bluuebunny/crossref_metadata_2025_split huggingface dataset:
A survey of 0 + 5 vascular surgery residency candidates: Perceptions of an applicant pool
Authors: Lajos Paul , Negrete Alejandro , Ravin Reid , Marin Michael , Faries Peter 
Published: February 2016

Background Applications to integrated (0 + 5) vascular surgery residencies have increased, while total applications have stayed relatively constant. This survey sought to document the perceptions of 0 + 5 vascular surgery applicants. Methods Academic faculty conducted interviews for 0 + 5 residency match at an academic medical center in preparation for the National Resident Matching Program (NRMP) Main Residency Match. Applicant pool (n = 20) perceptions were determined with surveys. Participation was anonymous and voluntary. Results Nineteen interviewees (26.3% female: 73.7% male), age (26.8 ± 2.6 years) responded (95% response rate). Of 19 respondents, 68% became interested in vascular surgery in their third year with 53% becoming aware of 0 + 5 programs in their third year. All respondents identified a vascular surgery attending at their institution as significant mentors. Forty-seven percent identified their mentor during their third year of medical school. All respondents felt that 0 + 5 training would prepare them adequately for the workforce and board certification exams. Almost all (89%) had plans to seek jobs immediately upon completion of residency. Conclusion Applicants remained positive about their planned training and career paths. Attending vascular surgeons were identified as the strongest mentors, yet most students decided only in their third and fourth years to pursue 0 + 5 residencies. Educational debt remains a concern, and there may be consideration for a concerted effort to recruit potential candidates sooner.
A comparison between the MoCA and the MMSE visuoexecutive sub-tests in detecting abnormalities in TIA/stroke patients
Authors: Mai Lauren M , Sposato Luciano A , Rothwell Peter M , Hachinski Vladimir , Pendlebury Sarah T 
Published: February 2016

Background Executive dysfunction predicts stroke risk, dementia, and mortality. The Montreal cognitive assessment detects more visuoexecutive dysfunction than the mini-mental state examination but it is unclear which of the individual Montreal cognitive assessment visuoexecutive items contribute to the better performance of the Montreal cognitive assessment. We therefore determined the relative performance of the Montreal cognitive assessment visuoexecutive sub-tests versus the mini-mental state examination pentagon copying in patients with stroke and transient ischemic attack. Methods Mini-mental state examination and Montreal cognitive assessment were administered to a prospective, population-based cohort of stroke, and transient ischemic attack patients from the Oxford Vascular Study at six month or five-year follow-up between November 2007 and June 2009. We compared the proportion of participants with incorrect Montreal cognitive assessment visuoexecutive tasks and sub-tasks but correct mini-mental state examination pentagon copying versus the proportion with incorrect MMSE pentagon copying but correct visuoexecutive Montreal cognitive assessment sub-test and individual sub-test items. Results Among 412 patients assessed with the mini-mental state examination and Montreal cognitive assessment, the Montreal cognitive assessment detected more visuoexecutive dysfunction than the mini-mental state examination (OR 11.4, 95% CI 8.2–15.8, p < 0.001). The likelihood of incorrect mini-mental state examination pentagon copying increased as the numbers of correct MoCA visuoexecutive responses decreased: 2/106 (1.9%) and 9/10 (90.0%) incorrect mini-mental state examination pentagon copying for 5/5 and 0/5 correct Montreal cognitive assessment visuoexecutive tasks, respectively (p for trend 0.005). Each Montreal cognitive assessment visuoexecutive sub-task, including trails (39.6%), cube copying (49.5%), and clock drawing (59.0%), detected more patients with visuoexecutive dysfunction than the mini-mental state examination pentagon copying (20.6%, p < 0.001). Conclusion All three of the Montreal cognitive assessment visuoexecutive sub-tests detected more abnormalities than the mini-mental state examination pentagon copying and thus contributed to the over 10-fold superiority of Montreal cognitive assessment over the mini-mental state examination for detection of visuoexecutive dysfunction.
The anti-inflammatory effects of baicalin through suppression of NLRP3 inflammasome pathway in LPS-challenged piglet mononuclear phagocytes
Authors: Ye Chun , Li Sali , Yao Wenxu , Xu Lei , Qiu Yinsheng , Liu Yu , Wu Zhongyuan , Hou Yongqing 
Published: February 2016

