bluuebunny/crossref_metadata_2025_split huggingface dataset:
False negative rate for intraoperative sentinel lymph node frozen section in patients with breast cancer: a retrospective analysis of patients in a single Asian institution
Authors: Wong Jolene , Yong Wei Sean , Thike Aye Aye , Iqbal Jabed , Salahuddin Ahmed Syed , Ho Gay Hui , Madhukumar Preetha , Tan Benita Kiat Tee , Ong Kong Wee , Tan Puay Hoon 
Published: April 2015

Background and objectiveIntraoperative frozen section of the sentinel lymph node (SLN) in clinically node negative breast cancer patients detects metastatic disease and enables axillary lymph node dissection to be performed in the same operative setting. Internationally, the false negative rate (FNR) for SLN biopsy ranges from 5.5% to 43%. The size of SLN metastasis has been identified as a key factor affecting FNR. We review our institutional experience on the accuracy of intraoperative SLN biopsy.MethodsData were collected retrospectively from patients undergoing SLN biopsy performed at Singapore General Hospital. The SLN was identified using blue dye, radioisotope or both. Frozen section was performed intraoperatively. When SLN was positive for metastasis on frozen section, completion axillary clearance was performed. False negative cases were defined as patients in whom a negative frozen section result was obtained, whose final permanent paraffin section was positive. We determined the FNR of SLN frozen section and evaluated the factors associated with it.ResultsA total of 2202 SLN biopsies were performed between January 2005 and June 2012. There were 89 false negative cases, of which there were 23 (25.8%) cases of isolated tumour cells (ITCs), 49 (55.1%) cases of micrometastasis, and 17 (19.1%) cases of macrometastasis. The overall FNR was 13.5%. FNR was 79.3% in ITCs, 59.8% in micrometastasis, and 3.1% in macrometastatic disease. Non-ductal histological subtype, absence of lymphovascular invasion and the size of SLN metastasis were identified as significant independent factors associated with a higher FNR.ConclusionsFNRin our institution is acceptable when compared to other large centres. Failure to detect metastasis in frozen section in more than half of our patients was due to ITCs and micrometastasis.
Complexities of Some Problems Related to Synchronizing, Non-Synchronizing and Monotonic Automata
Authors: Türker Uraz Cengiz , Yenigün Hüsnü 
Published: April 2015

In this study, we first introduce several problems related to finding reset words for deterministic finite automata, and present motivations for these problems for practical applications in areas such as robotics and bio-engineering. We then analyse computational complexities of these problems. Second, we consider monotonic and partially specified automata. Monotonicity is known to be a feature simplyfing the synchronizability problems. On the other hand for partially specified automata, synchronizability problems are known to be harder than the completely specified automata. We investigate the complexity of some synchronizability problems for automata that are both monotonic and partially specified. We show that checking the existence, computing one, and computing a shortest reset word for a monotonic partially specified automaton is NP-hard. We also show that finding a reset word that synchronizes 𝓚 number of states (or maximum number of states) of a given monotonic non-synchronizable automaton to a given set of states is NP-hard.
Vimentin–ERK Signaling Uncouples Slug Gene Regulatory Function
Authors: Virtakoivu Reetta , Mai Anja , Mattila Elina , De Franceschi Nicola , Imanishi Susumu Y. , Corthals Garry , Kaukonen Riina , Saari Markku , Cheng Fang , Torvaldson Elin , Kosma Veli-Matti , Mannermaa Arto , Muharram Ghaffar , Gilles Christine , Eriksson John , Soini Ylermi , Lorens James B. , Ivaska Johanna 
Published: April 2015

