bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients’ adherence-related beliefs about methotrexate: a qualitative study of the role of written patient information
Authors: Hayden Charlotte , Neame Rebecca , Tarrant Carolyn 
Published: May 2015

ObjectivesMethotrexate is effective in treating inflammatory arthritis, but both underadherence and overadherence can put patients at risk. Patients may fail to adhere due to practicalities including the unusual weekly dosing regimen, but medication beliefs also play a role. This study explored how both beliefs about necessity and concerns about methotrexate become established in patients with inflammatory arthritis and how patients use information in managing their beliefs and concerns.DesignSemistructured interviews were conducted with patients taking oral methotrexate for inflammatory arthritis. Interviews were transcribed verbatim and analysed thematically.SettingParticipants were recruited from a single Trust in the East Midlands.ParticipantsFifteen patients (4 male, 11 female) with inflammatory arthritis.ResultsMethotrexate was commonly prescribed at the time of diagnosis; at this point, experience of illness was influential for beliefs about medication necessity. Following prescription, patients absorbed information from written and verbal sources which reinforced beliefs about necessity but also raised concerns, including fear of side effects. Over time, beliefs were modified on the basis of personal experience, particularly of medication effectiveness and side effects. Some patients described tensions and dissonance in their beliefs and experiences of methotrexate, which put them at risk of non-adherence. Patients used information-seeking and information-avoidance as strategies to resolve these tensions. The available information did little to help suppress dissonance and sometimes exacerbated it.ConclusionsPatients’ experiences of coming to terms with taking methotrexate are complex, and their experiences of dissonance are particularly problematic. Experiences might be improved by supporting patients to assess necessity (particularly in the presence of side effects) and by providing information to moderate unnecessary concerns. Improving recording and sharing of monitoring results may be one way to meet these needs.
Perspectives from health, social care and policy stakeholders on the value of a single self-report outcome measure across long-term conditions: a qualitative study
Authors: Hunter Cheryl , Fitzpatrick Ray , Jenkinson Crispin , Darlington Anne-Sophie Emma , Coulter Angela , Forder Julien E , Peters Michele 
Published: May 2015

ObjectivesTo explore the views of a range of stakeholders regarding whether patient-reported outcome measures (PROMs) can be developed to measure key attributes of long-term conditions (LTCs) care in England, and the potential value of a single generic measure.DesignQualitative semistructured interview study, analysed using a framework approach.Participants and settingInterviews with 31 stakeholders from primary care, secondary care, social care, policy and patient-focused voluntary organisations in England.ResultsThere was broad support for a single PROM that could be used to measure outcomes for patients with any LTCs in any health or social care setting. Interviewees identified three desired uses for a PROM: to improve the quality of individual care; to increase people's engagement in their own care; and to monitor the performance of services. Interviewees felt that a PROM for LTCs should incorporate a mixture of traditional and non-traditional domains, such as functioning, empowerment and social participation, and be codesigned with patients and professional end-users. Stakeholders emphasised the need for a PROM to be feasible for practical implementation at the individual clinical level as a first priority. A number of concerns and potential problems were identified in relation to the application and interpretation of an LTC PROM.ConclusionsThis study has demonstrated support for a single self-report outcome measure that reflects the priorities of people with LTCs, if such a measure can be shown to be meaningful and useful at the individual level. People with LTCs and professional end-users in health and social care should be involved in the development and evaluation of such a measure.
Why do patients with ‘primary care sensitive’ problems access ambulance services? A systematic mapping review of the literature
Authors: Booker Matthew J , Shaw Ali R G , Purdy Sarah 
Published: May 2015

