bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence‐Based Practice Beliefs and Implementation Before and After an Initiative to Promote Evidence‐Based Nursing in an Ambulatory Oncology Setting
Authors: Underhill Meghan , Roper Kristin , Siefert Mary Lou , Boucher Jean , Berry Donna 
Published: February 2015

ABSTRACTBackgroundThe purpose of evidence‐based practice (EBP) in nursing is to improve patient outcomes, providing the best and most up‐to‐date care practices. In 2011, a nurse‐led committee convened to develop an institute‐wide initiative to promote EBP with oncology nurses at the Dana‐Farber Cancer Institute.AimsCompare and describe oncology nurse beliefs and perceived implementation of EBP and explore beliefs and implementation before and after implementing an institutional EBP initiative.MethodsBased on the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence‐Based Practice Beliefs (EBP‐B) and Implementation (EBP‐I) scales were distributed to all Dana‐Farber Cancer Institute registered and advanced practice nurses through an online survey in 2011 (T1) and again in 2013 (T2) after the implementation of an institute‐wide nursing EBP initiative (orientation, poster presentations, education). Descriptive and correlation statistics were completed on total scores and demographics. Differences in beliefs and implementation scores based on demographics were analyzed with Mann–Whitney U tests. Open‐ended item responses at each time point (T) were summarized for EBP barriers and promoters.FindingsThirty‐two percent (n = 112 at T1; n = 113 at T2) of 350 nurses began the survey. A history of formal EBP education and nurse role were associated with higher EBP‐B and EBP‐I scores (p < .05). Highest level of education was significantly correlated with both EBP‐B (r = .25; p = .03) and EBP‐I (r = .32; p = .01). Narrative responses to open‐ended questions described perceived personal and environmental barriers to engaging in EBP.Linking Evidence to ActionAlthough no significant differences were noted in beliefs and implementation after the EBP initiative, nurses reported valuing EBP. Respondents acknowledged a lack of full preparation in the EBP process to engage in and implement EBP consistently. Nurse role, formal EBP education, and highest level of education were associated with perceptions of EBP beliefs and implementation. Nurses should be provided the mentorship and support to obtain continuing education about how to engage in EBP and about implementing EBP change.
Regulation of
Csf1r
and
Bcl6
in Macrophages Mediates the Stage-Specific Effects of MicroRNA-155 on Atherosclerosis
Authors: Wei Yuanyuan , Zhu Mengyu , Corbalán-Campos Judit , Heyll Kathrin , Weber Christian , Schober Andreas 
Published: February 2015

Objective—
The function of microRNAs is highly context and cell type dependent because of their highly dynamic expression pattern and the regulation of multiple mRNA targets. MicroRNA-155 (miR-155) plays an important role in the innate immune response by regulating macrophage function; however, the effects of miR-155 in macrophages on atherosclerosis are controversial. We hypothesized that the stage-dependent target selection of miR-155 in macrophages determines its effects on atherosclerosis.

Approach and Results—

The expression of miR-155 increased in lesional macrophages of apolipoprotein E–deficient mice between 12 and 24 weeks of a high-cholesterol diet.
Mir155
knockout in apolipoprotein E–deficient mice enhanced lesion formation, increased the lesional macrophage content, and promoted macrophage proliferation after 12 weeks of the high-cholesterol diet. In vitro, miR-155 inhibited macrophage proliferation by suppressing colony-stimulating factor-1 receptor, which was upregulated in lesional macrophages of
Mir155

–/–

apolipoprotein E–deficient mice. By contrast,
Mir155
deficiency reduced necrotic core formation and the deposition of apoptotic cell debris, thereby preventing the progression of atherosclerosis between 12 and 24 weeks of the high-cholesterol diet. miR-155 inhibited efferocytosis in vitro by targeting B-cell leukemia/lymphoma 6 and thus activating RhoA (ras homolog gene family, member A). Accordingly, B-cell leukemia/lymphoma 6 was upregulated in lesional macrophages of
Mir155

–/–

apolipoprotein E–deficient mice after 24 weeks, but not after 12 weeks of the high-cholesterol diet.

