bluuebunny/crossref_metadata_2025_split huggingface dataset:
A review of the effects of impermeable bedding encasements on dust‐mite allergen exposure and bronchial hyper‐responsiveness in dust‐mite‐sensitized patients
Authors: Recer G. M. 
Published: February 2004

SummaryBackground
Sensitization and exposure to dust‐mite antigens are causative factors in the development and exacerbation of asthma. Impermeable bedding encasements are considered a first‐line treatment to reduce dust‐mite antigen exposure in clinical asthma‐management guidelines. Public‐health recommendations for environmental asthma treatments should be based on the weight of evidence supporting the reliability of environmental interventions so that uncertainties regarding their effectiveness can be accurately communicated to patients, and so that limited public‐health resources can be most effectively utilized.Objective
To evaluate the strength of a clinical‐trial evidence supporting the efficacy of bedding encasements as an asthma treatment.Methods
A narrative review was conducted of all clinical trials involving bedding encasement for the treatment of asthma. Collective statistical analyses were also performed to characterize the quantitative effect of bedding encasement on dust‐mite allergen exposure and bronchial hyper‐responsiveness (BHR) when used by asthma patients.Results
Over 30 clinical trials were reviewed. Of those studies reporting adequate exposure and BHR results, four reported significant reduction in dust‐mite allergen exposure and concomitant BHR reduction in active‐treatment groups using bedding encasements. In 10 studies, mite‐allergen exposure was reportedly decreased during the study, but BHR was not changed in the active‐treatment group or was reduced to a similar degree in the active‐treatment and control groups. Five other studies reported a lack of significant effect of the intervention on exposure and BHR. Collective paired analyses found that the effect of bedding encasement on allergen exposure and BHR tended toward only a modest, non‐significant improvement. Collectively, effects of bedding encasement on BHR and dust‐mite allergen exposure were modestly correlated only when the baseline exposure was above 2 μg Type 1 antigen per gram settled dust.Conclusion
Although bedding encasement might be an effective asthma treatment under some conditions, when implemented in clinical trials by asthma patients, its effectiveness is inconsistent and appears to be, at best, modest. Therefore, its significance as a reliable asthma management modality for any individual asthma patient is uncertain. Where resource constraints are significant, targeting the use of variably effective interventions such as bedding encasements toward those patient sub‐populations most likely to derive substantial benefit may gain the largest net public‐health benefit.
Inflammatory changes associated with circadian variation in pulmonary function in subjects with mild asthma
Authors: Kelly E. A. B. , Houtman J. J. , Jarjour N. N. 
Published: February 2004

SummaryBackground
Nocturnal enhancement of airway inflammation has been demonstrated in patients with asthma who have a significant drop in pulmonary function at night.Objective
To investigate the circadian changes in airway inflammation and their relationship with variations in pulmonary function in subjects with mild atopic asthma.Methods
Twelve asthma subjects were admitted to the hospital for two separate 24‐h visits. Bronchoalveolar lavage (BAL) was performed at 04:00 hours during one visit, and at 16:00 hours during another visit. BAL cells were analysed for lymphocyte phenotype and the capacity to secrete cytokines following ex vivo stimulation with phytohaemagglutinin (PHA).Results
The numbers of BAL lymphocytes and the percentage of CD4+ T cells were higher at 04:00 hours compared with 16:00 hours. At 04:00 hours, the forced expiratory volume in 1 s (FEV1) was inversely correlated with BAL lymphocytes and CD4+ cells. PHA‐induced generation of IL‐5 by BAL cells correlated with BAL eosinophils and CD4+ cells. Moreover, there was a linear relationship between the relative change (16:00–04:00 hours) in IL‐5 and circadian variation in FEV1.Conclusions
These data suggest that the circadian variation in lung function in asthma is associated with increased airway CD4+ lymphocyte numbers and their capacity to generate IL‐5. Furthermore, in mild asthma, these circadian changes appear to fall into a continuous range, suggesting that day/night variations in airway inflammation and lung function occur on a continuum, rather than as an all‐or‐none phenomenon.
Gene–gene synergistic effect on atopic asthma: tumour necrosis factor‐α‐308 and lymphotoxin‐α‐NcoI in Taiwan's children
Authors: Wang T.‐N. , Chen W.‐Y. , Wang T.‐H. , Chen C.‐J. , Huang L.‐Y. , Ko Y.‐C. 
Published: February 2004

