bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variations in time to receiving first surgical treatment for breast cancer as a function of racial/ethnic background: a cohort study
Authors: Bustami Rami T , Shulkin Daniel B , O'Donnell Nancy , Whitman Eric D 
Published: July 2014

Objective To evaluate surgical treatment delay disparities by race/ethnic group in a group of breast cancer patients treated in the New York region. Design Cohort study. Setting Two affiliated hospitals in the New York region. Participants Patients admitted at two affiliated hospitals in the New York region for breast cancer treatment during 2007–2011. Main outcome measure Time to receiving first surgery for breast cancer, defined as the time in days between initial diagnosis (biopsy) and definitive surgical treatment (lumpectomy or mastectomy). Predicted time to first surgery by race group was also analysed using a multivariate linear regression model with adjustments made for several demographic and clinical factors. Results Totally, 3071 patients who were first treated with surgery were identified. Racial background was classified as White, African American or Asian/other. Overall median time to surgery was 28 days: 28 days in whites, and 34 and 29 days in African Americans and Asian/others, respectively ( p = 0.032). Multivariate analyses showed that only African Americans, not Asian/others, had significantly increased surgical delay compared to whites ( p = 0.019). Conclusions This study demonstrates significant racial differences in surgical delay in a group of breast cancer patients treated in the New York region. These differences may reflect tacit attitudes of medical providers or processes insensitive to patient educational needs. Additional studies may improve our understanding of this delay.
Early life factors in relation to cardiovascular risk and cardiovascular disease in old age in Bergen: a Norwegian retrospective cohort study based on the Hordaland Health Study (HUSK)
Authors: Skogen Jens Christoffer , Stewart Robert , Knapstad Marit , Øverland Simon , Mykletun Arnstein 
Published: July 2014

Summary Objectives The fetal origins of adult disease hypothesis describes associations found for fetal or early-life exposures with cardiovascular risk and disease in adulthood. The extension or not of these associations into old age has received less attention. We investigated if maternal health and family circumstances were associated with cardiovascular risk factors and cardiovascular disease (CVD) in late life and discuss results in light of possible selection effects and measurement error. Design A retrospective cohort study based on community survey. We examined 224 possible associations between anthropometric measures, maternal health information and family socioeconomic status at birth versus CVD and CVD-related risk factors 72–74 years later. Participants Of 3341 participants in a community survey of people aged 72–74 years, we were able to trace birth records from a historical archive in a broadly representative subsample of 480. Setting Bergen, Norway Main outcome measures Established cardiovascular risk factors and indicators of CVD. Results Only 11 (4.9%) of these associations were found to be statistically significant, and no strong or consistent patterns in the associations between exposures and outcomes were found. Conclusions There was little evidence in this relatively elderly sample for an association between early life factors and CVD outcomes of clinical or public health relevance. Further research is required to confirm the extent to which a diminution of early life influences into old age, if genuine, can be accounted for by selective mortality, systematic bias or by dilution of effects due to competing risk factors.
Conditions triggering local incident reviews in UK hospital maternity units: A national survey
Authors: Shah Anjali , Mohamed-Ahmed Olaa , McClymont Charlotte , Knight Marian 
Published: July 2014

Objectives In countries, such as the UK, where maternal deaths are rare, reviews of other severe complications of pregnancy and the puerperium can provide an additional perspective to help learn lessons to improve future care. The objective of this survey was to identify the types of incidents which triggered local reviews in the UK, in order to inform national safety reporting guidance. Design A national descriptive survey. Setting UK. Participants Consultant-led maternity units. Main outcome measure Seventy-one per cent of maternity units provided an incident review trigger list. The conditions included were classified by two assessors. Incidents that were listed by at least 5% of maternity units were reported and compared with incidents recommended for review by the Royal College of Obstetricians and Gynaecologists (RCOG). Results The conditions covered were highly variable, although those recommended by the RCOG were most highly represented. The most commonly listed conditions that had not been recommended for review by the RCOG included inadequate staffing levels (70%), cardiac arrest (69%) and maternal sepsis (64%). Conclusions Substantial variation exists in the types of incident listed for review by maternity units in the UK. Importantly, some units are not reviewing cases of severe infective complications even though this is a current major concern. Future guidance concerning local serious incident review processes should include how the list of conditions triggering a review should be managed in the light of changing clinical and safety priorities.
Tacrolimus/sirolimus vs tacrolimus/methotrexate as GVHD prophylaxis after matched, related donor allogeneic HCT
Authors: Cutler Corey , Logan Brent , Nakamura Ryotaro , Johnston Laura , Choi Sung , Porter David , Hogan William J. , Pasquini Marcelo , MacMillan Margaret L. , Hsu Jack W. , Waller Edmund K. , Grupp Stephan , McCarthy Philip , Wu Juan , Hu Zhen-Huan , Carter Shelly L. , Horowitz Mary M. , Antin Joseph H. 
Published: July 2014

