bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Insights into Gastric Cancer: Methylation of R-spondins and Regulation of LGR5 by SP1
Authors: Wilhelm Franziska , Simon Eva , Böger Christine , Behrens Hans-Michael , Krüger Sandra , Röcken Christoph 
Published: February 2017

Abstract
Recently, it was shown that leucine-rich repeat-containing receptor 5 (LGR5)–expressing stem cells are the cellular origin of intestinal-type gastric cancer. The aim of our study was to uncover regulatory mechanisms of LGR5 expression in gastric mucosa and their implications for cancer development. Reporter assays identified an LGR5 promoter fragment, which is highly relevant for active LGR5 expression. Chromatin immunoprecipitation verified that SP1 is bound within this region, and reporter activity increased in SP1 transfected cells. Subsequently, the expression of R-spondins (RSPO1 and RSPO2), ligands of LGR5, was explored in neoplastic and nonneoplastic gastric tissue and gastric cancer cell lines. Using IHC, distinct spatial expression patterns of LGR5, RSPO1, and RSPO2 were found in nonneoplastic stomach mucosa and gastric cancer. RSPO expression was lower in gastric cancer compared with nonneoplastic mucosa on both the transcriptional (P = 0.003 for RSPO1 and P = 0.000 for RSPO2; n = 50) and the translational level. Methylation-specific PCR showed higher methylation levels of RSPO1/2 and reexpression of RSPOs in the gastric cancer cell lines MKN45 and MKN74 were induced by demethylating 5-aza-C treatment. Finally, expression patterns of LGR5 and RSPO were similar in gastric cancer.
Implications: This report identifies a regulatory mechanism of LGR5 expression in gastric carcinogenesis, with SP1 as an important component of the transcriptional complex and LGR5 activity, which is modulated by its ligands RSPO1 and RSPO2, whose expression is modulated by methylation.
Visual Overview: http://mcr.aacrjournals.org/content/15/6/776/F1.large.jpg. Mol Cancer Res; 15(6); 776–85. ©2017 AACR.
ОСОБЛИВОСТІ СИМУЛЯЦІЙНОГО НАВЧАННЯ ПРИ ВИВЧЕННІ ПЕДІАТРИЧНИХ ДИСЦИПЛІН
Authors: Boyarchuk O. R. , Chornomydz I. B. , Vorontsova T. O. , Kinash M. I. 
Published: February 2017

У статті викладено досвід проведення занять з педіатрії у симуляційному центрі Тернопільського державного медичного університету імені І. Я. Горбачевського. Проаналізовано основні переваги симуляційного навчання, та висвітлено методики викладання занять з педіатрії, а зокрема пропедевтичної педіатрії, догляду за хворими та сестринської практики, використовуючи технічні можливості симуляційного центру університету.
ДОСЛІДЖЕННЯ НАВЧАЛЬНОЇ МОТИВАЦІЇ У СТУДЕНТІВ ПЕРШОГО КУРСУ ТЕРНОПІЛЬСЬКОГО ДЕРЖАВНОГО МЕДИЧНОГО УНІВЕРСИТЕТУ ІМЕНІ І. Я. ГОРБАЧЕВСЬКОГО
Authors: Burmas N. M. , Boyko L. A. , Bekus I. R. , Kyryliv M. V. 
Published: February 2017

У статті проведено діагностику навчальної мотивації студентів першого курсу медичного факультету методом анкетування. Отримані дані розкривають структуру мотивації першокурсників і свідчать про необхідність втручання у процес її формування. Домінуючими для студентів медичного факультету виявилися професійні мотиви. Результати дослідження показали різні мотиви студентів до навчання, що потребує організаційних та виховних зусиль професорсько-викладацького складу для компетентного впливу на підвищення навчальної мотивації.
СУЧАСНІ ІННОВАЦІЙНО-ТЕХНОЛОГІЧНІ ПРИЙОМИ ТА ШЛЯХИ ПОЛІПШЕННЯ ВИВЧЕННЯ ТЕМИ “ГОСТРИЙ АПЕНДИЦИТ ТА ЙОГО УСКЛАДНЕННЯ” СТУДЕНТАМИ МЕДИЧНОГО ФАКУЛЬТЕТУ
Authors: Dmytruk O. M. 
Published: February 2017

