bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral vitamin B12therapy in the primary care setting: a qualitative and quantitative study of patient perspectives
Authors: Kwong Jeff C , Carr David , Dhalla Irfan A , Tom-Kun Denise , Upshur Ross EG 
Published: February 2005

Abstract
Background
Although oral replacement with high doses of vitamin B12 is both effective and safe for the treatment of B12 deficiency, little is known about patients' views concerning the acceptability and effectiveness of oral B12. We investigated patient perspectives on switching from injection to oral B12 therapy.

Methods
This study involved a quantitative arm using questionnaires and a qualitative arm using semi-structured interviews, both to assess patient views on injection and oral therapy. Patients were also offered a six-month trial of oral B12 therapy. One hundred and thirty-three patients who receive regular B12 injections were included from three family practice units (two hospital-based academic clinics and one community health centre clinic) in Toronto.

Results
Seventy-three percent (63/86) of respondents were willing to try oral B12. In a multivariate analysis, patient factors associated with a "willingness to switch" to oral B12 included being able to get to the clinic in less than 30 minutes (OR 9.3, 95% CI 2.2–40.0), and believing that frequent visits to the health care provider (OR 5.4, 95% CI 1.1–26.6) or the increased costs to the health care system (OR 16.7, 95% CI 1.5–184.2) were disadvantages of injection B12. Fifty-five patients attempted oral therapy and 52 patients returned the final questionnaire. Of those who tried oral therapy, 76% (39/51) were satisfied and 71% (39/55) wished to permanently switch. Factors associated with permanently switching to oral therapy included believing that the frequent visits to the health care provider (OR 35.4, 95% CI 2.9–432.7) and travel/parking costs (OR 8.7, 95% CI 1.2–65.3) were disadvantages of injection B12. Interview participants consistently cited convenience as an advantage of oral therapy.

Conclusion
Switching patients from injection to oral B12 is both feasible and acceptable to patients. Oral B12 supplementation is well received largely due to increased convenience. Clinicians should offer oral B12 therapy to their patients who are currently receiving injections, and newly diagnosed B12-deficient patients who can tolerate and are compliant with oral medications should be offered oral supplementation.
Docetaxel plus cisplatin is effective for patients with metastatic breast cancer resistant to previous anthracycline treatment: a phase II clinical trial
Authors: Park Se Hoon , Cho Eun Kyung , Bang Soo-Mee , Shin Dong Bok , Lee Jae Hoon , Lee Young Don 
Published: February 2005

Abstract
Background
Patients with metastatic breast cancer (MBC) are frequently exposed to high cumulative doses of anthracyclines and are at risk of resistance and cardiotoxicity. This phase II trial evaluated the efficacy and toxicity of docetaxel plus cisplatin, as salvage chemotherapy in patients with MBC resistant to prior anthracyclines.

Methods
Patients with MBC that had progressed after at least one prior chemotherapy regimen containing anthracyclines received docetaxel 75 mg/m2 followed by cisplatin 60 mg/m2 every 3 weeks for a maximum of 6 cycles or until disease progression.

Results
Between Jan 2000 and May 2002, 24 patients with tumors primary resistant and 15 with secondary resistant disease were accrued. All 39 patients were evaluable for safety and 36 for efficacy. The objective response rate was 31% (95% CI, 16–45%) with 3 complete responses. The median time to disease progression was 7 months, and the median overall survival was 23 months (median follow-up of 41 months). Neutropenia was the most frequently observed severe hematologic toxicity (39% of patients), whereas asthenia and nausea were the most common non-hematologic toxicities. No treatment-related death was observed.

Conclusion
In conclusion, we found docetaxel plus cisplatin to be an active and safe chemotherapy regimen for patients with MBC resistant to anthracyclines.
Rural Indian tribal communities: an emerging high-risk group for HIV/AIDS
Authors: Naik Eknath , Karpur Arun , Taylor Richard , Ramaswami Balasubramaniam , Ramachandra Seetharam , Balasubramaniam Bindu , Galwankar Sagar , Sinnott John , Nabukera Sarah , Salihu Hamisu M 
Published: February 2005

Abstract
Background
Rural Indian tribes are anthropologically distinct with unique cultures, traditions and practices. Over the years, displacement and rapid acculturation of this population has led to dramatic changes in their socio-cultural and value systems. Due to a poor health infrastructure, high levels of poverty and ignorance, these communities are highly vulnerable to various health problems, especially, communicable diseases including HIV/AIDS. Our study sought to assess knowledge, attitudes and practices regarding sexuality, and the risk factors associated with the spread of HIV/AIDS and STDs among these communities.

