bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does accountability for reasonableness work? A protocol for a mixed methods study using an audit tool to evaluate the decision-making of clinical commissioning groups in England
Authors: Kieslich Katharina , Littlejohns Peter 
Published: July 2015

IntroductionClinical commissioning groups (CCGs) in England are tasked with making difficult decisions on which healthcare services to provide against the background of limited budgets. The question is how to ensure that these decisions are fair and legitimate. Accounts of what constitutes fair and legitimate priority setting in healthcare include Daniels’ and Sabin's accountability for reasonableness (A4R) and Clark's and Weale's framework for the identification of social values. This study combines these accounts and asks whether the decisions of those CCGs that adhere to elements of such accounts are perceived as fairer and more legitimate by key stakeholders. The study addresses the empirical gap arising from a lack of research on whether frameworks such as A4R hold what they promise. It aims to understand the criteria that feature in CCG decision-making. Finally, it examines the usefulness of a decision-making audit tool (DMAT) in identifying the process and content criteria that CCGs apply when making decisions.Methods and analysisThe adherence of a sample of CCGs to criteria emerging from theories of fair priority setting will be examined using the DMAT developed by PL. The results will be triangulated with data from semistructured interviews with key stakeholders in the CCG sample to ascertain whether there is a correlation between those CCGs that performed well in the DMAT exercise and those whose decisions are perceived positively by interviewees. Descriptive statistical methods will be used to analyse the DMAT data. A combination of quantitative and qualitative content analysis methods will be used to analyse the interview transcripts.Ethics and disseminationFull ethics approval was received by the King's College London Biomedical Sciences, Dentistry, Medicine and Natural and Mathematical Sciences Research Ethics Subcommittee. The results of the study will be disseminated through publications in peer review journals.
Qualitative approach to patient-reported outcomes in oncology: protocol of a French study
Authors: Orri Massimiliano , Sibeoni Jordan , Labey Mathilde , Bousquet Guilhem , Verneuil Laurence , Revah-Levy Anne 
Published: July 2015

IntroductionThe past decade has been characterised by movement from a doctor-centred to a patient-centred approach to treatment outcomes, in which doctors try to see the illness through their patients’ eyes. Patients, family members and doctors are the three participants in cancer care, but their perspectives about what have been helpful during cancer treatment have never simultaneously and explicitly compared in the same qualitative study. The aim of this study project is to explore patients’ perspectives about the care they receive, as well as families’ and doctors’ perspectives about what have been helpful for the patient. These three points of view will be compared and contrasted in order to analyse the convergences and divergences in these perspectives.Methods and analysisThis is a national multicentre qualitative study. Participants will be constituted by three different subsamples: (1) patients with cancer (skin, breast, urological and lung cancers), (2) their relatives, and (3) their referring physicians. Recruitment will follow the purposive sample technique, and the final sample size will be determined by data saturation. Data will be collected through open-ended semistructured interviews and independently analysed with NVivo V.10 software by three researchers according to the principles of Interpretative Phenomenological Analysis.Ethics and disseminationThe research protocol received approval from the University Paris Descartes review board (IRB number: 20140600001072), and participants will provide written consent. To the best of our knowledge, this is the first study to focus on the simultaneous exploration of the separate points of view of patients, families and doctors about the care received during the cancer care journey. We expect that our findings will help to improve communication and relationships between doctors, patients and families. Comparison of these three points of view will provide information about the convergences and divergences of these perspectives and how to address the needs of all three groups.
Quality of life and coping strategies among immigrant women living with pain in Denmark: a qualitative study
Authors: Michaëlis Camilla , Kristiansen Maria , Norredam Marie 
Published: July 2015

