bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and economic effects of selective radiological evaluation of high-energy trauma patients: a prospective experience of a level 1 busy trauma centre
Authors: Paydar Shahram , Ahmadi Armin , Dalfardi Behnam , Shakibafard Alireza , Abbasi Hamidreza , Bolandparvaz Shahram 
Published: September 2014

IntroductionCervical spine, thoracic and pelvic fractures are the main causes of devastation in patients who have suffered blunt trauma. Radiographic imaging plays an important role in diagnosing such injuries. Nevertheless, the present dominant approach, the routine use of X-ray studies, seems to have no cost-benefit justification for healthcare systems.MethodsThis prospective cross-sectional study was performed over a 3-month period. During the determined time frame, all haemodynamically stable, high-energy blunt trauma patients were included. Based on the predefined criteria, selective radiographic images of the neck, chest and pelvis were obtained. Patients were followed during their hospital stay and for a 2-week period after discharge.Results1002 cases were included in the final survey. 247/1002 (24.6%) cervical radiographic images, 500/1002 (49.9%) CXRs and 171/1002 (17%) pelvic radiographic images of the patients were taken on the first day of hospital admission. New X-ray images required during the patients’ hospital stay resulted in 5/1002 (0.4%) cervical, 4/1002 (0.3%) chest and 8/1002 (0.7%) pelvic radiographies. In the 2-week period after discharge, 4/1002 cases (0.3%) needed to repeat neck radiography. Overall, 697.44 mSv X-ray radiation was potentially prevented and US$426 450 were potentially saved.ConclusionsSelective radiographic imaging of the neck, chest and pelvis together with a precise history-taking and physical examination in cases of high-energy blunt trauma could eliminate unnecessary costs to patients and healthcare systems, and significantly save resources.
Adjunctive techniques for optimization of ocular hemodynamics in children undergoing ophthalmic artery infusion chemotherapy
Authors: Abruzzo Todd A , Geller James I , Kimbrough Dale A , Michaels Samantha , Corrêa Zélia M , Cornell Kevin , Augsburger James J 
Published: September 2014

PurposeTo develop a reproducible technique for selective ophthalmic artery infusion chemotherapy (SOAIC) that is technically efficacious in children with unfavorable patterns of ophthalmic artery (OA) flow.Materials and methodsInitially, all SOAIC was performed with intention to treat using a standard selective OA (microcatheter) infusion technique (sSOAIC). Temporary balloon occlusion (TBO) of the external carotid artery (ECA), a balloon-assisted SOAIC (bSOAIC) technique, was performed only if OA angiography did not show robust and sustained anterograde OA flow. In our more recent experience, all SOAIC was performed with intention to treat by bSOAIC. Verapamil infusion into the OA and internal carotid artery was performed in selected cases. Technical success was defined as delivery of chemotherapeutic agent(s) into the OA with robust and sustained anterograde perfusion. sSOAIC was considered to have failed if converted to bSOAIC.Results19 eyes were treated in 17 patients (age 5 months to 16 years) between December 2008 and May 2013. Eighty-three procedures were undertaken and the OA was successfully catheterized in all. Technical success was achieved in 35/41 (85%) sSOAIC cases and 42/42 (100%) bSOAIC cases. TBO of the ECA augmented anterograde OA flow and converted all cases of retrograde OA flow to anterograde. Verapamil further augmented anterograde ocular perfusion during SOAIC. There were no access site complications, strokes, or deaths.ConclusionsTBO of the ECA is a safe, effective, and reproducible method for optimizing ocular hemodynamics during SOAIC regardless of baseline OA flow pattern. Verapamil infusion may further favorably modify OA flow.Trial registration numberNCT01466855.
Fostering professionalism among doctors: the role of workplace discussion groups
Authors: Gill Deborah , Griffin Ann , Launer John 
Published: September 2014