SummaryBackground
Asthma is now known to be an inflammatory response caused by the release of inflammatory mediators and cytokines. Tumour necrosis factor (TNF) is a potent cytokine in the inflammation response of the airway, and the polymorphisms of TNF genes have been associated with asthma.Objective
This study investigated two variants, TNF‐α‐308*2 and lymphotoxin (LT)‐α‐NcoI*1, which may predispose individuals to asthma and atopy pathogenesis.Methods
PCR‐based assays were performed to determine LT‐α‐NcoI*1 and TNF‐α‐308*2 genotypes among our subjects, with 128 atopic asthmatics and 51 non‐atopic asthmatics, 55 atopic controls, and 78 non‐atopic controls in this genetic case–control study.Results
The TNF‐α‐308*2 polymorphism increased in subjects with atopic asthma vs. non‐atopic controls after adjusting for age distribution (adjusted odds ratios, AOR=2.73, 95% confidence interval, CI=1.16–6.64), but was not associated with non‐atopic asthma (AOR=2.40, 95% CI=0.81–7.09). LT‐α‐NcoI*1 did not show an independent association with either atopic asthma or any one phenotype of specific IgE. The synergistic effect between these two genes was conducted, and the interaction between TNF‐α‐308*2 and LT‐α‐NcoI*1 polymorphisms was seen for atopic asthma (OR=2.59, 95% CI=1.10–6.10) when compared with all controls.Conclusion
We have concluded that TNF‐α‐308 may be a risk factor for atopic asthma, whereas the LT‐α‐NcoI polymorphism may modify risk to atopic asthma with TNF‐α‐308.
Resolution of allergic airways inflammation but persistence of airway smooth muscle proliferation after repeated allergen exposures
Authors: Leung S.‐Y. , Eynott P. , Noble A. , Nath P. , F. Chung K. 
Published: February 2004

SummaryBackground
Chronic inflammation in asthmatic airways can lead to characteristic airway smooth muscle (ASM) thickening and pathological changes within the airway wall.Objective
We investigated the long‐term effects of repeated allergen exposure.Methods
Brown‐Norway (BN) rats sensitized to ovalbumin (OVA) were exposed to OVA or saline aerosol every third day on six occasions and studied 24 h, 7 days and 35 days after the final exposure. We measured airway inflammation, ASM cell proliferation (by incorporation of bromodeoxyuridine; BrdU) and bronchial responsiveness to acetylcholine.Results
At 24 h, in OVA‐exposed rats, we detected elevated OVA‐specific serum IgE, increased numbers of macrophages, eosinophils, lymphocytes and neutrophils in the bronchoalveolar lavage (BAL) fluid and increased numbers of MBP+ (major basic protein) eosinophils and CD2+ T cells within the bronchial submucosa. This coincided with increased numbers of ASM cells expressing BrdU and with bronchial hyper‐responsiveness (BHR). At 7 days, BHR was detected in OVA‐exposed rats, coincident with increased numbers of macrophages and lymphocytes in BAL fluid together with increased numbers of CD2+ T cells within the bronchial submucosa. This coincided with increased numbers of ASM cells expressing BrdU. By day 35, the number of ASM cells expressing BrdU remained elevated in the absence of cellular infiltration and BHR.Conclusion
Repeated OVA‐challenge results in persistent ASM cell proliferation in the absence of bronchial inflammation and BHR, which lasts for at least 1 week following cessation of exposure.
Respiratory allergy to peach leaves and lipid‐transfer proteins
Authors: García B. E. , Lombardero M. , Echechipía S. , Olaguibel J. M. , Díaz‐Perales A. , Sánchez‐Monge R. , Barber D. , Salcedo G. , Tabar A. I. 
Published: February 2004

