bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Gallbladder Carcinoma: A Single-Center Experience
Authors: Cangemi Vincenzo , Fiori Enrico , Picchi Cristina , De Cesare Alessandro , Cangemi Roberto , Galati Gaspare , Volpino Patrizia 
Published: July 2019

Aims and background Controversy continues regarding the best surgical treatment for early gallbladder carcinoma defined as a tumor confined to the mucosa (pT1a) or to the muscularis propria (pT1 b) according to the TNM classification. This study evaluates the effectiveness of different surgical approaches in patients with early gallbladder carcinoma in terms of long-term survival. Materials and methods From 1980 to 2001, 175 patients with gallbladder carcinoma were admitted to our department. Fifteen of them underwent resections for early gallbladder carcinoma: 4 patients for pT1a tumors and 11 patients for pT1b tumors. All patients with pT1a tumors and 8 patients with pT1b tumors underwent simple cholecystectomy. The remaining 3 patients with pT1 b tumors underwent extended cholecystectomy. Results The 5-10 year cumulative survival rate was 100% for patients with pT1a tumors, 37.5% for patients with pT1b tumors who underwent simple cholecystectomy, and 100% for patients with pT1b tumors who underwent extended cholecystectomy. Conclusions Simple cholecystectomy is the appropriate treatment for patients with pT1a tumors, whereas patients with pT1b tumors require an extended cholecystectomy.
Gene Expression of E-Selectin in Tissue and its Protein Level in Serum of Breast Cancer Patients
Authors: Shaker Olfat G , El-Deen Mohamed A Ay , El-Rahim Mohamed T Abd , Talaat Randa M 
Published: July 2019

Aims and background This study aims to detect the expression of E-selectin in tissue and the serum level of its soluble form in patients with primary breast cancer and benign breast tumors and to correlate the results with the clinicopathological data of the subjects. Methods Fifty participants were included in the study and stratified into 3 subgroups. Group A comprised 30 patients with primary breast cancer, group B 9 patients with benign breast tumors, and group C 11 healthy control women undergoing reduction mammoplasty. E-selectin gene expression was investigated in breast tissues by PCR techniques and soluble E-selectin was measured in sera by ELISA. Results The E-selectin gene was expressed in 73.3% of group A, 44.4% of group B and 9.1% of group C. It was expressed in 61.5% of patients with grade 2 breast cancer and in 82.4% of patients with grade 3 breast cancer. E-selectin gene expression was detected in 60%, 73.3% and 100% of patients with stage II, III and IV tumors, respectively. It was detected in 81.8% of patients with node-positive primary breast cancer and in 50% of patients with node-negative cancer. PCR in situ hybridization was done to locate the site of E-selectin expression. E-selectin was found on the membranes of peritumoral endothelial cells while it was not found on breast epithelial cells. Serum levels of soluble E-selectin were significantly elevated in group A compared to groups B and C ( P <0.001). They increased significantly with increasing breast cancer stage ( P <0.001) and were significantly higher in patients with lymph node involvement than in patients without node involvement ( P <0.001). Conclusions The studied marker showed associations with established prognostic parameters such as lymph node involvement and histological tumor grade. Further studies are needed to evaluate E-selectin as a possible target for antimetastat-ic therapy through modulation of the expression of the cell adhesion molecule. E-selectin can be regarded as a promising strategy in improving tumor therapy.
Kit Protein (CD 117) and Proliferation Index (Ki-67) Evaluation in Well and Poorly Differentiated Neuroendocrine Tumors
Authors: Ferrari Leonardo , Torre Silvia Della , Collini Paola , Martinetti Antonia , Procopio Giuseppe , De Dosso Sara , Bajetta Roberto , Catena Laura 
Published: July 2019

