bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality indicators for palliative and end of life care: a review of Swedish policy documents
Authors: Lind Susanne , Adolfsson Jan , Axelsson Bertil , Fürst Carl Johan 
Published: March 2013

BackgroundAll patients with palliative and end of life care needs should be guaranteed equal and safe treatment and care, regardless of their disease or site of care. The inclusion of quality indicators in national guidelines and other guiding documents supports quality assurance and improvement in provision of care. The aim of this paper was to review existing quality indicators in national Swedish policy documents relevant to palliative and end of life care.MethodsWe reviewed existing guidelines for diseases expected to require palliative care issued by the National Board of Health and Welfare, existing regional clinical practice guidelines and the annual report of the Swedish Register of Palliative Care (SRPC) up until 2010.ResultsWe found 11 quality indicators pertinent to palliative and end of life care in the guidelines for cancer diseases and ‘The care and nursing of the elderly’. The indicators included assessment and treatment of pain, communication with the patient and the family, documentation in the patient record and registration in the SRPC. In the national guidelines for cardiology, pulmonary diseases, stroke, diabetes and dementia, there were no indicators relevant for palliative or end of life care.ConclusionsIn the existing Swedish national guidelines for many different diseases, there is still a great need to define clinically relevant and feasible outcome measures of quality of palliative and end of life care.
Point-of-care testing improves accuracy of STI care in an emergency department
Authors: Huppert Jill S , Taylor Regina G , St Cyr Sarah , Hesse Elizabeth A , Reed Jennifer L 
Published: March 2013

ObjectivesWe aimed to examine the impact of a point-of-care (POC) test on overtreatment and undertreatment of sexually transmitted infections (STIs) by comparing treatment patterns for gonorrhoea (detected with nucleic acid amplification testing (NAAT)) with trichomoniasis (detected by POC test) for young women seen in an emergency department (ED).MethodsWe reviewed the database of a quality improvement (QI) project that aims to improve follow-up care for STIs in the ED. Data included the test result and antibiotic given (if any) during visits by women age 14–21 for whom an STI test was ordered. We generated Shewhart control charts and compared overtreatment and undertreatment rates for gonorrhoea and trichomoniasis using χ2testing.ResultsOf 1877 visits over 18 months, 8.8% of women had gonorrhoea and 16.5% had trichomoniasis. Overtreatment was higher for women with gonorrhoea than trichomoniasis (54% vs 23%, p<0.001). Overtreatment for gonorrhoea decreased from 58% to 47% (p<0.01) and overtreatment for trichomoniasis decreased from 24% to 18% (p<0.01), which corresponded to improvements in patient follow-up for the QI project. Undertreatment was higher for women with gonorrhoea than trichomoniasis (29% vs 21%, p=0.03), and did not change over time.ConclusionsA POC test improves the accuracy of STI care in an ED compared with NAAT testing. An unanticipated benefit of QI efforts to improve patient follow-up is the observed decrease in antibiotic use in the ED. Given the ability of gonorrhoea to develop antibiotic resistance, future efforts should focus on development of an accurate POC test for gonorrhoea.
Polygon mesh repairing
Authors: Attene Marco , Campen Marcel , Kobbelt Leif 
Published: March 2013

Nowadays, digital 3D models are in widespread and ubiquitous use, and each specific application dealing with 3D geometry has its own quality requirements that restrict the class of acceptable and supported models. This article analyzes typical defects that make a 3D model unsuitable for key application contexts, and surveys existing algorithms that process, repair, and improve its structure, geometry, and topology to make it appropriate to case-by-case requirements.
The analysis is focused on polygon meshes, which constitute by far the most common 3D object representation. In particular, this article provides a structured overview of mesh repairing techniques from the point of view of the application context. Different types of mesh defects are classified according to the upstream application that produced the mesh, whereas mesh quality requirements are grouped by representative sets of downstream applications where the mesh is to be used. The numerous mesh repair methods that have been proposed during the last two decades are analyzed and classified in terms of their capabilities, properties, and guarantees. Based on these classifications, guidelines can be derived to support the identification of repairing algorithms best-suited to bridge the compatibility gap between the quality provided by the upstream process and the quality required by the downstream applications in a given geometry processing scenario.
Molecular Pathways: Inhibiting Steroid Biosynthesis in Prostate Cancer
Authors: Ferraldeschi Roberta , Sharifi Nima , Auchus Richard J. , Attard Gerhardt 
Published: March 2013

