bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity among medical students in Southern Thailand: a mixed methods study
Authors: Wattanapisit Apichai , Fungthongcharoen Krittanu , Saengow Udomsak , Vijitpongjinda Surasak 
Published: September 2016

ObjectivesThe study aimed to investigate the prevalence of physical activity (PA) and factors influencing PA behaviours among medical students in Southern Thailand.DesignThe study implemented a mixed methods approach. The sequential design consisted of 2 phases: a survey followed by in-depth interviews.SettingThe study was conducted in the 3 campuses of a medical school in Southern Thailand. The preclinical students (years 1–3) studied general and basic science subjects at Nakhon Si Thammarat campus. The clinical students (years 4–6) received clinical training and hospital attachments at Trang or Phuket campuses. Total number of students was 285, with 46–48 students in each class. The study was conducted from September 2015 to February 2016.ParticipantsParticipants were medical students, 18 years old and above, from 3 campuses without disabilities or medical conditions which limited their ability to perform PA.Outcome measuresThe prevalence of the recommended levels of PA was measured using Global Physical Activity Questionnaire (GPAQ). The association between the demographic data and the recommended PA levels were analysed by univariate and multivariate analysis. In-depth interviews and thematic analysis were completed to explore PA behaviours.ResultsA total of 279 (response rate 97.9%) medical students participated in the study. Approximately half (49.5%) of the participants were physically active. The median total energy use was 540 metabolic equivalent-min/week (range 0–5640). Male and preclinical students were more likely to be physically active (p<0.05). Twenty-four in-depth interviews were conducted. Supportive factors included social support from friends and families. Study-related activities and overtime shift work were barriers.ConclusionsMore than half of the medical students have insufficient PA because of study-related activities and overtime shift work. Future studies should focus on finding ways to improve PA in clinical and female students in Thailand.
How stressful is the Newborn Life Support airway test? An observational study
Authors: Holme Nicola , Harrison Catherine , Newland Paul , Shaw Ben N J 
Published: September 2016

ObjectivesTo determine whether there is a significant stress response to the Newborn Life Support airway test (NLSAT) among healthcare professionals in the UK.DesignQuantitative study measuring both stress and anxiety of candidates on Newborn Life Support (NLS) courses measuring salivary cortisol levels along with validated anxiety questionnaires (State Trait Anxiety Inventory).SettingUK NLS course centres.Participants80 healthcare professionals (nurses, doctors and midwives) on NLS courses.InterventionsStress levels measured (cortisol swabs and State-Trait Anxiety Inventory (STAI)) at baseline, immediately before and 20 min after starting the NLSAT.ResultsCortisol measurements failed to detect any significant rise in stress levels as a result of the NLSAT. Significant anxiety was induced by the NLSAT based on STAI scores. STAI scores rose significantly in all professionals from baseline to post-NLSAT, with the greatest change detected for midwives (+11.82 (SD 7.64, p<0.001)) compared with nurses (+8.86 (SD 12.1, p<0.001)) and doctors (+7.96 (SD 2.9.69, p<0.001)). Experience had no impact on stress levels.ConclusionsAnxiety levels induced by the NLSAT are significant and should be considered when instructing and developing the NLS course.
Off-label use of the Angioseal vascular closure device for femoral arteriotomy: retrospective analysis of safety and efficacy
Authors: Shah Sumedh S , Perez Giancarlo , Snelling Brian M , Haussen Diogo C , Sur Samir , Sharma Ishna , Yavagal Dileep R , Elhammady Mohamed Samy , Peterson Eric C 
Published: September 2016