Aims and background Kit protein expression seems to be associated with a poor outcome in cancer patients and may be an important target for new anticancer drugs. We examined by immunohistochemistry the presence of Kit protein in neuroendocrine tumors (NETs) to explore its relationship with histological grade and proliferation index. Patients and methods Thirty-five tumor specimens from patients with 24 well differentiated and 11 poorly differentiated NETs were examined for the presence of Kit protein and the proliferation index marker Ki-67. Results Eleven specimens were positive for Kit protein expression, 8 of which had poorly-differentiated histology and only 3 had well-differentiated histology. Most of the tumors showing immunopositivity for Kit protein were also characterized by a high proliferation index. Conclusions Immunohistochemical positivity for Kit protein is mainly related to poorly differentiated NETs. In our study, the percentage of tumors with immunopositivity for Kit protein was lower than that observed by other authors. This difference could be attributable to the different immunohistochemistry procedures used and to the biological heterogeneity of NETs. The number of Kit protein-positive NETs may justify targeted therapy with a tyrosine kinase receptor-associated inhibitor only in a selected subset of patients, whenever no other therapy is available and an autocrine loop sustained by the Kit receptor and its specific ligand has been demonstrated.
Critical Care Nurses’ Perceptions of Parenteral and Enteral Nutrition at the End-of-Life in South Korea
Authors: Seol Eun-Mi , Koh Chin Kang , Kim Eun Kyung 
Published: July 2019

Purpose: The purpose of this study was to explore the perceptions of critical care nurses regarding the withdrawal or withholding of enteral nutrition (EN) and parenteral nutrition (PN) at the end-of-life, which is not allowed according to the current law in South Korea. Methods: This was a cross-sectional study utilizing a self-report survey. The participants in the study were 141 nurses working in the intensive care units of a tertiary university hospital. The critical care nurses’ general attitudes about EN and PN at the end-of-life were measured using the questionnaires developed by Lubart, Leibovitz, and Habot. The nurses responded to additional questions on whether withdrawal or withholding of EN or PN at the end-of-life should be legally allowed. Results: The mean scores of the general attitude items on EN ranged between 3.03 and 3.35 on a 5-point Likert scale where a value of 1 represents “strongly disagree” and a value of 5 represents “strongly agree,” while those for PN ranged between 2.89 and 3.65. Respecting attitudes toward EN and PN, critical care nurses had more negative attitudes about stopping PN than EN. Regarding attitudes about whether patients should be legally able to refuse EN, 34.3% agreed, while 25.7% disagreed. For PN, 40.0% agreed, while 24.3% disagreed. Conclusion: Discussions about making the withdrawal and withholding of artificial nutrition legal should be initiated. Moreover, education regarding evidence about the outcomes of EN and PN during end-of-life care and up-to-date clinical guidelines about it should be provided.
Behaviours of healthcare professionals towards difficult patients: A structural equation modelling study
Authors: Cerit Kamuran , Karataş Tuğba , Ekici Dilek 
Published: July 2019

Background: Some patients are stigmatised as difficult patients by healthcare professionals. This phenomenon has great many negative consequences. The behaviours of healthcare professionals towards difficult patients are important. Objective: To explore the behaviours of all healthcare professionals towards difficult patients. Research Design: This study was based on a cross-sectional research design using structural equation modelling. Participants and Research Context: Two hundred and fifty-four healthcare professionals were involved in the study in Turkey. ‘Participant Information Form’ and the ‘Healthcare Professionals Behaviour Assessment Questionnaire For Difficult Patient’ were used to collect data from participants. Ethical Consideration: Ethical approval was obtained from Gazi University Ethics Committee for the study. Informed consent of the participants in the study was taken and the confidentiality of the participants was ensured. Findings: It was explored that the behaviours of healthcare professionals towards difficult patients were categorised into ethical, supportive and negative. The highest mean score was supportive behaviour and the least mean score was negative. According to structural equation modelling, the most important predictor of difficult encounters was an ethical dimension. One-unit increase in ethical behaviour contributed to 0.92 unit increase in positive patient behaviour. Discussion: Patients generally are perceived as ‘difficult patient’ by the healthcare professionals, so the patients’ treatment and care services are affected negatively due to healthcare professionals’ negative beliefs and attitudes. The healthcare professionals should behave supportively towards difficult patients. Conclusion: Healthcare professionals should be aware of management strategies in dealing with difficult encounters. The behaviours of healthcare professionals should be improved in a positive way and awareness of ethical dimension of difficult encounters should be increased.
Relationship Between FIIs’ Herding and Returns in the Indian Equity Market: Further Empirical Evidence
Authors: Choudhary Kapil , Singh Parminder , Soni Amit 
Published: July 2019

