bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structure, organisation and clinical outcomes in cancer patients of hospital support teams in Spain
Authors: Tuca-Rodriguez Albert , Gómez-Batiste Xavier , Espinosa-Rojas Jose , Martínez-Muñoz Marisa , Codorniu Nuria , Porta-Sales Josep 
Published: October 2012

ObjectivesTo describe the structure, characteristics of patients and basic clinical outcomes in cancer patients receiving care from palliative care hospital support teams (HSTs) in Spain.MethodA multi-centre observational two phase study. Phase I: A descriptive survey of all HSTs in Spain. Phase II: A quasi-experimental prospective cohort study to describe the clinical outcomes, symptom severity and survival.Results60 HSTs in Spain met the inclusion criteria. All HSTs were multidisciplinary with wide experience (mean 6.8 years). HSTs coverage was 21.5% of all cancer deaths in Spain. A total number of 364 advanced cancer patients were included in the cohort study; 76% were classified as moderate or high complexity. Overall, 64% were male subjects and the most frequent primary cancer site was lung (26%). Half of the patients had no detailed information about cancer staging and only 19% knew their short-term prognosis. The mean length of intervention was 6.5 days (mean three visits per patient). Outcomes were: 34% deaths during the admission process; 38% were discharged home; and 28% were transferred to another medium-term-stay specialist unit. The main symptoms were pain (68%), dyspnoea (43%), vomiting (24%), anorexia (72%), asthenia (78%), insomnia (50%), anxiety (45%) and depression (35%). After the HSTs intervention, the symptom severity was significantly reduced (p<0.001) for all symptoms, except for weakness and anorexia. The mean survival from inclusion was 111 days.ConclusionsPalliative intervention of HSTs is characterised by being adjusted to patient needs and short duration. Their care was focused on the preterminal phase of cancer patients of moderate–high complexity.
The impact of adult major trauma centre status on paediatric trauma activity
Authors: Hannon Edward , Potter Stuart , Jaiganesh Thiagarajan , Muhktar Zahid , Okoye Bruce 
Published: October 2012

ObjectivesThe London Trauma Network was launched in April 2010 in order to centralise trauma care in the capital city. The consultation and resourcing of the four new major trauma centres (MTC) was adult focused. The objective of this study was to assess the impact that adult MTC status has on paediatric trauma workload.MethodsA retrospective review of paediatric major trauma calls was performed between 1 April 2009 to 31 January 2010, before MTC status, and the same time period in 2010/11 when St George's Healthcare Trust was a designated adult MTC. The following variables were assessed; number of trauma calls, admissions to hospital, radiological services usage, inpatient stay, mechanism of injury and injury severity score (ISS)—calculated from abbreviated injury score.ResultsThere was a 200% increase in trauma calls between the two time periods and a 191% increase in admission to hospital. The usage of radiology increased 221% for CT and 161% for plain radiology. Mean inpatient stay decreased by 0.2 days. Mechanisms of injury were similar. Despite becoming a MTC the relative volume of major injuries (ISS>15) decreased between the two time periods by 1% with a relative increase in minor trauma (ISS<5) from 63% to 72%. These results may suggest at present paediatric trauma patients are being over triaged.ConclusionsMajor adult trauma centre status has a significant effect on paediatric trauma workload and hence resources. When reconfiguration of trauma services are being considered it is essential to take into account the impact on paediatric services alongside those of the adult population.
Factors associated with vitamin D deficiency in a multicultural inflammatory bowel disease cohort
Authors: Chatu Sukhdev , Chhaya Vivek , Holmes Rosamund , Neild Penny , Kang Jin-Yong , Pollok Richard C , Poullis Andrew 
Published: October 2012

