bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does general experience affect self‐assessment?
Authors: Rezaiefar Parisa , Forse Kelly , Burns Joseph K , Johnston Sharon , Muggah Elizabeth , Kendall Claire , Archibald Douglas 
Published: May 2018

SummaryBackgroundThe assessment of clinical competence is critical in medical education. Understanding the effect of general experience on a physician's self‐assessment would help design more effective curricula and evaluations of procedural skills in postgraduate training and continuing professional development (CPD). In this observational study, we assessed the effect of general experience on the correlation between confidence and competence amongst experienced clinicians (ECs) and postgraduate trainees (PGTs) when learning an office‐based procedure in pessary care.MethodsWe recruited 19 first‐year family medicine residents and 18 family medicine faculty members in two outpatient academic clinics. All participants attended a simulation‐based workshop for a routine gynaecological office procedure. We used a confidence survey as a measure of the participants' self‐assessed competence and an objective structured clinical examination (OSCE) to evaluate participants' competence before and after the workshop.The assessment of clinical competence is critical in medical educationResultsWe found no significant correlation between confidence and competence at baseline for either group (EC, r = 0.25, p = 0.35; PGT, r = 0.15, p = 0.60). After the workshop, we observed a statistically significant correlation between confidence and competence for ECs (r = 0.60, p = 0.01), but not for PGTs. The change in this correlation was not statistically significant for either group, however.DiscussionOur findings suggest that ECs are not any more accurate in the assessment of their competence compared with PGTs. All procedural skills curricula can benefit from OSCE‐format evaluation to better evaluate the improvement in performance of participants.
Fifteen years of HIV and syphilis outcomes among a prevention of mother‐to‐child transmission program in Haiti: from monotherapy to Option B+
Authors: Deschamps Marie Marcelle , Jannat‐Khah Deanna , Rouzier Vanessa , Bonhomme Jerry , Pierrot Julma , Lee Myung Hee , Abrams Elaine , Pape Jean , McNairy Margaret L. 
Published: May 2018

SummaryObjectiveTo evaluate mother and infant outcomes in the largest prevention of mother‐to‐child‐transmission (PMTCT) programme in Haiti in order to identify gaps towards elimination of HIV and syphilis.MethodsBased on retrospective data from HIV+ pregnant women and their infants enrolled in PMTCT care from 1999 to 2014, we assessed maternal enrolment in PMTCT, receipt of antiretrovirals before delivery, maternal retention through delivery as well as infant enrolment in PMTCT, HIV testing and HIV infection. Four PMTCT programme periods were compared: period 1 (1999–2004, mono ARV), period 2 (2005–2009, dual ARV), period 3 (2010–2012, Option B) and period 4 (Oct 2012–2014, Option B+). Kaplan–Meier methods were used to assess retention in PMTCT care.ResultsAmong 4665 pregnancies, median age was 27 years and median CD4+ was 494 cells/μl (IQR 328–691). A total of 75% of women received antiretrovirals before delivery, and 73% were retained in care through delivery. Twenty‐two percent of women were lost before delivery, <1% died and 6% had stillbirths or abortions. Ninety‐four percent of infants who were born alive enrolled in PMTCT, of whom 92% had complete HIV testing. One hundred and sixty‐one infants were HIV+, giving a 5.4% HIV transmission rate (9.8%, 4.6%, 5.8% and 3.6% in periods 1–4). Retention among women through 12 months after PMTCT enrolment did not significantly differ across periods. However, among women who received antiretrovirals at the time of enrolment, retention 12 months later was lower in the Option B+ period (83%) than in periods 2 and 3 (94% and 93%) (P < 0.001). Syphilis infection among women decreased from 16% in period 1 to 8% in period 4, whereas syphilis testing of infants increased from 17% to 91%.ConclusionDespite dramatic reductions in MTCT in Haiti, interventions are needed to improve retention to achieve MTCT elimination of HIV and syphilis.
Arabidopsis inositol phosphate kinases IPK1 and ITPK1 constitute a metabolic pathway in maintaining phosphate homeostasis
Authors: Kuo Hui‐Fen , Hsu Yu‐Ying , Lin Wei‐Chi , Chen Kai‐Yu , Munnik Teun , Brearley Charles A. , Chiou Tzyy‐Jen 
Published: May 2018

