bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between self-efficacy, career interest and rural career intent in Australian medical students with rural clinical school experience
Authors: Isaac Vivian , Walters Lucie , McLachlan Craig S 
Published: December 2015

ObjectivesTo investigate medical student's self-efficacy at the time of finishing their rural clinical school (RCS) placement and factors associated with self-efficacy. Secondary aims are to explore whether interest levels or self-efficacy are associated with rural or remote career intentions.Design, setting and participantsA cross-sectional study of medical students who had completed their RCS term in 17 Australian universities. Data were derived from the 2013 Federation of Rural Australian Medical Educators (FRAME) evaluation survey. Questionnaire responses were analysed from 653 medical students from regional Australia. All 732 students who completed their RCS term in 2013 were invited to participate.Primary and secondary outcome measuresRural self-efficacy: Six questions to measure self-efficacy beliefs in rural medical practice, based on the sources of self-efficacy described by Bandura. Rural career intention: Students were asked to identify their preferred location for future practice. The options were, Capital or Major City; Inner regional city or large town; Smaller town and very remote area.ResultsQuestionnaire responses were analysed from 653 medical students from regional Australia (response rate 89.2%). 83.8% of all students recalled an increase in their interest levels for rural medicine as a result of their RCS experience. Actual career intention to work in a regional area or rural area was 60.2%. Bivariate analyses showed female gender (p=0.003), rural background (p<0.001), an RCS preference for clinical training (p<0.001) and general practice intentions (p=0.004) were factors associated with higher levels of self-efficacy. Logistic regression analyses showed that self-efficacy was independently associated with increased interest in rural medicine (OR 1.4 (95% CI 1.3 to 1.5)) and rural career intent (OR 1.2 (95% CI 1.1 to 1.3)). (Model included gender, rural background, preference for RCS, generalist intent, rural practice interest and self-efficacy).ConclusionsSelf-efficacy is associated with increased interest levels for rural medicine and rural medical career intent.
The effectiveness of buprenorphine for treating cancer pain: an abridged Cochrane review
Authors: Schmidt-Hansen Mia , Taubert Mark , Bromham Nathan , Hilgart Jennifer S , Arnold Stephanie 
Published: December 2015

ObjectivesTo assess the effectiveness and tolerability of buprenorphine for cancer pain in adults and children.MethodsWe searched CENTRAL, MEDLINE, EMBASE, ISI Web of Science, ISI BIOSIS, ClinicalTrials.gov,metaRegister of Controlled Trials, WHO International Clinical Trials Registry Platform and the Proceedings of the Congress of the European Federation of International Association for the Study of Pain to early 2015.ResultsWe included 19 randomised controlled trials comparing buprenorphine with placebo, buprenorphine or another active drug for cancer pain. The trials included 1421 patients and examined 16 different intervention comparisons. Of the 11 studies that compared buprenorphine to another drug, 5, 3 and 3 studies, respectively, found that buprenorphine was superior, no different or inferior to the alternative treatment in side effects profile or patient preference/acceptability. Pain intensity ratings did not differ significantly between intramuscular buprenorphine and buprenorphine suppository, although intramuscular treatment was associated with more adverse events (1 study). One study found faster onset of pain relief after sublingual than subdermal buprenorphine, with similar analgesia duration and adverse event rates. 2 studies found transdermal buprenorphine superior to placebo, whereas a third study found no difference between placebo and different doses of transdermal buprenorphine. No clear dose–response relationship was found for transdermal buprenorphine. The quality of this evidence base was limited by under-reporting, small sample sizes and attrition.ConclusionsBuprenorphine might be considered as a fourth-line option compared with the more standard therapies of morphine, oxycodone and fentanyl, and even then it would only be suitable for some patients.
ZEB1 expression is associated with prognosis of intrahepatic cholangiocarcinoma
Authors: Terashita Katsumi , Chuma Makoto , Hatanaka Yutaka , Hatanaka Kanako , Mitsuhashi Tomoko , Yokoo Hideki , Ohmura Takumi , Ishizu Hiroyuki , Muraoka Shunji , Nagasaka Atsushi , Tsuji Takahiro , Yamamoto Yoshiya , Kurauchi Nobuaki , Shimoyama Norihiko , Toyoda Hidenori , Kumada Takashi , Kaneoka Yuji , Maeda Atsuyuki , Ogawa Koji , Natsuizaka Mitsuteru , Kamachi Hirofumi , Kakisaka Tatsuhiko , Kamiyama Toshiya , Taketomi Akinobu , Matsuno Yoshihiro , Sakamoto Naoya 
Published: December 2015

