ra, 230Th) and a few analyses of anthropogenic 137Cs in cores collected during the 2005 Healy-Oden Trans-Arctic Expedition (HOTRAX). Cores from the Mendeleev Ridge, representing distinct bathymetric settings, are analyzed in more detail as a means to assess the dating potential of such radionuclides at sites characterized by very low sedimentation rates (∼3 mm ka–1). The sediment consists of variable proportions of fine-grained carbonates, clays, and ice-rafted debris and shows excesses in 210Pb (210Pbxs) over parent 226Ra content, down to ∼1 cm below core top. This 210Pbxs distribution is due to shallow mixing by benthic organisms and (or) diffusion from the sediment–water interface, as also indicated by 137Cs activities. From ∼1 to 7 cm downcore, 210Pb activities closely follow 226Ra activities. Below 7 cm downcore, 226Ra activities are controlled by variable excesses in parent 230Th (230Thxs) resulting from its scavenging in the overlying water column. 226Ra diffusion is observed towards the water column occuring from the upper ∼7 cm of sediment below the seafloor (with a flux of ∼0.043 disintegrations per minute (dpm) cm–2 a–1) and deeper in the sediment below 230Thxs peaks but with lesser fluxes. Both cores show identical 210Pb profiles despite their 1 km bathymetric difference. This suggests negligible 230Th and 210Pb scavenging below water depths of ∼1.6 km, i.e., the bathymetry of the shallower core. In such settings where sedimentation rates are very low and vertical particle rain is the major sediment source, estimates of the actual 210Pbxs require precise knowledge of the 226Ra-supported fraction, which is controlled by 230Thxs, Ra diffusion, and thus sedimentation rates and porosity.
Arctic vs. North Atlantic water mass exchanges in Fram Strait from Pb isotopes in sedimentsThis article is one of a series of papers published in this Special Issue on the theme Polar Climate Stability Network.
Authors: Carignan Jean , Hillaire-Marcel Claude , de Vernal Anne 
Published: January 2009

Surface sediment samples (n = 10), collected between Spitzbergen and Greenland, and two cores raised east (C04) and west (C16) from Fram Strait were analyzed for their chemical and isotopic (Pb) compositions to trace the source of sediments and water masses exchanging between the Arctic and the North Atlantic oceans. In surface sediments, variable major and trace element concentrations suggest variations in both the mineralogy (carbonate and quartz dilution of other silicate minerals) and source regions of detrital supplies, based on Th/Zr and, to a lesser extent, on Th/U ratios. Each core site shows specific but nearly constant Th/Zr ratios, indicating homogeneous source supplies. At both core sites, Pb concentrations and isotopic compositions display similar patterns: homogeneous low Pb and radiogenic crustal signals below 5–10 cm, contrasting with high Pb and less radiogenic anthropogenic inputs at core-tops. However, the differing pre-anthropogenic Pb isotopic ratios in C04 and C16 confirm the involvement of distinct source supplies east and west of Fram Strait. We suggest that this isotopic specificity is mainly owing to inputs of material carried from northwestern Europe by the North Atlantic water mass and from the Laptev Sea by the Transpolar Drift, respectively. Some material from the Greenland margin and possibly from the North Atlantic Ocean may reach this zone as well. Sediments from the western Arctic are not significantly transported into the Fram Strait area, suggesting that the Canadian and the Eurasian basins remained decoupled, at least during the time span of the cored sediments (∼2000 years).
The practical use of goal attainment scaling for people with acquired brain injury who receive cognitive rehabilitation
Authors: Bouwens Sharon FM , van Heugten Caroline M , Verhey Frans RJ 
Published: January 2009

Objective: To examine the feasibility of and clinical experiences with goal attainment scaling when used for the evaluation of cognitive rehabilitation in people with acquired brain injury. Design: A prospective observational longitudinal study. Setting: A 21-week cognitive rehabilitation programme and a cognitive programme with varying length in two different Dutch rehabilitation centres. Subjects: Forty-eight consecutive patients with acquired brain injury enrolled during a 15-month period. Interventions: Cognitive rehabilitation programme. Main measure: Goal attainment scaling; the number of goals was counted; time to set goals was recorded; the number of different domains in which goals were set was counted; goal attainment scaling score was calculated at baseline, one week after the end of the cognitive rehabilitation programme and at six months follow-up; clinical experiences that could be useful for both clinical and research practice were recorded. Results: The mean (SD) age of the patients was 46.1 (10.7) years; 29 (60%) were male; 186 goals were set with a mean (SD) number of 4 (1) goals per patient. It was possible to set at least three realistic goals per patient within 30 minutes. Most goals were set in the cognitive domain (i.e. memory and attention), followed by the behavioural domain (i.e. fatigue and aggression). Conclusion: It proved possible to set three goals within an acceptable time-frame, to involve patients in the goal-setting procedure, to set realistic goals, and to set goals within relevant domains. Based on clinical experiences, goal attainment scaling is less feasible for research when patients lack insight, or suffer from comorbidity or mood problems.
Safety and immunogenicity of a new formulation of interferon β-1a (Rebif® New Formulation) in a Phase IIIb study in patients with relapsing multiple sclerosis: 96-week results
Authors: Giovannoni G , Barbarash O , Casset-Semanaz F , King J , Metz L , Pardo G , Simsarian J , Sørensen PS , Stubinski B ,   on behalf of the Rebif® New Formulation Study Group
Published: January 2009

