bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior Cervical lymph Node Metastasis as the Valuable Prognostic Factor for Stage IVA/IVB Nasopharyngeal Carcinoma Treated with Induction Chemotherapy Followed by Concurrent Chemo-Radiotherapy
Authors: Thephamongkhol Kullathorn , Setakornnukul Jiraporn , Rojwatkarnjana Sunanta , Chansilpa Yaowalak 
Published: November 2014

Introduction/Aim To evaluate the prognostic properties of retropharyngeal lymph node (RP), posterior cervical lymph node (PCN), and supraclavicular lymph node (SPC), in stage IVA/IVB nasopharyngeal carcinoma (NPC) patients in setting of induction chemotherapy. Methods We performed a retrospective study including 43 patients with stage IVA/IVB NPC (7th AJCC) treated with induction chemotherapy followed by concurrent chemo-radiotherapy. We analyzed prognosis with the multivariate Cox regression model and p-value from the Wald's test, using the backward elimination method (by likelihood ratio test and percent change of coefficient factors). Result Overall, 24 patients (55.8%) were in stage IVA and 19 (44.2%) in stage IVB. After a median follow-up time of 30 months, the 2-year overall survival (OS) was 79.1%, while the 2-year progression free survival (PFS) and distant metastasis free survival (DMFS) were 59.8% and 69.1%, respectively. In multivariate analysis for predicting DMFS, SPC involvement was not statistically significant (HR 3.39; 95% CI 0.76-15.07; p=0.1), whereas RP involvement was statistically significant (HR 5.81; 95% CI 1.08-31.16; p=0.04). Moreover, and more importantly, PCN involvement was the only nodal factor to predict all of DMFS, PFS, and OS (respectively HR 5.57, 95% CI 1.12-27.71, p=0.036; HR 16.05, 95% CI 1.93-133.65, p=0.01; and HR 28.02, 95% CI 2.74-286.22, p=0.005). Discussion PCN involvement is the only independent prognostic factor of stage IVA/IVB NPC patients treated by induction chemotherapy that predicts DMFS and turns this effect to PFS and OS. PCN involvement is a highly accurate predictor for failure of conventional chemo-radiotherapy. Therefore, patients with PCN involvement should be defined at high-risk, as to be investigated for a new staging system.
Clinical outcomes model in renal cell cancer patients treated with modified vaccinia Ankara plus tumor-associated antigen 5T4
Authors: Amato Robert J. , Xiong Youxin , Peng Hui , Mohlere Virginia 
Published: November 2014

Aims We developed an outcomes model to select patients for renal cell cancer vaccine immunotherapy. Materials and methods We examined clinical data from 2 phase II studies of modified vaccinia Ankara as vector to express 5T4 (MVA-5T4), calculated progression-free survival (PFS) and overall survival (OS), and created risk groups based on the number of factors involved. Results Median OS was 12.4 months; median PFS was 3.6 months. Significant factors (p<0.05) included neutrophils (both), bone metastases (OS), ECOG performance status (OS), lactate dehydrogenase levels (both), prior therapy with tyrosine kinase inhibitors plus immunotherapy (OS), Fuhrman grade (OS), and 5T4-specific ELISPOT response (PFS). By group, median OS was not reached in patients with favorable risk (censored at cutoff), was 13.7 months in those with intermediate risk and 4.0 months in those with poor risk. Conclusions Further validation of this model will identify the patients most likely to respond to MVA-5T4 and provide a framework for outcomes models for other vaccine therapies.
Investigation of BK virus, Epstein-Barr virus and human papillomavirus sequences in postoperative thyroid gland specimens
Authors: Stamatiou Dimitris , Derdas Stavros P. , Symvoulakis Emmanouil K. , Sakorafas Georgios H. , Zoras Odysseas , Spandidos Demetrios A. 
Published: November 2014

