bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ephrin-B2 expression critically influences Nipah virus infection independent of its cytoplasmic tail
Authors: Thiel Lena , Diederich Sandra , Erbar Stephanie , Pfaff Dennis , Augustin Hellmut G , Maisner Andrea 
Published: December 2008

Abstract

Background
Cell entry and cell-to-cell spread of the highly pathogenic Nipah virus (NiV) requires binding of the NiV G protein to cellular ephrin receptors and subsequent NiV F-mediated fusion. Since expression levels of the main NiV entry receptor ephrin-B2 (EB2) are highly regulated in vivo to fulfill the physiological functions in axon guidance and angiogenesis, the goal of this study was to determine if changes in the EB2 expression influence NiV infection.

Results
Surprisingly, transfection of increasing EB2 plasmid concentrations reduced cell-to-cell fusion both in cells expressing the NiV glycoproteins and in cells infected with NiV. This effect was attributed to the downregulation of the NiV glycoproteins from the cell surface. In addition to the influence on cell-to-cell fusion, increased EB2 expression significantly reduced the total amount of NiV-infected cells, thus interfered with virus entry. To determine if the negative effect of elevated EB2 expression on virus entry is a result of an increased EB2 signaling, receptor function of a tail-truncated and therefore signaling-defective ΔcEB2 was tested. Interestingly, ΔcEB2 fully functioned as NiV entry and fusion receptor, and overexpression also interfered with virus replication.

Conclusion
Our findings clearly show that EB2 signaling does not account for the striking negative impact of elevated receptor expression on NiV infection, but rather that the ratio between the NiV envelope glycoproteins and surface receptors critically influence cell-to-cell fusion and virus entry.
Altered ATP Release and Metabolism in Dorsal Root Ganglia of Neuropathic Rats
Authors: Matsuka Yoshizo , Ono Takeshi , Iwase Hirotate , Mitrirattanakul Somsak , Omoto Kevin S , Cho Ting , Lam Yan Yan N , Snyder Bradley , Spigelman Igor 
Published: December 2008

Background: Adenosine 5′-triphosphate (ATP) has a ubiquitous role in metabolism and a major role in pain responses after tissue injury. We investigated the changes in basal and KCl-evoked ATP release from rat dorsal root ganglia (DRG) after peripheral neuropathy induction by unilateral sciatic nerve entrapment (SNE). Results: After SNE, rats develop long-lasting decreases in ipsilateral hindpaw withdrawal thresholds to mechanical and thermal stimulation. At 15–21 days after neuropathy induction, excised ipsilateral L4–L5 DRG display significantly elevated basal extracellular ATP levels compared to contralateral or control (naive) DRG. However, KCl-evoked ATP release is no longer observed in ipsilateral DRG. We hypothesized that the differential SNE effects on basal and evoked ATP release could result from the conversion of extracellular ATP to adenosine with subsequent activation of adenosine A1 receptors (A1Rs) on DRG neurons. Adding the selective A1R agonist, 2-chloro-N6-cyclopentyladenosine (100 nM) significantly decreased basal and evoked ATP release in DRG from naïve rats, indicating functional A1R activation. In DRG ipsilateral to SNE, adding a selective A1R antagonist, 8-cyclopentyl-1,3-dipropylxanthine (30 nM), further increased basal ATP levels and relieved the blockade of KCl-evoked ATP release suggesting that increased A1R activation attenuates evoked ATP release in neurons ipsilateral to SNE. To determine if altered ATP release was a consequence of altered DRG metabolism we compared O2 consumption between control and neuropathic DRG. DRG ipsilateral to SNE consumed O2 at a higher rate than control or contralateral DRG. Conclusion: These data suggest that peripheral nerve entrapment increases DRG metabolism and ATP release, which in turn is modulated by increased A1R activation.
Nestin and CD133: valuable stem cell-specific markers for determining clinical outcome of glioma patients
Authors: Zhang Mingyu , Song Tao , Yang Liang , Chen Ruokun , Wu Lei , Yang Zhuanyi , Fang Jiasheng 
Published: December 2008

Abstract

Aim
Gliomas represent the most frequent neoplasm of the central nervous system. Unfortunately, surgical cure of it is practically impossible and their clinical course is primarily determined by the biological behaviors of the tumor cells. The aim of this study was to investigate the correlation of the stem cell markers Nestin and CD133 expression with the grading of gliomas, and to evaluate their prognostic value.