ObjectiveTo examine quality of life and coping strategies among immigrant women living with chronic pain.DesignQualitative content analysis based on in-depth semistructured interviews.SettingA clinic specifically targeting immigrants at a larger university hospital in Copenhagen, Denmark.ParticipantsNon-western female immigrant patients suffering from chronic pain (n=13).Main outcome measuresExperiences of the impact of chronic pain on quality of life.ResultsChronic pain was perceived to have an extensive, adverse effect on all aspects of quality of life, including physical health, mental well-being and social relations. This included the ability to maintain activities of daily living and the ability to work. Chronic pain was further experienced as a cause of emotional distress, depression and altered personalities, which all had great consequences on women's social interactions, causing change and loss of social relations. A variety of coping strategies were used to cope with the pain, manage its consequences, and restore a level of health that would enable women to function and fulfil social roles. Many participants coped with the pain by altering everyday life, keeping daily activities to a minimum and taking pain-killing drugs, offering temporary relief. Seeking healthcare was another coping strategy used as an active means to assert agency and as a temporary distraction from pain. However, accessing healthcare also involved a risk of disagreement and disappointments.ConclusionsChronic pain had a severe negative impact on quality of life and necessitated alterations in everyday life and active health-seeking strategies. Implications for practice imply a need for a more holistic approach to immigrant women with chronic pain, including a family-centred approach. Further research is needed to explore similarities or differences in and between populations with diverse ethnic, socioeconomic and psychosocial backgrounds, and to assess how ethnicity and culture might influence the experiences of chronic pain.
Diet quality and adherence to a healthy diet in Japanese male workers with untreated hypertension
Authors: Kanauchi Masao , Kanauchi Kimiko 
Published: July 2015

ObjectivesAs Japanese societies rapidly undergo westernisation, the prevalence of hypertension is increasing. We investigated the association between dietary quality and the prevalence of untreated hypertension in Japanese male workers.Design and methodsWe conducted a cross-sectional study of 433 male workers who completed a brief food frequency questionnaire. Adherence to the WHO-based Healthy Diet Indicator (HDI), the American Heart Association 2006 Diet and Lifestyle Recommendations, the Dietary Approaches to Stop Hypertension (DASH) diet, and Mediterranean-style diet was assessed using four adherence indexes (HDI score, AI-84 score, DASH score and MED score). Hypertension classes were classified into three categories: non-hypertension, untreated hypertension and treated hypertension (ie, taking antihypertensive medication).ResultsThe prevalence of untreated hypertension and treated hypertension was 22.4% and 8.5%, respectively. Patients with untreated hypertension had significantly lower HDI and AI-84 scores compared with non-hypertension. DASH and MED scores across the three hypertension classes were comparable. After adjusting for age, energy intake, smoking habit, alcohol drinking, physical activity and salt intake, a low adherence to HDI and a lowest quartile of AI-84 score were associated with a significantly higher prevalence of untreated hypertension, with an OR of 3.33 (95% CI 1.39 to 7.94, p=0.007) and 2.23 (1.09 to 4.53, p=0.027), respectively.ConclusionsA lower dietary quality was associated with increased prevalence of untreated hypertension in Japanese male workers. Our findings support a potential beneficial impact of nutritional assessment using diet qualities.
Impact of the angulus biopsy for the detection of gastric preneoplastic conditions and gastric cancer risk assessment
Authors: Varbanova M , Wex T , Jechorek D , Röhl FW , Langner C , Selgrad M , Malfertheiner P 
Published: July 2015

BackgroundGastric atrophy and intestinal metaplasia (IM) are preneoplastic conditions in the development of gastric cancer. Histopathological assessment is based on the updated Sydney system and superordinate staging systems, operative link on gastritis assessment (OLGA) and operative link on gastritis assessment using IM (OLGIM), all requiring a biopsy from theincisura angularis(angulus).AimTo determine the value of the angulus biopsy for the detection of preneoplastic conditions and cancer risk evaluation using OLGA and OLGIM prospectively.MethodsBiopsies from antrum (2), angulus (1) and corpus (2) were obtained from 213 patients (age 19–94 years, median 54 years, female to male ratio 138:75) undergoing upper endoscopy. Histological assessment according to the updated Sydney system, OLGA and OLGIM staging was performed by gastrointestinal pathologists. Statistical analysis used exact confidence limits for dichotomous variables and repeated measurement analysis of variance.Results8% of the cases with atrophic gastritis and 3% with IM (17 vs 6/213) would have been missed without the angulus biopsy. More patients were diagnosed with a preneoplastic condition when the angulus biopsy was considered (13.1%, CI 8.9% to 18.4%), but the grade of atrophy, if present at both sides, did not vary significantly in angulus and antrum. OLGA and OLGIM scores dropped significantly when recalculated without the angulus (difference in means±SD 0.131±0.402 and 0.075±0.313, respectively). The impact on the identification of high-risk stages is limited.ConclusionsThe angulus biopsy adds to the detection of mild gastric atrophy in particular. It allows identifying a small additional number of patients with high-risk gastritis.
Twist predicts poor outcome of patients with astrocytic glioma
Authors: Nordfors Kristiina , Haapasalo Joonas , Mäkelä Katri , Granberg Kirsi J , Nykter Matti , Korja Miikka , Paavonen Timo , Haapasalo Hannu , Soini Ylermi 
Published: July 2015