SummaryEmerging studies have suggested that there is a close link between inositol phosphate (InsP) metabolism and cellular phosphate (Pi) homeostasis in eukaryotes; however, whether a common InsP species is deployed as an evolutionarily conserved metabolic messenger to mediate Pi signaling remains unknown. Here, using genetics and InsP profiling combined with Pi‐starvation response (PSR) analysis in Arabidopsis thaliana, we showed that the kinase activity of inositol pentakisphosphate 2‐kinase (IPK1), an enzyme required for phytate (inositol hexakisphosphate; InsP6) synthesis, is indispensable for maintaining Pi homeostasis under Pi‐replete conditions, and inositol 1,3,4‐trisphosphate 5/6‐kinase 1 (ITPK1) plays an equivalent role. Although both ipk1‐1 and itpk1 mutants exhibited decreased levels of InsP6 and diphosphoinositol pentakisphosphate (PP‐InsP5; InsP7), disruption of another ITPK family enzyme, ITPK4, which correspondingly caused depletion of InsP6 and InsP7, did not display similar Pi‐related phenotypes, which precludes these InsP species from being effectors. Notably, the level of d/l‐Ins(3,4,5,6)P4 was concurrently elevated in both ipk1‐1 and itpk1 mutants, which showed a specific correlation with the misregulated Pi phenotypes. However, the level of d/l‐Ins(3,4,5,6)P4 is not responsive to Pi starvation that instead manifests a shoot‐specific increase in the InsP7 level. This study demonstrates a more nuanced picture of the intersection of InsP metabolism and Pi homeostasis and PSRs than has previously been elaborated, and additionally establishes intermediate steps to phytate biosynthesis in plant vegetative tissues.
Reporting quality of randomised controlled trial abstracts on age-related macular degeneration health care: a cross-sectional quantification of the adherence to CONSORT abstract reporting recommendations
Authors: Baulig Christine , Krummenauer Frank , Geis Berit , Tulka Sabrina , Knippschild Stephanie 
Published: May 2018

ObjectiveTo assess the reporting quality of randomised controlled trial (RCT) abstracts on age-related macular degeneration (AMD) healthcare, to evaluate the adherence to the Consolidated Standards of Reporting Trials (CONSORT) statement’s recommendations on minimum abstract information and to identify journal characteristics associated with abstract reporting quality.DesignCross-sectional evaluation of RCT abstracts on AMD healthcare.MethodsA PubMed search was implemented to identify RCT abstracts on AMD healthcare published in the English language between January 2004 and December 2013. Data extraction was performed by two parallel readers independently by means of a documentation format in accordance with the 16 items of the CONSORT checklist for abstracts. The total number of criteria fulfilled by an abstract was derived as primary endpoint of the investigation; incidence rate ratios (IRRs) with unadjusted 95% CI were estimated by means of multiple Poisson regression to identify journal and article characteristics (publication year, multicentre design, structured abstract recommendations, effective sample size, effective abstract word counts and journal impact factor) possibly associated with the total number of fulfilled items.Study characteristics136 of 673 identified abstracts (published in 36 different journals) fulfilled all eligibility criteria.ResultsThe median number of fulfilled items was 7 (95% CI 7 to 8). No abstract reported all 16 recommended items; the maximum total number was 14, the minimum 3 of 16 items. Multivariate analysis only demonstrated the abstracts’ word counts as being significantly associated with a better reporting of abstracts (Poisson regression-based IRR 1.002, 95% CI 1.001 to 1.003).ConclusionsReporting quality of RCT abstracts on AMD investigations showed a considerable potential for improvement to meet the CONSORT abstract reporting recommendations. Furthermore, word counts of abstracts were identified as significantly associated with the overall abstract reporting quality.
Immediate and long-term effects of a team-based quality improvement training programme
Authors: O’Leary Kevin J , Fant Abra L , Thurk Jessica , Bilimoria Karl Y , Didwania Aashish K , Gleason Kristine M , Groth Matthew , Holl Jane L , Knoten Claire A , Martin Gary J , O’Sullivan Patricia , Schumacher Mark , Woods Donna M 
Published: May 2018

