bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimized contrast‐enhanced ultrasonography for characterization of focal liver lesions in cirrhosis: A single‐center retrospective study
Authors: de Sio Ilario , Iadevaia Maddalena D , Vitale Luigi M , Niosi Marco , Del Prete Anna , de Sio Chiara , Romano Lorenzo , Funaro Annalisa , Meucci Rosaria , Federico Alessandro , Loguercio Carmelina , Romano Marco 
Published: June 2014

BackgroundHepatocellular carcinoma (HCC) is the leading cause of death amongst cirrhotic patients. Its diagnosis and discrimination from non‐HCC malignant lesions in cirrhosis includes contrast enhanced computed tomography (CECT), contrast enhanced magnetic resonance imaging (CEMRI), or, in selected cases, liver biopsy. The role of contrast‐enhanced ultrasonography (CEUS) is still controversial.AimsTo evaluate whether, by selecting an appropriate ‘time to wash‐out’ cut‐off value, CEUS capability of discriminating between HCC and non‐HCC malignancies in cirrhotic patients may be enhanced.MethodsWe enrolled 282 cirrhotic patients who underwent CEUS at our institute, from January 2008 to January 2012, for focal liver lesions (FLLs) detected at ultrasound (US). We used liver biopsy and subsequent histological evaluation as the gold standard for correct classification of FLLs. We calculated the area under receiver operator characteristic curves for CEUS to distinguish patients with HCC from those with non‐HCC malignancies. The best ‘time to wash‐out’ cut‐off values were selected.ResultsHistological diagnosis of FLLs was as follows: 34 benign lesions (i.e. 25 regenerative nodules and 9 dysplastic nodules) and 248 malignant lesions (223 well‐to‐moderately differentiated HCCs; 7 poorly‐differentiated HCCs; 5 intrahepatic colangiocellular carcinomas (ICCs); 5 primary non‐Hodgkin B‐cell lymphomas (NHBLs); and 8 metastatic liver tumors). A time to wash‐out > 55 s identified patients with HCC with the highest level of accuracy (92.7%). Similarly, a time to wash‐out ≤ 55 s correctly identified the vast majority of the non‐HCC malignancies (100% sensitivity, 98.2% specificity and diagnostic accuracy of 98.3%).ConclusionsCEUS is an accurate and safe procedure for discriminating FLLs in cirrhotic patients, especially when a cut‐off time to wash‐out of 55 s is chosen as a reference value.
14-3-3σ induces heat shock protein 70 expression in hepatocellular carcinoma
Authors: Liu Chia-Chia , Jan Yee-Jee , Ko Bor-Sheng , Wu Yao-Ming , Liang Shu-Man , Chen Shyh-Chang , Lee Yen-Ming , Liu Tzu-An , Chang Tzu-Ching , Wang John , Shyue Song-Kun , Sung Li-Ying , Liou Jun-Yang 
Published: June 2014

Abstract

Background
14-3-3σ is implicated in promoting tumor development of various malignancies. However, the clinical relevance of 14-3-3σ in hepatocellular carcinoma (HCC) tumor progression and modulation and pathway elucidation remain unclear.

Methods
We investigated 14-3-3σ expression in 109 HCC tissues by immunohistochemistry. Overexpression and knockdown experiments were performed by transfection with cDNA or siRNA. Protein expression and cell migration were determined by Western blot and Boyden chamber assay.

Results
In this study, we found that 14-3-3σ is abundantly expressed in HCC tumors. Stable or transient overexpression of 14-3-3σ induces the expression of heat shock factor-1α (HSF-1α) and heat shock protein 70 (HSP70) in HCC cells. Moreover, expression of 14-3-3σ significantly correlates with HSF-1α/HSP70 in HCC tumors and both 14-3-3σ and HSP70 overexpression are associated with micro-vascular thrombi in HCC patients, suggesting that 14-3-3σ/HSP70 expression is potentially involved in cell migration/invasion. Results of an in vitro migration assay indicate that 14-3-3σ promotes cell migration and that 14-3-3σ-induced cell migration is impaired by siRNA knockdown of HSP70. Finally, 14-3-3σ-induced HSF-1α/HSP70 expression is abolished by the knockdown of β-catenin or activation of GSK-3β.