Abstract
Epithelial–mesenchymal transition (EMT) in cells is a developmental process adopted during tumorigenesis that promotes metastatic capacity. In this study, we advance understanding of EMT control in cancer cells with the description of a novel vimentin–ERK axis that regulates the transcriptional activity of Slug (SNAI2). Vimentin, ERK, and Slug exhibited overlapping subcellular localization in clinical specimens of triple-negative breast carcinoma. RNAi-mediated ablation of these gene products inhibited cancer cell migration and cell invasion through a laminin-rich matrix. Biochemical analyses demonstrated direct interaction of vimentin and ERK, which promoted ERK activation and enhanced vimentin transcription. Consistent with its role as an intermediate filament, vimentin acted as a scaffold to recruit Slug to ERK and promote Slug phosphorylation at serine-87. Site-directed mutagenesis established a requirement for ERK-mediated Slug phosphorylation in EMT initiation. Together, these findings identified a pivotal step in controlling the ability of Slug to organize hallmarks of EMT. Cancer Res; 75(11); 2349–62. ©2015 AACR.
Benefits of prophylaxis versus on-demand treatment in adolescents and adults with severe haemophilia A: the POTTER study
Authors: Feola Giulio , Molinari Angelo Claudio , Santoro Cristina , Rivolta Gianna Franca , Cultrera Dorina Bianca , Gagliano Fabio , Zanon Ezio , Mancuso Maria Elisa , Valdrè Lelia , Mameli Luciana , Amoresano Susanna , Mathew Prasad , Coppola Antonio , Tagliaferri Annarita ,   for the POTTER Study Group
Published: April 2015

SummaryRigorous evidence is lacking on long-term outcomes of factor VIII (FVIII) prophylaxis initiated in adolescent or adult patients with severe haemophilia A. The prospective, open-label Prophylaxis versus On-demand Therapy Through Economic Report (POTTER) study (Clinical-Trials.gov NCT01159587) compared long-term late secondary prophylaxis (recombinant FVIII-FS 20–30 IU/kg thrice weekly) with on-demand treatment in patients aged 12 to 55 years with severe haemophilia A. The annual number of joint bleeding episodes (primary endpoint), total bleeding episodes, orthopaedic and radiologic (Pettersson) scores, health-related quality of life (HRQoL), pharmacoeconomic impact, and safety were evaluated over a > 5-year period (2004–2010). Fifty-eight patients were enrolled at 11 centres in Italy; 53 (27 prophylaxis, 26 on demand) were evaluated and stratified into 2 age subgroups (12–25 and 26–55 years). Patients receiving prophylaxis experienced a significantly lower number of joint bleeding episodes vs the on–demand group (annualised bleeding rate, 1.97 vs 16.80 and 2.46 vs 16.71 in younger and older patients, respectively; p=0.0043). Results were similar for total bleeding episodes. Prophylaxis was associated with significantly fewer target joints (p< 0.001), better orthopaedic (p=0.0019) and Pettersson (p=0.0177) scores, better HRQoL, and fewer days of everyday activities lost (p< 0.0001) but required significantly higher FVIII product consumption. The POTTER study is the first prospective, controlled trial documenting long-term benefits of late secondary prophylaxis in adolescents and adults with severe haemophilia A. The benefits of reduced bleeding frequency, improved joint status, and HRQoL may offset the higher FVIII consumption and costs.
Contrast-Enhanced Ultrasound Assessment of Impaired Adipose Tissue and Muscle Perfusion in Insulin-Resistant Mice
Authors: Belcik J. Todd , Davidson Brian P. , Foster Ted , Qi Yue , Zhao Yan , Peters Dawn , Lindner Jonathan R. 
Published: April 2015

Background—
In diabetes mellitus, reduced perfusion and capillary surface area in skeletal muscle, which is a major glucose storage site, contribute to abnormal glucose homeostasis. Using contrast-enhanced ultrasound, we investigated whether abdominal adipose tissue perfusion is abnormal in insulin resistance and correlates with glycemic control.

Methods and Results—

Contrast-enhanced ultrasound perfusion imaging of abdominal adipose tissue and skeletal muscle was performed in obese insulin resistance (db/db) mice at 11 to 12 or 14 to 16 weeks of age and in control lean mice. Time–intensity data were analyzed to quantify microvascular blood flow (MBF) and capillary blood volume (CBV). Blood glucose response for 1 hour was measured after insulin challenge (1 U/kg, IP). Compared with control mice, db/db mice at 11 to 12 and 14 to 16 weeks had a higher glucose concentration area under the curve after insulin (11.8±2.8, 20.6±4.3, and 28.4±5.9 mg·min/dL [×1000], respectively;
P
=0.0002) and also had lower adipose MBF (0.094±0.038, 0.035±0.010, and 0.023±0.01 mL/min per gram;
P
=0.0002) and CBV (1.6±0.6, 1.0±0.3, and 0.5±0.1 mL/100 g;
P
=0.0017). The glucose area under the curve correlated in a nonlinear fashion with both adipose and skeletal muscle MBF and CBV. There were significant linear correlations between adipose and muscle MBF (
r
=0.81) and CBV (
r
=0.66). Adipocyte cell volume on histology was 25-fold higher in 14- to 16-week db/db versus control mice.

