bluuebunny/crossref_metadata_2025_split huggingface dataset:
Grassroots Partnership to See and Treat Cervical Cancer in Rural Uganda
Authors: Cherniak William , Stern Eben , Picart Carol , Sinasac Sarah , Iwasa Carolyn , Silverman Michael , Anguyo Geoffrey 
Published: April 2017

Abstract 9 Background: In Uganda, cervical cancer is the leading cause of cancer death, affecting 45 in every 100,000 women annually and killing 25 in every 100,000 annually. To effect change, two Canadian registered charities partnered with a Ugandan nongovernmental organization, a university, and the Ministry of Health to develop a novel screening, treatment, and educational training program. The two major goals of our program were to develop a training program for health care providers in southwestern Uganda for visual inspection of the cervix with acetic acid (VIA) and a cryotherapy see and treat model; and to implement the first cervical cancer screening program of its kind in the Kabale region of southwestern Uganda. Methods: Our program was developed in partnership with Mbarara University of Science and Technology, a grass-roots Ugandan community development organization (Kigezi Healthcare Foundation [KIHEFO]), a Canadian charity that is focused on providing medical and dental care and educational training and infrastructure development (Bridge to Health Medical and Dental), and a Canadian charity that is focused on treatment for advanced cervical cancer (Road to Care). Results: Requisite supplies were obtained by Bridge to Health Medical and Dental and left behind with KIHEFO. A partnership was formed between academia, government, and civil society across Canada and Uganda. Over 5 days, 15 Ugandan health care workers were trained in VIA and cryotherapy, and 96 patients were screened for cervical cancer. Six patients were successfully treated for precancerous lesions. One biopsy was sent for pathology review and analysis. Conclusion: Since the pilot program, KIHEFO has conducted two additional cervical cancer screening programs using VIA and the see and treat approach. A new cervical cancer screening and treatment campaign, along with a quality control and educational training refresher, for the original 15 health care providers is planned for February 2017. Funding: Bridge to Health Medical and Dental and Kigezi Healthcare Foundation in partnership with the Ugandan Ministry of Health. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.
Adequacy of Cancer Pain Management and Pain Interference With Daily Functioning Among Patients Visiting the Oncology Ward of an Ethiopian University
Authors: Tegegn Henok G. , Gebreyohannes Eyob A. 
Published: April 2017

Abstract 4 Background: Pain is the most common of symptoms among patients with cancer. Cancer pain has also been associated with interference in the daily activity, reported by nearly one half of patients with cancer. Despite the availability of several established guidelines for management of cancer pain, undertreatment is well documented. We aimed to assess the adequacy of cancer pain treatment, its subsequent interference on daily functioning, and associated factors in the oncology ward of Gondar University Hospital. Methods: This cross-sectional study was conducted from February 15, 2016, to May 15, 2016, in the oncology ward of Gondar University Hospital. A questionnaire-based interview using the Brief Pain Inventory-Short Form and chart review were used Results: Of 83 patients with cancer, 76 (91.6%) experienced pain with varying degrees of severity. Fifty-four patients (65%) had received inadequate cancer pain treatment, with a negative pain management index. Of 76 patients with cancer who experienced pain, 68 (89.2%) experienced pain interference with their daily activities. Educational level, metastasis status, and number and types of analgesics for adequacy of cancer pain management, whereas tumor stage, presence of metastasis, history of treatment modality, history of pain, and pain management adequacy for pain interference in patient daily functioning were identified as statistically significantly predicting factors. Conclusion: It is vital to anticipate and assess the pain of patients with cancer as a routine clinical practice to optimize analgesic therapy through identification of barriers to adequate pain management and intervening, thereby improving patient health outcome and quality of life. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from either author.
Analysis of Delays in Breast Cancer Treatment and Late-Stage Diagnosis in Kazakhstan By Using Electronic Cancer Registry Data
Authors: Chukmaitov Askar S. , Sianghpoe Umaporn , Kaidarova Dilyara R. , Talaeva Snnar T. , Sheppard Vanessa B. , Ettner Susan L. 
Published: April 2017

