bluuebunny/crossref_metadata_2025_split huggingface dataset:
The evaluation of bcl-2 expression as a prognostic marker in early stage laryngeal cancer
Authors: Gurlek Umit , Abakay Candan Demiroz , Ozkan Lutfi , Saraydaroglu Ozlem , Kurt Meral , Cetintas Sibel Kahraman 
Published: February 2018

Aims and background To evaluate the effect of bcl-2 expression on the local control and overall survival of patients with early stage laryngeal cancer treated with radiotherapy alone. Methods and study design We included 53 patients with stage Tis, T1, and T2 laryngeal cancer who were irradiated in our department. Paraffin blocks of all biopsy specimens were subjected to immunohistochemical analysis with a bcl-2 oncoprotein mouse clone 124 Scytek kit. Results The mean follow-up time was 61 months (range, 7–166). Local-regional recurrence was observed in 10 (19%) patients. Forty-three patients (81%) had negative bcl-2 staining, 5 patients (9%) had + staining, 3 patients (6%) ++ staining, and 2 patients (4%) +++ staining. No relationship was detected between bcl-2 expression and local control or overall survival. The emergence of a recurrence and a younger age (<50 years) were significantly related to poor overall survival (P = 0.000 and P = 0.021, respectively). Patients with hemoglobin levels in the middle of radiotherapy and at the end of radiotherapy higher than 13 g/dl had improved overall survival in multivariate analyses (P = 0.002 and P = 0.001, respectively). Regarding local control, the following were poor prognostic factors: smoking more than 20 cigarettes a day (P = 0.001) and being younger than 50 years of age (P = 0.001). Conclusions No correlation was observed between bcl-2 expression and local control or overall survival. Whereas hemoglobin level, age and existence of a recurrence had a prognostic impact on overall survival, patient age and smoking status influenced local control rates.
Increased expression of EphA2 and E-N cadherin switch in primary hepatocellular carcinoma
Authors: Fan Min , Liu Yu , Xia Fada , Wang Zhuolu , Huang Yun , Li Jingdong , Wang Zhiming , Li Xinying 
Published: February 2018

Aim To investigate the expression and clinical significance of ephrin type-A receptor 2 and epithelial-mesenchymal transition-related proteins in primary hepatocellular carcinoma. Methods Tissues from 52 primary hepatocellular carcinomas and 12 human normal liver tissues were detected for expression of ephrin type-A receptor 2, E-cadherin, and N-cadherin by immunochemistry. Cinicopathological features of hepatocellular carcinoma and tumor recurrence after operation were studied for the association with these molecular expressions and E-N cadherin switch. Results Increased expressions of ephrin type-A receptor 2 and N-cadherin and reduced expression of E-cadherin were significantly detected in hepatocellular carcinoma compared with normal liver tissues. Univariate analysis showed that there were close associations between unfavorable clinicopathological features and expressions of ephrin type-A receptor 2, E-cadherin, N-cadherin, and E-N cadherin switch. Ephrin type-A receptor 2 and E-cadherin expressions were confirmed as independent prognostic factors when corrected with age, gender, AFP, HBsAg, liver cirrhosis, tumor size, nodules, capsule, portal vein invasion, cell differentiation, and TNM stage. Conclusions The overexpression of ephrin type-A receptor 2 protein is correlated with the number of tumors, capsular integrity, portal vein cancer thrombus and clinical stages. Epithelial-mesenchymal transition regulated by ephrin type-A receptor 2 is involved in the aggressive clinicopathological features and prognosis, suggesting that the receptor may play an important role in the progression and metastasis of hepatocellular carcinoma.
Trefoil factor 1 gene alternations and expression in colorectal carcinomas
Authors: Huang You-Guang , Li Yun-Feng , Pan Bao-Long , Wang Li-Ping , Zhang Yong , Lee Wen-Hui , Zhang Yun 
Published: February 2018

