bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Handbook: an end to 'I wish I had known that before I started'
Authors: Davies Mike , Panchal Sonia , Misra Nikhil 
Published: March 2015

AbstractThe importance of an effective handover between clinicians is vital, particularly for junior doctors when commencing a new clinical rotation. When junior doctors commence a new rotation there is often a significant amount of new information and tasks that they must learn, whilst also maintaining a high level of care for patients. However, very little information is formally passed from the outgoing junior doctor to the incoming junior doctor when changing rotations, resulting in a gap in knowledge and information having to be relearned by each junior doctor for each ward.Through a junior doctor led service improvement initiative we created an intranet-based, updateable, easily accessible, and secure resource to assist junior doctors during this transition period. Our project was not only beneficial to junior doctors when starting on a new rotation but also helped them understand their role within the ward environment and become more efficient in their clinical work. The project is an example of a sustainable service improvement project implemented with no cost that due to its format and low maintenance, could be easily adapted on a wider scale in other hospitals or Trusts.
Alterations to calling criteria for Between the Flags (an early warning system)
Authors: Davis Tessa , Nogajski Bec 
Published: March 2015

AbstractEarly warning systems aim to detect clinical deterioration of patients at an early stage. Between the Flags was introduced in New South Wales Health for this purpose. When patients are transferred from the emergency department to the ward, there are circumstances when the calling criteria need to be altered to take into account the clinical context. It is recognised that confusion exists among junior medical staff about the process of making alterations to the Between the Flags calling criteria.A quality improvement project was implemented by undertaking a baseline survey of junior medical staff, providing education and training (to junior medical staff on the existing guidelines for making alteration to the calling criteria), and conducting a post-implementation survey.A baseline survey demonstrated that 74% of junior medical staff had received no education on making alterations and only 5% knew how long their alterations would last once the patient was transferred to the ward. This has potentially serious consequences for patient safety following transfer.After implementation of training, we found that 63% of junior medical staff were aware of the guidelines on making alterations and 50% knew how long their alterations would last once the patient was transferred to the ward. We conclude that educating junior medical staff improved knowledge on the guidelines for making alterations to calling criteria.
Perivascular epithelioid tumours (PEComas) of the gynaecological tract
Authors: Conlon Niamh , Soslow Robert A , Murali Rajmohan 
Published: March 2015

Perivascular epithelioid tumours (PEComas) of the gynaecological tract are rare tumours which were first recognised and diagnosed within the last 20 years. They represent a unique diagnostic challenge with regard to their accurate and reproducible distinction from more common entities such as smooth muscle tumours of the uterine corpus. In this review article, we trace the development of the concept of the PEComa tumour family, highlight what is known about extra-gynaecological tract PEComa at an immunohistochemical, molecular and therapeutic level and then present a summary of all reported cases of gynaecological tract PEComa to date. In the summary, we highlight rare subtypes of gynaecological tract PEComa and compare the performances of extant prognostic classification systems for malignancy in these tumours.
Fulminant amoebic colitis: a clinicopathological study of 30 cases
Authors: Chaturvedi Rachana , Gupte Prajakta A , Joshi Amita S 
Published: March 2015

ABSTRACT

Aims
To review the clinical and pathological factors associated with fulminant amoebic colitis (FAC) requiring colonic resection and its outcome.

Methods
We retrospectively identified adult patients admitted to our centre between June 2007 and December 2011 with FAC who underwent colonic resection and were diagnosed with amoebic colitis based on the presence of trophozoites on histological examination. The clinical details were extracted from the medical notes and correlated with the pathological findings.

Results
Thirty patients (18 men and 12 women) met the inclusion criteria. Their mean age was 50.1 years (range 21–89). The most frequent symptoms were abdominal pain, vomiting and fever. More than half the patients (16/30) had underlying conditions associated with immunosuppression including diabetes mellitus and tuberculosis. Pathological investigation of colonic resections showed predominantly right-sided involvement with geographic colonic ulcers covered with a creamy-white pseudomembrane, perforations, gangrenous changes, amoeboma and lesions mimicking inflammatory bowel disease. All showed basophilic dirty necrosis with abundant nuclear debris and amoebic trophozoites on histological examination. 21/30 patients (70%) had involvement beyond the caecum. 17/30 patients (57%) died. Those with involvement beyond the caecum were more likely to die (15/21, 71.4%) than those with less extensive disease.

