bluuebunny/crossref_metadata_2025_split huggingface dataset:
Downregulation of serum microRNA-205 as a potential diagnostic and prognostic biomarker for human glioma
Authors: Yue Xiao , Lan FengMing , Hu Man , Pan Qiang , Wang Qiong , Wang JinHuan 
Published: July 2015

OBJECT
Circulating microRNAs (miRNAs) are a new class of highly promising cancer biomarkers. Malignant glioma is one of the most devastating and lethal forms of intrinsic CNS tumor. Here, the authors evaluated serum miRNA 205 (miR-205) levels in patients with glioma.

METHODS
Sixty-four patients in whom glioma was diagnosed and 45 healthy controls were recruited between October 2011 and March 2012 and randomly assigned to the screening cohort or the validation cohort. Cohorts of patients with other brain tumors, including meningioma (n = 8), primary diffuse large B-cell lymphoma of the CNS (n = 6), and pituitary adenoma (n = 5), were investigated and compared. miR-205 extraction from serum was detected by real-time quantitative reverse-transcription polymerase chain reaction. The Kaplan-Meier method was applied to perform survival analysis, the risk factors were analyzed by using a Cox regression model, and the receiver operating characteristic working curve was used to analyze the value of miR-205 in the prognostic evaluation of the patients.

RESULTS
The authors first demonstrated that serum miR-205 expression was significantly lower in patients with glioma than in healthy controls (p < 0.001). It is important to note that serum miR-205 expression demonstrated a stepwise decrease with ascending pathological grades. The serum miR-205 biomarker had high sensitivity, specificity, and accuracy in patients with glioma. Serum levels of miR-205 were identified as an individual diagnostic marker and were significantly lower in the glioma cohort than in the other brain tumor cohorts. Serum miR-205 levels were significantly increased in postoperative samples over those in the preoperative samples and were reduced again during glioblastoma recurrences. Statistical analysis revealed a significant correlation between low serum miR-205 expression and both ascending pathological grades (p = 0.002) and low Karnofsky Performance Scale scores (p = 0.01). Patients with glioma at an advanced pathological grade (Grade III or IV) and a higher miR-205 serum level showed longer overall survival than those with a lower miR-205 serum concentration (p < 0.01). Furthermore, Cox regression analysis revealed that miR-205 serum levels were independently associated with overall survival.

CONCLUSIONS
These data indicate that serum miR-205 expression is a novel and valuable biomarker for the diagnosis of glioma and a prognostic factor for those with a tumor at an advanced pathological grade.
Shunt placement after cyst fenestration for middle cranial fossa arachnoid cysts in children
Authors: Kimiwada Tomomi , Hayashi Toshiaki , Narisawa Ayumi , Shirane Reizo , Tominaga Teiji 
Published: July 2015

OBJECT
Some pediatric patients with middle cranial fossa arachnoid cysts present with symptoms of increased intracranial pressure (ICP) and require shunt placement after a cyst fenestration. However, factors concerning increased ICP after fenestration followed by shunt placement have not been elucidated. This study evaluated factors that are associated with shunt placement following cyst fenestration in pediatric patients with middle cranial fossa arachnoid cysts.

METHODS
Twenty-six pediatric patients with middle cranial fossa arachnoid cysts who were surgically treated at a single institution between 2004 and 2013 were retrospectively identified. The surgical indications for middle cranial fossa arachnoid cysts were as follows: 1) arachnoid cysts associated with symptoms such as headache and abnormally enlarging head circumference; 2) progressively expanding arachnoid cysts; and 3) large arachnoid cysts such as Galassi Type III. A cyst fenestration was performed as a first-line treatment, and shunt placement was required if symptoms associated with increased ICP were found following fenestration. The risk factors evaluated included age, sex, presenting symptoms, the presence of head enlargement, progressive cyst expansion, and subdural hematoma/hygroma.

RESULTS
Four patients (15.4%) required shunt placement after cyst fenestration. Younger age, abnormal head enlargement, and progressive cyst expansion before fenestration were significantly associated with the need for shunt placement following fenestration. Arachnoid cysts decreased in size in 22 patients (84.6%) after fenestration and/or shunt placement. The presence of symptoms was not associated with postoperative cyst size in this study.

