bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing and medical contribution to Defence Healthcare Engagement: initial experiences of the UK Defence Medical Services
Authors: Bowley Douglas M , Lamb D , Rumbold P , Hunt P , Kayani J , Sukhera A M 
Published: August 2018

IntroductionThe WHO Constitution enshrines ‘…the highest attainable standard of health as a fundamental right of every human being.’ Strengthening delivery of health services confers benefits to individuals, families and communities, and can improve national and regional stability and security. In attempting to build international healthcare capability, UK Defence Medical Services (DMS) assets can contribute to the development of healthcare within overseas nations in a process that is known as Defence Healthcare Engagement (DHE).MethodsIn the first bespoke DMS DHE tasking, a team of 12 DMS nurses and doctors deployed to a 1000-bedded urban hospital in a partner nation and worked alongside indigenous healthcare workers (doctors, nurses and paramedical staff) during April and May 2016. The DMS nurses focused on nursing hygiene skills by demonstrations of best practice and DMS care standards, clinical leadership and female empowerment. A Quality Improvement Programme was initiated that centred on hand hygiene (HH) compliance before and after patient contact, and the introduction of peripheral cannula care and surveillance.ResultsAfter a brief induction on the ward, it was apparent that compliance with HH was poor. Peripheral cannulas were secured with adhesive zinc oxide tape and no active surveillance process (such as venous infusion phlebitis (VIP) scoring) was in place. After intensive education and training, initial week-long audits were undertaken and repeated after a further 2 weeks of training and coworking. In the second audit cycle, HH compliance had increased to 69% and VIP scoring compliance to 99%. In the final audit cycle, it was noted that nursing compliance with HH (75/98: 77%) was significantly higher than the doctors’ HH compliance (76/200: 38%); p<0.0001.ConclusionsDHE is a long-term collaborative process based on the establishment and development of comprehensive relationships that can help transform indigenous healthcare services towards patient-centred systems with a focus on safety and quality of care. Short deployments to allow clinical immersion of UK healthcare workers within indigenous teams can have an immediate impact. Coworking is a powerful method of demonstrating standards of care and empowering staff to institute transformative change. A multidisciplinary group of Quality Improvement Champions has been identified and a Hospital Oversight Committee established, which will offer the prospect of longer term sustainability and development.
Summer rainfall dissolved organic carbon, solute, and sediment fluxes in a small Arctic coastal catchment on Herschel Island (Yukon Territory, Canada)
Authors: Coch Caroline , Lamoureux Scott F. , Knoblauch Christian , Eischeid Isabell , Fritz Michael , Obu Jaroslav , Lantuit Hugues 
Published: August 2018

Coastal ecosystems in the Arctic are affected by climate change. As summer rainfall frequency and intensity are projected to increase in the future, more organic matter, nutrients and sediment could be mobilized and transported into the coastal nearshore zones. However, knowledge of current processes and future changes is limited. We investigated streamflow dynamics and the impacts of summer rainfall on lateral fluxes in a small coastal catchment on Herschel Island in the western Canadian Arctic. For the summer monitoring periods of 2014–2016, mean dissolved organic matter flux over 17 days amounted to 82.7 ± 30.7 kg km−2 and mean total dissolved solids flux to 5252 ± 1224 kg km−2. Flux of suspended sediment was 7245 kg km−2 in 2015, and 369 kg km−2 in 2016. We found that 2.0% of suspended sediment was composed of particulate organic carbon. Data and hysteresis analysis suggest a limited supply of sediments; their interannual variability is most likely caused by short-lived localized disturbances. In contrast, our results imply that dissolved organic carbon is widely available throughout the catchment and exhibits positive linear relationship with runoff. We hypothesize that increased projected rainfall in the future will result in a similar increase of dissolved organic carbon fluxes.
Cellular Cytotoxicity of Next-Generation CD20 Monoclonal Antibodies
Authors: VanDerMeid Karl R. , Elliott Michael R. , Baran Andrea M. , Barr Paul M. , Chu Charles C. , Zent Clive S. 
Published: August 2018