AbstractBackgroundThe professionalism of doctors has come in for increasing scrutiny and discussion, within the profession and in society. Professionalism has also become of central interest in undergraduate and postgraduate medical education. There is a great deal of debate about the nature of medical professionalism, how to promote it and what approaches to learning are most effective.ObjectiveThis study aims to identify the role of workplace-based discussion groups in encouraging and supporting the development of professionalism among doctors.MethodsWorkplace-based discussion groups including doctors from all non-consultant grades and specialties were established in five hospitals over a 6 month period in 2010–2011. A mixed-methods approach was used to identify the perceived impact of these groups on participants, which included interviewing the group facilitators and education leaders at participating hospitals.ResultsUnderstanding of professionalism at an individual level was improved along with an increased awareness of the collective nature of professionalism in everyday clinical practice. Key to the success of the groups was the creation of a legitimate space to explore professionalism and professional challenges and the use of experienced facilitators who could build trust in the groups.ConclusionsA purely individualistic approach to professionalism does not resonate with contemporary, team-based healthcare. Work-based groups can provide a focus for an approach to professionalism that is mindful of self, the team, the culture and the organisation. This evaluation provides guidance to a range of stakeholders on how to develop educational interventions that foster professionalism, personal and collective, and offers some pointers towards the range of factors that may impact on the outcomes of such activities.
Outbreak of disease associated with Mycoplasma meleagridis in a free‐range mixed poultry farm
Authors: Catania Salvatore , Rodio Stefania , Moronato Maria Luisa , Ayling Roger D , Nicholas Robin A J 
Published: September 2014

Mycoplasma meleagridis is mainly a pathogen of turkeys causing poor growth and skeletal abnormalities. Very few cases have been reported in poultry in Europe over the last 20 years largely because of control measures including selective breeding and strict biosecurity. The authors report here evidence of M meleagridis infection in a flock of free‐range turkeys and, for the first time, in guinea fowl presenting decreased growth rate and significant mortality, which were in direct contact with the turkeys. The majority of turkeys were seropositive for M meleagridis but the guinea fowl were seronegative. M meleagridis was isolated by culture and identified by PCR/denaturing gradient gel electrophoresis and 16S rDNA sequencing in the cloacae and tracheas of several affected turkeys and the cloacae of guinea fowl.
Phase diagram of an extended t-U-J chain with frustrated exchange interaction
Authors: Ding Hanqin , Zhang Jun 
Published: September 2014

Using the low-energy effective field theory scenario combined Abelian bosonization and renormalization-group techniques, we study the Hubbard chain with additional anisotropic nearest-neighbor and isotropic next-nearest-neighbor spin exchanges J and J′ in the weak-coupling regime. The spin correlations are non-critical due to the anisotropic J (Jxy ≠ Jz). The frustrating antiferromagnetic exchange J′ leads to an enhancement of the dimerized phase and induces a long-range charge-density-wave (CDW) phase. For smaller values of J′ (J′ < 2U/3), the quantum phase diagram consists of the insulating spin-density-wave ( SDW xy, SDW z) and bond-charge-density-wave (BCDW) phases and the triplet superconducting ( TS 0, TS ±) phase. For larger J′ (J′ ≥ 2U/3), a finite CDW phase appears. The result shows that the frustrated spin exchange J′ changes the topological structure of the usual t-U-J chain.
When an Extension of Nagata Rings Has Only Finitely Many Intermediate Rings, Each of Those Is a Nagata Ring
Authors: Dobbs David E. , Picavet Gabriel , Picavet-L’Hermitte Martine 
Published: September 2014

LetR⊂Sbe an extension of commutative rings, withXan indeterminate, such that the extensionRX⊂SXof Nagata rings has FIP (i.e.,SXhas only finitely manyRX-subalgebras). Then, the number ofRX-subalgebras ofSXequals the number ofR-subalgebras ofS. In fact, the function from the set ofR-subalgebras ofSto the set ofRX-subalgebras ofSXgiven byT ↦TXis an order-isomorphism.
Using High-Throughput Transcriptomic Data for Prognosis: A Critical Overview and Perspectives
Authors: Domany Eytan 
Published: September 2014