AbstractA significant proportion of castration-resistant prostate cancers (CRPC) remains driven by ligand activation of the androgen receptor. Although the testes are the primary source of testosterone, testosterone can also be produced from peripheral conversion of adrenal sex hormone precursors DHEA and androstenedione in the prostate and other tissues. CYP17A1 catalyzes two essential reactions in the production of DHEA and androstenedione: the hydroxylation (hydroxylase activity) and the subsequent cleavage of the C17-20 side chain (lyase activity). Potent and selective inhibition of CYP17A1 by abiraterone depletes residual nongonadal androgens and is an effective treatment for CRPC. Elucidation of the mechanisms that underlie resistance to abiraterone will inform the development of novel therapeutic strategies post-abiraterone. Preclinical evidence that androgen biosynthesis in prostate cancer cells does not necessarily follow a single dominant pathway, and residual androgens or alternative ligands (including administered glucocorticoids) can reactivate androgen receptor signaling, supports cotargeting of more than one enzyme involved in steroidogenesis and combining a CYP17A1 inhibitor with an antiandrogen. Furthermore, given the drawbacks of 17α-hydroxylase inhibition, there is considerable interest in developing new CYP17A1 inhibitors that more specifically inhibit lyase activity and are therefore less likely to require glucocorticoid coadministration. Clin Cancer Res; 19(13); 3353–9. ©2013 AACR.
Analysis of Tumor Specimens at the Time of Acquired Resistance to EGFR-TKI Therapy in 155 Patients with EGFR-Mutant Lung Cancers
Authors: Yu Helena A. , Arcila Maria E. , Rekhtman Natasha , Sima Camelia S. , Zakowski Maureen F. , Pao William , Kris Mark G. , Miller Vincent A. , Ladanyi Marc , Riely Gregory J. 
Published: March 2013

Abstract
Purpose: All patients with EGF receptor (EGFR)–mutant lung cancers eventually develop acquired resistance to EGFR tyrosine kinase inhibitors (TKI). Smaller series have identified various mechanisms of resistance, but systematic evaluation of a large number of patients to definitively establish the frequency of various mechanisms has not been conducted.
Experimental Design: Patients with lung adenocarcinomas and acquired resistance to erlotinib or gefitinib enrolled onto a prospective biopsy protocol and underwent a rebiopsy after the development of acquired resistance. Histology was reviewed. Samples underwent genotyping for mutations in EGFR, AKT1, BRAF, ERBB2, KRAS, MEK1, NRAS and PIK3CA, and FISH for MET and HER2.
Results: Adequate tumor samples for molecular analysis were obtained in 155 patients. Ninety-eight had second-site EGFR T790M mutations [63%; 95% confidence interval (CI), 55%–70%] and four had small cell transformation (3%, 95% CI, 0%–6%). MET amplification was seen in 4 of 75 (5%; 95% CI, 1%–13%). HER2 amplification was seen in 3 of 24 (13%; 95% CI, 3%–32%). We did not detect any acquired mutations in PIK3CA, AKT1, BRAF, ERBB2, KRAS, MEK1, or NRAS (0 of 88, 0%; 95% CI, 0%–4%). Overlap among mechanisms of acquired resistance was seen in 4%.
Conclusions: This is the largest series reporting mechanisms of acquired resistance to EGFR-TKI therapy. We identified EGFR T790M as the most common mechanism of acquired resistance, whereas MET amplification, HER2 amplification, and small cell histologic transformation occur less frequently. More comprehensive methods to characterize molecular alterations in this setting are needed to improve our understanding of acquired resistance to EGFR-TKIs. Clin Cancer Res; 19(8); 2240–7. ©2013 AACR.
An Unholy Alliance: Cooperation between BRAF and NF1 in Melanoma Development and BRAF Inhibitor Resistance
Authors: Gibney Geoffrey T. , Smalley Keiran S.M. 
Published: March 2013

Abstract
Summary: In this issue of Cancer Discovery, 2 studies provide new evidence implicating loss of the tumor suppressor neurofibromin (NF1) in the biologic behavior of cutaneous melanoma. The first study from Maertens and colleagues describes a new transgenic mouse model in which mutant BRAF cooperates with NF1 loss to drive melanoma development through the abrogation of oncogene-induced senescence. The second, from Whittaker and colleagues, used a high-throughput short hairpin RNA screening approach to identify NF1 loss as a key mediator of acquired and intrinsic BRAF inhibitor resistance. Together these studies provide new insights into the signaling that underlies melanoma initiation and progression and suggests novel therapeutic strategies for patients whose melanomas are BRAF-mutant/NF1-deficient. Cancer Discov; 3(3); 260–3. ©2013 AACR.
See related article by Maertens et al., p. 338
See related article by Whittaker et al., p. 350
Bcl-2 Inhibition or FBXW7 Mutation Sensitizes Solid Tumor Cells to HDAC Inhibition In Vitro but Could Prove Difficult to Validate in Patients
Authors: Pickering Curtis R. , Myers Jeffrey N. 
Published: March 2013