In this study, the anti-inflammatory effects and mechanisms of baicalin on LPS-induced NLRP3 inflammatory pathway were investigated in piglet mononuclear phagocytes (control, LPS stimulation, LPS stimulation + 12.5 µg/ml baicalin, LPS stimulation + 25 µg/ml baicalin, LPS stimulation + 50 µg/ml baicalin and LPS stimulation + 100 µg/ml baicalin). The levels of reactive oxygen species (ROS), the secretion levels of IL-1β, IL-18 and TNF-α, mRNA expression levels of IL-1β, IL-18, TNF-α and NLRP3, as well as the protein levels of cleaved caspase-1 p20 were significantly increased after LPS-challenge in vitro. However, LPS stimulation did not influence apoptosis-associated speck-like protein and caspase-1 mRNA levels, which are also components of the NLRP3 inflammasome. Baicalin at 50 µg/ml and 100 µg/ml could inhibit the production of ROS, TNF-α, IL-1β and IL-18, and down-regulate mRNA expression of IL-1β, IL-18, TNF-α and NLRP3, as well as expression of cleaved caspase-1 p20. These results showed that the anti-inflammatory effects of baicalin occurred via the regulation of the release of ROS and mRNA expression of NLRP3. The anti-inflammatory activity of baicalin could be related to the suppression of NLRP3 inflammasome pathway under LPS stimulation.
Efficacy and toxicity of salvage weekly paclitaxel chemotherapy in non-Asian patients with advanced oesophagogastric adenocarcinoma
Authors: Tarazona Noelia , Smyth Elizabeth C. , Peckit Clare , Chau Ian , Watkins David , Rao Sheela , Starling Naureen , Cunningham David 
Published: February 2016

Objectives: Survival for oesophagogastric adenocarcinoma (OGA) patients varies globally and clinical trial results are seldom replicated in clinical practice. We sought to examine the efficacy and toxicity of salvage paclitaxel chemotherapy for patients with advanced OGA at our institution. Methods: Advanced OGA patients treated with paclitaxel between June 2011 and February 2014 were identified from the electronic record at the Royal Marsden Hospital (RMH), London. Chart review was performed to obtain demographics, performance status (PS), laboratory parameters, radiological response and dates of progression, death and last follow up. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method. Multivariate Cox regression analysis examined the interaction between clinical and laboratory parameters and survival. Results: Fifty-seven patients were identified; OS and PFS were 5.8 and 2.6 months respectively. From first-line chemotherapy, median OS was 14.3 months. Two-year and three-year survival rates from diagnosis were 26% and 13%. More than or equivalent to Grade 3 neutropenia occurred in 13% of patients. In multivariate analysis, PS more than or equal to 2, alkaline phosphatase (ALP) more than or equal to100 U/L, and previous rechallenge with platinum were independent prognostic factors for OS. Conclusions: OGA cancer patients treated at RMH with salvage paclitaxel had an OS equivalent to patients in clinical trials with more (33%) PS = 2 patients treated and less haematological toxicity than Asian patients. Eastern Cooperative Oncology Group (ECOG) PS more than or equal to 2, ALP more than or equal to 100 U/L, and prior platinum rechallenge were associated with poor survival. However, the proportion of patients surviving more than or equal to two years from diagnosis demonstrates a clinically relevant improvement from historical controls.
Changes in Type 2 Diabetes Mellitus Patients in German Primary Care Prior to (2006) and After (2010, 2014) Launch of New Drugs
Authors: Jacob Louis , Waehlert Lilia , Kostev Karel 
Published: February 2016