ObjectiveThe aim of this study was to determine the prevalence of vitamin D deficiency in a multicultural inflammatory bowel disease (IBD) cohort and determine predictors of deficiency including ethnicity.DesignPatients with IBD were recruited into a dedicated database over a 6-month period and evaluated retrospectively.SettingDepartment of Gastroenterology, St George's University Hospital, London, UK.Outcomes measuredClinical data including demographics, ethnic group, disease phenotype by the Montreal classification, vitamin D level and season tested were recorded from clinical and electronic medical records. Vitamin D levels were classified as normal (≥50 nmol/l) and deficient (<50 nmol/l).Results168 patients had a vitamin D level measured subsequent to diagnosis. There was no significant difference in the median vitamin D level between patients with Crohn's disease (CD) and ulcerative colitis (UC) (39 nmol/l (IQR 23–56) vs 28 nmol/l (IQR 17–51), p=0.35). Overall the median vitamin D level was significantly lower in non-Caucasians (Asian and Black) versus Caucasians (28 nmol/l (IQR 17–41) vs 41 nmol/l (IQR 25–63), p<0.0001). Multiple regression analysis revealed IBD related surgery (OR 2.9) and ethnicity (OR 6.0 non-Caucasian vs Caucasian) in CD and ethnicity (OR 5.0 non-Caucasian vs Caucasian) in UC were independently associated with vitamin D deficiency.ConclusionsVitamin D deficiency is common in IBD patients; therefore, we suggest monitoring of vitamin D levels and correction with supplements especially in non-Caucasians and those with a history of IBD related surgery.
Prostate needle biopsy processing: a survey of laboratory practice across Europe
Authors: Varma Murali , Berney Daniel M , Algaba Ferran , Camparo Philippe , Compérat Eva , Griffiths David F R , Kristiansen Glen , Lopez-Beltran Antonio , Montironi Rodolfo , Egevad Lars 
Published: October 2012

AimTo determine the degree of variation in the handling of prostate needle biopsies (PBNx) in laboratories across Europe.MethodsA web based survey was emailed to members of the European Network of Uropathology and the British Association of Urological Pathologists.ResultsResponses were received from 241 laboratories in 15 countries. PNBx were generally taken by urologists (93.8%) or radiologists (23.7%) but in 8.7% were also taken by non-medical personnel such as radiographers, nurses or biomedical assistants. Of the responding laboratories, 40.8% received cores in separate containers, 42.3% processed one core/block, 54.2% examined three levels/block, 49.4% examined one H&E section/level and 56.1% retained spare sections for potential immunohistochemistry. Of the laboratories, 40.9% retained unstained spares for over a year while 36.2% discarded spares within 1 month of reporting. Only two (0.8%) respondents routinely performed immunohistochemistry on all PNBx. There were differences in laboratory practice between the UK and the rest of Europe (RE). Procurement of PNBx by non-medical personnel was more common in the UK. RE laboratories more commonly received each core in a separate container, processed one core/block, examined fewer levels/block and examined more H&E sections/level. RE laboratories also retained spares for potential immunohistochemistry less often and for shorter periods. Use of p63 as the sole basal cell marker was more common in RE.ConclusionsThere are marked differences in procurement, handling and processing of PNBx in laboratories across Europe. This data can help the development of best practice guidelines.
Peroxiredoxins and their expression in ependymomas
Authors: Haapasalo Toomas , Nordfors Kristiina , Järvelä Sally , Kok Eloise , Sallinen Pauli , Kinnula Vuokko L , Haapasalo Hannu Kalervo , Soini Ylermi 
Published: October 2012

AimsPeroxiredoxins I–VI (Prxs) have recently been shown to have a role in the tumorigenesis of astrocytic brain tumours. In some tumour types they are associated with Nrf2 (transcription factor NF-E2-related factor), a sensor of oxidative stress, and DJ-1 (also known as PARK7), a protein known to stabilise Nrf2.MethodsWe investigated the immunohistochemical expression of Prxs I–VI, Nrf2 and DJ-1 in a total of 76 ependymomas and their relationship with clinicopathological features of these tumours.ResultsThere was a significant expression of all Prxs except Prx IV in the ependymomas. Strong nuclear and cytoplasmic expression of Nrf2 could be detected in these tumours. Prx I expression was significantly associated with cytoplasmic and nuclear Nrf2 expression. Prx I expression was also associated with tumour site, with cerebellar ependymomas having a lower expression of Prx I than other tumours. DJ-1 did not associate with Prxs but nuclear DJ-1 had an inverse association with nuclear Nrf2. Cytoplasmic DJ-1 associated with worse survival in ependymoma patients.ConclusionsThis study indicates that oxidative mechanisms as reflected by Nrf2 expression are highly activated in ependymomas. Prxs, especially Prx I, were associated with Nrf2 expression, suggesting a role for Nrf2 in Prx I synthesis in ependymomas. While DJ-1 did not associate with any of the Prxs, its expression was associated with worsened patient survival and could have a role as a prognostic marker in ependymomas.
Improved alignment of reticulocyte counts between Sysmex XT-2000i instruments
Authors: Ashenden Michael , Sharpe Ken , Habel James , Vicentin Anthony , Schischka Steven 
Published: October 2012

