bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘It's on my iPhone’: attitudes to the use of mobile computing devices in medical education, a mixed-methods study
Authors: Wallace Sean , Clark Marcia , White Jonathan 
Published: August 2012

ObjectiveThe last decade has seen the introduction of new technology which has transformed many aspects of our culture, commerce, communication and education. This study examined how medical teachers and learners are using mobile computing devices such as the iPhone in medical education and practice, and how they envision them being used in the future.DesignSemistructured interviews were conducted with medical students, residents and faculty to examine participants’ attitudes about the current and future use of mobile computing devices in medical education and practice. A thematic approach was used to summarise ideas and concepts expressed, and to develop an online survey. A mixed methods approach was used to integrate qualitative and quantitative findings.Setting and participantsMedical students, residents and faculty at a large Canadian medical school in 2011.ResultsInterviews were conducted with 18 participants (10 students, 7 residents and 1 faculty member). Only 213 participants responded to the online survey (76 students, 65 residents and 41 faculty members). Over 85% of participants reported using a mobile-computing device. The main uses described for mobile devices related to information management, communication and time management. Advantages identified were portability, flexibility, access to multimedia and the ability to look up information quickly. Challenges identified included: superficial learning, not understanding how to find good learning resources, distraction, inappropriate use and concerns about access and privacy. Both medical students and physicians expressed the view that the use of these devices in medical education and practice will increase in the future.ConclusionsThis new technology offers the potential to enhance learning and patient care, but also has potential problems associated with its use. It is important for leadership in medical schools and healthcare organisations to set the agenda in this rapidly developing area to maximise the benefits of this powerful new technology while avoiding unintended consequences.
Equal cancer treatment regardless of education level and family support? A qualitative study of oncologists’ decision-making
Authors: Cavalli-Björkman Nina , Glimelius Bengt , Strang Peter 
Published: August 2012

ObjectiveTreatment gradients by socioeconomic status have been observed within cancer care in several countries. The objective of this study was to explore whether patients’ educational level and social network influence oncologists’ clinical decision-making.DesignSemi-structured interviews on factors considered when deciding on treatment for cancer patients. Interviews were transcribed and analysed using inductive qualitative content analysis.SettingOncologists in Swedish university- and non-university hospitals were interviewed in their respective places of work.ParticipantsTwenty Swedish clinical oncologists selected through maximum-variation sampling.Primary and secondary outcome measuresElements which influence oncologists’ decision-making process were explored with focus on educational level and patients’ social support systems.ResultsOncologists consciously used less combination chemotherapy for patients living alone, fearing treatment toxicity. Highly educated patients were considered as well-read, demanding and sometimes difficult to reason with. Patients with higher education, those very keen to have treatment and persuasive relatives were considered as challenges for the oncologist. Having large groups of relatives in a room made doctors feel outnumbered. A desire to please patients and relatives was posed as the main reason for giving in to patients’ demands, even when this resulted in treatment with limited efficacy.ConclusionsOncologists tailor treatment for patients living alone to avoid harmful side-effects. Many find patients’ demands difficult to handle and this may result in strong socioeconomic groups being over-treated.
The role of hypoxic-inducible factor (HIF1α) and aldolaseC protein in endometrial carcinogenesis: a retrospective study of 279 patients
Authors: Mhawech-Fauceglia Paulette , Wang Dan , Samrao Damanzoopinder , Menesses Teodulo , Godoy Heidi , Ough Faith , Lele Shashikant , Liu Song , Pejovic Tanja 
Published: August 2012

