bluuebunny/crossref_metadata_2025_split huggingface dataset:
Education level and survival after oesophageal cancer surgery: a prospective population-based cohort study
Authors: Brusselaers Nele , Ljung Rickard , Mattsson Fredrik , Johar Asif , Wikman Anna , Lagergren Pernilla , Lagergren Jesper 
Published: December 2013

ObjectivesThis study aimed to investigate whether a higher education level is associated with an improved long-term survival after oesophagectomy for cancer.DesignA prospective, population-based cohort study.SettingSweden—nationwide.Participants90% of all patients with oesophageal and cardia cancer who underwent a resection in Sweden in 2001–2005 were enrolled in this study (N=600; 80.3% male) and followed up until death or the end of the study period (2012). The study exposure was level of education, defined as compulsory (≤9 years), moderate (10–12 years) or high (≥13 years).Outcome measuresThe main outcome measure was overall 5-year survival after oesophagectomy. Cox regression was used to estimate the associations between education level and mortality, expressed as HRs with 95% CIs, with adjustment for sex, age, tumour stage, histological type, complications, comorbidities and annual surgeon volume. The patient group with highest education was used as the reference category.ResultsAmong the 600 included patients, 281 (46.8%) had compulsory education, 238 (39.7%) had moderate education and 81 (13.5%) had high education. The overall 5-year survival rate was 23.1%, 24.4% and 32.1% among patients with compulsory, moderate and high education, respectively. After adjustment for confounders, a slightly higher, yet not statistically significantly increased point HR was found among the compulsory educated patients (HR 1.08, 95% CI 0.80 to 1.47). In patients with tumour stage IV, increased adjusted HRs were found for compulsory (HR 2.88, 95% CI 1.07 to 7.73) and moderately (HR 2.83, 95% CI 1.15 to 6.95) educated patients. No statistically significant associations were found for the other tumour stages.ConclusionsThis study provides limited evidence of an association between lower education and worse long-term survival after oesophagectomy for cancer.
Epidemiology and genetics of common mental disorders in the general population: the PEGASUS-Murcia project
Authors: Navarro-Mateu Fernando , Tormo MJ , Vilagut G , Alonso J , Ruíz-Merino G , Escámez T , Salmerón D , Júdez J , Martínez S , Navarro C 
Published: December 2013

BackgroundMultidisciplinary collaboration between clinicians, epidemiologists, neurogeneticists and statisticians on research projects has been encouraged to improve our knowledge of the complex mechanisms underlying the aetiology and burden of mental disorders. The PEGASUS-Murcia (Psychiatric Enquiry to General Population in Southeast Spain-Murcia) project was designed to assess the prevalence of common mental disorders and to identify the risk and protective factors, and it also included the collection of biological samples to study the gene–environmental interactions in the context of the World Mental Health Survey Initiative.Methods and analysisThe PEGASUS-Murcia project is a new cross-sectional face-to-face interview survey based on a representative sample of non-institutionalised adults in the Region of Murcia (Mediterranean Southeast, Spain). Trained lay interviewers used the latest version of the computer-assisted personal interview of the Composite International Diagnostic Interview (CIDI 3.0) for use in Spain, specifically adapted for the project. Two biological samples of buccal mucosal epithelium will be collected from each interviewed participant, one for DNA extraction for genomic and epigenomic analyses and the other to obtain mRNA for gene expression quantification. Several quality control procedures will be implemented to assure the highest reliability and validity of the data. This article describes the rationale, sampling methods and questionnaire content as well as the laboratory methodology.Ethics and disseminationInformed consent will be obtained from all participants and a Regional Ethics Research Committee has approved the protocol. Results will be disseminated in peer-reviewed publications and presented at the national and the international conferences.DiscussionCross-sectional studies, which combine detailed personal information with biological data, offer new and exciting opportunities to study the gene–environmental interactions in the aetiology of common mental disorders in representative samples of the general population. A collaborative multidisciplinary research approach offers the potential to advance our knowledge of the underlying complex interactions and this opens the field for further innovative study designs in psychiatric epidemiology.
Changes in household, transport and recreational physical activity and television viewing time across the transition to retirement: longitudinal evidence from the EPIC-Norfolk cohort
Authors: Barnett Inka , van Sluijs Esther , Ogilvie David , Wareham Nicholas J 
Published: December 2013