AbstractCD20 monoclonal antibodies (CD20 mAb) induce cellular cytotoxicity, which is traditionally measured by antibody-dependent cellular cytotoxicity (ADCC) assays. However, data suggest that antibody-dependent cellular phagocytosis (ADCP) is the primary cytotoxic mechanism. We directly compared in vitro ADCP versus ADCC using primary human cells. After establishing the primacy of ADCP, we examined next-generation CD20 mAbs, including clinically relevant drug combinations for their effects on ADCP. ADCP and ADCC induction by rituximab, ofatumumab, obinutuzumab, or ocaratuzumab was measured using treatment-naïve chronic lymphocytic leukemia (CLL) target cells and either human monocyte-derived macrophages (for ADCP) or natural killer (NK) cells (for ADCC). Specific effects on ADCP were evaluated for clinically relevant drug combinations using BTK inhibitors (ibrutinib and acalabrutinib), PI3Kδ inhibitors (idelalisib, ACP-319, and umbralisib), and the BCL2 inhibitor venetoclax. ADCP (∼0.5–3 targets/macrophage) was &gt;10-fold more cytotoxic than ADCC (∼0.04–0.1 targets/NK cell). ADCC did not correlate with ADCP. Next-generation mAbs ocaratuzumab and ofatumumab induced ADCP at 10-fold lower concentrations than rituximab. Ofatumumab, selected for enhanced complement activation, significantly increased ADCP in the presence of complement. CD20 mAb-induced ADCP was not inhibited by venetoclax and was less inhibited by acalabrutinib versus ibrutinib and umbralisib versus idelalisib. Overall, ADCP was a better measure of clinically relevant mAb-induced cellular cytotoxicity, and next-generation mAbs could activate ADCP at significantly lower concentrations, suggesting the need to test a wide range of dose sizes and intervals to establish optimal therapeutic regimens. Complement activation by mAbs can contribute to ADCP, and venetoclax, acalabrutinib, and umbralisib are preferred candidates for multidrug therapeutic regimens. Cancer Immunol Res; 6(10); 1150–60. ©2018 AACR.
The Primacy of the Patient’s Wishes in the Medical Decision-making Procedure Established by French Law
Authors: Bouvet Renaud 
Published: August 2018

Abstract
In its promotion of an autonomy model of decision-making in medical matters, French law, after making patients’ consent to medical procedures compulsory by case law then by legislation, established the primacy of the expression of patients’ wishes. Lawmakers followed the principle of shared medical decision-making and, for situations in which subjects are not fit to express their wishes, created mechanisms to represent their wishes as expressed previously. Examination of comparable legal provisions in other countries raises questions about the pertinence of the French model, which has not fully incorporated the concept of decision-making capacity but limited itself to a binary appreciation of fitness to express one’s wishes.
A Transformational Approach to Winter Orographic Weather Modification Research: The SNOWIE Project
Authors: Tessendorf Sarah A. , French Jeffrey R. , Friedrich Katja , Geerts Bart , Rauber Robert M. , Rasmussen Roy M. , Xue Lulin , Ikeda Kyoko , Blestrud Derek R. , Kunkel Melvin L. , Parkinson Shaun , Snider Jefferson R. , Aikins Joshua , Faber Spencer , Majewski Adam , Grasmick Coltin , Bergmaier Philip T. , Janiszeski Andrew , Springer Adam , Weeks Courtney , Serke David J. , Bruintjes Roelof 
Published: August 2018

AbstractThe Seeded and Natural Orographic Wintertime Clouds: The Idaho Experiment (SNOWIE) project aims to study the impacts of cloud seeding on winter orographic clouds. The field campaign took place in Idaho between 7 January and 17 March 2017 and employed a comprehensive suite of instrumentation, including ground-based radars and airborne sensors, to collect in situ and remotely sensed data in and around clouds containing supercooled liquid water before and after seeding with silver iodide aerosol particles. The seeding material was released primarily by an aircraft. It was hypothesized that the dispersal of the seeding material from aircraft would produce zigzag lines of silver iodide as it dispersed downwind. In several cases, unambiguous zigzag lines of reflectivity were detected by radar, and in situ measurements within these lines have been examined to determine the microphysical response of the cloud to seeding. The measurements from SNOWIE aim to address long-standing questions about the efficacy of cloud seeding, starting with documenting the physical chain of events following seeding. The data will also be used to evaluate and improve computer modeling parameterizations, including a new cloud-seeding parameterization designed to further evaluate and quantify the impacts of cloud seeding.
Differentiation of intrapancreatic accessory spleen from small hypervascular neuroendocrine tumor of the pancreas: textural analysis on contrast-enhanced computed tomography
Authors: Lin Xubo , Xu Lei , Wu Aiqin , Guo Chuangen , Chen Xiao , Wang Zhongqiu 
Published: August 2018

