bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can first aid training encourage individuals’ propensity to act in an emergency situation? A pilot study
Authors: Oliver Emily , Cooper Jane , McKinney David 
Published: June 2013

ObjectiveTo explore the effect that different activities included in first aid training can have on an individual's propensity to act in a medical emergency.DesignAdditional pilot-developed activities were added to a core first aid training session to create six unique groups, including a control group where no activities were added. Participants rated their agreement to pre-identified fears following the course and scored their self-efficacy and willingness to act before, immediately after and 2 months after the course. Change values were compared between groups.SettingThree locations in the UK (community halls, schools).Participants554 members of the public were recruited using advertising and community groups. A deliberately broad demographic was sought and achieved using targeted approaches where a particular demographic was deficient.InterventionEach participant attended one British Red Cross first aid course lasting 2 h.Main outcome measuresThe same questionnaire was completed by all participants before and after each course. Two months later all participants were asked a series of follow-up questions.ResultsAll courses showed an increase in self-efficacy and willingness to act immediately following the course. The course, which included both factual information relevant to helping in an emergency and ‘helper’ identity activities, produced significantly more positive responses to pre-identified fears.ConclusionsActivities which allow the learner to explore and discuss behaviour in an emergency situation can effectively increase the learner's propensity to act. First aid education should be expanded to support the learner to develop both the skill and the will to help.
A population based study on the night-time effect in trauma care
Authors: Di Bartolomeo Stefano , Marino Massimiliano , Ventura Chiara , Trombetti Susanna , De Palma Rossana 
Published: June 2013

BackgroundThe so-called off hour effect—that is, increased mortality for patients admitted outside normal working hours—has never been demonstrated in trauma care. However, most of the studies excluded transferred cases. Because these patients are a special challenge for trauma systems, we hypothesised that their processes of care could be more sensitive to the off hour effect.MethodsThe study design was retrospective, cohort and population based. We compared the mortality of all patients by daytime and night-time admittance to hospitals in an Italian region, with 4.5 million inhabitants, following a major injury in 2011. Logistic regression was used, adjusted for demographics and severity of injury (TMPM-ICD9), and stratified by transfer status.Results1940 major trauma cases were included; 105 were acutely transferred. Night-time admission had a significant pejorative effect on mortality in the adjusted analysis (OR=1.49; 95% CI 1.05 to 2.11). This effect was most evident in transferred cases (OR=3.71; 95% CI 1.11 to 12.43).ConclusionsThe night-time effect in trauma care was demonstrated for the first time and was maximal in transferred cases. This may explain why it was not found in previous studies where these patients were mostly excluded. Also, the use of population based data—whereby patients not accessing trauma centre care and presumably receiving poorer care were included—may have contributed to the findings.
Biomechanical analysis of spinal immobilisation during prehospital extrication: a proof of concept study
Authors: Dixon Mark , O'Halloran Joseph , Cummins Niamh M 
Published: June 2013

BackgroundIn most countries, road traffic collisions (RTCs) are the main cause of cervical spine injuries. There are several techniques in use for spinal immobilisation during prehospital extrication; however, the evidence for these is currently poor.ObjectiveThe objective of this study is to establish which technique provides the minimal deviation of the cervical spine from the neutral inline position during the extrication of the RTC patient using biomechanical analysis techniques.MethodsA crew of two paramedics and four fire-fighter first responders extricated a simulated patient from a prepared motor vehicle using nine different extrication techniques. The patient was marked with biomechanical sensors and relative movement between the sensors was captured via high speed infrared motion analysis cameras. A 3D mathematical model was developed from the recorded movement.ResultsControl measurements were taken from the patient during self-extrication and movement was recorded of 4.194° left of midline (LOM) to 2.408° right of midline (ROM) resulting in a total movement of 6.602°. The least deviation recorded during equipment aided extrication was movement of 3.365° LOM and 8.352° ROM resulting in a total movement of 11.717°. The most deviation recorded during equipment aided extrication was movement of 1.588° LOM and 24.498° ROM resulting in a total movement of 26.086°.ConclusionsConventional extrication techniques record up to four times more cervical spine movement during extrication than controlled self-extrication. This proof of concept study demonstrates the need for further evaluation of current rescue techniques and the requirement to investigate the clinical and operational significance of such movement.
Salt or sugar for your injured brain? A meta-analysis of randomised controlled trials of mannitol versus hypertonic sodium solutions to manage raised intracranial pressure in traumatic brain injury
Authors: Rickard A C , Smith J E , Newell P , Bailey A , Kehoe A , Mann C 
Published: June 2013

