bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick’s framework: a mixed methods study
Authors: Kumar Arunaz , Sturrock Sam , Wallace Euan M , Nestel Debra , Lucey Donna , Stoyles Sally , Morgan Jenny , Neil Peter , Schlipalius Michelle , Dekoninck Philip 
Published: February 2018

ObjectivesThe aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick’s framework. We explored participants’ acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants’ perception of usefulness of PROMPT in their clinical practice.Study designMixed methods approach with a pre-test/post-test design.SettingHealthcare network providing obstetric care in Victoria, Australia.ParticipantsMedical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011–2012 (n=15 361 births) and 2014–2015 (n=12 388 births).InterventionAttendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills.Main outcome measureClinical outcomes compared before and after embedding PROMPT in educational practice.Secondary outcome measureAssessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice.ResultsThere was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies.ConclusionParticipants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period after PROMPT. However, the skills acquired by medical and midwifery staff justify embedding PROMPT in educational programmes.
Which patients benefit specifically from short-term psychodynamic psychotherapy (STPP) for depression? Study protocol of a systematic review and meta-analysis of individual participant data
Authors: Driessen Ellen , Abbass Allan A , Barber Jacques P , Connolly Gibbons Mary Beth , Dekker Jack J M , Fokkema Marjolein , Fonagy Peter , Hollon Steven D , Jansma Elise P , de Maat Saskia C M , Town Joel M , Twisk Jos W R , Van Henricus L , Weitz Erica , Cuijpers Pim 
Published: February 2018

IntroductionShort-term psychodynamic psychotherapy (STPP) is an empirically supported treatment that is often used to treat depression. However, it is largely unclear if certain subgroups of depressed patients can benefit specifically from this treatment method. We describe the protocol for a systematic review and meta-analysis of individual participant data (IPD) aimed at identifying predictors and moderators of STPP for depression efficacy.Method and analysisWe will conduct a systematic literature search in multiple bibliographic databases (PubMed, PsycINFO, Embase.com, Web of Science and Cochrane’s Central Register of Controlled Trials), ‘grey literature’ databases (GLIN and UMI ProQuest) and a prospective trial register (http://www.controlled-trials.com). We will include studies reporting (a) outcomes on standardised measures of (b) depressed (c) adult patients (d) receiving STPP. We will next invite the authors of these studies to share the participant-level data of their trials and combine these data to conduct IPD meta-analyses. The primary outcome for this study is post-treatment efficacy as assessed by a continuous depression measure. Potential predictors and moderators include all sociodemographic variables, clinical variables and psychological patient characteristics that are measured before the start of treatment and are assessed consistently across studies. One-stage IPD meta-analyses will be conducted using mixed-effects models.Ethics and disseminationInstitutional review board approval is not required for this study. We intend to submit reports of the outcomes of this study for publication to international peer-reviewed journals in the fields of psychiatry or clinical psychology. We also intend to present the outcomes at international scientific conferences aimed at psychotherapy researchers and clinicians. The findings of this study can have important clinical implications, as they can inform expectations of STPP efficacy for individual patients, and help to make an informed choice concerning the best treatment option for a given patient.PROSPERO registration numberCRD42017056029.
Outcomes after sudden cardiac arrest in sports centres with and without on-site external defibrillators
Authors: Aschieri Daniela , Penela Diego , Pelizzoni Valentina , Guerra Federico , Vermi Anna Chiara , Rossi Luca , Torretta Lucia , Losi Giulia , Villani Giovanni Quinto , Capucci Alessandro 
Published: February 2018