BackgroundReticulocytes are the most sensitive index available to authorities who seek to sanction athletes for blood doping based on deviations beyond individual reference ranges. Because such data comprise longitudinal results that are generated by different laboratories, the comparability of reticulocyte counts from different instruments is of crucial importance.AimsTo enhance between-instrument comparability of reticulocyte counts reported by the Sysmex XT-2000i automated haematology analyser.MethodsWe optimised recalibration of instruments towards assigned values of control material (e-CHECK) in tandem with fresh blood verification.ResultsIn terms of reticulocyte counts reported as a percentage of all cells in a fresh blood sample, it was possible to recalibrate all three test instruments so that the mean of 10 samples was within 0.1% of the comparative instrument's mean value.ConclusionsThis approach provides a straightforward means of reducing between-instrument differences in reticulocyte counts generated by the Sysmex XT-2000i.
Cancer stem cells markers CD44, CD24 and ALDH1 in breast cancer special histological types
Authors: Beça Francisco Ferro de , Caetano Pedro , Gerhard Renê , Alvarenga Cesar Augusto , Gomes Madalena , Paredes Joana , Schmitt Fernando 
Published: October 2012

AimsCD44, CD24 and ALDH1 are the most consistently used biomarkers to identify and characterise the breast cancer stem cell (CSC) phenotype. However, most studies performed until now analysed samples of invasive ductal carcinomas of no special type (IDC-NST). Therefore, prevalence and clinical significance of these CSC markers in breast carcinomas of special histological types (SHT) is largely unknown. For that reason, this study aims to determine the distribution of the breast CD44, CD24 and ALDH1 CSC markers among a series of invasive breast carcinomas of SHT, in comparison with a series of IDC-NST.Methods117 invasive SHT breast carcinomas were analysed for the expression of CD44, CD24 and ALDH1, by immuhohistochemistry. The distribution of these CSC markers was evaluated among the distinct histological special types, and the results were compared with a series of 466 IDC-NST.ResultsThe expression prevalence of the breast CSC markers differed between special types and IDC-NST. Medullary, papillary and tubular carcinomas were enriched in the CSC phenotype CD44+/CD24−/low(80.0%, 100.0% and 100.0%, respectively, vs 45.3% in IDC-NST). Considering the ALDH1 cytoplasmic tumour expression, only medullary and metaplastic carcinomas displayed significant increase in CD44+/CD24-/low/ALDH1+CSC phenotype frequency (36.4% and 28.6%, respectively, vs 4.8% in IDC-NST).ConclusionsThe expression distribution of breast CSC markers is largely dependent on histological type. Interestingly, within the distinct SHT, medullary and metaplastic carcinomas are the two types highly associated with high-grade carcinomas, basal-like and claudin-low molecular subtypes, and to the CSC phenotype CD44+/CD24−/low/ALDH1+.
Prevalence of metabolic syndrome and its selected determinants among urban adult women in South Delhi, India
Authors: Sinha Smita , Misra Puneet , Kant Shashi , Krishnan Anand , Nongkynrih Baridalyne , Vikram Naval K 
Published: October 2012

Abstract

Aims
Metabolic syndrome is a clustering of cardiovascular risk factors. Asian Indians, particularly women, have been reported to be at higher risk of developing metabolic syndrome. We aimed to estimate the prevalence of metabolic syndrome and its selected known determinants among adult Asian Indian women of lower socioeconomic status.

Methods
We conducted a cross-sectional study over a period of 1 year from January 2008 to December 2008 in South Delhi, which included 300 women (&gt;20 years) recruited through multistage systematic random sampling. Blood pressure and anthropometric measurements were taken. Biochemical tests were performed on blood samples collected after overnight fasting. Metabolic syndrome was defined using updated National Cholesterol Education Program/Adult Treatment Panel-III (NCEP/ATP-III) guidelines with modified waist circumference for Indians and International Diabetes Federation (IDF) criteria.