Background/AimIntrahepatic cholangiocarcinoma (ICC) is one of the most aggressive malignant tumours, so the identification of molecular targets for ICC is an important issue. Zinc finger E-box binding homeobox 1 (ZEB1) is a key inducer of epithelial–mesenchymal transition (EMT). The aim of the present study was to clarify the clinical significance of ZEB1 in ICC and the associations between ZEB1 expression and EMT-related proteins.MethodsWe immunohistochemically examined the expression of EMT-related proteins, namely ZEB1, vimentin and E-cadherin, in ICC specimens from 102 patients. The clinicopathological and prognostic values of these markers were evaluated.ResultsZEB1 and vimentin were expressed in 46.1% and 43.1% of tumours, respectively, and E-cadherin expression was lost in 44.1% of tumours. ZEB1 expression showed a significant inverse correlation with E-cadherin expression (p=0.004) and a positive correlation with vimentin expression (p=0.022). Altered expression of ZEB1 was associated with aggressive tumour characteristics, including advanced tumour stage (p=0.037), undifferentiated-type histology (p=0.017), lymph node metastasis (p=0.024) and portal vein invasion (p=0.037). Moreover, overall survival rates were significantly lower for patients with high ZEB1 expression than for patients with low ZEB1 expression (p=0.027). Kaplan–Meier analysis also identified E-cadherin expression (p=0.041) and vimentin expression (p=0.049) as prognostic indicators for overall survival.ConclusionsZEB1 expression is associated with tumour progression and poor prognosis in patients with ICC through positive correlations with vimentin and negative correlations with E-cadherin. ZEB1 expression is associated with a poor prognosis and might be an attractive target for the treatment of ICC.
Clinician-educators in emerging graduate medical education systems: description, roles and perceptions
Authors: Ibrahim Halah , Stadler Dora J , Archuleta Sophia , Shah Nina G , Bertram Amanda , Chandrasekhar Nair Satish , Alkhal Abdullatif , Ali Al-Mohammed Ahmed , Cofrancesco Joseph 
Published: December 2015

AbstractObjectivesTo describe clinician-educators (CEs) in new graduate medical education (GME) systems and characterize perception of preparedness, roles and rewards, and factors affecting job satisfaction and retention.MethodsA cross-sectional survey of all CEs of institutions using competency-based GME and accredited by the Accreditation Council for Graduate Medical Education-International (ACGME-I).Results274 of 359 eligible participants (76.3%) responded, representing 47 residency programs across 17 specialties. CEs were predominantly married men aged in their 40s, employed at their current institution 9.3 years (±6.4 years). CEs judged themselves competent or expert in teaching skills (91.5%), trainee assessment (82%) and mentoring (75%); less so in curriculum development (44%) and educational research skills (32%). Clinical productivity was perceived by the majority (62%) as the item most valued by their institutions, with little or no perceived value for teaching or educational efforts. Overall, 58.3% were satisfied or very satisfied with their roles, and 77% expected to remain in academic medicine for 5 years. A strong negative correlation was found between being a program or associate program director and likelihood of staying in academic medicine (aOR 0.42; 0.22 to 0.80).ConclusionsIn the GME systems studied, CEs, regardless of country or programme, report working in environments that value clinical productivity over educational efforts. CEs feel competent and prepared for many aspects of their roles, have positive attitudes towards teaching, and report overall job satisfaction, with most likely to remain in academic medicine. As medical training advances internationally, the impact on and by CEs requires ongoing attention.
Noninvasive Quantification of 2-Hydroxyglutarate in Human Gliomas with IDH1 and IDH2 Mutations
Authors: Emir Uzay E. , Larkin Sarah J. , de Pennington Nick , Voets Natalie , Plaha Puneet , Stacey Richard , Al-Qahtani Khalid , Mccullagh James , Schofield Christopher J. , Clare Stuart , Jezzard Peter , Cadoux-Hudson Tom , Ansorge Olaf 
Published: December 2015