AbstractAccurate prognosis and prediction of response to therapy are essential for personalized treatment of cancer. Even though many prognostic gene lists and predictors have been proposed, especially for breast cancer, high-throughput “omic” methods have so far not revolutionized clinical practice, and their clinical utility has not been satisfactorily established. Different prognostic gene lists have very few shared genes, the biological meaning of most signatures is unclear, and the published success rates are considered to be overoptimistic. This review examines critically the manner in which prognostic classifiers are derived using machine-learning methods and suggests reasons for the shortcomings and problems listed above. Two approaches that may hold hope for obtaining improved prognosis are presented. Both are based on using existing prior knowledge; one proposes combining molecular “omic” predictors with established clinical ones, and the second infers biologically relevant pathway deregulation scores for each tumor from expression data, and uses this representation to study and stratify individual tumors. Approaches such as the second one are referred to in the physics literature as “phenomenology”; they will, hopefully, play a significant role in future studies of cancer.See all articles in this Cancer Research section, “Physics in Cancer Research.”Cancer Res; 74(17); 4612–21. ©2014 AACR.
Toward Decoding the Principles of Cancer Metastasis Circuits
Authors: Lu Mingyang , Jolly Mohit Kumar , Onuchic Jose' , Ben-Jacob Eshel 
Published: September 2014

Abstract
Understanding epithelial–mesenchymal transitions (EMT) during cancer metastasis remains a major challenge in modern biology. Recent observations of cell behavior together with progress in mapping the underlying regulatory genetic networks led to new understandings of carcinoma metastasis. It is now established that the genetic network that regulates the EMT also enables an epithelial–mesenchymal hybrid phenotype. These hybrid cells possess mixed carcinoma epithelial and mesenchymal characteristics that enable specialized capabilities such as collective cell migration. On the gene network perspective, a four-component decision unit composed of two highly interconnected chimeric modules—the miR34/SNAIL and the miR200/ZEB mutual-inhibition feedback circuits—regulates the coexistence of and transitions between the different phenotypes. Here, we present a new tractable theoretical framework to model and decode the underlying principles governing the operation of the regulatory unit. Our approach connects the knowledge about intracellular pathways with observations of cellular behavior and advances toward understanding the logic of cancer decision-making. We found that the miR34/SNAIL module acts as an integrator while the miR200/ZEB module acts as a three-way switch. Consequently, the combined unit can give rise to three phenotypes (stable states): (i) a high miR200 and low ZEB, or (1, 0) state; (ii) a low miR200 and high ZEB, or (0, 1) state; and (iii) a medium miR200 and medium ZEB, or (½, ½) state. We associate these states with the epithelial, mesenchymal, and hybrid phenotypes, respectively. We reflect on the consistency between our theoretical predictions and recent observations in several types of carcinomas and suggest new testable predictions.
See all articles in this Cancer Research section, “Physics in Cancer Research.”
Cancer Res; 74(17); 4574–87. ©2014 AACR.
Diffusion-Weighted Imaging in Cancer: Physical Foundations and Applications of Restriction Spectrum Imaging
Authors: White Nathan S. , McDonald Carrie R. , Farid Niky , Kuperman Josh , Karow David , Schenker-Ahmed Natalie M. , Bartsch Hauke , Rakow-Penner Rebecca , Holland Dominic , Shabaik Ahmed , Bjørnerud Atle , Hope Tuva , Hattangadi-Gluth Jona , Liss Michael , Parsons J. Kellogg , Chen Clark C. , Raman Steve , Margolis Daniel , Reiter Robert E. , Marks Leonard , Kesari Santosh , Mundt Arno J. , Kane Christopher J. , Carter Bob S. , Bradley William G. , Dale Anders M. 
Published: September 2014

Abstract
Diffusion-weighted imaging (DWI) has been at the forefront of cancer imaging since the early 2000s. Before its application in clinical oncology, this powerful technique had already achieved widespread recognition due to its utility in the diagnosis of cerebral infarction. Following this initial success, the ability of DWI to detect inherent tissue contrast began to be exploited in the field of oncology. Although the initial oncologic applications for tumor detection and characterization, assessing treatment response, and predicting survival were primarily in the field of neurooncology, the scope of DWI has since broadened to include oncologic imaging of the prostate gland, breast, and liver. Despite its growing success and application, misconceptions about the underlying physical basis of the DWI signal exist among researchers and clinicians alike. In this review, we provide a detailed explanation of the biophysical basis of diffusion contrast, emphasizing the difference between hindered and restricted diffusion, and elucidating how diffusion parameters in tissue are derived from the measurements via the diffusion model. We describe one advanced DWI modeling technique, called restriction spectrum imaging (RSI). This technique offers a more direct in vivo measure of tumor cells, due to its ability to distinguish separable pools of water within tissue based on their intrinsic diffusion characteristics. Using RSI as an example, we then highlight the ability of advanced DWI techniques to address key clinical challenges in neurooncology, including improved tumor conspicuity, distinguishing actual response to therapy from pseudoresponse, and delineation of white matter tracts in regions of peritumoral edema. We also discuss how RSI, combined with new methods for correction of spatial distortions inherent in diffusion MRI scans, may enable more precise spatial targeting of lesions, with implications for radiation oncology and surgical planning.
See all articles in this Cancer Research section, “Physics in Cancer Research.”
Cancer Res; 74(17); 4638–52. ©2014 AACR.
Force Engages Vinculin and Promotes Tumor Progression by Enhancing PI3K Activation of Phosphatidylinositol (3,4,5)-Triphosphate
Authors: Rubashkin Matthew G. , Cassereau Luke , Bainer Russell , DuFort Christopher C. , Yui Yoshihiro , Ou Guanqing , Paszek Matthew J. , Davidson Michael W. , Chen Yunn-Yi , Weaver Valerie M. 
Published: September 2014

