bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lifestyle risk factors for invasive pneumococcal disease: a systematic review
Authors: Cruickshank Helen C , Jefferies Johanna M , Clarke Stuart C 
Published: June 2014

ObjectiveTo systematically review the literature for evidence of smoking and alcohol intake as independent risk factors for invasive pneumococcal disease (IPD).DesignSystematic review.MethodsMEDLINE (1946—May 2012) and EMBASE (1947—May 2012) were searched for studies investigating alcohol or smoking as risk factors for acquiring IPD and which reported results as relative risk. Studies conducted exclusively in clinical risk groups, those assessing risk factors for outcomes other than acquisition of IPD and studies describing risk factors without quantifying a relative risk were excluded.ResultsSeven observational studies were identified and reviewed; owing to the heterogeneity of study design, meta-analysis was not attempted. Five of six studies investigating smoking reported an increased risk of IPD in the range 2.2–4.1. Four of the six studies investigating alcohol intake reported a significant increased risk for IPD ranging from 2.9 to 11.4, while one reported a significant protective effect.ConclusionsOverall, these observational data suggest that smoking and alcohol misuse may increase the risk of IPD in adults, but the magnitude of this risk remains unclear and should be explored with further research. The findings of this review will contribute to the debate on whether pneumococcal vaccine should be offered to smokers and people who misuse alcohol in addition to other clinically defined risk groups.
Urgent off-label use of the pipeline flow diverter stent in selected ischemic cerebrovascular conditions: thrombotic segments and tortuous arteries
Authors: Cohen José E , Gomori J Moshe , Rajz Gustavo , Itshayek Eyal , Eichel Roni , Leker Ronen R 
Published: June 2014

ObjectiveFlow diverter stents were originally designed for the endovascular management of certain types of cerebral aneurysms; however, these devices present characteristics that make them more suitable that regular carotid stents or neurostents for the management of selected ischemic cerebrovascular conditions.MethodsEight patients with steno-occlusive disease of the internal carotid (ICA) or vertebral (VA) arteries underwent endovascular reconstruction by means of flow diverter stent implant at our center. Five patients presented with ICA steno-occlusive lesions that involved tortuous segments not amenable to regular carotid stent placement and three patients presented with severe and complex proximal VA dissections.ResultsIn all cases the procedures were considered technically successful. Flow diverter stent implant allowed recanalization of the treated vessels (stenosis of 89±10.5% was improved to 26±13%) without procedure related complications. At the 3 month clinical and radiological follow-up, patients either improved or remained stable, and showed stent patency. One patient presented with asymptomatic occlusion of the revascularized artery at 13 months, emphasizing the need for prolonged antiplatelet therapy.ConclusionsThis preliminary series of patients with high risk steno-occlusive lesions affecting tortuous arterial segments or presenting with heavy thrombotic load managed by the implant of flow diverter stents shows that this approach is feasible, safe, and effective in achieving arterial recanalization. Further studies will elucidate the role of this technique in ischemic cerebrovascular settings.
Technical limitations of dual-energy CT in neuroradiology: 30-month institutional experience and review of literature
Authors: Dinkel Julien , Khalilzadeh Omid , Phan Catherine M , Goenka Ajit H , Yoo Albert J , Hirsch Joshua A , Gupta Rajiv 
Published: June 2014

BackgroundDual-energy CT (DECT) has been shown to be a useful modality in neuroradiology.ObjectiveTo assess failure modes and limitations of DECT in different neuroimaging applications.Patients and methodsDual-source DECT scans were performed in 72 patients over 30 months to differentiate contrast agent staining or extravasation from intracranial hemorrhage (ICH) (n=40); to differentiate calcium from ICH (n=2); for metal-artifact reduction (n=5); and for angiographic assessment (n=25). A three-material decomposition algorithm was used to obtain virtual non-contrast (VNC) and iodine (or calcium) overlay images. Images were analyzed in consensus by two board-certified radiologists to determine the success of the algorithm and to assess confounding factors. Furthermore, a dilution experiment using cylinders containing defined heparinized swine blood, normal saline, and selected iodine concentrations was conducted to assess other possible confounding factors.ResultsDual-energy analysis was successful in 65 (90.2%) patients. However, the algorithm failed when images were affected by beam hardening (n=3, 4.2%), the presence of a fourth material (parenchymal calcification) (n=3, 4.2%), or motion (n=1, 1.4%). In the dilution experiment, a saturation effect was seen at high iodine concentrations (≥37 mg/ml). VNC and iodine overlay images were not reliable above this concentration, and beam-hardening artifacts were noted.ConclusionsDECT material decomposition is usually successful in neuroradiology. However, it can only distinguish up to three preselected materials. A fourth material such as parenchymal calcium may confound the analysis. Artifacts such as beam hardening, metallic streak, or saturation effect can also impair material decomposition.
Mentorship for newly appointed consultants: what makes it work?
Authors: Harrison Reema , Anderson John , Laloë Pierre-Antoine , Santillo Marta , Lawton Rebecca , Wright John 
Published: June 2014

