bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of biological markers of epithelial to mesenchymal transition in oesophageal adenocarcinoma, an immunohistochemical study
Authors: Prins M J D , Ruurda J P , Lolkema M P , Sitarz R , ten Kate F J W , van Hillegersberg R 
Published: April 2015

BackgroundE-cadherin, β-catenin, epidermal growth factor receptor (EGFR), neuronal cadherin (N-cadherin) and Cyclin D1 are involved in epithelial to mesenchymal transition (EMT). However, the prognostic significance of EMT markers in oesophageal adenocarcinoma (OAC) is unknown. Aim of this study was to evaluate the prognostic value of, and the association between different EMT markers in OAC.MethodsTumour cores of 154 patients with OAC were included in a tissue microarray. Scoring criteria was based on immunohistochemical staining intensity.ResultsEMT-associated markers were expressed in OAC: reduced membranous E-cadherin and β-catenin were seen in 11.4% and 51.7%, nuclear β-catenin in 19.1% and EGFR and Cyclin D1 overexpression in 56.5% and 27.4% of tumours. Mesenchymal marker N-cadherin was not expressed in OAC. A positive correlation was seen between membranous β-catenin and E-cadherin expression (R=0.209, p=0.001) and between EGFR and Cyclin D1 (R=0.257, p=0.002). In univariate analysis, EGFR overexpression and membranous β-catenin staining were significantly associated with a poor survival (HR 2.145; 95% CI 1.429 to 3.218, p<0.001 and HR 1.665; 95% CI 1.114 to 2.488; p=0.013). However, Cyclin D1 (HR 1.092; 95% CI 0.702 to 1.698; p=0.697), nuclear β-catenin (HR 1.322; 95% CI 0.799 to 2.189; p=0.277) and E-cadherin (HR 1.012; 95% CI 0.554 to 1.851; p=0.968) were not associated with survival. In multivariate analysis, EGFR overexpression was an independent prognostic factor for poor survival (HR 1.678; 95% CI 1.055 to 2.668; p=0.029) together with T stage (HR 2.759; 95% CI 1.356 to 5.576; p=0.005).ConclusionsThis study supports the presence of EMT in OAC. Moreover, EGFR overexpression was independently associated with a poor survival.
Folic acid in pregnancy and mortality from cancer and cardiovascular disease: further follow-up of the Aberdeen folic acid supplementation trial
Authors: Taylor Caroline M , Atkinson Charlotte , Penfold Chris , Bhattacharya Sohinee , Campbell Doris , Davey Smith George , Leary Sam , Ness Andy 
Published: April 2015

BackgroundSupplemental periconceptional folic acid is recommended to reduce the risk of fetal neural tube defects. A previous report indicated an elevated risk of breast cancer and all cancer deaths in later life among women randomised by alternate allocation to high-dose (5 mg/day) folic acid in pregnancy compared with placebo; however, findings were based on small numbers of cases. Our aim was to extend the previous analysis by including data from an additional 10 years of follow-up.MethodsRecords of participants in a large (n=2928) trial of folate supplementation (5 or 0.2 mg folic acid, or placebo) in pregnancy in the 1960s were linked to central registries in Scotland. Unadjusted and adjusted HRs were calculated for all-cause, cardiovascular, all cancer and breast cancer mortality, and all cancer and breast cancer morbidity. Analyses were done using (1) data from the time of the previous linkage (2002) to March 2013; and (2) data from 1980 to March 2013.ResultsThere was no evidence to suggest an excess risk of morbidity or mortality in either supplementation group compared with placebo for 2002–2013 and no associations were seen for the full time period (1980–2013).ConclusionsFindings from this extended follow-up do not support our previous observation of an elevated risk of mortality from breast cancer or all cancers in later life among women who had taken 5 mg folic acid/day during pregnancy. Furthermore, there were no associations with risk of mortality from all-causes, all cancers or cardiovascular disease.
Post-abortion initiation of long-acting reversible contraception in New Zealand
Authors: Rose Sally B , Garrett Susan M 
Published: April 2015