BackgroundAngioseal, an arteriotomy closure device (ACD), functions as a collagen plug that physically closes arteriotomy sites and can simultaneously induce platelet activation and aggregation. When used ‘on-label’, the safety and efficacy profile of Angioseal is superior compared with those of other ACDs. However, Angioseal is sometimes deployed in less than ideal situations. Therefore, we sought to assess the safety and efficacy of ‘off-label’ Angioseal use in patients undergoing femoral arteriotomies.MethodsWe performed a retrospective review of all femoral arterial angiograms executed at our institution between 2008 and 2014. Patients whose femoral punctures did not fit the criteria for on-label Angioseal use were included, and were dichotomized based on vascular closure (off-label Angioseal vs manual compression).ResultsOf the 521 patients (1023 angiograms) reviewed, 303 (58.2%) patients had off-label Angioseal groin punctures. Mean patient age was 46.2±14.0 years, and 113 were men. 234 patients (77%) had off-label Angioseal deployment while 69 (22%) individuals received manual pressure, serving as controls. Demographic and procedural variables were nearly identical between the two groups but the Angioseal group comprised mostly patients that underwent neurointerventional procedures and thus received intraprocedural heparinization (41%) more often than the manual compression group (19%). The overall rate of major complications associated with off-label Angioseal deployment was low (<0.85%), and clinical complications were not independently associated with Angioseal use (OR 0.76 (95% CI 0.06 to 8.86); p=0.69).ConclusionsOff-label use of Angioseal was found to be safe and was not associated with an increased complication rate in our cohort.
Mast cells and acute coronary syndromes: relationship between serum tryptase, clinical outcome and severity of coronary artery disease
Authors: Morici Nuccia , Farioli Laura , Losappio Laura Michelina , Colombo Giulia , Nichelatti Michele , Preziosi Donatella , Micarelli Gianluigi , Oliva Fabrizio , Giannattasio Cristina , Klugmann Silvio , Pastorello Elide Anna 
Published: September 2016

ObjectiveTo assess the relationship between serum tryptase and the occurrence of major cardiovascular and cerebrovascular events (MACCE) at 2-year follow-up in patients admitted with acute coronary syndrome (ACS). To compare serum tryptase to other validated prognostic markers (maximum high-sensitivity troponin (hs-Tn), C reactive protein (CRP) levels at admission, Synergy between percutaneous coronary intervention with Taxus and Cardiac Surgery (SYNTAX) score).MethodsWe measured serum tryptase at admission in 140 consecutive patients with ACS and in 50 healthy controls. The patients’ follow-up was maintained for 2 years after discharge. The predictive accuracy of serum tryptase for 2-year MACCE was assessed and compared with hs-Tn, CRP and SYNTAX score.ResultsSerum tryptase levels at admission were significantly higher in patients with ACS compared with the control group (p=0.0351). 2 years after discharge, 28/140 patients (20%) experienced MACCE. Serum tryptase levels, maximum hs-Tn measurements and SYNTAX score were higher in patients who experienced MACCE compared with those without (p<0.0001). Conversely, we found no significant association between MACCE and CRP. The predictive accuracy of serum tryptase for MACCE was set at the cut-off point of 6.7 ng/mL (sensitivity 46%, specificity 84%).ConclusionsIn patients with ACS, serum tryptase measured during index admission is significantly correlated to the development of MACCE up to 2 years, demonstrating a possible long-term prognostic role of this biomarker.
A nutritional evaluation of common barley varieties grown for silage by beef and dairy producers in western Canada
Authors: Nair Jayakrishnan , Christensen David , Yu Peiqiang , Beattie Aaron D. , McAllister Tim , Damiran Daalkhaijav , Preston Natalie , Fuhr Leland , McKinnon John J. 
Published: September 2016

This study evaluated the nutritional and neutral detergent fiber digestibility (NDFD) characteristics of seven barley varieties (‘Conlon’, ‘CDC Copeland’, ‘CDC Cowboy’, ‘Falcon’, ‘Legacy’, ‘AC Metcalfe’, and ‘Xena’) grown for silage. Commercial samples (n = 80) harvested at the mid-dough stage were collected over 2 years (2012 and 2013). Average pH and dry matter (DM) content were 4.05% ± 0.17% and 36.8% ± 4.1%, respectively. ‘Falcon’ and ‘AC Metcalfe’ had higher (P < 0.05) CP relative to ‘CDC Copeland’ and ‘Xena’, with intermediate values for the other varieties. Acid (ADF) and neutral (NDF) detergent fiber contents were higher (P < 0.05) for ‘CDC Cowboy’ relative to ‘Conlon’. Starch was higher (P < 0.05) for ‘Legacy’ and ‘Conlon’ than ‘CDC Cowboy’, with intermediate values for other varieties. Legacy had a greater (P < 0.05) 6-h NDFD while ‘CDC Cowboy’ had a greater (P < 0.05) 30-h NDFD. Indigestible NDF (INDF; % NDF) was greater (P < 0.05) for ‘AC Metcalfe’ relative to ‘CDC Cowboy’ and ‘Falcon’. These results indicate that barley varieties vary with respect to chemical composition and NDFD and INDF contents. Selection for higher 30-h NDFD could result in improvements in DM and DE intake and performance of growing beef cattle.
Telomere Length and Breast Cancer Prognosis: A Systematic Review
Authors: Ennour-Idrissi Kaoutar , Maunsell Elizabeth , Diorio Caroline 
Published: September 2016