Conclusions—
Our findings demonstrate a stage-specific role of miR-155 in lesion formation. miR-155 suppressed macrophage proliferation by targeting colony-stimulating factor-1 receptor in early and impaired efferocytosis by downregulating B-cell leukemia/lymphoma 6 in advanced atherosclerosis. Therefore, targeting the interaction between miR-155 and B-cell leukemia/lymphoma 6 may be a promising approach to inhibit the progression of atherosclerosis.
Rates of Ischemic Stroke During Warfarin Treatment for Atrial Fibrillation
Authors: Tung Jennifer M. , Mamdani Muhammad M. , Juurlink David N. , Paterson J. Michael , Kapral Moira K. , Gomes Tara 
Published: February 2015

Background and Purpose—
Recent evidence suggests that there may be an increased risk of ischemic stroke immediately after warfarin initiation. We examined the rate of ischemic stroke among patients with atrial fibrillation newly started on warfarin therapy.

Methods—
We conducted a population-based cohort study among Ontario residents aged ≥66 years with atrial fibrillation who received warfarin between April 1, 1997, and March 31, 2010. Each patient was followed up for ≤5 years in 30-day intervals. For each interval, we determined the rate of ischemic stroke.

Results—
After 5 years, the cumulative incidence of ischemic stroke among new users of warfarin (n=148 446) was 4.0% (n=6006). The risk was highest during the first 30 days after initiation (6.0% per person-year; 95% confidence interval, 5.5%–6.4%) compared with the remainder of follow-up (1.6% per person-year; 95% confidence interval, 1.5%–1.6%), and increased with higher baseline CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes, previous stroke) scores. Less frequent monitoring may have contributed.

Conclusions—
In a large cohort of older patients with atrial fibrillation, we observed the highest rate of ischemic stroke in the first 30 days after warfarin initiation. Although causation cannot be established given the observational nature of this study, our findings highlight the need for future research in this population.
Occult Anterograde Flow Is an Under-Recognized but Crucial Predictor of Early Recanalization With Intravenous Tissue-Type Plasminogen Activator
Authors: Ahn Seong Hwan , d’Esterre Christopher D. , Qazi Emmad M. , Najm Mohammed , Rubiera Marta , Fainardi Enrico , Hill Michael D. , Goyal Mayank , Demchuk Andrew M. , Lee Ting Y. , Menon Bijoy K. 
Published: February 2015

Background and Purpose—
Thrombolysis depends on the ability of blood and thrombolytic agents to permeate thrombus. We devised a novel technique to quantify blood permeating through thrombi and determine whether this parameter predicts early recanalization with intravenous tissue-type plasminogen activator.

Methods—
Intravenous tissue-type plasminogen activator–treated patients with stroke and complete occlusion on computed tomographic angiography were analyzed using perfusion computed tomography and a delay insensitive algorithm. We generated maps that measure delay in arrival time of contrast within the intracranial arterial tree (T0 maps). A positive sloped regression line of T0 values measured along artery silhouette distal to thrombus was defined as marker of permeable thrombus (occult anterograde flow). Median T0 values at proximal and distal thrombus interface were measured. Early recanalization was assessed on first angiography of subsequent intra-arterial procedure or on a 4-hour computed tomographic angiography.

Results—

Of 66 patients, occult anterograde flow was detected in 17 (25.8%). Early recanalization was more in patients with occult anterograde flow versus not (66.7 versus 29.7%;
P
=0.031). Median T0 value (in s) at distal thrombus interface (1.5 versus 3.8;
P
=0.006) and difference in median T0 value between proximal and distal thrombus interface (1.3 versus 3.7;
P
=0.014) were less in early recanalizers versus in nonrecanalizers. In multivariable analysis, patients with occult anterograde flow and T0 value difference between proximal and distal thrombus interface ≤2 s recanalized most (71.4%; odds ratio, 12.15; 95% confidence interval, 2.05–71.91), whereas patients with retrograde flow and T0 value difference >2 s recanalized least (25.9%; odds ratio, 1).