Aims and methodsEpithelial-mesenchymal transition (EMT) has previously been linked to glioma invasion and progression. To determine whether EMT regulators, Twist and Zeb1, had clinical significance in astrocytic gliomas, the association of Twist and Zeb1 with clinicopathological and molecular factors was studied in 269 astrocytoma samples.ResultsTwist and Zeb1 were widely expressed in astrocytic gliomas, but the expression of the former did not correlate with that of the latter. Stronger Twist expression levels were associated with higher WHO grades (p=0.001), whereas Zeb1 did not correlate with WHO grades. We found no association between Twist and proliferation activity (Ki67/MIB-1), p53 status, epidermal growth factor receptor (EGFR) amplification or neural cell adhesion molecule (NCAM) expression. There was no significant difference in Twist or Zeb1 expression when primary and secondary gliomas were analysed. Tumours with high Twist expression wereIDH1negative (p=0.009). High hypoxia-inducible factor-1α expression correlated significantly with positive Twist expression (p<0.001), whereas it was not associated with Zeb1 expression. Zeb1 expression did not correlate with proliferation, EGFR orIDH1. Nevertheless, we did find a correlation between high Zeb1 expression and low p53 expression levels (p=0.027). Positive NCAM expression was significantly associated with Zeb1 positivity (p=0.022). Zeb1 had no association with patient survival, whereas positive Twist expression predicted poor survival for patients in both univariate (p<0.001) and multivariable analyses (p=0.027).ConclusionsEMT regulators, Twist and Zeb1, are common features of infiltrating astrocytomas, and Twist is upregulated in glioblastomas in particular. Twist may be a novel marker for poor prognosis in glioma patients.
Weight change and its determinants in Portuguese adult women: a longitudinal analysis in the EPIPorto cohort
Authors: Henriques Ana , Severo Milton , Alves Luís , Barros Henrique , Azevedo Ana 
Published: July 2015

BackgroundWe aimed to characterise between-women and within-women weight change in adult women, and to assess the association of sociodemographic, reproductive and lifestyle characteristics with the variations.MethodsThis study comprised 1040 adult women from a population-based cohort of adults from Porto, Portugal, assembled in 1999–2003 and re-evaluated in 2005–2008 (median follow-up 5 years). A mixed-effects model for longitudinal analysis of body weight was fitted, with random intercepts and random slopes. Multivariate-adjusted coefficients with 95% CIs were computed for the determinants of weight at baseline and weight change between visits.ResultsThere was an average crude increase of 0.11 kg of measured weight per calendar year (95% CI 0.05 to 0.17). In a multivariate model, despite not explaining differences in weight between women at baseline, years of fertile life were associated with individual weight change: −0.34 kg/year for women with up to 21 years of fertile life, whereas after that, weight increased progressively more with increasing fertile time (21.1–34 years: −0.34 kg+0.42 kg=0.08 kg; 34.1–41 years: −0.34 kg+0.46 kg=0.12 kg) up to 0.44 kg/year above 41 years. Height, age, education, marital status, residential neighbourhood deprivation, number of children delivered and use of oral contraceptives, influenced interindividual weight variation at baseline, but did not influence weight change from baseline to follow-up.ConclusionsCross-sectional determinants of weight and those of weight change over time are vary. Reproductive factors play important roles in explaining both differences among women as well as in individual weight change over time.
Benchmarking lava-flow models
Authors: Cordonnier B. , Lev E. , Garel F. 
Published: July 2015