Conclusions
FAC presents as acute abdomen and can mimic appendicitis, ischaemic bowel disease, tuberculosis and malignancy. Comorbidities causing immunosuppression frequently associated. Mortality remains high despite surgery, so FAC should be suspected in every case of acute abdomen with colonic perforation if associated with typical gross and microscopic findings and a history of stay in an endemic area.
Geomicrobiology of carbonate microbialites in the Tahiti reef
Authors: Warthmann Rolf J. , Camoin Gilbert , McKenzie Judith A. , Vasconcelos Crisógono 
Published: March 2015

Abstract
Integrated Ocean Drilling Program (IODP) Expedition 310 (Tahiti Sea Level) offered an opportunity to study the geomicrobiology of a reef framework. Offshore drilling was conducted on the coastal reefs of Tahiti (French Polynesia) at 22 sites in water depths of up to 117 m. Up to 80% of the retrieved core material comprises authigenic grey microbial carbonates with laminated or thrombolitic morphologies, which are associated with corals. Microbialites infilled the cavities during reef development and stabilized the coral reef framework. Rock-surface analyses were performed to track ongoing microbial activity in biofilms that could represent a modern counterpart of the processes at the origin of the formation of fossil microbialites. Significant concentrations of adenosine 5′-triphosphate, indicative of the presence of living microorganisms, were detected at relatively shallow depths, 0–6 m below the seafloor. Exoenzyme activities confirmed the presence of an active metabolizing microbiota forming biofilms in reef cavities. Onshore investigations of the recovered microbes and biofilms completed our picture that the rapid postglacial formation of carbonate microbialites was mediated by the activity of anaerobic microbes, such as sulphate-reducing bacteria and iron-respiring organisms, stimulated by the highly productive reef environment.
Science and scientists from a child's point of view: an overview from drawings
Authors: Rubbia G. , D'Addezio G. , Marsili A. , Carosi A. 
Published: March 2015

Abstract
An analysis of the perceived image of science, scientists and inventions was conducted with hundreds of drawings made by children for a competition held in Italian schools. The ‘draw a scientist’ approach, as used in several studies, was used to analyse images of scientists. A coarse-grain, quantitative analysis of the prevalence of features exhibited stereotypes as well as new trends, suggesting a further fine-grain, qualitative analysis was necessary. A generally positive picture of the work of scientists emerged as well as a great level of confidence in the potential of science, which is capable of responding to the needs and problems of humanity and of the environment in which we live.
Communicating natural hazards: marine extreme events and the importance of variability and forecast errors
Authors: Marone Eduardo , Camargo R. , Salcedo-Castro J. 
Published: March 2015

Abstract
Scientific knowledge has to meet some necessary conditions. Among these, it has to be properly communicated. Usually, scientists (mis)understand this requirement and believe that publishing their results in peer-reviewed journals is enough. Society demands the availability of information in other formats. This is particularly relevant when dealing with natural hazards, which affect the life and fate of human beings. Natural hazards and extreme events are becoming more frequent and energetic, and future scenarios sustain that this tendency will remain or even increase. Furthermore, in trying to explain scientific results to untrained members of society, scientists usually focus more on forecasts than on the prediction errors. Talking about our forecast limitations outside of academia seems shameful, rather than being a logical limitation of sciences and regardless of the fact that discussing limitations is not something of which to be ashamed. Using numerical modelling combined with field observations to predict extreme marine events we hope to show here that it is possible to be less cryptic. Also, the general public needs to know enough to properly deal with variability and uncertainties. Scientists have the ethical responsibility of communicating the uncertainties of our results to society because these limitations are neither obvious nor irrelevant.
Targeting the Spleen Tyrosine Kinase with Fostamatinib as a Strategy against Waldenström Macroglobulinemia
Authors: Kuiatse Isere , Baladandayuthapani Veerabhadran , Lin Heather Y. , Thomas Sheeba K. , Bjorklund Chad C. , Weber Donna M. , Wang Michael , Shah Jatin J. , Zhang Xing-Ding , Jones Richard J. , Ansell Stephen M. , Yang Guang , Treon Steven P. , Orlowski Robert Z. 
Published: March 2015