Abstract

Background
Mentorship has been identified as a beneficial practice for doctors and may be particularly valuable for newly appointed consultants. It is associated with a number of potential clinical and non-clinical gains, such as enhanced job satisfaction and well-being. Despite strong support, many formalised schemes fail to launch or gain momentum. Research to date has largely focused on the gains associated with mentorship but has lacked study of the factors that facilitate uptake and maintenance of mentoring relationships by physicians.

Objectives
To explore perceptions of mentorship, the extent to which UK doctors appear to value mentorship and factors that may contribute to its successful use.

Design
Qualitative, descriptive, multi-centre study.

Sample
30 doctors including registrars, those newly appointed to consultant grade, senior doctors and medical leaders from nine hospitals in the north of England.

Method
Semistructured individual interviews were undertaken between August and December 2013.

Results
Findings revealed a demand for mentorship for new consultants, with widely recognised benefits associated with its use. Several factors were identified as critical to successful mentorship relationships, including consistent understanding and expectations of mentorship between mentee and mentor, positive prior experiences, a suitable match between mentee and mentor, making time for people to act as mentors and the ensuring that mentors can meet a diverse and changing set of needs.

Conclusions
Mentorship for newly appointed consultants is valued, but current models of mentorship may suffer from rigid structures, mismatched expectations of participants and the absence of a culture of mentorship from training into practice. A social network approach, in which doctors have the opportunity to engage with a range of mentors through informal and naturally occurring relationships, may be one way to encourage successful and sustained mentoring relationships among doctors. An organisational culture in which mentorship is permitted and is the norm may enable such approaches to be widely adopted.
An Integrative Analysis of the Tumorigenic Role of TAZ in Human Non–Small Cell Lung Cancer
Authors: Noguchi Satoshi , Saito Akira , Horie Masafumi , Mikami Yu , Suzuki Hiroshi I. , Morishita Yasuyuki , Ohshima Mitsuhiro , Abiko Yoshimitsu , Mattsson Johanna Sofia Margareta , König Helena , Lohr Miriam , Edlund Karolina , Botling Johan , Micke Patrick , Nagase Takahide 
Published: June 2014

Abstract
Purpose: TAZ, also known as WWTR1, has recently been suggested as an oncogene in non–small cell lung cancer (NSCLC). We investigated the clinical relevance of TAZ expression and its functional role in NSCLC tumorigenesis.
Experimental Design: We characterized TAZ at the DNA (n = 192), mRNA (n = 196), and protein levels (n = 345) in an NSCLC patient cohort. Gene expression analysis was complemented by a meta-analysis of public datasets (n = 1,382). The effects of TAZ on cell proliferation and cell cycle were analyzed in cell cultures and on tumor growth in mice. TAZ-dependent microarray-based expression profiles in NSCLC cells were combined with molecular profiles in human NSCLC tissues for in silico analysis.
Results: Higher TAZ mRNA and protein levels were associated with shorter patient survival. Transduction of TAZ enhanced cell proliferation and tumorigenesis in bronchial epithelial cells, whereas TAZ silencing suppressed cell proliferation and induced cell cycle arrest in NSCLC cells. Microarray and cell culture experiments showed that ErbB ligands (amphiregulin, epiregulin, and neuregulin 1) are downstream targets of TAZ. Our in silico analysis revealed a TAZ signature that substantiated the clinical impact of TAZ and confirmed its relationship to the epidermal growth factor receptor signaling pathway.
Conclusion: TAZ expression defines a clinically distinct subgroup of patients with NSCLC. ErbB ligands are suggested to mediate the effects of TAZ on lung cancer progression. Our findings emphasize the tumorigenic role of TAZ and may serve as the basis for new treatment strategies. Clin Cancer Res; 20(17); 4660–72. ©2014 AACR.
Flutamide and Biomarkers in Women at High Risk for Ovarian Cancer: Preclinical and Clinical Evidence
Authors: Gruessner Christine , Gruessner Angelika , Glaser Katherine , AbuShahin Nisreen , Zhou Yi , Laughren Cynthia , Wright Heather , Pinkerton Samantha , Yi Xiaofang , Stoffer Jha'nae , Azodi Masoud , Zheng Wenxin , Chambers Setsuko K. 
Published: June 2014

