bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parity and Oral Contraceptive Use in Relation to Ovarian Cancer Risk in Older Women
Authors: McGuire Valerie , Hartge Patricia , Liao Linda M. , Sinha Rashmi , Bernstein Leslie , Canchola Alison J. , Anderson Garnet L. , Stefanick Marcia L. , Whittemore Alice S. 
Published: April 2016

Abstract
Background: Several studies have suggested that the ovarian cancer risk reductions associated with parity and oral contraceptive use are weaker in postmenopausal than premenopausal women, yet little is known about the persistence of these reductions as women age. This question gains importance with the increasing numbers of older women in the population.
Methods: We addressed the question using data from three large U.S. cohort studies involving 310,290 white women aged 50+ years at recruitment, of whom 1,815 developed subsequent incident invasive epithelial ovarian cancer. We used Cox regression, stratified by cohort, to examine age-related trends in the HRs per full-term pregnancy and per year of oral contraceptive use.
Results: The parity-associated risk reductions waned with age (Ptrend &lt; 0.001 in HR with increasing age), particularly among women aged 75 years or more, for whom we observed no association with parity. However, we observed no such attenuation in the oral contraceptive–associated risk reductions (P = 0.79 for trend in HR with increasing age).
Conclusion: These findings suggest that prior oral contraceptive use is important for ovarian cancer risk assessment among women of all ages, while the benefits of parity wane as women age.
Impact: This information, if duplicated in other studies, will be useful to preventive counseling and risk prediction, particularly for women at increased ovarian cancer risk due to a personal history of breast cancer or a family history of ovarian cancer. Cancer Epidemiol Biomarkers Prev; 25(7); 1059–63. ©2016 AACR.
Serum Estrogens and Estrogen Metabolites and Endometrial Cancer Risk among Postmenopausal Women
Authors: Brinton Louise A. , Trabert Britton , Anderson Garnet L. , Falk Roni T. , Felix Ashley S. , Fuhrman Barbara J. , Gass Margery L. , Kuller Lewis H. , Pfeiffer Ruth M. , Rohan Thomas E. , Strickler Howard D. , Xu Xia , Wentzensen Nicolas 
Published: April 2016

Abstract
Background: Although endometrial cancer is clearly influenced by hormonal factors, few epidemiologic studies have investigated the role of endogenous estrogens or especially estrogen metabolites.
Methods: We conducted a nested case–control study within the Women's Health Initiative Observational Study (WHI-OS), a cohort of 93,676 postmenopausal women recruited between 1993 and 1998. Using baseline serum samples from women who were non-current hormone users with intact uteri, we measured 15 estrogens/estrogen metabolites via HPLC/MS-MS among 313 incident endometrial cancer cases (271 type I, 42 type II) and 354 matched controls, deriving adjusted ORs and 95% confidence intervals (CI) for overall and subtype-specific endometrial cancer risk.
Results: Parent estrogens (estrone and estradiol) were positively related to endometrial cancer risk, with the highest risk observed for unconjugated estradiol (OR 5th vs. 1st quintile = 6.19; 95% CI, 2.95–13.03, Ptrend = 0.0001). Nearly all metabolites were significantly associated with elevated risks, with some attenuation after adjustment for unconjugated estradiol (residual risks of 2- to 3-fold). Body mass index (kg/m2, BMI) relations were somewhat reduced after adjustment for estrogen levels. The association with unconjugated estradiol was stronger for type I than type II tumors (Phet = 0.01).
Conclusions: Parent estrogens as well as individual metabolites appeared to exert generalized uterotropic activity, particularly for type I tumors. The effects of obesity on risk were only partially explained by estrogens.
Impact: These findings enhance our understanding of estrogen mechanisms involved in endometrial carcinogenesis but also highlight the need for studying additional markers that may underlie the effects on risk of certain risk factors, for example, obesity. Cancer Epidemiol Biomarkers Prev; 25(7); 1081–9. ©2016 AACR.
NQO1-Mediated Tumor-Selective Lethality and Radiosensitization for Head and Neck Cancer
Authors: Li Long-Shan , Reddy Srilakshmi , Lin Zhen-Hua , Liu Shuangping , Park Hyunsil , Chun Stephen G. , Bornmann William G. , Thibodeaux Joel , Yan Jingsheng , Chakrabarti Gaurab , Xie Xian-Jin , Sumer Baran D. , Boothman David A. , Yordy John S. 
Published: April 2016