Methods
The tissue samples consisted of 56 low- (WHO grade II), 69 high- (WHO grade III, IV) grade gliomas, and 10 normal brain tissues. The expression levels of Nestin and CD133 proteins were detected using SABC immunohistochemical analysis. Then, the correlation of the two markers' expression with gliomas' grading of patients and their prognostic value were determined.

Results
Immunohistochemical analysis with anti-Nestin and anti-CD133 antibodies revealed dense and spotty staining in the tumor cells and their expression levels became significantly higher as the glioma grade advanced (p < 0.05). There was a positive correlation between the two markers' expression in different gliomas tissues (rs = 0.89). The low expression of the two markers significantly correlated with long survival of the glioma patients (p < 0.05). The survival rate of the patients with Nestin+/CD133+ expression was the lowest (p < 0.01), and the multivariate analysis confirmed that conjoined expression of Nestin+/CD133+ and Nestin-/CD133- were independent prognostic indicators of gliomas (both p < 0.01, Cox proportional hazard regression model).

Conclusion
These results collectively suggest that Nestin and CD133 expression may be an important feature of human gliomas. A combined detection of Nestin/CD133 co-expression may benefit us in the prediction of aggressive nature of this tumor.
Migraineurs' perceptions of and interactions with pharmacists: a qualitative study
Authors: Skomo Monica L , Desselle Shane P , Shah Neel 
Published: December 2008

Abstract

Aims and objectives
Migraine is an underdiagnosed and undertreated condition. Diagnosed and undiagnosed migraineurs come into frequent contact with pharmacists, who are in a unique position to intervene and potentially improve the therapeutic outcomes of migraineurs; however, little is known about migraineurs' attitudes towards pharmacists' roles and the experiences they have shared with pharmacists. The purpose of this study was to evaluate migraineurs' perceptions of the roles that pharmacists may play in helping them manage their disease.

Setting
Duquesne University, Pittsburgh, Pennsylvania, USA.

Method
The study employed the use of two focus groups of migraineurs from a university population, approached from a phenomenologic perspective. Focus-group sessions were conducted using a flexible interview guide. Focus-group content was digitally recorded, then transcribed, verified for accuracy and content analysed according to established criteria, employing the use of a formal coding procedure. Inductive analysis was performed to establish patterns, themes and categories in the data.

Key findings
Six principal themes emerged. Among the most important findings were that (1) migraineurs were concerned about managing their headaches and the impact migraine has on their lives and their families' lives, (2) migraineurs did not discuss their headaches or migraine therapy with pharmacists and (3) migraineurs believe that many communication barriers exist in their pharmacistpatient relationship.

Conclusion
Community pharmacists have an opportunity to impact the level of care provided to migraine sufferers. As such, community pharmacists should strive to remove communication barriers and be more proactive during interactions with these patients. Further study may examine how pharmacists can elicit more social support for migraineurs and to help migraineurs cope with their condition.
Identifying criteria for assessing the quality of medicines use review referral documentation by community pharmacists
Authors: James Delyth H , Hatten Sarah , Roberts Debra , John Dai N 
Published: December 2008

Abstract

Aims and objectives
The medicines use review (MUR) service was introduced in April 2005 for England and Wales as part of the new community pharmacy contractual framework. Following a MUR, community pharmacists are required to document their interventions and refer any unresolved issues to the patient's general medical practitioner using a structured template. The patient also receives a copy of this form. Anecdotal feedback suggests that there is considerable variation in the quality of this documentation. The aim of this study was to develop explicit criteria against which the quality of MUR referral documentation can be assessed.

Setting
This study forms part of the Welsh School of Pharmacy's ongoing monitoring and evaluation of its MUR accreditation assessment.