Methods
A nested cross sectional study was undertaken as part of the on going Reproductive and Child Health Survey. A total of 5,690 participants age 18–44 were recruited for this study. Data were obtained through home interviews, and focused on socio-demographics, knowledge, attitudes and behaviors regarding sexuality, HIV/AIDS and other STDs.

Results
The study revealed that only 22% of adults had even heard of AIDS, and 18 % knew how it is transmitted. In addition, only 5% knew that STDs and AIDS were related to each other. AIDS awareness among women was lower compared to men (14% vs.30 %). Regarding sexual practices, 35% of the respondents reported having had extramarital sexual encounters, with more males than females reporting extramarital affairs.

Conclusion
Lack of awareness, permissiveness of tribal societies for premarital or extra-marital sexual relationships, and sexual mixing patterns predispose these communities to HIV/AIDS and STD infections. There is a dire need for targeted interventions in order to curtail the increasing threat of HIV and other STDs among these vulnerable populations.
A comparative study of reaction times between type II diabetics and non-diabetics
Authors: Richerson Samantha J , Robinson Charles J , Shum Judy 
Published: February 2005

Abstract

Background
Aging has been shown to slow reflexes and increase reaction time to varied stimuli. However, the effect of Type II diabetes on these same reaction times has not been reported. Diabetes affects peripheral nerves in the somatosensory and auditory system, slows psychomotor responses, and has cognitive effects on those individuals without proper metabolic control, all of which may affect reaction times. The additional slowing of reaction times may affect every-day tasks such as balance, increasing the probability of a slip or fall.

Methods
Reaction times to a plantar touch, a pure tone auditory stimulus, and rightward whole-body lateral movement of 4 mm at 100 mm/s2 on a platform upon which a subject stood, were measured in 37 adults over 50 yrs old. Thirteen (mean age = 60.6 ± 6.5 years) had a clinical diagnosis of type II diabetes and 24 (mean age = 59.4 ± 8.0 years) did not. Group averages were compared to averages obtained from nine healthy younger adult group (mean age = 22.7 ± 1.2 years).

Results
Average reaction times for plantar touch were significantly longer in diabetic adults than the other two groups, while auditory reaction times were not significantly different among groups. Whole body reaction times were significantly different among all three groups with diabetic adults having the longest reaction times, followed by age-matched adults, and then younger adults.

Conclusion
Whole body reaction time has been shown to be a sensitive indicator of differences between young adults, healthy mature adults, and mature diabetic adults. Additionally, the increased reaction time seen in this modality for subjects with diabetes may be one cause of increased slips and falls in this group.
Involvement of β-chemokines in the development of inflammatory demyelination
Authors: Banisor Ileana , Leist Thomas P , Kalman Bernadette 
Published: February 2005

AbstractThe importance of β-chemokines (or CC chemokine ligands – CCL) in the development of inflammatory lesions in the central nervous system of patients with multiple sclerosis and rodents with experimental allergic encephalomyelitis is strongly supported by descriptive studies and experimental models. Our recent genetic scans in families identified haplotypes in the genes of CCL2, CCL3 and CCL11-CCL8-CCL13 which showed association with multiple sclerosis. Complementing the genetic associations, we also detected a distinct regional expression regulation for CCL2, CCL7 and CCL8 in correlation with chronic inflammation in multiple sclerosis brains. These observations are in consensus with previous studies, and add new data to support the involvement of CCL2, CCL7, CCL8 and CCL3 in the development of inflammatory demyelination. Along with our own data, here we review the literature implicating CCLs and their receptors (CCRs) in multiple sclerosis and experimental allergic encephalomyelitis. The survey reflects that the field is in a rapid expansion, and highlights some of the pathways which might be suitable to pharmaceutical interventions.
Results of Whole-Brain Radiation As Salvage of Methotrexate Failure for Immunocompetent Patients With Primary CNS Lymphoma
Authors: Nguyen Paul L. , Chakravarti Arnab , Finkelstein Dianne M. , Hochberg Fred H. , Batchelor Tracy T. , Loeffler Jay S. 
Published: February 2005

