bluuebunny/crossref_metadata_2025_split huggingface dataset:
Final results from the Betaseron (interferon β-1b) Pregnancy Registry: a prospective observational study of birth defects and pregnancy-related adverse events
Authors: Coyle P K , Sinclair S M , Scheuerle A E , Thorp J M , Albano J D , Rametta M J 
Published: May 2014

ObjectiveWomen with multiple sclerosis are often diagnosed and treated during their reproductive years. Limited data are available on the safety of treatment during pregnancy. The Betaseron Pregnancy Registry prospectively monitored women exposed to interferon β-1b (IFNβ-1b) during pregnancy to estimate the rates of birth defects, spontaneous abortions (SABs) and other negative outcomes in this population.DesignFrom 2006 to 2011, this observational registry enrolled women exposed prior to conception or during pregnancy (but prior to or without abnormalities on prenatal screening). Follow-up continued from enrolment through the 4-month paediatric visit.SettingPatients in the USA who met these criteria were enrolled in the registry.ResultsThe registry enrolled 99 pregnant women; 3 were lost to follow-up. The earliest exposure to IFNβ-1b occurred during the first trimester for 95 pregnancies and in the third trimester for 1 pregnancy. There were 99 birth outcomes (3 twins), including 86 (86.9%) live births, 11 (11.1%) SABs and 2 (2%) stillbirths. Birth defects were reported in five (5.1%) cases. Rates of birth defects and SAB were not significantly different from population comparators. No developmental concerns were identified at the 4-month paediatric visit.ConclusionsThe small sample size limits the ability to draw definitive conclusions; however, there was no pattern to suggest increased negative outcomes with IFNβ-1b.Clinical trials registration numberNCT00317564.
Laboratory gas injection tests of compacted bentonite buffer material for TRU waste disposal
Authors: Namiki Kazuto , Asano Hidekazu , Takahashi Shinichi , Shimura Tomoyuki , Hirota Ken 
Published: May 2014

Abstract
The Radioactive Waste Management Funding and Research Center (RWMC) is leading a research programme to evaluate the gas transport mechanisms through a TRU (TRans-Uranium) waste disposal facility in Japan and acquire information on gas migration properties. In this paper we describe a series of laboratory gas injection tests using the bentonite adopted for use in Japanese TRU disposal, as well as an attempted visualization of the gas migration path inside the bentonite used as a buffer. By building a conceptual model from the results of these tests, the characteristics of gas migration through to breakthrough for bentonite can now be better understood in the context of Japanese TRU disposal. Thanks to the outcome of this research project, advanced knowledge may be applied to the conceptualization of TRU waste disposal.
Existence of Nontrivial Solutions for Perturbed Elliptic System inℝN
Authors: Jiang Juan 
Published: May 2014

We consider the perturbed nonlinear elliptic system-ε2Δu+V(x)u=K(x)|u|2*-2u+Hu(u,v), x∈ℝN,-ε2Δv+V(x)v=K(x)|v|2*-2v+Hv(u,v), x∈ℝN, whereN≥3,2*=2N/(N-2)is the Sobolev critical exponent. Under proper conditions onV,H, andK, the existence result and multiplicity of the system are obtained by using variational method providedεis small enough.
Acyl-Coenzyme A–Binding Protein Regulates Beta-Oxidation Required for Growth and Survival of Non–Small Cell Lung Cancer
Authors: Harris Fredrick T. , Rahman S.M. Jamshedur , Hassanein Mohamed , Qian Jun , Hoeksema Megan D. , Chen Heidi , Eisenberg Rosana , Chaurand Pierre , Caprioli Richard M. , Shiota Masakazu , Massion Pierre P. 
Published: May 2014