Abstract 27 Background: Although Kazakhstan (KZ) has made significant investments to improve population health, high cancer rates persist, with breast cancer as the most prevalent. We assessed factors that contribute to delays in treatment and late staging for patients with breast cancer. Methods: A retrospective follow-up study design was used. By using 2014 registry data, we identified 4,248 patients with breast cancer who were treated at cancer centers in the 16 KZ regions. Patients with delays in treatment as a result of medical errors and other reasons were identified. We used logistic regression to estimate associations of delays with patient demographics, occupation, and cancer center region; and associations of late-stage (III and IV) cancer diagnosis with delays in treatment while controlling for patient demographics, occupation, and cancer center region. Results: Approximately 9% (n = 378) of patients experienced delayed treatment. Older and Russian patients as well as those treated in regions further away from Almaty City had significantly higher adjusted risk of delayed treatment. However, risk of late-stage diagnosis was greater for patients who were treated in Almaty City and for those who were Russian, unemployed, or who had delayed treatment. Conclusion: The main driver of delayed treatment was cancer center region. Patients who were treated in Almaty City, where the national cancer research and treatment center is located, had fewer delays in treatment but a higher likelihood of late-stage diagnosis, likely as a result of referrals of sicker patients from neighboring regions. These findings suggest that referrals to new tertiary care centers being developed in KZ may reduce treatment delays but affect facility case mix. Future research will examine the role played by distance to cancer centers in access to specialty care and whether tertiary care is associated with improved outcomes conditional on case mix. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.
Building the Global Cancer Workforce: Assessing the Cancer Research and Control Progress of Low- and Middle-Income Country Participants in the National Cancer Institute Summer Curriculum in Cancer Prevention
Authors: Morgan Camille , Williams Makeda 
Published: April 2017

Abstract 48 Background: The National Cancer Institute (NCI) Summer Curriculum in Cancer Prevention, hosted by NCI’s Cancer Prevention Fellowship Program, has provided interdisciplinary training to physicians, scientists, nurses, and other cancer health care professionals in the principles and practice of cancer prevention, control, and molecular biology and genetics. Since 1998, the summer curriculum has enrolled an increasing number of international participants, with many nominees from All-Ireland NCI Cancer Consortium and the International Atomic Energy Agency’s Programme of Action for Cancer Therapy. NCI’s Center for Global Health selects meritorious international participants, specifically from low- and middle-income countries (LMICs), and has offered limited travel and subsistence scholarships. In spring 2016, the Center for Global Health conducted an evaluation of LMIC participants from 1999 to 2015 to assess the impact of the summer curriculum on participants’ engagement and activities in cancer research and control, including peer-reviewed publications, grants received, scientific presentations, cancer control planning, and advocacy. Methods: We surveyed participants about these topics by using an electronic survey system (Questionnaire Design Studio, v3.0) and analyzed responses in SPSS (SPSS, Chicago, IL) and Excel (Microsoft, Redmond, WA). Results: Of 427 LMIC participants from 1999 to 2015, 357 were surveyed via e-mail invitations to an online survey link, of which 156 responded (44%) during a 4-week study period with follow-up. Overall, 97% report using the knowledge and skills acquired frequently or sometimes, and 80% reported training at least one other person in course content. Nearly 50% reported publishing and 27% reported receiving research funding, of which 84% had not received a grant before participation. Conclusion: Participation of international attendees at the NCI Summer Curriculum builds a global cancer community, utilizing the expertise of Cancer Prevention Fellowship Program in training the cancer health care workforce. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from either author.
Sex-Specific Life Course Changes in the Neuro-Metabolic Phenotype of Glut3 Null Heterozygous Mice: Ketogenic Diet Ameliorates Electroencephalographic Seizures and Improves Sociability
Authors: Dai Yun , Zhao Yuanzi , Tomi Masatoshi , Shin Bo-Chul , Thamotharan Shanthie , Mazarati Andrey , Sankar Raman , Wang Elizabeth A. , Cepeda Carlos , Levine Michael S. , Zhang Jingjing , Frew Andrew , Alger Jeffry R. , Clark Peter M. , Sondhi Monica , Kositamongkol Sudatip , Leibovitch Leah , Devaskar Sherin U. 
Published: April 2017