Abstract
Mutations in the isocitrate dehydrogenase genes (IDH1/2) occur often in diffuse gliomas, where they are associated with abnormal accumulation of the oncometabolite 2-hydroxyglutarate (2-HG). Monitoring 2-HG levels could provide prognostic information in this disease, but detection strategies that are noninvasive and sufficiently quantitative have yet to be developed. In this study, we address this need by presenting a proton magnetic resonance spectroscopy (1H-MRS) acquisition scheme that uses an ultrahigh magnetic field (≥7T) capable of noninvasively detecting 2-HG with quantitative measurements sufficient to differentiate mutant cytosolic IDH1 and mitochondrial IDH2 in human brain tumors. Untargeted metabolomics analysis of in vivo 1H-MRS spectra discriminated between IDH-mutant tumors and healthy tissue, and separated IDH1 from IDH2 mutations. High-quality spectra enabled the quantification of neurochemical profiles consisting of at least eight metabolites, including 2-HG, glutamate, lactate, and glutathione in both tumor and healthy tissue voxels. Notably, IDH2 mutation produced more 2-HG than IDH1 mutation, consistent with previous findings in cell culture. By offering enhanced sensitivity and specificity, this scheme can quantitatively detect 2-HG and associated metabolites that may accumulate during tumor progression, with implications to better monitor patient responses to therapy. Cancer Res; 76(1); 43–49. ©2015 AACR.
The Initial Detection and Partial Characterization of Circulating Tumor Cells in Neuroendocrine Prostate Cancer
Authors: Beltran Himisha , Jendrisak Adam , Landers Mark , Mosquera Juan Miguel , Kossai Myriam , Louw Jessica , Krupa Rachel , Graf Ryon P. , Schreiber Nicole A. , Nanus David M. , Tagawa Scott T. , Marrinucci Dena , Dittamore Ryan , Scher Howard I. 
Published: December 2015

Abstract
Purpose: The transition of prostate adenocarcinoma to a predominantly androgen receptor (AR) signaling independent phenotype can occur in the later stages of the disease and is associated with low AR expression +/− the development of small-cell or neuroendocrine tumor characteristics. As metastatic tumor biopsies are not always feasible and are difficult to repeat, we sought to evaluate noninvasive methods to identify patients transitioning toward a neuroendocrine phenotype (NEPC).
Experimental Design: We prospectively studied a metastatic tumor biopsy, serum biomarkers, and circulating tumor cells (CTC, Epic Sciences) from patients with castration-resistant prostate cancer (CRPC) including those with pure or mixed NEPC histology present on biopsy. CTCs labeled with the patient's clinical status were used to learn features that discriminate NEPC patients, which was then applied to an independent cohort.
Results: Twenty-seven patients with CRPC including 12 NEPC and 5 with atypical clinical features suggestive of NEPC transition were studied. CTCs from NEPC patients demonstrated frequent clusters, low or absent AR expression, lower cytokeratin expression, and smaller morphology relative to typical CRPC. A multivariate analysis of protein and morphologic variables enabled distinguishing CTCs of NEPC from CRPC. This CTC classifier was applied to an independent prospective cohort of 159 metastatic CRPC patients and identified in 17/159 (10.7%) of cases, enriched in patients with high CTC burden (P &lt; 0.01) and visceral metastases (P = 0.04).
Conclusions: CTCs from patients with NEPC have unique morphologic characteristics, which were also identified in a subset of CRPC patients with aggressive clinical features potentially undergoing NEPC transition. Clin Cancer Res; 22(6); 1510–9. ©2015 AACR.
Outcomes of Argatroban Treatment in Patients With Atherothrombotic Stroke
Authors: Wada Tomoki , Yasunaga Hideo , Horiguchi Hiromasa , Matsubara Takehiro , Fushimi Kiyohide , Nakajima Susumu , Yahagi Naoki 
Published: December 2015

Background and Purpose—
Argatroban, a selective thrombin inhibitor, is recommended for the use in patients with atherothrombotic stroke by the Japanese Guidelines for the Management of Patients with Acute Ischemic Stroke. We performed a nationwide Japanese study to investigate whether argatroban improved early stroke outcomes in patients with acute atherothrombotic stroke.