BackgroundRetirement is associated with an increase in recreational physical activity but its impact on other domains of activity (at home, for transport) and sedentary behaviour, such as time spent watching television (TV) is unknown. We examined the association between retirement and changes in domain-specific and overall activity and TV viewing.MethodsData were derived from the population-based EPIC (European Prospective Investigation into Cancer)–Norfolk cohort. Physical activity and TV viewing time were self-reported at baseline (1997–2000) and follow-up 2 (2006–2007) by 3334 participants employed at baseline, of whom 785 (24%) were retired at follow-up 1 (2002–2006). Multivariable regression models were fitted to estimate the association between retirement and changes in physical activity and weekly TV viewing time.ResultsCompared with continued employment, retirement was associated with a decline in overall activity (men: non-manual, −40.9 MET h/wk; manual, −49.6 MET h/wk; women: non-manual, −26.9 MET h/wk; manual, −31.6 MET h/wk; all p<0.001 (MET, metabolic equivalent of task)). Domain-specific activity declined for transport and occupational (p<0.001) and increased for recreational (p<0.02) and household (p≤0.002) activity. We observed significant interaction between retirement and social class in respect of overall and domain-specific activity apart from household activity. Retirement was associated with a mean increase in TV viewing time, with the largest increase among manual social classes (men: +3.9 h/wk; women: +2.8 h/wk; both p<0.001).ConclusionsInterventions should aim to promote household and transport as well as recreational activity. Further research on the impact of retirement on sedentary behaviour is needed.
CCL2/CCR2-Dependent Recruitment of Functional Antigen-Presenting Cells into Tumors upon Chemotherapy
Authors: Ma Yuting , Mattarollo Stephen R. , Adjemian Sandy , Yang Heng , Aymeric Laetitia , Hannani Dalil , Portela Catani João Paulo , Duret Helene , Teng Michele W.L. , Kepp Oliver , Wang Yidan , Sistigu Antonella , Schultze Joachim L. , Stoll Gautier , Galluzzi Lorenzo , Zitvogel Laurence , Smyth Mark J. , Kroemer Guido 
Published: December 2013

Abstract
The therapeutic efficacy of anthracyclines relies, at least partially, on the induction of a dendritic cell– and T-lymphocyte–dependent anticancer immune response. Here, we show that anthracycline-based chemotherapy promotes the recruitment of functional CD11b+CD11c+Ly6ChighLy6G−MHCII+ dendritic cell–like antigen-presenting cells (APC) into the tumor bed, but not into lymphoid organs. Accordingly, draining lymph nodes turned out to be dispensable for the proliferation of tumor antigen–specific T cells within neoplastic lesions as induced by anthracyclines. In addition, we found that tumors treated with anthracyclines manifest increased expression levels of the chemokine Ccl2. Such a response is important as neoplasms growing in Ccl2−/− mice failed to accumulate dendritic cell–like APCs in response to chemotherapy. Moreover, cancers developing in mice lacking Ccl2 or its receptor (Ccr2) exhibited suboptimal therapeutic responses to anthracycline-based chemotherapy. Altogether, our results underscore the importance of the CCL2/CCR2 signaling axis for therapeutic anticancer immune responses as elicited by immunogenic chemotherapy. Cancer Res; 74(2); 436–45. ©2013 AACR.
Enhanced Cancer Radiotherapy through Immunosuppressive Stromal Cell Destruction in Tumors
Authors: Wu Chao-Yi , Yang Li-Hua , Yang Huang-Yu , Knoff Jayne , Peng Shiwen , Lin Yi-Hsin , Wang Chenguang , Alvarez Ronald D. , Pai Sara I. , Roden Richard B.S. , Hung Chien-Fu , Wu T-C 
Published: December 2013