Method
A two-round electronic Delphi technique was used to develop a consensus of the key quality indicators to assess the quality of MUR referral documentation. Statements were generated following a systematic review of the literature plus interviews. Sixteen panellists who responded to an invitation to participate in the study were involved in the Delphi process (these were 10 out of 14 MUR accreditation tutors who were invited to take part and six pharmacy practitioners from a possible 22 primary care organisations in Wales) to rate the usefulness of these statements as a measure of pharmacists' referral skills. Consensus was defined a priori as &gt; 70% of participants scoring the statement as 1–3 on an ordinal scale from 1–9 (where 1 is definitely and 9 is definitely not).

Key findings
The first round of the electronic Delphi survey comprised 30 statements of which consensus was gained for 19. Following the second round, consensus was achieved for 20 statements.

Conclusion
These criteria could be used to assess the quality of referral documentation following MUR and to provide feedback to pharmacists on their referral skills. However, further studies are needed to test the validity of the MUR quality indicators with community pharmacists and GPs and the feasibility of using this tool in practice.
The impact of an electronic prescribing and administration system on the safety and quality of medication administration
Authors: Franklin Bryony Dean , Jacklin Ann , Barber Nick 
Published: December 2008

Abstract

Objective
To assess the effect of an electronic prescribing and administration system on the safety and quality of medication administration in a UK hospital.

Setting
Surgical ward in a teaching hospital.

Method
Data were collected before and after introducing a closed-loop system comprising electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration records (ServeRx, MDG Medical). We observed medication administration during drug rounds and assessed medication administration error (MAE) rates for ward-stock and non-ward-stock drugs, accuracy of medication administration documentation, timeliness of administration, administration of medication from unlocked areas and supervision of patients taking oral medication by nursing staff.

Key findings
Pre- and post-intervention MAE rates were 6.4 and 2.3% respectively for ward-stock drugs (95% confidence interval for the difference (CI) −5.8 to −2.4%), and 14.6 and 13.7% for non-ward-stock drugs (CI −6.5 to 4.7%). Excluding omissions due to unavailability, pre- and post-intervention MAE rates were 6.2 and 2.2% respectively for ward-stock drugs (CI −5.7 to −2.3%), and 9.2 and 3.5% for non-ward-stock drugs (CI −9.3 to −2.1%). Pre-intervention, 2086 doses (96.3%) were documented correctly and 1557 (95.9%) post-intervention (CI −1.6 to 0.8%). There were five clinically significant documentation discrepancies pre-intervention (0.2%), and 33 (2.0%) afterwards (CI 1.1 to 2.5%). Timeliness of administration improved post-intervention (P &lt; 0.001; Chi-square test), as did administration of medication from unlocked areas (CI 4.7 to 7.3%) and supervision of patients taking oral medication (CI 17 to 23%).

Conclusion
Reductions in MAEs, excluding omissions due to unavailability, occurred for both ward-stock and non-ward-stock drugs. The system also improved timeliness and security of drug administration. However, there was an increase in potentially significant documentation discrepancies.
The social life of chemotherapy protocols in a UK cancer network
Authors: Hibbert Derek , Ryan-Woolley Bernadette , Amir Ziv 
Published: December 2008

Abstract

Aims and objectives
This paper explores the development of chemotherapy protocols in a UK NHS cancer network, using data from a study of a Macmillan-funded cancer network pharmacist post.

Setting
A UK NHS cancer network.

Method
Qualitative case study drawing mainly on interviews with stakeholders.

Key findings
The paper outlines the importance of protocols in addressing problems associated with service variability in cancer networks. It explores the development of a set of network-level chemotherapy protocols co-ordinated by a network pharmacist. The work to establish common protocols is seen in light of the congruent and conflicting agendas of constituent organisations. The potential for protocols to embody organisational interests is considered in the context of the network's particular political landscape. Whereas protocols could represent the interests of the network organisation, the latter also offered a bureaucratic process through which protocols might transcend their specific organisational origins. This depended on the democratic engagement of locality (hospital trust) specialist and generalist pharmacists in the network-level enterprise. The need for protocols to convince as network and locality documents entailed an ongoing process of negotiation, particularly around the extent to which documents could acknowledge and incorporate local practices.