Results
The overall prevalence of metabolic syndrome was 29.6% (95% CI 23.8 to 36.0) and 20.4% (95% CI 15.3 to 26.1) using NCEP/ATP-III and IDF criteria, respectively. The risk of metabolic syndrome increased with age and calorie intake. Most (203 (90%)) of the study participants were involved in physical activity with a low metabolic equivalent (MET) score but one-fifth (19.5%) had a calorie intake recommended for women involved in vigorous activity.

Conclusions
The high prevalence of metabolic syndrome among women of lower socioeconomic status is a cause of concern, and calls for an effective public health response.
New insights into an old disease: advanced imaging in the diagnosis and management of gout
Authors: McQueen Fiona Marion , Reeves Quentin , Dalbeth Nicola 
Published: October 2012

AbstractAdvanced imaging modalities including MRI, ultrasound (US), CT and dual energy CT have important applications in gout. While conventional radiography (X-ray) remains the most widely used form of imaging in the clinical setting and is helpful in revealing erosions in chronic gout, these new imaging tools can reveal joint damage and tophi at a much earlier stage. As all are multiplanar techniques, they can define the position and dimensions of tophi, with startling clarity, as well as the size and extent of bone erosions. US and MRI also reveal the severity of inflammation within and adjacent to the joint and can capture information about the composite, vascular nature of many tophaceous deposits. These features can be used as imaging outcome measures, to monitor responses to anti-inflammatory and urate lowering therapies. The new possibility that gout could be diagnosed using imaging, without aspirating the joint, is on the horizon. This review discusses the clinical and research applications of advanced imaging in gout with particular focus on diagnosis and monitoring of joint inflammation and damage.
Knowledge, skills and attitudes of doctors towards assessing cognition in older patients in the emergency department
Authors: Kennelly Sean P , Morley Deirdre , Coughlan Tara , Collins Ronan , Rochford Martin , O'Neill Desmond 
Published: October 2012

Abstract

Purpose of the study
Although cognitive impairment and delirium are highly prevalent in older patients who present to the emergency department, multiple studies have highlighted inadequate detection by doctors. This study investigated potential reasons underlying this.

Study Design
A 14-item self-administered questionnaire was distributed to all medical, surgical and emergency department physicians involved in the care of older patients in the emergency department of an urban university teaching hospital between January and March 2012.

Results
The questionnaire was completed by 76/97 (78%) of eligible respondents. Respondents reported screening an average of one in four older patients that they reviewed. Almost one-third (22/76, 29%) felt they lacked the relevant expertise to perform cognitive screening: those with training in geriatrics were less likely to cite lack of expertise as a factor. While the majority felt screening for cognition in the emergency department-setting was important (59/76, 78%), several limiting factors were identified: lack of a screening tool; lack of privacy; too much noise; and time constraints. There was no consensus on who should perform screening.

Conclusions
Doctors reviewing patients in the emergency department-setting reported several important factors limiting their ability to screen older patients for cognitive impairment. Respondents to this questionnaire did not feel the emergency department environment was conducive towards the assessment of cognition in older patients. Clarification of each discipline's responsibility in the detection, assessment and management of delirium and/or dementia, and the implementation of emergency department cognitive screening instruments more suited to this setting would likely improve detection and management.
Specificity of a coproantigen ELISA test for fasciolosis: lack of cross‐reactivity with Paramphistomum cervi and Taenia hydatigena
Authors: Kajugu P‐E. , Hanna R. E. B. , Edgar H. W. , Forster F. I. , Malone F. E. , Brennan G. P. , Fairweather I. 
Published: October 2012