ObjectiveEmergency ambulance use for problems that could be managed in primary care continues to rise owing to complex reasons that are poorly understood. The objective of this systematic review is to draw together published evidence across a variety of study methodologies and settings to gain a better understanding of why patients seek help from ambulance services for these problems.DesignSystematic searches were undertaken across the MEDLINE, EMBASE, PsychINFO, CINAHL, Health Management Information Consortium and Health Management Information Service publication databases. Google Scholar, Web of Science, OpenSigle, EThOS and DART databases were also systematically searched for reports, proceedings, book chapters and theses, along with hand-searching of grey literature sources. Studies were included if they reported on findings examining patient, carer, health professional or service management interactions with ambulance services for primary care problems. All study methodologies and perspectives were of interest. Data were extracted, quality assessed and systematically mapped according to key findings through generation of an iterative framework.ResultsA total of 31 studies met inclusion criteria. Findings were summarised across 5 broad categories: factors associated with individual patients; actions of care-givers and bystanders; population-level factors; health infrastructure factors; challenges faced by health professionals. A number of subcategories were developed to explore these factors in more detail.ConclusionsThis review reports important factors that may impact on ambulance use for primary care problems across a global setting, including demographic measures associated with deprivation, minority status and individual social circumstances. Categorising ambulance calls for primary care problems as ‘inappropriate’ is context dependant and may be unhelpful. Potential implications for triage and risk management strategies are discussed.
The diagnostic accuracy of chest ultrasound for CT-detected radiographic consolidation in hospitalised adults with acute respiratory failure: a systematic review
Authors: Hew Mark , Corcoran John P , Harriss Elinor K , Rahman Najib M , Mallett Susan 
Published: May 2015

Objectives(1) Summarise chest ultrasound accuracy to diagnose radiological consolidation, referenced to chest CT in patients with acute respiratory failure (ARF). (2) Directly compared ultrasound with chest X-ray.SettingHospitalised patients.ParticipantsStudies were eligible if adult participants in respiratory failure underwent chest ultrasound to diagnose consolidation referenced to CT. Exclusion: (1) not primary study, (2) not respiratory failure, (3) not chest ultrasound, (4) not consolidation, (5) translation unobtainable, (6) unable to extract data, (7) unable to obtain paper. 4 studies comprising 224 participants met inclusion.Outcome measuresAs planned, paired forest plots display 95% CIs of sensitivity and specificity for ultrasound and chest X-ray. Sensitivity and specificity from each study are plotted in receiver operator characteristics space. Meta-analysis was planned if studies were sufficiently homogeneous and numerous (≥4). Although this numerical requirement was met, meta-analysis was prevented by heterogeneous units of analysis between studies.ResultsAll studies were in intensive care, with either a high risk of selection bias or high applicability concerns. Studies had unclear or high risk of bias related to use of ultrasound. Only 1 study clearly performed ultrasound within 24 h of respiratory failure diagnosis. Ultrasound sensitivity ranged from 0.91 (95% CI 0.81 to 0.97) to 1.00 (95% CI 0.95 to 1.00). Specificity ranged from 0.78 (95% CI 0.52 to 0.94) to 1.00 (0.99 to 1.00). In two studies, chest X-ray had lower sensitivity than ultrasound, but there were insufficient patients to compare specificity.ConclusionsFour small studies suggest ultrasound is highly sensitive and specific for consolidation in ARF, but high risk of bias and concerns about applicability in all studies may have inflated diagnostic accuracy. Further robustly designed studies are needed to define the role of ultrasound in this setting.Trial registration numberhttp://www.crd.york.ac.uk/PROSPERO/(CRD42013006472).
Routine issuance of clinical magnets to patients receiving implantable defibrillators: retention of information and appropriateness of use
Authors: Thomas Dewi E , Barry James P , Churchouse Wendy , Anderson Mark H 
Published: May 2015

BackgroundThe application of a clinical magnet over an implantable cardioverter defibrillator (ICD) can be used to suspend tachycardia therapies in patients receiving recurrent or inappropriate shocks. In our institution, they have been routinely issued to patients undergoing ICD implantation during the past 5 years. The purpose of this survey was to investigate how well information concerning their use had been retained, and in what circumstances the magnets had been used.MethodsWe sent a questionnaire to 476 patients, and received a response from 343 (72%). Data was collated using ‘Microsoft Excel’, cross-referenced against our own pacing database, and analysed using basic statistical methods.Results256 (74.6%) patients recalled being issued with a magnet. 48% of these were still in possession of their written information leaflet at the time of survey; 62% felt that they were able to remember when and how to use the magnet—with patients who had received written instructions and verbal reinforcement demonstrating the best recall. 8% of patients had used their magnets and the most common reason for use was multiple or inappropriate shocks. In addition, almost half of the patients who had suffered inappropriate shocks had been able to successfully use their magnets. No cases of harm related to magnet use were identified.ConclusionsThe results of our survey suggest that routinely issuing clinical magnets to ICD patients is a safe and effective practice, and a small but significant number of patients were able to utilise their magnets in clinically important situations.
Emerging Treatment Paradigms in Radiation Oncology
Authors: Le Quynh-Thu , Shirato Hiroki , Giaccia Amato J. , Koong Albert C. 
Published: May 2015