Empirical evidence indicates that foreign institutional investors (FIIs) play a vital role in financial markets, and being the major players, they demonstrate positive feedback trading behaviour and usually follow one another’s actions. In order to examine this phenomenon, the present study endeavoured to unearth the relationship between foreign institutional investments (FIIs) and returns in the Indian stock market, trading volume and volatility. The return of the Nifty50 index has surrogated market returns, while volatility is represented by conditional volatility computed from Nifty50, from January 1999 to May 2017. The vector autoregression (VAR) results indicate a positive association between herding among FIIs and lagged market returns, while information asymmetry has no impact on herding. On the other hand, previous-day volatility has a significant bearing on the herding measure. Overall, the results portray a significant relationship between herding and stock market returns in India. The results of multivariate regression exhibit that market return was a primary factor for FII herding during the study period under consideration, while trading volume bore no relationship with herding. In case of market volatility, the empirical results are in congruence with the fact that during the period of the volatile market, FIIs prefer to not indulge in herding. Furthermore, the results of three sub-periods, that is, before, during and after the crisis, are similar to the results of the whole study period which indicates that the return is a prime and vital force for herding; on the contrary, market volatility appears to have a negative relationship with herding.
Palliative Care Consultation Is Underutilized in Critically Ill General Surgery Patients
Authors: Evans Brooke A. , Turner Megan C. , Gloria Jared N. , Pickett Lisa C. , Galanos Anthony N. 
Published: July 2019

Background: American College of Surgeons recommends palliative care and surgeons collaborate on the care of patients with poor prognoses. These collaborations are done to discuss symptom management and goals of care. However, contemporary practice patterns of palliative care consultation for surgical patients are poorly defined. We aim to describe the use of palliative care consultation for patients admitted to our institution’s surgical services who died during their index hospital admission. Methods: The Duke Enterprise Data Unified Content Explorer 2014 to 2016 was queried for patients admitted to general surgery services who died during their admission. Secondary measures included length of stay, time spent in consultation, days from consultation to death, and execution of a care plan. Results: Of the 105 patients identified, 6 died on the day of admission, and 39 (37%) received palliative care consultation. Our data showed that patients who received consultation were generally older, white, and insured. Median number of days between palliative consult and death was 3 days (interquartile range: 1-8). Goals-of-care conversations were the indication for consultation in 62.5% of patients. The proposed plan by the consultants was congruent with the primary team in 66.7% of cases. Conclusions: Palliative care consultations were underutilized in surgical patients who died while admitted to the general surgical service at our institution. When palliative care is consulted, the plan of the primary surgical team and the palliative team align. Identification of barriers to consultation and promotion of the benefits of palliative care among surgical teams is warranted.
Loratadine for Paclitaxel-Induced Myalgias and Arthralgias
Authors: Smith Caleb , Hendrickson Andrea Wahner , Grudem Megan , Klampe Carolyn , Deering Erin , Jatoi Aminah 
Published: July 2019

Background: Seventy percentage of patients who receive paclitaxel have diffuse, refractory myalgias, and arthralgias. Based on anecdotal reports, this study explored whether loratadine, an antihistamine, palliates these symptoms. Methods: The medical records of postoperative ovarian and patients with endometrial cancer were studied, as these patients are routinely prescribed paclitaxel. Records were screened for patients who received paclitaxel and loratadine concurrently. Results: Forty patients are the focus of this report. Eight had paclitaxel-induced myalgias and arthralgias and then took loratadine; of these, 6 (75%; 95% confidence interval: 35%, 97%) manifested evidence of symptom improvement: “She did experience some migrating generalized body aches and pains…but this has resolved.” Of those already receiving loratadine but with no myalgias and arthralgias, only 11 of 32, or 34% (95% confidence interval: 19%, 53%), developed myalgias and arthralgias (in contrast to the previously reported symptom rate of 70%). No adverse events were clearly attributed to loratadine. Conclusion: These preliminary data support further study of loratadine for paclitaxel-induced myalgias and arthralgias.
Etoposide and etoposide phosphate hypersensitivity in children: Incidence, risk factors, and prevention strategies
Authors: Stockton Winifred M , Nguyen Theresa , Zhang Lishi , Dowling Thomas C 
Published: July 2019