Aims and background Aberrant expression of the trefoil factor family (TFF) has been recognized to be involved in the development and/or progression of various solid tumors. Increased trefoil factor 1 (TFF1) expression is found associated with tumor progression in some tumors, and TFF1 missense mutations have been detected in gastric cancer. The aim of the study was to analyze TFF1 alternations and expression in colorectal carcinoma and their correlation with cancer progression and pathological aspects. Methods TFF1 mutations were detected in colorectal carcinomas by DNA sequencing. TFF1mRNA and protein levels in subsets of the primary tumors were determined using quantitative reverse transcription polymerase chain reaction and immunohistochemistry analyses. The serum level of TFF1 was also detected by enzyme-linked immunosorbent assay for patients with colorectal carcinoma. Results Five variants were detected in the 5'-untranslation region and intron 1 of TFF1. TFF1 expression was increased in colorectal carcinoma compared to paired distal colonic mucosa. Immunohistochemistry in primary colorectal carcinoma showed no significant differences in tumor TFF1 levels with respect to clinicopathological parameters such as the patient's sex, cancer differentiation, stage and lymph node metastasis. However, serum TFF1 levels were significantly elevated in patients with colorectal carcinoma compared to healthy individuals. Conclusions The results indicate that TFF1 missense mutations seem to be a rare event in colorectal carcinogenesis. Serum TFF1 may be a potential useful marker for patients with colorectal carcinoma.
Circulating Free DNA in a Screening Program for Early Colorectal Cancer Detection
Authors: Perrone Federica , Lampis Andrea , Bertan Claudia , Verderio Paolo , Ciniselli Chiara M , Pizzamiglio Sara , Frattini Milo , Nucifora Martina , Molinari Francesca , Gallino Gianfranco , Gariboldi Manuela , Meroni Emanuele , Leo Ermanno , Pierotti Marco A , Pilotti Silvana 
Published: February 2018

Aims and Background The quantification and molecular characterization of circulating free DNA (cfDNA) have attracted much interest as new and promising, noninvasive means of detecting and monitoring the presence of surgical resectable colorectal cancer (CRC). Instead, the role of cfDNA in the early detection of malignant and premalignant colorectal lesions is still unclear. The aim of this study was to evaluate the predictive power of the quantification and KRAS status of cfDNA in detecting early colorectal lesions in plasma from healthy high-risk subjects. Methods The study population consisted of 170 consecutive healthy high-risk subjects aged >50 years who participated in the screening program promoted by the Local Health Service (ASL-Milano) for early CRC detection and who underwent endoscopic examination after being found positive at fecal occult blood test (FOBT). Thirty-four participants had malignant lesions consisting of 12 adenocarcinomas (at an early stage in half of the cases) and 22 instances of high-grade intraepithelial neoplasia (HGIN) in adenomas; 73 participants had premalignant lesions (adenomas and hyperplasia), and 63 participants had no lesions. Plasma cfDNA was quantified by quantitative real-time PCR and analyzed for KRAS mutations by a mutant-enriched PCR. KRAS status was assessed also in matched adenocarcinoma and HGIN tissues. The distribution of cfDNA concentrations among FOBT-positive subjects with diagnosed lesion (cases) was compared with that of FOBT-positive subjects without lesions (controls) and its predictive capability (AUC) was assessed. Results The predictive capability of cfDNA levels was satisfactory in predicting adenocarcinomas (AUC 0.709; 95% CI, 0.508–0.909) but not HGIN and premalignant lesions. The rate of KRAS mutations in plasma was low (5/170 = 3%) compared with the rate observed in the matched adenocarcinoma and HGIN tissues (45%). Conclusions The use of cfDNA quantification to predict adenocarcinoma at an early stage in high-risk (aged >50 years and FOBT positive) subjects seems to be promising but needs more sensitive methods to improve cfDNA detection.
Do High-risk Features Support the Use of Adjuvant Chemotherapy in Stage II Colon Cancer? A Turkish Oncology Group Study
Authors: Artac Mehmet , Turhal Nazim Serdar , Kocer Murat , Karabulut Bulent , Bozcuk Hakan , Yalcin Suayip , Karaagac Mustafa , Gündüz Seyda , Isik Nalan , Uygun Kazim 
Published: February 2018