Abstract
We identified acyl-coenzyme A–binding protein (ACBP) as part of a proteomic signature predicting the risk of having lung cancer. Because ACBP is known to regulate β-oxidation, which in turn controls cellular proliferation, we hypothesized that ACBP contributes to regulation of cellular proliferation and survival of non–small cell lung cancer (NSCLC) by modulating β-oxidation. We used matrix-assisted laser desorption/ionization-imaging mass spectrometry (MALDI-IMS) and immunohistochemistry (IHC) to confirm the tissue localization of ABCP in pre-invasive and invasive NSCLCs. We correlated ACBP gene expression levels in NSCLCs with clinical outcomes. In loss-of-function studies, we tested the effect of the downregulation of ACBP on cellular proliferation and apoptosis in normal bronchial and NSCLC cell lines. Using tritiated-palmitate (3H-palmitate), we measured β-oxidation levels and tested the effect of etomoxir, a β-oxidation inhibitor, on proliferation and apoptosis. MALDI-IMS and IHC analysis confirmed that ACBP is overexpressed in pre-invasive and invasive lung cancers. High ACBP gene expression levels in NSCLCs correlated with worse survival (HR = 1.73). We observed a 40% decrease in β-oxidation and concordant decreases in proliferation and increases in apoptosis in ACBP-depleted NSCLC cells as compared with bronchial airway epithelial cells. Inhibition of β-oxidation by etomoxir in ACBP-overexpressing cells produced dose-dependent decrease in proliferation and increase in apoptosis (P = 0.01 and P &lt; 0.001, respectively). These data suggest a role for ACBP in controlling lung cancer progression by regulating β-oxidation. Cancer Prev Res; 7(7); 748–57. ©2014 AACR.
The Epidemiology and Outcomes of Percutaneous Coronary Intervention Before High‐Risk Noncardiac Surgery in Contemporary Practice: Insights From the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) Registry
Authors: Muthappan Palaniappan , Smith Dean , Aronow Herbert D. , Eagle Kim , Wohns David , Fox James , Share David , Gurm Hitinder S. 
Published: May 2014

Background

Percutaneous coronary intervention (
PCI
) is sometimes performed with the intent to lower cardiovascular risk before high‐risk noncardiac surgery (
HRNCS
). There are limited data on the frequency and outcome of
PCI
s performed in this setting.

Methods and Results

We assessed the frequency, characteristics, and in‐hospital outcomes of patients undergoing
PCI
as part of the preoperative workup for
HRNCS
among all 61 145 elective
PCI
s performed between 2002 and 2009 at 14 hospitals in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. Propensity matching was performed to compare outcomes of patients undergoing
PCI
before
HRNCS
with all other elective
PCI
patients. The frequency of
PCI
before
HRNCS
was low (4.2%). Patients undergoing
PCI
before
HRNCS
were older (67.3 versus 64.9 years,
P
<0.0001) and had a greater burden of comorbidity. Patients undergoing
PCI
before
HRNCS
had an increase in unadjusted
major adverse cardiovascular events
, postprocedure transfusion, contrast‐induced nephropathy, nephropathy requiring dialysis, and same‐admission coronary artery bypass graft surgery, but there was no difference in mortality (0.27% versus 0.14%,
P
=0.11). However, in propensity score–matched samples, there was a significant difference only in nephropathy requiring dialysis.

Conclusions

The incidence of
PCI
performed in preparation for high‐risk noncardiac surgery is low, and these procedures are currently being performed on a highly selected high‐risk patient population.
A Small Power’s Struggle for Independence in the Independent Era
Authors: Keethaponcalan S.I. 
Published: May 2014

Abstract
Can a small state stand up to some of the major powerful states? If the answer is yes, what sort of socio-political environment would enable a small state to stand up to powerful states and effectively relieve hegemonic pressure from powerful states? This paper argues that Sri Lanka, a small and weak state, managed in the last few years, to effectively relieve hegemonic pressure from India and is standing up to the the usa. The Sri Lankan case demonstrates that a small state can effectively relieve hegemonic pressure from powerful states if its political milieu entails the following three elements: (1) the will of the political leadership, (2) a supportive population, and (3) patronage of major rival states.
The relationship between measurement uncertainty and reporting interval
Authors: Badrick Tony , Hawkins Robert C 
Published: May 2014