Abstract
Purpose: Waldenström macroglobulinemia (WMG) is a lymphoproliferative disorder characterized by good initial responses to standard therapeutics, but only a minority of patients achieve complete remissions, and most inevitably relapse, indicating a need for novel agents. B-cell receptor signaling has been linked to clonal evolution in WMG, and Spleen tyrosine kinase (Syk) is overexpressed in primary cells, suggesting that it could be a novel and rational target.
Experimental Design: We studied the impact of the Syk inhibitor fostamatinib on BCWM.1 and MWCL-1 WMG-derived cell lines both in vitro and in vivo, as well as on primary patient cells.
Results: In WMG-derived cell lines, fostamatinib induced a time- and dose-dependent reduction in viability, associated with activation of apoptosis. At the molecular level, fostamatinib reduced activation of Syk and Bruton's tyrosine kinase, and also downstream signaling through MAPK kinase (MEK), p44/42 MAPK, and protein kinase B/Akt. As a single agent, fostamatinib induced tumor growth delay in an in vivo model of WMG, and reduced viability of primary WMG cells, along with inhibition of p44/42 MAPK signaling. Finally, fostamatinib in combination with other agents, including dexamethasone, bortezomib, and rituximab, showed enhanced activity.
Conclusions: Taken together, these data support the translation of approaches targeting Syk with fostamatinib to the clinic for patients with relapsed and possibly even newly diagnosed WMG. Clin Cancer Res; 21(11); 2538–45. ©2015 AACR.
Utility of Socioeconomic Status in Predicting 30-Day Outcomes After Heart Failure Hospitalization
Authors: Eapen Zubin J. , McCoy Lisa A. , Fonarow Gregg C. , Yancy Clyde W. , Miranda Marie Lynn , Peterson Eric D. , Califf Robert M. , Hernandez Adrian F. 
Published: March 2015

Background—
An individual’s socioeconomic status (SES) is associated with health outcomes and mortality, yet it is unknown whether accounting for SES can improve risk-adjustment models for 30-day outcomes among Centers for Medicare & Medicaid Services beneficiaries hospitalized with heart failure.

Methods and Results—

We linked clinical data on hospitalized patients with heart failure in the Get With The Guidelines-Heart Failure database (January 2005 to December 2011) with Centers for Medicare & Medicaid Services claims and county-level SES data from the 2012 Area Health Resources Files. We compared the discriminatory capabilities of multivariable models that adjusted for SES, patient, and hospital characteristics to determine whether county-level SES data improved prediction or changed hospital rankings for 30-day all-cause mortality and rehospitalization. After adjusting for patient and hospital characteristics, median household income (per $5000 increase) was inversely associated with odds of 30-day mortality (odds ratio, 0.97; 95% confidence interval, 0.95–1.00;
P
=0.032) and the percentage of people with at least a high school diploma (per 5 U increase) was associated with lower odds of 30-day rehospitalization (odds ratio, 0.95; 95% confidence interval, 0.91–0.99). After adjustment for county-level SES data, relative to whites, Hispanic ethnicity (odds ratio, 0.70; 95% confidence interval, 0.58–0.83) and black race (odds ratio, 0.57; 95% confidence interval, 0.50–0.65) remained significantly associated with lower 30-day mortality, but had similar 30-day rehospitalization. County-level SES did not improve risk adjustment or change hospital rankings for 30-day mortality or rehospitalization.

Conclusions—
County-level SES data are modestly associated with 30-day outcomes for Centers for Medicare & Medicaid Services beneficiaries hospitalized with heart failure, but do not improve risk adjustment models based on patient characteristics alone.
Survival After Out-of-Hospital Cardiac Arrest in Relation to Age and Early Identification of Patients With Minimal Chance of Long-Term Survival
Authors: Wissenberg Mads , Folke Fredrik , Hansen Carolina Malta , Lippert Freddy K. , Kragholm Kristian , Risgaard Bjarke , Rajan Shahzleen , Karlsson Lena , Søndergaard Kathrine Bach , Hansen Steen M. , Mortensen Rikke Normark , Weeke Peter , Christensen Erika Frischknecht , Nielsen Søren L. , Gislason Gunnar H. , Køber Lars , Torp-Pedersen Christian 
Published: March 2015

Background—
Survival after out-of-hospital cardiac arrest has increased during the last decade in Denmark. We aimed to study the impact of age on changes in survival and whether it was possible to identify patients with minimal chance of 30-day survival.