Abstract
We tested the hypothesis that exposure of glut3+/− mice to a ketogenic diet ameliorates autism-like features, which include aberrant behavior and electrographic seizures. We first investigated the life course sex-specific changes in basal plasma–cerebrospinal fluid (CSF)–brain metabolic profile, brain glucose transport/uptake, glucose and monocarboxylate transporter proteins, and adenosine triphosphate (ATP) in the presence or absence of systemic insulin administration. Glut3+/− male but not female mice (5 months of age) displayed reduced CSF glucose/lactate concentrations with no change in brain Glut1, Mct2, glucose uptake or ATP. Exogenous insulin-induced hypoglycemia increased brain glucose uptake in glut3+/− males alone. Higher plasma-CSF ketones (β-hydroxybutyrate) and lower brain Glut3 in females vs males proved protective in the former while enhancing vulnerability in the latter. As a consequence, increased synaptic proteins (neuroligin4 and SAPAP1) with spontaneous excitatory postsynaptic activity subsequently reduced hippocampal glucose content and increased brain amyloid β1-40 deposition in an age-dependent manner in glut3+/− males but not females (4 to 24 months of age). We then explored the protective effect of a ketogenic diet on ultrasonic vocalization, sociability, spatial learning and memory, and electroencephalogram seizures in male mice (7 days to 6 to 8 months of age) alone. A ketogenic diet partially restored sociability without affecting perturbed vocalization, spatial learning and memory, and reduced seizure events. We conclude that (1) sex-specific and age-dependent perturbations underlie the phenotype of glut3+/− mice, and (2) a ketogenic diet ameliorates seizures caused by increased cortical excitation and improves sociability, but fails to rescue vocalization and cognitive deficits in glut3+/− male mice.
Emerging Roles for MicroRNAs in Diabetic Microvascular Disease: Novel Targets for Therapy
Authors: Zhang Yu , Sun Xinghui , Icli Basak , Feinberg Mark W. 
Published: April 2017

AbstractChronic, low-grade systemic inflammation and impaired microvascular function are critical hallmarks in the development of insulin resistance. Accordingly, insulin resistance is a major risk factor for type 2 diabetes and cardiovascular disease. Accumulating studies demonstrate that restoration of impaired function of the diabetic macro- and microvasculature may ameliorate a range of cardiovascular disease states and diabetes-associated complications. In this review, we focus on the emerging role of microRNAs (miRNAs), noncoding RNAs that fine-tune target gene expression and signaling pathways, in insulin-responsive tissues and cell types important for maintaining optimal vascular homeostasis and preventing the sequelae of diabetes-induced end organ injury. We highlight current pathophysiological paradigms of miRNAs and their targets involved in regulating the diabetic microvasculature in a range of diabetes-associated complications such as retinopathy, nephropathy, wound healing, and myocardial injury. We provide an update of the potential use of circulating miRNAs diagnostically in type I or type II diabetes. Finally, we discuss emerging delivery platforms for manipulating miRNA expression or function as the next frontier in therapeutic intervention to improve diabetes-associated microvascular dysfunction and its attendant clinical consequences.
Acute Hypercortisolemia Exerts Depot-Specific Effects on Abdominal and Femoral Adipose Tissue Function
Authors: Manolopoulos Konstantinos N. , O’Reilly Michael W. , Bujalska Iwona J. , Tomlinson Jeremy W. , Arlt Wiebke 
Published: April 2017

