bluuebunny/crossref_metadata_2025_split huggingface dataset:
Environmental influences on energy balance-related behaviors: A dual-process view
Authors: Kremers Stef PJ , de Bruijn Gert-Jan , Visscher Tommy LS , van Mechelen Willem , de Vries Nanne K , Brug Johannes 
Published: May 2006

Abstract

Background
Studies on the impact of the 'obesogenic' environment have often used non-theoretical approaches. In this journal's debate and in other papers authors have argued the necessity of formulating conceptual models for differentiating the causal role of environmental influences on behavior.

Discussion
The present paper aims to contribute to the debate by presenting a dual-process view on the environment – behavior relationship. This view is conceptualized in the EnRG framework (Environmental Research framework for weight Gain prevention). In the framework, behavior is postulated to be the result of a simultaneous influence of conscious and unconscious processes. Environmental influences are hypothesized to influence behavior both indirectly and directly. The indirect causal mechanism reflects the mediating role of behavior-specific cognitions in the influence of the environment on behavior. A direct influence reflects the automatic, unconscious, influence of the environment on behavior. Specific personal and behavioral factors are postulated to moderate the causal path (i.e., inducing either the automatic or the cognitively mediated environment – behavior relation). In addition, the EnRG framework applies an energy balance-approach, stimulating the integrated study of determinants of diet and physical activity.

Conclusion
The application of a dual-process view may guide research towards causal mechanisms linking specific environmental features with energy balance-related behaviors in distinct populations. The present paper is hoped to contribute to the evolution of a paradigm that may help to disentangle the role of 'obesogenic' environmental factors.
Lack of CD117 and rare bcl-2 expression in stomach cancer by immunohistochemistry. An immunohistochemical study with review of the literature
Authors: Mireskandari Masoud , Shafaii Ali Fakhr , Kayser Gian , Kayser Klaus 
Published: May 2006

AbstractBackgroundGastric adenocarcinoma is one of the most frequent malignancies worldwide including Iran. This study was designed to immunohistochemically evaluate the CD117 and bcl-2 expression in gastric carcinomas and their potential use as therapeutic targets in the treatment of patients with advanced stage gastric cancer.Materials and methodsRepresentative paraffin blocks obtained from 38 operated gastric adenocarcinoma patients were retrieved from Afzalipour Hospital pathology department archive, Kerman, Iran. Immunohistochemical analysis (IHC) for CD117 was carried out in all cases including negative (normal gastric epithelium) and positive (Gastrointestinal Stromal Tumor) controls. In addition, the cases were evaluated immunohistochemically for apoptosis-related protein (bcl-2), to evaluating a potential association of CD117 expression with the cell proliferation regulatory pathways.ResultsNo positive reaction for CD117 was seen in gastric carcinoma tumor cells irrespective to the cell type, grade, and stage, proliferation and apoptosis rate. Expression of bcl-2 was observed in only one case.ConclusionWe conclude that CD117 overexpression detectable by immunohistochemistry does not play a significant role in gastric carcinoma pathways and development, although overexpression at the gene level and/or mutated CD117 expression might exist. Thus, it is unlikely that the CD117 pathway is of clinical significance in gastric carcinoma patients.
Inhibition of macropinocytosis blocks antigen presentation of type II collagen in vitro and in vivoin HLA-DR1 transgenic mice
Authors: von Delwig Alexei , Hilkens Catharien MU , Altmann Daniel M , Holmdahl Rikard , Isaacs John D , Harding Clifford V , Robertson Helen , McKie Norman , Robinson John H 
Published: May 2006