ObjectiveSudden cardiac arrest (SCA) is a rare but tragic event during amateur sports activities. Our aim is to analyse whether availability of automated external defibrillators (AEDs) in amateur sports centres could impact on SCA survival.MethodsThis is an observational study. During an 18-year period, data regarding exercise-related SCA in sports centres were prospectively collected. Survival rates and time to response were compared between centres with an AED already available and centres where an AED was not already present.ResultsOut of 252 sports facilities, 207 (82%) acquired an AED during follow-up while 45 (18%) did not. From 1999 to 2014, there were 26 SCAs (24 (92%) men, 54±17 years old) with 15 (58%) of them in centres with on-site AED. Neurologically intact survival rates were 93% in centres with on-site AED and 9% in centres without (P<0.001). Presence of on-site AED, presence of shockable rhythm, first assistance by a lay bystander and time to defibrillation were all related to neurological intact survival, but the presence of on-site AED was the only independent predictor in the multivariate analysis. The use of on-site AED resulted in a lower time to first shock when compared with emergency medical system-delivered AED (3.3±1.4min vs 7.3±3.2 min; P=0.001).ConclusionsThe presence of on-site AEDs is associated with neurologically intact survival after an exercise-related SCA. Continuous efforts are recommended in order to introduce AEDs in sports and fitness centres, implement educational programmes and increase common awareness about SCA.
Endovascular thrombectomy beyond 12 hours of stroke onset: a stroke network’s experience of late intervention
Authors: Motyer Ronan , Thornton John , Power Sarah , Brennan Paul , O’Hare Alan , Looby Seamus , Williams David J , Moynihan Barry , Murphy Sean 
Published: February 2018

BackgroundSelected patients with proximal anterior circulation ischemic stroke who demonstrate limited infarct and sufficient penumbra may benefit from endovascular thrombectomy (EVT) beyond conventional time limits.ObjectiveTo perform a retrospective review of all cases of EVT performed at our institution for proximal anterior circulation acute ischemic stroke with onset >12 hours.Materials and methodsPatients were assessed with non-contrast CT brain and multiphase CT angiography, with Alberta Stroke Program Early CT Score (ASPECTS) and collateral grade informing patient selection. Data, including patient demographics, workflow, neuroimaging findings, procedural details, recanalization rates, and 90-day functional outcomes, were collected.ResultsOf the 542 consecutive endovascular thrombectomy cases performed during the study period, 25 (4.6%) were >12 hours from stroke onset. Median age was 69 years (IQR 55–80), median National Institute of Health Stroke Scale score on presentation was 14 (IQR 11–18.5), median ASPECTS was 8 (IQR 8–9), and rate of moderate–good collateral status was 96% (n=24). Median time to groin puncture was 14 hours 40 min (IQR 12 hours 36 min – 16 hours 18 min). Rate of successful recanalization (modified Thrombolysis in Cerebral infarction 2b–3) was 88% (n=22). Rate of functional independence (90-day modified Rankin Scale score 0–2) was 52% (n=13). There were no cases of symptomatic intracranial haemorrhage and 90-day mortality rate was 12% (n=3).ConclusionWith the use of ASPECTS and collateral grade to guide patient selection, good functional outcome with acceptable safety parameters may be achieved in patients undergoing EVT beyond 12 hours from stroke onset.
Development of clinical sign‐based scoring system for assessment of omphalitis in neonatal calves
Authors: Steerforth Daniel‐Dean , Van Winden Steven 
Published: February 2018

Omphalitis contributes significantly to morbidity and mortality in neonatal calves. Diagnosis of omphalitis is based on the local signs of inflammation—pain, swelling, local heat and purulent discharge. An abattoir trial identified an optimal, sign‐based, scoring system for diagnosis of omphalitis. A sample of 187 calves aged between 7 and 15 days old were clinically examined for signs of umbilical inflammation and compared with postmortem examination of navels. On postmortem findings, 64 calves (34.2 per cent) had omphalitis. In the examined omphalitis cases, the most commonly affected umbilical structure was the urachus (78.1 per cent). Multivariable logistic regression revealed that thickening of the umbilical stump over 1.3 cm (P<0.001), discharge (P<0.001), raised local temperature (P=0.003) and the presence of umbilical hernia (P=0.024) were correlated and positive predictors of omphalitis. Discharge from the umbilical stump was associated with intra‐abdominal inflammation (P=0.004). Assigning weights based on the multivariable logistic regression coefficients, a clinical scoring algorithm was developed. The cumulative score ranged from 0 to 9. Using this scoring system, calves were categorised as positive if their total score was ≥2. This scoring method had a sensitivity of 85.9 per cent, specificity of 74.8 per cent and correctly classified 78.6 per cent of all calves.
Ultrasonic wave velocity measurements for detecting decay in carbonate rocks
Authors: Fioretti Giovanna , Andriani Gioacchino Francesco 
Published: February 2018