AbstractContext:Glucocorticoids have pleiotropic metabolic functions, and acute glucocorticoid excess affects fatty acid metabolism, increasing systemic lipolysis. Whether glucocorticoids exert adipose tissue depot-specific effects remains unclear.Objective:To provide an in vivo assessment of femoral and abdominal adipose tissue responses to acute glucocorticoid administration.Design and Outcome Measures:Nine healthy male volunteers were studied on two occasions, after a hydrocortisone infusion (0.2 mg/kg/min for 14 hours) and a saline infusion, respectively, given in randomized double-blind order. The subjects were studied in the fasting state and after a 75-g glucose drink with an in vivo assessment of femoral adipose tissue blood flow (ATBF) using radioactive xenon washout and of lipolysis and glucose uptake using the arteriovenous difference technique. In a separate study (same infusion design), eight additional healthy male subjects underwent assessment of fasting abdominal ATBF and lipolysis only. Lipolysis was assessed as the net release of nonesterified fatty acids (NEFAs) from femoral and abdominal subcutaneous adipose tissue.Results:Acute hypercortisolemia significantly increased basal and postprandial ATBF in femoral adipose tissue, but the femoral net NEFA release did not change. In abdominal adipose tissue, hypercortisolemia induced substantial increases in basal ATBF and NEFA release.Conclusions:Acute hypercortisolemia induces differential lipolysis and ATBF responses in abdominal and femoral adipose tissue, suggesting depot-specific glucocorticoid effects. Abdominal, but not femoral, adipose tissue contributes to the hypercortisolemia-induced systemic NEFA increase, with likely contributions from other adipose tissue sources and intravascular triglyceride hydrolysis.
How to Measure Adipose Tissue Insulin Sensitivity
Authors: Søndergaard Esben , Espinosa De Ycaza Ana Elena , Morgan-Bathke Maria , Jensen Michael D. 
Published: April 2017

Abstract

Context and Objective:
Adipose tissue insulin resistance may cause hepatic and skeletal muscle insulin resistance by releasing excess free fatty acids (FFAs). Because no consensus exists on how to quantify adipose tissue insulin sensitivity we compared three methods for measuring adipose tissue insulin sensitivity: the single step insulin clamp, the multistep pancreatic clamp, and the adipose tissue insulin resistance index (Adipo-IR).

Design and Participants:
We studied insulin sensitivity in 25 adults by measuring the insulin concentration resulting in 50% suppression of palmitate flux (IC50) using both a multistep pancreatic clamp and a one-step hyperinsulinemic-euglycemic clamp. Palmitate kinetics were measured using a continuous infusion of [U-13C]palmitate. Adipo-IR was calculated from fasting insulin and fasting FFA concentrations.

Results:
Adipo-IR was reproducible (sample coefficient of variability, 10.0%) and correlated with the IC50 measured by the multistep pancreatic clamp technique (r, 0.86; P &lt; 0.001). Age and physical fitness were significant predictors of the residual variation between Adipo-IR and IC50, with a positive relationship with age (r, 0.47; P = 0.02) and a negative association with VO2 peak (r, −0.46; P = 0.02). Likewise, IC50 measured by the multistep pancreatic clamp technique correlated with IC50 measured using the one-step hyperinsulinemic-euglycemic clamp technique (r, 0.73; P &lt; 0.001).

Conclusion:
Adipo-IR and the one-step hyperinsulinemic-euglycemic clamp technique using a palmitate tracer are good predictors of a gold standard measure of adipose tissue insulin sensitivity. However, age and physical fitness systematically affect the predictive values. Although Adipo-IR is suitable for larger population studies, the multistep pancreatic clamp technique is probably needed for mechanistic studies of adipose tissue insulin action.
Risk factors for post-operative periprosthetic fractures following primary total hip arthroplasty with a proximally coated double-tapered cementless femoral component
Authors: Gromov K. , Bersang A. , Nielsen C. S. , Kallemose T. , Husted H. , Troelsen A. 
Published: April 2017

Aims The aim of this study was to identify patient- and surgery-related risk factors for sustaining an early periprosthetic fracture following primary total hip arthroplasty (THA) performed using a double-tapered cementless femoral component (Bi-Metric femoral stem; Biomet Inc., Warsaw, Indiana). Patients and Methods A total of 1598 consecutive hips, in 1441 patients receiving primary THA between January 2010 and June 2015, were retrospectively identified. Level of pre-operative osteoarthritis, femoral Dorr type and cortical index were recorded. Varus/valgus placement of the stem and canal fill ratio were recorded post-operatively. Periprosthetic fractures were identified and classified according to the Vancouver classification. Regression analysis was performed to identify risk factors for early periprosthetic fracture. Results The mean follow-up was 713 days (1 to 2058). A total of 48 periprosthetic fractures (3.0%) were identified during the follow-up and median time until fracture was 16 days, (interquartile range 10 to 31.5). Patients with femoral Dorr type C had a 5.2 times increased risk of post-operative periprosthetic fracture compared with type B, while female patients had a near significant two times increased risk over time for post-operative fracture. Conclusion Dorr type C is an independent risk factor for early periprosthetic fracture, following THA using a double tapered cementless stem such as the Bi-Metric. Surgeons should take bone morphology into consideration when planning for primary THA and consider using cemented femoral components in female patients with poor bone quality. Cite this article: Bone Joint J 2017;99-B:451–7.
The diagnostic performance of radiographic criteria to detect aseptic acetabular component loosening after revision total hip arthroplasty
Authors: Abrahams J. M. , Kim Y. S. , Callary S. A. , De Ieso C. , Costi K. , Howie D. W. , Solomon L. B. 
Published: April 2017