Background Measurement uncertainty (MU) estimates can be used by clinicians in result interpretation for diagnosis and monitoring and by laboratories in assessing assay fitness for use and analytical troubleshooting. However, MU is not routinely used to assess the appropriateness of the analyte reporting interval. We describe the relationship between MU and the analyte reporting interval. Methods and results The reporting interval R is the smallest unit of measurement chosen for clinical reporting. When choosing the appropriate value for R, it is necessary that the reference change values and expanded MU values can be meaningfully calculated. Expanded MU provides the tighter criterion for defining an upper limit for R. This limit can be determined as R ≤  k·SDa/1.9, where SDa is the analytical standard deviation and k is the coverage factor (usually 2). Conclusion Using MU estimates to determine the reporting interval for quantitative laboratory results ensures that reporting practices match local analytical performance and recognizes the inherent error of the measurement process.
Pregnancy and levels of depression and anxiety: A prospective cohort study of Australian women
Authors: Leach Liana S , Christensen Helen , Mackinnon Andrew 
Published: May 2014

Objective: The effects of pregnancy on depression and anxiety remain unclear. Previous research is predominantly cross-sectional, not representative of the general community, and does not include data on mental health prior to pregnancy. This study used longitudinal Australian population-based data to examine whether pregnancy is associated with increases in women’s anxiety and depression levels (from pre-pregnancy). Method: A community sample of Australian women aged 20–24 years were recruited prospectively and assessed in 1999, 2003 and 2007. At the follow-up assessments 76 women were pregnant (with no prior children) and 542 remained nulliparous. Mixed models repeated measures analyses of variance were undertaken to compare change in levels of anxiety and depression (Goldberg Anxiety and Depression scales) between those who became pregnant and those who remained non-pregnant. Results: Pregnancy was not associated with increased symptoms of depression or anxiety. No association was found with depression, while pregnancy was associated with a decrease in anxiety. Including somatic items in the measures of depression and anxiety resulted in higher symptom levels in pregnancy, suggesting possible item bias. Conclusions: This study is one of the first to follow a community sample of women from pre-pregnancy to pregnancy. The findings suggest that pregnancy is not typically detrimental to women’s mental health. The current study offers a starting point for future prospective studies to follow women from pre-pregnancy to postpartum. Study limitations to be improved upon in follow-up research include expanding the sample size, and including both pregnancy-specific measures and trimester-specific data. Future research should continue to identify those women who are most (and least) at risk during pregnancy in order to target resources and assistance most effectively.
Stimulant and other substance use disorders in schizophrenia: Prevalence, correlates and impacts in a population sample
Authors: Sara Grant E , Burgess Philip M , Malhi Gin S , Whiteford Harvey A , Hall Wayne C 
Published: May 2014

Objectives: Stimulants may worsen psychotic symptoms but there is limited evidence about the impact of stimulant abuse in people with schizophrenia. This study examined the prevalence and correlates of stimulant and other drug disorders in a population-based sample of people with schizophrenia, examining associations with frequent service use, physical health comorbidities and accommodation instability. Methods: New South Wales (NSW) hospital, community mental health and emergency department data were used to examine health service contact over 5 years in 13,624 people with a diagnosis of schizophrenia. Associations of stimulant disorders were examined with multinomial logistic regression, comparing people with no substance disorders to those with cannabis disorders, stimulant disorders or both. Results: Of people with schizophrenia, 51% had substance disorders, including 14% with stimulant disorders. Stimulant disorders were more common in young adults and in urban areas, less common in migrants, and unrelated to initial social disadvantage. More than 80% of those with stimulant disorders also had cannabis disorders. Service use and harms were most common in this group, including frequent mental health admissions (59%), frequent emergency department presentations (52%), admissions with injury or self-harm (44%), infectious disease diagnoses (22%), multiple changes of residence (61%), movement to more disadvantaged locations (42%) and periods of homelessness (18%). People with stimulant disorders alone had higher rates of self-harm, infectious disease and non-mental health admissions than people with cannabis disorders alone. Conclusions: Stimulant disorders occur in people with schizophrenia and in first-episode psychosis at rates more than 10 times that of the broader population. Stimulant disorders are likely to worsen the burden of psychosis, and strategies are needed to engage and support the highly disadvantaged group of people with schizophrenia who have cannabis and stimulant disorders.
Patients’, family caregivers’, and professionals’ perspectives on quality of palliative care: A qualitative study
Authors: Vedel Isabelle , Ghadi Véronique , Lapointe Liette , Routelous Christelle , Aegerter Philippe , Guirimand Frédéric 
Published: May 2014