Abstract
Extracellular matrix (ECM) stiffness induces focal adhesion assembly to drive malignant transformation and tumor metastasis. Nevertheless, how force alters focal adhesions to promote tumor progression remains unclear. Here, we explored the role of the focal adhesion protein vinculin, a force-activated mechanotransducer, in mammary epithelial tissue transformation and invasion. We found that ECM stiffness stabilizes the assembly of a vinculin–talin–actin scaffolding complex that facilitates PI3K-mediated phosphatidylinositol (3,4,5)-triphosphate phosphorylation. Using defined two- and three-dimensional matrices, a mouse model of mammary tumorigenesis with vinculin mutants, and a novel super resolution imaging approach, we established that ECM stiffness, per se, promotes the malignant progression of a mammary epithelium by activating and stabilizing vinculin and enhancing Akt signaling at focal adhesions. Our studies also revealed that vinculin strongly colocalizes with activated Akt at the invasive border of human breast tumors, where the ECM is stiffest, and we detected elevated mechanosignaling. Thus, ECM stiffness could induce tumor progression by promoting the assembly of signaling scaffolds, a conclusion underscored by the significant association we observed between highly expressed focal adhesion plaque proteins and malignant transformation across multiple types of solid cancer.
See all articles in this Cancer Research section, “Physics in Cancer Research.”
Cancer Res; 74(17); 4597–611. ©2014 AACR.
Resistance to Chemotherapy: Patient Variability and Cellular Heterogeneity
Authors: Kessler David A. , Austin Robert H. , Levine Herbert 
Published: September 2014

Abstract
The issue of resistance to targeted drug therapy is of pressing concern, as it constitutes a major barrier to progress in managing cancer. One important aspect is the role of stochasticity in determining the nature of the patient response. We examine two particular experiments. The first measured the maximal response of melanoma to targeted therapy before the resistance causes the tumor to progress. We analyze the data in the context of a Delbruck–Luria type scheme, wherein the continued growth of preexistent resistant cells are responsible for progression. We show that, aside from a finite fraction of resistant cell-free patients, the maximal response in such a scenario would be quite uniform. To achieve the measured variability, one is necessarily led to assume a wide variation from patient to patient of the sensitive cells' response to the therapy. The second experiment is an in vitro system of multiple myeloma cells. When subject to a spatial gradient of a chemotherapeutic agent, the cells in the middle of the system acquire resistance on a rapid (two-week) timescale. This finding points to the potential important role of cell-to-cell differences, due to differing local environments, in addition to the patient-to-patient differences encountered in the first part.
See all articles in this Cancer Research section, “Physics in Cancer Research.”
Cancer Res; 74(17); 4663–70. ©2014 AACR.
Advanced Magnetic Resonance Imaging of the Physical Processes in Human Glioblastoma
Authors: Kalpathy-Cramer Jayashree , Gerstner Elizabeth R. , Emblem Kyrre E. , Andronesi Ovidiu C. , Rosen Bruce 
Published: September 2014