Key Points
Tac/Sir prophylaxis provides equivalent GVHD-free survival when compared with Tac/Mtx in MRD transplantation. Tac/Sir is associated with more rapid engraftment and reduced oropharyngeal mucositis after MRD transplantation.
Effects of sex hormones on bronchial reactivity during the menstrual cycle
Authors: Matteis Maria , Polverino Francesca , Spaziano Giuseppe , Roviezzo Fiorentina , Santoriello Carlo , Sullo Nikol , Bucci Maria Rosaria , Rossi Francesco , Polverino Mario , Owen Caroline A , D’Agostino Bruno 
Published: July 2014

AbstractBackgroundMany asthmatic women complain of symptom exacerbations in particular periods, i.e. during pregnancy and menstrual cycles (perimenstrual asthma: PMA)". The goal of this study was to study the effect of the luteal and follicular phases of the menstrual cycle on bronchial reactivity (BR) in a group of asthmatic women.MethodsFor this purpose, 36 pre-menopausal women were enrolled and underwent testing for resting pulmonary function, measurement of the diffusing capacity of the lung for carbon monoxide (DLCO), and airway responsiveness to methacholine in the follicular and luteal phases of their menstrual cycles. We also measured plasma hormone levels and levels of cyclic adenosine monophosphate (cAMP; a mediator of bronchial smooth muscle contraction) and testosterone in induced sputum samples.ResultsOur study showed that about 30% of the asthmatic women had decreased PC20FEV1.0in the follicular phase of menstrual cycle with a significant correlation between PC20FEV1.0and serum testosterone levels. Moreover, marked increases in sputum testosterone levels (mean = 2.6-fold increase) together with significant increases in sputum cAMP concentrations (mean = 3.6-fold increases) were observed during the luteal phase of asthmatic patients, suggesting that testosterone contributes to the pathophysiology of PMA. We excluded the possibility that testosterone directly inhibits phosphodiesterase (PDE) activity as incubating PDE with testosterone in vitro did not reduce PDE catalytic activity.ConclusionsIn conclusion, our data show that PC20FEV1.0was decreased in the follicular phase of the menstrual cycle in about 30% of women and was associated with lower cAMP levels in sputum samples, which may contribute to bronchoconstriction. Our results also suggest a link between PMA and testosterone levels. However, whether these findings are of clinical significance in terms of the management of asthma or asthma worsening during the menstrual cycle needs further investigation.
Clustering in mental health payment by results: a critical summary for the clinician
Authors: Yeomans David 
Published: July 2014

SummaryMental health payment by results (PbR) is a disruptive new prospective payment system intended to replace National Health Service block contracts in England and provide a mechanism for opening up the mental health economy. Patients are allocated to one of 21 treatment clusters, each with a different price or tariff. Clinicians perform cluster allocation using the Mental Health Clustering Tool. The clustering process makes demands on clinicians' time even with support from information systems. Clustering is novel and it is unclear how it will work in practice. The process is likely to be susceptible to gaming.LEARNING OBJECTIVESUnderstand that the clinical process of diagnostic classification is different from the financial process of clustering categorisation.Understand the importance of learning the clustering tool ratings definitions in order to make accurate cluster allocations.Recognise that mental health payment by results is driving the widespread adoption of outcomes measurement.
Use of medication for challenging behaviour in people with intellectual disability
Authors: Glover Gyles , Bernard Sarah , Branford David , Holland Anthony , Strydom Andre 
Published: July 2014