Abstract
We hypothesized that (i) preclinical biologic evidence exists for the role of androgens in ovarian cancer development and (ii) flutamide treatment of women at high risk for ovarian cancer may identify meaningful tissue biomarkers of androgen action and of ovarian cancer initiation. We showed that androgen ablation of male mice led to a 24-fold decrease in tumor burden from serous ovarian cells. In a phase II study, we studied the effect of preoperative flutamide treatment (125 mg/day × 6 weeks) in 12 women versus 47 controls, 47% with BRCA mutation. We analyzed immunohistochemical scores of candidate proteins CSF-1, CSF-1R, and ErbB4 in the epithelium and stroma of fallopian tube, ovary, and ovarian endosalpingiosis. Flutamide decreased the levels, notably, of CSF-1 and ErbB4 in ovarian stroma (P ≤ 0.0006) and ovarian endosalpingiosis (P ≤ 0.01), ErbB4 in ovarian epithelium (P = 0.006), and CSF-1R in ovarian endosalpingiosis (P = 0.009). Our logistic regression model clearly distinguished the flutamide patients from controls (P ≤ 0.0001). Our analysis of the precision of this model of CSF-1 and ErbB4 expression in ovarian stroma achieved 100% sensitivity and 97% specificity (AUC = 0.99). Thus, our data suggest that a short 6-week exposure of flutamide reversed elevated levels of CSF-1 and ErbB4 (both of which we had previously found correlated with high risk status). CSF-1 and ErbB4 in ovarian stroma led to a model with high predictive value for flutamide sensitivity. The effect of flutamide on marker expression in ovarian endosalpingiosis, previously associated with BRCA carrier status, suggests that ovarian endosalpingiosis may be a latent precursor to pelvic serous cancers. Cancer Prev Res; 7(9); 896–905. ©2014 AACR.
Are Hemodynamics Surrogate End Points in Pulmonary Arterial Hypertension?
Authors: Ventetuolo Corey E. , Gabler Nicole B. , Fritz Jason S. , Smith K. Akaya , Palevsky Harold I. , Klinger James R. , Halpern Scott D. , Kawut Steven M. 
Published: June 2014

Background—
Although frequently assessed in trials and clinical practice, hemodynamic response to therapy has never been validated as a surrogate end point for clinical events in pulmonary arterial hypertension (PAH).

Methods and Results—

We performed a patient-level pooled analysis of 4 randomized, placebo-controlled trials to determine whether treatment-induced changes in hemodynamic values at 12 weeks accounted for the relationship between treatment assignment and the probability of early clinical events (death, lung transplantation, atrial septostomy, PAH hospitalization, withdrawal for clinical worsening, or escalation in PAH therapy). We included 1119 subjects with PAH. The median (interquartile range) age was 48 years (37–59 years), and 23% were men. A total of 656 patients (59%) received active therapy (101 [15%] iloprost, 118 [18%] sitaxsentan, 204 [31%] sildenafil, and 233 [36%] subcutaneous treprostinil). Active treatment significantly lowered right atrial pressure, mean pulmonary artery pressure, and pulmonary vascular resistance and increased cardiac output and index (
P
<0.01 for all). Changes in hemodynamic values (except for right atrial pressure and mean pulmonary artery pressure) were significantly associated with the risk of a clinical event (
P
<0.02 for all). Although active treatment approximately halved the odds of a clinical event compared with placebo (
P
<0.001), changes in hemodynamics accounted for only 1.2% to 13.9% of the overall treatment effect.