Purpose This study evaluates the efficacy and toxicity of whole-brain radiation therapy (WBRT) as salvage therapy for immunocompetent patients who failed initial high-dose methotrexate for primary CNS lymphoma (PCNSL). Patients and Methods The study cohort included 27 consecutive patients who failed initial high-dose methotrexate and then received salvage WBRT (median dose, 36 Gy). Actuarial survival was measured from the initiation of radiotherapy. Results Ten patients (37%) achieved a complete radiographic response (CR), and 10 patients (37%) a partial response to WBRT, for a 74% overall radiographic response rate. At the time of maximal response, Karnofsky performance status improved in 12 (44%) of 27 patients and at least stabilized in 67%. Median estimated survival from initiation of WBRT was 10.9 months (range, 0.3 to 63.7 months). The univariate predictor of longer survival was age less than 60 years at the time of WBRT (P = .028). Among patients who survived 4 months, achievement of a CR to WBRT by 4 months (P = .002) predicted longer survival. Late treatment-associated neurotoxicity was diagnosed in four patients (15%) and was significantly associated with total radiation doses greater than 36 Gy (P = .04). No patient treated with daily fractions less than 1.8 Gy developed late neurotoxicity. Conclusion For patients with PCNSL who experience treatment failure with methotrexate, WBRT provides high response rates (74%) and a median survival of 10.9 months. Age less than 60 years and response to WBRT predict post-WBRT survival. Modest rates of late neurotoxicity (15%) were seen and were associated with a total dose greater than 36 Gy.
Diagnosis and Management of Waldenstrom's Macroglobulinemia
Authors: Dimopoulos Meletios A. , Kyle Robert A. , Anagnostopoulos Athanasios , Treon Steven P. 
Published: February 2005

Purpose To review the diagnostic criteria, prognostic factors, response criteria, and treatment options of patients with Waldenstrom's macroglobulinemia (WM). Methods A review of published reports was facilitated by the use of a MEDLINE computer search and by manual search of the Index Medicus. Results WM should be regarded as a distinct clinicopathologic entity and confined to those patients with lymphoplasmacytoid lymphoma who have demonstrable serum immunoglobulin M monoclonal protein. Treatment decisions should rely on specific clinical and laboratory criteria. Initiation of therapy should not be based on serum monoclonal protein levels per se. The three main choices for systemic primary treatment of symptomatic patients with WM include alkylating agents (chlorambucil), nucleoside analogs (fludarabine and cladribine), and the monoclonal antibody rituximab. There are no data from prospective randomized studies to recommend the use of one first-line agent over another, although consideration of a patient's candidacy for autologous stem-cell transplantation (ASCT) should be taken into account to avoid stem cell–damaging agents. There are preliminary data to suggest that combinations of nucleoside analogs and alkylating agents with or without rituximab may improve response rates at the expense of higher toxicity. Conclusion WM is a distinct low-grade lymphoproliferative disorder. When therapy is indicated, alkylating agents, nucleoside analogs, and rituximab are reasonable choices. Several factors, including the presence of cytopenias, need for rapid disease control, candidacy for ASCT, age, and comorbidities, should be taken into consideration when choosing the most appropriate primary treatment.
Atypical Teratoid/Rhabdoid Tumors (ATRT): Improved Survival in Children 3 Years of Age and Older With Radiation Therapy and High-Dose Alkylator-Based Chemotherapy
Authors: Tekautz Tanya M. , Fuller Christine E. , Blaney Susan , Fouladi Maryam , Broniscer Alberto , Merchant Thomas E. , Krasin Matthew , Dalton James , Hale Gregory , Kun Larry E. , Wallace Dana , Gilbertson Richard J. , Gajjar Amar 
Published: February 2005