BackgroundPost-abortion initiation of long-acting reversible contraception (LARC) reduces subsequent abortion rates within 24 months, but the prevalence of post-abortion LARC use in New Zealand is unknown.AimTo describe post-abortion initiation of intrauterine and implantable LARC methods in New Zealand between 2007 and 2012, and to determine what impact the introduction of government-funded (free) levonorgestrel (LNG) implants in August 2010 had on overall LARC use.Design and settingRetrospective observational study involving New Zealand abortion clinic data.MethodsNationally collated data on post-abortion LARC insertions were obtained for the period 2007–2012, and individual-level discharge data for patients attending a large urban hospital abortion clinic were analysed using descriptive statistics to describe annual uptake rates, and the demographic profile of LARC users during this period. Logistic regression analyses examined whether LARC use differed by parity and/or age over time.ResultsPost-abortion LARC use increased from 20.2% in 2007 to 45.6% in 2012. Intrauterine device use increased from 20.2% to 31.8% during this period, with implants contributing a further 14% to the overall use of LARC methods by 2012. Clinic data showed that LARC use increased among most demographic subgroups between 2009 and 2012, with the greatest increase among nulliparous under-20-year-olds (from 17.2% to 42.0%).ConclusionsPost-abortion LARC use has been steadily increasing in New Zealand since 2007. Overall LARC use significantly increased following the introduction of government-funded implants, particularly among young and nulliparous women. Improving access to alternative methods of LARC may further increase uptake and reduce unwanted pregnancy rates.
Adult Body Size and Physical Activity in Relation to Risk of Breast Cancer According to Tumor Androgen Receptor Status
Authors: Zhang Xuehong , Eliassen A. Heather , Tamimi Rulla M. , Hazra Aditi , Beck Andrew H. , Brown Myles , Collins Laura C. , Rosner Bernard , Hankinson Susan E. 
Published: April 2015

AbstractBackground: Obesity and physical activity have been hypothesized to affect breast cancer risk partly via the androgen signaling pathway. We conducted the first study to evaluate these associations by tumor androgen receptor (AR) status.Methods: Height, weight, and physical activity were assessed using questionnaires in the Nurses' Health Study. AR, estrogen receptor (ER), and progesterone receptor (PR) status were determined using immunohistochemistry on tumor tissue and medical/pathology reports.Results: A total of 1,701 AR+ and 497 AR− cases were documented during 26 years of follow-up of 103,577 women. After adjusting for ER/PR status and other risk factors, the relative risks (RR) and 95% confidence intervals (95% CI) for every 5 kg/m2 increase in body mass index (BMI) were 1.07 (1.01–1.13) for AR+ and 1.16 (1.05–1.29) for AR− tumors (P-heterogeneity = 0.17). The RRs (95% CIs) per 5 hours of brisk walking/week were 0.87 (0.73–1.04) for AR+ and 0.67 (0.45–0.99) for AR− tumors (P-heterogeneity = 0.22). Further, BMI, but not physical activity, associations differed significantly across ER/PR/AR subtypes (P-heterogeneity = 0.04 and 0.63, respectively). The RRs (95% CIs) for 5 kg/m2 increase in BMI were 1.23 (1.04–1.45) for ER+PR+AR−, 1.19 (1.01–1.39) for ER−PR−AR−, 1.15 (1.08–1.23) for ER+PR+AR+, and 0.88 (0.75–1.03) for ER+PR−AR+ tumors.Conclusions: Higher BMI was associated with an increased risk of both AR+ and AR− breast tumors in postmenopausal women, whereas physical activity, including brisk walking, was associated with a reduced risk of both subtypes. In addition, a significant positive association was observed between higher BMI and ER−PR−AR− tumors.Impact: The similar associations observed by AR status suggest that mechanisms other than androgen signaling underlie these two breast cancer risk factors. Cancer Epidemiol Biomarkers Prev; 24(6); 962–8. ©2015 AACR.
Tissue-type plasminogen activator-binding RNA aptamers inhibiting low-density lipoprotein receptor family-mediated internalisation
Authors: Bøtkjær Kenneth A. , Helsen Nicky , Andreasen Peter A. , Dupont Daniel M. , Bjerregaard Nils 
Published: April 2015