Methods—
This retrospective observational study, using the Diagnosis Procedure Combination database in Japan, included patients who were hospitalized from July 1, 2010, to March 31, 2012, with a diagnosis of atherothrombotic stroke within 1 day of stroke onset. Patients were divided into 2 groups: those receiving argatroban on admission (argatroban group), and those who did not receive argatroban during hospitalization (control group). To balance the baseline characteristics and concomitant treatments during hospitalization between the 2 groups, one-to-one propensity-score matching analyses were performed. The main outcomes were the modified Rankin Scale score at discharge and the occurrence of hemorrhagic complications during hospitalization. An ordinal logistic regression analysis evaluated the association between argatroban use and modified Rankin Scale at discharge.

Results—

After propensity-score matching, 2289 pairs of patients were analyzed. There were no significant differences in modified Rankin Scale at discharge between the argatroban and the control groups (adjusted odds ratio, 1.01; 95% confidence interval, 0.88–1.16). The occurrence of hemorrhagic complications did not differ significantly between the argatroban and the control groups (3.5% versus 3.8%;
P
=0.58).

Conclusions—
The present study suggested that argatroban was safe, but had no added benefit in early outcomes after acute atherothrombotic stroke.
Nonaspirin Nonsteroidal Anti-Inflammatory Drugs and Risk of Hemorrhagic Stroke
Authors: Ungprasert Patompong , Matteson Eric L. , Thongprayoon Charat 
Published: December 2015

Background and Purpose—
The association between hemorrhagic stroke and use of nonsteroidal anti-inflammatory drugs (NSAIDs) is not well established. We conducted a systematic review and meta-analysis of observation studies to further characterize this possible association.

Methods—
Case–control and cohort studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing risk of hemorrhagic stroke among NSAIDs users versus nonusers were systematically searched. Point estimates from each study were extracted. Pooled risk ratios (RR) and 95% confidence intervals (CI) for all NSAIDs and individual NSAIDs were calculated using random-effect, generic inverse variance method.

Results—
Ten studies were identified and included in our data analysis. As a single group, NSAIDs use was associated with a small but insignificant risk of hemorrhagic stroke with the pooled RR of 1.09 (95% CI, 0.98–1.22). Individual NSAIDs analysis revealed a significantly increased risk among diclofenac and meloxicam users (RR 1.27; 95% CI, 1.02–1.59 and RR 1.27; 95% CI, 1.08–1.50, respectively). The risk estimate for rofecoxib users was higher, but statistically nonsignificant (RR 1.35; 95% CI, 0.88–2.06).

Conclusions—
Overall, the use of NSAIDs is not associated with an increased risk of hemorrhagic stroke, although this risk was modestly significantly elevated in diclofenac and meloxicam users.
Latin America in the Beginning of the 20th Century: A Turn to Adjudication?
Authors: Packeiser Matthias 
Published: December 2015

The present study deals with the question of whether Latin American states turned towards adjudication and away from arbitration at the beginning of the 20th century. Little has been researched concerning the reasons why Latin American states had a friendly attitude towards this instrument to settle international disputes. This article shall endeavour to find out more about why this was the case.
The research focuses on an analysis of the conduct of Latin American countries at the Second Hague Peace Conference and at the Washington Conference (both in 1907). Ensuing developments are taken into consideration as well in order to arrive at the following conclusion: Although the idea of international adjudication was very well received by the Latin American states, and although they were the first to introduce a regional international court of law, they did not turn away from arbitration but continued to use it – in particular in inter-American relations.
Insights into Atmospheric Contributors to Urban Flash Flooding across the United States Using an Analysis of Rawinsonde Data and Associated Calculated Parameters
Authors: Schroeder Amanda , Basara Jeffrey , Shepherd J. Marshall , Nelson Steven 
Published: December 2015

