bluuebunny/crossref_metadata_2025_split huggingface dataset:
A favourable prognostic marker for EGFR mutant non-small cell lung cancer: immunohistochemical analysis of MUC5B
Authors: Wakata Kouki , Tsuchiya Tomoshi , Tomoshige Koichi , Takagi Katsunori , Yamasaki Naoya , Matsumoto Keitaro , Miyazaki Takuro , Nanashima Atsushi , Whitsett Jeffrey A , Maeda Yutaka , Nagayasu Takeshi 
Published: July 2015

ObjectivesTo determine the use of the mucin proteins MUC5B and MUC5AC as prognosis markers for non-small cell lung cancer (NSCLC) carrying epidermal growth factor receptor (EGFR) mutations.SettingPatients who underwent surgical resection at Nagasaki University Hospital and related facilities in Japan between June 1996 and March 2013.Participant159 Japanese patients (male: n=103; female: n=56) with NSCLC, who underwent surgical resection (EGFR-mutant type: n=78,EGFRwild type: n=81).ResultsPatients whose tumours expressed MUC5B had significantly longer overall survival and relapse-free survival compared to the MUC5B-negative patients withEGFRmutant NSCLC (p=0.0098 and p=0.0187, respectively). In patients withEGFRwild-type NSCLC, there was no association with MUC5B expression. MUC5AC expression was not different betweenEGFRmutant and wild-type NSCLC.ConclusionsPresent findings indicate that MUC5B, but not MUC5AC, is a novel prognostic biomarker for patients with NSCLC carryingEGFRmutations but not for patients with NSCLC carrying wild-typeEGFR.
An Empirical Study to Evaluate the Best Anchoring Positions in Nested Menus for Optimized Access Time
Authors: Kandari Pragya , Jain Ajay 
Published: July 2015

In any application user interface, a user spends some amount of time trying to access specific menu items. This time increases when the menu item is nested deep within hierarchical menu. The goal of a user is to reach a menu item with as few clicks, as possible. And, the number of clicks/time depends on how the parent and child menu items are nested and laid out on the interface.
This paper analyzes the organization of parent and child menu items on a user interface and is an empirical study to determine the optimum positions of anchoring points between the parent and child menus. The findings of this study would help user interface designers to optimize the time traversed by users in reaching a specific menu item.
Platelets, inflammation and anti-inflammatory effects of antiplatelet drugs in ACS and CAD
Authors: Müller Karin , Chatterjee Madhumita , Rath Dominik , Geisler Tobias 
Published: July 2015

SummaryPlatelets play a pivotal role in chronic inflammation leading to progression of atherosclerosis and acute coronary events. Recent discoveries on novel mechanisms and platelet-dependent inflammatory targets underpin the role of platelets to maintain a chronic inflammatory condition in cardiovascular disease. There is strong and clinically relevant crosslink between chronic inflammation and platelet activation. Antiplatelet therapy is a cornerstone in the prevention and treatment of acute cardiovascular events. The benefit of antiplatelet agents has mainly been attributed to their direct anti-aggregatory impact. Some anti-inflammatory off-target effects have also been described. However, it is unclear whether these effects are secondary due to inhibition of platelet activation or are caused by direct distinct mechanisms interfering with inflammatory pathways. This article will highlight novel platelet associated targets that contribute to inflammation in cardiovascular disease and elucidate mechanisms by which currently available antiplatelet agents evolve anti-inflammatory capacities, in particular by carving out the differential mechanisms directly or indirectly affecting platelet mediated inflammation. It will further illustrate the prognostic impact of antiplatelet therapies by reducing inflammatory marker release in recent cardiovascular trials.
Responding to changes in HIV policy: Updating and enhancing the Families Matter! curriculum
Authors: Miller Kim S , Winskell Kate , Berrier Faith L 
Published: July 2015