Introduction Etoposide is critical in treating pediatric cancers, although hypersensitivity can be severe and treatment-limiting. Reported rates of hypersensitivity range from 2% to 51%. Hypersensitivity data for etoposide phosphate, a newer product, are lacking. The primary objective of this study was to assess etoposide and etoposide phosphate hypersensitivity incidence. Secondary objectives included evaluation of potential risk factors for hypersensitivity and strategies to prevent recurrence. Methods This retrospective cohort study evaluated pediatric patients who received initial etoposide phosphate or etoposide dose between August 2012 and July 2017. The primary outcome was documentation of hypersensitivity within four months of initial dose. Potential risk factors evaluated included age, allergies, dose, infusion rate, infusion concentration, and premedication. Results Of 246 patients, hypersensitivity reactions occurred in five of 54 patients (9.3%) who received etoposide phosphate and 52 of 192 patients (27.1%) who received etoposide ( p = 0.0061). For etoposide, the mean initial infusion rate was 64.6 ± 40.9 mg/m2/h for patients with hypersensitivity and 49.5 ± 33.4 mg/m2/h without hypersensitivity ( p = 0.0886). Etoposide phosphate rate was not associated with hypersensitivity. Recurrent hypersensitivity occurred in one of nine patients (11.1%) who received etoposide desensitization and one of 38 patients (2.6%) who changed formulation to etoposide phosphate. Conclusions Etoposide was associated with more hypersensitivity than etoposide phosphate in pediatric patients. Etoposide hypersensitivity was associated with higher infusion rates, but not etoposide phosphate. Differences in hypersensitivity incidence and infusion rate influence indicate a formulation-effect. Etoposide hypersensitivity recurrence may be prevented by changing to etoposide phosphate formulation. During etoposide phosphate shortages, etoposide desensitization may prevent recurrent hypersensitivity.
Biomarkers of intestinal barrier function in multiple sclerosis are associated with disease activity
Authors: Camara-Lemarroy Carlos R , Silva Claudia , Greenfield Jamie , Liu Wei-Qiao , Metz Luanne M , Yong V Wee 
Published: July 2019

Background: Recent evidence suggests a role for the gut–brain axis in the pathophysiology of multiple sclerosis (MS). Materials and methods: We studied biomarkers of intestinal permeability in 126 people with MS (57 relapsing-remitting multiple sclerosis (RRMS) and 69 progressive MS) and in a group of healthy controls for comparison. Serum/plasma concentrations of zonulin (a regulator of enterocyte tight junctions), tight junction proteins (ZO-1 and occludin), intestinal fatty acid binding protein (IFABP)/ileal bile acid binding protein (IBABP), D-lactate, and lipopolysaccharide (LPS) binding protein were measured. Results: Zonulin concentrations were significantly higher when a concurrent magnetic resonance imaging (MRI) confirmed the presence of blood–brain barrier (BBB) disruption (Gad+ RRMS) and were correlated with tight junction proteins. IBABP and D-lactate were elevated in people with RRMS compared to controls, but did not discriminate between Gad+ and Gad– subgroups. Baseline zonulin concentrations were associated with 1-year disease progression in progressive MS. Conclusions: People with MS have altered biomarkers of intestinal barrier integrity. Zonulin concentrations are associated with 1-year disease progression in progressive MS and closely mirror BBB breakdown in RRMS. Zonulin may mediate breakdown of both the intestinal barrier and the BBB in gut dysbiosis through the regulation of tight junctions. This could explain how the gut–brain axis modulates neuroinflammation in MS.
A pilot study of the effects of running training on visuospatial memory in MS: A stronger functional embedding of the hippocampus in the default-mode network?
Authors: Huiskamp Marijn , Moumdjian Lousin , van Asch Paul , Popescu Veronica , Schoonheim Menno Michiel , Steenwijk Martijn D , Vanzeir Ellen , van Wijmeersch Bart , Geurts Jeroen JG , Feys Peter , Hulst Hanneke E 
Published: July 2019

