bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Take Ten’ improving the surgical post-take ward round: a quality improvement project
Authors: Banfield Danielle Alice , Adamson Carly , Tomsett Amy , Povey James , Fordham Tony , Richards Sarah Kathryn 
Published: March 2018

BackgroundThe surgical post-take ward round is a complex multidisciplinary interaction in which new surgical patients are reviewed and management plans formulated. Its fast-paced nature can lead to poor communication and inaccurate or incomplete documentation with potential detriment to patient safety. Junior team members often do not fully understand the diagnosis and management plan.AimsThe aims of this project were to improve both communication and documentation on the surgical post-take ward round, influencing patient safety.MethodsThe ward round was deconstructed to identify individual roles and determine where intervention would have the most impact. Ten important points were identified that should be documented in the management of an acute surgical patient; observations, examination, impression, investigations, antibiotics, intravenous fluids, VTE assessment, nutrition status, estimated length of stay and ceiling of treatment. A ‘Take Ten’ checklist was devised with these items to be used as a ‘time out’ after each patient with the whole team for discussion, clarification and clear documentation. Four plan do study act cycles were completed over a period of a year. A retrospective review of post-take documentation preintervention and postintervention was performed, and the percentage of points that were accurately documented was calculated. For further clarification, 2 weekends were compared—one where the checklist was used and one where it was not.ResultsResults showed documentation postintervention varied between categories but there was improvement in documentation of VTE assessment, fluids, observations and investigations. On direct comparison of weekends the checklist showed improved documentation in all categories except length of stay. Junior team members found the checklist improved understanding of diagnosis and management plan, and encouraged a more effective ward round.ConclusionThe ‘Take Ten’ checklist has been well received. Three years on from its inception, the checklist has become an integral part of the post-take ward round, thanks to the multidisciplinary engagement in the project.
Symptom severity and its effect on health-related quality of life over time in patients with pulmonary hypertension: a multisite longitudinal cohort study
Authors: Yorke Janelle , Deaton Christi , Campbell Malcolm , McGowen Linda , Sephton Paul , Kiely David G , Armstrong Iain 
Published: March 2018

IntroductionThe aim of this cohort study was to examine health-related quality of life (HRQoL) and symptomatology in patients with pulmonary hypertension (PH) and explore factors that influence its evolution over time.MethodsA prospective longitudinal multisite cohort study. Participants were recruited from specialist UK PH centres and completed a questionnaire pack at baseline, 6, 12 and 18 months to assess HRQoL (emPHasis-10), dyspnoea, fatigue, sleep, anxiety and depression.Results185 patients entered the study at baseline and 126 (68%) completed month 18. At baseline, patients had significant impairment of HRQoL, anxiety, depression, dyspnoea and severe fatigue. No significant changes, apart from a reduction in the Hospital Anxiety and Depression Scale-Anxiety score (P=0.04), were observed over 18 months. Depression and dyspnoea were predictors of HRQoL (P=0.002 and P=0.03, respectively). Oxygen use was also associated with diminished HRQoL and increased symptom severity.ConclusionPatients with PH experience high levels of symptom severity and the negative impact on HRQoL was unchanged over time. The use of oxygen therapy, in particular, was associated with a significant impact on HRQoL. Further study of factors impacting HRQoL and interventions that target a combination of physiological and psychosocial consequences of living with PH are needed.
Supercontinents and the case for Pannotia
Authors: Nance R. Damian , Murphy J. Brendan 
Published: March 2018

Abstract
Disagreement about the existence of the late Neoproterozoic supercontinent Pannotia highlights the limitation of defining supercontinents simply on the basis of size, which, for pre-Pangaean supercontinents, is difficult to determine. In the context of the supercontinent cycle, however, supercontinent assembly and break-up, respectively, mark the end of one cycle and the beginning of the next and can be recognized by the tectonic, climatic and biogeochemical trends that accompany them. Hence supercontinents need only be large enough to influence mantle circulation in such a way as to enable the cycle to repeat. Their recognition need not rely solely on continental reconstructions, but can also exploit a variety of secular trends that accompany their amalgamation and break-up. Although the palaeogeographical and age constraints for the existence of Pannotia remain equivocal, the proxy signals of supercontinent assembly and break-up in the late Neoproterozoic are unmistakable. These signals cannot be readily attributed to either the break-up of Rodinia or the assembly of Gondwana without ignoring either the assembly phase of Pan-African orogenesis and the changes in mantle circulation that accompany this phase, or the reality that Gondwana cannot be a supercontinent in the context of the supercontinent cycle because its break-up coincides with that of Pangaea.
Exploring the theory of plate tectonics: the role of mantle lithosphere structure
Authors: Heron Philip J. , Pysklywec Russell N. , Stephenson Randell 
Published: March 2018