AbstractFlooding is routinely one of the most deadly weather-related hazards in the United States, which highlights the need for more hydrometeorological research related to forecasting these hazardous events. Building upon previous literature, a synergistic study analyzes hydrometeorological aspects of major urban flood events in the United States from 1977 through 2014 caused by locally heavy precipitation. Primary datasets include upper-air soundings and climatological precipitable water (PW) distributions. A major finding of this work is that major urban flood events are associated with extremely anomalous PW values, many of which exceeded the 99th percentile of the associated climatological dataset and all of which were greater than 150% of the climatological mean values. However, of the 40 cases examined in this study, only 15 had PW values that exceeded 50.4 mm (2 in.), illustrating the importance of including the location-specific PW climatology in a PW analysis relevant to the potential for flash floods. Additionally, these events revealed that, despite geographic location and time of year, most had a warm cloud depth of at least 6 km, which is defined here as the layer between the lifting condensation level and the height of the −10°C level. A “composite” flood sounding was also calculated and revealed a characteristically tropical structure, despite cases related to tropical cyclones being excluded from the study.
ENSO Modulation of Interannual Variability of Dust Aerosols over the Northwest Indian Ocean*
Authors: Banerjee Priyanka , Kumar S. Prasanna 
Published: December 2015

Abstract
Mineral dust is known to affect many aspects of the climate of the north Indian Ocean (IO). However, what controls its interannual variability over this region is largely unknown. The authors study the mechanism controlling the interannual variability of dust aerosols in the principal dust belts bordering the northwest IO. It is shown that annual dust activity to the north of the Persian Gulf has an inverse relation with preceding precipitation during October–December and soil moisture during current dust season (April–August). These are in turn remotely controlled by El Niño–Southern Oscillation (ENSO) through the modification of the intensity of convection over the Indo-Pacific warm pool region, which affects moisture flux to the dust sources. While La Niña leads to a negative precipitation anomaly and more dust generation during the following summer, El Niño is responsible for the opposite. During the summer following La Niña, the air–sea interaction leads to a lowering of geopotential height over the Indo-Iranian region, resulting in an increased gradient between the Indo-Iranian region and the surrounding regions. This intensifies the dust-transporting northwesterly and northeasterly winds over the Arabian Peninsula. The dust transport by the intensified low-level southwesterlies and upper-level westerlies is the main factor responsible for enhanced dust over the open northwest IO during the years following La Niña. The Indian Ocean dipole potentially impacts the variability of dust over the northwest IO by modifying the moisture associated with El Niño.
Calibration, Validation, and Analysis of an Empirical Algorithm for the Retrieval of Wave Spectra from HF Radar Sea Echo
Authors: Lopez Guiomar , Conley Daniel C , Greaves Deborah 
Published: December 2015

AbstractThe accuracy of the wave products retrieved by a 12-MHz high-frequency (HF) phased-array radar is evaluated for a 5-month period. The two stations composing the system were deployed in 2011 to overlook the Wave Hub, a test site for marine renewable energy devices located on the southwestern coast of the United Kingdom. The system was conceived and configured to reduce the inaccuracies introduced by short time averaging and minimal overlap between stations, both associated with the most traditional HF radar deployments, whose primary activity is current measurement. Wave spectra were retrieved by an empirical algorithm distributed with Wellen Radars (WERA), which were calibrated using in situ measurements collected within the radar footprint. Evaluated through comparison against measurements acquired by three in situ devices, the results revealed estimates of significant wave height with nearly zero bias, linear correlations higher than 90%, and RMS errors that range from 29 to 44 cm. The relative error of wave energy period comparisons was within 10% for periods between 8 and 13 s, while both under- and overestimations were observed above and below that range, respectively. The validation demonstrated that when locally calibrated, the algorithm performs better than in its original form in all metrics considered. Observed discrepancies are mainly attributable to single-site estimations, antenna sidelobes, and the effect of the second-harmonic peaks of the Doppler spectrum.