bluuebunny/crossref_metadata_2025_split huggingface dataset:
History of labour market attachment as a determinant of health status: a 12-year follow-up of the Northern Swedish Cohort
Authors: Waenerlund Anna-Karin , Gustafsson Per E , Hammarström Anne , Virtanen Pekka 
Published: February 2014

ObjectiveThe present study aims at using trajectory analysis to measure labour market attachment (LMA) over 12 years and at examining whether labour market tracks relate to perceived health status.DesignData were retrieved from a 26-year prospective cohort study, the Northern Swedish Cohort.Setting and participantsAll ninth grade students (n=1083) within the municipality of Luleå in northern Sweden were included in the baseline investigation in 1981. The vast majority (94%) of the original cohort participated at the fourth follow-up. In this study, 969 participants were included.MeasuresPerceived health status (psychological distress and non-optimal self-rated health) at age 42 and the data obtained from questionnaires.ResultsWe have identified four tracks in relation to LMA across the 12-year period: ‘permanent’, ‘high level’, ‘strengthening’ and ‘poor level’ of attachment. LMA history relates to psychological distress. High level (OR 1.55 (95% CI 1.06 to 2.27)), strengthening (OR 1.95 (95% CI 1.29 to 2.93)) and poor attachment (OR 3.14 (95% CI 2.10 to 4.70) involve higher OR for psychological distress compared with permanent attachment. The overall p value remained significant in the final model (p=0.001). Analyses regarding non-optimal self-rated health displayed a similar pattern but this was not significant in the final model.ConclusionsOur results suggest that health status in mid-life, particularly psychological distress, is related to patterns of LMA history, to a large part independently of other social risk factors and previous health. Consideration of heterogeneity and time in LMA might be important when analysing associations with perceived health.
“It can't be very important because it comes and goes”—patients' accounts of intermittent symptoms preceding a pancreatic cancer diagnosis: a qualitative study
Authors: Evans Julie , Chapple Alison , Salisbury Helen , Corrie Pippa , Ziebland Sue 
Published: February 2014

ObjectiveThis article explores how people with pancreatic cancer interpreted prediagnostic signs and symptoms, and what triggered them to seek medical help for symptoms that occurred intermittently.DesignThematic analysis of prediagnostic symptom descriptions drawn from a qualitative interview study of people with experiences of pancreatic cancer.Participants40 people affected by pancreatic cancer (32 patients and 8 relatives of people who had died). Age at interview ranged from 35 to 84 years; 55% were men; and 57.5% of patients had been offered potentially curative surgery.SettingRespondents interviewed at home were recruited from different parts of the UK during 2009/2010.ResultsAnalysis of the interviews suggested thatintermittentsymptoms were not uncommon in the months, or even years, before diagnosis but that the fact that the symptom did not persist was often taken by the patient as a reassuring indicator that it could not be ‘very important’. Such symptoms were rarely acted upon until a pattern became apparent, the frequency of symptom episodes increased, there was a change in the nature of the intermittent symptoms or additional symptom(s) appeared. These findings build on social science theories of consultation behaviour.ConclusionsOur study—the largest reported collection of qualitative interviews with people with pancreatic cancer—reports for the first time that symptoms of an intermittent nature may precede a pancreatic cancer diagnosis. Patients (and potentially their doctors as well) may be falsely reassured by symptoms that come and go. Pancreatic cancer might be identified at a stage where curative treatment is more likely if there were greater awareness that intermittent gastrointestinal symptoms can have a serious cause, and if patients with intermittent pancreatitis-like symptoms were investigated more readily.
Factors associated with domestic violence: a cross-sectional survey among women in Jeddah, Saudi Arabia
Authors: Fageeh Wafa M K 
Published: February 2014

ObjectiveThis study aims to identify the factors associated with domestic violence (DV) among women in Jeddah.DesignCross-sectional survey.SettingOutpatient departments of three tertiary hospitals in Jeddah.ParticipantsConvenience sample of women, aged 15–70 years, at the outpatient and inpatient clinics.InterventionsBetween 15 December 2011 and 30 May 2012, a psychologist and a professional health assistant explained the purpose of the research to participants, who were then asked to fill a 50-item questionnaire. The questionnaire was created based on questions from three questionnaires: the NorVold Domestic Abuse Questionnaire, the Pregnancy Risk Assessment Monitoring System and the Kansas Marital Satisfaction Scale. The questionnaire was used to assess the association between DV and family status, male partner attitudes, age, educational attainment, employment, financial and socioeconomic status.ResultsA total of 2301 women participated in the survey (81% response rate). The mean±SD age of the participants was 34.4±10.9 years. The lifetime prevalence of DV was 34%. Abused women had more children than non-abused women (p=0.001), and their spouses were significantly older than those of non-abused women (p<0.0001). Financially dependent women and those with a high educational status were significantly more likely to report abuse (p=0.003 and p<0.001, respectively). Abused women were also likely to report that their spouse was a smoker (p<0.0001) and had completed at least primary or secondary education (p<0.0001). A significantly lower proportion of abused women reported that their male partners were alcohol users (p=0.001). The results of logistic regression showed that women who were financially dependent had about 1.5-fold odds of being physically abused by a spouse.ConclusionsMany factors are associated with DV against women, thereby highlighting the need to design effective DV prevention programmes.
Waterpipe dependence in university students and effect of normative beliefs: a cross-sectional study
Authors: Salameh P , Salamé J , Waked M , Barbour B , Zeidan N , Baldi I 
Published: February 2014