SummaryBackground
Several lipid‐transfer proteins (LTPs) have been identified as important food allergens, especially in fruits of the Rosaceae family. The major peach (Prunus persica) allergen has been identified, sequenced and designated Pru p 3.Objective
To present Pru p 3 as an aeroallergen able to induce occupational asthma.Methods
A thorough investigation was performed in a fruit grower with occupational asthma. Skin prick–prick tests with peach leaves and prick tests with perennial respiratory allergens and pollens, fruits and peach leaf extracts were done. Serum‐specific IgE was tested for peach leaf, peach fruit, peach skin and respiratory allergens that were positive in skin prick tests. Specific bronchial provocation tests (BPTs) with extracts of peach leaf were also done. Before and 24 h after the BPT, BPTs with methacholine and sputum induction were done. The IgE reactivity pattern to peach leaf and fruit extracts and to Pru p 3 was identified by using SDS‐PAGE and immunoblotting. Blotting inhibition of peach leaf extract by Pru p 3 was also performed. The putative allergen was quantified in leaf and fruit skin extracts with ELISA based on an anti‐Pru p 3 antibody.Results
Skin tests were positive for peach leaf and fruit. The BPT was positive, with immediate and delayed response. This test induced a decrease in PD20 (dose of agonist that induces a 20% fall in FEV1) methacholine and an increase in eosinophils and eosinophil cationic protein in sputum. Peach leaf extract contained concentrations of Pru p 3 similar to those found in peach skin. Specific IgE immunodetection showed that patient's sera reacted with Pru p 3, and with a single major band from the peach leaf extract fully inhibited by Pru p 3.Conclusion
Pru p 3 from peach leaves can act as a respiratory allergen and cause occupational rhinoconjunctivitis and asthma.
Phleum pratense pollen starch granules induce humoral and cell‐mediated immune responses in a rat model of allergy
Authors: Motta A. , Peltre G. , Dormans J. A. M. A. , Withagen C. E. T. , Lacroix G. , Bois F. , Steerenberg P. A. 
Published: February 2004

SummaryBackground
Timothy grass (Phleum pratense) pollen allergens are an important cause of allergic symptoms. However, pollen grains are too large to penetrate the deeper airways. Grass pollen is known to release allergen‐bearing starch granules (SG) upon contact with water. These granules can create an inhalable allergenic aerosol capable of triggering an early asthmatic response and are implicated in thunderstorm‐associated asthma.Objective
We studied the humoral (IgE) and bronchial lymph node cells reactivities to SG from timothy grass pollen in pollen‐sensitized rats.Methods
Brown–Norway rats were sensitized (day 0) and challenged (day 21) intratracheally with intact pollen and kept immunized by pollen intranasal instillation by 4 weeks intervals during 3 months. Blood and bronchial lymph nodes were collected 7 days after the last intranasal challenge. SG were purified from fresh timothy grass pollen using 5 μm mesh filters. To determine the humoral response (IgE) to SG, we developed an original ELISA inhibition test, based on competition between pollen allergens and purified SG. The cell‐mediated response to SG in the bronchial lymph node cells was determined by measuring the uptake of [3H]thymidine in a proliferation assay.Results
An antibody response to SG was induced, and purified SG were able to inhibit the IgE ELISA absorbance by 45%. Pollen extract and intact pollen gave inhibitions of 55% and 52%, respectively. A cell‐mediated response was also found, as pollen extract, intact pollen and SG triggered proliferation of bronchial lymph node cells.Conclusions
It was confirmed that timothy grass pollen contains allergen‐loaded SG, which are released upon contact with water. These granules were shown to be recognized by pollen‐sensitized rats sera and to trigger lymph node cell proliferation in these rats. These data provide new arguments supporting the implication of grass pollen SG in allergic asthma.
A dose‐ranging study of the effects of mequitazine on actual driving, memory and psychomotor performance as compared to dexchlorpheniramine, cetirizine and placebo
Authors: Theunissen E. L. , Vermeeren A. , Van Oers A. C. M. , Van Maris I. , Ramaekers J. G. 
Published: February 2004