У роботі узагальнено досвід кафедри хірургії № 1 ІФНМУ вивчення студентами теми “Гострий апендицит та його ускладнення”; впровадження й удосконалення інноваційних технологій при використанні інтерактивних методів навчання на всіх етапах навчального процесу з вивчення спеціальності, в т. ч. під час проведення загально-курсової конференції з актуальних проблем клініки, діагностики та лікувальної програми. На етапі визначення кінцевого рівня знань використовуються вирішення кейс-завдань, ігрові та неігрові методи модельованого навчання, а якість отриманих знань оцінюється поточним та підсумковим контролем.
Philosophy and its Re-Formation in Post-Soviet Russia
Authors: Pertsev Aleksandr A. , Cherepanova Yekaterina S. , Batyuta Yekaterina A. 
Published: February 2017

The article discusses the situation of philosophical education in Russia. After 1991, the teaching of the officially recognized “dialectical materialism” and “historical materialism” in Russia was stopped. Since then, there has been no unified curriculum in philosophy studies in Russia, and the discipline has been significantly changed and extended. Now it includes a variety of philosophical currents that correspond to the general image of this discipline in the world. Nevertheless, there are some distinctive features, which differentiate Russian philosophy teaching from the c of philosophy elsewhere. One significant trait of modern Russian philosophy is the quest for its own identity. This explains the steady and ongoing interest in the history of Russian philosophy and in religious philosophy, which is booming at present. It is also significant that a majority of post-Soviet philosophers still perceive themselves as successors to the scientific ideology in the Marxist sense and regard the working out of a scientific world outlook as their goal. Philosophical schools, such as phenomenology and hermeneutics, are still viewed with suspicion and considered as historical phenomena, which have been overcome a long time ago.
The paper will discuss the complex relationship between different positions in the understanding of philosophy in Russia, against the background of the struggle between conservative and progressive tendencies in Russian politics, culture and economics. The analysis of the mainstream of philosophical re-formation allows us to speak about the “New Epoch of Engineers” and the fall of the “Humanist Thaw”.
Avalanche Fatalities during Atmospheric River Events in the Western United States
Authors: Hatchett Benjamin J. , Burak Susan , Rutz Jonathan J. , Oakley Nina S. , Bair Edward H. , Kaplan Michael L. 
Published: February 2017

Abstract
The occurrence of atmospheric rivers (ARs) in association with avalanche fatalities is evaluated in the conterminous western United States between 1998 and 2014 using archived avalanche reports, atmospheric reanalysis products, an existing AR catalog, and weather station observations. AR conditions were present during or preceding 105 unique avalanche incidents resulting in 123 fatalities, thus comprising 31% of western U.S. avalanche fatalities. Coastal snow avalanche climates had the highest percentage of avalanche fatalities coinciding with AR conditions (31%–65%), followed by intermountain (25%–46%) and continental snow avalanche climates (&lt;25%). Ratios of avalanche deaths during AR conditions to total AR days increased with distance from the coast. Frequent heavy to extreme precipitation (85th–99th percentile) during ARs favored critical snowpack loading rates with mean snow water equivalent increases of 46 mm. Results demonstrate that there exists regional consistency between snow avalanche climates, derived AR contributions to cool season precipitation, and percentages of avalanche fatalities during ARs. The intensity of water vapor transport and topographic corridors favoring inland water vapor transport may be used to help identify periods of increased avalanche hazard in intermountain and continental snow avalanche climates prior to AR landfall. Several recently developed AR forecast tools applicable to avalanche forecasting are highlighted.
Elevated Mixing in the Periphery of Mesoscale Eddies in the South China Sea
Authors: Yang Qingxuan , Zhao Wei , Liang Xinfeng , Dong Jihai , Tian Jiwei 
Published: February 2017

AbstractDirect microstructure observations across three warm mesoscale eddies were conducted in the northern South China Sea during the field experiments in July 2007, December 2013, and January 2014, respectively, along with finestructure measurements. An important finding was that turbulent mixing in the mixed layer was considerably elevated in the periphery of each of these eddies, with a mixing level 5–7 times higher than that in the eddy center. To explore the mechanism behind the high mixing level, this study carried out analyses of the horizontal wavenumber spectrum of velocities and spectral fluxes of kinetic energy. Spectral slopes showed a power law of k−2 in the eddy periphery and of k−3 in the eddy center, consistent with the result that the kinetic energy of submesoscale motion in the eddy periphery was more greatly energized than that in the center. Spectral fluxes of kinetic energy also revealed a forward energy cascade toward smaller scales at the wavelength of kilometers in the eddy periphery. This study illustrated a possible route for energy cascading from balanced mesoscale dynamics to unbalanced submesoscale behavior, which eventually furnished turbulent mixing in the upper ocean.
The Relationship between Double-Diffusive Intrusions and Staircases in the Arctic Ocean
Authors: Bebieva Yana , Timmermans Mary-Louise 
Published: February 2017