Background: The quality of palliative care is the foremost preoccupation of clinicians, decision-makers, and managers as well as patients and families. Major input from healthcare professionals is required to develop indicators for the quality of palliative care, but the involvement of patients and families is also recognized as essential, even though this is rarely achieved in practice. Aim: The objectives of this study were to identify (1) convergences and divergences in the points of view of different stakeholders (patients, families, healthcare professionals) relative to key elements of the quality of palliative care and (2) avenues for refining existing indicators of quality of palliative care. Design: Cross-sectional qualitative study. Setting/participants: There were six settings: two hospital-based palliative care units, one hospice, and three other medical units where a mobile palliative care team intervene. Semi-structured interviews were conducted among 61 patients, families, healthcare professionals, and managers. Results: Four major dimensions of quality of care are deemed critical by patients, their families, and professionals: comprehensive support for the patients themselves, clinical management, involvement of families, and care for the imminently dying person and death. Differences exist between various stakeholders regarding perceptions of some dimensions of quality of care. Avenues for improving current quality of care indicators are identified. Conclusion: Our study results can be used to refine or develop quality indicators that truly mirror the points of view of patients and their families and of healthcare professionals.
1.5-T multiparametric MRI using PI-RADS: a region by region analysis to localize the index-tumor of prostate cancer in patients undergoing prostatectomy
Authors: Reisæter Lars A , Fütterer Jurgen J , Halvorsen Ole J , Nygård Yngve , Biermann Martin , Andersen Erling , Gravdal Karsten , Haukaas Svein , Monssen Jan A , Huisman Henkjan J , Akslen Lars A , Beisland Christian , Rørvik Jarle 
Published: May 2014

Background The use of multiparametric magnetic resonance imaging (mpMRI) to detect and localize prostate cancer has increased in recent years. In 2010, the European Society of Urogenital Radiology (ESUR) published guidelines for mpMRI and introduced the Prostate Imaging Reporting and Data System (PI-RADS) for scoring the different parameters. Purpose To evaluate the reliability and diagnostic performance of endorectal 1.5-T mpMRI using the PI-RADS to localize the index tumor of prostate cancer in patients undergoing prostatectomy. Material and Methods This institutional review board IRB-approved, retrospective study included 63 patients (mean age, 60.7 years, median PSA, 8.0). Three observers read mpMRI parameters (T2W, DWI, and DCE) using the PI-RADS, which were compared with the results from whole-mount histopathology that analyzed 27 regions of interest. Inter-observer agreement was calculated as well as sensitivity, specificity, positive predictive value (PPV), and negative predicted value (NPV) by dichotomizing the PI-RADS criteria scores ≥3. A receiver-operating curve (ROC) analysis was performed for the different MR parameters and overall score. Results Inter-observer agreement on the overall score was 0.41. The overall score in the peripheral zone achieved sensitivities of 0.41, 0.60, and 0.55 with an NPV of 0.80, 0.84, and 0.83, and in the transitional zone, sensitivities of 0.26, 0.15, and 0.19 with an NPV of 0.92, 0.91, and 0.92 for Observers 1, 2, and 3, respectively. The ROC analysis showed a significantly increased area under the curve (AUC) for the overall score when compared to T2W alone for two of the three observers. Conclusion 1.5 T mpMRI using the PI-RADS to localize the index tumor achieved moderate reliability and diagnostic performance.
A Radiographic Assessment of Failed Anterior Cruciate Ligament Reconstruction
Authors: Waltz Robert A. , Solomon Daniel J. , Provencher Matthew T. 
Published: May 2014