AbstractRapid advancements in radiotherapy and molecularly targeted therapies have resulted in the development of potential paradigm-shifting use of radiotherapy in the treatment of cancer. In this review, we discuss some of the most promising therapeutic approaches in the field of radiation oncology. These strategies include the use of highly targeted stereotactic radiotherapy and particle therapy as well as combining radiotherapy with agents that modulate the DNA damage response, augment the immune response, or protect normal tissues. Clin Cancer Res; 21(15); 3393–401. ©2015 AACR.
Rectal Optical Markers for In Vivo Risk Stratification of Premalignant Colorectal Lesions
Authors: Radosevich Andrew J. , Mutyal Nikhil N. , Eshein Adam , Nguyen The-Quyen , Gould Bradley , Rogers Jeremy D. , Goldberg Michael J. , Bianchi Laura K. , Yen Eugene F. , Konda Vani , Rex Douglas K. , Van Dam Jacques , Backman Vadim , Roy Hemant K. 
Published: May 2015

Abstract
Purpose: Colorectal cancer remains the second leading cause of cancer deaths in the United States despite being eminently preventable by colonoscopy via removal of premalignant adenomas. In order to more effectively reduce colorectal cancer mortality, improved screening paradigms are needed. Our group pioneered the use of low-coherence enhanced backscattering (LEBS) spectroscopy to detect the presence of adenomas throughout the colon via optical interrogation of the rectal mucosa. In a previous ex vivo biopsy study of 219 patients, LEBS demonstrated excellent diagnostic potential with 89.5% accuracy for advanced adenomas. The objective of the current cross-sectional study is to assess the viability of rectal LEBS in vivo.
Experimental Design: Measurements from 619 patients were taken using a minimally invasive 3.4-mm diameter LEBS probe introduced into the rectum via anoscope or direct insertion, requiring approximately 1 minute from probe insertion to withdrawal. The diagnostic LEBS marker was formed as a logistic regression of the optical reduced scattering coefficient \mu_s^* and mass density distribution factor D.
Results: The rectal LEBS marker was significantly altered in patients harboring advanced adenomas and multiple non-advanced adenomas throughout the colon. Blinded and cross-validated test performance characteristics showed 88% sensitivity to advanced adenomas, 71% sensitivity to multiple non-advanced adenomas, and 72% specificity in the validation set.
Conclusions: We demonstrate the viability of in vivo LEBS measurement of histologically normal rectal mucosa to predict the presence of clinically relevant adenomas throughout the colon. The current work represents the next step in the development of rectal LEBS as a tool for colorectal cancer risk stratification. Clin Cancer Res; 21(19); 4347–55. ©2015 AACR.
Obesity, Intrapancreatic Fatty Infiltration, and Pancreatic Cancer
Authors: Wang Hua , Maitra Anirban , Wang Huamin 
Published: May 2015