Abstract
Summary: In this issue of Cancer Discovery, He and colleagues determined that Mcl-1 levels are a key factor in the response to histone deacetylase (HDAC) inhibitors, and FBXW7 mutation is a biomarker for sensitivity to HDAC inhibition. They also present evidence for synergy between treatment with HDAC inhibitors and Bcl-2–targeted therapeutics. These data provide an exciting new biomarker and combination therapy that should be evaluated clinically. Cancer Discov; 3(3); 258–9. ©2013 AACR.
See related article by He et al., p. 324
Polymorphism in Endothelial Connexin40 Enhances Sensitivity to Intraluminal Pressure and Increases Arterial Stiffness
Authors: Chaston Daniel J. , Baillie Brett K. , Grayson T. Hilton , Courjaret Raphael J. , Heisler Jillian M. , Lau Katherine A. , Machaca Khaled , Nicholson Bruce J. , Ashton Anthony , Matthaei Klaus I. , Hill Caryl E. 
Published: March 2013

Objective—
To determine whether impairment of endothelial connexin40 (Cx40), an effect that can occur in hypertension and aging, contributes to the arterial dysfunction and stiffening in these conditions.

Approach and Results—
A new transgenic mouse strain, expressing a mutant Cx40, (Cx40T202S), specifically in the vascular endothelium, has been developed and characterized. This mutation produces nonfunctional hemichannels, whereas gap junctions containing the mutant are electrically, but not chemically, patent. Mesenteric resistance arteries from Cx40T202S mice showed increased sensitivity of the myogenic response to intraluminal pressure in vitro, compared with wild-type mice, whereas transgenic mice overexpressing native Cx40 (Cx40Tg) showed reduced sensitivity. In control and Cx40Tg mice, the sensitivity to pressure of myogenic constriction was modulated by both NO and endothelium-derived hyperpolarization; however, the endothelium-derived hyperpolarization component was absent in Cx40T202S arteries. Analysis of passive mechanical properties revealed that arterial stiffness was enhanced in vessels from Cx40T202S mice, but not in wild-type or Cx40Tg mice.

Conclusions—
Introduction of a mutant form of Cx40 in the endogenous endothelial Cx40 population prevents endothelium-derived hyperpolarization activation during myogenic constriction, enhancing sensitivity to intraluminal pressure and increasing arterial stiffness. We conclude that genetic polymorphisms in endothelial Cx40 can contribute to the pathogenesis of arterial disease.
Comparison of Clinical Interpretation With Visual Assessment and Quantitative Coronary Angiography in Patients Undergoing Percutaneous Coronary Intervention in Contemporary Practice
Authors: Nallamothu Brahmajee K. , Spertus John A. , Lansky Alexandra J. , Cohen David J. , Jones Philip G. , Kureshi Faraz , Dehmer Gregory J. , Drozda Joseph P. , Walsh Mary Norine , Brush John E. , Koenig Gerald C. , Waites Thad F. , Gantt D. Scott , Kichura George , Chazal Richard A. , O’Brien Peter K. , Valentine C. Michael , Rumsfeld John S. , Reiber Johan H.C. , Elmore Joann G. , Krumholz Richard A. , Weaver W. Douglas , Krumholz Harlan M. 
Published: March 2013

Background—
Studies conducted decades ago described substantial disagreement and errors in physicians’ angiographic interpretation of coronary stenosis severity. Despite the potential implications of such findings, no large-scale efforts to measure or improve clinical interpretation were subsequently undertaken.

Methods and Results—

We compared clinical interpretation of stenosis severity in coronary lesions with an independent assessment using quantitative coronary angiography (QCA) in 175 randomly selected patients undergoing elective percutaneous coronary intervention at 7 US hospitals in 2011. To assess agreement, we calculated mean difference in percent diameter stenosis between clinical interpretation and QCA and a Cohen weighted κ statistic. Of 216 treated lesions, median percent diameter stenosis was 80.0% (quartiles 1 and 3, 80.0% and 90.0%), with 213 (98.6%) assessed as ≥70%. Mean difference in percent diameter stenosis between clinical interpretation and QCA was 8.2±8.4%, reflecting an average higher percent diameter stenosis by clinical interpretation (
P
<0.001). A weighted κ of 0.27 (95% confidence interval, 0.18–0.36) was found between the 2 measurements. Of 213 lesions considered ≥70% by clinical interpretation, 56 (26.3%) were <70% by QCA, although none were <50%. Differences between the 2 measurements were largest for intermediate lesions by QCA (50% to <70%), with variation existing across sites.