CONCLUSIONS
In this study, younger age, abnormal head enlargement, and progressive cyst expansion were risk factors for shunt placement after cyst fenestration in pediatric patients with middle cranial fossa arachnoid cysts. It is important to consider that cyst fenestration may not be effective because of a latent derangement of CSF circulation in patients with these risk factors.
Impact of obesity on complications, infection, and patient-reported outcomes in adult spinal deformity surgery
Authors: Soroceanu Alex , Burton Douglas C. , Diebo Bassel Georges , Smith Justin S. , Hostin Richard , Shaffrey Christopher I. , Boachie-Adjei Oheneba , Mundis Gregory M. , Ames Christopher , Errico Thomas J. , Bess Shay , Gupta Munish C. , Hart Robert A. , Schwab Frank J. , Lafage Virginie , _ _ 
Published: July 2015

OBJECT
Adult spinal deformity (ASD) surgery is known for its high complication rate. This study examined the impact of obesity on complication rates, infection, and patient-reported outcomes in patients undergoing surgery for ASD.

METHODS
This study was a retrospective review of a multicenter prospective database of patients with ASD who were treated surgically. Patients with available 2-year follow-up data were included. Obesity was defined as having a body mass index (BMI) ≥ 30 kg/m2. Data collected included complications (total, minor, major, implant-related, radiographic, infection, revision surgery, and neurological injury), estimated blood loss (EBL), operating room (OR) time, length of stay (LOS), and patient-reported questionnaires (Oswestry Disability Index [ODI], Short Form-36 [SF-36], and Scoliosis Research Society [SRS]) at baseline and at 6 weeks, 1 year, and 2 years postoperatively. The impact of obesity was studied using multivariate modeling, accounting for confounders.

RESULTS
Of 241 patients who satisfied inclusion criteria, 175 patients were nonobese and 66 were obese. Regression models showed that obese patients had a higher overall incidence of major complications (IRR 1.54, p = 0.02) and wound infections (odds ratio 4.88, p = 0.02). Obesity did not increase the number of minor complications (p = 0.62), radiographic complications (p = 0.62), neurological complications (p = 0.861), or need for revision surgery (p = 0.846). Obesity was not significantly correlated with OR time (p = 0.23), LOS (p = 0.9), or EBL (p = 0.98). Both groups experienced significant improvement overtime, as measured on the ODI (p = 0.0001), SF-36 (p = 0.0001), and SRS (p = 0.0001) questionnaires. However, the overall magnitude of improvement was less for obese patients (ODI, p = 0.0035; SF-36, p = 0.0012; SRS, p = 0.022). Obese patients also had a lower rate of improvement over time (SRS, p = 0.0085; ODI, p = 0.0001; SF-36, p = 0.0001).

CONCLUSIONS
This study revealed that obese patients have an increased risk of complications following ASD correction. Despite these increased complications, obese patients do benefit from surgical intervention; however, their improvement in health-related quality of life (HRQL) is less than that of nonobese patients.
Ancillary findings assessed by ventilation/perfusiont omography
Authors: Begic A. , Opankovic E. , Cukic V. , Lindqvist A. , Miniati M. , Bajc M. 
Published: July 2015

SummaryVentilation/perfusion tomography (V/P SPECT) is a recommended method for diagnosing and follow-up of pulmonary embolism (PE). Moreover, it is possible to recognize other pathologies in addition to PE, such as pneumonia, COPD and left heart failure (LHF). The objective of this prospective study was to identify frequency of ancillary findings among patients with suspected PE. Patients, material, method: 331 consecutive patients with suspected PE were examined and classified with V/P SPECT. Patients were followed up clinically and by means of other laboratory tests. Results: 80 patients had a normal V/P SPECT and no clinical consequences in the follow-up. PE had 104 patients: 23 of them had also additional findings. Among the remaining 147 patients, pneumonias were shown in 82, acute in 75 patients and 7 had chronic post inflammatory state. COPD was present in 42 patients, in 3 combined with pneumonia. Sign of LHF was observed in 10: in 7 the acute LHF diagnosis was established, 3 were classified as having a chronic cardiopulmonary disease. Furthermore, in 16 patients, the V/P pattern was suggestive of a tumour. The clinical outcomes were 6 lung tumours, 3 empyema, one sarcoidosis, 2 were unclarified and 4 were lost in the follow-up. Conclusion: V/P SPECT identifies a high prevalence of other cardiopulmonary diseases among patients with a clinical suspicion of PE. Ancillary findings with V/P SPECT clarified patients' symptoms and had an impact on the treatment. These findings were verified by a clinical outcome by the follow-up over three months.
Easing the Transition From Clinician to Nurse Educator: An Integrative Literature Review
Authors: Grassley Jane S. , Lambe Andrea 
Published: July 2015

Background:
Experienced clinicians who choose to become academic nurse educators bring to their new faculty role strong clinical skills and a desire to influence the next generation of nurses. However, many find themselves unprepared for the challenges they encounter. Intentional mentoring is needed to ease their transition from clinician to nurse educator.