Conclusions—
Occult anterograde flow through thrombus can be assessed by perfusion computed tomography T0 maps and predicts early recanalization with intravenous tissue-type plasminogen activator robustly.
Decadal Rainfall Dipole Oscillation over Southern Africa Modulated by Variation of Austral Summer Land–Sea Contrast along the East Coast of Africa
Authors: Zhang Qiong , Holmgren Karin , Sundqvist Hanna 
Published: February 2015

Abstract
A rainfall dipole mode characterized by negative correlation between subtropical southern Africa and equatorial eastern Africa is identified in instrumental observation data in the recent 100 years. The dipole mode shows a pronounced oscillation signal at a time scale of about 18 years. This study investigates the underlying dynamical mechanisms responsible for this dipole pattern.
It is found that the southern African rainfall dipole index is highly correlated to the land–sea contrast along the east coast of Africa. When the land–sea thermal contrast strengthens, the easterly flow toward the continent becomes stronger. The stronger easterly flow, via its response to east coast topography and surface heating, leads to a low pressure circulation anomaly over land south of the maximum easterly flow anomalies and thus causes more rainfall in the south.
On a decadal time scale, an ENSO-like SST pattern acts to modulate this land–sea contrast and the consequent rainfall dipole. During a “wet in the south and dry in the north” dipole, there are warm SSTs over the central Indian Ocean and cold SSTs over the western Indian Ocean. The cold SSTs over the western Indian Ocean further enhance the land–sea contrast during austral summer. Moreover, these cold western Indian Ocean SSTs also play an important role in regulating land temperature, thereby suppressing clouds and warming the land via increased shortwave radiation over the less-cloudy land. This cloud–SST coupling acts to further strengthen the land–sea contrast.
Absolute and Convective Instability of the African Easterly Jet
Authors: Diaz Michael , Aiyyer Anantha 
Published: February 2015

Abstract
The stability of the African easterly jet (AEJ) is examined using idealized numerical simulations. It is found that a zonally homogeneous representation of the AEJ can support absolute instability in the form of African easterly waves (AEWs). This finding is verified through a local energy budget, which demonstrates the presence of both upstream and downstream energy fluxes. These energy fluxes allow unstable wave packets to spread upstream and downstream relative to their initial point of excitation. This finding is further verified by showing that the ground-relative group velocity of these wave packets has both eastward and westward components. In contrast with normal-mode instability theory, which emphasizes wave growth through energy extraction from the basic state, the life cycle of the simulated AEWs is strongly governed by energy fluxes. Convergent fluxes at the beginning of the AEW storm track generate new AEWs, whereas divergent fluxes at the end of the storm track lead to their decay. It is argued that, even with small normal-mode growth rates and a short region of instability, the presence of absolute instability allows AEWs to develop through the mixed baroclinic–barotropic instability mechanism, because upstream energy fluxes allow energy extracted through baroclinic and barotropic conversion to be recycled between successive AEWs.
Use of a voice and video internet technology as an alternative to in-person urgent care clinic visits
Authors: Brunett Patrick H , DiPiero Albert , Flores Christine , Choi Dongseok , Kum Hayley , Girard Donald E 
Published: February 2015

Summary This study aimed to determine the feasibility of patient-initiated online Internet urgent care visits, and to describe patient characteristics, scope of care, provider adherence to protocols, and diagnostic and therapeutic utilization. A total of 456 unique patients were seen via Internet-based technology during the study period, generating 478 consecutive total patient visits. Of the 82 patients referred for an in-person evaluation, 75 patients (91.5%) reported to the clinic as instructed. None of the 82 patients recommended for in-person evaluation required an emergency department referral, hospital admission or urgent consultative referral. We conclude that real-time online primary and urgent care visits are feasible, safe and potentially beneficial in increasing convenient access to urgent and primary care.
Three-year follow-up of treatment-naïve and previously treated patients with CLL and SLL receiving single-agent ibrutinib
Authors: Byrd John C. , Furman Richard R. , Coutre Steven E. , Burger Jan A. , Blum Kristie A. , Coleman Morton , Wierda William G. , Jones Jeffrey A. , Zhao Weiqiang , Heerema Nyla A. , Johnson Amy J. , Shaw Yun , Bilotti Elizabeth , Zhou Cathy , James Danelle F. , O'Brien Susan 
Published: February 2015

Key Points
Three-year follow-up of ibrutinib in CLL demonstrated continued activity with durable responses that improve in quality with extended treatment. Toxicity diminished over time with respect to grade ≥3 cytopenias, fatigue, infections, and adverse events leading to discontinuation.
Cellular fibronectin containing extra domain A promotes arterial thrombosis in mice through platelet Toll-like receptor 4
Authors: Prakash Prem , Kulkarni Paresh P. , Lentz Steven R. , Chauhan Anil K. 
Published: February 2015

Key PointsFn-EDA+ promotes arterial thrombosis. Platelet TLR4 mediates the prothrombotic effect of cellular Fn.
A case–control analysis of oral contraceptive use and breast cancer subtypes in the African American Breast Cancer Epidemiology and Risk Consortium
Authors: Bethea Traci N , Rosenberg Lynn , Hong Chi-Chen , Troester Melissa A , Lunetta Kathryn L , Bandera Elisa V , Schedin Pepper , Kolonel Laurence N , Olshan Andrew F , Ambrosone Christine B , Palmer Julie R 
Published: February 2015

Abstract
Introduction
Recent oral contraceptive (OC) use has been consistently associated with increased risk of breast cancer, but evidence on specific breast cancer subtypes is sparse.