Conclusions—
Physicians tended to assess coronary lesions treated with percutaneous coronary intervention as more severe than measurements by QCA. Almost all treated lesions were ≥70% by clinical interpretation, whereas approximately one quarter were <70% by QCA. These findings suggest opportunities to improve clinical interpretation of coronary angiography.
Endothelial Dysfunction and Arterial Stiffness in Ischemic Stroke
Authors: Cereda Carlo W. , Tamisier Renaud , Manconi Mauro , Andreotti Jennifer , Frangi Jane , Pifferini Valeria , Bassetti Claudio L. 
Published: March 2013

Background and Purpose—
Sleep-disordered breathing (SDB) represents a risk factor for cardiovascular morbidity after a cerebral ischemic event (acute ischemic event, ischemic stroke, or transient ischemic attack). In the present study, endothelial function and arterial stiffness were analyzed in patients who experienced a postacute ischemic event with relation to SDB, sleep disruption, and nocturnal oxygenation parameters.

Methods—
SDB was assessed by full polysomnography in patients with acute ischemic event 3 months after the admission at our stroke unit. Moderate-severe SDB was defined according to the apnea-hypopnea index as apnea-hypopnea index ≥20. Endothelial function and arterial stiffness were assessed by peripheral arterial tonometry using Endo-PAT 2000.

Results—

Thirty-seven patients were included. The augmentation index was significantly different between patients with apnea-hypopnea index <20 and apnea-hypopnea index ≥20 (22.4±15.6% versus 34.6±21.6%;
P
=0.042), whereas reactive hyperemia index level was not (2.02±0.65 versus 2.31±0.61;
P
=0.127). Patients with apnea-hypopnea index ≥20 showed an increased risk for arterial stiffness (odds ratio, 5.98 [95% CI, 1.11–41.72]) even when controlling for age, sex, body mass index, hypertension, and diabetes mellitus. The augmentation index was correlated with the arousal index (
P
=0.010) and with mean O
2
saturation (
P
=0.043).

Conclusions—

Poststroke patients with moderate-severe SDB were more prone to have increased arterial stiffness, although we did not find significant differences in endothelial function. Arterial stiffness also correlated with sleep disruption (arousal index) and mean O
2
saturation.
Troponin T, N-Terminal Pro–B-Type Natriuretic Peptide, and Incidence of Stroke
Authors: Folsom Aaron R. , Nambi Vijay , Bell Elizabeth J. , Oluleye Oludamilola W. , Gottesman Rebecca F. , Lutsey Pamela L. , Huxley Rachel R. , Ballantyne Christie M. 
Published: March 2013

Background and Purpose—
Increased levels of plasma troponins and natriuretic peptides are associated with increased risk of cardiovascular disease, but only limited information exists on these biomarkers and stroke occurrence. In a prospective epidemiological study, we tested the hypothesis that high-sensitivity troponin T (TnT) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) are associated positively with incidence of stroke.

Methods—
The Atherosclerosis Risk in Communities (ARIC) Study measured plasma TnT and NT-proBNP in 10 902 men or women initially free of stroke and followed them for a mean of 11.3 years for stroke occurrence (n=507).

Results—
Both biomarkers were associated positively with total stroke, nonlacunar ischemic, and especially cardioembolic stroke, but not with lacunar or hemorrhagic stroke. For example, after adjustment for prevalent risk factors and cardiac diseases, the hazard ratios (95% CIs) for jointly high values of TnT and NT-proBNP (versus neither biomarker high) were 2.70 (1.92–3.79) for total stroke and 6.26 (3.40–11.5) for cardioembolic stroke. Associations with stroke appeared somewhat stronger for NT-proBNP than TnT. Strikingly, ≈58% of cardioembolic strokes occurred in the highest quintile of prestroke NT-proBNP, and 32% of cardioembolic strokes occurred in participants who had both NT-proBNP in the highest quintile and were known by ARIC to have atrial fibrillation sometime before their cardioembolic stroke occurrence.