Method:
An integrative literature review was conducted to identify the essential components of a comprehensive mentoring program to facilitate a positive transition experience from expert clinician to novice nursing faculty. Searches were conducted of the ProQuest Central and CINAHL databases for peer-reviewed articles.

Results:
A review of 17 publications and seven Web sites identified formal preparation for teaching, guidance navigating the academic culture, and a structured mentoring program as essential to clinicians’ successful transition to academic nursing faculty.

Conclusion:

Sustainable mentoring programs require recognition of mentoring as central to nursing education and administrative investment of resources. [
J Nurs Educ.
2015;54(7):361–366.]
Academic and Institutional Review Board Collaboration to Ensure Ethical Conduct of Doctor of Nursing Practice Projects
Authors: Foote Jan M. , Conley Virginia , Williams Janet K. , McCarthy Ann Marie , Countryman Michele 
Published: July 2015

Background:
Navigating the regulations to protect human subjects and private health information for Doctor of Nursing Practice (DNP) projects can be a formidable task for students, faculty, and the institutional review board (IRB).

Method:
Key stakeholders from the University of Iowa College of Nursing and the Human Subjects Office developed a standardized process for DNP students to follow, using a decision algorithm, a student orientation to the human subjects review process conducted by faculty and IRB chairs and staff, and a brief Human Subjects Research Determination form.

Results:
Over 2 years, 109 students completed the process, and 96.3% of their projects were deemed not to be human subjects research. Every student submitted documentation of adherence to the standardized process. Less time was spent by students, faculty, and the IRB in preparing and processing review requests.

Conclusion:

The interprofessional collaboration resulted in a streamlined process for the timely review of DNP projects. [
J Nurs Educ.
2015;54(7):372–377.]
Nurse Practitioner Students Learning From the Medically Underserved: Impact on Attitude Toward Poverty
Authors: Ritten Angela , Waldrop Julee , Wink Diane 
Published: July 2015

Background:
With no antecedent in the literature, this project examined the effects of exposure to clients living in poverty on nurse practitioner (NP) students’ attitude toward poverty.

Method:
Students participating in adult health courses completed the Attitude Toward Poverty Scale at the start and end of the course. Eight students were immersed for a minimum of 32 hours with a faculty preceptor in a clinic caring for low-income, uninsured patients. These students also responded to open-ended questions regarding their experience.

Results:

NP students had an increase in positive attitude toward impoverished patients after the course (
p
< 0.001). Themes that emerged from the immersion experience were (a) misconception, (b) lack of knowledge about cost and access to care, (c) importance of the clinical environment on learning to be an NP, and (d) empowerment.

Conclusion:

Planned clinical rotations with medically underserved populations may serve to dispel misconceptions about low-income patients. [
J Nurs Educ.
2015;54(7):389–393.]
Five Steps to Providing Effective Feedback in the Clinical Setting: A New Approach to Promote Teamwork and Collaboration
Authors: Motley Cindy L. , Dolansky Mary A. 
Published: July 2015

Background:
Feedback is a major component of clinical education. Feedback reinforces or modifies behavior and helps learners to validate knowledge and feel motivated to learn. Traditionally, feedback is used by clinical educators who observe learners’ behavior and provide expert direction. Teamwork and collaboration is one of the six Quality and Safety Education for Nurses core competencies developed for prelicensure and graduate nurses. These skills are important in the current complex health care environment.

Method:
On the basis of the literature and prior experience, a new approach for clinical educators is using feedback to teach teamwork and collaboration skills.

Results:
Five steps educators can take to provide effective feedback in the clinical setting are to (a) create a culture of feedback, (b) use structured communication tools, (c) encourage dialogue, (d) acknowledge the human factor, and (e) embrace a leadership role.