SummaryRecombinant tissue-type plasminogen activator (tPA, trade name Alteplase), currently the only drug approved by the US Food and Drug Administration and the European Medicines Agency for the treatment of cerebral ischaemic stroke, has been implicated in a number of adverse effects reportedly mediated by interactions with the low-density lipo-protein (LDL) family receptors, including neuronal cell death and an increased risk of cerebral haemorrhage. The tissue-type plasminogen activator is the principal initiator of thrombolysis in human physiology, an effect that is mediated directly via localised activation of the plasmin zymogen plasminogen at the surface of fibrin clots in the vascular lumen. Here, we sought to identify a ligand to tPA capable of inhibiting the relevant LDL family receptors without interfering with the fibrinolytic activity of tPA. Systematic evolution of ligands by exponential enrichment (SELEX) was employed to isolate tPA-binding RNA aptamers, which were characterised in biochemical assays of tPA association to low density lipoprotein receptor-related protein-1 (LRP-1, an LDL receptor family member); tPA-mediated in vitro and ex vivo clot lysis; and tPA-mediated plasminogen activation in the absence and presence of a stimulating soluble fibrin fragment. Two aptamers, K18 and K32, had minimal effects on clot lysis, but were able to efficiently inhibit tPA-LRP-1 association and LDL receptor family-mediated endocytosis in human vascular endothelial cells and astrocytes. These observations suggest that coadministration alongside tPA may be a viable strategy to improve the safety of thrombolytic treatment of cerebral ischaemic stroke by restricting tPA activity to the vascular lumen.
Effect of Tricuspid Regurgitation and the Right Heart on Survival After Transcatheter Aortic Valve Replacement
Authors: Lindman Brian R. , Maniar Hersh S. , Jaber Wael A. , Lerakis Stamatios , Mack Michael J. , Suri Rakesh M. , Thourani Vinod H. , Babaliaros Vasilis , Kereiakes Dean J. , Whisenant Brian , Miller D. Craig , Tuzcu E. Murat , Svensson Lars G. , Xu Ke , Doshi Darshan , Leon Martin B. , Zajarias Alan 
Published: April 2015

Background—
Tricuspid regurgitation (TR) and right ventricular (RV) dysfunction adversely affect outcomes in patients with heart failure or mitral valve disease, but their impact on outcomes in patients with aortic stenosis treated with transcatheter aortic valve replacement has not been well characterized.

Methods and Results—

Among 542 patients with symptomatic aortic stenosis treated in the Placement of Aortic Transcatheter Valves (PARTNER) II trial (inoperable cohort) with a Sapien or Sapien XT valve via a transfemoral approach, baseline TR severity, right atrial and RV size and RV function were evaluated by echocardiography according to established guidelines. One-year mortality was 16.9%, 17.2%, 32.6%, and 61.1% for patients with no/trace (n=167), mild (n=205), moderate (n=117), and severe (n=18) TR, respectively (
P
<0.001). Increasing severity of RV dysfunction as well as right atrial and RV enlargement were also associated with increased mortality (
P
<0.001). After multivariable adjustment, severe TR (hazard ratio, 3.20; 95% confidence interval, 1.50–6.82;
P
=0.003) and moderate TR (hazard ratio, 1.60; 95% confidence interval, 1.02–2.52;
P
=0.042) remained associated with increased mortality as did right atrial and RV enlargement, but not RV dysfunction. There was an interaction between TR and mitral regurgitation severity (
P
=0.04); the increased hazard of death associated with moderate/severe TR only occurred in those with no/trace/mild mitral regurgitation.