Conclusions—
In the general population, elevated plasma TnT and NT-proBNP concentrations are associated with increased risk of cardioembolic and other nonlacunar ischemic strokes.
Goodman's Method of Analysis for Multivariate Data — a Practical Application
Authors: Simon A. 
Published: March 2013

Goodman's method of multivariate analysis is designed for use with nominal and ordinal data, extends to non-recursive models and can explain large variation in the data with residuals greater than 0,9 commonplace. A practical application of this method to a study of factors related to intended emigration by a group of students at the University of the Witwatersrand indicated that the best hypothesis-selected on the basis of a low Chi Square likelihood ratio coupled with a low degree of freedom-explained 97,3% of the data. ‘Religion’ was the variable most directly influentially related to ‘settle’ followed by what students considered the prospects for the future of Whites in South Africa to be, followed by attitudes towards the apartheid policy and ‘religiosity’ in that order. Specific related interlinks could not be omitted from the model, the strongest concerning students who disagreed with the apartheid policy and felt the prospects for the future of Whites were poor.
Cross-Cultural Psychology: An Eclectic and Idiosyncratic View
Authors: Deregowski J.B. 
Published: March 2013

The paper argues that cross-cultural psychology is not a discipline within the broad field of psychology but an approach to the subject. It describes briefly some of the applications of this approach to the studies of perception and traces the effects and possible effects of these on psychology in general and on further crosscultural works. Although applications of psychology are recognized as important, the paper is primarily concerned with theoretical issues and draws especial attention to the benefits which may accrue from symbiosis between cross-cultural psychology and ethnography. Some of the hostile reactions which cross-cultural psychology occasionally provokes are briefly dealt with.
'n Groeptegniek vir die hantering van depressie
Authors: Nel C.M. , Nel J.A. 
Published: March 2013

Depressie is vandag 'n algemene probleem in die gemeenskap. Dit manifesteer byvoorbeeld die studentebevolking as 'n verskynsel wat minstens een derde van alle studente raak. Hierdie hoë voorkoms van depressie plaas groot druk op die personeel van studentevoorligtingsburo's. 'n Wyse wat aangewend kan word om hierdie druk te verlig, is om van groeptegnieke gebruik te maak. Een tegniek wat in die buiteland suksesvol aangewend is, is een wat 'n kombinasie van RET en gedragsmodifikasiebeginsels gebruik. Indien hierdie tegniek onder Suid-Afrikaanse omstandighede goeie rekenskap kan gee, kan dit 'n aansienlike bydrae tot die oplossing van bogenoemde probleem maak. In 'n eenrigting variansie-analise is hierdie tegniek as een vlak van die onafhanklike veranderlike en die Beck depressievraelys as die afhanklike veranderlike gebruik. Die resultaat toon dat die strategie effektief kan wees, mits die groepsdinamiese fasette wat met groepsterapie gepaard gaan, in orde is.
An Evaluation of the Utility of Expectancy Theory in Studying the Turnover of Nurses
Authors: Birkenbach X.C. , van der Merwe Roux 
Published: March 2013

Although expectancy theory has been widely used in organizational behaviour research to study the motivation of individuals, its application in the field of turnover research has been limited. The aim of the present study was to assess the usefulness of the approach in the study of turnover behaviour of hospital nurses. In terms of the propositions of the theory, desirability of outcomes (valence) and expectancies about the achievement of these outcomes in the nursing work role as well as alternative work roles were assessed. The univariate results of the study showed that while nurses who left their jobs and those who remained did not differ significantly with regard to their nursing work roles, there were significant differences between the groups in their evaluations of alternative work roles. This finding underlined the importance of examining employees' perceptions of other work roles in employee turnover research. The results of the bivariate analysis revealed that the expectancy theory measures were not particularly good predictors of turnover. However, correlations with nurses' job satisfaction and organizational commitment were comparatively high and significant. It was concluded from the correlational analysis that respondents' ratings of expectancies of achieving outcomes were better predictors of the dependent variables than the traditional approach to operationalizing expectancy theory measures, namely, expectancies weighted by desirabilities.
Preliminary Standardization of the Durrell Listening-Reading Series
Authors: Doctor Estelle A. , Becker Margaret A. , Kulutbanis Georgette 
Published: March 2013

A preliminary item analysis of the ‘Durrell Listening-Reading Series’ was carried out on 380 English-speaking, Standard 3 children. This test is unique in that it provides comparable measures of reading and aural comprehension. The results indicated that although the performance of the South African children compared favourably with that of the American children on this test, it would be necessary to adapt the test extensively in order to make it more suitable for South African usage.