Background A high-risk group of patients with stage II colon cancer has been identified by the results of studies in Western populations. The aim of this study was to investigate the prognostic factors of adjuvant chemotherapy in Turkish patients with stage II colon cancer. Methods A total of 554 stage II colon cancer patients were retrospectively enrolled in the study. Three hundred fifty-three patients had received adjuvant chemotherapy (5-FU-LV, FOLFOX or FLOX) and 201 had received no adjuvant chemotherapy. T4 tumor stage, lymphovascular invasion, perineural invasion, bowel obstruction and/or perforation, <12 harvested lymph nodes, and poor differentiation were defined as high-risk factors. Results The median age of the patients was 62 years (range 26–88). The median disease-free survival (DFS) was 58.1 months (95% CI, 47.6 months to 68.5 months) in the non-treatment group and has not been reached in the treatment group (P <0.01). In univariate analysis, patient age >60 years and T4 tumor stage were statistically significant factors that affected DFS as poor prognostic factors. Adjuvant chemotherapy reduced the risk of recurrence with statistical significance (P <0.01). In multivariate analysis, patient age >60 years and T4 tumor stage were independent risk factors affecting DFS. In addition, adjuvant chemotherapy was an independent favorable prognostic factor for DFS (P <0.01). Conclusions Clinical and pathological risk factors in patients with stage II colon cancer may be different in the Turkish population compared to other populations. Further prospective studies in colon cancer are needed to understand the differences in biology and risk factors between races.
Radiotherapy in Patients with Vestibular Schwannoma and Neurofibromatosis Type 2: Clinical Results and Review of the Literature
Authors: Wagner Johanna , Welzel Thomas , Habermehl Daniel , Debus Jürgen , Combs Stephanie E 
Published: February 2018

Aims and Background To evaluate the long-term outcome of patients with vestibular schwannoma (VS) and neurofibromatosis type 2 (NF2) treated with fractionated stereotactic radiotherapy (FSRT) or stereotactic radiosurgery (SRS). Patients and Methods Sixteen VS in 14 patients with NF2 were treated with FSRT (n = 14) and SRS (n = 2). Patients with tumor progression and/or progression of clinical symptoms were selected for treatment. For patients treated with FSRT a median total dose of 57.6 Gy was prescribed with a median fractionation of 5 × 1.8 Gy per week. For patients who underwent SRS a median single dose of 17 Gy was prescribed to the 80% isodose. Results FSRT and SRS were well tolerated. Local control rate was 94% for a median follow-up time of 131 months; 2- and 5-year progression-free survival were 100%. The probability of maintaining the pretreatment hearing level was 44%. Useful hearing preservation was 33%. Cranial nerve toxicity was moderate. Trigeminal nerve function worsened in 2 patients (12%) and facial nerve function in 3 patients (19%). One patient developed a new tinnitus. Conclusion FSRT and SRS are both safe and effective noninvasive and minimally invasive treatment options for patients with VS in the setting of NF2. The long-term local control rates are excellent. Functional hearing preservation is worse in patients with VS and NF2 than in patients with sporadic VS.
Usefulness of Combined PET/CT to Assess Regional Lymph Node Involvement in Gastric Cancer
Authors: Park Kwonoh , Jang Geundoo , Baek Sora , Song Hunho 
Published: February 2018

Aims and Background The aim of this study was to evaluate the value of positron emission tomography/computed tomography (PET/CT) for preoperative staging of gastric cancer and to compare the diagnostic performance of PET/CT with that of contrast-enhanced computed tomography (CECT). Methods We retrospectively reviewed 74 gastric cancer patients who underwent preoperative PET/CT and CECT, and subsequent curative surgical resection between April 2007 and July 2011. Preoperative PET/CT and CECT images for primary tumors of the stomach and lymph node metastases were reviewed retrospectively. The final diagnoses of primary tumors and LN metastases were based on histopathological specimens in all patients. Results Advanced gastric cancer was present in 65% of patients (n = 48), and the remaining patients had early gastric cancer (n = 26). Sixteen patients (22%) showed signet-ring-cell histology. For the detection of the primary tumor, the sensitivity of PET/CT was significantly higher than that of CECT (67% vs 55%, respectively; P = 0.049). For the evaluation of regional lymph node metastasis, the sensitivity, specificity, and accuracy of PET/CT and CECT were 34% and 51% (P = 0.065), 88% and 79% (P = 0.687), and 58% and 64% (P = 0.332), respectively. Neither PET/CT nor CECT detected regional lymph node metastases in early gastric cancer patients. Signet-ringcell histology showed trends of non-FDG-avid lymph node metastases (odds ratio = 0.15, 95% confidence interval 0.17–1.37, P = 0.093) Conclusions The accuracy of PET/CT is low and it is not a useful tool in the staging of gastric cancer overall in early gastric cancer and in signet-ring-cell carcinoma. Furthermore, the sensitivity of PET/CT could be inferior to that of CECT in the diagnosis of regional lymph node metastasis.
Outcome and Patterns of Care in Advanced Biliary Tract Carcinoma (ABC): Experience from Two Tertiary Institutions in the United Kingdom
Authors: Huggett Matthew T , Passant Helen , Hurt Chris , Pereira Stephen P , Bridgewater John , Mukherjee Somnath 
Published: February 2018

