bluuebunny/crossref_metadata_2025_split huggingface dataset:
Varying uses of the ABCD2 scoring system in primary and secondary care: a qualitative study
Authors: Edwards Duncan , Cohn Simon R , Mavaddat Nahal , Virdee Satnam K , Lasserson Daniel , Milner Siobhan , Giles Matthew , McManus Richard , Mant Jonathan 
Published: November 2012

ObjectivesTo explore the usage of the ABCD2 risk stratification score by general practitioners (GPs) and hospital staff during the referral of patients with suspected transient ischaemic attack (TIA) or minor stroke.DesignQualitative study using semistructured interviews.SettingNine general practices and two hospital sites in England (Birmingham and Cambridge).ParticipantsNine GPs and nine hospital staff (two consultants, four nurses, two ultrasonographers and one administrator).ResultsIn both sites, clinicians used a referral proforma based around the ABCD2 scoring system for a range of purposes including self-education, to assist emphasising urgency to the patient, as a referral pathway facilitator and as a diagnostic tool. Negative views of its role included potential medicolegal threats, that it was a barrier to appropriate care, and led to misdiagnoses. Despite having differing uses by different clinicians, the ABCD2 proforma was the central means of interprofessional communication in TIA referrals across both sites.ConclusionsUnderstanding how prediction rules are used in practice is key to determining their impact on processes of care and clinical outcomes. In practice, GPs and their colleagues use the ABCD2 score in subtly different ways and it functions as a ‘boundary object’ by both accommodating these multiple purposes, yet still successfully aiding communication between them.
Does prior coronary artery bypass surgery alter the gender gap in patients presenting with acute coronary syndrome? A 20-year retrospective cohort study
Authors: Al-Aqeedi Rafid Fayadh , Al Suwaidi Jassim , Singh Rajvir , Al Binali Hajar A 
Published: November 2012

ObjectivesPrevious studies demonstrated women presenting with acute coronary syndrome (ACS) have poor outcomes when compared with men ‘the gender gap phenomenon’. The impact of prior coronary artery bypass graft (CABG) on women presenting with ACS is unknown. We hypothesised that the gender gap is altered in ACS patients with prior CABG. The aim of this study was to evaluate patients presenting with ACS according to their gender and history of prior CABG.DesignRetrospective, observational (cohort) study.SettingData were collected from hospital-based registry of patients hospitalised with ACS in Doha, Qatar, from 1991 through 2010. The data were analysed according to their gender and history of prior CABG.ParticipantsA total of 16 750 consecutive patients with ACS were studied. In total, 693 (4.3%) patients had prior CABG; among them 125 (18%) patients were women.Primary and secondary outcome measuresComparisons of clinical characteristics, inhospital treatment, and outcomes, including inhospital mortality and stroke were made.ResultsWomen with or without prior CABG were older, less likely to be smokers, but more likely to have diabetes mellitus (DM), hypertension and renal impairment than men (p=0.001). Women were less likely to receive reperfusion and early invasive therapies. When compared with men, women without prior CABG carried higher inhospital mortality (11% vs 4.9%; p=0.001) and stroke rates (0.9% vs 0.3%; p=0.001). Female gender was independent predictor of poor outcome. Among prior CABG patients, despite the fact that women had worse baseline characteristics and were less likely to receive evidence-based therapy, there were no significant differences in mortality or stroke rates between the two groups.ConclusionsConsistent with the world literature, women presenting with ACS and without prior CABG had higher death rates compared with men. Patients with prior CABG had comparable death rates regardless of the gender status.
Prophylactic antibiotic regimens in tumour surgery (PARITY): protocol for a multicentre randomised controlled study
Authors: Ghert Michelle , Deheshi Benjamin , Holt Ginger , Randall R Lor , Ferguson Peter , Wunder Jay , Turcotte Robert , Werier Joel , Clarkson Paul , Damron Timothy , Benevenia Joseph , Anderson Megan , Gebhardt Mark , Isler Marc , Mottard Sophie , Healey John , Evaniew Nathan , Racano Antonella , Sprague Sheila , Swinton Marilyn , Bryant Dianne , Thabane Lehana , Guyatt Gordon , Bhandari Mohit ,   The PARITY Investigators
Published: November 2012