AbstractTelomeres ensure genome integrity during replication. Loss of telomeric function leads to cell immortalization and accumulation of genetic alterations. The association of telomere length (TL) with breast cancer prognosis is examined through a systematic review. Electronic databases (MEDLINE, EMBASE, CENTRAL), from inception to December 2015, and relevant reviews were searched. Studies that evaluated TL (blood and/or tumor) in association with breast cancer survival or prognostic factor were included. Thirty-six studies met inclusion criteria. Overall risk of bias was critical. Eight studies reported survival outcomes. Overall, there was a trend toward an association of longer telomeres with better outcomes (tumor, not blood). Of the 33 studies reporting associations with prognostic factors, nine adjusted for potential confounders. Among the latter, shorter telomeres were associated with older age (blood, not tumor), higher local recurrence rates (normal tissue), higher tumor grade (tumor), and lower physical activity (blood), which were reported in one study each. TL was not associated with molecular subtype (blood, one study), family history (tumor, one study), chemotherapy (blood, three of four studies), and stress reduction interventions (blood, two of two studies). Although major methodologic differences preclude from drawing conclusive results, TL could be a valuable breast cancer prognostic marker. Cancer Epidemiol Biomarkers Prev; 26(1); 3–10. ©2016 AACR.
Pan-Cancer Analysis of the Mediator Complex Transcriptome Identifies CDK19 and CDK8 as Therapeutic Targets in Advanced Prostate Cancer
Authors: Brägelmann Johannes , Klümper Niklas , Offermann Anne , von Mässenhausen Anne , Böhm Diana , Deng Mario , Queisser Angela , Sanders Christine , Syring Isabella , Merseburger Axel S. , Vogel Wenzel , Sievers Elisabeth , Vlasic Ignacija , Carlsson Jessica , Andrén Ove , Brossart Peter , Duensing Stefan , Svensson Maria A. , Adler David , Kirfel Jutta , Perner Sven 
Published: September 2016

AbstractPurpose:The Mediator complex is a multiprotein assembly, which serves as a hub for diverse signaling pathways to regulate gene expression. Because gene expression is frequently altered in cancer, a systematic understanding of the Mediator complex in malignancies could foster the development of novel targeted therapeutic approaches.Experimental Design:We performed a systematic deconvolution of the Mediator subunit expression profiles across 23 cancer entities (n = 8,568) using data from The Cancer Genome Atlas (TCGA). Prostate cancer–specific findings were validated in two publicly available gene expression cohorts and a large cohort of primary and advanced prostate cancer (n = 622) stained by immunohistochemistry. The role of CDK19 and CDK8 was evaluated by siRNA-mediated gene knockdown and inhibitor treatment in prostate cancer cell lines with functional assays and gene expression analysis by RNAseq.Results:Cluster analysis of TCGA expression data segregated tumor entities, indicating tumor-type–specific Mediator complex compositions. Only prostate cancer was marked by high expression of CDK19. In primary prostate cancer, CDK19 was associated with increased aggressiveness and shorter disease-free survival. During cancer progression, highest levels of CDK19 and of its paralog CDK8 were present in metastases. In vitro, inhibition of CDK19 and CDK8 by knockdown or treatment with a selective CDK8/CDK19 inhibitor significantly decreased migration and invasion.Conclusions:Our analysis revealed distinct transcriptional expression profiles of the Mediator complex across cancer entities indicating differential modes of transcriptional regulation. Moreover, it identified CDK19 and CDK8 to be specifically overexpressed during prostate cancer progression, highlighting their potential as novel therapeutic targets in advanced prostate cancer. Clin Cancer Res; 23(7); 1829–40. ©2016 AACR.
Biomarkers of Response and Resistance to DNA Repair Targeted Therapies
Authors: Stover Elizabeth H. , Konstantinopoulos Panagiotis A. , Matulonis Ursula A. , Swisher Elizabeth M. 
Published: September 2016