SummaryBackground
Mequitazine is a so‐called ‘non‐sedative’ second‐generation antihistamine even though it has never been firmly established that this drug's sedative potential actually differs from that of the ‘sedative’ first‐generation antihistamines.Objective
The present study compares the sedative effects of three doses of mequitazine on actual driving, psychomotor performance and memory with those of a first‐ and a second‐generation antihistamine.Methods
Eighteen healthy volunteers received on separate days a single dose of 5, 10 and 15 mg mequitazine, 10 mg cetirizine, 6 mg dexchlorpheniramine and placebo. Drug effects were assessed using two actual driving tests (highway‐driving test and car‐following test), cognitive and psychometric tests (tracking, divided attention, memory, reasoning and critical flicker fusion), pupil size and questionnaires.Results
Highway‐driving data revealed an overall effect of Treatment on the standard deviation of lateral position (SDLP). Dexchlorpheniramine impaired driving performance as indicated by a significant rise in SDLP. Mequitazine significantly increased SDLP in a dose‐related manner, but the separate dose effects failed to reach statistical significance. Divided attention performance was also affected by Treatment. Reaction time (RT) during mequitazine treatments increased in a dose‐related manner and significantly differed from placebo at the highest dose. Subjects reported to be less alert after treatment with dexchlorpheniramine. Cetirizine did not affect performance in any of the tasks.Conclusion
It was concluded that mequitazine is mildly sedating. The effects of mequitazine are comparable to those of other second‐generation antihistamines, in that it causes mild driving impairment, particularly at higher doses.
Incidence of anaphylaxis with circulatory symptoms: a study over a 3‐year period comprising 940 000 inhabitants of the Swiss Canton Bern
Authors: Helbling A. , Hurni T. , Mueller U. R. , Pichler W. J. 
Published: February 2004

SummaryBackground
Diagnosis of anaphylaxis is clinically based and usually straightforward. However, data on the epidemiology of anaphylaxis, particularly the most profound and life‐threatening form such as anaphylactic shock are limited and thought to be under‐reported.Objective
The primary aim of this study was to investigate the incidence and the causes of severe anaphylaxis with circulatory signs in the Canton Bern, which comprises about 940 000 inhabitants or approximately one‐seventh of the population of Switzerland.Methods
During a 3‐year period, 1 January 1996 to 31 December 1998, all medical records (7739 documents) from the two allergy clinics of the Canton Bern have been reviewed. In addition, all seven board‐certified specialists of the Foederatio Medicorum Helveticorum (FMH) in Allergology and Clinical Immunology of this Canton as well as all 17 hospitals with emergency units of this area have been contacted for cases with an anaphylactic event not referred to the allergy clinics.Results
Overall, 226 individuals, 106 females (47%) with a mean age of 41 years (range, 5–74 years) and 120 males (53%) with a mean age of 38 years (8 months–83 years) were diagnosed as having presented generalized, life‐threatening anaphylaxis with circulatory symptoms. Altogether, these patients experienced 246 episodes of severe systemic reactions. In addition, death due to anaphylaxis occurred in three subjects. The annual incidence of anaphylaxis per 100 000 inhabitants per year ranged between 7.9 and 9.6 cases. Hymenoptera stings (58.8%), drugs (18.1%), and foods (10.1%) were the most commonly identified culprits for anaphylaxis. In 5.3% of all anaphylactic events, the cause could not be identified.Conclusion
The incidence rate of severe life‐threatening anaphylaxis with circulatory signs in the Canton Bern, Switzerland, with 7.9–9.6 per 100 000 inhabitants per year is comparable to the findings of other epidemiological investigations. In most events, a causal agent or allergen could be identified by a careful allergological examination.
Exhaled nitric oxide: relation to sensitization and respiratory symptoms
Authors: Olin A.‐C. , Alving K. , Torén K. 
Published: February 2004

SummaryBackground
Conflicting data have been presented as to whether nitric oxide (NO) in exhaled air is merely reflecting atopy rather than airway inflammation.Objective
To investigate the relationship between exhaled NO (eNO) and nasal NO (nNO), respiratory symptoms, and atopy, in the context of a cross‐sectional study of the respiratory health of bleachery workers.Methods
Two hundred and forty‐six non‐smoking bleachery and paper‐mill workers answered a questionnaire and were examined by measurements of eNO and nNO and spirometry, outside the pollen season. Blood samples were collected and analysed for specific IgE against common aeroallergens (birch, timothy, cat and house dust mite). Atopy was defined as a positive Phadiatop™ test.Results
The atopic and the non‐atopic subjects without asthma or rhinitis had similar levels of eNO. Subjects reporting asthma or rhinitis who were also sensitized to perennial allergens had higher levels of eNO, whereas those sensitized to only seasonal allergens had similar eNO levels as non‐atopic subjects with asthma or rhinitis. In multiple linear regression models adjusted for nNO, eNO was associated with asthma and sensitization to perennial allergens.Conclusion
The results indicate that only atopic subjects who have recently been exposed to the relevant allergen have elevated levels of eNO. Atopic subjects who are not being exposed to a relevant allergen or have never experienced symptoms of asthma or rhinitis show normal eNO. These data indicate that eNO relates to airway inflammation in atopic subjects.
Low incidence of cytomegalovirus disease in liver transplant recipients receiving sirolimus primary immunosuppression with 3‐day corticosteroid taper
Authors: Trotter J.F. , Wallack A. , Steinberg T. 
Published: February 2004