Conclusions
Our findings indicate that 14-3-3σ participates in promoting HCC cell migration and tumor development via β-catenin/HSF-1α/HSP70 pathway regulation. Thus, 14-3-3σ alone or combined with HSP70 are potential prognostic biomarkers for HCC.
Wage subsidies in developing countries as a tool to build human capital: design and implementation issues
Authors: Almeida Rita , Orr Larry , Robalino David 
Published: June 2014

Abstract
This paper reviews international experiences with the implementation of wage subsidies and develops a policy framework to guide their design in developing countries. The evidence suggests that, if the goal is only to create jobs, wage subsidies are unlikely to be an effective instrument. Wage subsidies, however, could have a role in helping first-time job seekers or those who have gone through long-periods of unemployment or inactivity, to gain some work experience and in the process build skills and improve their employability. If these “learning” effects are large enough, the social benefits of wage subsidies could outweigh their cost. When wage subsidies are designed with these objectives in mind, there are important implications in terms of eligibility and targeting, how the subsidy is set, its duration, and the types of conditionalities on employers and beneficiaries. Given uncertainty regarding their impact, in all cases, programs should be piloted and evaluated prior to full scale implementation.

JELs

J2, J3, J6
Standard operating procedures for antibiotic therapy and the occurrence of acute kidney injury: a prospective, clinical, non-interventional, observational study
Authors: Nachtigall Irit , Tafelski Sascha , Günzel Karsten , Uhrig Alexander , Powollik Robert , Tamarkin Andrey , Wernecke Klaus D , Spies Claudia 
Published: June 2014

Abstract
Introduction
Acute kidney injury (AKI) occurs in 7% of hospitalized and 66% of Intensive Care Unit (ICU) patients. It increases mortality, hospital length of stay, and costs. The aim of this study was to investigate, whether there is an association between adherence to guidelines (standard operating procedures (SOP)) for potentially nephrotoxic antibiotics and the occurrence of AKI.

Methods
This study was carried out as a prospective, clinical, non-interventional, observational study. Data collection was performed over a total of 170 days in three ICUs at Charité – Universitaetsmedizin Berlin. A total of 675 patients were included; 163 of these had therapy with vancomycin, gentamicin, or tobramycin; were >18 years; and treated in the ICU for >24 hours. Patients with an adherence to SOP >70% were classified into the high adherence group (HAG) and patients with an adherence of <70% into the low adherence group (LAG). AKI was defined according to RIFLE criteria. Adherence to SOPs was evaluated by retrospective expert audit. Development of AKI was compared between groups with exact Chi2-test and multivariate logistic regression analysis (two-sided P <0.05).

Results
LAG consisted of 75 patients (46%) versus 88 HAG patients (54%). AKI occurred significantly more often in LAG with 36% versus 21% in HAG (P = 0.035). Basic characteristics were comparable, except an increased rate of soft tissue infections in LAG. Multivariate analysis revealed an odds ratio of 2.5-fold for LAG to develop AKI compared with HAG (95% confidence interval 1.195 to 5.124, P = 0.039).

Conclusion
Low adherence to SOPs for potentially nephrotoxic antibiotics was associated with a higher occurrence of AKI.

Trial registration
Current Controlled Trials ISRCTN54598675. Registered 17 August 2007.
A Comparison of Milestone-Based and Buyout Options Contracts for Coordinating R&D Partnerships
Authors: Bhattacharya Shantanu , Gaba Vibha , Hasija Sameer 
Published: June 2014

We analyze optimal contractual arrangements in a bilateral research and development (R&D) partnership between a risk-averse provider that conducts early-stage research followed by a regulatory verification stage and a risk-neutral client that performs late-stage development activities, including production, distribution, and marketing. The problem is formulated as a sequential investment game with the client as the principal, where the investments are observable but not verifiable. The model captures the inherent incentive alignment problems of double-sided moral hazard, risk aversion, and holdup. We compare the efficacy of milestone-based options contracts and buyout options contracts from the client's perspective and identify conditions under which they attain the first-best outcome for the client. We find that milestone-based options contracts always attain the first-best outcome for the client when the provider has some bargaining power in renegotiation and identify their applicability to different R&D partnerships. This paper was accepted by Yossi Aviv, operations management.
Running Errands in Time: Approximation Algorithms for Stochastic Orienteering
Authors: Gupta Anupam , Krishnaswamy Ravishankar , Nagarajan Viswanath , Ravi R. 
Published: June 2014