Conclusions—
Treatment-induced changes in hemodynamics at 12 weeks only partially explain the impact of therapy on the probability of early clinical events in PAH. These findings suggest that resting hemodynamics are not valid surrogate end points for short-term events in PAH clinical trials.
The HARint Space: A methodology for compliant elevator traffic designs
Authors: Al-Sharif Lutfi , Abdel Aal Osama F , Abu Alqumsan Ahmad M , Abuzayyad Mohammad A 
Published: June 2014

A previous paper introduced the concept of the HARint plane, which is a tool to visualise the optimality of an elevator design. This paper extends the concept of the HARint plane to the HARint Space where the complete set of user requirements is used to implement a compliant elevator traffic design. In the HARint Space, the full set of user requirements are considered: the passenger arrival rate ( AR%), the target interval ( inttar), the target average travelling time ( ATT) and the target average waiting time ( AWT). The HARint Space provides an automated methodology in the form of a set of well-defined steps that allow the designer to convert these four user requirements into a compliant elevator traffic design. As with the HARint plane method, the target interval is used in combination with the expected arrival rate ( AR%) and the building population, U, in order to find an initial assessment of the number of passengers expected to board the elevator. The target average travelling time is then used to select a suitable elevator speed. This is then used to calculate the round trip time and then select the optimum number of elevators. An iteration is then carried out to find the actual number of passengers, and hence the elevator capacity. A check is then carried out to ensure that the target average waiting time has been met, and if not, then a modification of the design is required (usually by increasing the speed or increasing the number of elevators). While the HARint plane provides the optimum number of elevator cars to achieve the two user requirements, the HARint Space provides the optimum rated speed as well as the optimum number of elevators to meet the four user requirements of arrival rate, target interval, target average waiting time and target average travelling time. An obvious consequence of the introduction of the average travelling time as a user requirement is that the speed becomes an outcome of the HARint Space. The method also triggers a zoning recommendation in cases where the average travelling time cannot be met by varying the speed within reasonable limits. Practical application: The work in this paper presents a methodical procedure allowing the designer to select the number, speed and capacity of a group of elevators in a building in order to meet four user requirements: Arrival rate, target interval, target passenger waiting time and target passenger travelling time. Following this procedure ensures an optimal design. It also provides the user with a graphical method for visualising the optimality of the design.
A Feasibility Study to Develop a Diabetes Prevention Program for Young Adults With Prediabetes by Using Digital Platforms and a Handheld Device
Authors: Cha EunSeok , Kim Kevin H. , Umpierrez Guillermo , Dawkins Colleen R. , Bello Morenike K. , Lerner Hannah M. , Narayan K.M. Venkat , Dunbar Sandra B. 
Published: June 2014

Purpose The purpose of this pilot study was to examine the feasibility and preliminary efficacy of an age-specific diabetes prevention program in young adults with prediabetes. Methods A one-group pretest-posttest design was used. The inclusion criteria were age 18 to 29 years and the presence of prediabetes (either impaired fasting glucose of 100-125 mg/dL [5.55-6.94 mmol/L] or A1C of 5.7%-6.4%). Fifteen participants were enrolled in the study. A technology-based lifestyle coaching program focused on diet and physical activity and incorporating a handheld device and digital platforms was developed and tested. Psychosocial factors (health literacy, illness perception, self-efficacy, therapeutic efficacy) based on social cognitive theory, changes in diet and physical activity, and cardiometabolic risk factors were assessed at baseline and week 12 after the intervention. A paired-samples t test was performed to examine changes between baseline and postintervention on each psychosocial and physical variable. Results Participants’ (n = 13 completers) mean age was 24.4 ± 2.2 years, 23.1% were male, and 53.8% were African American. Overall, the participants were satisfied with the intervention (mean score, 4.15 on a 5-point, Likert-type scale). Between pre- and posttesting, mean body mass index and mean A1C decreased from 41.0 ± 7.3 kg/m2 and 6.0 ± 0.5% to 40.1 ± 7.0 kg/m2 and 5.6 ± 0.5%, respectively, whereas mean fasting glucose did not significantly change (from 92.6 ± 11 to 97.6 ± 14.3 mg/dL [5.14 ± 0.61 to 5.42 ± 0.79 mmol/L]). Conclusions The intervention resulted in reduced A1C and a trend toward decreased body mass index in obese sedentary young adults with prediabetes after 12 weeks. Further study through a randomized clinical trial with a longer intervention period is warranted.
Effectiveness of the palliative care ‘Availability, Current issues and Anticipation’ (ACA) communication training programme for general practitioners on patient outcomes: A controlled trial
Authors: Slort Willemjan , Blankenstein Annette H , Schweitzer Bart PM , Knol Dirk L , van der Horst Henriëtte E , Aaronson Neil K , Deliens Luc 
Published: June 2014