Conclusions—
In inoperable patients treated with transcatheter aortic valve replacement, moderate or severe TR and right heart enlargement are independently associated with increased 1-year mortality; however, the association between moderate or severe TR and an increased hazard of death was only found in those with minimal mitral regurgitation at baseline. These findings may improve our assessment of anticipated benefit from transcatheter aortic valve replacement and support the need for future studies on TR and the right heart, including whether concomitant treatment of TR in operable but high-risk patients with aortic stenosis is warranted.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01314313.
β‐Blocker Use and Mortality in COPD Patients After Myocardial Infarction: A Swedish Nationwide Observational Study
Authors: Andell Pontus , Erlinge David , Smith J. Gustav , Sundström Johan , Lindahl Bertil , James Stefan , Koul Sasha 
Published: April 2015

Background
Patients with myocardial infarction (MI) and concomitant chronic obstructive pulmonary disease (COPD) constitute a high‐risk group with increased mortality. β‐Blocker therapy has been shown to reduce mortality, prevent arrhythmias, and delay heart failure development after an MI in broad populations. However, the effect of β‐blockers in COPD patients is less well established and they may also be less treated due to fear of adverse reactions. We investigated β‐blocker prescription at discharge in patients with COPD after MI.

Methods and Results
Patients hospitalized for MI between 2005 and 2010 were identified from the nationwide Swedish SWEDEHEART registry. Patients with COPD who were alive and discharged after an MI were selected as the study population. In this cohort, patients who were discharged with β‐blockers were compared to patients not discharged with β‐blockers. The primary end point was all‐cause mortality. A total of 4858 patients were included, of which 4086 (84.1%) were discharged with a β‐blocker while 772 (15.9%) were not. After adjusting for potential confounders including baseline characteristics, comorbidities, and in‐hospital characteristics, patients discharged with a β‐blocker had lower all‐cause mortality (hazard ratio 0.87, 95% CI 0.78 to 0.98) during the total follow‐up time (maximum 7.2 years). In the subgroup of patients with a history of heart failure, the corresponding hazard ratio was 0.77 (95% CI 0.63 to 0.95).

Conclusions
Patients with COPD discharged with β‐blockers after an MI had a lower all‐cause mortality compared to patients not prescribed β‐blockers. The results indicate that MI patients with COPD may benefit from β‐blockers.
Coupled Atmospheric–Ice Load Model for Evaluation of Wind Plant Power Loss
Authors: Yang Jing , Yu Wei , Choisnard Julien , Forcione Alain , Antic Slavica 
Published: April 2015

AbstractIcing is a weather phenomenon that is typical of cold climates. It impacts human activities through ice accretion on tower structures, transmission lines, and the blades of wind turbines. Icing on turbine blades, in particular, results in wind turbine performance degradation and/or safety shutdowns. The objective of this study is to explore the feasibility of using a coupled atmospheric and ice load model to simulate icing start-up, duration, and amount while also quantitatively evaluating power loss in wind plants related to icing events and mechanisms. Eight of 27 icing episodes identified for a wind plant in the Gaspé region of Québec (Canada) during the period 2008–10 were simulated using a mesoscale model (the Global Environmental Multiscale Limited-Area Model, or GEM-LAM). The simulations were verified using near-surface temperature, relative humidity, and wind speed, all of which compared well to in situ observations. Simulated wind speed, precipitation, cloud liquid water content, and median volume diameter of the droplets were used to drive ice load models to simulate the total ice load on a cylindrical structure. The three ice load models accounted for freezing rain, wet snow, and in-cloud icing, respectively, and in all three cases a sink term was added to account for melting due to radiation. The start-up and duration of ice were well captured by the coupled model, and a positive correlation was found between icing episodes and wind power reduction. This study demonstrates the improvements of the icing forecasts by using three ice load models, and provides a framework for both qualitative and quantitative evaluation of icing impact on wind turbine operations.
Time-Expanded Sampling for Ensemble-Based Data Assimilation Applied to Conventional and Satellite Observations
Authors: Zhao Qingyun , Xu Qin , Jin Yi , McLay Justin , Reynolds Carolyn 
Published: April 2015