AbstractThe origin of double-diffusive staircases in the Arctic Ocean is investigated for the particular background setting in which both temperature and salinity increase with depth. Motivated by observations that show the coexistence of thermohaline intrusions and double-diffusive staircases, a linear stability analysis is performed on the governing equations to determine the conditions under which staircases form. It is shown that a double-diffusive staircase can result from interleaving motions if the observed bulk vertical density ratio is below a critical vertical density ratio estimated for particular lateral and vertical background temperature and salinity gradients. Vertical background temperature and salinity gradients dominate over horizontal gradients in determining whether staircases form, with the linear theory indicating that perturbations to stronger vertical temperature gradients are more likely to give rise to a staircase. Examination of Arctic Ocean temperature and salinity measurements indicates that observations are consistent with the theory for reasonable estimates of eddy diffusivity and viscosity.
A Surgical Technique for Treating Submuscular and Subglandular Symmastia Combining Standard Techniques with An Aggressive Medial Capsulorrhaphy
Authors: Vondrak Jessica , Fennema Matthew , Beltre Kevin , Abaskalova Jana , Blomain Erik Scott , Blomain Eric W 
Published: February 2017

Symmastia, the medial confluence of breast implants producing a ‘bread loaf’ quality, has continued to be a vexing complication of breast reconstruction and breast augmentation, despite numerous proposed repair methods. Previous procedures include capsulorrhaphy, allograft or xenograft sling suspensions, mastopexies and, in cases of subglandular implants, collapsing the pocket and reinserting the implant beneath the pectoralis major muscle. In the present article, the authors outline a reliable long-term correction of submuscular symmastia, combining the techniques of capsulorrhaphy, use of porcine xenograft slings, submuscular placement of the implants, and use of capsular tissue folded and sutured onto the presternal fascia with nonabsorbable sutures. This technique places the porcine xenograft sling between the implant and the folded capsular tissue sutured with nonabsorbable sutures, protecting the implant from erosion/puncture by the nonabsorbable sutures. The authors also propose a similar technique for the correction of subglandular symmastia. The patient in the current article presented with submuscular symmastia and has been followed for <4 years postoperatively with absolutely no recurrence of symmastia, even with forcible application of lateral pressure on her breasts in an attempt to reproduce medial confluence. The technique offers a promising solution to the frustrating difficulty of symmastia, a complication with a high recurrence rate despite many proposed repairs across decades.
Anaplastic Large Cell Lymphoma Associated with Double-Lumen Breast Implants: A Case Report and Review of the Literature
Authors: Wang Jessica S , Degeorge Brent R , Showalter Shayna L , Morgan Raymond F , Lin Kant Y 
Published: February 2017

Background: Breast implant-associated anaplastic large cell lymphoma (ALCL) is commonly associated with diagnostic delay due to the insidious nature of presentation with late periprosthetic fluid collection, mass or locoregional adenopathy. Case Presentation: A 75-year-old woman with a remote history of right breast cancer treated with modified radical mastectomy and immediate reconstruction with a double-lumen silicone implant presented 13 years later with volume asymmetry. The implant was removed and a saline implant was placed. Five years later, she presented with acute onset of right breast enlargement and pain. Ultrasound revealed an associated periprosthetic fluid accumulation. Cytology showed anaplastic lymphoma kinasenegative, CD30-positive ALCL without associated systemic disease. The patient was treated with implant removal and total capsulectomy. Conclusion: Due to the insidious presentation of ALCL, a high index of clinical suspicion must be maintained when evaluating patients for delayed presentation of volumetric discrepancy. Treatment typically entails implant removal. Indications for additional systemic treatment include extracapsular spread of ALCL or presence of a periprosthetic tumour.
Cutaneous Horn: A Devil Not Only in Appearance
Authors: Mir Mohd Altaf , Mahmud Ali Adil , Mohd Yaseen M Ch , Rehman Suhailur , Imran Ahmad M Ch , Lalit Mohan Bariar M Ch 
Published: February 2017