Background Although recent evidence has implicated viruses in the regulation of epithelial-to-mesenchymal transition and tumor progression, little is known regarding viral infections in thyroid malignancies. Thus the aim of this study was to detect sequences of 3 potentially oncogenic viruses – BK virus (BKV), Epstein-Barr virus (EBV) and human papillomavirus (HPV) – in a series of postoperative thyroid gland specimens. Methods Thirty patients with thyroid nodules who underwent surgery for thyroid disease within a 3-year period were enrolled. Both nodular and adjacent normal thyroid tissue was surgically excised from each patient. Viral gene sequences of BKV (VP1), EBV (LMP1, EBNA2 and EBER1) and HPV were amplified by PCR. The PCR results were confirmed by direct sequencing analysis. Results VP1 gene sequences were detected in 60% (18/30) of thyroid cancer or multinodular hyperplasia lesions compared with in 43.3% (13/30) of adjacent normal thyroid tissue specimens. Fifteen of thirty (50%) of thyroid cancer or multinodular hyperplasia samples revealed LMP1 sequences compared with 46.7% (14/30) of corresponding normal thyroid tissues. EBNA2 gene sequences were detected in 90% (27/30) of thyroid cancer or multinodular hyperplasia samples, compared with 90% (27/30) of adjacent normal thyroid tissue specimens. All samples were negative for EBER1 sequences, while HPV DNA was not detected in either nodular or normal thyroid tissue. Conclusions This study suggests that BKV and EBV “infection” is an early event, occurring within normal tissue. Our findings do not show a clear role for the viruses examined, instead they suggest an “endemicity” pattern rather than a causal effect.
Temporal Regulation of venous Extracellular Matrix Components during Arteriovenous Fistula Maturation
Authors: Hall Michael R. , Yamamoto Kota , Protack Clinton D. , Tsuneki Masayuki , Kuwahara Go , Assi Roland , Brownson Kirstyn E. , Bai Hualong , Madri Joseph A. , Dardik Alan 
Published: November 2014

Purpose The venous limb of arteriovenous fistulae (AVF) adapts to the arterial environment by dilation and wall thickening; however, the temporal regulation of the expression of extracellular matrix (ECM) components in the venous limb of the maturing AVF has not been well characterized. We used a murine model of AVF maturation that recapitulates human AVF maturation to determine the temporal pattern of expression of these ECM components. Methods Aortocaval fistulae were created in C57BL/6J mice and the venous limb was analyzed on postoperative days 1, 3, 7, 21, and 42. A gene microarray analysis was performed on day 7; results were confirmed by qPCR, histology, and immunohistochemistry. Proteases, protease inhibitors, collagens, glycoproteins, and other non-collagenous proteins were characterized. Results The maturing AVF has increased expression of many ECM components, including increased collagen and elastin. Matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinase 1 (TIMP1) showed increased mRNA and protein expression during the first 7 days of maturation. Increased collagen and elastin expression was also significant at day 7. Expression of structural proteins was increased later during AVF maturation. Osteopontin (OPN) expression was increased at day 1 and sustained during AVF maturation. Conclusions During AVF maturation, there is significantly increased expression of ECM components, each of which shows distinct temporal patterns during AVF maturation. Increased expression of regulatory proteins such as MMP and TIMP precedes increased expression of structural proteins such as collagen and elastin, potentially mediating a controlled pattern of ECM degradation and vessel remodeling without structural failure.
Effectiveness of Skin Perfusion Pressure Monitoring during Surgery for an Ischemic Steal Syndrome Associated Refractory Ulcer
Authors: Okubo Kentaro , Sato Takashi , Matsubara Chieko , Tsuboi Masato , Ishii Yasuo , Tojimbara Tamotsu 
Published: November 2014