Objectives: The past decade has seen changes in US HIV policy in sub-Saharan Africa in response to a new Administration and far-reaching technical, scientific and programmatic developments. These include dramatically increased access to life-saving anti-retroviral therapy (ART) and related services, the roll-out of voluntary medical male circumcision and growing sensitivity to gender-based violence, including child sexual abuse, and to its role in increasing vulnerability to HIV. The Families Matter! Program (FMP) is an intervention for parents and caregivers of 9- to 12-year-olds that promotes effective parent–child communication about sexuality and sexual risk reduction. FMP was adapted from a US evidence-based intervention in 2003–2004 and is now implemented in eight African countries. In 2012–2013, the FMP curriculum was updated and enhanced to respond to new US Government priorities. Methods: Enhancements to the curriculum drew on the results of Violence Against Children surveys, on a review of existing literature, on feedback from the field on the existing curriculum and on stories written by young people across Africa for scriptwriting competitions. Results: We updated FMP with scientific content and stronger linkages to services. We also intensified our focus on structural determinants of risk. This contextualisation of sexual risk-taking within structural constraints led us to place greater emphasis on gendered vulnerability and the diverse pressures children face and to intensify our situation-based pedagogical approach, drawing on the authentic youth-authored narratives. Conclusion: We describe these changes as an illustration of and source of insight into much-needed programmatic adaptation in response to evolving HIV policy.
Intermediate outcomes of rheumatic mitral stenosis post-balloon mitral valvotomy
Authors: Sharma Jugal , Goel Pravin K , Pandey Chandra Mani , Awasthi Ashish , Kapoor Aditya , Tewari Satyendra , Garg Naveen , Kumar Sudeep , Khanna Roopali 
Published: July 2015

Background Balloon mitral valvotomy is a standard therapeutic modality for managing rheumatic mitral stenosis. Data on intermediate outcomes of this procedure are limited. Thus we investigated the intermediate outcome after balloon mitral valvotomy performed at a large tertiary center in India. Methods Case records and follow-up data of 2330 patients who underwent valvotomy from June 1999 to December 2005 were retrieved from the hospital information system and analyzed. Results The median age of the patients was 32 ± 11 years, 1363 were female including 36 who were pregnant, and 379 were in atrial fibrillation. Follow-up ranged from 1 to 14 years (mean 4.5 years, median 4.0 years). The procedural success rate was 93%. Atrial fibrillation, higher functional class, and worse valve morphology were independent predictors of a poor procedural outcome. Patients with sinus rhythm had better event-free survival (10.43 years, 95% confidence interval: 10.1–10.7) compared to those with atrial fibrillation (8.17 years, 95% confidence interval: 7.5–8.8). Patients who achieved a valve area >1.75 cm2 had a better event-free survival (11.7 years, 95% confidence interval: 11.4–12.0) than those with a valve area of 1.5–1.74 cm2 (9.3 years, 95% confidence interval: 9.0–9.7). On multivariate analysis, higher functional class, worse valve morphology, and new significant mitral regurgitation were predictors of a poor outcome. Achieved mitral valve area >1.75 cm2 was an independent predictor of a good outcome. Conclusion Patients with sinus rhythm, less gross valve deformity, and a post-balloon mitral valvotomy area >1.75 cm2 had better intermediate outcomes.
Introducing a model incorporating early integration of specialist palliative care: A qualitative research study of staff’s perspectives
Authors: Michael Natasha , O’Callaghan Clare , Brooker Joanne E , Walker Helen , Hiscock Richard , Phillips David 
Published: July 2015

Background: Palliative care has evolved to encompass early integration, with evaluation of patient and organisational outcomes. However, little is known of staff’s experiences and adaptations when change occurs within palliative care services. Aim: To explore staff experiences of a transition from a service predominantly focused on end-of-life care to a specialist service encompassing early integration. Design: Qualitative research incorporating interviews, focus groups and anonymous semi-structured questionnaires. Data were analysed using a comparative approach. Service activity data were also aggregated. Setting/participants: A total of 32 medical, nursing, allied health and administrative staff serving a 22-bed palliative care unit and community palliative service, within a large health service. Results: Patients cared for within the new model were significantly more likely to be discharged home (7.9% increase, p = 0.003) and less likely to die in the inpatient unit (10.4% decrease, p < 0.001). While early symptom management was considered valuable, nurses particularly found additional skill expectations challenging, and perceived patients’ acute care needs as detracting from emotional and end-of-life care demands. Staff views varied on whether they regarded the new model’s faster-paced work-life as consistent with fundamental palliative care principles. Less certainty about care goals, needing to prioritise care tasks, reduced shared support rituals and other losses could intensify stress, leading staff to develop personalised coping strategies. Conclusion: Services introducing and researching innovative models of palliative care need to ensure adequate preparation, maintenance of holistic care principles in faster work-paced contexts and assist staff dealing with demands associated with caring for patients at different stages of illness trajectories.
Vestibular migraine in multicenter neurology clinics according to the appendix criteria in the third beta edition of the International Classification of Headache Disorders
Authors: Cho Soo-Jin , Kim Byung-Kun , Kim Byung-Su , Kim Jae-Moon , Kim Soo-Kyoung , Moon Heui-Soo , Song Tae-Jin , Cha Myoung-Jin , Park Kwang-Yeol , Sohn Jong-Hee 
Published: July 2015