BackgroundRising intracranial pressure (ICP) is a poor prognostic indicator in traumatic brain injury (TBI). Both mannitol and hypertonic sodium solutions are used to treat raised ICP in patients with TBI.ObjectiveThis meta-analysis compares the use of mannitol versus hypertonic sodium solutions for ICP control in patients with TBI.Data sources and study eligibilityRandomised clinical trials in adults with TBI and evidence of raised ICP, which compare the effect on ICP of hypertonic sodium solutions and mannitol.MethodsThe primary outcome measure is the pooled mean reduction in ICP. Studies were combined using a Forest plot.ResultsSix studies were included, comprising 171 patients (599 episodes of raised ICP). The weighted mean difference in ICP reduction, using hypertonic sodium solutions compared with mannitol, was 1.39 mm Hg (95% CI −0.74 to 3.53).LimitationsMethodological differences between studies limit the conclusions of this meta-analysis.ConclusionsThe evidence shows that both agents effectively lower ICP. There is a trend favouring the use of hypertonic sodium solutions in patients with TBI.
Inflammatory bowel disease in the UK: is quality of care improving?
Authors: Alrubaiy Laith , Arnott Ian , Protheroe Aimee , Roughton Michael , Driscoll Richard , Williams John G 
Published: June 2013

ObjectiveA national audit conducted in 2005/6 showed unacceptable quality of care for inpatients with inflammatory bowel disease (IBD) in the UK. This was re-audited in 2007/8 and 2010/11. The aim of this study is to examine the quality of care provided for inpatients with IBD in the UK.DesignA programme of engagement and re-audit in 128 hospitals in the UK providing care for adult patients with IBD admitted to hospital between 1 June 2005 and 31 May 2006, 1 September 2007 and 31 August 2008 and 1 September 2010 and 31August 2011.InterventionsWide dissemination of the results, selected site visits, development of national service standards, and the development of an online document repository.Main outcome measuresMortality, medical and surgical treatment, specialist nursing and dietetic care were audited.ResultsData from 1953, 2016 and 1948 patients with ulcerative colitis (UC) and 2074, 2109 and 1900 patients with Crohn's disease (CD) were audited in 2005/6, 2007/8 and 2010/11, respectively. The mortality rate fell from 1.7% to 0.8% (p=0.034) in UC and from 1.3% to 0.8% (p=0.226) in CD. The proportion of inpatients reviewed by an IBD specialist nurse has risen from 23.7% to 44.9% in UC and from 18.1% to 39.9% (p<0.001) in CD. Anti-tumour necrosis factor therapy has increased in UC and CD (p<0.001) while ciclosporin prescription has slightly fallen in UC. Laparoscopic surgeries have significantly increased in UC and CD (p<0.001).ConclusionsThe results show clear evidence of improvement in most aspects of the quality of care for IBD inpatients.
Osteoid osteoma and osteoblastoma: novel histological and immunohistochemical observations as evidence for a single entity
Authors: Barlow E , Davies A M , Cool W P , Barlow D , Mangham D C 
Published: June 2013

AimsOsteoid osteoma and osteoblastoma have, in the past, been variously regarded as both similar and distinct entities. Currently, WHO classifies these tumours separately. We compared archetypal cases to identify novel histomorphological and immunohistochemical features attempting to clarify their mutual relationship.Methods and results10 osteoid osteomas and 20 osteoblastomas (10 spinal and 10 non-spinal) were retrieved and reviewed clinically, radiologically and histologically. Immunohistochemistry was performed for: desmin, SMA, neurofilament, S100, vimentin, PGP9.5, GFAP, EMA, caldesmon, CD34, broad-spectrum cytokeratins, claudin-1. We identified features, common to both osteoid osteoma and osteoblastoma, namely, areas of lesional non-osteoblastic stroma and the presence of scattered, large cells with smudged/degenerate nuclei. Immunohistochemically, we confirmed the innervated status of osteoid osteomas, and found that osteoblastomas were similarly innervated. The non-osteoblastic lesional stroma was distinctive owing to expression of EMA and NSE by the mesenchymal spindle cells and expression of desmin, PGP9.5 and S100 by the scattered, large cells with ‘smudged’ nuclei.ConclusionsBoth osteoid osteoma and osteoblastoma are innervated bone-forming lesions which share novel histomorphological and immunohistochemical features supporting the view that separate classification is unjustified, and we offer a pathogenetic explanation for their apparent clinical and radiological variance.
The effect of childhood socioeconomic position on alcohol-related disorders later in life: a Swedish national cohort study
Authors: Gauffin Karl , Hemmingsson Tomas , Hjern Anders 
Published: June 2013

