bluuebunny/crossref_metadata_2025_split huggingface dataset:
Initial validation of a scale to measure purposelessness, understimulation, and boredom in cancer patients: Toward a redefinition of depression in advanced disease
Authors: PASSIK STEVEN D. , INMAN ALICE , KIRSH KENNETH , THEOBALD DALE , DICKERSON PAMELA 
Published: November 2003

Objective:The problem of boredom in people with cancer has received little research attention, and yet clinical experience suggests that it has the potential to profoundly affect quality of life in those patients. We were interested in developing a Purposelessness, Understimulation, and Boredom (PUB) Scale to identify this problem and to begin to differentiate it from depression.Methods:Cancer patients and professionals were interviewed using a semi-structured format to elicit their perceptions of the incidence, causes, scope, and consequences of boredom. From their responses, 45 questions were developed, edited for clarity, and piloted. A total of 100 cancer patients were recruited to participate in the study. Preliminary validation of the PUB using a cross-sectional survey of the measure was conducted. Other instruments used for purposes of convergent and divergent validity included the Functional Assessment of Cancer Therapy Scale–Anemia, Zung Self-Rating Depression Scale, Boredom Proneness Scale, Leisure Boredom Scale, Cancer Behavior Inventory, Systems of Belief Inventory, and the Eastern Cooperative Oncology Group Performance Status Scale.Results:The average age of the sample was 62.37 years (SD= 13.43) and was comprised of 60 women (60.00%) and 40 men (40.00%). The results of a factor analysis on the 45 initial items (selected on the basis of professional and patient interviews) created a two-factor scale. The eight items from the strongest factor (items 1, 2, 3, 4, 5, 6, 9, 10) seemed to best tap the construct that could be deemed as overt boredom whereas the six items of the second factor (items 36, 38, 39, 42, 44, 45) seemed to tap the construct of boredom related to meaning and spirituality. Total scale internal consistency, when all 14 items were included in the analysis, yielded a coefficient alpha of 0.84 and good test–retest reliability at 2 weeks (r= .80,p< .001). The novel 14-item PUB Scale was significantly correlated to other measures of boredom; the Boredom Proneness Scale (r= −.588,p< .001) and the Leisure Boredom Scale (r= .576,p< .001).Significance of results:The PUB Scale was found to be a statistically viable tool with the ability to detect boredom and differentiate it from depression. In many respects this work is in concert with much of the current research and clinical effort going on in psycho-oncology that defines components of distress that in sum, redefines depression in advanced cancer.
A pilot study to examine the relationship between boredom and
spirituality in cancer patients
Authors: INMAN ALICE , KIRSH KENNETH L. , PASSIK STEVEN D. 
Published: November 2003

Objective: Spirituality has been neglected when assessing
the well-being of cancer patients. Traditionally, researchers have
focused on areas such as physical, social, and emotional functioning.
However, there is a potential for spirituality to have a large impact
on quality of life in patients with cancer. The current study was
conducted to investigate the relationship between spirituality and
boredom, constraint, social contact, and depression.Methods: A total of 100 oncology patients completed several
assessment instruments, including the Purposelessness,
Under-stimulation, and Boredom (PUB) Scale, Functional Assessment of
Cancer Therapy Scale–Anemia, Brief Zung Self-Rating Depression
Scale (BZSDS), Cancer Behavior Inventory, Systems of Belief Inventory,
and Eastern Cooperative Oncology Group Performance Status Scale.Results: The average age of the sample was 62.37 years
(SD = 13.43) and was comprised of 60 women (60%) and 40 men
(40%). A regression analysis conducted to explore the impact of the
variables on quality of life found only the BZSDS (R2Δ
= .650, F = 180.392, p < .001) and the PUB Scale
(R2Δ = .077, F = 26.885, p <
.001) were significant predictors of quality of life. Another set of
regression analyses were conducted to explore whether spirituality had a
mediating effect on this relationship, but the mediated model was not
supported.Significance of results: We conclude that spirituality and
boredom are difficult concepts to define, operationalize, and measure,
but crucial to our understanding of quality of life in advanced cancer.
More research is needed to clarify the nature of the interrelationships
between these important concepts.
A communication tool for cancer patients with pain: The art therapy
technique of the Body Outline
Authors: LUZZATTO PAOLA , SERENO VALERIE , CAPPS ROY 
Published: November 2003

