bluuebunny/crossref_metadata_2025_split huggingface dataset:
Engaging migrants and other stakeholders to improve communication in cross-cultural consultation in primary care: a theoretically informed participatory study
Authors: Lionis Christos , Papadakaki Maria , Saridaki Aristoula , Dowrick Christopher , O'Donnell Catherine A , Mair Frances S , van den Muijsenbergh Maria , Burns Nicola , de Brún Tomas , O'Reilly de Brún Mary , van Weel-Baumgarten Evelyn , Spiegel Wolfgang , MacFarlane Anne 
Published: July 2016

ObjectivesGuidelines and training initiatives (G/TIs) are available to support communication in cross-cultural consultations but are rarely implemented in routine practice in primary care. As part of the European Union RESTORE project, our objective was to explore whether the available G/TIs make sense to migrants and other key stakeholders and whether they could collectively choose G/TIs and engage in their implementation in primary care settings.SettingAs part of a comparative analysis of 5 linked qualitative case studies, we used purposeful and snowball sampling to recruit migrants and other key stakeholders in primary care settings in Austria, England, Greece, Ireland and the Netherlands.ParticipantsA total of 78 stakeholders participated in the study (Austria 15, England 9, Ireland 11, Greece 16, Netherlands 27), covering a range of groups (migrants, general practitioners, nurses, administrative staff, interpreters, health service planners).Primary and secondary outcome measuresWe combined Normalisation Process Theory (NPT) and Participatory Learning and Action (PLA) research to conduct a series of PLA style focus groups. Using a standardised protocol, stakeholders' discussions about a set of G/TIs were recorded on PLA commentary charts and their selection process was recorded through a PLA direct-ranking technique. We performed inductive and deductive thematic analysis to investigate sensemaking and engagement with the G/TIs.ResultsThe need for new ways of working was strongly endorsed by most stakeholders. Stakeholders considered that they were the right people to drive the work forward and were keen to enrol others to support the implementation work. This was evidenced by the democratic selection by stakeholders in each setting of one G/TI as a local implementation project.ConclusionsThis theoretically informed participatory approach used across 5 countries with diverse healthcare systems could be used in other settings to establish positive conditions for the start of implementation journeys for G/TIs to improve healthcare for migrants.
Characteristics and outcomes of women using emergency medical services for third-trimester pregnancy-related problems in India: a prospective observational study
Authors: Strehlow Matthew C , Newberry Jennifer A , Bills Corey B , Min Hyeyoun (Elise) , Evensen Ann E , Leeman Lawrence , Pirrotta Elizabeth A , Rao G V Ramana , Mahadevan S V 
Published: July 2016

ObjectivesCharacterise the demographics, management and outcomes of obstetric patients transported by emergency medical services (EMS).DesignProspective observational study.SettingFive Indian states using a centralised EMS agency that transported 3.1 million pregnant women in 2014.ParticipantsThis study enrolled a convenience sample of 1684 women in third trimester of pregnancy calling with a ‘pregnancy-related’ problem for free-of-charge ambulance transport. Calls were deemed ‘pregnancy related’ if categorised by EMS dispatchers as ‘pregnancy’, ‘childbirth’, ‘miscarriage’ or ‘labour pains’. Interfacility transfers, patients absent on ambulance arrival and patients refusing care were excluded.Main outcome measuresEmergency medical technician (EMT) interventions, method of delivery and death.ResultsThe median age enrolled was 23 years (IQR 21–25). Women were primarily from rural or tribal areas (1550/1684 (92.0%)) and lower economic strata (1177/1684 (69.9%)). Time from initial call to hospital arrival was longer for rural/tribal compared with urban patients (66 min (IQR 51–84) vs 56 min (IQR 42–73), respectively, p<0.0001). EMTs assisted delivery in 44 women, delivering the placenta in 33/44 (75%), performing transabdominal uterine massage in 29/33 (87.9%) and administering oxytocin in none (0%). There were 1411 recorded deliveries. Most women delivered at a hospital (1212/1411 (85.9%)), however 126/1411 (8.9%) delivered at home following hospital discharge. Follow-up rates at 48 hours, 7 days and 42 days were 95.0%, 94.4% and 94.1%, respectively. Four women died, all within 48 hours. The caesarean section rate was 8.2% (116/1411). On multivariate regression analysis, women transported to private hospitals versus government primary health centres were less likely to deliver by caesarean section (OR 0.14 (0.05–0.43))ConclusionsPregnant women from vulnerable Indian populations use free-of-charge EMS for impending delivery, making it integral to the healthcare system. Future research and health system planning should focus on strengthening and expanding EMS as a component of emergency obstetric and newborn care (EmONC).
Association of obesity and overweight with the prevalence of insulin resistance, pre-diabetes and clinical–biochemical characteristics among infertile Mexican women with polycystic ovary syndrome: a cross-sectional study
Authors: Reyes-Muñoz Enrique , Ortega-González Carlos , Martínez-Cruz Nayeli , Arce-Sánchez Lidia , Estrada-Gutierrez Guadalupe , Moran Carlos , Sánchez-Serrano Ana Paola , Higareda-Sánchez Rodolfo , de la Jara-Díaz Julio Francisco 
Published: July 2016