Background: The pathology of most cutaneous horns are benign although malignancy potential has been reported in around 20 to 30 percent and not only the appearance of these lesions are a source of distress but also the fact that they can be associated with malignant transformations. The purpose of this article is to keep the clinician in constant vigil of this uncommon benign but potentially malignant lesions. Objective: To evaluate the association of Cutaneous horn with malignant change Methods: The six patients with cutaeous horn presented in our outpatient department of Plastic and Reconstructive surgery from 1st January 2014 to 30th November 2015 were evaluated and managed with wide local excision and reconstruction considering the principals of the reconstructive ladder. Histopathological reports of the specimen were collected and data was tabulated. The followup clinical examination was done every week. Results: In our study most of the lesions occured on the scalp and the remaining were found on the perineum and malignancy was confirmed on histopathology in half of these scalp lesions, whereas none of the perineal lesions in our sudy showed any malignant change. Conclusions: Cutaneous horn although an uncommon condition and usually neglected by the patient should be kept under high suspicion by the treating Surgeon and definitive management with wide local excision with adequate margins should always be explained to the patient.
Cost-Effectiveness of Immune Checkpoint Inhibition inBRAFWild-Type Advanced Melanoma
Authors: Kohn Christine G. , Zeichner Simon B. , Chen Qiushi , Montero Alberto J. , Goldstein Daniel A. , Flowers Christopher R. 
Published: February 2017

PurposePatients who are diagnosed with stage IV metastatic melanoma have an estimated 5-year relative survival rate of only 17%. Randomized controlled trials of recent US Food and Drug Administration–approved immune checkpoint inhibitors—pembrolizumab (PEM), nivolumab (NIVO), and ipilumumab (IPI)—demonstrate improved patient outcomes, but the optimal treatment sequence in patients with BRAF wild-type metastatic melanoma remains unclear. To inform policy makers about the value of these treatments, we developed a Markov model to compare the cost-effectiveness of different strategies for sequencing novel agents for the treatment of advanced melanoma.Materials and MethodsWe developed Markov models by using a US-payer perspective and lifetime horizon to estimate costs (2016 US$) and quality-adjusted life years (QALYs) for treatment sequences with first-line NIVO, IPI, NIVO + IPI, PEM every 2 weeks, and PEM every 3 weeks. Health states were defined for initial treatment, first and second progression, and death. Rates for drug discontinuation, frequency of adverse events, disease progression, and death obtained from randomized phase III trials were used to determine the likelihood of transition between states. Deterministic and probabilistic sensitivity analyses were conducted to evaluate model uncertainty.ResultsPEM every 3 weeks followed by second-line IPI was both more effective and less costly than dacarbazine followed by IPI then NIVO, or IPI followed by NIVO. Compared with the first-line dacarbazine treatment strategy, NIVO followed by IPI produced an incremental cost effectiveness ratio of $90,871/QALY, and first-line NIVO + IPI followed by carboplatin plus paclitaxel chemotherapy produced an incremental cost effectiveness ratio of $198,867/QALY.ConclusionFor patients with treatment-naive BRAF wild-type advanced melanoma, first-line PEM every 3 weeks followed by second-line IPI or first-line NIVO followed by second-line IPI are the most cost-effective, immune-based treatment strategies for metastatic melanoma.
Hormonal Maintenance Therapy for Women With Low-Grade Serous Cancer of the Ovary or Peritoneum
Authors: Gershenson David M. , Bodurka Diane C. , Coleman Robert L. , Lu Karen H. , Malpica Anais , Sun Charlotte C. 
Published: February 2017