A commercial coproantigen ELISA test for fasciolosis, based on the use of MM3 monoclonal antibody for antigen capture, was investigated for possible cross‐reactivity with Paramphistomum cervi, a trematode that commonly infects cattle and sheep grazing in fluke‐infested pasture in Ireland. Histological sections of adult and immature Fasciola hepatica and P cervi were incubated with MM3 monoclonal antibody, and its binding to tissue‐localised coproantigen was subsequently visualised by immunocytochemistry. In a related study, the soluble antigenic fractions derived from homogenates of P cervi adults and Taenia hydatigena metacestodes were tested for cross‐reactivity with MM3 monoclonal antibody in an antigen‐capture ELISA, using known F hepatica ‐positive and F hepatica ‐negative ovine faecal samples as natural controls. It was found that, while intense immunocytochemical labelling was located over the gastrodermis and gut contents of adult and immature F hepatica, sections of adult and immature P cervi were unlabelled. In the ELISA tests, the soluble fractions of F hepatica reacted strongly with MM3 monoclonal antibody, but those of P cervi and T hydatigena gave negative results. These findings support the specificity of the coproantigen ELISA test for fasciolosis in areas where paramphistomosis and cysticercosis are liable to occur singly or as coinfections with F hepatica.
BONE ADAPTATION AND REGENERATION – NEW DEVELOPMENTS
Authors: KLEIN-NULEND JENNEKE , BACABAC ROMMEL GAUD 
Published: October 2012

Bone is a dynamic tissue that is constantly renewed and adapts to its local loading environment. Mechanical loading results in adaptive changes in bone size and shape that strengthen bone structure. The mechanisms for adaptation involve a multistep process called mechanotransduction, which is the ability of resident bone cells to perceive and translate mechanical energy into a cascade of structural and biochemical changes within the cells. The transduction of a mechanical signal to a biochemical response involves pathways within the cell membrane and cytoskeleton of the osteocytes, the professional mechansensor cells of bone. During the last decade the role of mechanosensitive osteocytes in bone metabolism and turnover, and the lacuno-canalicular porosity as the structure that mediates mechanosensing, is likely to reveal a new paradigm for understanding the bone formation response to mechanical loading, and the bone resorption response to disuse. Strain-derived fluid flow of interstitial fluid through the lacuno-canalicular porosity seems to mechanically activate the osteocytes, as well as ensures transport of cell signaling molecules, nutrients and waste products. Cell-cell signaling from the osteocyte sensor cells to the effector cells (osteoblasts or osteoclasts), and the effector cell response – either bone formation or resorption, allow an explanation of local bone gain and loss as well as remodeling in response to fatigue damage as processes supervised by mechanosensitive osteocytes. The osteogenic activity of cultured bone cells has been quantitatively correlated with varying stress stimulations highlighting the importance of the rate of loading. Theoretically a possible mechanism for the stress response by osteocytes is due to strain amplification at the pericellular matrix. Single cell studies on molecular responses of osteocytes provide insight on local architectural alignment in bone during remodeling. Alignment seems to occur as a result of the osteocytes sensing different canalicular flow patterns around cutting cone and reversal zone during loading, thus determining the bone's structure. Disturbances in architecture and permeability of the 3D porous network will affect transduction of mechanical loads to the mechanosensors. Uncovering the cellular and mechanical basis of the osteocyte's response to loading represents a significant challenge to our understanding of cellular mechanotransduction and bone remodeling. In view of the importance of mechanical stress for maintaining bone strength, mechanical stimuli have great potential for providing a therapeutic approach for bone (re)generation.
The Fascadale Fault: A tectonic link between the Cenozoic volcanic centres of Rum and Ardnamurchan, Scotland, revealed by multibeam survey
Authors: Smith Kevin 
Published: November 2012

Synopsis
Current geological maps of the Ardnamurchan Central Complex show the Fascadale Fault as a short (1.2 km) NW-trending tectonic junction between a sliver of the superstructure of the former Cenozoic volcano and the western margin of its outermost quartz-gabbroic intrusion. To the south, the mapped fault appears to die out in an area of coalescing basic igneous intrusions, whereas to the north, it is buried by alluvium before passing offshore into Fascadale Bay. Detailed bathymetric data obtained from a marine multibeam echo-sounder survey north of the Ardnamurchan peninsula reveal that the onshore fault is in structural continuity with a similarly-trending linear bathymetric feature, which extends almost to the island of Rum. Sea-bed geological structures offset by this major lineament suggest that the segment of the Fascadale Fault mapped onshore marks the southern end of a Cenozoic dextral strike-slip fault (>22 km long), which extends between Ardnamurchan and Rum. Based on these observations, a tectonic model is outlined that suggests that the sites of volcanic centres in the British part of the North Atlantic Igneous Province are controlled by the interaction of NW-trending structures, like the Fascadale Fault, with NNE-trending (Caledonoid) structures in a Cenozoic strike-slip regime.