Abstract
Obesity and intrapancreatic fatty infiltration are associated with increased risk of pancreatic cancer and its precursor lesions. The interplay among obesity, inflammation, and oncogenic Kras signaling promotes pancreatic tumorigenesis. Targeting the interaction between obesity-associated inflammation and Kras signaling may provide new strategies for prevention and therapy of pancreatic cancer. Clin Cancer Res; 21(15); 3369–71. ©2015 AACR.
See related article by Rebours et al., p. 3522
Oxidative Stress Biomarkers and Incidence of Postoperative Atrial Fibrillation in the Omega‐3 Fatty Acids for Prevention of Postoperative Atrial Fibrillation (OPERA) Trial
Authors: Wu Jason H. Y. , Marchioli Roberto , Silletta Maria G. , Masson Serge , Sellke Frank W. , Libby Peter , Milne Ginger L. , Brown Nancy J. , Lombardi Federico , Damiano Ralph J. , Marsala Joann , Rinaldi Mauro , Domenech Alberto , Simon Caterina , Tavazzi Luigi , Mozaffarian Dariush 
Published: May 2015

Background

Animal study results point to oxidative stress as a key mechanism triggering postoperative atrial fibrillation (Po
AF
), yet the extent to which specific biomarkers of oxidative stress might relate to Po
AF
risk in humans remains speculative.

Methods and Results

We assessed the association of validated, fatty acid–derived oxidative stress biomarkers (F
2
‐isoprostanes, isofurans, and F
3
‐isoprostanes) in plasma and urine, with incident Po
AF
among 551 cardiac surgery patients. Biomarkers were measured at enrollment, the end of surgery, and postoperative day 2. Po
AF
lasting ≥30 seconds was confirmed with rhythm strip or electrocardiography and centrally adjudicated. Outcomes were assessed until hospital discharge or postoperative day 10, whichever occurred first. Urine level of each oxidative stress biomarker rose at the end of surgery (2‐ to 3‐fold over baseline,
P
<0.001) and subsequently declined to concentrations comparable to baseline by postoperative day 2. In contrast, plasma concentrations remained relatively stable throughout the perioperative course. Urine F
2
‐isoprostanes and isofurans at the end of surgery were 20% and 50% higher in subjects who developed Po
AF
(
P
≤0.009). While baseline biomarker levels did not associate significantly with Po
AF
, end of surgery and postoperative day 2 isoprostanes and isofurans demonstrated relatively linear associations with Po
AF
. For example, the end of surgery extreme quartile multivariate adjusted
OR
(95%
CI
) for urine isofurans and F
3
‐isoprostanes were 1.95 (1.05 to 3.62;
P
for trend=0.01) and 2.10 (1.04 to 2.25,
P
for trend=0.04), respectively. The associations of biomarkers with Po
AF
varied little by demographics, surgery type, and medication use (
P
≥0.29 for each).

Conclusions

These novel results add to accumulating evidence supporting the likely key pathogenic role of elevated oxidative stress in Po
AF
.

Clinical Trial Registration

URL:
Clinicaltrials.gov
Unique identifier: NCT00970489.
Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)
Authors: Dionne Audrey , Ibrahim Ragui , Gebhard Catherine , Bakloul Mohamed , Selly Jean‐Bernard , Leye Mohamed , Déry Julie , Lapierre Chantale , Girard Patrice , Fournier Anne , Dahdah Nagib 
Published: May 2015

Background

Coronary artery aneurysms (
CAA
) are serious complications of Kawasaki disease (
KD
). Optical coherence tomography (
OCT
) is a high‐resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe
CAA
wall sequelae after
KD
.

Methods and Results

KD
patients scheduled for routine coronary angiography underwent
OCT
imaging between March 2013 and August 2014. Subjects’ clinical courses, echocardiography, and coronary angiography examinations were reviewed retrospectively.
OCT
was performed in 18 patients aged 12.4±5.5 years, 9.0±5.1 years following onset of
KD
. Of those, 14 patients (77.7%) had a history of
CAA
(7 with giant
CAA
and 7 with regressed
CAA
at time of
OCT
). Intracoronary nitroglycerin was given to all patients (88.4±45.5 μg/m
2
). Mean radiation dose was 10.9±5.2
mG
y/kg. One patient suffered from a transitory uneventful vasospasm at the site of a regressed
CAA
; otherwise no major procedural complications occurred. The most frequent abnormality observed on
OCT
was intimal hyperplasia (15 patients, 83.3%) seen at both aneurysmal sites and angiographically normal segments amounting to 390.8±166.0 μm for affected segments compared to 61.7±17 μm for unaffected segments (
P
<0.001). Disappearance of the media, and presence of fibrosis, calcifications, macrophage accumulation, neovascularization, and white thrombi were seen in 72.2%, 77.8%, 27.8%, 44.4%, and 33.3% of patients.