Abstract
Prediction of the emplacement of volcanic mass flows (lava flows, pyroclastic density currents, debris avalanches and debris flows) is required for hazard and risk assessment, and for the planning of risk-mitigation measures. Numerical computer-based models now exist that are capable of approximating the motion of a given volume of volcanic material from its source to the deposition area. With these advances in technology, it is useful to compare the various codes in order to evaluate their respective suitability for real-time forecasting, risk preparedness and post-eruptive response. A ‘benchmark’ compares codes or methods, all aimed at simulating the same physical process using common initial and boundary conditions and outputs, but using different physical formulations, mathematical approaches and numerical techniques. We set up the basis for a future general benchmarking exercise on volcanic mass-flow models and, more specifically, establish a benchmark series for computational lava-flow modelling. We describe a set of benchmarks in this paper, and present a few sample results to demonstrate output analysis and code evaluation methodologies. The associated web-based communal facility for sharing test scenarios and results is also described.
Cyclophosphamide-Mediated Tumor Priming for Enhanced Delivery and Antitumor Activity of HER2-Targeted Liposomal Doxorubicin (MM-302)
Authors: Geretti Elena , Leonard Shannon Curtis , Dumont Nancy , Lee Helen , Zheng Jinzi , De Souza Raquel , Gaddy Daniel F. , Espelin Christopher W. , Jaffray David A. , Moyo Victor , Nielsen Ulrik B. , Wickham Thomas J. , Hendriks Bart S. 
Published: July 2015

Abstract
Given the bulky nature of nanotherapeutics relative to small molecules, it is hypothesized that effective tumor delivery and penetration are critical barriers to their clinical activity. HER2-targeted PEGylated liposomal doxorubicin (MM-302, HER2-tPLD) is an antibody–liposomal drug conjugate designed to deliver doxorubicin to HER2-overexpressing cancer cells while limiting uptake into nontarget cells. In this work, we demonstrate that the administration and appropriate dose sequencing of cyclophosphamide can improve subsequent MM-302 delivery and enhance antitumor activity in preclinical models without negatively affecting nontarget tissues, such as the heart and skin. We demonstrate that this effect is critically dependent on the timing of cyclophosphamide administration. Furthermore, the effect was found to be unique to cyclophosphamide and related analogues, and not shared by other agents, such as taxanes or eribulin, under the conditions examined. Analysis of the cyclophosphamide-treated tumors suggests that the mechanism for improved MM-302 delivery involves the induction of tumor cell apoptosis, reduction of overall tumor cell density, substantial lowering of interstitial fluid pressure, and increasing vascular perfusion. The novel dosing strategy for cyclophosphamide described herein is readily translatable to standard clinical regimens, represents a potentially significant advance in addressing the drug delivery challenge, and may have broad applicability for nanomedicines. This work formed the basis for clinical evaluation of cyclophosphamide for improving liposome deposition as part of an ongoing phase I clinical trial of MM-302 in HER2-positive metastatic breast cancer. Mol Cancer Ther; 14(9); 2060–71. ©2015 AACR.
Critical Analysis of the Supportive and Suppressive Factors for the Children’s Literature Program in Malaysia
Authors: Mustakim Siti Salina , Mustapha Ramlee , Lebar Othman 
Published: July 2015