Aims: The aim was to analyze the changes in a German type 2 diabetes population prior to (2006) and after (2010, 2014) launch of new drugs. Methods: Patients with T2DM in 2006, 2010, and 2014 were recruited for the study. Demographic data included age, gender, and health insurance type (private/statutory). Drug prescription, mean costs per patient, HbA1c levels, macrovascular complications, and time before first insulin prescription were analyzed. Results: In all, 64 098, 77 219, and 85 004 T2DM patients were included for 2006, 2010, and 2014, respectively. The mean age (65.9-66.9 years), proportion of men (50.8%-53.8%), and proportion of patients with private health insurance (6.6%-7.2%) differed significantly for each of the 3 years. There was a 1.25-fold increase in the total costs per patient, linked with an increase in the costs associated with the use of new drugs and a decrease in those associated with the use of old drugs, respectively. HbA1c levels were slightly better regulated in 2014 than in 2006 and 2010. The share of macrovascular complications decreased significantly over time, dropping from 27.4% in 2006 to 24.6% in 2014. The mean duration before first insulin treatment increased from 1225 days in 2006 to 1406 days in 2014. Conclusions: The new drugs analyzed in this study had positive effects on HbA1c levels, macrovascular complications, and mean time before first insulin treatment.
A High-Grade Chondrosarcoma of Calcaneum Mimicking as a Benign Pathology
Authors: Baba Muzamil Ahmad , Nazir Naila , Shabeer Maajid , Mir Bashir Ahmed , Kawoosa Altaf Ahmad 
Published: February 2016

This case is presented to highlight a rare case of chondrosarcoma of calcaneum in a young adult mimicking as a benign pathology and to highlight the diagnosis and early management of such cases to prevent complications and even death. Chondrosarcoma constitutes less than 10% of all primary malignancies of bone and occurs mostly in proximal locations such as pelvis, proximal femur, and proximal humerus. We present a case of high-grade chondrosarcoma at a very rare site, calcaneum of a 40-year-old male that was mimicking as a benign pathology. This case report highlights the importance of proper clinical examination, evaluation, and suspicion for benign occurring lesions to prevent complications related to a delay in diagnosis. Levels of Evidence: Therapeutic, Level IV: Case study
Athletes at High Altitude
Authors: Khodaee Morteza , Grothe Heather L. , Seyfert Jonathan H. , VanBaak Karin 
Published: February 2016

Context: Athletes at different skill levels perform strenuous physical activity at high altitude for a variety of reasons. Multiple team and endurance events are held at high altitude and may place athletes at increased risk for developing acute high altitude illness (AHAI). Training at high altitude has been a routine part of preparation for some of the high level athletes for a long time. There is a general belief that altitude training improves athletic performance for competitive and recreational athletes. Evidence Acquisition: A review of relevant publications between 1980 and 2015 was completed using PubMed and Google Scholar. Study Design: Clinical review. Level of Evidence: Level 3. Results: AHAI is a relatively uncommon and potentially serious condition among travelers to altitudes above 2500 m. The broad term AHAI includes several syndromes such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Athletes may be at higher risk for developing AHAI due to faster ascent and more vigorous exertion compared with nonathletes. Evidence regarding the effects of altitude training on athletic performance is weak. The natural live high, train low altitude training strategy may provide the best protocol for enhancing endurance performance in elite and subelite athletes. High altitude sports are generally safe for recreational athletes, but they should be aware of their individual risks. Conclusion: Individualized and appropriate acclimatization is an essential component of injury and illness prevention.
Oral dissolution therapy for radiolucent kidney stones. An old treatment revisited
Authors: Alsinnawi M , Maan Z , Rix GH 
Published: February 2016