Conclusions

In this study,
OCT
proved safe and insightful in the setting of
KD
, with the potential to add diagnostic value in the assessment of coronary abnormalities in
KD
. The depicted coronary structural changes correspond to histological findings previously described in
KD
.
The Earth Science Women’s Network (ESWN): Community-Driven Mentoring for Women in the Atmospheric Sciences
Authors: Adams Amanda S. , Steiner Allison L. , Wiedinmyer Christine 
Published: May 2015

Abstract
Women are a growing percentage of undergraduate and graduate students in the atmospheric sciences, yet they remain a minority in senior positions. One approach for the retention of women is increased mentoring, which is linked to successful promotions, higher incomes, and greater career satisfaction. Informal peer networking is a form of mentoring that may be effective for underrepresented groups. The Earth Science Women’s Network (ESWN) was established in 2002 with the mission to promote career development, build community, provide informal mentoring and support, and facilitate professional collaborations for early career women in the Earth sciences. Over time, ESWN has developed a mentoring philosophy that has reduced some barriers and challenges that women face in traditional mentoring relationships. The five main principles of the ESWN’s mentoring philosophy have evolved to include community-driven mentoring, diverse mentoring approaches for diverse individuals, mentoring across career phases, combined personal and professional mentoring, and effective mentoring in a safe space. Surveys of ESWN members report gains in areas that are often considered barriers to career advancement, including recognition that they are not alone, new understanding of obstacles faced by women in science, and access to professional resources. These gains have been accomplished through online and in-person ESWN activities guided by the ESWN’s mentoring philosophy. Understanding the success of the ESWN, as well as its limitations, has the potential to inform the larger atmospheric science community of additional strategies to improve mentoring and retention of women in the atmospheric sciences.
Impact of the North Atlantic Oscillation on Southern Europe Water Distribution: Insights from Geodetic Data
Authors: Valty Pierre , de Viron Olivier , Panet Isabelle , Collilieux Xavier 
Published: May 2015

Abstract
From space gravity and station position data over southern Europe from 2002 to 2010, this study investigates the interannual mass redistributions using principal component analysis. The dominant mode, which appears both in gravity and positioning, results from the North Atlantic Oscillation (NAO). This analysis allows us to isolate and characterize the NAO impact on the mass distribution, which appears centered over the Black Sea and its two main catchment basins, the Danube and Dnieper.
Connectivity between Historical Great Basin Precipitation and Pacific Ocean Variability: A CMIP5 Model Evaluation
Authors: Smith Kimberly , Strong Courtenay , Wang Shih-Yu 
Published: May 2015

Abstract
The eastern Great Basin (GB) in the western United States is strongly affected by droughts that influence water management decisions. Precipitation that falls in the GB, particularly in the Great Salt Lake (GSL) basin encompassed by the GB, provides water for millions of people living along the Wasatch Front Range. Western U.S. precipitation is known to be influenced by El Niño–Southern Oscillation (ENSO) as well as the Pacific decadal oscillation (PDO) in the North Pacific. Historical connectivity between GB precipitation and Pacific Ocean sea surface temperatures (SSTs) on interannual to multidecadal time scales is evaluated for 20 models that participated in phase 5 of the Coupled Model Intercomparison Project (CMIP5). While the majority of the models had realistic ENSO and PDO spatial patterns in the SSTs, the simulated influence of these two modes on GB precipitation tended to be too strong for ENSO and too weak for PDO. Few models captured the connectivity at a quasi-decadal period influenced by the transition phase of the Pacific quasi-decadal oscillation (QDO; a recently identified climate mode that influences GB precipitation). Some of the discrepancies appear to stem from models not capturing the observed tendency for the PDO to modulate the sign of the ENSO–GB precipitation teleconnection. Of all of the models, CCSM4 most consistently captured observed connections between Pacific SST variability and GB precipitation on the examined time scales.