SummaryMedications, particularly antipsychotics, are commonly used to manage challenging behaviour in people with intellectual disability. When the behaviour does not arise from an underlying mental illness, this is commonly off-licence and evidence of efficacy is lacking. A national audit programme would be one way to address the concerns this raises.
Second-Line Oxaliplatin, Folinic Acid, and Fluorouracil Versus Folinic Acid and Fluorouracil Alone for Gemcitabine-Refractory Pancreatic Cancer: Outcomes From the CONKO-003 Trial
Authors: Oettle Helmut , Riess Hanno , Stieler Jens M. , Heil Gerhard , Schwaner Ingo , Seraphin Jörg , Görner Martin , Mölle Matthias , Greten Tim F. , Lakner Volker , Bischoff Sven , Sinn Marianne , Dörken Bernd , Pelzer Uwe 
Published: July 2014

Purpose To assess the efficacy of a second-line regimen of oxaliplatin and folinic acid–modulated fluorouracil in patients with advanced pancreatic cancer who have experienced progression while receiving gemcitabine monotherapy. Patients and Methods A randomized, open-label, phase III study was conducted in 16 institutions throughout Germany. Recruitment ran from January 2004 until May 2007, and the last follow-up concluded in December 2012. Overall, 168 patients age 18 years or older who experienced disease progression during first-line gemcitabine therapy were randomly assigned to folinic acid and fluorouracil (FF) or oxaliplatin and FF (OFF). Patients were stratified according to the presence of metastases, duration of first-line therapy, and Karnofsky performance status. Results Median follow-up was 54.1 months, and 160 patients were eligible for the primary analysis. The median overall survival in the OFF group (5.9 months; 95% CI, 4.1 to 7.4) versus the FF group (3.3 months; 95% CI, 2.7 to 4.0) was significantly improved (hazard ratio [HR], 0.66; 95% CI, 0.48 to 0.91; log-rank P = .010). Time to progression with OFF (2.9 months; 95% CI, 2.4 to 3.2) versus FF (2.0 months; 95% CI, 1.6 to 2.3) was significantly extended also (HR, 0.68; 95% CI, 0.50 to 0.94; log-rank P = .019). Rates of adverse events were similar between treatment arms, with the exception of grades 1 to 2 neurotoxicity, which were reported in 29 patients (38.2%) and six patients (7.1%) in the OFF and FF groups, respectively (P < .001). Conclusion Second-line OFF significantly extended the duration of overall survival when compared with FF alone in patients with advanced gemcitabine-refractory pancreatic cancer.
Hydrodechlorination of para-Chloroacetophenone in Water/Ethanol Mixtures Using Organosilane-grafted Rh/SiO2 Catalysts
Authors: Yoneda Tetsuya , Aoyama Tadashi , Koizumi Koshiro , Takido Toshio 
Published: July 2014

Abstract
Hydrodechlorination was performed in water/ethanol mixtures over organosilane-grafted Rh/SiO2 catalysts. All catalysts in which organosilanes were covalently connected onto silica supports promoted hydrodechlorination, which may be attributed to the presence of a hydrophobic zone on the catalyst surfaces. Additional aromatic π–π interactions between the 4-tolylsilyl substituent in the catalyst and the aromatic ring of p-chloroacetophenone may be important for the activity of the most active Rh/SiO2–TS catalyst that was produced via silylation using trichloro-4-tolylsilane.
Marriage and Managers' Attitudes to Risk
Authors: Roussanov Nikolai , Savor Pavel 
Published: July 2014

Marital status can both reflect and affect individual preferences. We explore the impact of marriage on corporate chief executive officers (CEOs) and find that firms run by single CEOs exhibit higher stock return volatility, pursue more aggressive investment policies, and do not respond to changes in idiosyncratic risk. These effects are weaker for older CEOs. Our findings continue to hold when we use variation in divorce laws across states to instrument for CEO marital status, which supports the hypothesis that marriage itself drives choices rather than it just reflecting innate heterogeneity in preferences. We explore various potential explanations for why single CEOs may be less risk averse. Data, as supplemental material, are available at http://dx.doi.org/10.1287/mnsc.2014.1926 . This paper was accepted by Wei Jiang, finance.
The outcome of proximal humeral fractures in the elderly
Authors: Clement N. D. , Duckworth A. D. , McQueen M. M. , Court-Brown C. M. 
Published: July 2014