Objective: We present our experience using oral bicarbonate as a dissolution therapy for radiolucent kidney stones in the pre-dual energy CT era. Methods: A retrospective analysis of dissolution therapy was undertaken over a four-year period. Stones were diagnosed as radiolucent on conventional KUB X-ray in combination with either ultrasound or CT KUB. Oral bicarbonate was given at a dose of 2 g tds orally, increased to 2 g five times daily according to urinary pH. Patients monitored their own urine dipstick daily to achieve a pH of at least seven. Results: Altogether 27 patients were identified with radiolucent stones. Stone size varied from 4–40 mm. Average length of therapy was nine weeks. Of the patients, 17 had renal U/S and six had CT KUB as end point imaging. We found that 39% had complete dissolution, 18% had a partial response and 43% showed no response. A high serum uric acid level correlated with a higher incidence of dissolution. Cost-benefit analysis shows bicarbonate therapy to be more cost-effective than lithotripsy, ureteroscopy or nephrolithotomy. Conclusions: Bicarbonate therapy remains an attractive option for the treatment of radiolucent kidney stones. The presence of hyperuricaemia or hyperuricosuria appears to influence the success rate. Further prospective randomised studies are needed to identify the most tolerable and effective treatment regime as well as the optimal duration of treatment. Dual-energy CT may hold the key to identifying patients most likely to benefit from treatment.
Correlation of Inpatient Experience Survey Items and Domains With Overall Hospital Rating
Authors: Kemp Kyle , McCormack Brandi , Chan Nancy , Santana Maria J , Quan Hude 
Published: February 2016

Objective: To determine which individual patient experience questions and domains were most correlated with overall inpatient hospital experience. Methods: Within 42 days of discharge, 27 639 patients completed a telephone survey based upon the Hospital-Consumer Assessment of Healthcare Systems and Processes instrument. Patients rated their overall experience on a scale of 0 (worst care) to 10 (best care). Correlation coefficients were calculated to assess the relationships between individual survey questions and domains with overall experience. Results: Questions on provider coordination and nursing care were most correlated with overall experience. Hospital cleanliness, quietness, and discharge information questions showed poor correlation. Correlation with overall experience was strongest for the “communication with nurses” domain. Conclusions: Our individual question results are novel, while the domain-based findings replicate those of US-based providers, results which had not yet been reported in the Canadian context—one with universal health care coverage. Our results suggest that our large health care organization may attain initial inpatient experience improvements by focusing upon personnel-based initiatives, rather than physical attributes of our hospitals.
Polygenic mutations in the cytotoxicity pathway increase susceptibility to develop HLH immunopathology in mice
Authors: Sepulveda Fernando E. , Garrigue Alexandrine , Maschalidi Sophia , Garfa-Traore Meriem , Ménasché Gaël , Fischer Alain , de Saint Basile Geneviève 
Published: February 2016

Key Points
The accumulation of monoallelic mutations in HLH-causing genes impairs lymphocyte cytotoxicity contributing to HLH immunopathology in mice. A polygenic model may account for some of the cases of secondary HLH observed in humans.
Task sharing for the care of severe mental disorders in a low-income country (TaSCS): study protocol for a randomised, controlled, non-inferiority trial
Authors: Hanlon Charlotte , Alem Atalay , Medhin Girmay , Shibre Teshome , Ejigu Dawit A. , Negussie Hanna , Dewey Michael , Wissow Lawrence , Prince Martin , Susser Ezra , Lund Crick , Fekadu Abebaw 
Published: February 2016

Abstract

Background
Task sharing mental health care through integration into primary health care (PHC) is advocated as a means of narrowing the treatment gap for mental disorders in low-income countries. However, the effectiveness, acceptability, feasibility and sustainability of this service model for people with a severe mental disorder (SMD) have not been evaluated in a low-income country.

Methods/Design
A randomised, controlled, non-inferiority trial will be carried out in a predominantly rural area of Ethiopia. A sample of 324 people with SMD (diagnoses of schizophrenia, schizoaffective disorder, bipolar disorder or major depressive disorder) with an ongoing need for mental health care will be recruited from 1) participants in a population-based cohort study and 2) people attending a psychiatric nurse-led out-patient clinic. The intervention is a task-sharing model of locally delivered mental health care for people with SMD integrated into PHC delivered over 18 months. Participants in the active control arm will receive the established and effective model of specialist mental health care delivered by psychiatric nurses at an out-patient clinic within a centrally located general hospital. The hypothesis is that people with SMD who receive mental health care integrated into PHC will have a non-inferior clinical outcome, defined as a mean symptom score on the Brief Psychiatric Rating Scale, expanded version, of no more than six points higher, compared to participants who receive the psychiatric nurse-led service, after 12 months. The primary outcome is change in symptom severity. Secondary outcomes are functional status, relapse, service use costs, service satisfaction, drop-out and medication adherence, nutritional status, physical health care, quality of care, medication side effects, stigma, adverse events and cost-effectiveness. Sustainability and cost-effectiveness will be further evaluated at 18 months. Randomisation will be stratified by health centre catchment area using random permuted blocks. The outcome assessors and investigators will be masked to allocation status.