Background Vestibular migraine (VM), the common term for recurrent vestibular symptoms with migraine features, has been recognized in the appendix criteria of the third beta edition of the International Classification of Headache Disorders (ICHD-3β). We applied the criteria for VM in a prospective, multicenter headache registry study. Methods Nine neurologists enrolled consecutive patients visiting outpatient clinics for headache. The presenting headache disorder and additional VM diagnoses were classified according to the ICHD-3β. The rates of patients diagnosed with VM and probable VM using consensus criteria were assessed. Results A total of 1414 patients were enrolled. Of 631 migraineurs, 65 were classified with VM (10.3%) and 16 with probable VM (2.5%). Accompanying migraine subtypes in VM were migraine without aura (66.2%), chronic migraine (29.2%), and migraine with aura (4.6%). Probable migraine (75%) was common in those with probable VM. The most common vestibular symptom was head motion-induced dizziness with nausea in VM and spontaneous vertigo in probable VM. The clinical characteristics of VM did not differ from those of migraine without VM. Conclusion We diagnosed VM in 10.3% of first-visit migraineurs in neurology clinics using the ICHD-3β. Applying the diagnosis of probable VM can increase the identification of VM.
Juvenile systemic lupus erythematosus: onset patterns and short-term outcome in Egyptian children, a single-center experience
Authors: Abdel-Hafez M A , Abdel-Nabi H 
Published: July 2015

Objective The objective of this article is to define disease onset pattern and understand the response to therapy in children with systemic lupus erythematosus (SLE) in Egypt. Methods A prospective cohort of 41 Egyptian children diagnosed with SLE was analyzed. SLE Disease Activity Index (SLEDAI) score was used to record disease activity at onset, and renal biopsy was performed to define the stage of lupus nephritis. Response to therapy over a follow-up period ranging from 10 to 50 months was evaluated. Results The mean age at diagnosis was 12.12 ± 3.45 years. Thirty-six (87.8%) patients were females. Most patients had multiple manifestations at onset. The most common presenting symptoms were pallor and fever (51.2% and 43.9%, respectively). Lupus nephritis was found in 27 (65.9%) children. International Society of Nephrology (ISN) classes I and III were the most common findings on renal biopsy. Neuropsychiatric manifestations were present at disease onset in 19 patients (46.3%) with a bad prognostic course. At diagnosis, high SLEDAI scores were recorded (mean: 29.95 ± 2.06). The mean renal SLEDAI score was 10.2 ± 4. At follow-up 16 (39.02%) patients were in complete remission, 10 (24.39%) were in partial remission, two (4.87%) had active disease, five (12.9%) had relapsed, four (9.75%) had died and four (9.75%) patients were lost to follow-up. Conclusions Egyptian children with SLE appear to have severe disease on presentation with high SLEDAI scores and high prevalence of lupus nephritis, but respond well to therapy with a favorable short-term prognosis.
Assessing and managing suicidal patients in the emergency department
Authors: Ryan Christopher James , Large Matthew , Gribble Robert , Macfarlane Matthew , Ilchef Ralf , Tietze Tad 
Published: July 2015

Objective: The objective of this article is to set out consensus guidelines for the assessment and management of “suicidal patients” in the emergency department. Conclusions: Clinicians should be respectful and reassuring. They should review old notes, conduct a full history and examination, and talk to friends, family and any practitioners already involved in the patient’s care. Management should be guided, where possible, by the patient’s preferences, not by notions of risk. Every negotiated management plan and its rationale should be carefully documented.
An innovative community organizing campaign to improve mental health and wellbeing among Pacific Island youth in South Auckland, New Zealand
Authors: Han Hahrie , Nicholas Alexandra , Aimer Margaret , Gray Jonathon 
Published: July 2015