Abstract
Drugs targeting DNA damage repair (DDR) pathways are exciting new agents in cancer therapy. Many of these drugs exhibit synthetic lethality with defects in DNA repair in cancer cells. For example, ovarian cancers with impaired homologous recombination DNA repair show increased sensitivity to poly(ADP-ribose) polymerase (PARP) inhibitors. Understanding the activity of different DNA repair pathways in individual tumors, and the correlations between DNA repair function and drug response, will be critical to patient selection for DNA repair targeted agents. Genomic and functional assays of DNA repair pathway activity are being investigated as potential biomarkers of response to targeted therapies. Furthermore, alterations in DNA repair function generate resistance to DNA repair targeted agents, and DNA repair states may predict intrinsic or acquired drug resistance. In this review, we provide an overview of DNA repair targeted agents currently in clinical trials and the emerging biomarkers of response and resistance to these agents: genetic and genomic analysis of DDR pathways, genomic signatures of mutational processes, expression of DNA repair proteins, and functional assays for DNA repair capacity. We review biomarkers that may predict response to selected DNA repair targeted agents, including PARP inhibitors, inhibitors of the DNA damage sensors ATM and ATR, and inhibitors of nonhomologous end joining. Finally, we introduce emerging categories of drugs targeting DDR and new strategies for integrating DNA repair targeted therapies into clinical practice, including combination regimens. Generating and validating robust biomarkers will optimize the efficacy of DNA repair targeted therapies and maximize their impact on cancer treatment. Clin Cancer Res; 22(23); 5651–60. ©2016 AACR.
The MAPK Pathway Regulates Intrinsic Resistance to BET Inhibitors in Colorectal Cancer
Authors: Ma Yufang , Wang Lihong , Neitzel Leif R. , Loganathan Sudan N. , Tang Nan , Qin Lili , Crispi Emily E. , Guo Yan , Knapp Stefan , Beauchamp R. Daniel , Lee Ethan , Wang Jialiang 
Published: September 2016

Abstract
Purpose: The bromodomain and extra-terminal domain (BET) family proteins are epigenetic readers for acetylated histone marks. Emerging BET bromodomain inhibitors have exhibited antineoplastic activities in a wide range of human cancers through suppression of oncogenic transcription factors, including MYC. However, the preclinical activities of BET inhibitors in advanced solid cancers are moderate at best. To improve BET-targeted therapy, we interrogated mechanisms mediating resistance to BET inhibitors in colorectal cancer.
Experimental Design: Using a panel of molecularly defined colorectal cancer cell lines, we examined the impact of BET inhibition on cellular proliferation and survival as well as MYC activity. We further tested the ability of inhibitors targeting the RAF/MEK/ERK (MAPK) pathway to enhance MYC suppression and circumvent intrinsic resistance to BET inhibitors. Key findings were validated using genetic approaches.
Results: BET inhibitors as monotherapy moderately reduced colorectal cancer cell proliferation and MYC expression. Blockade of the MAPK pathway synergistically sensitized colorectal cancer cells to BET inhibitors, leading to potent apoptosis and MYC downregulation in vitro and in vivo. A combination of JQ1 and trametinib, but neither agent alone, induced significant regression of subcutaneous colorectal cancer xenografts.
Conclusions: Our findings suggest that the MAPK pathway confers intrinsic resistance to BET inhibitors in colorectal cancer and propose an effective combination strategy for the treatment of colorectal cancer. Clin Cancer Res; 23(8); 2027–37. ©2016 AACR.
Um Experimento com Tolstoi: a “Fenomenologia do Amor” em Ana Karenina
Authors: Gallian Dante Marcello Claramonte 
Published: September 2016

Partindo das narrativas produzidas pelos participantes do laboratório de humanidades – atividade acadêmica desenvolvida na Escola Paulista de Medicina da Unifesp e que se fundamenta na leitura e discussão de obras clássicas da literatura universal – este artigo procura mostrar como, na busca por contribuir para a formação humanística e a humanização na área da saúde, um experimento com Ana Karenina de Liev Tolstói possibilitou um profunda reflexão sobre questões essenciais da existência humana, em especial a temática do amor e seus desdobramentos nas relações humanas.
O DNA da relação médico-paciente
Authors: Plapler Hélio , Carelli Fabiana Buitor 
Published: September 2016