IntroductionLimb salvage with endoprosthetic reconstruction is the standard of care for the management of lower-extremity bone tumours in skeletally mature patients. The risk of deep postoperative infection in these procedures is high and the outcomes can be devastating. The most effective prophylactic antibiotic regimen remains unknown, and current clinical practice is highly varied. This trial will evaluate the effect of varying postoperative prophylactic antibiotic regimens on the incidence of deep infection following surgical excision and endoprosthetic reconstruction of lower-extremity bone tumours.Methods and analysisThis is a multicentre, blinded, randomised controlled trial, using a parallel two-arm design. 920 patients 15 years of age or older from 12 tertiary care centres across Canada and the USA who are undergoing surgical excision and endoprosthetic reconstruction of a primary bone tumour will receive either short (24 h) or long (5 days) duration postoperative antibiotics. Exclusion criteria include prior surgery or infection within the planned operative field, known colonisation withmethicillin-resistant Staphylococcus aureusorvancomycin-resistant Enterococcusat enrolment, or allergy to the study antibiotics. The primary outcome will be rates of deep postoperative infections in each arm. Secondary outcomes will include type and frequency of antibiotic-related adverse events, patient functional outcomes and quality-of-life scores, reoperation and mortality. Randomisation will be blocked, with block sizes known only to the methods centre responsible for randomisation, and stratified by location of tumour and study centre. Patients, care givers and a Central Adjudication Committee will be blinded to treatment allocation. The analysis to compare groups will be performed using Cox regression and log-rank tests to compare survival functions at α=0.05.Ethics and disseminationThis study has ethics approval from the McMaster University/Hamilton Health Sciences Research Ethics Board (REB# 12-009). Successful completion will significantly impact on clinical practice and enhance patients’ lives. More broadly, this trial will develop a network of collaboration from which further high-quality trials in Orthopaedic Oncology will follow.
Does recall of preinjury disability change over time?
Authors: Williamson Owen D , Gabbe Belinda J , Sutherland Ann M , Hart Melissa J ,   on behalf of the Victorian Orthopaedic Trauma Outcome Registry Project Group
Published: November 2012

BackgroundPre-injury disability must be determined when assessing whether treatment programs return people to pre-injury status, however there is little empirical evidence to support recommendations that this be done as soon as possible after injury to prevent recall bias.ObjectivesTo determine disagreement between recall of pre-injury disability at different time points post-injury and bias towards under- or overestimating pre-injury disability.MethodsSelf-reported pre-injury global disability was assessed within days, 6 months and 12 months post-injury in patients admitted to two level 1 adult trauma centres. Kappa statistics and multiple logistic regression models identified predictors of disagreement between time-points.ResultsPre-injury disability was measured at all time-points in 801 patients. Pre-injury disability at baseline was rated as none, mild, moderate, marked and severe in 80%, 12%, 5.1%, 1.9% and 1.0% respectively. Absolute agreement between baseline and 6 and 12 months respectively, was 79% and 80%. Corresponding kappa values (95% confidence intervals) were 0.33 (0.26−0.40) and 0.32 (0−25−0.38). Patients over 65 years or not completing high school were more likely to report less pre-injury disability at 6 and 12 months than at baseline with adjusted odds ratios (95% confidence intervals) for these groups being 8.24 (4.32−15.72) and 1.93 (1.03−3.64) respectively.ConclusionsThere was little evidence of recall bias in an adult trauma population if self-reported global pre-injury disability was assessed 6 months post-injury. The recall of pre-injury disability up to 6 months post-injury can be used to determine return to pre-injury status, if assessment is not feasible shortly after injury.
Why more male pedestrians die in vehicle-pedestrian collisions than female pedestrians: a decompositional analysis
Authors: Zhu Motao , Zhao Songzhu , Coben Jeffrey H , Smith Gordon S 
Published: November 2012

ObjectivePedestrians account for a third of the 1.2 million traffic fatalities annually worldwide, and men are overrepresented. We examined the factors that contribute to this male-female discrepancy: walking exposure (kilometres walked per person-year), vehicle-pedestrian collision risk (number of collisions per kilometres walked) and vehicle-pedestrian collision case fatality rate (number of deaths per collision).DesignThe decomposition method quantifies the relative contributions (RCs) of individual factors to death rate ratios among groups. The male-female ratio of pedestrian death rates can be expressed as the product of three component ratios: walking exposure, collision risk and case fatality rate. Data sources included the 2008–2009 US Fatality Analysis Reporting System, General Estimates System, National Household Travel Survey and population estimates.SettingUSA.ParticipantsPedestrians aged 5 years and older.Main outcome measuresDeath rate per person-year, kilometres walked per person-year, collisions per kilometres walked and deaths per collision by sex.ResultsThe pedestrian death rate per person-year for men was 2.3 times that for women. This ratio of male to female rates can be expressed as the product of three component ratios: 0.995 for walking exposure, 1.191 for collision risk and 1.976 for case fatality rate. The RCs of these components were 1%, 20% and 79%, respectively.ConclusionsThe majority of the male-female discrepancy in 2008–2009 pedestrian deaths in the US is attributed to a higher fatality per collision rate among male pedestrians.
The relative contributions of seed bank, seed rain, and understory vegetation dynamics to the reorganization of Tsuga canadensis forests after loss due to logging or simulated attack by Adelges tsugae
Authors: Farnsworth Elizabeth J. , Barker Plotkin Audrey A. , Ellison Aaron M. 
Published: November 2012