Background A new formulation of subcutaneous (s.c.) interferon-β-1a has been developed (Rebif® New Formulation, RNF), produced without fetal bovine serum and without human serum albumin as an excipient, with the aim of improving injection tolerability, and reducing immunogenicity. Objectives This article reports 96-week analyses of a Phase IIIb, open-label study of the safety and immunogenicity of RNF compared with historical (EVIDENCE study) and recent (REGARD study) data on the original formulation. Methods Patients with relapsing multiple sclerosis (McDonald criteria) and an Expanded Disability Status Scale score < 6.0 received RNF, 44 μg s.c. three times weekly. Results The proportion of neutralizing antibody-positive (NAb+) patients (serum NAb status ≥20 neutralizing units/mL) at week 96 (last observation carried forward; primary endpoint) was 17.4% (exact 95% confidence interval [CI]: 13.0–22.5), compared with 21.4% (95% CI: 17.2–26.2) in the EVIDENCE study, and 27.3% (95% CI: 22.8–32.1) in the REGARD study. The proportion of patients NAb+ at any time during the 96 weeks was 18.9% (95% CI: 14.4–24.2), compared with 27.1% (95% CI: 22.4–32.2) and 33.7% (95% CI: 28.9–38.7), respectively. Most pre-specified categories of adverse events were reported by patients in the RNF study at a similar or lower proportion than in the EVIDENCE and REGARD studies. Injection-site reactions were experienced by fewer patients than in the EVIDENCE and REGARD studies. Conclusions RNF has improved overall immunogenicity and safety profiles compared with the original formulation.
Characterization of tumefactive demyelinating lesions using MR imaging and in-vivo proton MR spectroscopy
Authors: Malhotra HS , Jain KK , Agarwal A , Singh MK , Yadav SK , Husain M , Krishnani N , Gupta RK 
Published: January 2009

Background and Objectives Diagnosis of tumefactive demyelinating lesions (TDLs) is challenging to both clinicians and radiologists. Our objective in this study was to analyze and characterize these lesions clinically, biochemically, electrophysiologically, and on imaging. Methods A retrospective analysis with prospective follow-up of 18 cases of TDLs was performed. Imaging included T2-, T1-weighted, fluid-attenuated inversion recovery (FLAIR), post-contrast T1-weighted, diffusion weighted imaging (DWI), and proton magnetic resonance spectroscopy (PMRS). Results All the lesions appeared hyperintense on T2 and FLAIR images. Increased Apparent diffusion coefficient (ADC) (0.93–2.21 × 10−3 mm2/s) in centre of the lesion was seen in 14/18 cases; however, peripheral restriction (ADC values 0.55–0.64 × 10−3 mm2/s) was noted in 11/18 cases. In all, 13/18 cases showed contrast enhancement with open ring ( n = 5), complete ring ( n = 1), minimal ( n = 4), and infiltrative ( n = 3) pattern of enhancement. Nine of these 13 cases also showed venular enhancement. On PMRS, nine showed glutamate/glutamine (Glx) at 2.4 ppm. Conclusion Clinical features along with several MRI characteristics such as open ring enhancement, peripheral restriction on DWI, venular enhancement, and presence of Glx on spectroscopy may be rewarding in differentiating TDLs from neoplastic lesions.
Deficiency of von Willebrand factor protects mice from ischemic stroke
Authors: Kleinschnitz Christoph , De Meyer Simon F. , Schwarz Tobias , Austinat Madeleine , Vanhoorelbeke Karen , Nieswandt Bernhard , Deckmyn Hans , Stoll Guido 
Published: January 2009

Abstract
We recently demonstrated that blockade of the platelet adhesion receptor glycoprotein (GP) Ibα protects mice from ischemic stroke. Although von Willebrand factor (VWF) is the major ligand for GPIbα, GPIbα can engage other counterreceptors on endothelial cells, platelets, and leukocytes (eg, Mac-1 or P-selectin) potentially involved in stroke outcome. To further analyze whether VWF is of particular relevance for stroke development, VWF−/− mice underwent 60 minutes of middle cerebral artery occlusion. After 24 hours, VWF−/− mice had significantly smaller infarctions (P < .05) and less severe neurologic deficits (P < .01) compared with controls. This effect was sustained after 1 week, and intracranial bleeding was absent in VWF−/− mice as revealed by serial magnetic resonance imaging. Hydrodynamic injection of a VWF-encoding plasmid restored the susceptibility for stroke in VWF−/− mice. This study indicates that VWF is critically involved in cerebral ischemia. Hence, targeted inhibition of the GPIbα-VWF pathway might become a promising therapeutic option.