Abstract
Ionizing radiation (IR) is a key therapeutic regimen for many head and neck cancers (HNC). However, the 5-year overall survival rate for locally advanced HNCs is approximately 50% and better therapeutic efficacy is needed. NAD(P)H:quinone oxidoreductase 1 (NQO1) is overexpressed in many cancers, and β-lapachone (β-lap), a unique NQO1 bioactivatable drug, exploits this enzyme to release massive reactive oxygen species (ROS) that synergize with IR to kill by programmed necrosis. β-Lap represents a novel therapeutic opportunity in HNC leading to tumor-selective lethality that will enhance the efficacy of IR. Immunohistochemical staining and Western blot assays were used to assess the expression levels of NQO1 in HNC cells and tumors. Forty-five percent of endogenous HNCs expressed elevated NQO1 levels. In addition, multiple HNC cell lines and tumors demonstrated elevated levels of NQO1 expression and activity and were tested for anticancer lethality and radiosensitization by β-lap using long-term survival assays. The combination of nontoxic β-lap doses and IR significantly enhanced NQO1-dependent tumor cell lethality, increased ROS, TUNEL-positive cells, DNA damage, NAD+, and ATP consumption, and resulted in significant antitumor efficacy and prolonged survival in two xenograft murine HNC models, demonstrating β-lap radiosensitization of HNCs through a NQO1-dependent mechanism. This translational study offers a potential biomarker-driven strategy using NQO1 expression to select tumors susceptible to β-lap–induced radiosensitization. Mol Cancer Ther; 15(7); 1757–67. ©2016 AACR.
Obstructive Sleep Apnea in Acute Stroke
Authors: Ifergane Gal , Ovanyan Andrey , Toledano Ronen , Goldbart Aviv , Abu-Salame Ibrahim , Tal Asher , Stavsky Moshe , Novack Victor 
Published: April 2016

Background and Purpose—
Sleep-disordered breathing is common among patients with stroke resulting in 4- to 6-fold higher prevalence of obstructive sleep apnea (OSA). We prospectively evaluated clinical characteristics and laboratory markers of inflammation and coagulability associated with OSA severity during the acute post stroke period.

Methods—
Consecutive patients admitted to the department of Neurology after an acute ischemic stroke were evaluated during the first 48 hours of symptom onset using Watch peripheral arterial tonometry, a wrist-worn ambulatory sleep study device that utilizes peripheral arterial tonometry. Morning blood samples of the patient were tested for tumor necrosis factor, interleukin-6, and plasminogen activator inhibitor-1 levels.

Results—
A total of 43 patients with acute stroke were admitted during the study period, 22 (51%) of which have been found to have moderate sleep apnea (apnea hypopnea index [AHI]≥15), AHI≥5 was found in 86% of the patients, and severe OSA (AHI≥30) in 32.5%. Patients with OSA (AHI≥15) did not differ from the rest in stroke severity or symptoms, yet they had higher prevalence of recurrent stroke and atrial fibrillation. All 3 biomarkers levels were higher among patients with AHI≥15: tumor necrosis factor (6.39 versus 3.57 pg/mL), interleukin-6 (6.64 versus 3.14 pg/mL), and plasminogen activator inhibitor-1 (176.64 versus 98.48 pg/mL). After the stratification of AHI into 3 groups (AHI<5, 5–14, and ≥15), the analysis showed that only the highest AHI group differed from the other 2 groups in biomarkers levels.