Conclusion:

This new approach enhances feedback and teaches teamwork and collaboration. [
J Nurs Educ.
2015;54(7):399–403.]
Ostomate-for-a-Day: A Novel Pedagogy for Teaching Ostomy Care to Baccalaureate Nursing Students
Authors: Kerr Noël 
Published: July 2015

Background:
The literature describing successful pedagogies for teaching ostomy care to baccalaureate nursing students is limited. This qualitative study investigated the potential benefits of participating in an immersive simulation that allowed baccalaureate nursing students to explore the physical and psychosocial impact of ostomy surgery.

Method:
Junior-level nursing students attended a 2-hour interactive session during which they learned about preoperative stoma site marking and practiced the maneuvers on a peer. Students then wore an ostomy appliance for the next 24 hours, completed tasks simulating ostomy self-care, and submitted a three- to four-page reflection on the experience. These data were coded using the iterative process of constant comparison described by Glaser.

Results:
Six major themes were identified: Accommodation for Activities of Daily Living, Coping with Annoyances, Body Image and Feelings, Disclosure, Insights for Teaching, and Empathy.

Conclusion:

Each participant affirmed the value of the experience. Suggestions for future research studies are discussed. [
J Nurs Educ.
2015;54(8):445–449.]
Critical Thinking and the Use of Nontraditional Instructional Methodologies
Authors: Orique Sabrina B. , McCarthy Mary Ann 
Published: July 2015

Background:The purpose of this study was to examine the relationship between critical thinking and the use of concept mapping (CM) and problem-based learning (PBL) during care plan development.Method:A quasi-experimental study with a pretest–posttest design was conducted using a convenience sample (n= 49) of first-semester undergraduate baccalaureate nursing students. Critical thinking was measured using the Holistic Critical Thinking Scoring Rubric. Data analysis consisted of a repeated measures analysis of variance with post hoc mean comparison tests using the Bonferroni method.Results:Findings indicated that mean critical thinking at phase 4 (CM and PBL) was significantly higher, compared with phase 1 (baseline), phase 2 (PBL), and phase 3 (CM [p< 0.001]).Conclusion:The results support the utilization of nontraditional instructional (CM and PBL) methodologies in undergraduate nursing curricula. [J Nurs Educ.2015;54(8):455–459.]
Collaborative Clinical Placements: Interactions Among Students From Different Programs
Authors: Lait Jana 
Published: July 2015

Background:
Shortages of clinical placements for health care students in Canada have led education and health care organizations to explore innovative ways to increase placement capacity. One way to increase capacity is to bring together students from various programs for their placements, which also allows students to learn about each other’s roles and how to work collaboratively. This article describes shared placements for students from bachelor of nursing, practical nurse, and health care aide programs.

Method:
Qualitative interviews were used.

Results:
Students benefited from this approach by learning about the roles of other providers and how to coordinate care with others. The challenges of the approach were competition among students for opportunities to practice clinical procedures and concerns about how to communicate with other students when sharing the care of patients.

Conclusion:

The objectives of increasing student placement capacity and expanding collaboration opportunities were partially achieved through this approach to clinical education. [
J Nurs Educ.
2015;54(8):460–463.]
Emotional Intelligence and Health Risk Behaviors in Nursing Students
Authors: Lana Alberto , Baizán Eva María , Faya-Ornia Goretti , López María Luisa 
Published: July 2015

Background:
To explore the association between emotional intelligence (EI) and risky health behaviors in nursing students at the University of Oviedo (Spain).

Method:
This cross-sectional study of 275 students used a validated questionnaire to measure EI level, nine risky behaviors (smoking, excessive alcohol consumption, illicit drug use, unhealthy diet, being overweight, sedentarism, risky sun exposure, occupational risk, and unsafe sex), and other factors that may influence EI.

Results:

Students with the highest EI score had a lower probability of drinking too much alcohol (odds ratio [
OR
], 0.31; 95% confidence interval [CI] [0.19, 0.67]), eating too few fruits and vegetables (
OR,
0.60; 95% CI [0.34, 0.99]), and having unsafe sex (
OR,
0.10; 95% CI [0.01, 0.74]). A dose-response effect was found for those three behaviors (
p
for trend <0.02).