Literature in Education (LIE) is aimed at enhancing the pupils’ linguistic competence by providing an early beginning to a foundation in literature and literary works. In 2006, the literature component was introduced to pupils in Malaysian primary schools through two programs: Contemporary Children’s Literature (CCL) and Extensive Reading Program. The literature program is viewed as a vehicle to provide an early exposure to pupils on literary genres to enhance their understanding and appreciation of people’s cultures, values, and traditions. The primary aim of this study was to evaluate the provision of support, resources, training, and time allocation in the implementation of children’s literature among upper primary school teachers in Malaysia via the utilization of survey questionnaires, classroom observations and interviews. This study was conducted in a district in the state of Selangor. A sample of 56 upper primary school teachers from 19 schools were selected to answer the survey questionnaires. Interviews were conducted in one selected school in the District. The school was chosen based on the highest academic performance in the Malaysia Standard Examination for Primary Schools. Data were analyzed using SPSS version 19, and coded manually. Findings from survey indicated that 75% of the school management understand the objectives and goals of CCL in order to provide effective support to the program. Majority of the respondents (82%) agreed that the school management has allowed the English Language Department to manage its own expenses or resources for the program. Almost three-fourths (71.4%) of the respondents agreed that the provision of training and resources has produced capable and knowledgeable teachers to teach literature. However, the majority of the respondents (76.8%) disagreed that the time allocation provides sufficient time for them to fulfil the requirements of teaching two textbooks in a year. Interview data confirming the survey data reveal that the respondents were less satisfied with the time allocation to conduct their lesson for literature.
How to Develop Character Education of Madrassa Students in Indonesia
Authors: Abu Lukman , Mokhtar Mahani , Hassan Zainudin , Darmanita Suhan Siti Zakiah 
Published: July 2015

In the last decades, the teachers criticized for failing to integrate the knowledge in the behavior of virtue. Therefore the character education is always considered in every design education, including in madrassas. The character education is the deliberate attempt to influence the behavior of students through customizing repeatedly. making it easy to do virtue and avoid crime. The research has focused on the approach to character education at madrassa. The qualitative method by interviewing, observation, and focus groups have been used in this study.A total of 16 teachers at four madrassas in South Sulawesi has been selected through purposive Sampling. The research suggest: Madrassa teachers have not managed to practice the concept of teaching character. Both conceptually and contextually. The failure of conceptually caused teachers do not embed character values are extracted from the behavior of student’s virtue. While the failure of the contextually is has caused teachers failed in an attempt to develop character values, such as social relationships, honesty, and discipline. In addition, the teachers are not managed to practice courteous and not empowered to detain students of behavior lie.
Low-Flow, Low-Gradient Severe Aortic Stenosis in the Setting of Constrictive Pericarditis
Authors: Tsang Michael Y.C. , Choi Jin-Oh , Borlaug Barry A. , Greason Kevin L. , Cha Stephen S. , Nishimura Rick A. , Oh Jae K. 
Published: July 2015

Background—
Low-flow, low-gradient aortic stenosis (AS), associated with a poor prognosis, can be caused by a reduced stroke volume despite a preserved ejection fraction (left ventricular ejection fraction). We hypothesized that impaired ventricular diastolic filling secondary to constrictive pericarditis (CP) could contribute to reduced transaortic gradients in patients with AS+CP. We sought to examine the characteristics and outcomes of this unique cohort.

Methods and Results—

We analyzed 84 patients with different degrees of AS and preserved left ventricular ejection fraction (≥50%): 28 diagnosed with concomitant CP by echocardiography and 56 patients without CP matched by age, sex, and AS severity during 1998 to 2013. Prior mediastinal radiation (32.1% versus 5.4%;
P
=0.0072) and cardiac surgery (50.0% versus 3.6%;
P
=0.0016) were more common in AS+CP patients than those with AS only. AS+CP patients had lower left ventricular stroke volume index and mean transaortic gradients. Five-year survival was 34.3% for AS+CP patients and 89.1% for those with AS only (
P
<0.001). In univariate analysis, prior mediastinal radiation (hazard ratio, 8.35; 95% confidence interval, 3.38–20.62;
P
<0.001), reduced left ventricular stroke volume index of <35 mL/m
2
(hazard ratio, 12.52; 95% confidence interval, 3.97–39.48;
P
<0.001), and concomitant CP (hazard ratio, 13.65; 95% confidence interval, 4.85–38.41;
P
<0.001) were highly associated with increased mortality.

Conclusions—
Our findings highlighted the possibility of CP as a pathophysiological mechanism for low-flow, low-gradient AS. Left ventricular stroke volume index and transaortic gradients were commonly reduced in AS in the setting of CP despite a preserved left ventricular ejection fraction, which may result in underestimation of AS severity. Prior mediastinal radiation, lower left ventricular stroke volume index, and concomitant CP were associated with poorer survival in AS patients.