Conclusions—
Use of bed-side somnography technology revealed that in an unselected sample of patients with acute ischemic stroke, almost 90% had sleep-disordered breathing with third having severe form of the disorder. Sleep-disordered breathing was associated with significantly increased levels of inflammatory biomarkers, providing possible pathophysiological explanation of OSA-associated stroke risk. These results warrant prospective screening of patients with stroke for the presence of sleep-disordered breathing and lay the rationale for an interventional trial.
A Real-Time Automated Quality Control of Hourly Rain Gauge Data Based on Multiple Sensors in MRMS System
Authors: Qi Youcun , Martinaitis Steven , Zhang Jian , Cocks Stephen 
Published: April 2016

Abstract
Automated rain gauge networks provide direct measurements of precipitation and have been used for numerous applications, such as generating regional and national precipitation maps, calibrating remote sensing quantitative precipitation estimation (QPE), and validating hydrological and meteorological model predictions. However, automated gauge observations are prone to be affected by a variety of error sources and require a careful quality-control (QC) procedure. Many previous gauge QC techniques were based on spatiotemporal checks within the gauge network itself, and their effectiveness can be dependent on gauge densities and precipitation regimes. The current study takes advantage of the multisensor data sources in the Multi-Radar Multi-Sensor (MRMS) system and develops an automated and computationally efficient gauge QC scheme based on the consistency of hourly gauge and radar QPE observations. Radar and gauge error characteristics related to radar sampling geometry, precipitation regimes, and freezing-level height is utilized within this scheme. This QC scheme is evaluated by testing its capability to identify suspect gauges and comparing the ability to quality-controlled gauges through statistical and spatial comparisons of gauge-influenced gridded QPE products. Spatial analysis of the gridded QPE products in MRMS resulted in a more physical spatial QPE distribution using quality-controlled gauges versus the same product created with non-quality-controlled gauge data.
The Impact of Quadratic Nonlinear Relations between Soil Moisture Products on Uncertainty Estimates from Triple Collocation Analysis and Two Quadratic Extensions
Authors: Zwieback Simon , Su Chun-Hsu , Gruber Alexander , Dorigo Wouter A. , Wagner Wolfgang 
Published: April 2016

Abstract
The error characterization of soil moisture products, for example, obtained from microwave remote sensing data, is a key requirement for using these products in applications like numerical weather prediction. The error variance and root-mean-square error are among the most popular metrics: they can be estimated consistently for three datasets using triple collocation (TC) without assuming any dataset to be free of errors. This technique can account for additive and multiplicative biases; that is, it assumes that the three products are linearly related. However, its susceptibility to nonlinear relations (e.g., due to sensor saturation and scale mismatch) has not been addressed. Here, a simulation study investigates the impact of quadratic relations on the TC error estimates [also when the products are first rescaled using the nonlinear cumulative distribution function (CDF) matching technique] and on those by two novel methods. These methods—based on error-in-variables regression and probabilistic factor analysis—extend standard TC by also accounting for nonlinear relations using quadratic polynomials. The relative differences between the error estimates of the ASCAT remotely sensed product by the quadratic and the linear methods are predominantly smaller than 10% in a case study based on remotely sensed, reanalysis, and in situ measured soil moisture over the contiguous United States. Exceptions with larger discrepancies indicate that nonlinear relations can pose a challenge to traditional TC analyses, as the simulations show they can introduce biases of either sign. In such cases, the use of nonlinear methods may complement traditional approaches for the error characterization of soil moisture products.
Patient education programme on immunotherapy in multiple sclerosis (PEPIMS): a controlled rater-blinded study
Authors: Köpke S , Kasper J , Flachenecker P , Meißner H , Brandt A , Hauptmann B , Bender G , Backhus I , Rahn AC , Pöttgen J , Vettorazzi E , Heesen C 
Published: April 2016