AbstractProfessional antigen-presenting cells, such as dendritic cells, macrophages and B cells have been implicated in the pathogenesis of rheumatoid arthritis, constituting a possible target for antigen-specific immunotherapy. We addressed the possibility of blocking antigen presentation of the type II collagen (CII)-derived immunodominant arthritogenic epitope CII259–273 to specific CD4 T cells by inhibition of antigen uptake in HLA-DR1-transgenic mice in vitro and in vivo. Electron microscopy, confocal microscopy, subcellular fractionation and antigen presentation assays were used to establish the mechanisms of uptake, intracellular localization and antigen presentation of CII by dendritic cells and macrophages. We show that CII accumulated in membrane fractions of intermediate density corresponding to late endosomes. Treatment of dendritic cells and macrophages with cytochalasin D or amiloride prevented the intracellular appearance of CII and blocked antigen presentation of CII259–273 to HLA-DR1-restricted T cell hybridomas. The data suggest that CII was taken up by dendritic cells and macrophages predominantly via macropinocytosis. Administration of amiloride in vivo prevented activation of CII-specific polyclonal T cells in the draining popliteal lymph nodes. This study suggests that selective targeting of CII internalization in professional antigen-presenting cells prevents activation of autoimmune T cells, constituting a novel therapeutic strategy for the immunotherapy of rheumatoid arthritis.
The incidence and outcome of septic shock patients in the absence of early-goal directed therapy
Authors: Ho Benjamin CH , Bellomo Rinaldo , McGain Forbes , Jones Daryl , Naka Toshio , Wan Li , Braitberg George 
Published: May 2006

Abstract
Introduction
The purpose of the present study was to measure the incidence and outcome of septic patients presenting at the emergency department (ED) with criteria for early goal-directed therapy (EGDT).

Method
This hospital-based, retrospective, observational study using prospectively collected electronic databases was based in a teaching hospital in Melbourne, Australia. We conducted outcome-blinded electronic screening of patients with infection admitted via the ED from 1 January 2000 to 30 June 2003. We obtained data on demographics, laboratory and clinical features on admission. We used paper records to confirm electronic identification of candidates for EGDT and to study their treatment. We followed up all patients until hospital discharge or death.

Results
Of 4,784 ED patients with an infectious disease diagnosis, only 50 fulfilled published clinical inclusion criteria for EGDT (EGDT candidates). Of these patients, 37 (74%) survived their hospital admission, two (4%) died in the ED, eight (16%) died in the intensive care unit and three (6%) died in the ward. After review of all ward cardiac arrests and non-NFR ('not for resuscitation') ward deaths, we identified a further two potential candidates for EGDT for an overall mortality of 28.8% (15 out of 52 patients). Analysis of treatment showed that twice as many (70%) of the EGDT candidates received vasopressor therapy in the ED, and their initial mean central venous pressure (10.8 mmHg) was almost twice that in patients from the EGDT study conducted by Rivers and coworkers.

Conclusion
In an Australian teaching hospital candidates for EGDT were uncommon and, in the absence of an EGDT protocol, their mortality was lower than that reported with EGDT.
Empiric broad-spectrum antibiotic therapy of nosocomial pneumonia in the intensive care unit: a prospective observational study
Authors: Álvarez-Lerma Francisco , Alvarez Bernabe , Luque Pilar , Ruiz Francisco , Dominguez-Roldan Jose-Maria , Quintana Elisabet , Sanz-Rodriguez Cesar ,   the ADANN Study Group
Published: May 2006

Abstract
Introduction
Antibiotic de-escalation, which consists of the initial institution of empiric broad-spectrum antibiotics followed by antibiotic streamlining driven by microbiological documentation, is thought to provide maximum benefit for the individual patient, while reducing the selection pressure for resistance.

Methods
To assess a carbapenem-based de-escalating strategy in nosocomial pneumonia (NP), a prospective observational study was conducted in critically ill patients with NP treated empirically with imipenem ± aminoglycoside/glycopeptide in 24 intensive care units of Spanish general hospitals. Overall, 244 patients were assessable (91% with late-onset NP). The primary outcome was therapeutic success 7–9 days post therapy.