Conclusion
The development of chemotherapy protocols in the cancer network was outlined as a complex and ongoing process, requiring collaborative work from a range of stakeholders. We note the relevance of Timmermans and Berg's analysis of the ‘local’ and ‘universal’ dimensions of protocols. The development process, co-ordinated by the network pharmacist, involved the negotiation of these two aspects with the aim of achieving standardisation in local contexts. Network structures and the network pharmacist served to promote a dialogue between local and universal domains. This enabled the network to embody local interests, while also encouraging adoption of an ‘extralocal’ perspective by locality stakeholders.
Evaluation of multi-dose repackaging for individual patients in long-term care institutions: savings from the perspective of statutory health insurance in Germany
Authors: Gerber Andreas , Stollenwerk Björn , Lauterbach Karl W , Stock Stephanie , Büscher Guido , Rath Thomas , Lungen Markus 
Published: December 2008

Abstract

Aims and objectives
Elderly people often have difficulty adhering to multi-drug medication regimens. The current study aimed to evaluate whether multi-dose repackaging for individual patients reduces medication expenses from the perspective of statutory health insurance in Germany.

Setting
A total of 307 residents, mean age 76.8 years, median age 80 years, from four long-term care facilities were included in the prospective pre—post study conducted from September 2004 to December 2005. Minimum periods of 9 months prior to and 9 months following the introduction of multi-dose packaging were compared at the individual level with respect to the expenses for medications that were repackaged in weekly blister packs.

Method
The main outcome measure was savings in medication expenses. Statistical evaluation was carried out using the program Rversion 2.1.0. Adjustments were made for effects of age and con currently increasing morbidity in so far as number of prescriptions were held constant at the individual level.

Key findings
In the subset of 181 people included in this analysis, approximately 6.0% (95% confidence interval, 5.1–7.0%; P &lt; 0.001) of expenses for medication were saved: 2.0% (1.6–2.3%; P &lt; 0.001) was due to price differences and 4.1% (3.2–5.0%; P &lt; 0.001) to reduced wastage of prescribed medication. The probability of being prescribed a generic compared with a brand-name medication was significantly lower prior to the introduction of repackaging (0.92, 0.89–0.94; P &lt; 0.01), although this did not have any effect on turnover of medications (0.996, 0.988–1.005; P &lt; 0.01).

Conclusion
Significant savings in medication expenses were found. Nonetheless, cost savings should not be the sole objective in reorganising drug dispensing.
Exploring the role of clinical self-audits as a professional development tool
Authors: Newby David , Robertson Jane , Higgins Gwen 
Published: December 2008

Abstract

Aims and objectives
To explore the knowledge, attitudes and practices of pharmacists towards continuing education and continuing professional development (CPD) in general and clinical self-audits specifically as a CPD tool.

Setting
Newcastle, New South Wales, Australia.

Method
Two focus groups were used, involving 22 hospital and community pharmacists, with a range of professional experience. The focus groups explored the barriers and enablers to participating in continuing education and professional development activities, and clinical self-audits in particular.

Key findings
Participants indicated support for CPD, although sometimes found it difficult to distinguish between CPD and continuing education. Not all pharmacists supported CPD being compulsory for continuing registration. The barriers to involvement in educational activities included time, cost and lack of locums. The main barriers to involvement in clinical self-audits were lack of time, and a lack of awareness of what they involved. Once explained, there was support for the concept of clinical self-audits as a professional development tool.

Conclusion
Pharmacists want professional development activities suitable for the variety of practice settings in which they now work. Clinical self-audits appear to address many of the limitations of current educational activities, being practice-focused, flexible, able to be accommodated within working routines and available at low cost. However, better promotion and increased exposure to them is required to improve their uptake.
Off-label promotion of drugs in Bangladesh: evidence from promotional brochures circulated among general practioners by pharmaceutical companies
Authors: Islam Mohammad Saidul 
Published: December 2008

Abstract

Aims and objectives
To gauge the incidences and nature of off-label promotion of drugs in the promotional brochures circulated among general practioners (GPs) in Bangladesh.