Background Intrapancreatic accessory spleens (IPASs) are usually misdiagnosed as pancreatic neuroendocrine tumors (PNETs). Texture analysis is valuable in tumor detection, diagnosis, and staging. Purpose To identify the potential of texture features in differentiating IPASs from small hypervascular PNETs. Material and Methods Twenty-one patients with PNETs and 13 individuals with IPASs who underwent pretreatment dynamic contrast-enhanced computed tomography (CT) were retrospectively analyzed. The routine imaging features—such as location, size, margin, cystic or solid appearance, enhancement degree and pattern, and lymph node enlargement—were recorded. Texture features, such as entropy, skewness, kurtosis, and uniformity, on contrast-enhanced images were analyzed. Receiver operating characteristic (ROC) analysis was performed to differentiate IPASs from PNETs. Results No significant differences were observed in margin, enhancement degree (arterial and portal phase), lymph node enlargement, or size between PNETs and IPASs (all P > 0.05). However, IPASs usually showed heterogeneous enhancement at the arterial phase and the same degree of enhancement as the spleen at the portal phase, both of which were greater than those of PNETs (69% vs. 35%, P = 0.06; 100% vs. 29%, P = 0.04). Entropy and uniformity were significantly different between IPASs and PNETs at moderate (1.5) and high sigma values (2.5) (both P < 0.01). ROC analysis showed that uniformity at moderate and high sigma had the highest area under the curve (0.82 and 0.89) with better sensitivity (85.0–95.0%) and acceptable specificity (75.0–83.3%) for differentiating IPASs from PNETs. Conclusions Texture parameters have potential in differentiating IPASs from PNETs.
Epidemiology of schizophrenia and risk factors of schizophrenia-associated aggression from 2011 to 2015
Authors: Wu Yeqing , Kang Ruiying , Yan Yuxiang , Gao Keming , Li Zhiwu , Jiang Jun , Chi Xueyang , Xia Lili 
Published: August 2018

Objective To investigate the risk factors associated with aggression in patients with schizophrenia. Methods Patient clinical, behavioural, and demographic information was collected and reported online to the Beijing Mental Health Information Management System by psychiatrists. We used chi-square tests to analyse information between 2011 and 2015 to determine the prevalence and incidence of schizophrenia and the rate of aggression. We used univariate and binary logistic regression to analyse risk factors of aggressive behaviours. Results The prevalence and incidence of schizophrenia, and the proportion of cases displaying aggressive behaviour, increased considerably from 2011 to 2015. Risk of aggression was associated with non-adherence to medication (odds ratio [OR]: 2.92; 95% confidence intervals [CI]: 2.08–4.11), being unmarried (OR: 1.62; 95% CI: 1.03–2.55), having physical disease (OR: 3.26; 95% CI: 2.28–4.66), and higher positive symptom scores (OR: 2.01; 95% CI: 1.06–3.81). Physical disease was a risk factor associated with committing more than one type of aggression. Conclusion We confirmed that demographic factors, treatment-related factors, and clinical symptoms were associated with aggression in patients with schizophrenia in Beijing. A focus on improving controllable factors, including medication adherence and physical health status, might help to prevent aggressive behaviour.
Current understanding of thalamic structure and function in migraine
Authors: Younis Samaira , Hougaard Anders , Noseda Rodrigo , Ashina Messoud 
Published: August 2018

Objective To review and discuss the literature on the role of thalamic structure and function in migraine. Discussion The thalamus holds an important position in our understanding of allodynia, central sensitization and photophobia in migraine. Structural and functional findings suggest abnormal functional connectivity between the thalamus and various cortical regions pointing towards an altered pain processing in migraine. Pharmacological nociceptive modulation suggests that the thalamus is a potential drug target. Conclusion A critical role for the thalamus in migraine-related allodynia and photophobia is well established. Additionally, the thalamus is most likely involved in the dysfunctional pain modulation and processing in migraine, but further research is needed to clarify the exact clinical implications of these findings.
Prospective associations between childhood externalising and internalising problems and adolescent alcohol and drug use
Authors: Heradstveit Ove , Skogen Jens Christoffer , Bøe Tormod , Hetland Jørn , Pedersen Mads Uffe , Hysing Mari 
Published: August 2018