Results
Microbial identification – based on cultures of tracheal aspirates in 82% of patients, cultures of protected specimen brush in 33%, and cultures of bronchoalveolar lavage in 4% – was only available for 131 (54%) patients. Initial antibiotics were inadequate for 23 (9%) patients. Of the remaining patients, antibiotics were streamlined in 56 (23%) patients and remained unchanged in 14 (6%) patients based on microbiology data, in 38 (16%) patients despite microbiology data favouring de-escalation, and in 113 (46%) patients due to unknown aetiology. Overall, de-escalation was implemented in only 23% of patients with potentially multiresistant pathogens, compared with 68% of patients with the remaining pathogens (P < 0.001). Response rates were 53% for patients continuously treated with imipenem-based regimens and 50% for the de-escalated patients. Higher Acute Physiology, Age, and Chronic Health Evaluation II scores were associated with greater mortality, whereas adequate empiric antibiotic therapy protected against fatal outcomes. No increase of superinfection rates caused by emerging pathogens was observed. The costs associated with de-escalation were mainly dependent on the duration of hospitalization.

Conclusion
This study mainly highlights the current practice of a specific algorithm of de-escalation solely based on the available microbiological data, and highlights the barriers to using it more widely. In this setting, de-escalation was less likely to occur in the presence of potentially multiresistant pathogens. Prior antibiotic administration and the low use of bronchoscopic techniques may have influenced negatively the implementation of de-escalation. Optimization of de-escalation strategies for NP should rely on a correct choice of empiric antibiotics, on appropriate microbiological investigations, and on a balanced interpretation of microbiological and clinical data.
Helicobacter pylori infection is not associated with an increased hemorrhagic risk in patients in the intensive care unit
Authors: Robert René , Gissot Valérie , Pierrot Marc , Laksiri Leila , Mercier Emmanuelle , Prat Gwenael , Villers Daniel , Vincent Jean-François , Hira Michel , Vignon Philippe , Charlot Patrick , Burucoa Christophe 
Published: May 2006

Abstract
Introduction
The potential role of Helicobacter pylori in acute stress ulcer in patients in an intensive care unit (ICU) is controversial. The aim of this study was to determine the frequency of H. pylori infection in ICU patients by antigen detection on rectal swabs, and to analyze the potential relationship between the presence of H. pylori and the risk of digestive gastrointestinal bleeding.

Methods
In this prospective, multicenter, epidemiological study, the inclusion criteria were as follows: patients admitted to the 12 participating ICU for at least two days, who were free of hemorrhagic shock and did not receive more than four units of red blood cells during the day before or the first 48 hours after admission to the ICU. Rectal swabs were obtained within the first 24 hours of admission to the ICU and were tested for H. pylori antigens with the ImmunoCard STAT! HpSA kit. The following events were analyzed according to H. pylori status: gastrointestinal bleeding, unexplained decline in hematocrit, and the number of red cell transfusions.

Results
The study involved 1,776 patients. Forty-nine patients (2.8%) had clinical evidence of upper digestive bleeding. Esophagogastroduodenoscopy was performed in 7.6% of patients. Five hundred patients (28.2%) required blood transfusion. H. pylori antigen was detected in 6.3% of patients (95% confidence interval 5.2 to 7.5). H. pylori antigen positivity was associated with female sex (p < 0.05) and with a higher Simplified Acute Physiology Score II (SAPS II; p < 0.05). H. pylori antigen status was not associated with the use of fiber-optic gastroscopy, the need for red cell transfusions, or the number of red cell units infused.

Conclusion
This large study reported a small percentage of H. pylori infection detected with rectal swab sampling in ICU patients and showed that the patients infected with H. pylori had no additional risk of gastrointestinal bleeding. Thus H. pylori does not seem to have a major role in the pathogenesis of acute stress ulcer in ICU patients.
Stroke Rates and Risk Factors in Patients Treated With Radiation Therapy for Early-Stage Breast Cancer
Authors: Jagsi Reshma , Griffith Kent A. , Koelling Todd , Roberts Rachel , Pierce Lori J. 
Published: May 2006