Objective: To examine whether being an organizer in a community organizing program improves personal agency and self-reported mental health outcomes among low-income Pacific Island youth in Auckland, New Zealand. Method: Counties Manukau Health initiated a community organizing campaign led and run by Pacific Island youth. We used interviews, focus groups and pre- and post-campaign surveys to examine changes among 30 youths as a result of the campaign. Results: Ten youths completed both pre- and post-campaign surveys. Eleven youths participated in focus groups, and four in interviews. Overall, youths reported an increased sense of agency and improvements to their mental health. Conclusions: Community organizing has potential as a preventive approach to improving mental health and developing agency over health among disempowered populations.
A Novel Aerosol Foam Formulation of Calcipotriol and Betamethasone Has No Impact on HPA Axis and Calcium Homeostasis in Patients With Extensive Psoriasis Vulgaris
Authors: Taraska Victoria , Tuppal Raj , Olesen Martin , Bang Pedersen Claus , Papp Kim 
Published: July 2015

Background: Fixed combination calcipotriol 50 µg/g (Cal; as hydrate) plus betamethasone 0.5 mg/g (as dipropionate; BD) has been formulated in an innovative aerosol foam. Objective: To assess systemic safety of Cal/BD aerosol foam. Methods: In a multicentre, single-arm, open-label, maximal-use systemic-exposure trial, adult patients with moderate to severe, extensive psoriasis (15%-30% of body surface area, including ≥30% of scalp) applied Cal/BD foam once daily. Endpoints were week 4 abnormal adrenocorticotropic hormone (ACTH) challenge test and change in albumin-corrected serum calcium, 24-hour urinary calcium excretion, and urinary calcium-creatinine ratio. Results: 35 patients reaching week 4 exhibited normal ACTH responses. At week 4, changes in calcium homeostasis were minor and not clinically relevant; no patients experienced elevations above normal. Disease severity generally improved, and 49% of patients achieved treatment success according to the Physician’s Global Assessment of Disease Severity. Conclusion: No clinically relevant HPA axis or calcium homeostasis impact was observed with 4 weeks of once-daily Cal/BD foam in patients with extensive psoriasis vulgaris.
Coronary artery disease secondary to familial hypercholesterolaemia: An infrequent cause of increasingly common pregnancy co-morbidity
Authors: Varnier Nicla A , Pettit Franzisca , Rees David , Thou Steven , Brown Mark , Henry Amanda 
Published: July 2015

Background Cardiovascular disease affects 0.2–4% of pregnancies. Coupled with the physiological stress of pregnancy, cardiovascular disease may present significant management challenges including appropriate risk:benefit analysis of medical and surgical management options. Case A 33-year-old gravida 4 para 1 miscarriage 2 presented at 18 weeks’ gestation to the high-risk pregnancy service with a history of coronary artery disease and homozygous familial hypercholesterolaemia. Pre-pregnancy echocardiogram showed probable aortic xanthoma and preserved cardiac function. Prior to planned interventional cardiology assessment for her coronary artery disease she became pregnant, taking aspirin and multivitamins only. She had exertional angina responsive to metoprolol, agreed to recommencing statin therapy when serum cholesterol worsened, but declined angiography during pregnancy. At 36 weeks’ gestation, she had further angina symptoms but no acute coronary syndrome. Induction in the High Dependency Unit with elective assisted vaginal delivery of a healthy female infant (birthweight 2460 g) occurred at 37 weeks. She underwent triple-vessel coronary artery bypass postpartum, recovering well. Conclusion Whilst this specific condition is rare, the increase in cardiovascular disease and cardiovascular risks in the obstetric population emphasises the need for clear, multidisciplinary management from the outset of pregnancy for these women.
Multisite Study of an Implanted Continuous Glucose Sensor Over 90 Days in Patients With Diabetes Mellitus
Authors: Dehennis Andrew , Mortellaro Mark A. , Ioacara Sorin 
Published: July 2015