Profound changes are occurring in forests as native insects, nonnative insects, or pathogens irrupt on foundation tree species; comprehensive models of vegetation responses are needed to predict future forest composition. We experimentally simulated hemlock woolly adelgid ( Adelges tsugae Annand) infestation (by girdling trees) and preemptive logging of eastern hemlock ( Tsuga canadensis (L.) Carrière) and compared vegetation dynamics in replicate 90 m × 90 m treatment plots and intact hemlock stands from 2004 to 2010. Using Chao–Sørensen abundance-based similarity indices, we assessed compositional similarities of trees, shrubs, forbs, and graminoids among the seed bank, seed rain, and standing vegetation over time and among treatments. Post-treatment seed rain, similar among treatments, closely reflected canopy tree composition. Species richness of the seed bank was similar in 2004 and 2010. Standing vegetation in the hemlock controls remained dissimilar from the seed bank, reflecting suppressed germination. Recruits from the seed rain and seed bank dominated standing vegetation in the logged treatment, whereas regeneration of vegetation from the seed bank and seed rain was slowed due to shading by dying hemlocks in the girdled treatment. Our approach uniquely integrates multiple regeneration components through time and provides a method for predicting forest dynamics following loss of foundation tree species.
Variations in salt expulsion style within the Sable Canopy Complex, central Scotian margin1This article is one of a series of papers published in this CJES Special Issue on the theme ofMesozoic–Cenozoic geology of the Scotian Basin.
Authors: Kendell Kristopher L. 
Published: November 2012

There are two allochthonous salt canopies within the central Scotian margin, one on the shelf and another in deeper waters on the Scotian slope. The Sable Shelf Canopy trends southwest–northeast and covers an area approximately 650 km2. Salt thickness within this canopy is generally <1000 m. Reloading of the salt has welded out the margins of the canopy, significantly reducing its extent. Salt tectonics related to this canopy produced many of the exploration targets drilled on the shelf. The Sable Slope Canopy is 50 km basinward on the Scotian slope. This canopy is significantly larger, covering 12 700 km2, and the allochthonous salt is as thick as 3500 m. Although the two canopies are separated by a significant distance, a common detachment surface connects them in multiple locations. Extensional systems detach in the Sable Shelf Canopy, displace strata downdip, and expel salt into the Sable Slope Canopy. The outer shelf and slope region separating these two canopies is dominated by detachment systems. One term, the Sable Canopy Complex, was developed to describe both salt canopies and the zone of detachment that separates them. Interpretation of two-dimensional and three-dimensional seismic data throughout the Sable Canopy Complex has resulted in a detailed allochthonous salt map and all related components including welded systems, salt stocks, faults, sutures, and minibasins. Four distinct expulsion styles are observed to contribute volumes of salt to the canopies: salt-based detachments, counterregional systems, hybrids, and salt stocks. Potential explanations for the variations in expulsion style range from varying volumes of sediment input to paleogeographic positions on the margin to salt sheet length.
Construction and analysis of an SSH cDNA library of early heat-induced genes ofVigna aconitifoliavariety RMO-40
Authors: Rampuria Sakshi , Joshi Uma , Palit Paramita , Deokar Amit A. , Meghwal Raju R. , Mohapatra T. , Srinivasan R. , Bhatt K.V. , Sharma Ramavtar 
Published: November 2012

