bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unannounced in situ simulation of obstetric emergencies: staff perceptions and organisational impact
Authors: Sørensen Jette Led , Lottrup Pernille , van der Vleuten Cees , Andersen Kristine Sylvan , Simonsen Mette , Emmersen Pernille , Rosthøj Susanne , Ottesen Bent 
Published: September 2014

Abstract

Aim
To describe how unannounced in situ simulation (ISS) was perceived by healthcare professionals before and after its implementation, and to describe the organisational impact of ISS.

Study design
Ten unannounced ISS involving all staff were scheduled March–August 2007. Questionnaire surveys on staff perceptions were conducted before (2003–2006) and after (2007–2008) implementation of unannounced ISS. Information from the debriefing sessions following each ISS constituted a proxy measure of the organisational impact of the ISS.

Results
Five out of ten of the unannounced ISS scheduled were conducted. Twenty-three members of the staff at work on a scheduled day for ISS were randomly selected to participate. Questionnaires before implementation revealed that 137/196 (70%) of staff members agreed or strongly agreed that ISS was a good idea and 52/199 (26%) thought it likely to be stressful and unpleasant. Questionnaires completed after implementation showed significantly more staff members, 135/153 (89%), thought ISS was a good idea. A significantly higher amount of staff members 50/153 (33%) found it to be stressful and unpleasant, and among midwives, 15/59 (25%) were anxious about ISS, whereas none of the obstetricians reported this. Information obtained through debriefing sessions generated learning points.

Conclusions
The number of staff members with a positive perception of multiprofessional unannounced ISS increased after implementation; however, one-third considered ISS to be stressful and unpleasant and midwives more frequently so. The specific perception of ISS by each healthcare profession should be taken into account when planning ISS. The information from the debriefing sessions showed that implementation of ISS had an impact as it provided information required for organisational changes.
Comparison of Proton Pump Inhibitor and Histamine-2 Receptor Antagonist in the Prevention of Recurrent Peptic Ulcers/Erosions in Long-Term Low-Dose Aspirin Users: A Retrospective Cohort Study
Authors: Chen Wen-Chi , Li Yun-Da , Chiang Po-Hung , Tsay Feng-Woei , Chan Hoi-Hung , Tsai Wei-Lun , Tsai Tzung-Jiun , Wang E-Ming , Cheng Jin-Shiung , Lai Kwok-Hung 
Published: September 2014

Background. Proton pump inhibitor and histamine-2 receptor antagonist can prevent aspirin-related ulcers/erosions but few studies compare the efficacy of these two agents.Aims. We evaluated the efficacy of omeprazole and famotidine in preventing recurrent ulcers/erosions in low-dose aspirin users.Methods. The 24-week clinical outcomes of the patients using low-dose aspirin for cardiovascular protection with a history of ulcers/erosions and cotherapy of omeprazole or famotidine were retrospectively reviewed. The incidence of gastrointestinal symptoms, recurrent ulcers/erosions, erosive esophagitis, gastrointestinal bleeding, and thromboembolic events was analyzed.Results. A total of 104 patients (famotidine group, 49 patients; omeprazole group, 55 patients) were evaluated. Famotidine group had more gastrointestinal symptoms episodes than omeprazole group (46.9% versus 23.6%,P=0.01). Fifteen famotidine group patients and 5 omeprazole group patients had recurrent ulcers/erosions (30.6% versus 9.1%,P=0.005). Lanza scale was significantly lower in omeprazole group than in famotidine group(1.2±0.7versus1.7±1.1, P=0.008). Only 1 famotidine group patient had ulcer bleeding. The incidences of erosive esophagitis and thromboembolic events were comparable between both groups.Conclusions. Omeprazole was superior to famotidine with less gastrointestinal symptoms and recurrent ulcers/erosions in patients using 24-week low-dose aspirin. The risk of erosive esophagitis, gastrointestinal bleeding, and thromboembolic events was similar between both groups.
Adverse Immunoregulatory Effects of 5FU and CPT11 Chemotherapy on Myeloid-Derived Suppressor Cells and Colorectal Cancer Outcomes
Authors: Kanterman Julia , Sade-Feldman Moshe , Biton Moshe , Ish-Shalom Eliran , Lasry Audrey , Goldshtein Aviya , Hubert Ayala , Baniyash Michal 
Published: September 2014