Ultrasonic testing is a non-destructive technique commonly employed for assessing indirectly some geomechanical parameters of natural building stones. Pulse wave propagation in rock materials depends not only on physical properties, e.g. density, elasticity, porosity and water content, but also on fabric elements and their arrangements, spatial distributions and preferred orientations. In contrast, ultrasonic velocity can reflect the state of conservation of stone by comparing data from fresh material with those obtained from tests made on decayed material.
The ‘Avorio’ limestone is a valuable building and ornamental material, quarried in the Trani stone basin (Apulia, southern Italy), which is very popular in Italy and abroad where it is used in modern and historic buildings.
The stone response to decay processes is not fully understood simply because this material has not yet been well studied. To better understand how durable this material is in terms of physical resistance to change with respect to salt and thermal deterioration mechanisms, selected samples of the ‘Avorio’ limestone were submitted to artificial ageing processes by thermal stresses and by stresses due to salt crystallization, performed independently. The artificial ageing processes involved thermal cycles at temperatures between 200 and 600°C, based on an experimental procedure, and a standardized salt crystallization test in sodium sulphate solution.
Repeated measurements of pulse velocity, before, during and after every accelerated ageing cycle, were compared with mass loss and porosity changes, the latter by water imbibition and capillarity testing. Very statistically significant relationships between physical response and rates and patterns of the stone decay were illustrated. The experimental results showed that the ultrasonic pulse velocity decreases as deterioration of the stone increases under accelerated ageing: a strong negative correlation exists between P-wave velocity and porosity. This study confirmed that ultrasonic pulse velocity is a good indicator of damage for carbonate stones, particularly for varieties without clear anisotropies, in terms of structure and texture.
Lithospheric heating by crustal thickening: a possible origin of the Parnaíba Basin
Authors: McKenzie D. , Rodríguez Tribaldos V. 
Published: February 2018

Abstract
The subsidence of basins formed by extension is now quite well understood. But that of cratonic basins is not, though a variety of models have been proposed. This volume is concerned with the structure and evolution of one such basin, the Parnaíba basin in NE Brazil. At the moment probably more is known about this basin than about any other cratonic basin. A long deep seismic reflection profile across the basin shows no evidence of extension, or of structural control by the underlying basement. Backstripping of two wells in the basin show that the time scales for their subsidence are 68 and 74 Ma. We show that these observations are consistent with a thermal model for the formation of the basin, where the thermal disturbance results from the emplacement and removal of a crustal layer whose thickness is 35–40 km, and not from extension. Such a layer is presently being emplaced as a gravity current on the thick lithosphere of northern India as Tibet flows southwards. Such currents and cratonic basins have similar circular shapes. This model is not incompatible with the relevant geological observations. It may be possible to test its predictions by careful study of the growth of metamorphic minerals.
Truncated Glioma-Associated Oncogene Homolog 1 (tGLI1) Mediates Mesenchymal Glioblastoma via Transcriptional Activation of CD44
Authors: Rimkus Tadas K. , Carpenter Richard L. , Sirkisoon Sherona , Zhu Dongqin , Pasche Boris C. , Chan Michael D. , Lesser Glenn J. , Tatter Stephen B. , Watabe Kounosuke , Debinski Waldemar , Lo Hui-Wen 
Published: February 2018