Background: Magnetic resonance imaging (MRI) showing an “intact” anterior cruciate ligament (ACL) graft may not correlate well with examination findings. Reasons for an ACL graft dysfunction may be from malpositioned tunnels, deficiency of secondary stabilizers, repeat injuries, or a combination of factors. Purpose: To evaluate the concordance/discordance of an ACL graft assessment between an arthroscopic evaluation, physical examination, and MRI and secondarily to evaluate the contributing variables to discordance. Study Design: Case series; Level of evidence, 4. Methods: A total of 50 ACL revisions in 48 patients were retrospectively reviewed. The ACL graft status was recorded separately based on Lachman and pivot-shift test data, arthroscopic findings from operative reports, and MRI evaluation and was categorized into 3 groups: intact, partial tear, or complete tear. Two independent evaluators reviewed all of the preoperative radiographs and MRI scans, and interrater and intrarater reliability were evaluated. Concordance and discordance between a physical examination, arthroscopic evaluation, and MRI evaluation of the ACL graft were calculated. Graft position and type, mechanical axis, collateral ligament injuries, chondral and meniscal injuries, and mechanism of injury were evaluated as possible contributing factors using univariate and multivariate analyses. Sensitivity and specificity of MRI to detect a torn ACL graft and meniscal and chondral injuries on arthroscopic evaluation were calculated. Results: The interobserver and intraobserver reliability for the MRI evaluation of the ACL graft were moderate, with combined κ values of .41 and .49, respectively. The femoral tunnel position was vertical in 88% and anterior in 46%. On MRI, the ACL graft was read as intact in 24%; however, no graft was intact on arthroscopic evaluation or physical examination. The greatest discordance was between the physical examination and MRI, with a rate of 52%. An insidious-onset mechanism of injury was significantly associated with discordance between MRI and arthroscopic evaluation of the ACL ( P = .0003) and specifically with an intact ACL graft on MRI ( P = .0014). The sensitivity and specificity of MRI to detect an ACL graft tear were 60% and 87%, respectively. Conclusion: Caution should be used when evaluating a failed ACL graft with MRI, especially in the absence of an acute mechanism of injury, as it may be unreliable and inconsistent.
Struggling on the Newstart unemployment benefit in Australia: The experience of a neoliberal form of employment assistance
Authors: Morris Alan , Wilson Shaun 
Published: May 2014

AbstractThe low level of the Newstart (unemployment benefit) payment has become a major source of concern about Australia’s willingness and ability to protect unemployed Australians from poverty. Despite this disquiet, there has been little scholarly examination of the implications of living on Newstart. In this article, through the use of a survey and in-depth interviews, we examine features of everyday life for Newstart recipients in the Sydney area, experiences that reveal the scarring potential of low benefits. The article illustrates that for a majority of interview participants, the most basic items were difficult to purchase and many of the interviewees were living in inadequate and even unsafe situations owing to an inability to afford satisfactory accommodation. For some, their lack of disposable income had severe health implications. Social isolation was a common phenomenon, and many of the interviewees found that the low payment made finding employment a lot more challenging.
The use of restraint in four general hospital emergency departments in Australia
Authors: Gerace Adam , Pamungkas Dewi R , Oster Candice , Thomson Del , Muir-Cochrane Eimear 
Published: May 2014

Objective: The purpose of this study was to investigate restraint use in Australian emergency departments (EDs). Method: A retrospective audit of restraint incidents in four EDs (from 1 January 2010 to 31 December 2011). Results: The restraint rate was 0.04% of total ED presentations. Males and females were involved in similar numbers of incidents. Over 90% of restrained patients had a mental illness diagnosis and were compulsorily hospitalised. Mechanical restraint with the use of soft shackles was the main method used. Restraint was enacted to prevent harm to self and/or others. Median incident duration was 2 hours 5 minutes. Conclusions: In order to better integrate the needs of mental health clients, consideration is needed as to what improvements to procedures and the ED environment can be made. EDs should particularly focus on reducing restraint duration and the use of hard shackles.
Changes in the Attitude and Practice Toward End-of-Life Care
Authors: Lam K. W. , Yeung K. W. Au , Lai K. Y. , Cheng F. 
Published: May 2014

Introduction: End-of-life care is affected by the attitude and cultural influence of doctors. Methods: To investigate the attitudes and practices of doctors on end-of-life care by questionnaire survey in 2004 and 2008. Results: In 2004, 31.7% of the respondents agreed that they “do not attempt resuscitation” (DNAR) form was useful and it rose to 54.4% in 2008. A higher proportion of respondents in 2008 claimed that they signed the DNAR form for documentation and accepted withholding noninvasive life-sustaining treatment compared to 2004. In 2004, 50% of the respondents regarded their training and education on handling DNAR issue as inadequate. Conclusion: Documentation by DNAR form is gaining wider acceptance. Many doctors are expected to have more training and coaching on communication for handling such sensitive issues.