Abstract: Background. Cytomegalovirus (CMV) disease is the most common infection following liver transplantation, occurring in approximately 20% of recipients. In liver transplant recipients, CMV is associated with a higher cost following transplantation, subsequent infections, and recurrent hepatitis C. Since we have initiated a prednisone‐free immunosuppressive regimen in January 2000, we have noted an extremely low incidence of CMV disease in our cohort of liver transplant recipients. We report our findings here.Methods. All 150 patients transplanted between January 2000 and December 2002 with tacrolimus (or cyclosporin A) and sirolimus, and 3‐day corticosteroid taper were retrospectively analyzed. Recipients who were CMV IgG negative with a CMV IgG‐positive donor (“CMV mismatch”) received conventional prophylactic therapy with intravenous and oral ganciclovir. The incidence of CMV disease (defined as positive tissue culture or positive immunohistochemical stain of affected tissue or CMV‐DNA >3000 associated with clinical symptoms) was recorded for each patient.Results. The proportion of “CMV mismatches” (donor CMV IgG positive, recipient CMV IgG negative) was 15%. The mean total number of days of ganciclovir prophylaxis (intravenous and/or oral) administered to “CMV mismatch” patients was 45.6 days. The incidence of CMV disease in patients receiving sirolimus primary immunosuppression was 2%. The mean time to diagnosis of CMV disease was 139 days.Conclusions. (1) The incidence of CMV disease is very low using a prednisone‐free, sirolimus immunosuppressive regimen. (2) Two possible explanations for this finding include appropriate prophylaxis with ganciclovir and low levels of immunosuppression including the absence of prednisone.
Quality assurance for distance learning: a case study at Brunel University
Authors: Clarke Malcolm , Butler Clive , Schmidt‐Hansen Peter , Somerville Mary 
Published: February 2004

AbstractBrunel University currently has four distance learning MSc courses, with over 500 students registered, and one undergraduate distance learning course. Some have been running for over five years, and well‐established practices have been developed and provide a basis of support for the university. Quality assurance in the university has always been considered in three, equally important, ways: the curriculum and its assessment; the handling of coursework and assignments; and the liaison with students. The lesson we have learned is that a distance learning programme must be based on an existing full‐time MSc programme, which is the gold standard for curriculum and its assessment, and where possible, common examinations and assessment be used. This can be further assured by scrutinisation by the associated research council. This is going to become ever more important with the increasing scrutiny by overseas governments on the academic quality of distance learning courses, which seek assurance on the comparability and quality of degrees. Quality assurance for the handling of coursework and assignments must be secure and demands a high overhead of paperwork. Detailed feedback to students on their assignments is essential, but this can, at the same time, form a quality assurance check for later progression decisions. We also copy and retain approximately 10% of the assignments for the same purpose. Rapid turnaround is essential if feedback is to be timely and therefore useful, and quality checks on processing time should be standard. Quality assurance for the procedures for liaison with distance learning students are somewhat harder to measure quantitatively. The mark of good distance learning must be its tutorial support. This demands good communications. Our own course, entitled Data Communications Systems, benefits from the high proportion of use of electronic communications, namely email, which allows fast turnaround of questions, yet is not intrusive. However, it is deemed essential that hard copy of all such correspondence is kept. Migration to other Internet support services, such as the World Wide Web, videoconferencing and groupware, is inevitable.
Quality in virtual education environments
Authors: Barbera Elena 
Published: February 2004

AbstractThe emergence of the Internet has changed the way we teach and learn. This paper provides a general overview of the state of the quality of virtual education environments. First of all, some problems with the quality criteria applied in this field and the need to develop quality seals are presented. Likewise, the dimensions and subdimensions of an empirical instrument to improve and assess the quality of online education are examined. This tool has already been applied to several educational contexts; though not definitive, it aims to improve not only specific areas, but also the whole educational approach as a system.