Methods and Results—

Using data from the nationwide Danish Cardiac Arrest Registry (2001─2011), we identified 21 480 patients ≥18 years old with a presumed cardiac-caused out-of-hospital cardiac arrest for which resuscitation was attempted. Patients were divided into 3 preselected age-groups: working-age patients 18 to 65 years of age (33.7%), early senior patients 66 to 80 years of age (41.5%), and late senior patients >80 years of age (24.8%). Characteristics in working-age patients, early senior patients, and late senior patients were as follows: witnessed arrest in 53.8%, 51.1%, and 52.1%; bystander cardiopulmonary resuscitation in 44.7%, 30.3%, and 23.4%; and prehospital shock from a defibrillator in 54.7%, 45.0%, and 33.8% (all
P
<0.05). Between 2001 and 2011, return of spontaneous circulation on hospital arrival increased: working-age patients, from 12.1% to 34.6%; early senior patients, from 6.4% to 21.5%; and late senior patients, from 4.0% to 15.0% (all
P
<0.001). Furthermore, 30-day survival increased: working-age patients, 5.8% to 22.0% (
P
<0.001); and early senior patients, 2.7% to 8.4% (
P
<0.001), whereas late senior patients experienced only a minor increase (1.5% to 2.0%;
P
=0.01). Overall, 3 of 9499 patients achieved 30-day survival if they met 2 criteria: had not achieved return of spontaneous circulation on hospital arrival and had not received a prehospital shock from a defibrillator.

Conclusions—
All age groups experienced a large temporal increase in survival on hospital arrival, but the increase in 30-day survival was most prominent in the young. With the use of only 2 criteria, it was possible to identify patients with a minimal chance of 30-day survival.
Comparison of Self-Reported and Medicare Claims-Identified Acute Myocardial Infarction
Authors: Yasaitis Laura C. , Berkman Lisa F. , Chandra Amitabh 
Published: March 2015

Background—
Cardiovascular disease is often studied through patient self-report and administrative data. However, these 2 sources provide different information, and few studies have compared them.

Methods and Results—

We compared data from a longitudinal, nationally representative survey of older Americans with matched Medicare claims. Self-reported heart attack in the previous 2 years was compared with claims-identified acute myocardial infarction (AMI) and acute coronary syndrome. Among the 3.1% of respondents with self-reported heart attack, 32.8% had claims-identified AMI, 16.5% had non-AMI acute coronary syndrome, and 25.8% had other cardiac claims; 17.3% had no inpatient visits in the previous 2.5 years. Claims-identified AMIs were found in 1.4% of respondents; of these, 67.8% reported a heart attack. Self-reports were less likely among respondents >75 years of age (62.7% versus 74.6%;
P
=0.006), with less than high school education (61.6% versus 71.4%;
P
=0.015), with at least 1 limitation in activities of daily living (59.6% versus 74.7%;
P
=0.001), or below the 25th percentile of a word recall memory test (60.7% versus 71.3%;
P
=0.019). Both self-reported and claims-identified cardiac events were associated with increased mortality; the highest mortality was observed among those with claims-identified AMI who did not self-report (odds ratio, 2.8; 95% confidence interval, 1.5–5.1) and among those with self-reported heart attack and claims-identified AMI (odds ratio, 2.5; 95% confidence interval, 1.7–3.6) or non-AMI acute coronary syndrome (odds ratio, 2.7; 95% confidence interval, 1.8–4.1).

Conclusions—
There is considerable disagreement between self-reported and claims-identified events. Although self-reported heart attack may be inaccurate, it indicates increased risk of death, regardless of whether the self-report is confirmed by Medicare claims.
Pentraxin 3 Induces Vascular Endothelial Dysfunction Through a P-selectin/Matrix Metalloproteinase-1 Pathway
Authors: Carrizzo Albino , Lenzi Paola , Procaccini Claudio , Damato Antonio , Biagioni Francesca , Ambrosio Mariateresa , Amodio Giuseppina , Remondelli Paolo , Del Giudice Carmine , Izzo Raffaele , Malovini Alberto , Formisano Luigi , Gigantino Vincenzo , Madonna Michele , Puca Annibale A. , Trimarco Bruno , Matarese Giuseppe , Fornai Francesco , Vecchione Carmine 
Published: March 2015

Background—
Pentraxin 3 (PTX3), the prototype of long pentraxins, has been described to be associated with endothelial dysfunction in different cardiovascular disorders. No study has yet evaluated the possible direct effect of PTX3 on vascular function.