Abstract
Colorectal cancer is associated with chronic inflammation and immunosuppression mediated by myeloid-derived suppressor cells (MDSC). Although chemotherapy reduces tumor burden at early stages, it tends to have limited effect on a progressive disease, possibly due to adverse effects on the immune system in dictating disease outcome. Here, we show that patients with advanced colorectal cancer display enhanced MDSC levels and reduced CD247 expression and that some conventional colorectal cancer chemotherapy supports the immunosuppressive tumor microenvironment. A FOLFOX combined therapy reduced immunosuppression, whereas a FOLFIRI combined therapy enhanced immunosuppression. Mechanistic studies in a colorectal cancer mouse model revealed that FOLFIRI-like therapy including the drugs CPT11 and 5-fluorouracil (5FU) damaged host immunocompetence in a manner that limits treatment outcomes. CPT11 blocked MDSC apoptosis and myeloid cell differentiation, increasing MDSC immunosuppressive features and mouse mortality. In contrast, 5FU promoted immune recovery and tumor regression. Thus, CPT11 exhibited detrimental immunoregulatory effects that offset 5FU benefits when administered in combination. Our results highlight the importance of developing therapeutic regimens that can target both the immune system and tumor towards improved personalized treatments for colorectal cancer. Cancer Res; 74(21); 6022–35. ©2014 AACR.
mTOR Inhibitors Induce Cell-Cycle Arrest and Inhibit Tumor Growth in Epstein–Barr Virus–Associated T and Natural Killer Cell Lymphoma Cells
Authors: Kawada Jun-ichi , Ito Yoshinori , Iwata Seiko , Suzuki Michio , Kawano Yoshihiko , Kanazawa Tetsuhiro , Siddiquey Mohammed Nure Alam , Kimura Hiroshi 
Published: September 2014

Abstract
Purpose: Epstein–Barr virus (EBV) infects B cells, as well as T cells and natural killer (NK) cells, and is associated with T or NK cell lymphoid malignancies. In various tumor cells, mTOR performs an essential function together with Akt with regard to cell growth. We investigated the effects of mTOR inhibitors on EBV-associated T- and NK-cell lymphomas.
Experimental Design: We investigated the Akt/mTOR activation pathway in EBV-positive and -negative T- and NK-cell lines (SNT13, SNT16, Jurkat, SNK6, KAI3, and KHYG1). We evaluated the antitumor effects of mTOR inhibitors (rapamycin and its analogue, CCI-779) against these cell lines in culture and in a murine xenograft model that was established by subcutaneous injection of SNK6 cells into NOG mice.
Results: All EBV-positive and -negative T- and NK-cell lines tested displayed activation of the Akt/mTOR pathway, and treatment with mTOR inhibitors suppressed mTOR activation. The inhibitors induced G1 cell-cycle arrest and inhibited cell proliferation in T- and NK-cell lines. Overall, T cell lines were more sensitive to rapamycin, but there were no significant differences between EBV-positive and -negative cell lines. Treatment with rapamycin did not affect lytic or latent EBV gene expression. Intraperitoneal treatment with CCI-779 significantly inhibited the growth of established tumors in NOG mice and reduced the EBV load in peripheral blood.
Conclusion: These results suggest that inhibition of mTOR signaling is a promising new strategy for improving treatment of EBV-associated T- and NK-cell lymphoma. Clin Cancer Res; 20(21); 5412–22. ©2014 AACR.
Comprehensive Genomic Analysis Identifies Novel Subtypes and Targets of Triple-Negative Breast Cancer
Authors: Burstein Matthew D. , Tsimelzon Anna , Poage Graham M. , Covington Kyle R. , Contreras Alejandro , Fuqua Suzanne A.W. , Savage Michelle I , Osborne C. Kent , Hilsenbeck Susan G. , Chang Jenny C. , Mills Gordon B. , Lau Ching C. , Brown Powel H. 
Published: September 2014