Abstract
This review of the role of the mantle lithosphere in plate tectonic processes collates a wide range of recent studies from seismology and numerical modelling. A continually growing catalogue of deep geophysical imaging has illuminated the mantle lithosphere and generated new interpretations of how the lithosphere evolves. We review current ideas about the role of continental mantle lithosphere in plate tectonic processes. Evidence seems to be growing that scarring in the continental mantle lithosphere is ubiquitous, which implies a reassessment of the widely held view that it is the inheritance of crustal structure only (rather than the lithosphere as a whole) that is most important in the conventional theory of plate tectonics (e.g. the Wilson cycle). Recent studies have interpreted mantle lithosphere heterogeneities to be pre-existing structures and, as such, linked to the Wilson cycle and inheritance. We consider the current fundamental questions in the role of the mantle lithosphere in causing tectonic deformation, reviewing recent results and highlighting the potential of the deep lithosphere in infiltrating every aspect of plate tectonics processes.
Multilevel Small-Area Estimation of Colorectal Cancer Screening in the United States
Authors: Berkowitz Zahava , Zhang Xingyou , Richards Thomas B. , Nadel Marion , Peipins Lucy A. , Holt James 
Published: March 2018

Abstract
Background: The U.S. Preventive Services Task Force recommends routine screening for colorectal cancer for adults ages 50 to 75 years. We generated small-area estimates for being current with colorectal cancer screening to examine sociogeographic differences among states and counties. To our knowledge, nationwide county-level estimates for colorectal cancer screening are rarely presented.
Methods: We used county data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS; n = 251,360 adults), linked it to the American Community Survey poverty data, and fitted multilevel logistic regression models. We post-stratified the data with the U.S. Census population data to run Monte Carlo simulations. We generated county-level screening prevalence estimates nationally and by race/ethnicity, mapped the estimates, and aggregated them into state and national estimates. We evaluated internal consistency of our modeled state-specific estimates with BRFSS direct state estimates using Spearman correlation coefficients.
Results: Correlation coefficients were ≥0.95, indicating high internal consistency. We observed substantial variations in current colorectal cancer screening estimates among the states and counties within states. State mean estimates ranged from 58.92% in Wyoming to 75.03% in Massachusetts. County mean estimates ranged from 40.11% in Alaska to 79.76% in Florida. Larger county variations were observed in various race/ethnicity groups.
Conclusions: State estimates mask county variations. However, both state and county estimates indicate that the country is far behind the “80% by 2018” target.
Impact: County-modeled estimates help identify variation in colorectal cancer screening prevalence in the United States and guide education and enhanced screening efforts in areas of need, including areas without BRFSS direct-estimates. Cancer Epidemiol Biomarkers Prev; 27(3); 245–53. ©2018 AACR.
Empowering Latinas to Obtain Breast Cancer Screenings: Comparing Intervention Effects, Part 2
Authors: Molina Y , San Miguel LG , Tamayo L , Sanchez-Diaz C , Robledo C , Peña K , Lucio A , Hernandez O , Arroyo J , Medina M , Coronado N , Irma V 
Published: March 2018