Aims and Background The ABC-02 trial has defined the standard therapy for patients with advanced biliary tract cancer (ABC); however, outcome in an unselected patient population in the UK has not been described. We aimed to investigate the outcome of a series of patients with ABC from two large UK cancer networks. Methods and Study Design We retrospectively reviewed all cases of ABC presenting to two UK cancer networks over a nine-year period. Overall survival (OS) and factors influencing OS were assessed. Results Four hundred and two patients were available for analysis. The median OS was 6.2 months. On univariate analysis, age ≥70 years (P = 0.047), advanced disease stage (P <0.001), gall bladder primary (P = 0.033), poor performance status (P <0.001) and lack of chemotherapy (P <0.001) were associated with worse outcome. Survival was superior in the 36.4% of patients who received palliative chemotherapy (12.5 vs 4.3 months; P <0.001). On multivariate analysis of patients who had chemotherapy, those who did not receive fluoropyrimidine-based regimens (HR = 5.12; P = 0.022) or gemcitabine-based regimens (HR = 5.01; P = 0.021) had a higher mortality, whereas the effect of platinum-containing regimens was of borderline significance (HR = 2.23; P = 0.086). Sites, age, and multi-agent regimens were not significant. Conclusions This is one of the largest retrospective studies reporting outcome of palliative chemotherapy for ABC. It confirms the benefit of palliative chemotherapy in an unselected group of patients. Fluoropyrimidine-based regimens appear to be as effective as gemcitabine-based treatments.
Workplace Mental Health Training in Health Care: Key Ingredients of Implementation
Authors: Moll Sandra E. , VandenBussche Jessica , Brooks Katelyn , Kirsh Bonnie , Stuart Heather , Patten Scott , MacDermid Joy C. 
Published: February 2018

Objectives: Despite growing awareness of the importance of workplace mental health training and an increasing number of educational resources, there is a gap in knowledge regarding what shapes training effectiveness. The purpose of this study was to compare and describe the active ingredients of 2 workplace mental health education programs for health care workers. Methods: Within the context of a randomized clinical trial, a multimethod process evaluation was conducted to explore key process elements shaping implementation outcomes: the innovation, service recipients, service providers, and the organizational context. Data collection included descriptive statistics regarding program participation, postprogram interviews with a purposive sample of 18 service recipients, 182 responses to open-ended questions on postgroup and follow-up surveys, and field journal reflections on the process of implementation. Data analysis was informed by an interpretive description approach, using a process evaluation framework to categorize responses from all data sources, followed by within and cross-case comparison of data from both programs. Results: Five key forces shaped the implementation and perceived outcomes of both programs: a contact-based education approach, information tailored to the workplace context, varied stakeholder perspectives, sufficient time to integrate and apply learning, and organizational support. The Beyond Silence program provided more opportunity for contact-based education, health care–specific content, and in-depth discussion of diverse perspectives. Conclusions: To increase mental health literacy and reduce stigma, workplace training should be based on best practice principles of contact-based education, with contextually relevant examples and support from all levels of the organization.
Metabolic Correlates of Health-Related Quality of Life in Patients With Type 2 Diabetes Mellitus
Authors: Rani Monika , Kumar Raghuvansh , Krishan Pawan 
Published: February 2018

Background: The increasing prevalence of type 2 diabetes mellitus (T2DM) and associated metabolic complications lead to the development of a syndrome known as “metabolic syndrome” (MetS), which is considered as one of the major risk factor not only for the development of cardiovascular diseases but also have a great impact on the quality of life. Research Design and Methods A descriptive, observational study involving the recruitment of patients with T2DM with and without MetS was carried out in outpatient department of endocrinology. The MetS was defined as per the National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criteria. Patients with T2DM were screened as per the American Diabetes Association (ADA; ie, fasting blood glucose [FBG] ≥ 126 mg/dL) and who were using oral antidiabetic drugs. Short Form-36 (SF-36) was used to assess the health-related quality of life (HRQoL). Results: Patients were grouped as T2DM with MetS (n = 100) and T2DM without MetS (n = 100). A greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with T2DM with MetS as compared to patients without MetS ( P ≤ .05). Multiple linear regression analysis revealed that in patients with T2DM having MetS, age and waist circumference (WC) are independent predictors for worsening of both PCS and MCS aspects of health-related quality of life (HRQOL). In addition, high triglycerides and raised FBG were found to be correlated with the decline in PCS and MCS, respectively. Conclusion: The study demonstrated that patients with T2DM with MetS have overall poor HRQOL as compared to patients with T2DM without MetS.
Mindful Self-Care and Secondary Traumatic Stress Mediate a Relationship Between Compassion Satisfaction and Burnout Risk Among Hospice Care Professionals
Authors: Hotchkiss Jason T. 
Published: February 2018