Abstract
Purpose: Genomic profiling studies suggest that triple-negative breast cancer (TNBC) is a heterogeneous disease. In this study, we sought to define TNBC subtypes and identify subtype-specific markers and targets.
Experimental Design: RNA and DNA profiling analyses were conducted on 198 TNBC tumors [estrogen receptor (ER) negativity defined as Allred scale value ≤ 2] with &gt;50% cellularity (discovery set: n = 84; validation set: n = 114) collected at Baylor College of Medicine (Houston, TX). An external dataset of seven publically accessible TNBC studies was used to confirm results. DNA copy number, disease-free survival (DFS), and disease-specific survival (DSS) were analyzed independently using these datasets.
Results: We identified and confirmed four distinct TNBC subtypes: (i) luminal androgen receptor (AR; LAR), (ii) mesenchymal (MES), (iii) basal-like immunosuppressed (BLIS), and (iv) basal-like immune-activated (BLIA). Of these, prognosis is worst for BLIS tumors and best for BLIA tumors for both DFS (log-rank test: P = 0.042 and 0.041, respectively) and DSS (log-rank test: P = 0.039 and 0.029, respectively). DNA copy number analysis produced two major groups (LAR and MES/BLIS/BLIA) and suggested that gene amplification drives gene expression in some cases [FGFR2 (BLIS)]. Putative subtype-specific targets were identified: (i) LAR: androgen receptor and the cell surface mucin MUC1, (ii) MES: growth factor receptors [platelet-derived growth factor (PDGF) receptor A; c-Kit], (iii) BLIS: an immunosuppressing molecule (VTCN1), and (iv) BLIA: Stat signal transduction molecules and cytokines.
Conclusion: There are four stable TNBC subtypes characterized by the expression of distinct molecular profiles that have distinct prognoses. These studies identify novel subtype-specific targets that can be targeted in the future for the effective treatment of TNBCs. Clin Cancer Res; 21(7); 1688–98. ©2014 AACR.
See related commentary by Vidula and Rugo, p. 1511
Genetic Variations Associated With Recurrent Venous Thrombosis
Authors: Vlieg Astrid van Hylckama , Flinterman Linda E. , Bare Lance A. , Cannegieter Suzanne C. , Reitsma Pieter H. , Arellano Andre R. , Tong Carmen H. , Devlin James J. , Rosendaal Frits R. 
Published: September 2014

Background—
The prediction of recurrent venous thrombosis using individual genetic risk predictors has proven to be challenging. The aim of this study was to assess whether multiple genetic single nucleotide polymorphism (SNP) analysis would predict recurrent venous thrombosis.

Methods and Results—
Patients with a first venous thrombosis were followed for a recurrent venous thrombosis up to 2009 (MEGA follow-up study), which occurred in 608 out of 4100 patients (2.7%/year). Thirty-one common thrombosis-associated single nucleotide polymorphisms (SNPs) were associated with the risk of recurrence. A genetic risk score (GRS) for each individual was calculated by summing the number of risk-increasing alleles for each of the 31 SNPs and for a simplified model consisting of 5 SNPs: rs6025, rs1799963, rs8176719, rs2066865, and rs2036914. The risk of recurrence associated with the GRS was calculated continuously and after stratification in a low and high score. All individual SNPs were at most mildly associated with recurrence risk. Regarding the 31-SNP GRS, recurrence risk was highest in patients with ≥31 and lowest in patients with <21 risk alleles. The discriminative power of the 5-SNP GRS was similar to that of the 31-SNP GRS. The 6-year cumulative incidence of recurrence was high for individuals with ≥5 (20.3%; 95% confidence interval, 16.5–24.1) and low for individuals with ≤1 (9.4%; 95% confidence interval, 6.7–12.1) risk alleles. Predictive power improved after stratification into provoked and unprovoked first events and sex.

Conclusions—
Multiple genetic SNP analysis is useful in the prediction of recurrent thrombosis, even more so when combining this model with clinical risk factors.
Age-Specific Incidence, Outcome, Cost, and Projected Future Burden of Atrial Fibrillation–Related Embolic Vascular Events
Authors: Yiin Gabriel S.C. , Howard Dominic P.J. , Paul Nicola L.M. , Li Linxin , Luengo-Fernandez Ramon , Bull Linda M. , Welch Sarah J.V. , Gutnikov Sergei A. , Mehta Ziyah , Rothwell Peter M. 
Published: September 2014

Background—
Prevalence of atrial fibrillation (AF) is >10% at age ≥80 years, but the impact of population aging on rates of AF-related ischemic events is uncertain.

Methods and Results—

We studied age-specific incidence, outcome, and cost of all AF-related incident strokes and systemic emboli from 2002 to 2012 in the Oxford Vascular Study (OXVASC). We determined time trends in incidence of AF-related stroke in comparison with a sister study in 1981 to 1986, extrapolated numbers to the UK population and projected future numbers. Of 3096 acute cerebral or peripheral vascular events in the 92 728 study population, 383 incident ischemic strokes and 71 systemic emboli were related to AF, of which 272 (59.9%) occurred at ≥80 years. Of 597 fatal or disabling incident ischemic strokes, 262 (43.9%) were AF-related. Numbers of AF-related ischemic strokes at age ≥80 years increased nearly 3-fold from 1981–1986 to 2002–2012 (extrapolated to the United Kingdom: 6621 to 18 176 per year), due partly to increased age-specific incidence (relative rate 1.52, 95% confidence interval 1.31-1.77,
P
=0.001), with potentially preventable AF-related events at age ≥80 years costing the United Kingdom £374 million per year. At current incidence rates, numbers of AF-related embolic events at age ≥80 years will treble again by 2050 (72 974/year), with 83.5% of all events occurring in this age group.