ObjectiveTo study the association of obesity and overweight with the prevalence of insulin resistance (IR), pre-diabetes and clinical–biochemical characteristics among infertile Mexican women with polycystic ovary syndrome (PCOS).DesignRetrospective cross-sectional study.SettingLevel-three medical institution, an infertility clinic in Mexico City.ParticipantsWe included infertile Mexican women with diagnosis of PCOS according to the Rotterdam criteria: group 1 (n=83), normal weight (body mass index (BMI) 18.5–24.9 kg/m2); group 2 (n=217), overweight (BMI 25–29.9 kg/m2); and group 3 (n=238), obese (BMI≥30 kg/m2).Primary and secondary outcome measuresIR was determined by homeostatic model assessment (HOMA) >2.5 and pre-diabetes by fasting glucose between 5.6 and 6.9 mmol/L and/or glucose value between 7.8 and 11 mmol/L at 2 hours during an oral glucose tolerance test. We compared clinical–biochemical characteristics among groups.ResultsPrevalence of IR for groups 1, 2 and 3 was 19.3%, 56.2% and 78.2%; overweight and obesity increase the IR OR (CI 95%) to 5.3 (2.9 to 9.8) and 14.9 (8.0 to 28), respectively. Prevalence of pre-diabetes for groups 1, 2 and 3 was 7.2%, 17.5% and 31.5%; overweight and obesity increase the pre-diabetes OR (CI 95%) to 2.7 (1.1 to 6.7) and 5.9 (2.4 to 14), respectively. Acanthosis nigricans was more frequent in group 3 than group 1. Free Androgen Index (FAI) and thyroid-stimulating hormone (TSH) levels were lower in group 1 than in groups 2 and 3. Progesterone and sex hormone-binding globulin (SHBG) levels were higher in group 1 than in groups 2 and 3. Dehydroepiandrosterone sulfate (DHEA-S) was higher in group 1 than group 3.ConclusionsObese and overweight infertile Mexican women with PCOS, attending to an infertility clinic, have a higher prevalence of IR and pre-diabetes compared with normal-weight women with PCOS. Therapeutic interventions should include those that improved metabolic functioning prior to attempting pregnancy in these groups of women.
Valsalva using a syringe: pressure and variation
Authors: Thornton Hilary Sarah , Elwan Mohammed H , Reynolds Joseph A , Coats Timothy J 
Published: July 2016

BackgroundThe Valsalva manoeuvre is commonly used in EDs to terminate supraventricular tachycardia by the patient blowing into a syringe.AimTo identify whether a specific syringe size can be recommended for use in the ED.Results20% of syringes ‘stuck’ and required high pressures to move. In the remaining 80% of syringes, a 20 mL syringe was the most appropriate size to achieve the recommended 40 mm Hg. Once ‘released’ plunger position did not make a difference.ConclusionsUse of a syringe of any size cannot be recommended if a consistent pressure is required.
ARID4B is a good biomarker to predict tumour behaviour and decide WHO grades in gliomas and meningiomas
Authors: Tsai Wen-Chiuan , Hueng Dueng-Yuan , Nieh Shin , Gao Hong-Wei 
Published: July 2016