Abstract
We compare the effects of breast cancer education and empowerment approaches on non-adherent Latinas' breast health behaviors and dissemination of health information. Methods: The setting for this ongoing, quasi-experimental trial is two Latino, lower income communities in Chicago. Women were recruited via two community-based organizations and snowball sampling. Eligibility criteria were: 1) age of 52–74; 2) lack of screening within past 2 years; 3) no previous breast cancer diagnosis; and, 4) no health volunteerism experience. Women were assigned to a three week group intervention (3 2 hour sessions). The education intervention is administered in East Side/South Chicago and the empowerment intervention is administered in Pilsen/Little Village to avoid contamination effects. The education intervention has 3 sessions focused on early detection and prevention (diet, physical activity). The empowerment intervention has 3 sessions focused on early detection, sharing information with family/friends, and health volunteerism. Navigation is provided if women wish to obtain mammograms. Three questionnaires are given at baseline, post-intervention, and a 6 month follow-up. Results: Among our 68 participants (34 education; 34 empowerment), 87% were born in Mexico; 59% had &lt;9th grade education; 52% had a median household income of &lt;$10K; and, 51% were uninsured. The average age was 61.21 (SD = 6.20). Relative to education participants, more empowerment participants have scheduled mammograms (94% vs. 74%; P = 0.05) and obtained mammograms (77% vs. 38%, P = 0.001). Empowerment participant also spoke to more individuals about breast health relative to education participants (M = 6.24, SD = 5.30 vs. M = 3.00, SD = 3.04, P = 0.003). A greater proportion of engagement participants also spoke about specific types of breast cancer screening (58% vs. 38%, P = 0.01) and discussed breast cancer across multiple settings (58% vs. 24%, P = 0.003). Discussion: The empowerment approach may be particularly effective in changing non-adherent Latinas' screening behaviors and promoting them to become agents of change in their communities. Limitations concern generalizability due a non-probability based sample, and limited ability for causal inferences due to a lack of randomization.
Prevalence and Characteristics of Liver Fibrosis Detected by Elastography: Results from the Cameron County Hispanic Cohort
Authors: Watt GP , Lee M , Pan JJ , Fallon MB , McCormick JP , Fisher-Hoch SP 
Published: March 2018

Abstract
Mexican Americans in south Texas have among highest rates of hepatocellular carcinoma (HCC) in the US. Non-invasive measures of liver fibrosis are needed to identify those at high risk of HCC. The purpose of the study was to determine the prevalence of and factors associated with liver fibrosis using acoustic radiation force impulse (ARFI) elastography, an accurate and non-invasive modality, in the Cameron County Hispanic Cohort (CCHC). Methods. The CCHC is a well characterized population-based cohort in south Texas. Liver stiffness was measured by ARFI in 404 participants in the CCHC by two separate operators. Median liver stiffness &gt; 1.34 m/s was considered significant (F2-F4) fibrosis. Ultrasound was used to determine presence of steatosis. Absence of HCV and HBsAg antigen, and absence of heavy drinking, was considered non-alcoholic fatty liver disease (NAFLD). We calculated design-based prevalence of fibrosis and determined clinical associations with (1) significant fibrosis and (2) simple steatosis using multinomial logistic regression. Results. Mean age was 51.1 years, 44.6% were male, and 29.1% had diabetes. The prevalence of significant fibrosis was 16.5%. In the fibrosis group, most (47/57, 84%) had NAFLD. We excluded participants with etiologies other than NAFLD for further analyses. After adjustment for age and sex, hypertension [Odds Ratio (OR) 3.0, 95% confidence interval (CI) 1.1–8.1), platelet count (OR 0.6, 95% CI, 0.5–1.0), and potassium level (OR 1.5, 95% CI, 1.1–2.0) were significantly associated with fibrosis, but not steatosis. HDL cholesterol (OR 0.5, 95% CI, 0.4–0.7), obesity (OR 2.2, 95% CI, 1.2–4.0) and insulin level (OR 2.1, 95% CI, 1.2–3.7) were significantly associated with steatosis, but not fibrosis. Elevated fasting glucose, diabetes, and elevated ALT levels were significantly associated with both steatosis and fibrosis. Conclusion. This is the first population-based application of liver elastography in the US. We find a high prevalence of fibrosis in Mexican Americans, dominated by NAFLD. Our results indicate a higher burden of fibrosis than population-based studies of liver fibrosis conducted elsewhere. We urge community intervention for the early detection of liver disease and prevention of NAFLD-related HCC.
Family History of Melanoma and Lifetime Patterns of Daytime Hours Spent Outdoors in Melanoma-prone Families
Authors: Duan C , Qian L , Mitra N , Kanetsky PA 
Published: March 2018