Conclusions—
Numbers of AF-related incident ischemic strokes at age ≥80 years have trebled over the last 25 years, despite the introduction of anticoagulants, and are projected to treble again by 2050, along with the numbers of systemic emboli. Improved prevention in older people with AF should be a major public health priority.
Characterization of recycled polyethylene terephthalates and polyethylene terephthalate–nylon6 blend knitted fabrics
Authors: Choi Yeon Joo , Kim Seong Hun 
Published: September 2014

For environmental conservation, post-consumer polyethylene terephthalate (PET) bottles are recycled using methods ranging from mechanical recycling to various chemical recycling processes. In this study, the characterization of recycled PETs and PET–nylon6 blend knitted fabrics, and virgin PET knitted fabric, was carried out with the aim of broadening the application of recycled PET fabrics. The tensile strength values of mechanically and chemically recycled PET knitted fabrics were similar to those of virgin PET knitted fabric. The elongation of recycled PET–nylon6 blend knitted fabric was the best. Both virgin and recycled PET knitted fabrics had excellent pilling resistance. Based on the drape ratio, the recycled PET–nylon6 blend knitted fabric was more flexible than other samples. The warm/cool feeling ( Qmax), compressional and surface properties were measured using the Kawabata evaluation system for fabrics (KES-FB system). The compressional properties of mechanically recycled PET knitted fabric were similar to those of virgin PET knitted fabric. The recycled PET–nylon6 blend knitted fabric showed the smoothest appearance and coolest feeling among the four samples. Moisture regain and moisture permeability were the best in recycled PET–nylon6 blend knitted fabric. However, the wickability of mechanically recycled PET knitted fabric was better than other recycled PET knitted fabrics.
Magnetic resonance imaging relaxation times of female reproductive organs
Authors: Takatsu Yasuo , Okada Tsutomu , Miyati Tosiaki , Koyama Takashi 
Published: September 2014

Background Relaxation time of female reproductive organs affects the tissue contrast of magnetic resonance image (MRI), and is used for quantitative analysis. Purpose To evaluate the relaxation times of normal female reproductive organs in the luteal phase of the menstrual cycle. Material and Methods On a 1.5-T MRI, relaxation times were measured in pelvic tissues (endometrium, junctional zone, myometrium, follicle, and stroma) of 32 female healthy volunteers (33.5 ± 6.8 years). The Look–Locker sequence was used to measure T1 relaxation times. Furthermore, a multiple spin-echo method with 32 different echo times was used to measure T2 relaxation times. The images were obtained in the luteal phase of each volunteer’s menstrual cycle. Results The measured relaxation times (means ± standard deviations) were as follows: endometrium (T1, 1703 ± 147 ms; T2, 214 ± 35 ms), junctional zone (T1, 1168 ± 63 ms; T2, 72 ± 12 ms), myometrium (T1, 1314 ± 103 ms; T2, 138 ± 20 ms), follicle (T1, 2267 ± 249 ms; T2, 603 ± 68 ms), and stroma (T1, 1481 ± 129 ms; T2, 126 ± 29 ms). Conclusion Reliable MRI measurements of T1 and T2 relaxation times of normal female reproductive organs in the luteal phase of the menstrual cycle are useful as references to recognize the normal value.
Degree of Preoperative Subchondral Bone Edema Is Not Associated With Pain and Graft Outcomes After Matrix-Induced Autologous Chondrocyte Implantation
Authors: Ebert Jay R. , Smith Anne , Fallon Michael , Wood David J. , Ackland Timothy R. 
Published: September 2014