BackgroundAlcohol use is the third most important global-health risk factor and a main contributor to health inequalities. Previous research on social determinants of alcohol-related disorders has delivered inconsistent results. We aimed to investigate whether socioeconomic position (SEP) in childhood predicts alcohol-related disorders in young adulthood in a Swedish national cohort.MethodsWe studied a register-based national cohort of Swedish citizens born during 1973–1984 (N=948 518) and followed them up to 2009 from age 15. Childhood SEP was defined by a six-category socioeconomic index from the Censuses of 1985 and 1990. HRs of alcohol-related disorders, as indicated by register entries on alcohol-related death and alcohol-related medical care, were analysed in Cox regression models with adjustment for sociodemographic variables and indicators of parental morbidity and criminality.ResultsLow childhood SEP was associated with alcohol-related disorders later in life among both men and women in a stepwise manner. Growing up in a household with the lowest SEP was associated with risk for alcohol-related disorders of HR: 2.24 (95% CI 2.08 to 2.42) after adjustment for sociodemographic variables, compared with the highest SEP group. Adjusting the analysis for parental psychosocial problems attenuated the association to HR 1.87 (95% CI 1.73 to 2.01).ConclusionsThe study demonstrates that low SEP in childhood predicts alcohol-related disorders in young adulthood. Alcohol abuse needs to be addressed in policies to bridge the gap of health inequalities.
Cenozoic landscape and ice drainage evolution in the Lambert Glacier–Amery Ice Shelf system
Authors: White Duanne A. 
Published: July 2013

Abstract

Landforms and sediments in the Prince Charles Mountains record the timing and magnitude of Cenozoic palaeotopographic changes in the Lambert Glacier–Amery Ice Shelf system. A review of geomorphic and sedimentological evidence indicates that considerable (>1–2 km) glacial incision into a pre-glacial palaeosurface occurred along the major outlet glaciers during the Cenozoic. This erosion was in turn the likely driver for uplift that averaged
c.
50 m/Ma along the flank of the Amery Ice Shelf since at least the mid-Miocene Epoch. The volume of eroded material is an order of magnitude greater than the quantity of sediment presently preserved in Prydz Bay, suggesting considerable export of Cenozoic sediment off the continental shelf. The magnitude of erosion recorded in the Prince Charles Mountains is sufficient to have focussed Cenozoic ice-drainage patterns, but was too slow to have driven Quaternary changes in ice volume.
Candidate Tumor Suppressor and pVHL Partner Jade-1 Binds and Inhibits AKT in Renal Cell Carcinoma
Authors: Zeng Liling , Bai Ming , Mittal Amit K. , El-Jouni Wassim , Zhou Jing , Cohen David M. , Zhou Mina I. , Cohen Herbert T. 
Published: July 2013

Abstract
The von Hippel–Lindau (VHL) tumor suppressor pVHL is lost in the majority of clear-cell renal cell carcinomas (RCC). Activation of the PI3K/AKT/mTOR pathway is also common in RCC, with PTEN loss occurring in approximately 30% of the cases, but other mechanisms responsible for activating AKT at a wider level in this setting are undefined. Plant homeodomain protein Jade-1 (PHF17) is a candidate renal tumor suppressor stabilized by pVHL. Here, using kinase arrays, we identified phospho-AKT1 as an important target of Jade-1. Overexpressing or silencing Jade-1 in RCC cells increased or decreased levels of endogenous phospho-AKT/AKT1. Furthermore, reintroducing pVHL into RCC cells increased endogenous Jade-1 and suppressed endogenous levels of phospho-AKT, which colocalized with and bound to Jade-1. The N-terminus of Jade-1 bound both the catalytic domain and the C-terminal regulatory tail of AKT, suggesting a mechanism through which Jade-1 inhibited AKT kinase activity. Intriguingly, RCC precursor cells where Jade-1 was silenced exhibited an increased capacity for AKT-dependent anchorage-independent growth, in support of a tumor suppressor function for Jade-1 in RCC. In support of this concept, an in silico expression analysis suggested that reduced Jade-1 expression is a poor prognostic factor in clear-cell RCC that is associated with activation of an AKT1 target gene signature. Taken together, our results identify 2 mechanisms for Jade-1 fine control of AKT/AKT1 in RCC, through loss of pVHL, which decreases Jade-1 protein, or through attenuation in Jade-1 expression. These findings help explain the pathologic cooperativity in clear-cell RCC between PTEN inactivation and pVHL loss, which leads to decreased Jade-1 levels that superactivate AKT. In addition, they prompt further investigation of Jade-1 as a candidate biomarker and tumor suppressor in clear-cell RCC. Cancer Res; 73(17); 5371–80. ©2013 AACR.
Acquired Expression of NFATc1 Downregulates E-Cadherin and Promotes Cancer Cell Invasion
Authors: Oikawa Tsukasa , Nakamura Atsuko , Onishi Nobuyuki , Yamada Taketo , Matsuo Koichi , Saya Hideyuki 
Published: June 2013