AimsAlthough ARID4B is known to promote tumour metastasis in breast cancer and inhibit transformation and progression in leukaemia, the possible effect of ARID4B on primary brain tumours (PBTs) is not well characterised. We tested the hypothesis that expression of ARID4B correlates with WHO grade and survival in patients with PBTs.MethodsWestern blot analysis was performed on protein lysates prepared from normal brain tissue and glioma cell lines (U87MG, LN229, GBM8401 and U118MG). Subsequently, immunohistochemical analysis of ARID4B was performed on 2 tissue microarrays, including 12 normal brain tissues, 63 meningiomas with different subtypes, 232 gliomas of various grades and degrees of differentiation, 8 central neurocytomas and 4 chordomas. The ARID4B immunostaining score was calculated by multiplying the intensity score by the percentage of tumour cells expressing ARID4B.ResultsIn vitro, ARID4B protein expression was increased in some glioma cell lines. In addition, the average ARID4B immunostaining score was 38.03, 79.09, 129.76 and 119.32, respectively, in gliomas of WHO grade I, II, III and IV. Higher ARID4B immunostaining score was significantly correlated with more advanced WHO grade of gliomas (p=7.4×10–6) and meningiomas. Finally, higher ARID4B expression tended to the shorter survival rates, but did not reach statistical significance.ConclusionsARID4B overexpression presented in most of PBTs, rather than non-neoplastic brain tissue, and correlated with WHO grades in meningiomas and gliomas. Therefore, ARID4B is a satisfactory biomarker to highlight tumour component and predict tumour behaviour in primary brain neoplasms.
Mexico's epidemic of violence and its public health significance on average length of life
Authors: Canudas-Romo Vladimir , Aburto José Manuel , García-Guerrero Victor Manuel , Beltrán-Sánchez Hiram 
Published: July 2016

ObjectivesA disproportionate number of homicides have caused Mexican life expectancy to stagnate during the new millennium. No efforts currently exist to quantify the harm of violent acts on the lives of the general population. We quantified the impact of perceived vulnerability on life expectancy.MethodsThree Mexican national surveys on perceptions of public safety, life tables, and crime and vital statistics (2000–2014) were used. Prevalence rates of vulnerability/safety by age and sex were obtained from surveys at 2 different levels: federal state and home. The Sullivan method was used to estimate life expectancy lived with and without vulnerability for Mexican women and men.ResultsOverall life expectancy at age 20 stagnated between 2005 and 2014 for females and males; yet, there was an increase of 40% and 70% in average number of years lived with vulnerability at the state and home levels, respectively. In 2014, female life expectancy at age 20 was 59.5 years (95% CI 59.0 to 60.1); 71% of these years (42.3 years, 41.6 to 43.0) were spent with perceived vulnerability of violence taking place in the state and 26% at the home (15.3 years, 15 to 15.8). For males, life expectancy at age 20 was 54.5 years (53.7 to 55.1); 64% of these years (34.6 years, 34.0 to 35.4) were lived with perceived vulnerability of violence at the state and 20% at the home (11.1 years, 10.8 to 11.5).ConclusionsThe number of years lived with perceived vulnerability among Mexicans has increased by 30.5 million person-years over the last 10 years. If perceived vulnerability remains at its 2014 level, the average Mexican adults would be expected to live a large fraction of his/her life with perceived vulnerability of violence. Acts of violence continue to rise in the country and they should be addressed as a major public health issue before they become endemic.
Whole‐flock, metaphylactic tilmicosin failed to eliminate contagious ovine digital dermatitis and footrot in sheep: a cluster randomised trial
Authors: Angell J. W. , Grove‐White D. H. , Williams H. J. , Duncan J. S. 
Published: July 2016

The aim of this study was to evaluate the clinical success of whole‐flock systemic tilmicosin and enhanced biosecurity in eliminating active contagious ovine digital dermatitis (CODD) from sheep flocks. Thirty flocks in the UK were randomly allocated to receive either treatment as usual (as per the farmer's normal routine) or whole‐flock treatment with tilmicosin, together with isolation and extended treatment of clinically affected individuals and isolation and treatment of purchased sheep during the study period. All flocks were visited once at onset of the trial to examine all sheep. One year later, all sheep were re‐examined to determine the presence/absence of clinical lesions. The primary outcome was the clinical elimination of CODD from flocks. Secondary outcomes were reduction in prevalence of CODD, clinical elimination of footrot and reduction in prevalence of footrot. The analysis included 11 control flocks and 13 intervention flocks, with initially 3460 and 4686 sheep, respectively. For CODD: at follow‐up, in the intervention group, 6/13 (46 per cent) flocks had a prevalence of zero compared with 1/11 (9 per cent) in the control group (P=0.12). For footrot: at follow‐up, no flocks had a prevalence of zero. Therefore, the intervention is not recommended for the elimination of CODD or footrot in the UK.
Dynamics of water trimer in femtosecond laser pulses
Authors: Wang Zhiping , Zhang Fengshou , Xu Xuefeng , Wang Yanbiao , Qian Chaoyi 
Published: July 2016