This study describes the epidemiology and outcome of 637 proximal humeral fractures in 629 elderly (≥ 65 years old) patients. Most were either minimally displaced (n = 278, 44%) or two-part fractures (n = 250, 39%) that predominantly occurred in women (n = 525, 82%) after a simple fall (n = 604, 95%), who lived independently in their own home (n = 560, 88%), and one in ten sustained a concomitant fracture (n = 76, 11.9%). The rate of mortality at one year was 10%, with the only independent predictor of survival being whether the patient lived in their own home (p = 0.025). Many factors associated with the patient’s social independence significantly influenced the age and gender adjusted Constant score one year after the fracture. More than a quarter of the patients had a poor functional outcome, with those patients not living in their own home (p = 0.04), participating in recreational activities (p = 0.01), able to perform their own shopping (p < 0.001), or able to dress themselves (p = 0.02) being at a significantly increased risk of a poor outcome, which was independent of the severity of the fracture (p = 0.001).A poor functional outcome after a proximal humeral fracture is not independently influenced by age in the elderly, and factors associated with social independence are more predictive of outcome.Cite this article: Bone Joint J 2014;96-B:970–7.
A reverse shoulder arthroplasty with increased offset for the treatment of cuff-deficient shoulders with glenohumeral arthritis
Authors: Middleton C. , Uri O. , Phillips S. , Barmpagiannis K. , Higgs D. , Falworth M. , Bayley I. , Lambert S. 
Published: July 2014

Inherent disadvantages of reverse shoulder arthroplasty designs based on the Grammont concept have raised a renewed interest in less-medialised designs and techniques. The aim of this study was to evaluate the outcome of reverse shoulder arthroplasty (RSA) with the fully-constrained, less-medialised, Bayley–Walker prosthesis performed for the treatment of rotator-cuff-deficient shoulders with glenohumeral arthritis. A total of 97 arthroplasties in 92 patients (53 women and 44 men, mean age 67 years (standard deviation (sd) 10, (49 to 85)) were retrospectively reviewed at a mean follow-up of 50 months ((sd 25) (24 to 96)). The mean Oxford shoulder score and subjective shoulder value improved from 47 (sd 9) and 24 points (sd 18) respectively before surgery to 28 (sd 11) and 61 (sd 24) points after surgery (p < 0.001). The mean pain at rest decreased from 5.3 (sd 2.8) to 1.5 (sd 2.3) (p < 0.001). The mean active forward elevation and external rotation increased from 42°(sd 30) and 9°(sd 15) respectively pre-operatively to 78°(sd 39) and 24°(sd 17) post-operatively (p < 0.001). A total of 20 patients required further surgery for complications; 13 required revision of components. No patient developed scapular notching.The Bayley–Walker prosthesis provides reliable pain relief and reasonable functional improvement for patients with symptomatic cuff-deficient shoulders. Compared with other designs of RSA, it offers a modest improvement in forward elevation, but restores external rotation to some extent and prevents scapular notching. A longer follow-up is required to assess the survival of the prosthesis and the clinical performance over time.Cite this article: Bone Joint J 2014;96-B:936–42.
The operative treatment of fractures of the distal radius is increasing
Authors: Mellstrand-Navarro C. , Pettersson H. J. , Tornqvist H. , Ponzer S. 
Published: July 2014

The aim of this study was to investigate the epidemiology of fractures of the distal radius in the Swedish population and to review the methods used to treat them between 2005 and 2010. The study population consisted of every patient in Sweden who was diagnosed with a fracture of the wrist between 1 January 2005 and 31 December 2010. There were 177 893 fractures of the distal radius. The incidence rate in the total population was 32 per 10 000 person-years. The mean age of the patients was 44 years (0 to 104). The proportion of fractures treated operatively increased from 16% in 2005 to 20% in 2010. The incidence rate for plate fixation in the adult population increased 3.61 fold. The incidence rate for external fixation decreased by 67%. The change was greatest in the 50 years to 74 years age group. In Sweden, there is an increasing tendency to operate on fractures of the distal radius. The previously reported increase in the use of plating is confirmed: it has increased more than threefold over a five-year period. Cite this article: Bone Joint J 2014;96-B:963–9.
Mid term results with the curved modular tapered, fluted titanium Revitan stem in revision hip replacement
Authors: Fink B. , Urbansky K. , Schuster P. 
Published: July 2014