AbstractPurpose: Radiotherapy kills cancer cells by causing DNA damage, and stimulates a systemic antitumor immune response by releasing tumor antigen and endogenous adjuvant within the tumor microenvironment. However, radiotherapy also induces the recruitment of immunosuppressive myeloid cells, which can interfere with the antitumor immune responses elicited by apoptotic tumor cells. We hypothesized that local delivery of vaccine following radiotherapy will lead to the priming of antigen-specific CTL immune responses and render immunosuppressive myeloid cells susceptible to killing by the activated CTLs.Experimental Design: Using several antigenic systems, we tested whether intratumoral injection of antigenic peptide/protein in irradiated tumors would be able to prime CTLs as well as load myeloid cells with antigen, rendering them susceptible to antigen-specific CTL killing.Results: We show that by combining radiotherapy and targeted antigenic peptide delivery to the tumor, the adjuvant effect generated by radiotherapy itself was sufficient to elicit the priming and expansion of antigen-specific CTLs, through the type I IFN-dependent pathway, leading to synergistic therapeutic antitumor effects compared with either treatment alone. In addition, using two different types of transgenic mice, we demonstrated that CTL-mediated killing of stromal cells in tumors by our approach is important for tumor control. Finally, we confirmed the efficacy of this approach in our preclinical model using two clinically tested therapeutic human papilloma virus (HPV) vaccines.Conclusions: These data serve as an important foundation for the future clinical translation of radiotherapy combined with a clinically tested therapeutic HPV vaccine for the control of HPV-associated cancers. Clin Cancer Res; 20(3); 644–57. ©2013 AACR.
Hypoxia-Independent Gene Expression Mediated by SOX9 Promotes Aggressive Pancreatic Tumor Biology
Authors: Camaj Peter , Jäckel Carsten , Krebs Stefan , DeToni Enrico N. , Blum Helmut , Jauch Karl-Walter , Nelson Peter J. , Bruns Christiane J. 
Published: December 2013

Abstract
Pancreatic cancer aggressiveness is characterized by its high capacity for local invasion, ability to promote angiogenesis, and potential to metastasize. Hypoxia is known to represent a crucial step in the development of aggressive malignant features of many human cancers. However, micrometastatic tumors are not typically subjected to hypoxic events during early stages of dissemination; therefore, it is unclear how these tumors are able to maintain their aggressive phenotype. Thus, the identification of regulators of hypoxia-related genes in aggressive/metastatic tumors represents a fundamental step for the design of future therapies to treat pancreatic cancer. To this end, transcriptomic profiles were compared between the nonmetastatic pancreatic cancer cell line FG (LMET) and its angiogenic/metastatic derivate L3.6pl (HMET) under normoxic or hypoxic conditions. Cluster analysis revealed a number of transcripts that were induced by hypoxia in nonmetastatic cancer cells. Strikingly, this cluster was determined to be constitutively activated under normoxia in the metastatic cancer cells and could not be further induced by hypoxia. A subset of these transcripts were regulated by the transcription factor SOX9 in the aggressive-metastatic cells, but driven by hypoxia-inducible factor-1α (HIF-1α) in the parental nonmetastatic cell line. Moreover, these transcripts were enriched in cancer-related networks including: WNT, CXCR4, retinoic acid, and (FAK) focal adhesion kinase, gene PTK2 signaling pathways. In functional assays, inhibition of SOX9 expression in HMET cells led to increased apoptosis and reduced migration in vitro and a significant reduction in primary tumor growth, angiogenesis, and metastasis following orthotopic tumor cell injection. At the molecular level, the control of SOX9 expression was associated with changes in the methylation status of the SOX9 promoter. Finally, SOX9 upregulation was verified in a series of tumor specimens of patients with pancreatic carcinoma.
Implications: SOX9 represents a novel target for pancreatic cancer therapy. Mol Cancer Res; 12(3); 421–32. ©2013 AACR.
Preoperative Statins and Limb Salvage After Lower Extremity Revascularization in the Medicare Population
Authors: Vogel Todd R. , Dombrovskiy Viktor Y. , Galiñanes Edgar Luis , Kruse Robin L. 
Published: December 2013

Background—
Statins stabilize atherosclerotic plaque, decrease mortality after surgical procedures, and are linked to anti-inflammatory effects. The objective of this study was to evaluate preoperative administration of statins and longitudinal limb salvage after lower extremity endovascular revascularization and lower extremity open surgery.

Methods and Results—

Patients were selected from 2007 to 2008 Medicare claims using the
International Classification of Diseases, Ninth Revision, Clinical Modification
, diagnosis codes for claudication (N=8128), rest pain (N=3056), and ulceration/gangrene (N=11 770) and Current Procedural Terminology codes for endovascular revascularization (N=14 353) and open surgery (N=8601). Half (N=11 687) were identified as statin users before revascularization using Part D files. Amputations were identified using Current Procedural Terminology codes. Statin users compared with nonusers had lower amputation rates at 30 days (11.5% versus 14.4%;
P
<0.0001), 90 days (15.5% versus 19.3%;
P
<0.0001), and 1 year (20.9% versus 25.6%;
P
<0.0001). Survival analysis demonstrated improved limb salvage during 1 year for statin users compared with nonusers for the diagnosis of claudication (
P
=0.003), a similar trend for rest pain (
P
=0.061), and no improvement for ulceration/gangrene (
P
=0.65).