Methods
We investigated recency and duration of OC use in relation to molecular subtypes of breast cancer in a pooled analysis of data from the African American Breast Cancer Epidemiology and Risk Consortium. The study included 1,848 women with estrogen receptor-positive (ER+) breast cancer, 1,043 with ER-negative (ER-) breast cancer (including 494 triple negative (TN) tumors, which do not have receptors for estrogen, progesterone, and human epidermal growth factor 2), and 10,044 controls. Multivariable polytomous logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for exposure categories relative to never use, controlling for potential confounding variables.

Results
OC use within the previous 5 years was associated with increased risk of ER+ (OR 1.46, 95% CI 1.18 to 1.81), ER- (OR 1.57, 95% CI 1.22 to 1.43), and TN (OR 1.78, 95% CI 1.25 to 2.53) breast cancer. The risk declined after cessation of use but was apparent for ER+ cancer for 15 to 19 years after cessation and for ER- breast cancer for an even longer interval after cessation. Long duration of use was also associated with increased risk of each subtype, particularly ER-.

Conclusions
Our results suggest that OC use, particularly recent use of long duration, is associated with an increased risk of ER+, ER-, and TN breast cancer in African American women. Research into mechanisms that explain these findings, especially the association with ER- breast cancer, is needed.
RANK-ligand (RANKL) expression in young breast cancer patients and during pregnancy
Authors: Azim Hatem A , Peccatori Fedro A , Brohée Sylvain , Branstetter Daniel , Loi Sherene , Viale Giuseppe , Piccart Martine , Dougall William C , Pruneri Giancarlo , Sotiriou Christos 
Published: February 2015

Abstract
Introduction
RANKL is important in mammary gland development during pregnancy and mediates the initiation and progression of progesterone-induced breast cancer. No clinical data are available on the effect of pregnancy on RANK/RANKL expression in young breast cancer patients.

Methods
We used our previously published dataset of 65 pregnant and 130 matched young breast cancer patients with full clinical, pathological, and survival information. 85% of patients had available transcriptomic data as well. RANK/RANKL expression by immunohistochemistry using H-score on the primary tumor and adjacent normal tissue was performed. We examined the difference in expression of RANK/RANKL between pregnant and non-pregnant patients and their association with clinicopathological features and prognosis. We also evaluated genes and pathways associated with RANK/RANKL expression on primary tumors.

Results
RANKL but not RANK expression was more prevalent in the pregnant group, both on the tumor and adjacent normal tissue, independent of other clinicopathological factors (both P <0.001). 18.7% of pregnant and 5.3% of non-pregnant patients had tumors showing ≥10% of cells with 3+ RANKL expression. RANKL expression was significantly higher in progesterone receptor-positive, and luminal A-like tumors, with negative correlation with Ki-67 (all P <0.001). On the contrary, RANK expression was higher in triple negative tumors (P <0.001). Using false discovery rate <0.05, 151 and 1,207 genes were significantly correlated with tumor-expressed RANKL and RANK expression by immunohistochemistry, respectively. High RANKL expression within primary tumor was associated with pathways related to mammary gland development, bone resorption, T-cell proliferation and regulation of chemotaxis, while RANK expression was associated with immune response and proliferation pathways. At a median follow-up of 65 months, neither RANK nor RANKL expression within tumor was associated with disease free survival in pregnant or non-pregnant group.