Purpose To describe clinical features, therapeutic approaches, and prognostic factors in pediatric patients with atypical teratoid/rhabdoid tumors (ATRT) treated at St Jude Children's Research Hospital (SJCRH). Patients and Methods Primary tumor samples from patients diagnosed with ATRT at SJCRH between July 1984 and June 2003 were identified. Pathology review included histologic, immunohistochemical analysis, and fluorescence in situ hybridization for SMARCB1 (also known as hSNF5/INI1) deletion. Clinical records of patients with pathologic confirmation of ATRT were reviewed. Results Thirty-seven patients were diagnosed with ATRT at SJCRH during the 19-year study interval. Six patients were excluded from this clinical review based on pathologic or clinical criteria. Of the remaining 31 patients, 22 were younger than 3 years. Posterior fossa primary lesions and metastatic disease at diagnosis were more common in younger patients with ATRT. All patients underwent surgical resection; 30 received subsequent chemotherapy. The majority of patients aged 3 years or older received postoperative craniospinal radiation. Two-year event-free (EFS) and overall survival (OS) of children aged 3 years or older (EFS, 78% + 14%; OS, 89% ± 11%) were significantly better than those for younger patients (EFS, 11% ± 6%; OS, 17% ± 8%); EFS, P = .009 and OS, P = .0001. No other clinical characteristics were predictive of survival. Three of four patients 3 years or older with progressive disease were successfully rescued with ifosfamide, carboplatin, and etoposide therapy. Conclusion Children presenting with ATRT before the age of 3 years have a dismal prognosis. ATRT presenting in older patients can be cured using a combination of radiation and high-dose alkylating therapy. Older patients with relapsed ATRT can have salvage treatment using ICE chemotherapy.
Site of Primary Tumor Has a Prognostic Role in Operable Breast Cancer: The International Breast Cancer Study Group Experience
Authors: Colleoni Marco , Zahrieh David , Gelber Richard D. , Holmberg Stig B. , Mattsson Jan E. , Rudenstam Carl-Magnus , Lindtner Jurij , Eržen Darja , Snyder Raymond , Collins John , Fey Martin F. , Thürlimann Beat , Crivellari Diana , Murray Elizabeth , Mendiola Caesar , Pagani Olivia , Castiglione-Gertsch Monica , Coates Alan S. , Price Karen , Goldhirsch Aron 
Published: February 2005

Purpose Cancer presenting at the medial site of the breast may have a worse prognosis compared with tumors located in external quadrants. For medial tumors, axillary lymph node staging may not accurately reflect the metastatic potential of the disease. Patients and Methods Eight-thousand four-hundred twenty-two patients randomly assigned to International Breast Cancer Study Group clinical trials between 1978 and 1999 were classified as medial site (1,622; 19%) or lateral, central, and other sites (6,800; 81%). Median follow-up was 11 years. Results A statistically significant difference was observed for patients with medial tumors versus those with nonmedial tumors in disease-free survival (DFS; 10-year DFS, 46% v 48%; HR, 1.10; 95% CI, 1.02 to 1.18; P = .01) and overall survival (10-year OS 59% v 61%; HR, 1.09; 1.01 to 1.19; P = .04). This difference increased after adjustment for other prognostic factors (HR, 1.22; 95% CI, 1.13 to 1.32 for DFS; and HR, 1.24; 95% CI, 1.14 to 1.35 for OS; both P = .0001). The risk of relapse for patients with medial presentation was largest for the node-negative cohort and for patients with tumors larger than 2 cm. In the subgroup of 2,931 patients with negative axillary lymph nodes, 10-year DFS was 61% v 67%, and OS was 73% v 80% for medial versus nonmedial sites, respectively (HR 1.33; 95% CI, 1.15 to 1.54; P = .0001 for DFS; and HR 1.40; 95% CI, 1.17 to 1.67; P = .0003 for OS). Conclusion Tumor site has a significant prognostic utility, especially for axillary lymph node–negative disease, that should be considered in therapeutic algorithms. New staging procedures such as biopsy of the sentinel internal mammary nodes or novel imaging methods should be further studied in patients with medial tumors.
Size of Breast Cancer Metastases in Axillary Lymph Nodes: Clinical Relevance of Minimal Lymph Node Involvement
Authors: Colleoni Marco , Rotmensz Nicole , Peruzzotti Giulia , Maisonneuve Patrick , Mazzarol Giovanni , Pruneri Giancarlo , Luini Alberto , Intra Mattia , Veronesi Paolo , Galimberti Viviana , Torrisi Rosalba , Cardillo Anna , Goldhirsch Aron , Viale Giuseppe 
Published: February 2005

Background Overt ipsilateral axillary lymph node metastases of breast cancer are the most significant prognostic indicators for women who have undergone surgery, yet the clinical relevance of minimal involvement (isolated tumor cells and micrometastases) of these nodes is uncertain. Patients and Methods We evaluated biologic features, adjuvant treatment recommendations, and prognosis for 1,959 consecutive patients with pT1-3, pN0, minimal lymph node involvement (pN1mi or pN0i+), or pN1a (single positive node) and M0, who were operated on and counseled for medical therapy from April 1997 to December 2000. Results Patients with pN1a and pN1mi/pN0i+, when compared with patients with pN0 disease, were more often prescribed anthracycline-containing chemotherapy (39.1% v 33.2% v 6.1%, respectively; P < .0001) and were less likely to receive endocrine therapy alone (9.8% v 19.4% v 41.9%, respectively; P < .0001). At the multivariate analysis, a statistically significant difference in disease-free survival (DFS) and in the risk of distant metastases was observed for patients with pN1a versus pN0 disease (hazard ratio [HR] = 2.04; 95% CI, 1.46 to 2.86; P < .0001 for DFS; HR = 2.32; 95% CI, 1.42 to 3.80; P = .0007 for distant metastases) and for patients with pN1mi/pN0i+ versus pN0 disease (HR = 1.58; 95% CI, 1.01 to 2.47; P = .047 for DFS; HR = 1.94; 95% CI, 1.04 to 3.64; P = .037 for distant metastases). Conclusion Even minimal involvement of a single axillary node in breast cancer significantly correlates with worse prognosis compared with no axillary node involvement. Further studies are required before widespread modification of clinical practice.
Direct Amination of Toluene with Hydroxylamine in the Presence of Vanadium-based Catalysts
Authors: Yu Tianhua , Hu Changwei , Wang Xueqin 
Published: February 2005