Conclusions—
Abnormal adipose MBF and CBV in insulin resistance can be detected by contrast-enhanced ultrasound and correlates with the degree of impairment in glucose storage. Abnormalities in adipose tissue and muscle seem to be coupled. Impaired adipose tissue perfusion is in part explained by an increase in adipocyte size without proportional vascular response.
Temperature Biases in Public Opinion Surveys
Authors: Potoski Matthew , Urbatsch R. , Yu Cindy 
Published: April 2015

AbstractThe quasi experiment of deviations from normal temperatures shows how local temperature conditions bias selected survey results. Responses in eight CBS News surveys from 2001 to 2007 change with the weather, with unseasonable temperatures reducing concern about climate change and unusually warm temperatures increasing presidential approval. Unusual temperatures also influence who answers surveys; wealthier respondents are overrepresented in warmer conditions. These results jointly suggest that surveys are at risk for temperature-induced response bias. Weighting-based methods can account for survey results’ temperature-induced differences in samples.
Prosthetics for Nasoseptal Perforations
Authors: Taylor Robert J. , Sherris David A. 
Published: April 2015

ObjectiveProsthetics serve as an option for nasoseptal perforation treatment in patients who have active systemic disease, are poor surgical candidates, or wish to avoid surgery. Through systematic review of the literature on prosthetics for nasoseptal perforation treatment, the objective of the present study is to critically appraise previous studies, evaluate the success rate for nasoseptal prosthetics, provide evidence‐based guidelines for nasoseptal prosthetic use, and identify areas for further investigation.Data SourcesCochrane Controlled Trials Register, EMBASE, PubMed, and Web of Science.Review MethodsData sources were queried for relevant articles published from 1965 to 2013. Articles were selected for inclusion if they presented primary data for human nasoseptal perforation treatment utilizing prosthetic materials. Each included article’s level of evidence and risk of bias were identified and grades of recommendation were assigned. A quantitative meta‐analysis was performed on articles with low risk of bias.ResultsThe search yielded 4756 abstracts for review, with 23 included case series and 5 case reports; 706 total cases of prosthetic nasoseptal perforation treatment were identified. All articles provided level 4 evidence, with an overall conclusion grade of C for improvement in nasoseptal perforation symptoms, prosthetic in situ rate, and complication rate. Meta‐analysis of 6 low‐risk‐of‐bias studies with 297 patients demonstrated an overall success rate of 65%.ConclusionsThe literature provides level 4 evidence for the efficacy and safety of prosthetics for nasoseptal perforation treatment with favorable success rates and few reports of complications—only 1 fungal infection and 9 unspecified infections—in 706 cases.
The adolescent’s experience when a parent has advanced cancer: A qualitative inquiry
Authors: Phillips Farya , Lewis Frances M 
Published: April 2015

Background: Parental cancer is a stressful experience for young people, constituting a potential threat to physical and mental health and normative development. Currently, there is insufficient information describing the sources and nature of this distress during advanced parental cancer, especially concerning families with adolescent children. Aim: To address the significant gap in the literature by providing the adolescent’s perspective on the impact of their parent’s advanced cancer on their lives. Design: This qualitative study involved single-occasion, semi-structured elicitation interviews with adolescents whose parents were diagnosed with advanced stage cancer. Setting/participants: The study sample consisted of seven adolescents from six families, five females and two males ranging in age from 11 to 15 years (mean = 13.6 years, standard deviation = 1.4 years). The ill parents consisted of four females and two males diagnosed with Stage IV cancer. Results: The core construct that organized study results was Weaving a Normal Life with Cancer which involved five major domains: feeling the weight of the world on my shoulders; cancer changes everything; confronting or getting away from the cancer; talking about it; and cancer was a positive for me … it taught me. Conclusion: Study findings shed light on how adolescents self-manage their parent’s advanced cancer and work to delimit the illness even as they are aware of its constant presence. Future research and intervention studies are needed to support and add to the adolescents’ self-management strategies to weave a normal life for themselves while in the throes of the cancer’s uncertainty and challenges with family communication.
Therapeutic Horse Riding: What Has This to Do with Occupational Therapists?
Authors: Bracher Maggie 
Published: April 2015