Abstract
The molecular pathways driving mesenchymal glioblastoma (GBM) are still not well understood. We report here that truncated glioma-associated oncogene homolog 1 (tGLI1) is a tumor-specific transcription factor that facilitates GBM growth, is enriched in the mesenchymal subtype of GBM and glioma stem cells (GSC), and promotes mesenchymal GSC by upregulating transcription of CD44. In an orthotopic GBM xenograft mouse model, tGLI1-overexpressing tumors grew more aggressively with increased proliferation and angiogenesis compared with control and GLI1-overexpressing xenografts. tGLI1 was highly expressed in GBM clinical specimens but undetectable in normal brains, whereas GLI1 was expressed in both tissues. A tGLI1 activation signature (tGAS) correlated with glioma grade, tumor angiogenesis, and poor overall survival, and GBMs with high tGAS were enriched with mesenchymal GBM/GSC gene signatures. Neurospheres contained increased levels of tGLI1, but not GLI1, compared with the monolayer culture; mesenchymal GSC expressed more tGLI1 than proneural GSC. Ectopic tGLI1 expression enhanced the ability of mesenchymal GSC to yield neurospheres in vitro and to form tumors in mouse brains. Selective tGLI1 knockdown reduced neurosphere formation of GBM cells. tGLI1 bound to and transactivated the promoter of the CD44 gene, a marker and mediator for mesenchymal GSC, leading to its expression. Collectively, these findings advance our understanding of GBM biology by establishing tGLI1 as a novel transcriptional activator of CD44 and a novel mediator of mesenchymal GBM and GSC.
Significance: These findings highlight the role of a tumor-specific gain-of-function transcription factor tGLI1 in mesenchymal glioma stem cell maintenance and mesenchymal GBM growth. Cancer Res; 78(10); 2589–600. ©2018 AACR.
Phase Ib Study of Glasdegib, a Hedgehog Pathway Inhibitor, in Combination with Standard Chemotherapy in Patients with AML or High-Risk MDS
Authors: Savona Michael R. , Pollyea Daniel A. , Stock Wendy , Oehler Vivian G. , Schroeder Mark A. , Lancet Jeffrey , McCloskey James , Kantarjian Hagop M. , Ma Weidong Wendy , Shaik M. Naveed , Laird A. Douglas , Zeremski Mirjana , O'Connell Ashleigh , Chan Geoffrey , Cortes Jorge E. 
Published: February 2018

AbstractPurpose: This open-label, multicenter, dose-finding, phase Ib study (NCT01546038) evaluated the safety, pharmacokinetics, pharmacodynamics, and clinical activity of the novel Hedgehog pathway Smoothened inhibitor glasdegib (PF-04449913) in patients (N = 52) with acute myeloid leukemia (AML) or high-risk myelodysplastic syndrome (MDS).Experimental Design: Glasdegib 100 or 200 mg was administered orally, once daily in 28-day cycles, in combination with low-dose cytarabine (arm A) or decitabine (arm B) to newly diagnosed patients considered not suitable for standard induction chemotherapy, and in combination with cytarabine/daunorubicin (arm C) to fit patients. The study followed a standard 3+3 dose-escalation design. The primary endpoint was dose-limiting toxicity (DLT). Ten additional patients were enrolled in expansion cohorts of arms A (n = 23) and C (n = 22) to confirm the recommended phase II dose (RP2D).Results: No DLTs were observed in arms A and B; 1 DLT (grade 4 neuropathy) occurred in arm C. The most common treatment-related nonhematologic adverse events were mostly grades 1 and 2 in all arms. Muscle spasms, dysgeusia, and alopecia were generally mild. Overall, 16 patients (31%) achieved a complete remission (CR)/CR with incomplete blood count recovery. Note that 100 mg daily was selected as the RP2D for glasdegib in combination with standard chemotherapies in the absence of an estimated MTD in this setting.Conclusions: Treatment with glasdegib in combination with standard chemotherapy was generally well-tolerated and consistent with prior findings, warranting further evaluation of glasdegib-based combinations in patients with AML or high-risk MDS. Clin Cancer Res; 24(10); 2294–303. ©2018 AACR.
Molecular Lymph Node Status for Prognostic Stratification of Prostate Cancer Patients Undergoing Radical Prostatectomy with Extended Pelvic Lymph Node Dissection
Authors: Heck Matthias M. , Retz Margitta , Bandur Miriam , Souchay Marc , Vitzthum Elisabeth , Weirich Gregor , Schuster Tibor , Autenrieth Michael , Kübler Hubert , Maurer Tobias , Thalgott Mark , Herkommer Kathleen , Gschwend Jürgen E. , Nawroth Roman 
Published: February 2018