Background: Continuous glucose monitoring (CGM), which enables real-time glucose display and trend information as well as real-time alarms, can improve glycemic control and quality of life in patients with diabetes mellitus. Previous reports have described strategies to extend the useable lifetime of a single sensor from 1-2 weeks to 28 days. The present multisite study describes the characterization of a sensing platform achieving 90 days of continuous use for a single, fully implanted sensor. Method: The Senseonics CGM system is composed of a long-term implantable glucose sensor and a wearable smart transmitter. Study subjects underwent subcutaneous implantation of sensors in the upper arm. Eight-hour clinic sessions were performed every 14 days, during which sensor glucose values were compared against venous blood lab reference measurements collected every 15 minutes using mean absolute relative differences (MARDs). Results: All subjects (mean ± standard deviation age: 43.5 ± 11.0 years; with 10 sensors inserted in men and 14 in women) had type 1 diabetes mellitus. Most (22 of 24) sensors reported glucose values for the entire 90 days. The MARD value was 11.4 ± 2.7% (range, 8.1-19.5%) for reference glucose values between 40-400 mg/dl. There was no significant difference in MARD throughout the 90-day study ( P = .31). No serious adverse events were noted. Conclusions: The Senseonics CGM, composed of an implantable sensor, external smart transmitter, and smartphone app, is the first system that uses a single sensor for continuous display of accurate glucose values for 3 months.
KCNQ Channels in Nociceptive Cold-Sensing Trigeminal Ganglion Neurons as Therapeutic Targets for Treating Orofacial Cold Hyperalgesia
Authors: Abd-Elsayed Alaa A , Ikeda Ryo , Jia Zhanfeng , Ling Jennifer , Zuo Xiaozhuo , Li Min , Gu Jianguo G 
Published: July 2015

Background Hyperexcitability of nociceptive afferent fibers is an underlying mechanism of neuropathic pain and ion channels involved in neuronal excitability are potentially therapeutic targets. KCNQ channels, a subfamily of voltage-gated K+ channels mediating M-currents, play a key role in neuronal excitability. It is unknown whether KCNQ channels are involved in the excitability of nociceptive cold-sensing trigeminal afferent fibers and if so, whether they are therapeutic targets for orofacial cold hyperalgesia, an intractable trigeminal neuropathic pain. Methods Patch-clamp recording technique was used to study M-currents and neuronal excitability of cold-sensing trigeminal ganglion neurons. Orofacial operant behavioral assessment was performed in animals with trigeminal neuropathic pain induced by oxaliplatin or by infraorbital nerve chronic constrictive injury. Results We showed that KCNQ channels were expressed on and mediated M-currents in rat nociceptive cold-sensing trigeminal ganglion (TG) neurons. The channels were involved in setting both resting membrane potentials and rheobase for firing action potentials in these cold-sensing TG neurons. Inhibition of KCNQ channels by linopirdine significantly decreased resting membrane potentials and the rheobase of these TG neurons. Linopirdine directly induced orofacial cold hyperalgesia when the KCNQ inhibitor was subcutaneously injected into rat orofacial regions. On the other hand, retigabine, a KCNQ channel potentiator, suppressed the excitability of nociceptive cold-sensing TG neurons. We further determined whether KCNQ channel could be a therapeutic target for orofacial cold hyperalgesia. Orofacial cold hyperalgesia was induced in rats either by the administration of oxaliplatin or by infraorbital nerve chronic constrictive injury. Using the orofacial operant test, we showed that retigabine dose-dependently alleviated orofacial cold hyperalgesia in both animal models. Conclusion Taken together, these findings indicate that KCNQ channel plays a significant role in controlling cold sensitivity and is a therapeutic target for alleviating trigeminal neuropathic pain that manifests orofacial cold hyperalgesia.
At the Center of Everything: Regional Rivalries, Imperial Politics, and the Mapping of the Mosetenes Frontier in Late Colonial Bolivia
Authors: Scott Heidi V. 
Published: July 2015

AbstractThe late colonial mapping of frontiers in the eastern Andes of Charcas (colonial Bolivia) has been neglected both in scholarship on frontier mapping, which overlooks this region, and historical studies of frontier formation in Charcas, which pay little attention to cartography. This article examines a set of maps made by a midlevel colonial official in 1797 amid efforts to open a road from Chulumani district in the Intendancy of La Paz to the Franciscan mission of Mosetenes. The article advances understandings of the material and imaginative interconnectedness of frontiers in Charcas by highlighting regional rivalries in frontier colonization and demonstrating how the piedmont regions were given meaning in relation to other, more distant lowland frontiers. Additionally, by comparing the 1797 maps with a map of Chulumani district made by the same individual in 1810, the essay demonstrates how the Mosetenes frontier was resignified in the wake of the 1809 political upheavals.