Setting
A single district town of Bangladesh.

Methods
Pharmaceutical promotional brochures were obtained from the ten GPs seeing the most patients using convenience sampling. Data sheets for both proprietary and generic products were used to identify off-label promotion in the brochures. This was done because drug formulations as well as other scientific information are copied from the original brands in Bangladesh. Data management and statistical analysis were performed using Microsoft Excel.

Key findings
Of the total promotional claims, 32% were found to be off-label while the rest were as per the approved indications. Brochures for drugs used in cases of diabetes contained the highest rates (66.7%) of off-label claims followed by centrally acting drugs (56.3%). Among the centrally acting drugs, clonazepam was found to have the highest (44%) level of off-label claims. Brochures on vitamin and mineral preparations were reported to promote off-label use with mecobalamin alone having 50% off-label claims. Brochures on flucloxacillin were reported to have the highest (19%) level of off-label claims among the antibiotics. Significant levels (35%) of off-label claims were found in brochures for anti-ulcerant drugs, with ranitidine having about 58%. Promotional brochures on cardiovascular drugs and non-steroidal anti-inflammatory drugs (NSAIDs) showed 29.7% and 19.4% off-label claims respectively.

Conclusion
In this study, a high level of off-label promotional claims was reported in the pharmaceutical promotional brochures distributed among GPs in Bangladesh.
The Natural History of Audiologic and Tympanometric Findings in Patients with an Unrepaired Cleft Palate
Authors: Zheng Wei , Smith James D. , Shi Bing , Li Yu , Wang Yan , Li Sheng , Meng Zhaoli , Zheng Qian 
Published: December 2008

Objective: To present the tympanometric findings in 552 patients (115 over 10 years of age) with unrepaired cleft palate (256 had audiologic findings) and to show the natural history and outcome of these cases. Setting: The cleft lip and palate clinic for the Division of Cleft Lip and Palate Surgery at the West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China. Design: Pure-tone audiometric and tympanometric evaluations were performed on 552 patients with an unrepaired cleft palate. Results were analyzed by looking at the patient's age and cleft palate type. Results: This study demonstrated an age-related decrease in the frequency of hearing impairment and abnormal tympanometry. The frequency of hearing impairment and abnormal tympanometry in patients with submucous cleft palate was significantly lower than in patients from the other four major cleft palate categories (p  =  .001, p  =  .006, respectively). Conclusions: The middle ear function and hearing levels of unrepaired cleft palate patients improved with age, but at least 30% of the patients’ ears demonstrated a hearing loss and abnormal tympanometry in each age group, including those over 19 years of age. In the crucial language-learning stage, the frequency of hearing impairment and abnormal tympanometry was as high as 60%. Considering these results, palate repair and surgical intervention, such as tube insertion, for otological problems should be considered at an early age.
The Management of Otitis Media with Early Routine Insertion of Grommets in Children with Cleft Palate—A Systematic Review
Authors: Ponduri Sirisha , Bradley Rebecca , Ellis Pamela E. , Brookes Sara T. , Sandy Jonathan R. , Ness Andy R. 
Published: December 2008

Objective: To determine whether early routine grommet insertion in children with cleft palate has a beneficial effect on hearing and speech and language development compared with conservative management. Design: Systematic review of randomized controlled trials, controlled clinical trials, case series, and prospective and historical cohort studies. Main Outcome Measures: The main outcome measure was the effect of early routine grommet placement on the degree of conductive hearing loss. Secondary outcome measures included differences in hearing level, possible side effects, speech and language development, and quality of life. Results: We identified 368 citations for review. From a review of the titles, 34 potentially relevant papers were selected. Of these, 18 studies met our inclusion criteria, including eight case series, six historical cohort studies, three prospective cohort studies, and one randomized trial. Most studies were either small or of poor quality or both. The results of the studies were contradictory, with some studies suggesting early placement of grommets was beneficial and others reporting there was no benefit. Conclusions: There is currently insufficient evidence on which to base the clinical practice of early routine grommet placement in children with cleft palate.