Conclusion:

Poor EI is associated with excessive alcohol consumption, unhealthy diet, and unsafe sex. Training nursing students about EI could improve health behaviors, and thus the role of nurses as health promoters. [
J Nurs Educ.
2015;54(8):464–467.]
Campanian Politics and Poetics in Silius Italicus’ Punica
Authors: Augoustakis Antony 
Published: July 2015

Abstract
This article discusses the references to Campania in Silius Italicus’ Punica and the prominent role of the region in the Capua episode in book 11. Campania is underscored as a place within Italy where politics and poetic activity intertwine to promote the region as a birthplace of prominent politicians and as a locus of otium for poetic activity. In addition, the synergy between Capua and Rome, anachronistically foreshadowed by the poet, seems to question the appearance of a seamless Italian unity, thus locating the seeds of Rome’s decline in the Second Punic War.
Comparison of 5 Immunohistochemical Markers of Hepatocellular Differentiation for the Diagnosis of Hepatocellular Carcinoma
Authors: Nguyen Thuy , Phillips Daniel , Jain Dhanpat , Torbenson Michael , Wu Tsung-Teh , Yeh Matthew M. , Kakar Sanjay 
Published: July 2015

ContextSeveral immunohistochemical markers are available to establish the diagnosis of hepatocellular carcinoma. Judicious selection is essential to achieve a reliable diagnosis in limited tissue provided by liver biopsy.ObjectiveTo compare the efficacy of 5 hepatocellular markers for the diagnosis of hepatocellular carcinoma across various levels of differentiations.DesignImmunohistochemistry for hepatocyte paraffin antigen 1 (Hep Par 1), polyclonal carcinoembryonic antigen (CEA), glypican-3, arginase-1, and bile salt export pump transporter was performed in 79 hepatocellular carcinomas, yielding 93 observations (13 well-differentiated [14%], 41 moderately differentiated [44%], and 39 poorly differentiated [42%] tumors).ResultsArginase-1 and Hep Par 1 had the highest sensitivity for well-differentiated hepatocellular carcinoma, whereas arginase-1 and glypican-3 had the highest sensitivity for poorly differentiated hepatocellular carcinoma. When staining of more than 50% of the tumor was considered a positive result, arginase-1 remained the most sensitive marker for all differentiations, whereas sensitivity for Hep Par 1 in poorly differentiated hepatocellular carcinoma dropped to 30% and that of glypican-3 in well-differentiated hepatocellular carcinoma was 15%. The addition of Hep Par 1 and/or polyclonal CEA to arginase-1 did not lead to an increase in sensitivity for any differentiation. The combined use of arginase-1 and glypican-3 yielded 100% sensitivity for poorly differentiated hepatocellular carcinoma.ConclusionArginase-1 was the most sensitive marker in all differentiations of hepatocellular carcinoma. Glypican-3 had high sensitivity for poorly differentiated cases and its combined use with arginase-1 enabled identification of nearly all cases of poorly differentiated hepatocellular carcinoma. Although bile salt export pump transporter has good overall sensitivity, it has a limited role in establishing hepatocellular differentiation when added to a panel of arginase-1 with either glypican-3 or Hep Par 1.
Attention Deficit Hyperactivity Disorder - A Pre Audit Study of the Pattern of Drug Treatment in a Specialist Community Child and Adolescent Mental Health Service in the UK
Authors: Olubokun Jibowu 
Published: July 2015

Attention deficit hyperactivity disorder (ADHD) is a neuro developmental disorder and a common disorder of childhood with functional impairments and a significant personal, family and psychosocial burden. This is a pre audit study of children and young people with ADHD who were referred to the Specialist Community Child and Adolescent Mental Health service in Calderdale, Halifax in East Yorkshire. The main aim of the pre audit study was to determine and study the pattern of drug treatment with psycho stimulant medication in the service as well to study the socio-demographic characteristics of the children and young people referred. This was a cross - sectional study. Twenty cases were randomly selected from the available records and data was extracted directly from the medical records using data sheets designed for the pre-audit study. Males constituted 85% of the study sample and Females 15%. Age group 9-12 constituted 65% of the sample. The modified release preparation of Ritalin was more commonly prescribed than the immediate release preparation. Some practical advantages and limitations of brands are highlighted. The initial findings are useful and would help to modify the data sheet for improved quality and help to set the ‘audit standards’ for the main audit study. This has clinical governance implications in terms of delivering the most expedient quality care in a Child and Adolescent Mental Health Service.