AimsThis study aimed to determine the diagnostic performance of radiographic criteria to detect aseptic acetabular loosening after revision total hip arthroplasty (THA). Secondary aims were to determine the predictive values of different thresholds of migration and to determine the predictive values of radiolucency criteria.Patients and MethodsAcetabular component migration to re-revision was measured retrospectively using Ein-Bild-Rontgen-Analyse (EBRA-Cup) and manual measurements (Sutherland method) in two groups: Group A, 52 components (48 patients) found not loose at re-revision and Group B, 42 components (36 patients) found loose at re-revision between 1980 and 2015. The presence and extent of radiolucent lines was also assessed.ResultsUsing EBRA, both proximal translation and sagittal rotation were excellent diagnostic tests for detecting aseptic loosening. The area under the receiver operating characteristic (ROC) curves was 0.94 and 0.93, respectively. The thresholds of 2.5 mm proximal translation or 2° sagittal rotation (EBRA) in combination with radiolucency criteria had a sensitivity of 93% and specificity of 88% to detect aseptic loosening. The sensitivity, specificity, positive predictive value and negative predictive value (NPV) of radiolucency criteria were 41%, 100%, 100% and 68% respectively. Manual measurements of both proximal translation and sagittal rotation were very good diagnostic tests. The area under the ROC curve was 0.86 and 0.92 respectively. However, manual measurements had a decreased specificity compared with EBRA. Radiolucency criteria had a poor sensitivity and NPV of 41% and 68% respectively.ConclusionThis study shows that EBRA and manual migration measurements can be used as accurate diagnostic tools to detect aseptic loosening of cementless acetabular components used at revision THA. Radiolucency criteria should not be used in isolation to exclude loosening of cementless acetabular components used at revision THA given their poor sensitivity and NPV. Cite this article: Bone Joint J 2017;99-B:458–64.
Epidermal growth factor receptor mutations should be considered as a prognostic factor for survival of patients with pathological fractures or painful bone metastases from non-small cell lung cancer
Authors: Willeumier J. J. , van der Hoeven N. M. A. , Bollen L. , Willems L. N. A. , Fiocco M. , van der Linden Y. M. , Dijkstra P. D. S. 
Published: April 2017

Aims This study aims to assess first, whether mutations in the epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (kRAS) genes are associated with overall survival (OS) in patients who present with symptomatic bone metastases from non-small cell lung cancer (NSCLC) and secondly, whether mutation status should be incorporated into prognostic models that are used when deciding on the appropriate palliative treatment for symptomatic bone metastases. Patients and Methods We studied 139 patients with NSCLC treated between 2007 and 2014 for symptomatic bone metastases and whose mutation status was known. The association between mutation status and overall survival was analysed and the results applied to a recently published prognostic model to determine whether including the mutation status would improve its discriminatory power. Results The median OS was 3.9 months (95% confidence interval (CI) 2.1 to 5.7). Patients with EGFR (15%) or kRAS mutations (34%) had a median OS of 17.3 months (95% CI 12.7 to 22.0) and 1.8 months (95% CI 1.0 to 2.7), respectively. Compared with EGFR-positive patients, EGFR-negative patients had a 2.5 times higher risk of death (95% CI 1.5 to 4.2). Incorporating EGFR mutation status in the prognostic model improved its discriminatory power. Conclusion Survival prediction models for patients with symptomatic bone metastases are used to determine the most appropriate (surgical) treatment for painful or fractured lesions. This study shows that NSCLC should not be regarded as a single entity in such models. Cite this article: Bone Joint J 2017;99-B:516–21.