Abstract
The most common malignant primary brain tumor, glioblastoma multiforme (GBM) is a devastating disease with a grim prognosis. Patient survival is typically less than two years and fewer than 10% of patients survive more than five years. Magnetic resonance imaging (MRI) can have great utility in the diagnosis, grading, and management of patients with GBM as many of the physical manifestations of the pathologic processes in GBM can be visualized and quantified using MRI. Newer MRI techniques such as dynamic contrast enhanced and dynamic susceptibility contrast MRI provide functional information about the tumor hemodynamic status. Diffusion MRI can shed light on tumor cellularity and the disruption of white matter tracts in the proximity of tumors. MR spectroscopy can be used to study new tumor tissue markers such as IDH mutations. MRI is helping to noninvasively explore the link between the molecular basis of gliomas and the imaging characteristics of their physical processes. We, here, review several approaches to MR-based imaging and discuss the potential for these techniques to quantify the physical processes in glioblastoma, including tumor cellularity and vascularity, metabolite expression, and patterns of tumor growth and recurrence. We conclude with challenges and opportunities for further research in applying physical principles to better understand the biologic process in this deadly disease.
See all articles in this Cancer Research section, “Physics in Cancer Research.”
Cancer Res; 74(17); 4622–37. ©2014 AACR.
Growth differentiation factor GDF-15 does not influence iron metabolism in stable chronic haemodialysis patients
Authors: Li Xiang-Yang , Ying Jiang , Li Jiu-Hong , Zhu Sheng-Lang , Li Jiang , Pai Pearl 
Published: September 2014

Background Growth differentiation factor-15 (GDF-15) is a divergent member of transforming growth factor-beta super family. Under physiological states, it is weakly expressed in most tissues, but it is elevated in impaired kidney function. High concentrations of GDF-15 have been found in some haemoglobinopathies associated with suppressed concentration of hepcidin and iron overload. It is not clear whether the increased concentration of GDF-15 in chronic kidney disease influences iron metabolism. Methods The serum concentrations of GDF-15 and hepcidin, iron (Fe), ferritin, transferrin (Tf), total iron binding capacity, transferrin saturation, soluble transferrin receptor1 (sTfR1), erythropoietin and Hb were measured in 32 stable chronic kidney disease stage 5-dialysis (CKD5-D) patients and 24 healthy adults (controls) to investigate any relationship between GDF-15 and iron indices. Results GDF-15 was significantly elevated in the haemodialysis group (4840.6 ± 1520.5 ng/L) compared to control (472.8 ± 148.1 ng/L). There was a positive correlation between GDF-15 concentration and age in both groups. In the haemodialysis group, hepcidin was increased and correlated with serum ferritin, Tf, total iron binding capacity and sTfR1. There was no correlation between GDF-15 and hepcidin or other iron indices. Conclusions GDF-15 was significantly elevated in our haemodialysis patients but there was no correlation between GDF-15, hepcidin and various iron indices. In this small observational study, GDF-15 would not appear to be associated with iron metabolism in stable CKD5-D patients.
Experience of left atrial appendage closure performed under conscious sedation
Authors: Chan Ngai-Yin , Lau Chun-Leung , Tsui Ping-Tim , Lo Ying-Keung , Mok Ngai-Shing 
Published: September 2014

Background Percutaneous left atrial appendage closure is typically performed with transesophageal echocardiography guidance under general anesthesia. This study was performed to investigate the safety, feasibility, procedural characteristics, and outcomes of performing this procedure under conscious sedation without an anesthetist’s support. Methods Eleven patients (6 men; mean age 64.6 ± 10.4 years) with atrial fibrillation (median CHA2DS2VASc score 3) underwent transesophageal echocardiography-guided left atrial appendage occlusion under conscious sedation. Results All patients had successful procedures. Procedural duration and fluoroscopic times were 93.8 ± 25.3 and 16.2 ± 6.5 min, respectively. The doses of midazolam and fentanyl required were 5.4 ± 1.8 mg and 54.5 ± 27 µg, respectively. No complications arose from conscious sedation. Watchman (mean size 29 ± 5 mm) and Amplatzer Cardiac Plug (mean size 24 ± 4 mm) devices were implanted in 5 and 6 patients, respectively. One patient had device displacement due to over-compression on day one, and underwent successful percutaneous retrieval without any long-term sequelae. Warfarin was stopped in all patients after day 45, with transesophageal echocardiography showing optimal device position without a significant jet flow. In a mean follow-up of 12.1 ± 10.1 months, no thromboembolic complications were observed. Conclusions Percutaneous left atrial appendage occlusion can be performed safely and effectively under conscious sedation. This approach will significantly reduce the complexity and costs of this increasingly performed procedure.