We report our experience of revision total hip replacement (THR) using the Revitan curved modular titanium fluted revision stem in patients with a full spectrum of proximal femoral defects. A total of 112 patients (116 revisions) with a mean age of 73.4 years (39 to 90) were included in the study. The mean follow-up was 7.5 years (5.3 to 9.1). A total of 12 patients (12 hips) died but their data were included in the survival analysis, and four patients (4 hips) were lost to follow-up. The clinical outcome, proximal bone regeneration and subsidence were assessed for 101 hips. The mean Harris Hip Score was 88.2 (45.8 to 100) after five years and there was an increase of the mean Barnett and Nordin-Score, a measure of the proximal bone regeneration, of 20.8 (-3.1 to 52.7). Five stems had to be revised (4.3%), three (2.9%) showed subsidence, five (4.3%) a dislocation and two of 85 aseptic revisions (2.3%) a periprosthetic infection. At the latest follow-up, the survival with revision of the stem as the endpoint was 95.7% (95% confidence interval 91.9% to 99.4%) and with aseptic loosening as the endpoint, was 100%. Peri-prosthetic fractures were not observed. We report excellent results with respect to subsidence, the risk of fracture, and loosening after femoral revision using a modular curved revision stem with distal cone-in-cone fixation. A successful outcome depends on careful pre-operative planning and the use of a transfemoral approach when the anatomy is distorted or a fracture is imminent, or residual cement or a partially-secured existing stem cannot be removed. The shortest appropriate stem should, in our opinion, be used and secured with > 3 cm fixation at the femoral isthmus, and distal interlocking screws should be used for additional stability when this goal cannot be realised. Cite this article: Bone Joint J 2014;96-B:889–95.
The use of a lipped acetabular liner decreases the rate of revision for instability after total hip replacement
Authors: Insull P. J. , Cobbett H. , Frampton C. M. , Munro J. T. 
Published: July 2014

We compared the rate of revision for instability after total hip replacement (THR) when lipped and non-lipped acetabular liners were used. We hypothesised that the use of a lipped liner in a modular uncemented acetabular component reduces the risk of revision for instability after primary THR. Using data from the New Zealand Joint Registry, we found that the use of a lipped liner was associated with a significantly decreased rate of revision for instability and for all other indications. Adjusting for the size of the femoral head, the surgical approach and the age and gender of the patient, this difference remained strongly significant (p < 0.001). We conclude that evidence from the New Zealand registry suggests that the use of lipped liners with modular uncemented acetabular components is associated with a decreased rate of revision for instability after primary THR. Cite this article: Bone Joint J 2014;96-B:884–8.
A decade of change in the uptake of parathyroidectomy in England and Wales
Authors: Evans LM , Owens D , Scott-Coombes DM , Stechman MJ 
Published: July 2014

Introduction Since the late 1990s, a number of factors have reduced the threshold for parathyroidectomy in patients with primary hyperparathyroidism. This study examined whether this has translated into increased numbers of parathyroid operations over the last decade. Methods A retrospective analysis was performed of the Patient Episode Database for Wales and English Hospital Episode Statistics annual data from 2000 to 2010 for parathyroidectomy admissions per 100,000 population. Statistical analysis was by linear regression. Results Between 2000 and 2010 there were 24,247 parathyroid operations in England and Wales (0.005% of the population), with 3 times as many women treated as men. Overall, incidence of parathyroidectomy rose from 3.3/100,000 population in 2000 to 5.8/100,000 in 2010 (p<0.0001). In England, it increased from 3.3/100,000 population to 5.8/100,000 and in Wales, it increased from 2.4/100,000 population to 4.6/100,000. Despite similar population demographics, the difference in the rate of change between England and Wales was significant (p<0.05). Uptake also varied according to age; in those aged 0–14 years, incidence of parathyroidectomy remained static whereas in all other age groups, uptake of parathyroidectomy increased significantly from 2000 to 2010. Most notably, surgical intervention in those aged 60–74 and >75 years nearly doubled over the decade (p<0.0001). Conclusions The incidence of parathyroidectomy in adults has increased significantly in the last decade in England and Wales. This likely reflects changes in population demography, available guidelines, lower threshold for referral, changing surgical approach and the realisation that surgical morbidity is now infrequent.