Objective: To investigate the effectiveness of a multi-component evidence-based education programme on disease modifying therapies in multiple sclerosis. Design: Controlled trial with two consecutive patient cohorts and a gap of two months between cohorts. Setting: Three neurological rehabilitation centres. Subjects: Patients with multiple sclerosis within rehabilitation. Interventions: Control group (CG) participants were recruited and received standard information. Two months later, intervention group (IG) participants were recruited and received a six-hour nurse-led interactive group education programme consisting of two parts and a comprehensive information brochure. Main measures: Primary endpoint was “informed choice”, comprising of adequate risk knowledge in combination with congruency between attitude towards immunotherapy and actual immunotherapy uptake. Further outcomes comprised risk knowledge, decision autonomy, anxiety and depression, self-efficacy, and fatigue. Results: A total of 156 patients were included (IG=75, CG=81). The intervention led to significantly more participants with informed choice (IG: 47% vs. CG: 23%, P=0.004). The rate of persons with adequate risk knowledge was significantly higher in the IG two weeks after the intervention (IG: 54% vs. CG: 31%, P=0.007), but not after six months (IG: 48% vs. CG: 31%, P=0.058). No significant differences were shown for positive attitude towards disease modifying therapy (IG: 62% vs. CG: 71%, P=0.29) and for disease modifying therapy status after six months (IG: 61.5% vs CG: 68.6%, P=0.39). Also no differences were found for autonomy preferences and decisional conflict after six months. Conclusion: Delivering evidence-based information on multiple sclerosis disease modifying therapies within a rehabilitation setting led to a marked increase of informed choices.
Oxytocin and emotion processing
Authors: Di Simplicio Martina , Harmer Catherine J 
Published: April 2016

Since the observation that oxytocin has key effects on social decision making, research on this exciting neuropeptide has doubled in volume: hundreds of studies have pursued the promise of a specific oxytocin action on high-level cognition and social function with wide potential translational implications (from autism to social anxiety to dementia). Here we review the evidence on whether the complex behavioural effects observed in humans after exogenous oxytocin administration build on changes in basic emotional information processing, in particular emotional facial expressions recognition, and attention and memory for emotionally-valenced stimuli. We observe that recent studies confirm a facilitatory effect of oxytocin to more accurate emotion processing, irrespective of emotion type. However, it remains unclear whether this action precedes, is independent of or even secondary to the neuropeptide promoting a greater salience of social stimuli. Overall, this growing research area has shown that oxytocin produces behavioural and neurofunctional outcomes that are highly dependent on the experimental context and on individual differences (gender, personality, life experiences). This poses an exciting challenge for future experimental medicine designs to address and unpack complex interactions between individual and context characteristic, which is needed for the development of more precise clinical applications.
Factor seven activating protease (FSAP) predicts response to intravenous thrombolysis in acute ischemic stroke
Authors: Bustamante Alejandro , Díaz-Fernández Belén , Giralt Dolors , Boned Sandra , Pagola Jorge , Molina Carlos A , García-Berrocoso Teresa , Kanse Sandip M , Montaner Joan 
Published: April 2016