Abstract
Purpose: Molecular lymph node (LN) analysis using quantitative polymerase chain reaction (qPCR) detects LN metastases with higher sensitivity than histopathology. However, the prognostic role of molecular LN status in prostate cancer patients treated with radical prostatectomy (RP) and extended pelvic LN dissection (ePLND) is unclear. To investigate the association of molecular compared with histopathologic LN status with biochemical recurrence.
Experimental Design: Patients with intermediate and high-risk prostate cancer were prospectively enrolled and underwent RP with ePLND, including the obturator, internal, external, and the common iliac region. LNs ≥3 mm were bisected and examined by standard histopathology and qPCR for Kallikrein3 (KLK3) expression. Biochemical recurrence was defined by confirmed postoperative PSA &gt; 0.2 ng/mL.
Results: In 111 patients, 2,411 of 3,173 removed LNs were examined by both methods. Histopathology detected 68 LN metastases in 28 (25%) patients. Molecular analysis confirmed elevated KLK3 expression in 65 histopathologic LN metastases of all 28 pN1 patients (pN1/molN1) and additionally reclassified 224 histopathologic negative LNs and 32 (29%) pN0 patients as LN-positive (pN0/molN1).
At a median follow-up of 48 months, 52 (47%) patients developed biochemical recurrence. Median biochemical recurrence-free survival was 9 months [95% confidence interval (CI), 0.0–20.1] in pN1/molN1 patients, 24 months (95% CI, 1.7–46.3) in pN0/molN1 patients and was not reached in pN0/molN0 patients (P &lt; 0.001). On multivariable Cox regression analysis, molecular LN status [HR 4.1 (95% CI, 1.9–8.8), P &lt; 0.001] but not histopathologic LN status [HR 1.5 (95% CI, 0.8–3.0), P = 0.198] was confirmed as independent predictor of biochemical recurrence.
Conclusions: Molecular LN analysis identified pN0 patients with a high risk of biochemical recurrence and provided superior prognostic information in comparison with histopathology alone. Clin Cancer Res; 24(10); 2342–9. ©2018 AACR.
Florence as “Paradise Lost”
Authors: Crum Roger J. 
Published: February 2018

Abstract
The city of Florence has been a place of artistic pilgrimage for centuries. This essay discusses late nineteenth- and early twentieth-century British and American interest in Florence and, specifically, two of its masterpieces in Ghiberti’s Gates of Paradise and Botticelli’s Birth of Venus as indicative of a melancholic perspective on the Florentine Renaissance as a “Paradise Lost.” The city was ambivalently idealized as an “Earthly Paradise.”
Translating Dante
Authors: Docherty Linda J. 
Published: February 2018

Abstract
Isabella Stewart Gardner’s museum (Fenway Court) owes its distinctive character to the influence of Dante Alighieri. Gardner’s interest in the Italian poet originated in a context of late nineteenth-century Boston’s enthusiasm for his writing and her personal quest for a meaningful life’s work. As a student of Charles Eliot Norton, a member of the Cambridge Dante Society, and a collector of rare editions of The Divine Comedy, Gardner became apprised of issues surrounding literary translation. When she began to study visual images inspired by Dante’s poetry and to acquire European masterpieces, she was poised to conceive a variation on this practice. As a visual translation of Paradiso, Fenway Court was not an illustration of a classic text but rather a conversion of a spiritual idea of love and beauty from one art form to another. In creating a museum for public education and enjoyment, Gardner exemplified Dante’s moral concept of free will and evoked his poetic vision of heavenly beauty.