A narrativa em medicina e nas demais áreas da saúde está se firmando como um modo de conhecimento do doente e seus males e uma forma de humanização do seu atendimento. Um ponto comum entre os diversos grupos que se dedicam ao estudo da chamada “narrativa médica” é ver a relação médico-paciente como eixo motriz da compreensão entre estes dois polos do atendimento em saúde . Hurwitz estabelece que a consulta médica é uma forma específica de encontro que produz narrativas e, portanto, pode ser analisada narrativamente. São diversas as formas possíveis de análise textual com a finalidade de compreender como essa relação acontece e evolui discursivamente. Tal relação, contudo, tem sido avaliada apenas como um fenômeno inter-subjetivo que ocorre aleatoriamente, em que o paciente (ou suas doenças) ocupam o papel de mero objeto do conhecimento. Nosso objetivo é mostrar que ela ocorre em função de um vínculo específico entre elementos (tempo, cuidado, guia e atenção) que podem ser analisados narrativamente
Time-Based Expectancy for Task Relevant Stimulus Features
Authors: Thomaschke Roland , Hoffmann Joachim , Haering Carola , Kiesel Andrea 
Published: September 2016

When a particular target stimulus appears more frequently after a certain interval than after another one, participants adapt to such regularity, as evidenced by faster responses to frequent interval-target combinations than to infrequent ones. This phenomenon is known as time-based expectancy. Previous research has suggested that time-based expectancy is primarily motor-based, in the sense that participants learn to prepare a particular response after a specific interval. Perceptual time-based expectancy — in the sense of learning to perceive a certain stimulus after specific interval — has previously not been observed. We conducted a Two-Alternative-Forced-Choice experiment with four stimuli differing in shape and orientation. A subset of the stimuli was frequently paired with a certain interval, while the other subset was uncorrelated with interval. We varied the response relevance of the interval-correlated stimuli, and investigated under which conditions time-based expectancy transfers from trials with interval-correlated stimuli to trials with interval-uncorrelated stimuli. Transfer was observed only where transfer of perceptual expectancy and transfer of response expectancy predicted the same behavioral pattern, not when they predicted opposite patterns. The results indicate that participants formed time-based expectancy for stimuli as well as for responses. However, alternative interpretations are also discussed.
Influences on Observed Near-Surface Gust Factors in Landfalling U.S. Gulf Coast Hurricanes: 2004–08
Authors: Giammanco Ian M. , Schroeder John L. , Masters Forrest J. , Vickery Peter J. , Krupar Richard J. , Balderrama Juan-Antonio 
Published: September 2016

AbstractThe deployment of ruggedized surface observing platforms by university research programs in the path of landfalling tropical cyclones has yielded a wealth of information regarding the near-surface wind flow characteristics. Data records collected by Texas Tech University’s Wind Engineering Mobile Instrument Tower Experiment and StickNet probes and by the Florida Coastal Monitoring Program along the Gulf Coast of the United States from 2004 to 2008 were compiled to examine influences on near-surface gust factors. Archived composite reflectivity data from coastal WSR-88D instruments were also merged with the tower records to investigate the influence of precipitation structure. Wind records were partitioned into 10-min segments, and the ratio of the peak moving-average 3-s-gust wind speed to the segment mean was used to define a gust factor. Observations were objectively stratified into terrain exposure categories to determine if factors beyond those associated with surface frictional effects can be extracted from the observations. Wind flow characteristics within exposure classes were weakly influenced by storm-relative position and precipitation structure. Eyewall observations showed little difference in mean gust factors when compared with other regions. In convective precipitation, only peak gust factors were slightly larger than those found in stratiform conditions, with little differences in the mean. Gust factors decreased slightly with decreasing radial distance in rougher terrain exposures and did not respond to radar-observed changes in precipitation structure. In two limited comparisons, near-surface gusts did not exceed the magnitude of the wind maximum aloft detected through wind profiles that were derived from WSR-88D velocity–azimuth displays.