Background: Although communicating effectively with patients receiving palliative care can be difficult, it may contribute to maintaining or enhancing patients’ quality of life. Little is known about the effect of training general practitioners in palliative care–specific communication. We hypothesized that palliative care patients of general practitioners exposed to the ‘Availability, Current issues and Anticipation’ communication training programme would report better outcomes than patients of control general practitioners. Aim: To evaluate the effectiveness of the Availability, Current issues and Anticipation training programme for general practitioners on patient-reported outcomes. Design: In a controlled trial, general practitioners followed the Availability, Current issues and Anticipation programme or were part of the control group. Patients receiving palliative care of participating general practitioners completed the Palliative Care Outcome Scale, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative, the Rest & Peace Scale, the Patient Satisfaction Questionnaire–III and the Availability, Current issues and Anticipation Scale, at baseline and 12 months follow-up. We analysed differences between groups using linear mixed models. Trial registration: ISRCTN56722368. Setting/participants: General practitioners who attended a 2-year Palliative Care Training Course in the Netherlands. Results: Questionnaire data were available for 145 patients (89 in intervention and 56 in control group). We found no significant differences over time between the intervention and control groups in any of the five outcome measures. Ceiling effects were observed for the Rest & Peace Scale, Patient Satisfaction Questionnaire–III and Availability, Current issues and Anticipation Scale. Conclusion: General practitioner participation in the Availability, Current issues and Anticipation training programme did not have a measurable effect on any of the outcomes investigated. Patients reported high levels of satisfaction with general practitioner care, regardless of group assignment. Future research might focus on general practitioners without special interest in palliative care.
Radiologist-performed hand-held ultrasound screening at average risk of breast cancer: results from a single health screening center
Authors: Chang Jung Min , Koo Hye Ryoung , Moon Woo Kyung 
Published: June 2014

Background Ultrasound (US) screening is not currently recommended as a routine screening modality in the general population of average risk. The cancer detection yield and positive predictive value in an average risk general population who undergo breast screening by experienced radiologists is unclear. Purpose To determine the performance of screening breast US in women at an average risk for breast cancer undergoing breast screening by experienced radiologists. Material and Methods This study received institutional review board approval, and informed consent was waived. A retrospective review of our database revealed 1526 women who underwent prevalence screening US at a single health screening center and had negative findings on digital mammography (MG). The Breast Imaging and Reporting Data System (BI-RADS) final assessments of the breast US were analyzed retrospectively, with the reference standard defined as a combination of pathology and a 12-month follow-up. The cancer detection rate and positive predictive value (PPV2) of the biopsies were calculated according to breast density. Results The average time to perform a screening US examination was 15–20 min. Of 1526 women, 1095 (71.8%) were classified as BI-RADS category 1 or 2; 340 (22.3%) were classified as category 3; and 91 (6.0%) were classified as category 4. Five malignant lesions were found in women with dense breasts. The overall cancer detection rate was 3.3, and the cancer detection rate for dense breasts was 5.1 per 1000 screens (4.1 per 1000 screens [heterogeneously dense breast], 7.7 per 1000 screens [extremely dense breast]). The PPV2 for biopsies was 5.3%. Conclusion The radiologist-performed screening US offered to women with an average risk and dense breasts can detect additional mammographically occult breast cancers. In screening US, a relatively high rate of BI-RADS category 3 and 4 lesions was observed.