Background/objective: Endurance exercise can improve memory function in persons with multiple sclerosis (pwMS), but the effects on hippocampal functioning are currently unknown. We investigated the effects of a running intervention on memory and hippocampal functional connectivity in pwMS. Methods/results: Memory and resting-state functional magnetic resonance imaging (fMRI) data were collected in a running intervention ( n = 15) and waitlist group ( n = 14). Visuospatial memory improvement was correlated to increased connectivity between the hippocampus and the default-mode network (DMN) in the intervention group only. Conclusion: As a result of endurance exercise, improvements in visuospatial memory may be mediated by a stronger functional embedding of the hippocampus in the DMN.
Improved performance of the 2017 McDonald criteria for diagnosis of multiple sclerosis in children in a real-life cohort
Authors: Hacohen Yael , Brownlee Wallace , Mankad Kshitij , Chong Wui K ‘Kling’ , Thompson Alan , Lim Ming , Wassmer Evangeline , Hemingway Cheryl , Barkhof Frederik , Ciccarelli Olga 
Published: July 2019

Objective: To compare the performance of the 2017 McDonald criteria with that of the 2010 criteria for the diagnosis of multiple sclerosis (MS) in children in the clinical setting. Methods: In this retrospective, multi-centre study, we identified children who presented with symptoms suggestive of a clinically isolated syndrome (CIS) and were followed up for at least 2 years or until their second attack. Results: Of 156 children with CIS followed up for a median of 4.17 years, 94 (60.3%) were diagnosed with MS. In all, 83 (88.3%) of these fulfilled the 2010 dissemination in space (DIS) criteria at onset. Three additional children fulfilled the 2017 DIS criteria because of the inclusion of symptomatic lesions. Of the 59 children with MS who underwent post-gadolinium magnetic resonance imaging (MRI), 44 (74.6%) fulfilled the 2010 dissemination in time (DIT) criteria at baseline. When the presence of oligoclonal bands (OCBs) was used to substitute DIT, an additional 35 children (79/94, 84.0%) were diagnosed with MS according to the 2017 criteria. The 2017 criteria had higher accuracy (87.2% vs 66.7%), higher sensitivity (84.0% vs 46.8%), but reduced specificity (91.9% vs 96.8%) when compared to the 2010 criteria. Conclusion: The improved performance of the 2017 criteria when compared to the 2010 criteria was predominantly due to the inclusion of intrathecal OCBs.
Function and progression of non-suicidal self-injury and relationship with suicide attempts: A qualitative investigation with an adolescent clinical sample
Authors: Taliaferro Lindsay A , Almeida Joanna , Aguinaldo Laika D , McManama O’Brien Kimberly H 
Published: July 2019

Aim: To investigate the function and progression of non-suicidal self-injury (NSSI) and its relationship with suicide attempts. Method: Qualitative in-depth interviews were conducted with 15 adolescents psychiatrically hospitalized following a suicide attempt who reported NSSI. Applied thematic analysis was used to identify and examine themes from the interview data. Results: Thematic analysis revealed that the primary function of NSSI was relief from emotional pain, though the function often changed over time. NSSI was often not directly related to patients’ suicide attempts, yet risk of suicidal behavior seemed to increase once NSSI lost its effectiveness, and suicide became the only option. Conclusion: Clinicians need to understand and monitor the functions of NSSI, and its relationship with suicidality, to prevent suicide attempts among adolescents.