Abstract
NFATc1 is a transcription factor that regulates T-cell development, osteoclastogenesis, and macrophage function. Given that T cells, osteoclasts, and macrophages in the tumor microenvironment are thought to modulate tumor progression, tumor cells may acquire NFATc1 expression through fusion with these NFATc1-expressing normal cells. We here revealed that a small proportion of tumor cells in human carcinoma specimens expressed NFATc1. To investigate the consequences of NFATc1 acquisition by tumor cells, we established A549 and MCF7 cell lines expressing a constitutively active form of NFATc1 (NFATc1CA) in an inducible manner. The expression of NFATc1CA promoted cancer cell invasion in association with changes in cell morphology. Analysis of gene expression and RNA interference experiments revealed that NFATc1CA suppressed E-cadherin expression by upregulating the transcriptional repressors Snail and Zeb1 in a manner independent of TGF-β signaling. Induced expression of NFATc1CA also downregulated E-cadherin expression and increased invasive activity in tumor xenografts in vivo. Our results thus suggest that the acquisition of NFATc1 expression contributes to tumor progression. Cancer Res; 73(16); 5100–9. ©2013 AACR.
Pleiotropy between Genetic Markers of Obesity and Risk of Prostate Cancer
Authors: Edwards Todd L. , Giri Ayush , Motley Saundra , Duong Wynne , Fowke Jay H. 
Published: June 2013

AbstractBackground: To address inconsistent findings of obesity and prostate cancer risk, we analyzed the association between prostate cancer and genetic markers of obesity and metabolism.Methods: Analyses included 176,520 single-nucleotide polymorphisms (SNP) associated with 23 metabolic traits. We examined the association between SNPs and prostate cancer in 871 cases and 906 controls, including 427 high-grade cases with Gleason ≥ 7. Genetic risk scores (GRS) for body mass index (BMI) and waist-to-hip ratio (WHR) were also created by summing alleles associated with increasing BMI or WHR.Results: Prostate cancer was associated with five loci, including cyclin M2, with P values less than 1 × 10−4. In addition, the WHR GRS was associated with high-grade prostate cancer versus controls [OR, 1.05; 95% confidence interval (CI), 1.00–1.11; P = 0.048] and high-grade prostate cancer versus low-grade prostate cancer (OR, 1.07; 95% CI, 1.01–1.13; P = 0.03). None of these findings exceeds the threshold for significance after correction for multiple testing.Conclusions: Variants in genes known to be associated with metabolism and obesity may be associated with prostate cancer. We show evidence for pleiotropy between WHR GRS and prostate cancer grade. This finding is consistent with the function of several WHR genes and previously described relationships with cancer traits.Impact: Limitations in standard obesity measures suggest alternative characterizations of obesity may be needed to understand the role of metabolic dysregulation in prostate cancer. The underlying genetics of WHR or other Metabochip SNPs, while not statistically significant beyond multiple testing thresholds within our sample size, support the metabolic hypothesis of prostate carcinogenesis and warrant further investigation in independent samples. Cancer Epidemiol Biomarkers Prev; 22(9); 1538–46. ©2013 AACR.
PTGS2 (Cyclooxygenase-2) Expression and Survival among Colorectal Cancer Patients: A Systematic Review
Authors: Kunzmann Andrew T. , Murray Liam J. , Cardwell Chris R. , McShane Charlene M. , McMenamin Úna C. , Cantwell Marie M. 
Published: June 2013