Abstract
Longer daytime hours spent outdoors reflect higher ultraviolet radiation exposure, which is a modifiable risk factor of melanoma. Among individuals of melanoma-prone families, we sought to describe lifetime patterns for hours spent outdoors, and to investigate whether having an affected family member with melanoma from an older generation was associated with patterning. Methods: Information on hours spent outdoors on weekdays, weekends, and holidays beginning at age 10 was obtained from individuals from melanoma-prone families. We determined time-weighted average hours outdoors for warmer months, colder months, and the entire year. K-means for longitudinal data was used to identify lifetime patterns. We created a variable to indicate whether there was an existing melanoma in a prior generation of an individual's family. Multinomial logistic regression models were used to examine the association between family history of melanoma and lifetime patterns of daytime hours spent outdoors, adjusting for covariates. Results: We analyzed 2540 individuals from 669 families ascertained across 15 countries, and four lifetime patterns were identified. Three patterns began with moderate hours that (B) decreased slowly (n = 1014); (C) decreased sharply until age 20 and then remained low (n = 572); or (D) increased at age 20 and remained high (n = 173). One pattern, (A) began with few hours that decreased at age 20 then remained very low (n = 781). Compared to individuals with the high (D) pattern, individuals with an existing melanoma in a prior family generation were more likely to have the low (A) pattern (OR = 1.92, 95% CI: 1.34–2.76), the moderate and slowly decreasing (B) pattern (OR = 1.72, 95% CI: 1.15–2.57), or the sharply decreasing (C) pattern (OR = 2.01, 95% CI: 1.40–2.87). Similar associations were observed separately in warmer and colder months. Examining lifetime patterns of hours spent outdoors during holidays, we noticed a stronger relationship with family history of melanoma in warmer months than in colder months. Conclusions: As expected, the diagnosis of a melanoma in a prior generation may impact family members' awareness of UVR exposure leading to reduced daytime hours spent outdoors.
Genetic Associations with Indoor Tanning Addiction
Authors: Mays D , Ahn J , Zhang B , Atkins MB , Goerlitz D , Tercyak KP 
Published: March 2018

Abstract
Some young people are prone to develop addiction to indoor tanning along with psychiatric comorbidity. This study examined genetic hypotheses that liabilities in neurobiological addiction reward pathways influence risk of indoor tanning addiction and are affected by psychiatric comorbidity. Methods: Data were from an observational study investigating factors associated with indoor tanning addiction in a community sample of non-Hispanic white women ages 18–30 years with a history of indoor tanning in the past year. A total of 295 participants completed self-report measures and provided DNA samples. DNA samples were genotyped and analyzed for 36 single nucleotide polymorphisms (SNPs) in candidate genes involved in hypothesized addiction reward pathways (e.g., opioid and dopamine receptor genes). Self-report measures included indoor tanning frequency and dependence symptoms, appearance beliefs, and depressive symptoms. Results: Over 20% of the sample screened positive for indoor tanning addiction. Two SNPs in the DRD2 dopamine receptor gene, rs4436578 and rs4648318, were significantly associated (P &lt; 0.05) with indoor tanning addiction after multiple testing adjustment using the false discovery rate. In logistic regression analyses adjusting for indoor tanning frequency, appearance beliefs, and depressive symptoms, homozygous major allele genotypes for both SNPs were associated with indoor tanning addiction (Odds Ratio [OR] 2.29, 95% Confidence Interval [CI] 1.11–4.77, and OR 1.95, 95% CI, 1.02–3.72, respectively). The major allele genotypes for both SNPs also interacted with depressive symptoms to influence the risk of indoor tanning addiction: OR 7.03, 95% CI, 3.26–15.19, OR 4.35, 95% CI, 2.06–9.20, respectively. Conclusions: This study is among the first to demonstrate SNPs in the DRD2 dopamine receptor gene are associated with indoor tanning addiction. Our findings demonstrate young women with risk-conferring genotypes and exhibiting depressive symptoms are at especially high risk. These data can inform personalized interventions tailored to neurobiological and behavioral differences to prevent melanoma and nonmelanoma skin cancer.
A Phase I Clinical Trial of Guadecitabine and Carboplatin in Platinum-Resistant, Recurrent Ovarian Cancer: Clinical, Pharmacokinetic, and Pharmacodynamic Analyses
Authors: Matei Daniela , Ghamande Sharad , Roman Lynda , Alvarez Secord Angeles , Nemunaitis John , Markham Merry Jennifer , Nephew Kenneth P. , Jueliger Simone , Oganesian Aram , Naim Sue , Su Xiang Yao , Keer Harold , Azab Mohammad , Fleming Gini F. 
Published: March 2018