The horse has been used as a therapeutic medium since the time of the ancient Greeks and Xenophon is quoted as saying that ‘the best thing for the inside of a man is the outside of the horse’ (Longden 1998, p44). Man has been using horses for more than 3,500 years as draught horses or for riding; therefore, the man-horse relationship may be perceived ‘as a close psychophysical attachment’ (Schulz 1997, p65). The horse and its environment has been and continues to be used as a therapeutic tool for people with a wide range of needs and abilities, as is evidenced in the literature. This paper identifies some of the benefits and limitations of therapeutic horse riding and its relationship with occupational therapy, through a review of the literature and the use of case summaries from the author's personal experience.
Occupational Therapy, Gender and Mental Health: An Inclusive Perspective?
Authors: Pollard Nick , Walsh Sue 
Published: April 2015

This article offers an understanding of how the gendered nature of occupational therapy has an impact on relationships between therapist and client, qualified staff and support workers, and occupational therapy managers and workers. It analyses the development of occupational therapy from its early, mainly female and middle-class, origins and explores how the profession has struggled to define its status and role to fit structures determined by the medical profession. The tensions that these pressures have exerted on occupational therapy's original concerns with domestic and creative activities are considered, drawing on feminist theories and sociological interpretations of gender and professional development in the context of mental health. It is argued that in trying to meet medicine's demand for a more scientific occupational therapy as well as orientate rehabilitation to returning clients to work, occupational therapists risk, first, losing sight of their core domestic activities and traditional caring roles and, secondly, devaluing the skills and abilities of their support worker colleagues. The article suggests that occupational therapists should claim domestic activities as central to practice and reconsider the feminine principles of caring, connectedness and the importance of relationships to produce a wholly inclusive and reflective practice.
Variations in the Provision of Occupational Therapy for Patients Undergoing Primary Elective Total Hip Replacement in the United Kingdom
Authors: McMurray Robert , Heaton Janet , Sloper Patricia , Nettleton Sarah 
Published: April 2015

Despite growing interest in the potential of rehabilitation therapies to reduce patient dependency and maximise the benefits of surgical intervention, there is only limited information available on the nature of, and variation in, rehabilitation for common procedures such as total hip replacement. This paper describes the nature and variability of occupational therapy provision for patients undergoing primary elective total hip replacement in the United Kingdom, based on the results of a postal survey of National Health Service trusts providing orthopaedic surgery. A response rate of 69% (n=183) was obtained, yielding a final sample of 166 trusts. The widest variations in rehabilitation practice related to the provision of, and charges for, adaptive equipment; the presence of the therapist during preadmission clinics; the number of hours patients spent in contact with therapists during hospitalisation; and the provision of written information on the benefits of total hip replacement and the care of the hip beyond 3 months after surgery. These results suggest that considerable variation exists in the provision of occupational therapy for total hip replacement across the United Kingdom. Future research identifying the most effective configuration of therapeutic interventions is needed to inform the production of guidelines in this area.
Safe Use of Disability Equipment and Manual Handling: Legal Aspects — Part 1, Disability Equipment
Authors: Mandelstam Michael 
Published: April 2015