ObjectivesHypoxia-inducible factor (HIF1α) plays an integral role in response to hypoxia, controlling dozens of target genes including aldolaseC (ALDC), an important enzyme in the glycolytic pathway. It also induces angiogenesis, allowing survival and proliferation of cancer cells. The aims of our study were to evaluate the expressions of HIF1α and ALDC in patients with endometrial cancer (EC) and define their association with disease outcome and to determine the existence of an association between HIF1α and ALDC proteins.DesignThis is a population-based retrospective cohort study using the gynaecological-oncology database. The authors identified all women with EC with adequate follow-up. Immunohistochemistry using antibodies to ALDC and HIF1α was performed on paraffin-embedded tissue from 279 patients. To test the association between ALDC /HIF1α protein using immunohistochemistry (IHC) (positive and negative) and the clinical parameters, Fisher's exact test was performed for categorical parameters and the logistic regression model was used for continuous ones. Pearson correlation was used to check the association of IHC between ALDC and HIF1α.SettingAcademic referral centre.ParticipantsWomen with EC from 2000 to 2010 obtained from the gynaecological-oncology database.Outcome measuresThe disease outcome is defined by alive with no evidence of disease versus all other outcomes.ResultsALDC and HIF1α were overexpressed in the vast majority of EC cases (78% and 76%, respectively). There was a strong positive association between HIF1α and ALDC (p=0.0017). There was a significant association between ALDC and depth of myometrial invasion (p=0.0438), and between HIF1α and tumour grade (p=0.0231) and tumour subtype (p=0.018). However, there was no association between neither ALDC nor HIF1α and disease status.ConclusionsALDC and HIF1α play an important role in endometrial carcinogenesis. Their expression by the majority of EC makes inhibition of HIF1α a very attractive therapeutic option for treating patients with EC and we suggest that it will be prospectively validated in future studies.
Myocardial performance assessment in neonates by one-segment strain and strain rate analysis by tissue Doppler - a quality improvement cohort study
Authors: Nestaas Eirik , Støylen Asbjørn , Fugelseth Drude 
Published: August 2012

ObjectivesTo investigate one-segment strain and strain rate indices as measures of myocardial performance in asphyxiated term neonates.DesignQuality improvement cohort study.SettingNewborns admitted to a neonatal intensive care unit at a Norwegian University Hospital for perinatal asphyxia and non-asphyxiated newborn recruited from the maternity ward at the same hospital.ParticipantsTwenty asphyxiated and 48 non-asphyxiated term neonates.Primary outcome measureStrain and strain rate indices and repeatability measures. One-segment longitudinal strain and strain rate by tissue Doppler were assessed on days 1, 2 and 3 of life in nine heart walls. Repeatability was compared against measurements from two-segment analyses previously performed in the same images.ResultsThe 95% limits of agreement were significantly better for the one-segment than two-segment repeatability analyses, the inter-rater peak systolic strain (PSS) was (−3.1, 3.3) vs (−11.4, 18.3)%, the inter-rater peak systolic strain rate (PSSR) was (−0.38, 0.40) vs (−0.79, 1.15)/s, the intra-rater PSS was (−2.5, 2.6) vs (−8.0, 9.8)% and the intra-rater PSSR was (−0.23, 0.25) vs (−0.75, 0.80)/s (p<0.05). The myocardial performance was lower in the asphyxiated neonates (indices closer to zero) than in the non-asphyxiated neonates, PSS was −17.8 (0.6) (mean (SEM)) vs −21.2 (0.3)%, PSSR −1.43 (0.08) vs −1.61 (0.03)/s, early diastolic strain rate 1.72 (0.11) vs 2.00 (0.11)/s and strain rate during the atrial systole 1.92 (0.17) vs 2.27 (0.10)/s (p<0.05), despite no difference in fractional shortening (29.0 (0.5) vs 29.1 (1.0)%) (p>0.05).ConclusionsOne-segment strain and strain rate assessed the reduced myocardial performance in asphyxiated neonates with significantly improved reproducibility as compared with two-segment analysis and was therefore more feasible than two-segment analyses for assessment of myocardial performance after perinatal asphyxia.
Low predictive value of positive transplant perfusion fluid cultures for diagnosing postoperative infections in kidney and kidney–pancreas transplantation
Authors: Cotter Meaghan P , Smyth Elizabeth , O'Gorman Joanne , Browne Sarah , Hickey David P , Humphreys Hilary 
Published: August 2012