With the help of the time-dependent local-density approximation (TDLDA) coupled non-adiabatically to molecular dynamics (MD), we studied both the static properties and irradiation dynamics of water trimer subject to the short and intense femtosecond laser field. It is shown that the optimized geometry and the optical absorption strength of the water trimer accord well with results in literature. Three typical possible irradiated scenarios of water trimer which are “normal oscillation”, “dissociation and formation” and “pure OH dissociation” are exhibited by investigating the ionization and the level depletion related to electrons as well as the OH bonds, proton-transfer, the intermolecular distance and the kinetic energy connected with ions. In three scenarios, the behaviors of water trimer can be attributed to the sequential combination of responses of the electrons emission, the proton-transfer, OH vibration and rotation, OH dissociation and hydroxyl formation, respectively. The relevant time scales of the first proton-transfer and OH dissociation are identified as 13 fs and 10–20 fs, respectively. The study of kinetic energies of ions show that the kinetic energies of the remaining ions are all below 4.5 eV and outgoing hydrogen ions carry a kinetic energy about 5–12 eV. Furthermore, it is found that in the tunneling ionization situations the depletion is fairly shared between the various levels except the most deep occupied electronic level while in the multiphotonic ionization case the electron loss comes from all single-electron levels and the HOMO level contributes the most.
Decoding Intratumoral Heterogeneity of Breast Cancer by Multiparametric In Vivo Imaging: A Translational Study
Authors: Schmitz Jennifer , Schwab Julian , Schwenck Johannes , Chen Qian , Quintanilla-Martinez Leticia , Hahn Markus , Wietek Beate , Schwenzer Nina , Staebler Annette , Kohlhofer Ursula , Aina Olulanu H. , Hubbard Neil E. , Reischl Gerald , Borowsky Alexander D. , Brucker Sara , Nikolaou Konstantin , la Fougère Christian , Cardiff Robert D. , Pichler Bernd J. , Schmid Andreas M. 
Published: July 2016

Abstract
Differential diagnosis and therapy of heterogeneous breast tumors poses a major clinical challenge. To address the need for a comprehensive, noninvasive strategy to define the molecular and functional profiles of tumors in vivo, we investigated a novel combination of metabolic PET and diffusion-weighted (DW)-MRI in the polyoma virus middle T antigen transgenic mouse model of breast cancer. The implementation of a voxelwise analysis for the clustering of intra- and intertumoral heterogeneity in this model resulted in a multiparametric profile based on [18F]Fluorodeoxyglucose ([18F]FDG)-PET and DW-MRI, which identified three distinct tumor phenotypes in vivo, including solid acinar, and solid nodular malignancies as well as cystic hyperplasia. To evaluate the feasibility of this approach for clinical use, we examined estrogen receptor-positive and progesterone receptor-positive breast tumors from five patient cases using DW-MRI and [18F]FDG-PET in a simultaneous PET/MRI system. The postsurgical in vivo PET/MRI data were correlated to whole-slide histology using the latter traditional diagnostic standard to define phenotype. By this approach, we showed how molecular, structural (microscopic, anatomic), and functional information could be simultaneously obtained noninvasively to identify precancerous and malignant subtypes within heterogeneous tumors. Combined with an automatized analysis, our results suggest that multiparametric molecular and functional imaging may be capable of providing comprehensive tumor profiling for noninvasive cancer diagnostics. Cancer Res; 76(18); 5512–22. ©2016 AACR.
Calcium-Sensing Receptor Promotes Breast Cancer by Stimulating Intracrine Actions of Parathyroid Hormone–Related Protein
Authors: Kim Wonnam , Takyar Farzin M. , Swan Karena , Jeong Jaekwang , VanHouten Joshua , Sullivan Catherine , Dann Pamela , Yu Herbert , Fiaschi-Taesch Nathalie , Chang Wenhan , Wysolmerski John 
Published: July 2016

Abstract
Parathyroid hormone–related protein (PTHrP) contributes to the development and metastatic progression of breast cancer by promoting hypercalcemia, tumor growth, and osteolytic bone metastases, but it is not known how PTHrP is upregulated in breast tumors. Here we report a central role in this process for the calcium-sensing receptor, CaSR, which enables cellular responses to changes in extracellular calcium, through studies of CaSR–PTHrP interactions in the MMTV-PymT transgenic mouse model of breast cancer and in human breast cancer cells. CaSR activation stimulated PTHrP production by breast cancer cells in vitro and in vivo. Tissue-specific disruption of the casr gene in mammary epithelial cells in MMTV-PymT mice reduced tumor PTHrP expression and inhibited tumor cell proliferation and tumor outgrowth. CaSR signaling promoted the proliferation of human breast cancer cell lines and tumor cells cultured from MMTV-PyMT mice. Further, CaSR activation inhibited cell death triggered by high extracellular concentrations of calcium. The actions of the CaSR appeared to be mediated by nuclear actions of PTHrP that decreased p27kip1 levels and prevented nuclear accumulation of the proapoptotic factor apoptosis inducing factor. Taken together, our findings suggest that CaSR–PTHrP interactions might be a promising target for the development of therapeutic agents to limit tumor cell growth in bone metastases and in other microenvironments in which elevated calcium and/or PTHrP levels contribute to breast cancer progression. Cancer Res; 76(18); 5348–60. ©2016 AACR.
Mitochondria-Targeted Doxorubicin: A New Therapeutic Strategy against Doxorubicin-Resistant Osteosarcoma
Authors: Buondonno Ilaria , Gazzano Elena , Jean Sae Rin , Audrito Valentina , Kopecka Joanna , Fanelli Marilù , Salaroglio Iris C. , Costamagna Costanzo , Roato Ilaria , Mungo Eleonora , Hattinger Claudia M. , Deaglio Silvia , Kelley Shana O. , Serra Massimo , Riganti Chiara 
Published: July 2016