Methods and Results—
Through in vitro experiments of vascular reactivity and ultrastructural analyses, we demonstrate that PTX3 induces dysfunction and morphological changes in the endothelial layer through a P-selectin/matrix metalloproteinase-1 pathway. The latter hampered the detachment of endothelial nitric oxide synthase from caveolin-1, leading to an impairment of nitric oxide signaling. In vivo studies showed that administering PTX3 to wild-type mice induced endothelial dysfunction and increased blood pressure, an effect absent in P-selectin–deficient mice. In isolated human umbilical vein endothelial cells, PTX3 significantly blunted nitric oxide production through the matrix metalloproteinase-1 pathway. Finally, using ELISA, we found that hypertensive patients (n=31) have higher plasma levels of PTX3 and its mediators P-selectin and matrix metalloproteinase-1 than normotensive subjects (n=21).

Conclusions—
Our data show for the first time a direct role of PTX3 on vascular function and blood pressure homeostasis, identifying the molecular mechanisms involved. The findings in humans suggest that PTX3, P-selectin, and matrix metalloproteinase-1 may be novel biomarkers that predict the onset of vascular dysfunction in hypertensive patients.
Lymphatic Drainage Patterns in Oral Squamous Cell Carcinoma
Authors: Farmer Roger W. , McCall Linda , Civantos Francisco J. , Myers Jeffrey N. , Yarbrough Wendell G. , Murphy Barbara , O’Leary Miriam , Zitsch Robert , Siegel Barry A. 
Published: March 2015

ObjectiveThe purpose of our study was to correlate sentinel lymph nodes (SLN) found on planar lymphoscintigraphy (LS) to SLN found with gamma probe–directed sentinel lymph node biopsy (SLNB) for T1/T2 N0 oral cavity cancer.Study DesignProspective cooperative group trial.SettingAcademic medical centers.Subjects and MethodsOne hundred forty adults with untreated T1/T2 N0 squamous cell carcinoma (SCC) of the oral cavity underwent planar LS, resection, SLNB, and neck dissection. Location of SLN by planar LS and SLNB and of metastases were compared to each other and historical data of regional metastases.ResultsSLNs located by planar LS and SLNB were predominantly in levels I through IV. There was heterogeneity in the number of SLNs found at planar LS and at SLNB, which was significantly different in levels II and III (P <. 0001). In 14 of 33 cases with bilateral drainage on planar LS, SLNB detected only unilateral SLN. Sensitivity of planar LS in predicting the level of SLN was 41% to 63%, and specificity was 68% to 95%. Comparison of locations of the metastases to historical data showed fewer metastases to level I in our study (P =. 03). Metastases occurred predominantly in levels I through III. In 1 case of a lateral tongue cancer, a contralateral SLN was the only positive node.ConclusionLymphatic drainage patterns and metastases involved predominantly levels I through III. Planar LS is not sensitive for predicting the levels of SLN, and in levels II and III, the rate of detection of SLN between the 2 modalities is significantly different.
A rat model of aortic arch aneurysm with excellent survival
Authors: Wang Jun , Liu Hong , Jiang Nan Qing , Jiang Bo , Wei Ning 
Published: March 2015

Background The complex mechanisms of aortic arch aneurysm have not been well studied. An animal model of aortic arch aneurysm would be beneficial to study this fatal disease. In this study, we tried to establish a rat model of aortic arch aneurysm by constricting the aortic isthmus. Methods Forty-eight male Sprague-Dawley rats were randomly divided into three groups. Rats with no aortic isthmus constriction were assigned to group A (control group). The aortic isthmus was constricted to 1.5 mm in group B and to 0.8 mm in group C. The blood pressure of the rats was measured at 0, 1, 3 and 6 months after the operation. The diameter and wall thickness of aortic arch were measured at 3 and 6 months after surgery. Results Compared to group A, group B showed no significant increase in blood pressure or aortic diameter after the operation. Compared to the control group, group B showed a marked increase in wall thickness at 3 and 6 months after surgery ( p < 0.05). Compared to group A, group C showed significant increases in both blood pressure ( p < 0.05) and aortic diameter ( p < 0.05) after the operation. Group C also showed a more than 50% increase in wall thickness at 3 and 6 months after surgery ( P < 0.05). Conclusions By constricting the aortic isthmus to 0.8 mm, a rat model of aortic arch aneurysm could be induced at 3 and 6 months after surgery.