AimsInfection following transplantation is a cause of morbidity and mortality. Perfusion fluid (PF) used to preserve organs between recovery and transplantation represents a medium suitable for the growth of microbes. We evaluated the relevance of positive growth from PF sampled before the implantation of kidney or kidney–pancreas (KP) allografts.MethodsBetween January 2007 and January 2011, 548 kidney/KP transplants were performed in our centre. A retrospective review of patient records with culture-positive PF was performed.ResultsPF was received from 483 (88%) patients, of which 35 (7%, 95% CI 5.3% to 9.9%) were positive for bacteria (31/483, 6.4%, 95% CI 4.6% to 9.8%) and fungi (4/483, 0.8%, 95% CI 0.3% to 2.1%). Thirty-two of the 35 culture-positive PF (91.4%, 95% CI 77.6% to 97%) were considered insignificant. The remaining three patients developed sepsis postoperatively, which was considered to be possibly related to growth in PF;Escherichia coliin one andKlebsiella pneumoniaein two. Of the non-skin flora bacteria cultured from PF, six were resistant to the prophylactic antibiotic given intraoperatively, but only one developed infection postoperatively (E coli, resistant to the co-amoxiclav).ConclusionsSignificant attributable morbidity associated with PF-positive culture results was relatively rare. Culture of organisms other than Enterobacteriaceae or fungi are likely to represent contamination.
The value of examination of multiple levels of mammary needle core biopsy specimens taken for investigation of lesions other than calcification
Authors: Lee Andrew H S , Villena Salinas Nadia M , Hodi Zsolt , Rakha Emad A , Ellis Ian O 
Published: August 2012

AimsIt is a standard practice to examine multiple levels of needle core biopsies taken for mammographic calcification, but there is almost no evidence on the value of levels in core biopsies taken for other reasons. This study aimed to assess the value of levels for needle core biopsies taken for investigation of lesions other than calcification. A secondary aim was to assess interobserver agreement of diagnosis.MethodsFor each of the 375 breast core biopsies with three levels the first level was reviewed and a diagnosis made. Then levels 2 and 3 were reviewed and a final diagnosis was made.ResultsThe diagnosis after examining three levels was different from that in the initial level in 4 of 272 (1.5%, 95% CI 0.04% to 3%) core biopsies taken for reasons other than calcification and in 13 of 103 (13%, 95% CI 6% to 19%) biopsies taken for investigation of calcification. Interobserver agreement of the original diagnosis at the time of reporting and the final diagnosis at the review for this study was 96% (κ 0.947).ConclusionsThis study confirms the value of levels of biopsies taken to investigate mammographic calcification, but suggests that routine levels are of limited value for breast core biopsies taken for other reasons.
Comparison of a rebound tonometer with an applanation tonometer in dogs with glaucoma
Authors: Slack J. M. , Stiles J. , Moore G. E. 
Published: August 2012

Eighteen dogs which presented to the Purdue University Ophthalmology Service with a final diagnosis of primary or secondary glaucoma, and 5 dogs with normal eye examinations, were evaluated. Each dog underwent a complete ophthalmic examination. An eye was categorised as glaucomatous if an intraocular pressure (IOP) measurement ≥25 mm Hg was obtained, and clinical signs consistent with glaucoma were present. Readings with the TonoVet were always performed first without topical anaesthesia. After obtaining readings with the TonoVet, one drop of proparacaine was applied to each eye, followed by IOP measurement with the Tono‐Pen XL. As IOP increased, the difference between measurements obtained with the two tonometers was statistically significant. The TonoVet consistently gave higher IOP values compared with the Tono‐Pen XL in glaucomatous eyes with Tono‐Pen XL IOP readings ≥25 mm Hg. IOP readings were not significantly different between tonometers for normotensive eyes. Based on the results of the current study, the same device should be used for monitoring of IOP in individual patients.
International disease monitoring, April to June 2012
Authors: Roberts H. , Lopez M. 
Published: August 2012

African swine fever continues to spread in western Russia
Brucellosis outbreaks in Europe
Foot‐and‐mouth disease outbreaks across the Middle East and north Africa continue to present a threat to Europe
Highly pathogenic avian influenza H3N7 in Mexico in an area of high poultry density
Continued outbreaks of HPAI H5N1 in endemic areas
Information on Schmallenberg virus in ruminants in northern Europe
These are among matters discussed in the international disease monitoring report for April to June 2012, prepared by Defra's Animal Health and Veterinary Laboratories Agency
Behavioral and electroencephalographic manifestations of thioacetamide-induced encephalopathy in rats
Authors: Mladenović Dušan , Radosavljević Tatjana , Hrnčić Dragan , Rašić-Marković Aleksandra , Puškaš Nela , Maksić Nebojša , Djuric Dragan , Stanojlović Olivera 
Published: August 2012