Conclusions
Pregnancy increases RANKL expression both in normal breast and primary tumors. These results could guide further development of RANKL-targeted therapy.
Unraveling heterogeneous susceptibility and the evolution of breast cancer using a systems biology approach
Authors: Castellanos-Martín Andrés , Castillo-Lluva Sonia , Sáez-Freire María del Mar , Blanco-Gómez Adrián , Hontecillas-Prieto Lourdes , Patino-Alonso Carmen , Galindo-Villardon Purificación , Pérez del Villar Luis , Martín-Seisdedos Carmen , Isidoro-Garcia María , Abad-Hernández María del Mar , Cruz-Hernández Juan Jesús , Rodríguez-Sánchez César Augusto , González-Sarmiento Rogelio , Alonso-López Diego , De Las Rivas Javier , García-Cenador Begoña , García-Criado Javier , Lee Do Yup , Bowen Benjamin , Reindl Wolfgang , Northen Trent , Mao Jian-Hua , Pérez-Losada Jesús 
Published: February 2015

Abstract
Background
An essential question in cancer is why individuals with the same disease have different clinical outcomes. Progress toward a more personalized medicine in cancer patients requires taking into account the underlying heterogeneity at different molecular levels.

Results
Here, we present a model in which there are complex interactions at different cellular and systemic levels that account for the heterogeneity of susceptibility to and evolution of ERBB2-positive breast cancers. Our model is based on our analyses of a cohort of mice that are characterized by heterogeneous susceptibility to ERBB2-positive breast cancers. Our analysis reveals that there are similarities between ERBB2 tumors in humans and those of backcross mice at clinical, genomic, expression, and signaling levels. We also show that mice that have tumors with intrinsically high levels of active AKT and ERK are more resistant to tumor metastasis. Our findings suggest for the first time that a site-specific phosphorylation at the serine 473 residue of AKT1 modifies the capacity for tumors to disseminate. Finally, we present two predictive models that can explain the heterogeneous behavior of the disease in the mouse population when we consider simultaneously certain genetic markers, liver cell signaling and serum biomarkers that are identified before the onset of the disease.

Conclusions
Considering simultaneously tumor pathophenotypes and several molecular levels, we show the heterogeneous behavior of ERBB2-positive breast cancer in terms of disease progression. This and similar studies should help to better understand disease variability in patient populations.
Alpha-synucleinopathy and neuropsychological symptoms in a population-based cohort of the elderly
Authors: Zaccai Julia , Brayne Carol , Matthews Fiona E , Ince Paul G ,   on behalf of the MRC Cognitive Function and Ageing Neuropathology Study
Published: February 2015

Abstract
Introduction
Studies with strong selection biases propose that alpha-synucleinopathy (AS) spreads upwards and downwards in the neuraxis from the medulla, that amygdala-dominant AS is strongly associated with Alzheimer’s disease (AD), and that a more severe involvement of the cerebral cortex is correlated with increasing risk of dementia. This study examines the association of AS patterns and observed neuropsychological symptoms in brains of a population-representative donor cohort.

Methods
Brains donated in 2 out of 6 cognitive function and ageing study cohorts (Cambridgeshire and Nottingham) were examined. Over 80% were >80 years old at death. The respondents were evaluated prospectively in life for cognitive decline and dementia. Immunocytochemistry for tau and alpha-synuclein (using LB509 by Zymed Laboratories) was carried out in 208 brains to establish Braak stage and the pattern and severity of AS following the dementia with Lewy bodies (DLB) consensus recommendations. Dementia, specific neuropsychological measures as measured using the Cambridge cognitive examination, the presence of hallucinations and Parkinson’s disease were investigated.

Results
Four patterns of AS were observed: no AS pathology (n = 92), AS pathology following the DLB consensus guidelines (n = 33, of which five were ‘neocortical’), amygdala-predominant AS (n = 18), and other AS patterns (n = 33). Each group was subdivided according to high/low neurofibrillary tangles (NFT) Braak stage. Results showed no association between dementia and these patterns of AS, adjusting for the presence of NFT or not. The risk of visual hallucinations shows a weak association with AS in the substantia nigra (odds ratio (OR) = 3.2; 95% confidence interval (CI) 0.5 to 15.5; P = 0.09) and amygdala (OR = 3.0; 95% CI 0.7 to 12.3; P = 0.07). The analysis is similar for auditory hallucinations in subcortical regions.

Conclusions
Among the whole population of older people, AS does not increase the risks for dementia, irrespective of Braak stage of NFT pathology. There was no evidence that the pattern of AS pathology in cortical areas was relevant to the risk of hallucination. In general, the hypothesis that AS as measured using these methods per se is a key determinant of cognitive clinical phenotypes is not supported.