We describe an 80-year-old man with end-stage renal disease due to type 2 diabetes who had been maintained on hemodialysis for 9 years. He developed refractory ulcers from an abraded wound in the right hand of his access arm. The arteriovenous fistula (AVF) was located between the right brachial artery and the median antecubital vein draining into the cephalic vein and the deep veins close to the elbow. The blood flow of the right brachial artery measured by using Doppler ultrasonography was 920 ml/min. On the contrary, the radial and ulnar arteries were poorly palpable near the wrist, and ultrasonography could not be performed accurately because of a high degree of calcification. The skin perfusion pressure (SPP) of the first finger on the affected side decreased to 22 mmHg. However, the SPP improved to approximately 40 mmHg upon blocking an inflow into the deep vein. According to SPP data, only a communicating branch of the deep vein was ligated, and the AVF itself was preserved. One month after surgery, the skin ulcer healed, and maintenance hemodialysis was performed by using the preserved cephalic vein for blood access. In conclusion, we successfully treated a refractory wound associated with steal syndrome, without terminating the AVF. SPP-guided surgery may be safe and effective to adjust the blood flow in patients with AVF having steal syndrome.
Ultrasound-Guided Subclavian Venipuncture is More Rapidly Learned than the Anatomic Landmark Technique in Simulation Training
Authors: Tokumine Joho , Matsushima Hisao , Lefor Alan Kawarai , Igarashi Hiroshi , Ono Kazuyuki 
Published: November 2014

Purpose Both ultrasound-guided subclavian venipuncture (US-SV) and landmark-guided subclavian venipuncture (LM-SV) are important in critical care, because the clinical utility of ultrasound guidance is still debated. Education of residents and medical students should include both techniques. The aim of this study is to compare learning these two techniques in a simulation environment. Methods This study was approved by the research ethics review committee. Trainees included residents and medical students who were instructed using the “Videos in Clinical Medicine” for LM-SV, or a dedicated slide series for US-SV, using the long-axis in-plane with needle-guide technique. After the lecture, trainees attempted to perform venipuncture in a simulator. All participants performed both techniques. The procedure time from initial skin puncture to detecting back-flow of fluid from the simulated vein was measured. A procedure time over 3 min, arterial puncture, or pneumothorax was counted as a failure. The end-point for each trainee was three successive successful venipunctures without a failure. A trainee who reached the end-point was considered as having acquired adequate skill. Statistical analysis of the procedure time comparing the techniques was done using the Mann-Whitney U test. Results Twenty trainees participated in this training. Adequate skill to perform US-SV was achieved within three tries, but up to nine attempts were needed for LM-SV. One arterial puncture occurred during LM-SV. No pneumothoraxes occurred during the simulation training. Conclusions US-SV was learned more quickly than LM-SV in a simulation model.
Hoe Europa zijn zigeuners uitvond
Authors: Bogdal K.M. 
Published: November 2014

How Europe invented its gypsies. On the dark side of modernity
Europe is commonly depicted as the cradle of modernity. But this image usually has a blind eye for marginal communities and cultures existing seemingly apart of the big developments. An example of this is the neglect of the Roma people who settled here early, on the threshold of the Middle Ages and the modern era. The attitude of the European people towards this mobile ethnic group can be described as moving between contempt and fascination. Referring to images of gypsies in literature and other cultural expressions the author shows how during the Romantic era the gypsies were serving as a projection object for desires and fantasies about socially deviant lifestyles. The subsequent process of ‘de-Europeanization’ together with the creation of exotic images through ethnology is described as well as the racial theories and their political consequences for the Roma people in the twentieth century. Instead of contributing to the creation of borderlines and fuelling destruction fantasies, art and sciences should give more attention to the undividedness of humankind and to human dignity.
De taal van de Roma en Sinti
Authors: Bakker P. 
Published: November 2014

The language of the Roma and Sinti
The Roma and Sinti (formerly called gypsies) have a language of their own called Romani or Romanes. The language has been present in the Netherlands since 1420, and the first documentation from our country dates from the 1500s. Linguists have established that the language is a continuation of Indian languages. The dialects of Romani from all corners of Europe also show the clear unity of the language. It is not – as sometimes supposed – a secret jargon. After centuries of neglect or downright oppression of the people and their language, Romani is now recognized at the national and European levels. This also led to an increasing use of a written language, used for all genres, from literature to cookbooks and political texts. Despite having been spoken beside other languages for over a millennium, its vitality is higher than for all of the more recent immigrant languages in the Netherlands.
Tussen eigenheid en aanpassing
Authors: Jorna P. 
Published: November 2014