The aim of our study was to investigate the behavioral and electroencephalographic manifestations of thioacetamide-induced encephalopathy in rats. Male Wistar rats were divided among (i) control, saline-treated, and (ii) thioacetamide-treated groups (TAA300(300 mg/kg body mass); TAA600(600 mg/kg); and TAA900(900 mg/kg)). The daily dose of thioacetamide (300 mg/kg) was administered intraperitoneally once (TAA300), twice (TAA600), or 3 times (TAA900), on subsequent days. Behavioral manifestations were determined at 0, 2, 4, 6, and 24 h, while electroencephalographic changes were recorded 22–24 h after the last dose. General motor activity and exploratory behavior, as well as head shake, auditory startle reflex, placement, and equlibrium tests were diminished in the TAA600and TAA900groups compared with the control, and were absent in the TAA900group 24 h after treatment. Corneal, withdrawal, grasping, and righting reflexes were significantly diminished in the TAA900group compared with the control. Mean electroencephalographic power spectra density was significantly higher in TAA300and TAA600and lower in the TAA900group by comparison with the control. Only a score of 3 (mean dominant frequency ≤ 7.3 Hz and δ relative power ≥ 45%) was observed in the TAA900group. Thioacetamide induces encephalopathy in rats in a dose-dependent manner. A dose of 900 mg/kg TAA may be used as a suitable model of all stages of hepatic encephalopathy.
Variation in diet of Semipalmated Sandpipers (Calidris pusilla) during stopover in the upper Bay of Fundy, Canada
Authors: Quinn J.T. , Hamilton D.J. 
Published: August 2012

Semipalmated Sandpipers ( Calidris pusilla (L., 1766)) use the upper Bay of Fundy, Canada, as a critical stopover site during their annual fall migration to wintering grounds in South America. While in the area, they feed extensively on mudflat invertebrates. Historically the amphipod Corophium volutator (Pallas, 1766) has been thought to make up the majority of their diet. However, we have recently observed flexibility in foraging behaviour and prey selection by sandpipers. The extent of this flexibility and the current diet composition is unknown. To address these knowledge gaps, we assessed Semipalmated Sandpiper diets using stable isotope analyses of blood plasma and available prey items. Data were collected in two arms of the Bay of Fundy during summer 2009 and 2010. Diets fluctuated between years and sites, but in all cases the diet was much more diverse than previously thought. Polychaetes and biofilm made substantial contributions, and C. volutator was still present in the diet, but at much reduced levels than previously noted. This previously unrecognized inclusion of biofilm in the diet is consistent with recent observations of other calidrid shorebirds. Based on measures of prey availability, there is little evidence of preference for C. volutator.
Diurnal changes and levels of fibrin generation are not altered by continuous positive airway pressure (CPAP) in obstructive sleep apnoea (OSA)
Authors: Morel-Kopp Marie-Christine , Yee Brendon J. , Sullivan David R. , Ward Christopher M. , Tofler Geoffrey H. , Grunstein Ronald R. , McEwen Bradley J. , Phillips Craig L. 
Published: August 2012