Abstract
Background: Studies have examined whether tumor expression of PTGS2 (also known as COX-2), an enzyme inhibited by nonsteroidal anti-inflammatory drugs such as aspirin, is associated with prognosis in patients with colorectal cancer. However, results to date have been mixed.
Methods: Using terms for PTGS2 and colorectal cancer, the Medline, Embase, and Web of Science databases were systematically searched for studies published, in any language, until December 2011. Random effects meta-analyses were used to calculate pooled HRs [95% confidence intervals (CI)] for the association between PTGS2 expression and tumor recurrence, colorectal cancer–specific survival, and overall survival.
Results: In total, 29 studies, which had prognostic data on 5,648 patients, met the inclusion criteria. PTGS2-positive patients were at an increased risk of tumor recurrence (n = 9 studies; HR, 2.79; 95% CI, 1.76–4.41; P &lt; 0.001) and had poorer colorectal cancer–specific survival (n = 7; HR, 1.36; 95% CI, 1.02–1.82; P = 0.04). However, there was funnel plot asymmetry, possibly due to publication bias, for the association with cancer-specific survival but less so for recurrence. PTGS2 expression was not associated with overall survival [(n = 16; pooled unadjusted HR, 1.30; 95% CI, 0.94–1.79; P = 0.11) and (n = 9; pooled adjusted HR, 1.02; 95% CI, 0.72–1.45; P = 0.91)].
Conclusions: PTGS2 expression was associated with an increased risk of tumor recurrence and poorer colorectal cancer–specific survival but not overall survival among patients with colorectal cancer. However, confounding by tumor characteristics such as tumor stage seems likely.
Impact: There is insufficient evidence to recommend PTGS2 expression as a prognostic marker in patients with colorectal cancer. Furthermore, studies providing adjusted results are required. Cancer Epidemiol Biomarkers Prev; 22(9); 1490–7. ©2013 AACR.
Ki67 Measured after Neoadjuvant Chemotherapy for Primary Breast Cancer
Authors: von Minckwitz Gunter , Schmitt Wolfgang D. , Loibl Sibylle , Müller Berit M. , Blohmer Jens U. , Sinn Bruno V. , Eidtmann Holger , Eiermann Wolfgang , Gerber Bernd , Tesch Hans , Hilfrich Jörn , Huober Jens , Fehm Tanja , Barinoff Jana , Rüdiger Thomas , Erbstoesser Erhard , Fasching Peter A. , Karn Thomas , Müller Volkmar , Jackisch Christian , Denkert Carsten 
Published: June 2013

AbstractPurpose: The value of Ki67 measured on residual disease after neoadjuvant chemotherapy is not sufficiently described.Experimental Design: Participants of the GeparTrio study with primary breast cancer randomly received neoadjuvant response-guided [8 cycles TAC (docetaxel/doxorubicin/cyclophosphamide) in responding and TAC-NX (vinorelbine/capecitabine) in nonresponding patients] or conventional (6 cycles TAC) chemotherapy according to interim response assessment. Ki-67 levels were centrally measured immunohistochemically after neoadjuvant treatment if tumor tissue was available. Here, we analyze 1,151 patients having a pathologic complete response (pCR; n, 484), or residual disease with low (0–15%), intermediate (15.1–35%), or high (35.1–100%) posttreatment Ki67 levels in 488, 77, and 102 patients, respectively.Results: Patients with high posttreatment Ki67 levels showed higher risk for disease relapse (P &lt; 0.0001) and death (P &lt; 0.0001) compared with patients with low or intermediate Ki67 levels. Patients with low Ki67 levels showed a comparable outcome to patients with a pCR (P = 0.211 for disease-free and P = 0.779 for overall survival). Posttreatment Ki67 levels provided more prognostic information than pretreatment Ki67 levels or changes of Ki67 from pre- to posttreatment. Information on pCR plus posttreatment Ki67 levels surmount the prognostic information of pCR alone in hormone–receptor-positive disease [hazard ratios (HR), 1.82–5.88] but not in hormone–receptor-negative disease (HR: 0.61–1.73). Patients with conventional and response-guided treatment did not show a different distribution of posttreatment Ki67 (P = 0.965).Conclusions: Posttreatment Ki67 levels provide prognostic information for patients with hormone–receptor-positive breast cancer and residual disease after neoadjuvant chemotherapy. Levels were not prognostic for outcome after response-guided chemotherapy. High posttreatment Ki67 indicates the need for innovative postneoadjuvant treatments. Clin Cancer Res; 19(16); 4521–31. ©2013 AACR.