Background: Effective self-care in hospice is anecdotally proclaimed to reduce burnout risk. Yet, the topic has received little empirical attention. Purpose: This study developed a model for predicting burnout risk from compassion satisfaction (CS), secondary traumatic stress (STS), and mindful self-care. Participants: Hospice care professionals (n = 324). Design: Cross-sectional self-report survey. Results: Mindful self-care was correlated with CS ( r = 0.497, p < .01), Burnout ( r = −0.726, p < .01), and STS ( r = −0.276, p < .01). A multiple regression model indicated that the combined effect of CS, STS, and mindful self-care explained 73.7% of the variance in Burnout. Mindful self-care and STS mediated a relationship between CS and Burnout. Each self-care category was statistically significant protective factors against burnout risk ( p < .01). Associations with Burnout in order of strength were self-compassion and purpose (SC; r = −0.673), supportive structure (SS; r = −0.650), mindful self-awareness (MS; r = −0.642), mindful relaxation (MR; r = −0.531), supportive relationships (SR; r = −0.503), and physical care (PC; r = −0.435). However, for STS, only SS ( r = −0.407, p < .01) and MR ( r = −0.285, p < .05) were statistically significant protective factors. Conclusion: Hospice care professional had higher self-care, CS, lower STS, and Burnout compared to published norms. Those who engaged in multiple and frequent self-care strategies experienced higher professional quality of life. Implications for hospice providers and suggestions for future research are discussed.
Experimental study of ballistic resistance of sandwich targets with aluminum face-sheet and graded foam core
Authors: Nia A Alavi , Kazemi M 
Published: February 2018

In this research, we have investigated the ballistic resistance of sandwich structures with aluminum face-sheet and graded polyurethane foam core with different densities. The effects of graded changes of core foam density and the effect of the sequence of foam layers with different densities on energy absorption and ballistic limit of sandwich structures under the impact of hemispherical nose projectiles at high speeds (160 to 300 m/s) are studied. The results of this study showed that increasing the density and thickness of the foam core leads to increase in the ballistic limit and energy absorption; also, the ballistic limit of sandwich structures with the same mass with graded foam core for three- and five-layer panels is, respectively, 10.37 and 5.57% more than single-layer foam core with the average density in case the foam layer with less density is placed in the impact side. By using the graded foam core (laminate), the core resistance is increased and the damaged zone shape is changed, and the energy absorption of back face-sheet is increased.
Online meditation training for people with multiple sclerosis: A randomized controlled trial
Authors: Cavalera Cesare , Rovaris Marco , Mendozzi Laura , Pugnetti Luigi , Garegnani Massimo , Castelnuovo Gianluca , Molinari Enrico , Pagnini Francesco 
Published: February 2018

Background: Multiple sclerosis (MS) has a relevant impact on quality of life (QOL) and is associated with increased risks of psychological morbidity. Mindfulness-based interventions (MBIs) are among the most studied interventions, although few well-conducted studies have tested them in this field. Furthermore, the participation in typical MBIs may be impaired by time and logistics. Objective: We aimed to test the efficacy of an online MBI to improve QOL, psychological well-being, sleep, and fatigue. Methods: We conducted a randomized controlled trial, in which 139 participants were randomly assigned to an MS-specific online mindfulness meditation intervention or to a psychoeducational (active control) group. Participants were assessed for QOL, depression, anxiety, sleep problems, and fatigue, at three different times: at recruitment, after 2 months, and after 6 months. Results: In comparison to the control group, the experimental subjects reported higher QOL and lower depression, anxiety, and sleep problems at the end of intervention. However, after 6 months these group differences were no longer significant. Conclusion: An online MBI could be an effective psychological treatment for the promotion of well-being in MS in short-term. However, the lack of lasting effects requires the development of new strategies to support long-term changes.