Objective: The multidimensional aspect of pain suggests the
use of multimodal interventions. The Memorial Sloan-Kettering Cancer
Center has recently utilized the art therapy modality to help patients
communicate the painful side of their illness in such a way that they
can feel understood and respected. In this paper we describe a simple
innovative art therapy intervention that we have developed within the
Art Therapy Service in the Psychiatric Department of Memorial
Sloan-Kettering Cancer Center.Method: The patients work with a Body Outline as a starting
template, together with the art therapist, in sessions lasting
approximately 45 minutes. They are encouraged to fill the space inside
and outside the Body Outline. They can use colored pastels, markers, or
watercolor or cut out images for a collage.Results: Seventy hospitalized adult cancer patients, 60
women and 10 men, used this intervention between January 1999 and May
2000. We have analyzed the variety of responses from the 70 patients,
and three main groups have emerged, which have focused on the following
issues: (1) visualization of physical pain, (2) communication of
emotions, and (3) search for meaning/spirituality.Significance of results: The results suggest that because of
its abstract symbolic feature, the Body Outline is a very flexible
therapeutic intervention. It must be offered within the relationship
with the art therapist, and it may fulfill quite a variety of
expressive needs, from the description of physical pain to the
elaboration of spiritual longings.
Family care giving for patients at life's end: Report from the
Cultural Variations Study (CVAS)
Authors: PHIPPS ETIENNE , BRAITMAN LEONARD E. , TRUE GALA , HARRIS DIANA , TESTER WILLIAM 
Published: November 2003

Objective: To investigate differences between African
American and White family caregivers in self-reported health, use of
social support and external resources, and emotional and financial
strain in the context of their care of a family member with advanced
cancer.Methods: Sixty-nine patient-designated family caregivers of
patients with advanced lung or colon cancer interviewed between
December 1999 and July 2001.Results: Most African American and White family caregivers
were able to identify someone else who was helping them in the care of
their family member. Few caregivers used outside resources (e.g.,
home-based medical care, meal delivery, pastoral care, outside social
support visitor) to assist in the support and care of the patient. At
baseline, White caregivers were more likely to agree that caregiving
caused work adjustments (ρ = .28, p = .02) and emotional
difficulties (ρ = .32, p = .008) and that caregiving had
been completely overwhelming (ρ = .19, p = .12) than were
African American caregivers. At follow-up, among family caregivers of
patients who had died, 44% reported having to quit work to provide
personal care for the patient. Twenty-five percent of family caregivers
reported using most or all of the family's saving in caring for
the patient.Significance of results: Caregivers of patients at end of
life experience substantial emotional and financial difficulties
related to caregiving. Family caregiving is a private undertaking with
little use of outside resources to mitigate the burden.
Branched‐chain L‐amino acid metabolism in classical maple syrup urine disease after orthotopic liver transplantation
Authors: Bodner‐Leidecker A. , Wendel U. , Saudubray J‐M. , Schadewaldt P. 
Published: November 2003