SummaryObstructive sleep apnoea (OSA) is associated with increased cardiovascular disease (CVD) risk. In the general population, CVD events peak at 9:00–10:00 AM, associated with diurnal changes in thrombotic potential. However in OSA, these CVD events occur frequently at night. Measuring thrombotic potential across the sleep-wake cycle may provide insight into the temporal association of OSA with CVD. This study aimed to determine diurnal changes in fibrin generation in OSA and whether treatment of OSA with continuous positive airway pressure (CPAP) alters fibrin generation across the sleep-wake cycle. In a randomised placebo-controlled crossover trial, patients with OSA were assigned to two months each of therapeutic CPAP and placebo. After each treatment period, fibrin generation was determined by overall haemostatic potential assay at seven time points over 24 hours (h). Twenty-eight patients (25 men, 3 women) with severe OSA (Apnoea Hypopnoea Index = 37.9 ± 23.9/h, Oxygen Desaturation Index 31.3 ± 22.4/h) completed the study. All parameters, except lag time to fibrin generation, showed significant diurnal changes, both on CPAP and placebo. Compared to 9:00 AM, fibrin generation parameters were significantly lower at midnight and 3:00 AM for overall coagulation potential (OCP), overall haemostasis potential (OHP), maximum optical density, and maximum slope (all p≤0.001). CPAP produced no change in fibrin generation parameters compared to placebo. In severe OSA patients, fibrin generation peaked at 6:00 AM and 9:00 AM rather than during the sleep period (midnight and 3:00 AM). These findings suggest a prothrombotic shift in the morning similar to individuals without OSA. There was no difference between CPAP and placebo on fibrin generation.
Determinants of bleeding phenotype in adult patients with moderate or severe von Willebrand disease
Authors: de Wee Eva M. , Sanders Yvonne V. , Mauser-Bunschoten Eveline P. , van der Bom Johanna G. , Degenaar-Dujardin Manon E. L. , Eikenboom Jeroen , de Goede-Bolder Arja , Laros-van Gorkom Britta A. P. , Meijer Karina , Hamulyák Karly , Nijziel Marten R. , Fijnvandraat Karin , Leebeek Frank W. G. ,   for the WiN study group
Published: August 2012

SummaryWe performed a nation-wide cross-sectional study to evaluate determinants of bleeding symptoms in a large unselected cohort of adults with von Willebrand disease (VWD). VWD patients were included (n=664), based on lowest historically measured VWF:Ag and VWF:Act levels ≤30 U/dl. Menorrhagia (85%), cutaneous bleeding (77%), bleeding from minor wounds (77%) and oral-cavity bleeding (62%) occurred most frequently. Higher age was associated with a higher bleeding score (BS), determined according to Tosetto, in females. A 10 year increase in age was associated with 0.8 point (95% confidence interval [CI] 0.4–1.1) higher BS. Females had higher BS than males (median 12 vs. 10, p=0.012). BS differed significantly between VWD type 1, 2 and 3: median 9 (-2–31), 13 (-1–33) and 19.5 (1–35), respectively (p<0.001). BS was strongly associated with VWF and FVIII levels: individuals with VWF:Ag levels ≤10 IU/dl, VWF:Act ≤10 IU/dl and FVIII:C ≤10 IU/dl had, respectively, 5.3 point (95%CI 3.2–7.3), 4.3 point (95%CI 2.9–5.8) and 9.6 point (95%CI 6.5–12.7) higher BS, than those with levels >30 IU/dl. In type 3 patients 1 IU/dl FVIII:C decrease was associated with 0.6 point (95% CI 0.1–1.1) BS increase (p=0.021). In conclusion, in VWD patients the bleeding phenotype is strongly associated with type of VWD and VWF and FVIII levels.
Intermedin
Authors: Zhang Wei , Wang Li-Jun , Xiao Fei , Wei Yi , Ke Wei , Xin Hong-Bo 
Published: August 2012

Objective—
Intermedin (IMD), a member of calcitonin family, was suggested to play a role in angiogenesis and cancer. The aim of this study was to investigate the role of IMD in the angiogenic process and the underlying mechanism, and the possibility for it to be used as a target for angiogenesis-based anticancer therapies.

Methods and Results—
Using in vivo and in vitro 3-dimensional angiogenic models, we found that IMD induced a well-ordered vasculature with hierarchical structure and had a synergistic effect with vascular endothelial growth factor. Using RNA interference, real-time polymerase chain reaction, and Western blot analysis, we found that IMD alleviated the undesirable effects of vascular endothelial growth factor by restricting the excessive vessel sprouting and uneven lumen formation through the regulation of vascular endothelial-cadherin and identified its receptor on the endothelial cells. Both mitogen-activated protein kinase/extracellular signal–regulated kinase and phosphoinositide 3-kinase/Akt activation were involved in the effects. Furthermore, using experimental tumor models, we demonstrated that IMD was involved in tumor angiogenesis, and the blockade of IMD severely impaired blood supply and eventually inhibited tumor growth.

Conclusion—
We demonstrated that IMD played a critical role in the vascular remodeling process and tumor angiogenesis and may serve as a novel target for the development of angiogenesis-based anticancer therapies.