Background: Matrix-induced autologous chondrocyte implantation (MACI) is an established technique for the repair of knee chondral defects. While a number of factors may affect the clinical outcome, little is known about the influence of subchondral bone abnormalities at the time of surgery on pain and graft outcomes after MACI. Purpose: To investigate the association between subchondral bone marrow edema within 3 months before MACI surgery on preoperative and postoperative reported pain and symptoms as well as postoperative graft outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study was undertaken in 56 patients undergoing MACI with clinical and radiological assessments before surgery and at 3, 12, 24, and 60 months after surgery. Patients were assessed using the Pain and Symptoms subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS). High-resolution magnetic resonance imaging (MRI) was used to evaluate the severity of preoperative subchondral bone marrow edema, while graft infill and an MRI composite graft score were evaluated after surgery via the magnetic resonance observation of cartilage repair tissue (MOCART) scoring system. Linear regression utilizing generalized estimating equations was used to investigate the association between preoperative subchondral bone marrow edema scores and preoperative and postoperative KOOS subscores as well as postoperative MRI-based scores of graft repair. Results: The degree of preoperative subchondral bone marrow edema was not significantly associated with postoperative outcomes, whereby there was no evidence of a difference between edema subgroups over all time points for the KOOS-Pain subscore ( P = .644), KOOS-Symptoms subscore ( P = .475), or MRI composite score ( P = .685) after adjustment for potential confounders of age, body mass index, defect size, and defect location. Conclusion: No association was demonstrated between the severity of preoperative subchondral bone marrow edema with postoperative patient-reported knee pain or symptoms or postoperative graft repair assessed via MRI.
A Randomized Trial of Wraparound Facilitation Versus Usual Child Protection Services
Authors: Browne Dillon T. , Puente-Duran Sofia , Shlonsky Aron , Thabane Lehana , Verticchio Dominic 
Published: September 2014

Objective: To evaluate whether the addition of a wraparound facilitator to regular child protection services improved child and family functioning over 20 months. Method: A single blind randomized controlled trial with concealment and stratification across three sites ( N = 135 eligible families with substantiated maltreatment). Results: Based on 2 × 2 mixed analysis of variance and intention to treat, both groups improved in child impairments, d = −.60 [−.81, −.39], caregiver psychological distress, d = −.33 [−.52, −.13], and family resources, d = .44 [.27, .62]. No measurable benefit was associated with the intervention (e.g., child impairments, d = .14 [−.12, .52]). However, treatment fidelity analysis revealed that many components of wraparound were either missing or present in both groups. Conclusions: The presence of a facilitator alone did not appear to improve child or family functioning if the various components of wraparound were not adequately implemented.
The Shared Traumatic and Professional Posttraumatic Growth Inventory
Authors: Tosone Carol , Bauwens Jennifer , Glassman Marc 
Published: September 2014

Purpose: While there are established instruments offering psychometrically sound measurement of primary or secondary trauma, none capture the essence of dual exposure for mental health professionals living and working in traumatological environments. Methods: This study examined the experience of 244 mental health workers who lived and worked in New Orleans during Hurricane Katrina. An instrument, the Shared Trauma and Professional Posttraumatic Growth Inventory (STPPG), a 14-item, Likert-type scale composed of three subscales (Technique-Specific Shared Trauma, Personal Trauma, and Professional Posttraumatic Growth), was developed to understand the nature of dual trauma exposure. Results: The STPPG supports the reciprocal nature of shared trauma and correlates well to existing measures for posttraumatic stress, secondary trauma, shared trauma, and posttraumatic growth. Discussion: The STPPG suggests that personal traumatic experience can impact professional practice, and client traumatic narratives influence one’s personal trauma responses. Implications of STPPG for practice and future research are discussed.
Predictors of the physical impact of Multiple Sclerosis following community-based, exercise trial
Authors: Kehoe M , Saunders J , Jakeman P , Coote S 
Published: September 2014

Background: Studies evaluating exercise interventions in people with multiple sclerosis (PwMS) demonstrate small to medium positive effects and large variability on a number of outcome measures. No study to date has tried to explain this variability. Objective: This paper presents a novel exploration of data examining the predictors of outcome for PwMS with minimal gait impairment following a randomised, controlled trial evaluating community-based exercise interventions ( N = 242). Methods: The primary variable was the physical component of the Multiple Sclerosis Impact Scale-29, version 2 (MSIS-29, v2) after a 10-week, controlled intervention period. Predictors were identified a priori and were measured at baseline. Multiple linear regression was conducted. Results: Four models are presented lower MSIS-29, v2 scores after the intervention period were best predicted by a lower baseline MSIS-29,v2, a lower baseline Modified Fatigue Impact Score (physical subscale), randomisation to an exercise intervention, a longer baseline walking distance measured by the Six Minute Walk Test and female gender. This model explained 57.4% of the variance (F (5, 211) = 59.24, p < 0.01). Conclusion: These results suggest that fatigue and walking distance at baseline contribute significantly to predicting MSIS-29, v29 (physical component) after intervention, and thus should be the focus of intervention and assessment. Exercise is an important contributor to minimising the physical impact of MS, and gender-specific interventions may be warranted.