AbstractWe characterized the effect of orthotopic liver transplantation on the catabolism of branched‐chain L‐amino acids in a female patient with classical form of maple syrup urine disease. Transplantation was performed at the age of 7.4 years due to a terminal liver failure triggered by a hepatitis A infection. Since then, the patient is on an unrestricted diet and plasma concentrations of branched‐chain L‐amino and 2‐oxo acids are stable, yet at moderately increased levels (2‐ to 3‐fold of control). L‐Alloisoleucine concentrations, however, remained remarkably elevated (>5‐fold of control). In vivo catabolism was investigated by measuring the metabolic L‐alloisoleucine clearance and whole‐body leucine oxidation in the postabsorptive state. In an oral loading test with 580 μmol alloisoleucine per kg body wt, the L‐alloisoleucine elimination rate constant (0.067 h−1) was in the normal range (0.069±0.012 h−1, n=4). In an oral L‐[1‐13C]leucine load (38 μmol/kg body wt), 19.5% of the tracer dose applied was recovered in exhaled 13CO2 versus 18.9±3.6% in healthy subjects (n=10). Thus, the patient exhibited obviously normal whole‐body catabolic rates although branched‐chain L‐amino acid oxidation was confined to the liver transplant. Most likely, the enhanced substrate supply from extrahepatic sources led to an elevation of the plasma concentrations and thus induced a compensatory enhancement of the metabolic flux through the branched‐chain 2‐oxo acid dehydrogenase complex in the intact liver tissue.
Dynamic process model for denitrogenation and dehydrogenation by vacuum degassing
Authors: Kleimt B. , Köhle S. , Johann K. P. , Jungreithmeier A. , Molinero Joseba 
Published: November 2003

Background/aims:One main purpose of vacuum degassing is the removal of nitrogen and hydrogen from the liquid steel. The progress of dehydrogenation and denitrogenation during degassing cannot be observed on‐line from measured waste gas values. It is therefore usual to elongate the vacuum treatment more than necessary to be sure that the aim values are reached. To overcome the uncertainty in the required degassing duration, a dynamic process model for dehydrogenation and denitrogenation was developed.Results and conclusions:The dynamic process model for denitrogenation and dehydrogenation is based on the principles of thermodynamics and reaction kinetics. It was applied to the vacuum tank degassing (VD) and the vacuum circulation (RH) process. The model was validated by comparison of simulation results with measured process data. The resulting simulation accuracy is about 8 ppm for nitrogen and 0.2 ppm for hydrogen. A simplified version of the process model is used for on‐line observation of the current nitrogen and hydrogen content.
Interactions of growing folds and coeval depositional systems
Authors: Burbank Douglas , Meigs Andrew , Brozović Nicholas 
Published: November 2003

Responses of both modern and ancient fluvial depositional systems to growing folds can be interpreted in terms of interactions among competing controlling variables which can be incorporated into simple conceptual models. The ratio of the rate of sediment accumulation to the rate of structural uplift determines whether a fold develops a topographic expression above local base level. The balance between (a) stream power and rates of upstream deposition vs. (b) bedrock resistance and rates of crestal uplift and of fold widening determines whether an antecedent stream maintains its course or is defeated by a growing structure. Modern drainage configurations in actively folding landscapes can often be interpreted in terms of these competing variables, and through analysis of digital topography, detailed topographic characteristics of these folds can be quantified. Modern examples of growing folds display both defeated and persistent antecedent rivers, deflected drainages and laterally propagating structures. The topography associated with a defeated antecedent river at Wheeler Ridge, California, is consistent with a model in which defeat results from forced aggradation in the piggyback basin, without the need to vary discharge or uplift rate.Reconstruction of the long‐term interplay between a depositional system and evolving folds requires a stratigraphic perspective, such as that provided by syntectonic strata which are directly juxtaposed with ancient folds and faults. Analysis of Palaeogene growth strata bounding the Catalan Coastal Ranges of NE Spain demonstrates the synchronous growth and the kinematic history of multiple folds and faults in the proximal foreland basin. Although dominated by transverse rivers which crossed fold crests, palaeovalleys, interfan lows, structural re‐entrants and saddles, and rising anticlines diverted flow and influenced local deposition. In the ancient record, drainage‐network events, such as avulsion or defeat of a transverse stream, usually cannot be unambiguously attributed to a single cause. Examination of ancient syntectonic strata from a geomorphological perspective, however, permits successive reconstructions of synorogenic topography, landscapes and depositional systems.
Importance of inherited rift margin structures in the early North Alpine Foreland Basin, Switzerland
Authors: Lihou Joanne C. , Allen Philip A. 
Published: November 2003