This is a two-part article about legal aspects of safety in two overlapping areas of work relevant to occupational therapists: disability equipment and manual handling. This first part, on safe use of equipment, considers negligence, consumer protection and health and safety at work law, including codes of practice, guidance and notices from bodies such as the Health and Safety Executive and the Medical Devices Agency. A number of common and relatively straightforward themes are picked out through what otherwise might appear to be a forbidding body of law; these are illustrated with practical examples. It is argued that in judging whether a particular action or omission was unlawful and breached safety obligations, the courts do not generally resort to incomprehensible principles. Instead, they often, in effect, simply hold up a mirror to the professional(s) involved and ask whether reasonably competent or practicable steps were taken. To the extent that this is so, it is clear that avoidance of legal liability is very much more within the power of occupational therapists and their employer organisations than is often supposed and that such avoidance is consonant both with patient and client welfare and with good professional practice.
Living with under-Fives: A Programme for Parents with a Mental Illness
Authors: Bassett Hazel , Lampe Jill , Lloyd Chris 
Published: April 2015

Parenthood is considered a major life role. Yet for people with a major mental illness, it is one that is fraught with difficulties and for which they receive the least support. Research on parenting and parenting programmes for people with a major mental illness is sparse and most of the papers presented do not provide a working model that can be easily replicated. This lack of support for parents or knowledge of working parenting programmes has often resulted in children being placed in care. Occupational therapists working in an Australian mental health service developed a two-stream programme which aimed to consolidate the parent/child relationship and enable the parents to develop effective parenting skills. This programme has a parents' educational stream and a stream with developmentally appropriate activities for the children. Observed outcomes have included the parents becoming more responsive to their children, increased treatment compliance, improved community access, and a decrease in the number of children in temporary foster care.
Using Qualitative Research to Inform the Client-Centred Evidence-Based Practice of Occupational Therapy
Authors: Hammell Karen Whalley 
Published: April 2015

Demands for increased accountability for health care expenditure, and recognition of clients' rights to interventions and methods of service delivery that are grounded in sound evidence, are compelling occupational therapists to use research findings to inform their clinical decision making. Occupational therapists also state that they embrace a client-centred orientation to practice, yet this espoused ethic seems rarely to influence decisions concerning what research is undertaken and how it is undertaken or what counts as evidence for practice. Given the widely divergent perspectives, priorities and values between health care professionals and their clients, practice based upon therapist-centred research may be neither relevant nor valid. This paper explores the philosophical underpinning of methods used to develop theory, proposing that occupational therapy's evidence-based practice must be ethically consistent with its espoused client-centred philosophy to avoid a tendency towards hypocrisy. It explores issues concerning client-centred practice and evidence-based practice and suggests that qualitative research methods may be the most appropriate tools to identify and address client priorities. While traditional quantitative research approaches render client voices silent, qualitative methods may enable occupational therapists to explore the complexities of clinical practice and of living with a disability, thereby informing a more client-centred, evidence-based practice of occupational therapy.
The Efficacy of Neurodevelopmental Treatment in Paediatrics: A Systematic Review
Authors: Brown G Ted , Burns Scott A 
Published: April 2015

Neurodevelopmental treatment (NDT) is widely used by clinicians when working with children diagnosed with neurological dysfunction, such as cerebral palsy, high-risk/low-birthweight infants or traumatic brain injury. The objective of this project was to determine the efficacy of NDT, used with a group of paediatric subjects diagnosed with a neurological dysfunction, through the completion of a systematic search and review of the relevant published research literature. Using a computerised literature search strategy of nine databases, expert consultation, and a hand search of 14 relevant journals and reference lists, 147 relevant citations were identified for consideration. Of the 147 articles reviewed, 17 met the inclusion criteria for further review. These studies were assessed for concealment of treatment allocation (Shulz et al 1995), quality assessment of randomised clinical trial using the Jadad scale (Jadad et al 1996) and level of evidence using the Sackett scale (Sackett 1989). A level of agreement between the two independent reviewers was calculated for each step of the systematic review process using the kappa statistic (κ). Tables containing the details and status of the 17 studies are included. Overall, the results regarding the efficacy of NDT were largely inconclusive since there were a similar number of published research studies supporting the benefit of NDT intervention (n=6) as compared with no benefit (n=9). One study did not specifically address the efficacy of NDT, while another study was unclear as to whether or not NDT was beneficial. The studies that included the use of NDT with paediatric subjects diagnosed with cerebral palsy also had inconsistent results regarding the efficacy of NDT. The studies that included the use of NDT with high-risk/low-birthweight infants did not support the usefulness of NDT with this paediatric client group. A detailed description of the systematic review process used in the completion of this paper is also included.