In the stochastic orienteering problem, we are given a finite metric space, where each node contains a job with some deterministic reward and a random processing time. The processing time distributions are known and independent across nodes. However the actual processing time of a job is not known until it is completely processed. The objective is to compute a nonanticipatory policy to visit nodes (and run the corresponding jobs) so as to maximize the total expected reward, subject to the total distance traveled plus the total processing time being at most a given budget of B. This problem combines aspects of the stochastic knapsack problem with uncertain item sizes as well as the deterministic orienteering problem. In this paper, we consider both nonadaptive and adaptive policies for Stochastic Orienteering. We present a constant-factor approximation algorithm for the nonadaptive version and an O(log log B)-approximation algorithm for the adaptive version. We extend both these results to directed metrics and a more general sequence orienteering problem. Finally, we address the stochastic orienteering problem when the node rewards are also random and possibly correlated with the processing time and obtain an O(log n log B)-approximation algorithm; here n is the number of nodes in the metric. All our results for adaptive policies also bound the corresponding “adaptivity gaps”.
Inside the male psyche: men and healthcare
Authors: Barber Chris 
Published: June 2014

This article, the second in this series on men's health issues, will provide a basic overview of some of the issues that men face in relation to their general healthcare, such as social attitudes to men, the ‘male psyche’, male health and whether (and why) men do not access healthcare services in the same way that women do. A number of local, national and international reports into men's health will be highlighted; these may be of use in helping support staff understand how our society's construction of the male identity prevents men from accessing health services.
Reflective practice on inpatient mental health wards (1/2): integrating cognitive-behavioural framework with reflective learning process
Authors: Mankiewicz Pawel D 
Published: June 2014

This first article—of two—is in three parts. First, it discusses the important role of reflective learning in the modern practice of mental health practitioners, and summarises the relevance of national policies for reflective clinical practice. Second, it highlights the benefits that regular and structured reflection on clinical experiences might have for the professional development of nurses and healthcare assistants working on inpatient mental health wards. Finally, this paper argues for an incorporation of cognitive-behavioural therapy (CBT) principles into the reflective learning process. The second article will build on this, and evaluate the clinical effectiveness of the CBT-integrated model of reflective practice.
Research roundup: June 2014
Authors: Greener Mark 
Published: June 2014

In brief ▪ Antidepressants at high doses appear to increase suicidal behaviour in children and young people ▪ Acamprosate and oral naltrexone reduce the likelihood that people abusing alcohol will return to drinking ▪ Nurses should be aware of the elevated sexual health risks experienced by those who misuse opiates or crack cocaine ▪ Exenatide enhances motor and non-motor performance in people with Parkinson's disease
Psychosocial Intervention
Authors: Martin Stephen 
Published: June 2014

The term schizophrenia applied with proper diagnostic criteria is not a glib label, but a helpful diagnosis. Unfortunately it has frightening connotations that have largely been stirred up by misuse of psychiatric terminology by the media, with over-dramatic and over-emphasised coverage of rare disasters. Stephen Martin looks at psychosocial intervention and its use in treating patients with schizophrenia.
No such thing as a healthy tan
Authors: Robertshaw Hazel , Hammick Marilyn 
Published: June 2014

The quest for a healthy lifestyle has been epitomised by a glowing tan since the 1940s, in sharp contrast to the Victorian premise that pale was beautiful. The media portrayal of bronzed beauty has led to many people baring their bodies to the damaging effects of the sun for two weeks each year on holiday. The result has been an increase in the number of reported skin cancers and, in particular, malignant melanoma. Malignant melanoma is a rare form of skin cancer, but its incidence is rising. Early detection affords the best chance of a cure.
Urticaria: Causes and management
Authors: Watkins Jean 
Published: June 2014

Urticaria is well known in lay terms as nettle rash or hives. It frequently presents in the surgery as an acute problem. The patient complains of irritating skin blotches, blisters or wheals that may be pale or pink in the centre and red around the edges. Dr Jean Watkins looks at the causes, management and treatment of urticaria.
PN perceptions of support workers
Authors: Dunn Lynne 
Published: June 2014