The earliest evolution of the North Alpine Foreland Basin in Switzerland was characterized by deposition in small, structurally partitioned sub‐basins during the Late Cretaceous and Early Tertiary, rather than in a single, large foredeep. These sub‐basins, which were probably located between old rift margin fault‐blocks reactivated during Alpine compression, were incorporated into the thrust wedge during thin‐skinned deformation. In eastern Switzerland, the most external sub‐basins with respect to the orogenic wedge (North Helvetic Flysch and Blattengrat units) have at their base an unconformity attributed to flexural forebulge erosion. More internal sub‐basins (Sardona and Prättigau units) contain a conformable succession from the underlying passive margin stage and are dominated by deep‐water sedimentation. In western Switzerland, both external sub‐basins, now found in the Helvetic Diablerets and Wildhorn nappes, and deep‐water internal sub‐basins (Höchst‐Meilleret Flysch, Neisen Flysch, Tarentaise Flysch) preserve a well‐developed basal unconformity. Comparison of the eastern and western Swiss transects shows important intrabasinal lateral variations to be present.The western Swiss area was a topographic high for much of the Late Cretaceous and Early Tertiary; this is demonstrated by the increased chronostratigraphic gap at the karstified basal unconformity surface in western Switzerland. The strata onlapping this unconformity young to the west, suggesting that drowning of the emergent area was delayed compared with the east. In addition, reactivation and uplift of the rift margin structures occurred earlier in western Switzerland compared with eastern Switzerland. There is therefore strong evidence for lateral topographic gradients in the early foreland basin caused by differential amounts of tectonic reactivation of rift margin structures. In the early foreland basin‐fill, these lateral variations are as important in determining depositional patterns as strike‐normal changes across the basin.
The epitope specificity of heparin‐induced thrombocytopenia
Authors: HORSEWOOD PETER , WARKENTIN THEODORE E. , HAYWARD CATHERINE P. M. , KELTON JOHN G. 
Published: November 2003

Heparin‐induced thrombocytopenia (HIT) is caused by antibodies (HIT‐Abs) that bind to a complex of heparin and platelet factor 4. We investigated the epitope specificity of the HIT‐Abs, and found that the HIT‐Abs recognized solid‐phase immobilized complexes with an optimum ratio of four to eight molecules of PF4 per molecule of heparin. To try to define the epitopes within the PF4 molecule, intact and reduced (linearized) PF4 was tested against 29 different sera from patients with HIT. In addition, eight different peptides that spanned the PF4 molecule were studied for their ability to bind to the HIT‐Abs either alone or in the presence of heparin. With the exception of a subpopulation of patient samples (5/29, 17%), we found that reduced PF4 and the peptides were uniformly nonreactive with the HIT‐Abs in the presence of heparin. Reduced PF4 and PF4 carboxy‐terminal peptides with a minimum size of 19 amino acids were recognized by a minority (5/29) of HIT‐Abs samples but only when heparin was present. The specificity of this subgroup of samples from patients with HIT was highly restricted and the loss of one amino acid (peptide reduced in length from 19 to 18 amino acids) rendered the peptides non‐reactive. The clinical characteristics of these patients were similar to the other HIT patients.These studies demonstrate that the majority of HIT‐Abs recognize a noncontiguous conformational epitope on the PF4 molecule that is produced when four to eight PF4 molecules are bound together by heparin.
Amplification of mitochondrial DNA in acute myeloid leukaemia
Authors: Boultwood J. , Fidler C. , Mills K. I. , Frodsham P. M. , Kusec R. , Gaiger A. , Gale R. E. , Linch D. C. , Littlewood T. J. , Moss P. A. H. , Wainscoat J. S. 
Published: November 2003