Discussion
Evidence about the effectiveness of task sharing mental health care for people with SMD in a rural, low-income African country will inform the World Health Organisation’s mental health Gap Action Programme to scale-up mental health care globally.

Trial registration
NCT02308956 (ClinicalTrials.gov). Date of registration: 3 December 2014.
Attitude, barriers and facilitators to practice-based research: cross-sectional survey of hospital pharmacists in Saudi Arabia
Authors: Sultana Khizra , Al Jeraisy Majed , Al Ammari Maha , Patel Rahul , Zaidi Syed Tabish R. 
Published: February 2016

Abstract
Background
Little is known about the perceived attitude, barriers and facilitators of Saudi Pharmacists about practice based research. We aimed to measure the attitude, barriers, and facilitators of Saudi hospital pharmacists towards pharmacy practice research.

Method
A cross-sectional survey of hospital pharmacists (n = 216) working in King Abdulaziz Medical Cities in Central, Eastern and Western region hospitals was conducted during first week of September, 2013. The survey instrument comprised of six different sections that explored pharmacists previous participation in research, items regarding attitude, perception and willingness to participate, motivators, barriers, different areas of interest for doing research and patient demographics. Quantitative data collected was initially explored using frequency distribution, and descriptive analysis was carried out. Mann-Whitney U and independent samples t-test were used to explore the differences between the study variables.

Results
One hundred and eighty two pharmacists completed the survey yielding a response rate of 84 %. Fifty-nine percent of pharmacists have prior research experience. Pharmacists with research experience were more confident in reading and evaluating research papers (p = 0.01), and designing a research study (p = 0.001). Pharmacists with previous research experience were also more likely to participate in future research opportunities (p = 0.004) and were confident in their research skills (p = 0.003). No differences were observed about the perceived value of research, facilitators and barriers to participate in research, between pharmacists with prior research experience and pharmacists who have no prior experience to do research.

Conclusion
Pharmacists in this study were unanimous about the importance of research but showed considerable differences in their confidence to carry out research. There is a need to provide additional support to enable Saudi pharmacists in conducting practice based research.
Management of Chemoradiation-Induced Mucositis in Head and Neck Cancers With Oral Glutamine
Authors: Pattanayak Lucy , Panda Niharika , Dash Manoj Kumar , Mohanty Sumita , Samantaray Sagarika 
Published: February 2016

Purpose Head and neck cancers are the third most common cancers worldwide. Oral mucositis is the most common toxicity seen in patients who receive chemoradiation to treat head and neck cancer. The aim of this study was to evaluate the efficacy and safety of oral glutamine supplementation in these patients. Materials and Methods From December 2013 to December 2014, we randomly assigned to two arms 162 patients who had squamous cell carcinoma of the head and neck. Patients in arm A were given oral glutamine once per day, whereas those in arm B served as negative control subjects. All patients received radiotherapy given as 70 Gy in 35 fractions over 7 weeks with an injection of cisplatin once per week. Patients were assessed once per week to evaluate for the onset and severity of mucositis, pain, use of analgesics, and for Ryle tube feeding. Results We observed that 53.1% of patients developed mucositis toward the fifth week in the glutamine arm compared with 55.5% of patients in the control arm at the third week. None in the glutamine arm compared with 92.35% of patients in the control arm developed G3 mucositis. Rates of adverse events like pain, dysphagia, nausea, edema, and cough, as well as use of analgesics and Ryle tube feeding, were significantly lower in the glutamine arm than in the control arm. Conclusion This study highlights that the onset as well as the severity of mucositis in patients receiving glutamine was significantly delayed. None of the patients receiving glutamine developed G3 mucositis. Hence, the findings emphasize the use of oral glutamine supplementation as a feasible and affordable treatment option for mucositis in patients with head and neck cancers who are receiving chemoradiation.