Aims: The literature on associations between internalising problems and subsequent alcohol/drug use and problems shows mixed results, and it is important to consider different aspects of internalising problems along with co-occurring externalising problems. Methods: In a longitudinal study ( n = 2438) followed up when the subjects were 7–9, 11–13, and 16–19 years of age, we investigated associations between parent/teacher-reported externalising and internalising problems (Strengths and Difficulties Questionnaire, SDQ) and adolescent self-reported alcohol and illicit drug use and problems. Socioeconomic status (SES), gender, and age were included as potential confounding variables. We also adjusted for the potential confounding effects from externalising problems on the association between internalising problems and alcohol/drug use, and vice versa. Results: Externalising problems were positively associated with all measures of alcohol/drug use and problems (adjusted odds ratios [ AORs] ranging from 1.24 to 1.40, all p < .05), while internalising problems were negatively associated with all measures of alcohol/drug use ( AORs ranging 0.83 to 0.88, all p < .05). Full-scale SDQ externalising problems were somewhat stronger and more robust predictors of adolescent alcohol/drug-related problems compared with SDQ externalising subscales, while only full-scale SDQ internalising problems were negatively associated with alcohol/drug-related problems. All estimates were similar across genders. Conclusions: Childhood externalising problems are positively associated while internalising problems are negatively associated with alcohol/drug use and problems in late adolescence.
Evaluation of open reduction and internal fixation of proximal humerus fractures using a locking plate with smooth pegs – A retrospective study
Authors: Hansson Frida , Riddar Magdalena , Ekelund Anders 
Published: August 2018

Background Optimal treatment of displaced proximal humeral fractures is controversial. This retrospective study aims to identify complications and clinical outcomes using a locking plate with smooth pegs instead of screws (S3 plate). Method Eighty-two patients with displaced proximal humeral fracture classified with 2–4 fragments (Neer’s classification) treated with open reduction and internal fixation (ORIF) with S3 plate were studied retrospectively. Clinical outcome according to constant score; Single Shoulder Value; Disabilities of Arm, Shoulder and Hand; and European Quality of life-5 dimensions and complication rate defined radiologically including peg penetration, avascular necrosis, and loss of reduction was assessed minimum 2.5 years after surgery. Results A total of 11 peg penetrations were identified (13.6%). Avascular necrosis was seen in 8.5% (n = 7). Mean constant score at follow-up was 64.4 with a relative constant score of 87% (standard deviation 18%) compared to the contralateral uninjured side. The mean Disabilities of Arm, Shoulder and Hand score was 12.7 and mean European Quality of life-5 dimensions score 0.83. The mean Single Shoulder Value was 78.3. No cases of deep infection were seen. Conclusions Fixation with S3 plate shows a proper osteosynthesis and the functional outcome is good. Symptomatic peg penetrations are rare and the incidence is lower compared to what has been reported with locked screws.
Neoadjuvant Chemoradiotherapy Followed by Surgery Versus Surgery Alone for Locally Advanced Squamous Cell Carcinoma of the Esophagus (NEOCRTEC5010): A Phase III Multicenter, Randomized, Open-Label Clinical Trial
Authors: Yang Hong , Liu Hui , Chen Yuping , Zhu Chengchu , Fang Wentao , Yu Zhentao , Mao Weimin , Xiang Jiaqing , Han Yongtao , Chen Zhijian , Yang Haihua , Wang Jiaming , Pang Qingsong , Zheng Xiao , Yang Huanjun , Li Tao , Lordick Florian , D’Journo Xavier Benoit , Cerfolio Robert J. , Korst Robert J. , Novoa Nuria M. , Swanson Scott J. , Brunelli Alessandro , Ismail Mahmoud , Fernando Hiran C. , Zhang Xu , Li Qun , Wang Geng , Chen Baofu , Mao Teng , Kong Min , Guo Xufeng , Lin Ting , Liu Mengzhong , Fu Jianhua ,   on behalf of the AME Thoracic Surgery Collaborative Group
Published: August 2018