BackgroundAlthough many studies of quality improvement (QI) education programmes report improvement in learners’ knowledge and confidence, the impact on learners’ future engagement in QI activities is largely unknown and few studies report project measures beyond completion of the programme.MethodWe developed the Academy for Quality and Safety Improvement (AQSI) to prepare individuals, across multiple departments and professions, to lead QI. The 7-month programme consisted of class work and team-based project work. We assessed participants’ knowledge using a multiple choice test and an adapted Quality Improvement Knowledge Assessment Test (QIKAT) before and after the programme. We evaluated participants’ postprogramme QI activity and project status using surveys at 6 and 18 months.ResultsOver 5 years, 172 individuals and 32 teams participated. Participants had higher multiple choice test (71.9±12.7 vs 79.4±13.2; p<0.001) and adapted QIKAT scores (55.7±16.3 vs 61.8±14.7; p<0.001) after the programme. The majority of participants at 6 months indicated that they had applied knowledge and skills learnt to improve quality in their clinical area (129/148; 87.2%) and to implement QI interventions (92/148; 62.2%). At 18 months, nearly half (48/101; 47.5%) had led other QI projects and many (41/101; 40.6%) had provided QI mentorship to others. Overall, 14 (43.8%) teams had positive postintervention results at AQSI completion and 20 (62.5%) had positive results at some point (ie, completion, 6 months or 18 months after AQSI).ConclusionsA team-based QI training programme resulted in a high degree of participants’ involvement in QI activities beyond completion of the programme. A majority of team projects showed improvement in project measures, often occurring after completion of the programme.
Juxtacrine Signaling Inhibits Antitumor Immunity by Upregulating PD-L1 Expression
Authors: Yang Wen-Hao , Cha Jong-Ho , Xia Weiya , Lee Heng-Huan , Chan Li-Chuan , Wang Ying-Nai , Hsu Jennifer L. , Ren Guoxin , Hung Mien-Chie 
Published: May 2018

Abstract
Programmed death-ligand 1 (PD-L1) is a well-known immune checkpoint protein that helps cancer cells evade immune response. Anti–PD-L1 immune therapy has been approved for the treatment of several advanced human cancers. Therefore, further understanding of the regulatory mechanisms of PD-L1 is critical to improve PD-L1–targeting immunotherapy. Recent studies indicated that contact-dependent pathways may regulate anticancer immunity, highlighting the importance of cell contact–induced signaling in cancer immunity. Here, we show that tumor cell contact upregulates PD-L1 expression and reduces T-cell–mediated cell killing through the membrane receptor tyrosine kinase ephrin receptor A10 (EphA10), which is not expressed in normal tissues except testis and is known to mediate cell contact–dependent juxtacrine signaling. Knockout of EphA10 in tumor cells increased T-cell–mediated antitumor immunity in syngeneic mouse models. EphA10 expression also correlated positively with PD-L1 in human breast tumor tissues. Together, our data reveal that in addition to paracrine/autocrine signaling, cell contact–mediated juxtacrine signaling also promotes PD-L1 expression, implying that tumor cells may escape immune surveillance via this mechanism and that targeting EphA10 to boost antitumor immunity may be a new immune checkpoint blockade strategy for female patients with breast cancer.
Significance: Regulation of PD-L1 expression by cell contact–mediated signaling promotes immune escape in breast cancer and may lead to the development of an immunotherapy with less adverse effects in female patients. Cancer Res; 78(14); 3761–8. ©2018 AACR.
Hepatocellular Carcinoma Outcome Is Predicted by Expression of Neuronal Calcium Sensor 1
Authors: Schuette Daniel , Moore Lauren M. , Robert Marie E. , Taddei Tamar H. , Ehrlich Barbara E. 
Published: May 2018

Abstract
Background: Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide. There is an urgent demand for prognostic biomarkers that facilitate early tumor detection, as the incidence of HCC has tripled in the United States in the last three decades. Biomarkers to identify populations at risk would have significant impact on survival. We recently found that expression of Neuronal Calcium Sensor 1 (NCS1), a Ca2+-dependent signaling molecule, predicted disease outcome in breast cancer, but its predictive value in other cancer types is unknown. This protein is potentially useful because increased NCS1 regulates Ca2+ signaling and increased Ca2+ signaling is a hallmark of metastatic cancers, conferring cellular motility and an increasingly aggressive phenotype to tumors.
Methods: We explored the relationship between NCS1 expression levels and patient survival in two publicly available liver cancer cohorts and a tumor microarray using data mining strategies.
Results: High NCS1 expression levels are significantly associated with worse disease outcome in Asian patients within these cohorts. In addition, a variety of Ca2+-dependent and tumor growth-promoting genes are transcriptionally coregulated with NCS1 and many of them are involved in cytoskeleton organization, suggesting that NCS1 induced dysregulated Ca2+ signaling facilitates cellular motility and metastasis.
Conclusions: We found NCS1 to be a novel biomarker in HCC. Furthermore, our study identified a pharmacologically targetable signaling complex that can influence tumor progression in HCC.
Impact: These results lay the foundation for using NCS1 as a prognostic biomarker in prospective cohorts of HCC patients and for further functional assessment of the characterized signaling axis. Cancer Epidemiol Biomarkers Prev; 27(9); 1091–100. ©2018 AACR.
Machine Learning–Based Radiomics for Molecular Subtyping of Gliomas
Authors: Lu Chia-Feng , Hsu Fei-Ting , Hsieh Kevin Li-Chun , Kao Yu-Chieh Jill , Cheng Sho-Jen , Hsu Justin Bo-Kai , Tsai Ping-Huei , Chen Ray-Jade , Huang Chao-Ching , Yen Yun , Chen Cheng-Yu 
Published: May 2018