This qualitative research focuses on practice nurses' perceptions of their role and philosophy with implications for the role of support workers. A Heideggarian Phenomenological approach was used to explore opportunistic and purposeful samples of thirteen nurses, from various general practice work environments in Devon, between October 1995 and April 1996. Focus group interviews enabled participants to express themselves, exploring their role and philosophy in depth and to reflect and consider the reasons for their opinions of support worker roles. Most practice nurses reported delegating tasks to support workers for non clinical work at some time, and some practice nurses enabled support workers to undertake minor clinical roles in the right circumstances. Practice nurses always, however, felt it was essential to undertake initial assessment themselves.
Asthma: what else could it be?
Authors: Booker Rachel 
Published: June 2014

Asthma is common, affecting about 5% of the population of Great Britain, and may present as cough, wheeze, ‘chest-tightness’ and breathlessness on exertion. Although the peak age of onset is in childhood, it can, and does, present at any age (LAIA, 1999). At each end of the age spectrum there is potential for misdiagnosis. The aim of this article is to give a brief ‘A–Z’ (omitting several letters of the alphabet) of the differential diagnosis of asthma in adults.
Walk-in Clinic Sunburn
Authors: Fisher Pam , Holmes Peter 
Published: June 2014

Too much sun can precipitate a range of acute to chronic conditions Sunburn is defined as a superficial cutaneous reaction to ultra violet radiation (UVR) exposed areas (Caumes 1996). Affected skin becomes red several hours later, maximally after one day, then settling over the next two or three days. The amount of damage is dependant on the skin type, the time, the locality and the circumstances of exposure. Pam Fisher and Peter Holmes consider effects, treatments and prevention
Walk-in Clinic Joint pain
Authors: Johnson Wendy , Johnson Stephen 
Published: June 2014

Joint pain may signal degeneration, infection, trauma, or connective tissue disorders Pain in the joints is a very common symptom seen in primary care for which there are a multitude of causes. These range from acute to chronic, progressive, conditions; and can result in much misery to sufferers, as well as numerous lost working days. Eight million people every year seek help from their GP for ‘rheumatic’ disorders (Souhami and Moxham, 1990). Wendy and Stephen Johnson consider the different causes and treatments
Introduction to qualitative research
Authors: Baird Anne 
Published: June 2014

Nursing research is continuing to develop, consolidating the professionalism of the discipline and its place in higher education. Government support has been crucial to ensuring nursing research has taken on a higher profile in recent years. Different research methodologies i.e. quantative and qualitative both have a place, depending on the nature of the results desired. The second part of this article explores the nurse's role in conducting the qualitative research intrerview. This work was prepared as part of an MA in Health Care Practice (Nurse Practitioner).
Occupational allergy
Authors: Cross Sue 
Published: June 2014

An agent inhaled in the workplace causes occupational asthma. As well as asthma, the patient often suffers with rhinitis (Steimacher et al, 1999). Compensation (in Britain) is an important consideration in occupational asthma. It is legally defined as ‘asthma that develops after a variable period of symptomless exposure to a sensitizing agent encountered at work’. Patients with pre-exhisting asthma may develop broncho-constriction at work after exposure to irritants. Sue Cross outlines the key factors which can contribute to occupational asthma and how it should be managed.
From practice manager to PCG chief executive
Authors: Lawrence-Parr Carole 
Published: June 2014

I have spent 23 years working in the National Health Service, the last 13 of which were as general manager of a practice in which I was responsible for 80 staff. Life at the practice was hectic, dealing with the demands of a large, multidisciplinary team, the patients who were registered with our practice and, of course, the doctors themselves. My day was always busy with unexpected demands, but I had the support of well trained staff, who knew that I demanded high standards from them, which, in turn, resulted in excellent patient care.
High Expression of the Mismatch Repair Protein MSH6 Is Associated With Poor Patient Survival in Melanoma
Authors: Alvino Ester , Passarelli Francesca , Cannavò Elda , Fortes Cristina , Mastroeni Simona , Caporali Simona , Jiricny Josef , Cappellini Gian Carlo Antonini , Scoppola Alessandro , Marchetti Paolo , Modesti Andrea , D’Atri Stefania 
Published: June 2014

Abstract

Objectives:
The outcome of patients with primary melanoma (PM) cannot be completely explained based on currently adopted clinical-histopathologic criteria. In this study, we evaluated the potential prognostic value of mismatch repair protein expression in PMs.