Conclusions—
Preoperative statins were associated with improved 1-year limb salvage after lower extremity revascularization. The strongest association was found for patients with the diagnosis of claudication. Statins seem to be underused among Medicare patients with peripheral artery disease. Further evaluation of the use of preoperative statins and the potential benefits for peripheral vascular interventions is warranted.
Effects of Promoting Longer-Term and Exclusive Breastfeeding on Cardiometabolic Risk Factors at Age 11.5 Years
Authors: Martin Richard M. , Patel Rita , Kramer Michael S. , Vilchuck Konstantin , Bogdanovich Natalia , Sergeichick Natalia , Gusina Nina , Foo Ying , Palmer Tom , Thompson Jennifer , Gillman Matthew W. , Smith George Davey , Oken Emily 
Published: December 2013

Background—
The duration and exclusivity of breastfeeding in infancy have been inversely associated with future cardiometabolic risk. We investigated the effects of an experimental intervention to promote increased duration of exclusive breastfeeding on cardiometabolic risk factors in childhood.

Methods and Results—
We followed-up children in the Promotion of Breastfeeding Intervention Trial, a cluster-randomized trial of a breastfeeding promotion intervention based on the World Health Organization/United Nations Children’s Fund Baby-Friendly Hospital Initiative. In 1996 to 1997, 17 046 breastfeeding mother-infant pairs were enrolled from 31 Belarusian maternity hospitals and affiliated polyclinics (16 intervention versus 15 control sites); 13 879 (81.4%) children were followed up at 11.5 years, with 13 616 (79.9%) who had fasted and did not have diabetes mellitus. The outcomes were blood pressure; fasting insulin, adiponectin, glucose, and apolipoprotein A1; and the presence of metabolic syndrome. Analysis was by intention to treat, accounting for clustering within hospitals/clinics. The intervention substantially increased breastfeeding duration and exclusivity in comparison with the control arm (43% versus 6% and 7.9% versus 0.6% exclusively breastfed at 3 and 6 months, respectively). Cluster-adjusted mean differences at 11.5 years between experimental versus control groups were as follows: 1.0 mm Hg (95% confidence interval, −1.1 to 3.1) for systolic and 0.8 mm Hg (−0.6 to 2.3) for diastolic blood pressure; −0.1 mmol/L (−0.2 to 0.1) for glucose; 8% (−3% to 34%) for insulin; −0.3 μg/mL (−1.5 to 0.9) for adiponectin; and 0.0 g/L (−0.1 to 0.1) for apolipoprotein A1. The cluster-adjusted odds ratio for metabolic syndrome, comparing experimental versus control groups, was 1.21 (0.85 to 1.72).

Conclusions—
An intervention to improve breastfeeding duration and exclusivity among healthy term infants did not influence cardiometabolic risk factors in childhood.

Clinical Trial Registration—

Current Controlled Trials: ISRCTN37687716 (
http://www.controlled-trials.com/ISRCTN37687716
). URL:
http://clinicaltrials.gov
. Unique identifier: NCT01561612.
Balloon Guide Catheter Improves Revascularization and Clinical Outcomes With the Solitaire Device
Authors: Nguyen Thanh N. , Malisch Timothy , Castonguay Alicia C. , Gupta Rishi , Sun Chung-Huan J. , Martin Coleman O. , Holloway William E. , Mueller-Kronast Nils , English Joey D. , Linfante Italo , Dabus Guilherme , Marden Franklin A. , Bozorgchami Hormozd , Xavier Andrew , Rai Ansaar T. , Froehler Michael T. , Badruddin Aamir , Taqi Muhammad , Abraham Michael G. , Janardhan Vallabh , Shaltoni Hashem , Novakovic Roberta , Yoo Albert J. , Abou-Chebl Alex , Chen Peng R. , Britz Gavin W. , Kaushal Ritesh , Nanda Ashish , Issa Mohammad A. , Masoud Hesham , Nogueira Raul G. , Norbash Alexander M. , Zaidat Osama O. 
Published: December 2013

Background and Purpose—
Efficient and timely recanalization is an important goal in acute stroke endovascular therapy. Several studies demonstrated improved recanalization and clinical outcomes with the stent retriever devices compared with the Merci device. The goal of this study was to evaluate the role of the balloon guide catheter (BGC) and recanalization success in a substudy of the North American Solitaire Acute Stroke (NASA) registry.