Abstract
Purpose: The new classification announced by the World Health Organization in 2016 recognized five molecular subtypes of diffuse gliomas based on isocitrate dehydrogenase (IDH) and 1p/19q genotypes in addition to histologic phenotypes. We aim to determine whether clinical MRI can stratify these molecular subtypes to benefit the diagnosis and monitoring of gliomas.
Experimental Design: The data from 456 subjects with gliomas were obtained from The Cancer Imaging Archive. Overall, 214 subjects, including 106 cases of glioblastomas and 108 cases of lower grade gliomas with preoperative MRI, survival data, histology, IDH, and 1p/19q status were included. We proposed a three-level machine-learning model based on multimodal MR radiomics to classify glioma subtypes. An independent dataset with 70 glioma subjects was further collected to verify the model performance.
Results: The IDH and 1p/19q status of gliomas can be classified by radiomics and machine-learning approaches, with areas under ROC curves between 0.922 and 0.975 and accuracies between 87.7% and 96.1% estimated on the training dataset. The test on the validation dataset showed a comparable model performance with that on the training dataset, suggesting the efficacy of the trained classifiers. The classification of 5 molecular subtypes solely based on the MR phenotypes achieved an 81.8% accuracy, and a higher accuracy of 89.2% could be achieved if the histology diagnosis is available.
Conclusions: The MR radiomics-based method provides a reliable alternative to determine the histology and molecular subtypes of gliomas. Clin Cancer Res; 24(18); 4429–36. ©2018 AACR.
Prediction of Thrombotic and Bleeding Events After Percutaneous Coronary Intervention: CREDO‐Kyoto Thrombotic and Bleeding Risk Scores
Authors: Natsuaki Masahiro , Morimoto Takeshi , Yamaji Kyohei , Watanabe Hirotoshi , Yoshikawa Yusuke , Shiomi Hiroki , Nakagawa Yoshihisa , Furukawa Yutaka , Kadota Kazushige , Ando Kenji , Akasaka Takashi , Hanaoka Keiichi Igarashi , Kozuma Ken , Tanabe Kengo , Morino Yoshihiro , Muramatsu Toshiya , Kimura Takeshi ,   the CREDO‐Kyoto PCI/CABG Registry Cohort 2, RESET, and NEXT trial investigators
Published: May 2018

Background
Prediction of thrombotic and bleeding risk is important to optimize antithrombotic therapy after percutaneous coronary intervention.

Methods and Results

We developed the prediction rules for thrombotic and bleeding events separately in Japanese patients. Derivation and validation cohorts consisted of 4778 patients from
CREDO
‐Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort 2 and 4669 patients from RESET (Randomized Evaluation of Sirolimus‐Eluting Versus Everolimus‐Eluting Stent Trial) and NEXT (Nobori Biolimus‐Eluting Versus Xience/Promus Everolimus‐Eluting Stent Trial). Primary thrombotic and bleeding events were a composite of myocardial infarction, definite or probable stent thrombosis or ischemic stroke, and GUSTO (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) moderate or severe bleeding. The prediction rule for thrombosis assigned 2 points for severe chronic kidney disease, atrial fibrillation, peripheral vascular disease, and anemia and 1 point for age ≥75 years, heart failure, diabetes mellitus, and chronic total occlusion. The prediction rule for bleeding assigned 2 points for thrombocytopenia, severe chronic kidney disease, peripheral vascular disease, and heart failure and 1 point for prior myocardial infarction, malignancy, and atrial fibrillation. In derivation and validation cohorts, area under the curve was 0.68 and 0.64, respectively, for thrombosis and 0.66 and 0.66, respectively, for bleeding. In the validation cohort, a high thrombosis risk score (≥4, n=682) was associated with higher 3‐year incidence of thrombotic events than a score that was intermediate (2–3, n=1178) or low (0–1, n=2809) (7.6%, 3.7%, versus 2.4%, respectively;
P
<0.0001). A high bleeding risk score (≥3, n=666) was associated with higher incidence of bleeding than scores that were intermediate (1–2, n=1802) or low (0, n=2201) (8.8%, 4.1%, versus 2.3%, respectively;
P
<0.0001). Among 682 patients at high thrombotic risk, only 39 (5.7%) had low bleeding risk, whereas 401 (58.8%) had high bleeding risk with very high incidence of bleeding (11.6%).