AbstractDoxorubicin is one of the leading drugs for osteosarcoma standard chemotherapy. A total of 40% to 45% of high-grade osteosarcoma patients are unresponsive, or only partially responsive, to doxorubicin (Dox), due to the overexpression of the drug efflux transporter ABCB1/P-glycoprotein (Pgp). The aim of this work is to improve Dox-based regimens in resistant osteosarcomas. We used a chemically modified mitochondria-targeted Dox (mtDox) against Pgp-overexpressing osteosarcomas with increased resistance to Dox. Unlike Dox, mtDox accumulated at significant levels intracellularly, exerted cytotoxic activity, and induced necrotic and immunogenic cell death in Dox-resistant/Pgp-overexpressing cells, fully reproducing the activities exerted by anthracyclines in drug-sensitive tumors. mtDox reduced tumor growth and cell proliferation, increased apoptosis, primed tumor cells for recognition by the host immune system, and was less cardiotoxic than Dox in preclinical models of drug-resistant osteosarcoma. The increase in Dox resistance was paralleled by a progressive upregulation of mitochondrial metabolism. By widely modulating the expression of mitochondria-related genes, mtDox decreased mitochondrial biogenesis, the import of proteins and metabolites within mitochondria, mitochondrial metabolism, and the synthesis of ATP. These events were paralleled by increased reactive oxygen species production, mitochondrial depolarization, and mitochondria-dependent apoptosis in resistant osteosarcoma cells, where Dox was completely ineffective. We propose mtDox as a new effective agent with a safer toxicity profile compared with Dox that may be effective for the treatment of Dox-resistant/Pgp-positive osteosarcoma patients, who strongly need alternative and innovative treatment strategies. Mol Cancer Ther; 15(11); 2640–52. ©2016 AACR.
Inhibition of Breast Cancer Metastasis by Presurgical Treatment with an Oral Matrix Metalloproteinase Inhibitor: A Preclinical Proof-of-Principle Study
Authors: Winer Arthur , Janosky Maxwell , Harrison Beth , Zhong Judy , Moussai Dariush , Siyah Pinar , Schatz-Siemers Nina , Zeng Jennifer , Adams Sylvia , Mignatti Paolo 
Published: July 2016

Abstract
Breast cancer has the second highest death toll in women worldwide, despite significant progress in early diagnosis and treatments. The main cause of death is metastatic disease. Matrix metalloproteinases (MMP) are required for the initial steps of metastasis, and have therefore been considered as ideal pharmacologic targets for antimetastatic therapy. However, clinical trials of MMP inhibitors were unsuccessful. These trials were conducted in patients with advanced disease, beyond the stage when these compounds could have been effective. We hypothesized that early treatment with a selective MMP inhibitor between the time of diagnosis and definitive surgery, the so-called “window-of-opportunity,” can inhibit metastasis and thereby improve survival. To investigate our hypothesis, we used the 4T1 mouse model of aggressive mammary carcinoma. We treated the animals with SD-7300, an oral inhibitor of MMP-2, -9, and -13, starting after the initial detection of the primary tumor. Seven days later, the primary tumors were excised and analyzed for MMP activity, and the SD-7300 treatment was discontinued. After 4 weeks, the animals were sacrificed and their lungs analyzed histologically for number of metastases and metastatic burden (metastases' area/lung section area). SD-7300 treatment inhibited 70% to 80% of tumor-associated MMP activity (P = 0.0003), reduced metastasis number and metastatic burden by 50% to 60% (P = 0.002 and P = 0.0082, respectively), and increased survival (92% vs. 66.7%; P = 0.0409), relative to control vehicle. These results show that treatment of early invasive breast cancer with selective MMP inhibitors can lower the risk of recurrence and increase long-term disease-free survival. Mol Cancer Ther; 15(10); 2370–7. ©2016 AACR.