Abstract
The amination of toluene to toluidines with hydroxylamine hydrochloride was investigated over vanadium-based catalysts supported on different carriers and in different reaction media. Over 50% total yield of toluidines was obtained on the catalysts operated at optimal conditions.
Lewis Base-catalyzed Trifluoromethylation of Aldimines with (Trifluoromethyl)trimethylsilane
Authors: Kawano Yoshikazu , Fujisawa Hidehiko , Mukaiyama Teruaki 
Published: February 2005

Abstract
A catalytic trifluoromethylation of various aldimines with (trifluoromethyl)trimethylsilane in the presence of Lewis bases such as lithium acetate or benzoate proceeded smoothly to afford the corresponding trifluoromethylated adducts in good yields.
Enhanced Selectivity to Decalin in Naphthalene Hydrogenation under Supercritical Carbon Dioxide
Authors: Hiyoshi Norihito , Miura Ritsuko , Rode Chandrashekhar V , Sato Osamu , Shirai Masayuki 
Published: February 2005

Abstract
A charcoal-supported rhodium catalyst was highly active and selective to decalin for the hydrogenation of naphthalene at very low temperature (333 K) under supercritical carbon dioxide.
The predictability of deep convection in cloud‐resolving simulations over land
Authors: Petch J. C. 
Published: February 2005

AbstractCloud‐resolving models (CRMs) can be used to provide subgrid information for use in improving the representation of convection in large‐scale models. However, it is shown here that, for a 24‐hour simulation of convection over land, the total daily rainfall and instant rain rates can often be hard to predict. An ensemble of 2D CRM runs, which differ only in the initial white‐noise temperature perturbations added to the lowest 200 m, show a large spread of results. The size of the spread is shown to be dependent on the nature and strength of the forcing with the most significant differences between ensemble members when only a small number of convective cells exist in the domain. Further sensitivity experiments show that stronger forcing or increased domain size can reduce the spread of results due to an increased number of clouds. However, in all the simulations described in this paper, convection tended to organize into fewer but larger clouds during the day and, as this occurs, the ensemble members began to diverge even with a domain size of 1000 km. © Crown copyright, 2004.
An updated length‐scale formulation for turbulent mixing in clear and cloudy boundary layers
Authors: Lenderink G. , Holtslag A. A. M. 
Published: February 2005

AbstractA new mixing‐length scale is presented for turbulence‐closure schemes, with special emphasis on neutral‐to‐convective conditions in clear and cloudy boundary layers. The length scale is intended for a prognostic turbulent‐kinetic‐energy closure. It is argued that present‐day length‐scale formulations may easily fail in one of two limiting situations. Schemes based on a local stability measure (e.g. the Richardson number) display unrealistic behaviour and instabilities in the convective limit. This strongly limits the representation of mixing in cloudy boundary layers. On the other hand, it is shown that non‐local parcel methods may misrepresent mixing near the surface. The new length‐scale formulation combines local and non‐local stability in a new way; it uses vertical integrals over the stability (the Richardson number) in a simple ‘parcel’ framework. The length scale matches with surface‐layer similarity for near‐neutral conditions and displays a realistic convective limit. The use of the length‐scale formulation can be extended easily to cloudy boundary layers. The scheme is numerically stable and computationally cheap. The behaviour of the length scale is evaluated in a single‐column model (SCM) and in a high‐resolution limited‐area model (LAM). The SCM shows good behaviour in three cases with and without boundary‐layer clouds. The prediction of the near‐surface wind and temperature in the LAM compares favourably with tower measurements at Cabauw (the Netherlands). Copyright © 2004 Royal Meteorological Society