Abstract
The time-expanded sampling (TES) method, designed to improve the effectiveness and efficiency of ensemble-based data assimilation and subsequent forecast with reduced ensemble size, is tested with conventional and satellite data for operational applications constrained by computational resources. The test uses the recently developed ensemble Kalman filter (EnKF) at the Naval Research Laboratory (NRL) for mesoscale data assimilation with the U.S. Navy’s mesoscale numerical weather prediction model. Experiments are performed for a period of 6 days with a continuous update cycle of 12 h. Results from the experiments show remarkable improvements in both the ensemble analyses and forecasts with TES compared to those without. The improvements in the EnKF analyses by TES are very similar across the model’s three nested grids of 45-, 15-, and 5-km grid spacing, respectively. This study demonstrates the usefulness of the TES method for ensemble-based data assimilation when the ensemble size cannot be sufficiently large because of operational constraints in situations where a time-critical environment assessment is needed or the computational resources are limited.
Towards the Development of a Policy of Recycling Assistive Technology for People Living with a Disability
Authors: Vincent Claude 
Published: April 2015

Assistive technology (AT) or assistive devices, such as wheelchairs, bathroom safety equipment and lift systems, constitute one type of equipment used to maximise independence for disabled people and fragile elderly people. The practice of recycling health care equipment has been increasingly considered to be a cost-effective and feasible means to meet consumer needs, but this has not been addressed for AT. Many countries in Europe and some Canadian provinces have recycling programmes for AT yet little is known about all the issues related to this practice, particularly from the perspectives of the various players involved. Some occupational therapists are proactive in this area but the majority are waiting for the government to start the recycling. Even if occupational therapists consider recycling AT to be a good idea, they still need political and administrative support to build an efficient practice of recycling. In November 1996, a special council in the Canadian province of Quebec recommended that rigorous procedures be put in place to recycle AT within the public health insurance system and in institutions funded by the provincial ministry of health. The aim of this article is to document the conditions necessary for the successful implementation of a recycling policy for AT in this province. A qualitative study was conducted with 22 experts in the industry, health and community sectors. Using a conceptual model of health systems, 33 elements and 99 basic factors were identified as important for the content and strategies employed in a policy of recycling AT. These elements are distributed among the technocratic, professional, market and political worlds. The discussion recommends intersectoral collaboration that takes into account the different perspectives of the various stakeholders that would be affected by a policy of recycling AT. The role of occupational therapists is also explored concerning recycling AT.
Priorities in Mental Health Research: The Results of a Live Research Project
Authors: Davis Sally Fowler , Bannigan Katrina 
Published: April 2015

Occupational therapists are increasingly being asked to identify priorities for research. This article is based on a questionnaire survey which was used to identify a priority list for research into occupational therapy in mental health. The delegates at the Association of Occupational Therapists in Mental Health's 3rd Annual Conference were surveyed. The demographic data collected included grade and specialism (as defined by the AOTMH). The delegates were asked to prioritise the area of intervention that they most needed to know was effective, to justify this choice and then to write an associated research question. The data were collected during the ‘Research in Action‘ session at the conference and analysed using SPSS and thematic analysis. The results were presented to the conference the following day. The top three priorities identified were activity/occupation, groupwork and occupational performance skills. The background literature, method and results are discussed and recommendations are made for further action.
Living Space: The Changing Meaning of Home
Authors: Steward Barbara 
Published: April 2015

The home is often viewed as an unproblematic location in which new occupational roles, relationships and uses can be fitted. There has been a marked increase in home-based work, leisure and medical care. How these functions can be accommodated within houses designed for conventional domestic and household activities often remains unclear. Drawing on an in-depth study of teleworking (home-based computer working), this article explores the meaning and experience of real, symbolic and lived household space. The findings suggest that households strive to retain the conventional look, feel and function of the home even when occupants are required to establish new roles and occupations. This resistance to spatial change occurs as a deliberate and rational choice. The article is theoretical in content and does not directly explore the experiences of disabled people. It provides a sociological perspective of the home, which is often missing from medical and rehabilitation literature. It challenges a number of taken-for-granted notions about the social construction of the home, which will be of interest to therapists whose work often involves the incorporation of new roles and daily activities into the home.