There is a long‐standing interest in the possible role of mitochondria in malignancy. We sought to discover whether amplification of mitochondrial DNA (mtDNA) occurred in leukaemia, and found it was often remarkably amplified in the blast cells of acute myeloid leukaemia (AML).We used gene dosage experiments to quantify the amount of mtDNA relative to nuclear DNA. DNA extracted from peripheral blood leucocytes or bone marrow of healthy individuals or patients was simultaneously hybridized with a probe for the mitochondrial genome and a control probe for the renin gene on human chromosome 1. Comparative densitometric ratios of approximately 1 were obtained between the two signals in 20 normal control peripheral blood samples. In contrast, comparative ratios in the range of 2–50 were observed in 25 AML samples and 13 of these showed 8‐fold or greater amplification of mtDNA relative to normal peripheral blood controls. An additional four cases of AML were investigated at both presentation and remission and showed 3–10‐fold amplification of mtDNA at presentation, but no amplification when in clinical remission. 18 cases of chronic granulocytic leukaemia (CGL) were also studied in chronic phase and showed mtDNA dosage levels equivalent to normal peripheral blood controls. However, 8/9 CGL patients showed mtDNA amplification during transformation from chronic phase. We conclude that amplification of mtDNA is an invariable feature of acute myeloid leukaemia and that it may be a useful marker for detecting transformation of CGL.
Specificities of anti‐platelet antibodies in multitransfused patients with haemato‐oncological disorders
Authors: Kurz Martin , Greinix Hildegard , HO¨cker Paul , Kalhs Peter , Knöbl Paul , Mayr Wolfgang Richard , Pober Michael , Panzer Simon 
Published: November 2003

The clinical condition and the formation of platelet‐reactive antibodies influence the post‐transfusion platelet increment. We analysed the specificities of platelet‐reactive antibodies in 81 multitransfused patients with haemato‐oncological diseases refractory to platelet transfusions, or prior to a scheduled stem cell transplantation. In 17 additional patients we prospectively determined the development of platelet‐reactive antibodies at the time of chemotherapy in weekly intervals. Sera were tested by the monoclonal antibody‐specific immobilization of platelet antigens (MAIPA)‐technique for antiplatelet antibodies against HLA class I antigens, the human platelet‐specific alloantigens (HPA)‐1, ‐2, ‐3, ‐5, and the platelet membrane glycoproteins (GP) Ia/IIa, Ib/IX, IIb/IIIa (panreactive).Platelet reactive antibodies were found in 54% of blood samples. They were frequent in patients with a history of possible previous immunization, particularly if patients were refractory to platelet transfusions. Platelet‐reactive HLA antibodies were the most common antibodies. Even patients without a known risk of primary immunization who received exclusively leucocyte‐depleted blood products formed antibodies. By the MAIPA technique, even LCT‐negative sera were found to contain platelet‐reactive antibodies.
Immunomagnetic selection of CD34+peripheral blood stem cells for autografting in patients with breast cancer
Authors: Hohaus Stefan , Pförsich Margit , Murea Simona , Abdallah Alhossain , Lin Yung‐Sheng , Funk Liane , Voso Maria Teresa , Kaul Sepp , Schmid Hans , Wallwiener Diethelm , Haas Rainer 
Published: November 2003

Contamination of transplants with tumour cells may contribute to relapse after peripheral blood stem cell transplantation (PBSCT). We studied the feasibility of CD34+ cell selection from blood‐derived autografts obtained following G‐CSF‐supported cytotoxic chemotherapy in a group of 25 patients with breast cancer (10 with high‐risk stage II/III and 15 with stage IV without bone or bone marrow involvement).Using immunomagnetic beads (Isolex 300 SA, Baxter) CD34+ cells were enriched and released by chymopapain resulting in a median purity of 95% (range 82–99%) and a median recovery of 80% (range 27–132%). The enrichment procedure did not change the proportion of CD34+ subsets coexpressing HLA‐DR, CD38 and Thy‐1, while L‐selectin was removed from the cell surface following selection. Using a sensitive immunocytological technique with a cocktail of epithelial‐specific antibodies (anti‐cytokeratin 8, 18 and 19; HEA125; BM7 and BM8), five leukaphereses products contained epithelial cells, whereas the selected CD34+ cell fraction was free of tumour cells. A neutrophil count of 0.5×109/l and a platelet count of 20×109/l was reached after a median time of 14 and 10 d following 40 high‐dose chemotherapy (HDC) cycles. Our results indicate that immunomagnetic selection of CD34+ cells yields highly purified autografts devoid of tumour cells whereas the engraftment ability of the progenitor and stem cells is fully retained.