Methods:
We examined the immunohistochemical staining of mismatch repair proteins in 18 benign nevi and 101 stage I to III PMs and investigated their association with tumor clinicopathologic variables and melanoma mortality.

Results:
Expression of MSH2, MLH1, and PMS2 was high in benign nevi and reduced in a subset of PMs. Conversely, MSH6 expression was absent or extremely low in benign nevi and increased in a subset of PMs. In the multivariate analysis, including sex, age, Breslow thickness, and ulceration, high MSH6 expression in PMs (ie, immunostaining in &gt;20% of tumor cells) was significantly associated with an increased risk of melanoma mortality (relative risk, 3.76; 95% confidence interval, 1.12–12.70).

Conclusions:
MSH6 protein expression can be a valuable marker to improve prognosis assessment in PMs.
Effectiveness Evaluation of a Pharmacist-Driven Monitoring Database for Tardive Dyskinesia
Authors: Diefenderfer Lauren A. , Nelson Leigh Anne , Elliott Ellie , Liu Yifei , Iuppa Courtney , Winans Elizabeth , Sommi Roger W. 
Published: June 2014

Background Tardive dyskinesia (TD) is a potentially irreversible, chronic syndrome related to antipsychotic medication use characterized by hyperkinetic abnormal involuntary movements. Various studies have shown that development of TD is possible with both first- and second-generation antipsychotics. Regular monitoring for emergence of TD symptoms is recommended in clinical practice for early recognition and intervention. Methods This is a retrospective, single-center, observational study of the effectiveness of a pharmacist-driven monitoring database for TD assessment. Subjects were adult inpatients at a state psychiatric hospital who received antipsychotic treatment for at least 3 or 6 months between January 2006 and December 2011. The primary objective was to assess compliance rates with TD monitoring based on facility policy before and after implementation of the database at 3 and 6 months following initiation of antipsychotic therapy. Results A significant improvement in compliance with TD monitoring policy was seen after implementation of the database (2.9% vs 66.7%; P < .001). Compliance with TD monitoring did not differ between classes of antipsychotic medication, hospital units, or age groups. Conclusion The results of this study demonstrate that pharmacists can help improve compliance with TD assessment and that monitoring databases may be useful for similar extended or long-term care settings to ensure timely assessment of patients for the development or progression of TD.
Evaluation of Serum Carnitine Levels for Pediatric Patients Receiving Carnitine-Free and Carnitine-Supplemented Parenteral Nutrition
Authors: Winther Brian , Jackson Daniel , Mulroy Cecilia , MacKay Mark 
Published: June 2014

Purpose Carnitine is a carrier molecule transporting long-chain fatty acids (LCFAs) into the mitochondria for fatty acid β-oxidation. The purpose of this study is to evaluate the role of carnitine supplementation in parenteral nutrition (PN) within the pediatric population. Our goal was to determine a weight range for which empiric carnitine supplementation is justified and to determine a weight range at which a carnitine level should first be drawn to confirm a deficiency prior to supplementation. Secondarily, we tried to determine a relationship among carnitine deficiency, hypoglycemia, and hypertriglyceridemia. Methods This was a retrospective observational study to evaluate 2 groups of pediatric patients (weighing 0.68 kg to 60 kg) who were NPO and receiving PN. The first group of patients ( n = 454) received carnitine supplementation (15 mg/kg/day) upon initiation of PN. The second group ( n = 299) did not receive carnitine supplementation until they were determined to have a carnitine deficiency. Results The data indicated that 82% of the patients weighing less than 5 kg were deficient. Patients weighing more than 5 kg had serum carnitine levels within the normal range. Therefore, patients receiving PN and weighing less than 5 kg should be supplemented with carnitine. Comparison of triglyceride, glucose, and carnitine showed no statistically significant difference ( P = .1936). Conclusion Patients weighing more than 5 kg should have serum carnitine levels drawn within 7 days to determine whether supplementation is needed. There is no statistical correlation among carnitine deficiency, hypoglycemia, and hypertriglyceridemia.