Purpose The efficacy of neoadjuvant chemoradiotherapy (NCRT) plus surgery for locally advanced esophageal squamous cell carcinoma (ESCC) remains controversial. In this trial, we compared the survival and safety of NCRT plus surgery with surgery alone in patients with locally advanced ESCC. Patients and Methods From June 2007 to December 2014, 451 patients with potentially resectable thoracic ESCC, clinically staged as T1-4N1M0/T4N0M0, were randomly allocated to NCRT plus surgery (group CRT; n = 224) and surgery alone (group S; n = 227). In group CRT, patients received vinorelbine 25 mg/m2 intravenously (IV) on days 1 and 8 and cisplatin 75 mg/m2 IV day 1, or 25 mg/m2 IV on days 1 to 4 every 3 weeks for two cycles, with a total concurrent radiation dose of 40.0 Gy administered in 20 fractions of 2.0 Gy on 5 days per week. In both groups, patients underwent McKeown or Ivor Lewis esophagectomy. The primary end point was overall survival. Results The pathologic complete response rate was 43.2% in group CRT. Compared with group S, group CRT had a higher R0 resection rate (98.4% v 91.2%; P = .002), a better median overall survival (100.1 months v 66.5 months; hazard ratio, 0.71; 95% CI, 0.53 to 0.96; P = .025), and a prolonged disease-free survival (100.1 months v 41.7 months; hazard ratio, 0.58; 95% CI, 0.43 to 0.78; P < .001). Leukopenia (48.9%) and neutropenia (45.7%) were the most common grade 3 or 4 adverse events during chemoradiotherapy. Incidences of postoperative complications were similar between groups, with the exception of arrhythmia (group CRT: 13% v group S: 4.0%; P = .001). Peritreatment mortality was 2.2% in group CRT versus 0.4% in group S ( P = .212). Conclusion This trial shows that NCRT plus surgery improves survival over surgery alone among patients with locally advanced ESCC, with acceptable and manageable adverse events.
Genomic Landscape of Appendiceal Neoplasms
Authors: Ang Celina S.-P. , Shen John Paul , Hardy-Abeloos Camille J. , Huang Justin K. , Ross Jeffrey S. , Miller Vincent A. , Jacobs Miriam T. , Chen Ingrid L. , Xu David , Ali Siraj M. , Baumgartner Joel , Lowy Andrew , Fanta Paul , Ideker Trey , Millis Sherri Z. , Harismendy Olivier 
Published: August 2018

Purpose Appendiceal neoplasms are heterogeneous and are often treated with chemotherapy similarly to colorectal cancer (CRC). Genomic profiling was performed on 703 appendiceal cancer specimens to compare the mutation profiles of appendiceal subtypes to CRC and other cancers, with the ultimate aim to identify potential biomarkers and novel therapeutic targets. Methods Tumor specimens were submitted to a Clinical Laboratory Improvement Amendments–certified laboratory (Foundation Medicine, Cambridge, MA) for hybrid-capture–based sequencing of 3,769 exons from 315 cancer-related genes and 47 introns of 28 genes commonly rearranged in cancer. Interactions between genotype, histologic subtype, treatment, and overall survival (OS) were analyzed in a clinically annotated subset of 76 cases. Results There were five major histopathologic subtypes: mucinous adenocarcinomas (46%), adenocarcinomas (30%), goblet cell carcinoids (12%), pseudomyxoma peritonei (7.7%), and signet ring cell carcinomas (5.2%). KRAS (35% to 81%) and GNAS (8% to 72%) were the most frequent alterations in epithelial cancers; APC and TP53 mutations were significantly less frequent in appendiceal cancers relative to CRC. Low-grade and high-grade tumors were enriched for GNAS and TP53 mutations, respectively (both χ2 P < .001). GNAS and TP53 were mutually exclusive (Bonferroni corrected P < .001). Tumor grade and TP53 mutation status independently predicted OS. The mutation status of GNAS and TP53 strongly predicted OS (median, 37.1 months for TP53 mutant v 75.8 GNAS- TP53 wild type v 115.5 GNAS mutant; log-rank P = .0031) and performed as well as grade in risk stratifying patients. Conclusion Epithelial appendiceal cancers and goblet cell carcinoids show differences in KRAS and GNAS mutation frequencies and have mutation profiles distinct from CRC. This study highlights the benefit of performing molecular profiling on rare tumors to identify prognostic and predictive biomarkers and new therapeutic targets.