Abstract
Purpose: Epigenetic changes are implicated in acquired resistance to platinum. Guadecitabine is a next-generation hypomethylating agent (HMA). Here, we report the clinical results, along with pharmacokinetic (PK) and pharmacodynamic analyses of the phase I study of guadecitabine and carboplatin in patients with recurrent, platinum-resistant high-grade serous ovarian cancer, primary peritoneal carcinoma (PPC), or fallopian tube cancer (FTC).
Experimental Design: Guadecitabine was administered once daily on days 1 to 5 followed by carboplatin i.v. on day 8 of a 28-day cycle. Patients had either measurable or detectable disease. Safety assessments used CTCAE v4.
Results: Twenty patients were enrolled and treated. Median age was 56 years (38–72 years). The median number of prior regimens was 7 (1–14). In the first cohort (N = 6), the starting doses were guadecitabine 45 mg/m2 and carboplatin AUC5. Four patients experienced dose-limiting toxicity (DLT; neutropenia and thrombocytopenia), leading to dose deescalation of guadecitabine to 30 mg/m2 and of carboplatin to AUC4. No DLTs were observed in the subsequent 14 patients. Grade ≥3 adverse events ≥10% were neutropenia, leukopenia, anemia, nausea, vomiting, ascites, constipation, hypokalemia, pulmonary embolism, small-intestinal obstruction, and thrombocytopenia. Three patients had a partial response (PR), and 6 patients had stable disease (SD) &gt;3 months, for an overall response rate (ORR) and clinical benefit rate of 15% and 45%, respectively. LINE-1 demethylation in PBMCs and promoter demethylation/gene reexpression in paired tumor biopsies/ascites were recorded.
Conclusions: Guadecitabine and carboplatin were tolerated and induced clinical responses in a heavily pretreated platinum-resistant ovarian cancer population, supporting a subsequent randomized phase II trial. Clin Cancer Res; 24(10); 2285–93. ©2018 AACR.
IDO1 Inhibition Synergizes with Radiation and PD-1 Blockade to Durably Increase Survival Against Advanced Glioblastoma
Authors: Ladomersky Erik , Zhai Lijie , Lenzen Alicia , Lauing Kristen L. , Qian Jun , Scholtens Denise M. , Gritsina Galina , Sun Xuebing , Liu Ye , Yu Fenglong , Gong Wenfeng , Liu Yong , Jiang Beibei , Tang Tristin , Patel Ricky , Platanias Leonidas C. , James C. David , Stupp Roger , Lukas Rimas V. , Binder David C. , Wainwright Derek A. 
Published: March 2018

Abstract
Purpose: Glioblastoma is the most aggressive primary brain tumor in adults with a median survival of 15–20 months. Numerous approaches and novel therapeutics for treating glioblastoma have been investigated in the setting of phase III clinical trials, including a recent analysis of the immune checkpoint inhibitor, nivolumab (anti-PD-1), which failed to improve recurrent glioblastoma patient survival. However, rather than abandoning immune checkpoint inhibitor treatment for glioblastoma, which has shown promise in other types of cancer, ongoing studies are currently evaluating this therapeutic class when combined with other agents.
Experimental Design: Here, we investigated immunocompetent orthotopic mouse models of glioblastoma treated with the potent CNS-penetrating IDO1 enzyme inhibitor, BGB-5777, combined with anti-PD1 mAb, as well as radiotherapy, based on our recent observation that tumor-infiltrating T cells directly increase immunosuppressive IDO1 levels in human glioblastoma, the previously described reinvigoration of immune cell functions after PD-1 blockade, as well as the proinflammatory effects of radiation.
Results: Our results demonstrate a durable survival benefit from this novel three-agent treatment, but not for any single- or dual-agent combination. Unexpectedly, treatment efficacy required IDO1 enzyme inhibition in non-glioblastoma cells, rather than tumor cells. Timing of effector T-cell infiltration, animal subject age, and usage of systemic chemotherapy, all directly impacted therapy-mediated survival benefit.
Conclusions: These data highlight a novel and clinically relevant immunotherapeutic approach with associated mechanistic considerations that have formed the basis of a newly initiated phase I/II trial for glioblastoma patients. Clin Cancer Res; 24(11); 2559–73. ©2018 AACR.