Methods—
The investigator-initiated NASA registry recruited 24 clinical sites within North America to submit demographic, clinical, site-adjudicated angiographic, and clinical outcome data on consecutive patients treated with the Solitaire Flow Restoration device. BGC use was at the discretion of the treating physicians.

Results—

There were 354 patients included in the NASA registry. BGC data were reported in 338 of 354 patients in this subanalysis, of which 149 (44%) had placement of a BGC. Mean age was 67.3±15.2 years, and median National Institutes of Health Stroke Scale score was 18. Patients with BGC had more hypertension (82.4% versus 72.5%;
P
=0.05), atrial fibrillation (50.3% versus 32.8%;
P
=0.001), and were more commonly administered tissue plasminogen activator (51.6% versus 38.8%;
P
=0.02) compared with patients without BGC. Time from symptom onset to groin puncture and number of passes were similar between the 2 groups. Procedure time was shorter in patients with BGC (120±28.5 versus 161±35.6 minutes;
P
=0.02), and less adjunctive therapy was used in patients with BGC (20% versus 28.6%;
P
=0.05). Thrombolysis in cerebral infarction 3 reperfusion scores were higher in patients with BGC (53.7% versus 32.5%;
P
<0.001). Distal emboli and emboli in new territory were similar between the 2 groups. Discharge National Institutes of Health Stroke Scale score (mean, 12±14.5 versus 17.5±16;
P
=0.002) and good clinical outcome at 3 months were superior in patients with BGC compared with patients without (51.6% versus 35.8%;
P
=0.02). Multivariate analysis demonstrated that the use of BGC was an independent predictor of good clinical outcome (odds ratio, 2.5; 95% confidence interval, 1.2–4.9).

Conclusions—
Use of a BGC with the Solitaire Flow Restoration device resulted in superior revascularization results, faster procedure times, decreased need for adjunctive therapy, and improved clinical outcome.
Frequency of perinatal depression in Serbia and associated risk factors
Authors: Dmitrovic Bojana Kitanovic , Dugalić Miroslava Gojnic , Balkoski Gordana Nikolic , Dmitrovic Aleksandar , Soldatovic Ivan 
Published: December 2013

Objective: To screen 212 women for depression symptoms during pregnancy and postpartum in Serbia. Methods: Questionnaires that covered key demographic and obstetric information and Edinburgh Postnatal Depression Scale (EPDS) were administered at the third trimester of pregnancy and at 8 weeks postpartum. Results: In all, 21% of the sample was screened as depression positive during pregnancy. Subsequently, efforts were made to follow up 195 women through postpartum. Of the 195 women, 11% were screened positive during postpartum. Risk factors were low education level, low satisfaction with financial situation, high-risk pregnancy and depression during pregnancy. Logistic regression with backward elimination showed that women who had high-risk pregnancy have threefold increased risk of postpartum depression, and women who had antenatal depressive symptoms have 10-fold increased risk of postpartum depression. Conclusion: In countries where screening tool for depression is not applied routinely in obstetrics settings, clinicians should be aware of risk factors, frequency and level of depressive symptoms during pregnancy and postpartum.
Building Local Integrity Systems in Southern Europe: the case of urban local corruption in Spain
Authors: Quesada Mónica García , Jiménez-Sánchez Fernando , Villoria Manuel 
Published: December 2013

From 1997 to 2007, Spain suffered from major cases of political corruption associated with local urban development. To analyse their causes, this article examines the institutional mechanisms designed to monitor and control the performance of local policy-makers and to ensure they operated independently from private influence. It also analyses their actual effectiveness with reference to particular cases of local corruption unveiled during that decade. The Spanish case shows that local representatives had a large amount of power in distributing financial gains within the municipality, but faced little pressure to account for their actions. It argues that insufficient control mechanisms on the activities of local representatives from 1997 to 2007 can adequately explain the intensity and spread of local corruption in Spain. Points for practitioners The article contributes to a better understanding of the factors and the causes that explain local corruption, particularly in countries where local governments fit with the ‘strong-mayor’ type. Following the Local Integrity System framework, it provides a strategy to analyse the role and impact of control mechanisms, distinguishing between internal and external controls, and administrative and judicial controls. The article also helps to understand, and presents evidence of, the mismatch between ‘formal’ institutional mechanisms on the one hand, and their actual implementation and effects on the other.