Between authenticity and adjustment. On the culture and integration of Dutch Roma and Sinti
This article focuses on ‘culture’ as a concept currently dominating the approach towards Roma and Sinti, in policies and public opinion in the Netherlands and probably in Europe too. The author argues that a culture-sensitive approach is useful indeed, but a fixation on culture leads into a dead end street – especially in the static way in which it is (implicitly) conceptualised. Explaining some traditional Roma habits and values, the author describes examples of everyday life in Roman communities, as well as some lively debates among Roma and Sinti insiders. It is important that the complexity and dynamics of Roma culture are recognised and that outsiders stop defining what Roma culture ‘is’. Instead, recognising the differences between communities as well as the reality of changing norms and values will provide a breeding ground for finding a healthy balance between authenticity and adjustment.
MiFID II, een complex product
Authors: Schreuder Erwin 
Published: November 2014

MiFID II, een complex product
Op 12 juni 2014 zijn de herziene Richtlijn voor Markten in Financiële Instrumenten (MiFID II) en de Verordening voor Markten in Financiële Instrumenten (MiFIR) gepubliceerd. MiFID II en MiFIR zijn de gezamenlijke opvolger van MiFID I. De regelgeving is relevant voor beleggingsondernemingen (zoals effectenbemiddelaars en vermogensbeheerders) en exploitanten van handelsplatformen voor financiële instrumenten. Vergeleken met MiFID I gelden er veel nieuwe regels, waaronder transparantievereisten bij beurshandel en nieuwe gedragsregels voor beleggingsondernemingen. Tevens worden voorheen ongereguleerde activiteiten onder toezicht geplaatst. De uitdaging voor marktpartijen om per uiterlijk januari 2017 te voldoen aan de nieuwe regels is groot, mede vanwege vele rule-based normen.Richtlijn 2014/65/EU van het Europees Parlement en de Raad van 15 mei 2014 betreffende markten voor financiële instrumenten en tot wijziging van Richtlijn 2002/92/EG en Richtlijn 2011/61/EU, Pb. EU 2014, L 173/34.
De modernisering voorbij: de mededingingsbeperking in het kartelverbod en in het staatssteunverbod
Authors: Parret Laura 
Published: November 2014

De modernisering voorbij: de mededingingsbeperking in het kartelverbod en in het staatssteunverbod: Een aanzet voor een vergelijkende studie
Zowel de mededingingsregels als de staatssteunregels hebben de afgelopen jaren een zogenoemde modernisering ondergaan. De meest recente modernisering, die van de staatssteunregels, vond inspiratie in de eerdere modernisering van de mededingingsregels. Beide hebben minstens één gemeenschappelijk kenmerk: de invoering van een meer economische benadering. Aanleiding genoeg om stil te staan bij het verband tussen beide onderdelen van het brede mededingingsrecht. Deze bijdrage doet dat aan de hand van het aan de artikelen 101 en 107 VWEU gemeenschappelijke begrip ‘mededingingsbeperking’ en de impact van de modernisering daarop. Zullen de respectievelijke moderniseringen het kartelverbod en het staatssteunverbod dichter bij elkaar brengen of juist niet?Artikel 101 en 107 VWEU
Simulatie onder slachtoffers van schokkende gebeurtenissen
Authors: Kunst Maarten 
Published: November 2014

Malingering psychological symptoms among victims of critical incidents: A plea for independent assessment of psychological symptoms in compensation procedures
High-impact incidents, such as (natural) disasters, severe (traffic) accidents, and exposure to (war) violence, may have severe psychological consequences, both for direct and indirect victims. Such consequences may qualify for financial compensation. However, some victims malinger their psychological status to get compensated for damages they have not suffered. This type of fraudulent behavior costs insurance companies and publicly funded compensation services enormous amounts of money and may eventually make compensation unaffordable. To prevent this from occurring, it is argued that lawyers who need to decide upon victims’ claims for compensation should call in independent experts to evaluate the genuineness of victims’ reported psychological symptoms by administrating a malingering detection test. To enable correct interpretation of the outcome of such a test, the base rate problem is extensively discussed. In short, this problem means that correct test interpretation in individual cases depends on the prevalence of malingering in the population to which a victim belongs. Finally, several counter arguments for the standard assessment of malingering by independent experts are discussed.
Bidirectional links between HIV and intimate partner violence in pregnancy: implications for prevention of mother‐to‐child transmission
Authors: Hatcher Abigail M , Woollett Nataly , Pallitto Christina C , Mokoatle Keneuoe , Stöckl Heidi , MacPhail Catherine , Delany‐Moretlwe Sinead , García‐Moreno Claudia 
Published: November 2014