Purpose To examine whether stroke risk is elevated in American breast cancer patients treated with modern techniques, as well as whether supraclavicular radiation therapy (RT) is associated with increased risk. Methods Observed rates of stroke in 820 eligible early-stage breast cancer patients treated at the University of Michigan Hospital (Ann Arbor, MI) were compared with expected rates. Relationships between potential risk factors and actuarial rate of first stroke were analyzed. Results Median follow-up was 6.8 years. Twenty patients had at least one cerebrovascular accident (CVA) in follow-up; 35 patients had at least one CVA or transient ischemic attack (CVA/TIA). The standardized incidence ratios were 1.74 (0.94 to 2.37) for CVA and 1.68 (1.003 to 2.06) for CVA/TIA. The absolute excess risk per 1,000 patients per year was 1.67 for CVA and 2.76 for CVA/TIA. On bivariate analysis, factors significantly associated with actuarial rate of first CVA included hypertension (P = .002), age (P < .0001), coronary artery disease (P = .001), atrial fibrillation (P = .009), and supraclavicular RT (P = .021). Factors associated with CVA/TIA were hypertension (P < .001), coronary artery disease (P = .002), and age (P < .0001). Tamoxifen use alone was not significant (P = .19), but tamoxifen combined with baseline hypertension led to increased risk of CVA/TIA (log-rank P < .0001). On multivariate analysis, only age (P < .001) and hypertension (P = .003) remained significant predictors of CVA/TIA. Age was the only significant predictor of CVA alone (P < .001). Conclusion American breast cancer survivors may have an elevated risk of stroke compared with the general population, but the absolute excess risk is low. This study found no significant association between supraclavicular RT and stroke after controlling for other factors.
Complete Excision of Primary Breast Tumor Improves Survival of Patients With Metastatic Breast Cancer at Diagnosis
Authors: Rapiti Elisabetta , Verkooijen Helena M. , Vlastos Georges , Fioretta Gerald , Neyroud-Caspar Isabelle , Sappino André Pascal , Chappuis Pierre O. , Bouchardy Christine 
Published: May 2006

Purpose Surgery of the primary tumor usually is not advised for patients with metastatic breast cancer at diagnosis because the disease is considered incurable. In this population-based study, we evaluate the impact of local surgery on survival of patients with metastatic breast cancer at diagnosis. Methods We included all 300 metastatic breast cancer patients recorded at the Geneva Cancer Registry between 1977 and 1996. We compared mortality risks from breast cancer between patients who had surgery of the primary breast tumor to those who had not and adjusted these risks for other prognostic factors. Results Women who had complete excision of the primary breast tumor with negative surgical margins had a 40% reduced risk of death as a result of breast cancer (multiadjusted hazard ratio [HR], 0.6; 95% CI, 0.4 to 1.0) compared with women who did not have surgery (P = .049). This mortality reduction was not significantly different among patients with different sites of metastasis, but in the stratified analysis the effect was particularly evident for women with bone metastasis only (HR, 0.2; 95% CI, 0.1 to 0.4; P = .001). Survival of women who had surgery with positive surgical margins was not different from that of women who did not have surgery. Conclusion Complete surgical excision of the primary tumor improves survival of patients with metastatic breast cancer at diagnosis, particularly among women with only bone metastases.
The Role of Prevention in Oncology Practice: Results From a 2004 Survey of American Society of Clinical Oncology Members
Authors: Ganz Patricia A. , Kwan Lorna , Somerfield Mark R. , Alberts David , Garber Judy E. , Offit Kenneth , Lippman Scott M. 
Published: May 2006

Purpose In 2004, the American Society of Clinical Oncology (ASCO) Cancer Prevention Committee surveyed the members to describe involvement in clinical prevention activities. Methods A previously administered survey, with updated items on genetics, chemoprevention, and survivorship, was mailed to a stratified random sample of 2,000 domestic members and a convenience sample of 3,144 international members. Results A total of 49.7% of domestic members contacted and survey eligible responded (n = 851). Nonresponders were younger (50.5 v 51.7 years; P < .01); 465 international members responded. Overall, 35% had received formal instruction in cancer prevention and control, and most respondents expected increased use of prevention, screening/early detection, and risk reduction/genetic counseling in their practices in the next 5 years. Most reported caring for cancer survivors, including providing general medical care. They also either directly provide or refer patients for cancer prevention and control services (eg, cancer screening, tobacco and nutrition counseling, risk reduction, and chemoprevention). Multivariable modeling found fewer perceived barriers to inclusion of cancer prevention activities in clinical practice among those practicing in an academic setting, seeing a higher proportion of patients without a cancer diagnosis, having formal training in prevention and control, expecting an increase in prevention activities in the next 5 years, and providing community advice on prevention. Conclusion Barriers to the inclusion of cancer prevention and control activities in oncology clinical practice exist. Nevertheless, a substantial proportion of both domestic and international ASCO members report an interest in cancer prevention and control activities, with a desire for more specific educational programs in this emerging area of oncology practice.
The politics of evidence and methodology: lessons from the EPPI-Centre
Authors: Oakley Ann , Gough David , Oliver Sandy , Thomas James 
Published: May 2006