Conclusions

CREDO
‐Kyoto thrombotic and bleeding risk scores demonstrated modest accuracy in stratifying thrombotic and bleeding risks; however, a large proportion of patients at high thrombotic risk also had high bleeding risk.
Illness Identity: A Novel Predictor for Healthcare Use in Adults With Congenital Heart Disease
Authors: Van Bulck Liesbet , Goossens Eva , Luyckx Koen , Oris Leen , Apers Silke , Moons Philip 
Published: May 2018

Background
To optimize healthcare use of adults with congenital heart disease, all important predictors of healthcare utilization should be identified. Clinical and psychological characteristics (eg, age and depression) have been found to be associated with healthcare use. However, the concept of illness identity, which assesses the degree to which congenital heart disease is integrated into one's identity, has not yet been investigated in association with healthcare use. Hence, the purpose of the study is to examine the predictive value of illness identity for healthcare use.

Methods and Results
In this ambispective analytical observational cohort study, 216 adults with congenital heart disease were included. The self‐reported Illness Identity Questionnaire was used to assess illness identity states: engulfment, rejection, acceptance, and enrichment. After 1 year, self‐reported healthcare use for congenital heart disease or other reasons over the past 6 months was assessed including hospitalizations; visits to general practitioner; visits to medical specialists; and emergency room visits. Binary logistic and negative binomial regression analyses were conducted, adjusting for age, sex, disease complexity, and depressive and anxious symptoms. The more profoundly the heart defect dominated one's identity (ie, engulfment), the more likely this person was to be hospitalized (odds ratio=3.76; 95% confidence interval=1.43–9.86), to visit a medical specialist (odds ratio=2.32; 95% confidence interval=1.35–4.00) or a general practitioner (odds ratio=1.78; 95% confidence interval=1.01–3.17), because of their heart defect.

Conclusions
Illness identity, more specifically engulfment, has a unique predictive value for the occurrence of healthcare encounters. This association deserves further investigation, in which the directionality of effects and the contribution of illness identity in terms of preventing inappropriate healthcare use should be determined.
Blood Pressure-Attained Analysis of ATACH 2 Trial
Authors: Qureshi Adnan I. , Palesch Yuko Y. , Foster Lydia D. , Barsan William G. , Goldstein Joshua N. , Hanley Daniel F. , Hsu Chung Y. , Moy Claudia S. , Qureshi Mushtaq H. , Silbergleit Robert , Suarez Jose I. , Toyoda Kazunori , Yamamoto Haruko ,   on behalf of ATACH 2 Trial Investigators*
Published: May 2018

Background and Purpose—
We compared the rates of death or disability, defined by modified Rankin Scale score of 4 to 6, at 3 months in patients with intracerebral hemorrhage according to post-treatment systolic blood pressure (SBP)–attained status.

Methods—
We divided 1000 subjects with SBP ≥180 mm Hg who were randomized within 4.5 hours of symptom onset as follows: SBP <140 mm Hg achieved or not achieved within 2 hours; subjects in whom SBP <140 mm Hg was achieved within 2 hours were further divided: SBP <140 mm Hg for 21 to 22 hours (reduced and maintained) or SBP was ≥140 mm Hg for at least 2 hours during the period between 2 and 24 hours (reduced but not maintained).

Results—
Compared with subjects without reduction of SBP <140 mm Hg within 2 hours, subjects with reduction and maintenance of SBP <140 mm Hg within 2 hours had a similar rate of death or disability (relative risk of 0.98; 95% confidence interval, 0.74–1.29). The rates of neurological deterioration within 24 hours were significantly higher in reduced and maintained group (10.4%; relative risk, 1.98; 95% confidence interval, 1.08–3.62) and in reduced but not maintained group (11.5%; relative risk, 2.08; 95% confidence interval, 1.15–3.75) compared with reference group. The rates of cardiac-related adverse events within 7 days were higher among subjects with reduction and maintenance of SBP <140 mmHg compared to subjects without reduction (11.2% versus 6.4%).

Conclusions—
No decline in death or disability but higher rates of neurological deterioration and cardiac-related adverse events were observed among intracerebral hemorrhage subjects with reduction with and without maintenance of intensive SBP goals.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01176565.