IntroductionPrevention of mother‐to‐child transmission (PMTCT) has the potential to eliminate new HIV infections among infants. Yet in many parts of sub‐Saharan Africa, PMTCT coverage remains low, leading to unacceptably high rates of morbidity among mothers and new infections among infants. Intimate partner violence (IPV) may be a structural driver of poor PMTCT uptake, but has received little attention in the literature to date.MethodsWe conducted qualitative research in three Johannesburg antenatal clinics to understand the links between IPV and HIV‐related health of pregnant women. We held focus group discussions with pregnant women (n=13) alongside qualitative interviews with health care providers (n=10), district health managers (n=10) and pregnant abused women (n=5). Data were analysed in Nvivo10 using a team‐based approach to thematic coding.FindingsWe found qualitative evidence of strong bidirectional links between IPV and HIV among pregnant women. HIV diagnosis during pregnancy, and subsequent partner disclosure, were noted as a common trigger of IPV. Disclosure leads to violence because it causes relationship conflict, usually related to perceived infidelity and the notion that women are “bringing” the disease into the relationship. IPV worsened HIV‐related health through poor PMTCT adherence, since taking medication or accessing health services might unintentionally alert male partners of the women's HIV status. IPV also impacted on HIV‐related health via mental health, as women described feeling depressed and anxious due to the violence. IPV led to secondary HIV risk as women experienced forced sex, often with little power to negotiate condom use. Pregnant women described staying silent about condom negotiation in order to stay physically safe during pregnancy.ConclusionsIPV is a crucial issue in the lives of pregnant women and has bidirectional links with HIV‐related health. IPV may worsen access to PMTCT and secondary prevention behaviours, thereby posing a risk of secondary transmission. IPV should be urgently addressed in antenatal care settings to improve uptake of PMTCT and ensure that goals of maternal and child health are met in sub‐Saharan African settings.
Large disparities in HIV treatment cascades between eight European and high‐income countries – analysis of break points
Authors: Raymond Alice , Hill Andrew , Pozniak Anton 
Published: November 2014

IntroductionPatients on antiretroviral treatment with undetectable HIV RNA levels have a significantly lower risk of clinical disease progression and onward HIV transmission. This study aimed to estimate and compare the percentage of all HIV‐positive people who are diagnosed, are linked to care, are taking antiretroviral treatment and have undetectable HIV RNA, in eight European and high‐income countries: the United States, the United Kingdom, France, the Netherlands, Denmark, Australia, British Columbia (Canada) and Georgia.Materials and MethodsFor each country, the number of people in five key stages of the HIV treatment cascade was collected: 1. HIV infected, 2. Known to be HIV positive, 3. Linked to care, 4. Taking antiretroviral treatment, and 5. Having undetectable HIV RNA. Estimates were extracted from national reports [1–3], the UNAIDS database, conference proceedings [4] and peer‐reviewed articles [5–7]. The quality of the estimates and reporting methods were assessed individually for each country, with selection criteria such as availability of nationwide database and routinely collected data. Treatment cascades were constructed using estimates from 2010 to 2012.ResultsAs shown in Table 1, the percentage of all infected people with undetectable HIV RNA ranged from 20% in Georgia to 59% in Denmark. Of the high‐income countries, the United States has the lowest percentage of individuals with undetectable viral load (25% to median 52%), associated with the highest HIV incidence rate (15.30 per 100,000 to median 6.07 per 100,000). The pattern of the cascades differed between countries: in the United States, there is a fall from 66% to 33% (−33%) between linkage to care and start of antiretroviral treatment. However, in Georgia, the greatest loss in continuum was zat diagnosis, with 48% of undiagnosed HIV‐positive individuals.ConclusionsThere are great disparities among European and high‐income countries in the percentage of HIV‐positive individual with undetectable HIV RNA. Furthermore, the treatment cascades show different key break points, underlying inequalities in HIV care between countries.