Moth bean ( Vigna aconitifolia (Jacq.) Marechal) is an important grain legume crop grown in rain fed areas of hot desert regions of Thar, India, under scorching sun rays with very little supplementation of water. An SSH cDNA library was generated from leaf tissues of V. aconitifolia var. RMO-40 exposed to an elevated temperature of 42 °C for 5 min to identify early-induced genes. A total of 488 unigenes (114 contigs and 374 singletons) were derived by cluster assembly and sequence alignment of 738 ESTs; out of 206 ESTs (28%) of unknown proteins, 160 ESTs (14%) were found to be novel to moth bean. Only 578 ESTs (78%) showed significant BLASTX similarity (<1 × 10–6) in the NCBI non-redundant database. Gene ontology functional classification terms were retrieved for 479 (65%) sequences, and 339 sequences were annotated with 165 EC codes and mapped to 68 different KEGG pathways. Four hundred and fifty-two ESTs were further annotated with InterProScan (IPS), and no IPS was assigned to 153 ESTs. In addition, the expression level of 27 ESTs in response to heat stress was evaluated through semiquantitative RT–PCR assay. Approximately 20 different signaling genes and 16 different transcription factors have been shown to be associated with heat stress in moth bean for the first time.
Targeting Galectin-1 Overcomes Breast Cancer-Associated Immunosuppression and Prevents Metastatic Disease
Authors: Dalotto-Moreno Tomás , Croci Diego O. , Cerliani Juan P. , Martinez-Allo Verónica C. , Dergan-Dylon Sebastián , Méndez-Huergo Santiago P. , Stupirski Juan C. , Mazal Daniel , Osinaga Eduardo , Toscano Marta A. , Sundblad Victoria , Rabinovich Gabriel A. , Salatino Mariana 
Published: November 2012

Abstract
Galectin-1 (Gal1), an evolutionarily conserved glycan-binding protein, contributes to the creation of an immunosuppressed microenvironment at sites of tumor growth. In spite of considerable progress in elucidating its role in tumor-immune escape, the mechanisms underlying the inhibitory functions of Gal1 remain obscure. Here, we investigated the contribution of tumor Gal1 to tumor growth, metastasis, and immunosuppression in breast cancer. We found that the frequency of Gal1+ cells in human breast cancer biopsies correlated positively with tumor grade, while specimens from patients with benign hyperplasia showed negative or limited Gal1 staining. To examine the pathophysiologic relevance of Gal1 in breast cancer, we used the metastatic mouse mammary tumor 4T1, which expresses and secretes substantial amounts of Gal1. Silencing Gal1 expression in this model induced a marked reduction in both tumor growth and the number of lung metastases. This effect was abrogated when mice were inoculated with wild-type 4T1 tumor cells in their contralateral flank, suggesting involvement of a systemic modulation of the immune response. Gal1 attenuation in 4T1 cells also reduced the frequency of CD4+CD25+ Foxp3+ regulatory T (Treg) cells within the tumor, draining lymph nodes, spleen, and lung metastases. Further, it abrogated the immunosuppressive function of Treg cells and selectively lowered the expression of the T-cell regulatory molecule LAT (linker for activation of T cells) on these cells, disarming their suppressive activity. Taken together, our results offer a preclinical proof of concept that therapeutic targeting of Gal1 can overcome breast cancer-associated immunosuppression and can prevent metastatic disease. Cancer Res; 73(3); 1107–17. ©2012 AACR.
Loss of miR-204 Expression Enhances Glioma Migration and Stem Cell-like Phenotype
Authors: Ying Zhe , Li Yun , Wu Jueheng , Zhu Xun , Yang Yi , Tian Han , Li Wei , Hu Bo , Cheng Shi-Yuan , Li Mengfeng 
Published: November 2012

Abstract
Phenotypic similarities have long been recognized between subpopulations of glioma and neural stem cells. Many of these similar properties, including the robust abilities to self-renew, migrate, and invade, are hallmarks of glioma cells that render them extremely aggressive. However, the molecular mechanisms underlying this character, particularly in glioma stem-like cells that drive this disease, remain poorly understood. Here, we report the results of a differential miRNA expression screen that compared glioma and neural stem cells, where we found that miR-204 was markedly downregulated in both types of cells. Mechanistic investigations revealed that miR-204 simultaneously suppressed self-renewal, stem cell-associated phenotype, and migration of glioma cells by targeting the stemness-governing transcriptional factor SOX4 and the migration-promoting receptor EphB2. Restoring miR-204 expression in glioma cells suppressed tumorigenesis and invasiveness in vivo and increased overall host survival. Further evaluation revealed that the miR-204 promoter was hypermethylated and that attenuating promoter methylation was sufficient to upregulate miR-204 in glioma cells. Together, our findings reveal miR-204 as a pivotal regulator of the development of stem cell-like phenotypes and cell motility in malignant glioma cells. Cancer Res; 73(2); 990–9. ©2012 AACR.
Gene Expression Profiles in Peripheral Blood Mononuclear Cells of Chinese Nickel Refinery Workers with High Exposures to Nickel and Control Subjects
Authors: Arita Adriana , Muñoz Alexandra , Chervona Yana , Niu Jingping , Qu Qingshan , Zhao Najuan , Ruan Ye , Kiok Kathrin , Kluz Thomas , Sun Hong , Clancy Hailey A. , Shamy Magdy , Costa Max 
Published: November 2012