Background Prediction of recanalization after intravenous thrombolysis could be important to direct secondary reperfusion techniques. Factor seven activating protease (FSAP) has been described to have a relevant pathophysiological role in stroke. Aim The aim is to determine whether plasma FSAP levels are associated with recanalization after tissue plasminogen activator in acute stroke. Methods FSAP antigen, activity, and FSAP-inhibitor complexes were measured in 120 acute stroke patients admitted to Hospital Vall d’Hebron with arterial occlusions, before intravenous thrombolysis. Recanalization was assessed by transcranial Doppler 2 h after thrombolysis. Predictors of recanalization were determined by logistic regression analysis and the additional predictive value of FSAP over them was determined by integrated discrimination improvement index. Results Complete recanalization was achieved in 31 patients. FSAP antigen levels were lower in patients achieving recanalization (8.2 (6.3–11.7) µg/mL vs. 9.8 (7.6–12.8) µg/mL; p = 0.046). After adjustment by age, sex, and National Institutes of Health Stroke Scale, Oxfordshire Community Stroke Project (odds ratio = 0.33 (0.13–0.82), p = 0.017) and FSAP antigen (odds ratio = 3.22 (1.22–8.47), p = 0.018) were independently associated with recanalization, and the addition of FSAP improved the model discrimination (integrated discrimination improvement = 5.5% (1.4–9.7), p = 0.009). Conclusions Our study showed that lower FSAP antigen plasma levels were associated with a higher chance of arterial recanalization after tissue plasminogen activator treatment, suggesting an involvement of FSAP in tissue plasminogen activator-induced clot lysis. FSAP antigen determination might be useful in predicting tissue plasminogen activator response in stroke patients.
Investing in health information management
Authors: Makinde Olusesan Ayodeji , Mami Mohammed Ibrahim , Oweghoro Benson Macaulay , Oyediran Kolawole Azeez , Mullen Stephanie 
Published: April 2016

Aim: To describe the process adopted to review the academic curriculum for training health information management professionals in Nigeria. Context: Health information management professionals are responsible for managing patients’ health service records and hospital information systems across health facilities in Nigeria. An assessment found many are inadequately skilled in information and communications technology (ICT) skills believed to be needed for them to play leadership roles in hospital information systems and function effectively. This was traced to a dearth of relevant ICT courses in their academic training curriculum. Case study: A review of the curriculum for training health information management professionals was instituted following an agreed need to address these issues. Lessons learned: Health records management is evolving across the world including the developing countries. This advancement requires evolution of training programs to meet the increasing application of ICT in this sector. Conclusion: After several sessions, a new curriculum that addresses all the identified educational deficiencies has been developed. It is believed that this step will help improve the quality of training programs.
Documentation of clinical care in hospital patients’ medical records
Authors: Rowlands Stella , Coverdale Steven , Callen Joanne 
Published: April 2016

Background: Clinical documentation is essential for communication between health professionals and the provision of quality care to patients. Objective: To examine medical students’ perspectives of their education in documentation of clinical care in hospital patients’ medical records. Method: A qualitative design using semi-structured interviews with fourth-year medical students was undertaken at a hospital-based clinical school in an Australian university. Results: Several themes reflecting medical students’ clinical documentation education emerged from the data: formal clinical documentation education using lectures and tutorials was minimal; most education occurred on the job by junior doctors and student’s expressed concerns regarding variation in education between teams and receiving limited feedback on performance. Respondents reported on the importance of feedback for their learning of disease processes and treatments. They suggested that improvements could be made in the timing of clinical documentation education and they stressed the importance of training on the job. Conclusion: On-the-job education with feedback in clinical documentation provides a learning opportunity for medical students and is essential in order to ensure accurate, safe, succinct and timely clinical notes.
Efficacy, durability, and response predictors of low-dose interleukin-2 therapy for chronic graft-versus-host disease
Authors: Koreth John , Kim Haesook T. , Jones Kyle T. , Lange Paulina B. , Reynolds Carol G. , Chammas Marie J. , Dusenbury Katherine , Whangbo Jennifer , Nikiforow Sarah , Alyea Edwin P. , Armand Philippe , Cutler Corey S. , Ho Vincent T. , Chen Yi-Bin , Avigan David , Blazar Bruce R. , Antin Joseph H. , Ritz Jerome , Soiffer Robert J. 
Published: April 2016

Key Points
Low-dose IL-2 is efficacious in steroid-refractory cGVHD, with objective responses in >50% of patients, and durable disease control. IL-2 initiation earlier after cGVHD onset, prior to severe impairment of Treg:Tcon ratios, improves likelihood of clinical response.