Purpose The purpose of this study was to examine outcomes associated with hormonal maintenance therapy (HMT) compared with routine observation (OBS) after primary cytoreductive surgery and platinum-based chemotherapy in women with stage II to IV low-grade serous carcinoma of the ovary or peritoneum. Patients and Methods Eligibility criteria for patients from our database were: treatment with primary surgery followed by platinum-based chemotherapy, stage II to IV disease, at least 2 years of follow-up for patients who had not experienced recurrence, and adequate clinical information. The two groups were compared for progression-free survival (PFS) and overall survival, and a multivariable Cox regression analysis was performed. Subset analyses for patients who were disease free or had persistent disease were also performed. Results Between 1981 and 2013, 203 eligible patients—133 who underwent OBS and 70 who received HMT—were seen at our institution. Median PFS for patients who underwent OBS was 26.4 months, compared with 64.9 months for those who received HMT ( P < .001). No statistically significant difference in overall survival was observed between the two groups (102.7 v 115.7 months, respectively). For subgroups of women who were disease free or had persistent disease, median PFS was superior for those who received HMT (81.1 v 30.0 months; P < .001 and 38.1 v 15.2 months; P < .001, respectively). Women who received HMT had a significantly lower risk of disease progression compared with those who underwent OBS (hazard ratio, 0.44; 95% CI, 0.31 to 0.64; P < .001). Conclusion Women with stage II to IV low-grade serous carcinoma who received HMT after primary treatment had significantly longer PFS compared with women who underwent OBS. These findings warrant further investigation using a prospective trial design.
Use of Evidence-Based Prostate Cancer Imaging in a Nongovernmental Integrated Health Care System
Authors: Salloum Ramzi G. , O’Keeffe-Rosetti Maureen , Ritzwoller Debra P. , Hornbrook Mark C. , Lafata Jennifer Elston , Nielsen Matthew E. 
Published: February 2017

Purpose: The overuse of imaging, particularly for staging of low-risk prostate cancer, is well documented and widespread. The existing literature, which focuses on the elderly in fee-for-service settings, points to financial incentives as a driver of overuse and may not identify factors relevant to policy solutions within integrated health care systems, where physicians are salaried. Methods: Imaging rates were analyzed among men with incident prostate cancer diagnosed between 2004 and 2011 within the Colorado and Northwest regions of Kaiser Permanente. The sample was stratified according to indication for imaging, ie, high risk for whom imaging was necessary versus low risk for whom imaging was discouraged. Logistic regression was used to model the association between imaging receipt and clinical/demographic patient characteristics by risk strata. Results: Of the men with low-risk prostate cancer, 35% received nonindicated imaging at diagnosis, whereas 42% of men with high-risk prostate cancer did not receive indicated imaging. Compared with men diagnosed in 2004, those diagnosed in subsequent years were less likely to receive imaging across both risk groups. Men with high-risk cancer diagnosed at ≥ 65 years of age and those with clinical stage ≥ T2 were more likely to receive indicated imaging. Men with comorbidities were more likely to receive imaging across both risk groups. Men with low-risk prostate cancer who had higher median household incomes were less likely to receive nonindicated imaging. Conclusion: Nonindicated imaging for diagnostic staging of patients with low-risk prostate cancer was common, but has decreased over the past decade. These findings suggest that factors other than financial incentives may be driving overuse of imaging.
Experiencias en la aplicación de Tabletas en Secundaria
Authors: Buendía García Felix , Benlloch Dualde José Vicente , Zahonero Viana Inmaculada , Cubel Barea Andrés 
Published: February 2017

El objetivo de este trabajo consiste en presentar una serie de experiencias sobre el uso de dispositivos “tablet” (tabletas) en el ámbito de la Enseñanza Secundaria. Este tipo de dispositivos vienen utilizándose en diversos centros educativos repartidos por el estado español, principalmente en Educación Primaria, y pese a su potencial innovador y las ventajas tecnológicas que aportan, también aparecen dificultades cuando se busca una implantación efectiva de los mismos. Por un lado, en el trabajo se plantean ciertas cuestiones sobre el aprovechamiento didáctico de estos dispositivos y las necesidades o requisitos que ello implica. Por otra parte, se trata de extraer una serie de recomendaciones/guías para una aplicación efectiva de este tipo de dispositivos. Para ello, se cuenta con la experiencia de un centro educativo a lo largo de varios cursos en la aplicación de tales tecnologías. A partir de dicha experiencia se analizan los resultados obtenidos y se pretende dar una nueva perspectiva en el uso didáctico de las tabletas.
Tarefa de casa e tecnologia
Authors: Camin de Menezes Ana Maria 
Published: February 2017

Acredita-se na importância da tarefa de casa, no entanto, no contexto do ensino da língua inglesa percebe-se um grande “abismo” entre o movimento de integração da tecnologia em sala de aula e as mesmas velhas tarefas de casa. Diante desta contradição, surge o projeto descrito neste artigo, em que uma professora de inglês propõe a alternância de exercícios tradicionais com tarefas de casa utilizando a internet, a fim de propiciar aos alunos a possibilidade da prática das 4 habilidades na aprendizagem de línguas e a chance de utilizarem a língua inglesa de forma personalizada e criativa.