English
The ‘evidence movement’ poses particular challenges to social science. This article describes and reflects on some of these challenges, using as a case study the development over the period from 1993 of the Evidence for Policy and Practice Information and Coordinating (EPPI-Centre) at the Institute of Education, University of London. The article describes the development of EPPICentre resources for supporting evidence-informed policy in the fields of education and health promotion, and in so doing explores many of the challenges that confront research reviewers in the social sciences. These include technical and methodological issues affecting the quality and reporting of primary research, and the retrieval quality of bibliographic databases; and wider factors such as the culture of academia, and research funding practices that militate against the building of a cumulative evidence base.
Is the evidence-based practice movement doing more good than harm? Reflections on Iain Chalmers’ case for research-based policy making and practice
Authors: Hammersley Martyn 
Published: May 2006

English
Powerful voices are currently insisting that policy and practice must be based on research evidence, and that social science inquiry should be reformed in order to serve this need more effectively. An influential figure in the evidence-based practice movement is Sir Iain Chalmers, previously director of the UK Cochrane Centre. Taking evidence-based medicine as his model, he presents the task of research as to determine which policies and practices work. This is to be achieved through the use of randomised controlled trials and systematic reviews of their results. In this article, some of the central assumptions of his case are assessed.
Evidence-based practice in the real world
Authors: Moseley Alice , Tierney Stephanie 
Published: May 2006

English
Despite growing awareness of and enthusiasm for evidence-based practice (EBP) among front-line social care staff employed by member agencies of the Centre for Evidence-based Social Services, using evidence in practice is a demanding task. This article highlights some of the challenges to evidence-based practice experienced by those involved in its implementation, which can be characterised as cultural, infrastructural and practical. Despite these hurdles, creative, practical steps have been taken by social care staff to promote EBP within their workplaces, and these are briefly summarised.
Foreign‐grammar acquisition while watching subtitled television programmes
Authors: Van Lommel Sven , Laenen Annouschka , d'Ydewalle Géry 
Published: May 2006

Background. Past research has shown that watching a subtitled foreign movie (i.e. foreign language in the soundtrack and native language in the subtitles) leads to considerable foreign‐language vocabulary acquisition; however, acquisition of the grammatical rules has failed to emerge.Aims. The aim of this study was to obtain evidence for the acquisition of grammatical rules in watching subtitled foreign movies. Given an informal context, younger children were predicted to outperform older children in acquiring a foreign language; however, older children will take more advantage of explicit instruction compared with younger children.Sample. In Experiment 1, 62 sixth‐graders from a primary school and 47 sixth‐graders from a secondary school volunteered to participate. The participants in Experiment 2 were 94 sixth‐graders from primary schools and 84 sixth‐graders from secondary schools.Method. The two experiments manipulated the instructions (incidental‐ vs. intentional‐language learning). Moreover, before the experiments began, some participants explicitly received some of the foreign grammatical rules (presented rules), while the movie contained cases of presented rules as well as cases of rules which had to be inferred (not‐presented rules).Results. Rule acquisition through the movie only was not obtained; there was a strong effect of advance rule presentation but only on the items of presented rules, particularly among the older participants.Conclusions. Contrary to vocabulary, grammar may be too complicated to acquire from a rather short movie presentation.