AbstractBackground: Occupational exposure to nickel (Ni) is associated with an increased risk of lung and nasal cancers. Ni compounds exhibit weak mutagenic activity, alter the cell's epigenetic homeostasis, and activate signaling pathways. However, changes in gene expression associated with Ni exposure have only been investigated in vitro. This study was conducted in a Chinese population to determine whether occupational exposure to Ni was associated with differential gene expression profiles in the peripheral blood mononuclear cells (PBMC) of Ni-refinery workers when compared with referents.Methods: Eight Ni-refinery workers and ten referents were selected. PBMC RNA was extracted and gene expression profiling was conducted using Affymetrix exon arrays. Differentially expressed genes (DEG) between both groups were identified in a global analysis.Results: There were a total of 2,756 DEGs in the Ni-refinery workers relative to the referents [false discovery rate (FDR) adjusted P &lt; 0.05] with 770 upregulated genes and 1,986 downregulated genes. DNA repair and epigenetic genes were significantly overrepresented (P &lt; 0.0002) among the DEGs. Of 31 DNA repair genes, 29 were repressed in the Ni-refinery workers and 2 were overexpressed. Of the 16 epigenetic genes, 12 were repressed in the Ni-refinery workers and 4 were overexpressed.Conclusions: The results of this study indicate that occupational exposure to Ni is associated with alterations in gene expression profiles in PBMCs of subjects.Impact: Gene expression may be useful in identifying patterns of deregulation that precede clinical identification of Ni-induced cancers. Cancer Epidemiol Biomarkers Prev; 22(2); 261–9. ©2012 AACR.
Efficacy and safety of thromboprophylaxis with low-molecular-weight heparin or rivaroxaban in hip and knee replacement surgery
Authors: Lützner Jörg , Donath Lars , Tittl Luise , Knoth Holger , Radke Oliver C. , Kuhlisch Eberhard , Stange Thoralf , Hartmann Albrecht , Günther Klaus-Peter , Weiss Norbert , Werth Sebastian , Beyer-Westendorf Jan 
Published: November 2012

SummaryProspective trials have shown that rivaroxaban thromboprophylaxis is superior over low-molecular-weight heparin (LMWH) in patients undergoing hip and knee replacement surgery. However, patients treated under trial conditions are different from unselected routine patients, which may affect efficacy and safety of thromboprophylaxis. The objective was to evaluate the efficacy and safety of rivaroxaban or LMWH thromboprophylaxis in unselected patients undergoing hip and knee replacement surgery in daily care. In a monocentric, retrospective cohort study in 5,061 consecutive patients undergoing hip and knee replacement surgery a comparison of LMWH (hospital standard in 2006–2007) and rivaroxaban (since 2009) was made with regard to rates of symptomatic VTE, bleeding and surgical complications and length of hospital stay. Rates of symptomatic VTE were 4.1 % (LMWH) and 2.1 % (rivaroxaban; p=0.005) with rates for distal DVT 2.5 vs. 1.1 % (p<0.001). Rates of major VTE were numerically higher with LMWH (1.7 vs. 1.1%, not statistically significant). Rates of major bleeding (overt bleeding leading to surgical revision or death, occurring in a critical site, or transfusion of at least two units of packed red blood cells) were statistically lower with rivaroxaban (2.9 vs. 7.0%; p<0.001). Rivaroxaban patients had fewer surgical complications (1.1 vs. 3.7%; p<0.001) and a shorter length of hospitalisation (8.3 days; 95% CI 8.1– 8.5 vs. 11.1 days; 10.7– 11.5; p< 0.001). We conclude that rivaroxaban thromboprophylaxis is more effective than LMWH in unselected patients undergoing hip and knee replacement surgery in daily care and that switching from LMWH to rivaroxaban could be beneficial. Prospective comparisons are warranted to confirm our findings.