ObjectivesThe objective of this study was to measure the correlates, including normative beliefs, associated with waterpipe (WP) and cigarette smoking prevalence and dependence.SettingA cross-sectional study was carried out using a proportionate cluster sample of Lebanese students in 17 public and private universities.ParticipantsOf the 4900 distributed questionnaires, 3384 (69.1%) were returned to the field worker. All available students during break times were approached, with no exclusion criteria.Primary and secondary outcome measuressociodemographic variables, detailed active and passive smoking, in addition to items of the tobacco dependence scales were all evaluated.ResultsCorrelates to WP smoking were studying in a private university (adjusted OR, aOR=1.50 (1.26 to 1.79); p<0.001) and ever smoking cigarettes (aOR=1.80(1.44 to 2.26); p<0.001); friends’ and societal influence were found on smoking behaviour and dependence. Although the role of parents was not visible in decreasing the risk of smoking WP, their protective influence seemed more important on WP dependence (β=−1.09(−1.79 to −0.28); p<0.001), a behaviour that is considered more deleterious for health. Parents’ and friends’ disagreement with smoking had a protective effect on cigarette smoking and dependence (aOR<1; p<0.01), while thinking that idols and successful people smoke increased the risk of both cigarette smoking and dependence (aOR>1; p<0.01).ConclusionsIn conclusion, WP smoking and dependence are influenced by parents’ and friends’ opinions, and idols’ smoking status. Future research is necessary to further improve our understanding of motives for WP smoking and dependence.
The use of supplementary immunisation activities to improve uptake of current and future vaccines in low-income and middle-income countries: a systematic review protocol
Authors: Kagina Benjamin M , Wiysonge Charles S , Machingaidze Shingai , Abdullahi Leila H , Adebayo Esther , Uthman Olalekan A , Hussey Gregory D 
Published: February 2014

IntroductionImmunisation coverage data in low-income and middle-income countries (LMICs) suggest that more strategies need to be implemented to achieve and sustain optimal vaccine uptake. Among possible strategies to improve immunisation coverage are supplementary immunisation activities (SIAs). We are therefore interested in conducting a systematic review to assess whether SIAs complement routine immunisation programmes to improve vaccination coverage and prevent disease outbreaks.MethodsOur systematic review will focus on studies conducted in LMICs. With the help of an information specialist, we will search for eligible studies in PubMed, Web of Science, Scopus, Africa-Wide, Cochrane Library, WHOLIS, CINAHL, PDQ-Evidence as well as reference lists of relevant publications. Additionally, we will contact relevant organisations such as WHO and GAVI. Two authors will independently extract data from eligible studies and independently assess risk of bias by assessing the adequacy of study characteristics. The primary meta-analysis will use random effects models due to expected interstudies heterogeneity. Dichotomous data will be analysed using relative risk and continuous data using weighted mean differences (or standardised mean differences), both with 95% CIs.DiscussionThe findings from this systematic review will be discussed in the context of strengthening routine childhood immunisation services, routine adolescent immunisation services and introduction of future vaccines against tuberculosis and HIV/AIDS.Study strengthsUnbiased selection of many studies conducted in different settings. This will strengthen the validity of the review results.Study limitationsHeterogeneity of the study settings of the low-income, lower-middle-income and upper-middle-income countries as well as heterogeneity in study designs.
Inequalities in the care experiences of patients with cancer: analysis of data from the National Cancer Patient Experience Survey 2011–2012
Authors: Bone Anna , Mc Grath-Lone Louise , Day Sophie , Ward Helen 
Published: February 2014

ObjectivesTo explore inequalities in the care experiences of care by patients clinical or trust-level factors for patients with cancer.DesignSecondary analysis of data from the National Cancer Patient Experience Survey 2011–2012.Setting and participantsAdult patients with a primary diagnosis of cancer who attended an acute or specialist National Health Service (NHS) trust in England.Outcome measureOR of a patient rating their overall care positively, adjusting for other patient, clinical and trust-level factors.MethodsUsing cross-sectional data from 71 793 patients with cancer who completed the National Cancer Patient Experience Survey 2011–2012, we examined associations between patient, clinical and trust-level factors and a summary measure of patient experience, namely overall rating of care. Multivariate logistic regression was used to investigate variation by sociodemographic characteristics adjusting for other patient, clinical and trust-level factors.ResultsFemale, non-white and younger patients were less likely to rate their overall care as excellent or very good. Patients with long-standing conditions, particularly those with learning disabilities or mental health conditions, also reported poorer overall care. This variation persisted when other patient, clinical and trust-level factors were controlled for, indicating that there are real differences in experiences among patients with cancer by sociodemographic characteristics.ConclusionsThere is evidence of inequalities in the experiences of patients with cancer in the UK by sociodemographic characteristics such as gender, age, ethnicity and disability. Quality cancer care services must strive to meet the needs of a diverse patient population equally; this study identifies patient groups for whom it appears cancer care services are in greatest need of improvement.
Epidemiology of injuries in elite taekwondo athletes: two Olympic periods cross-sectional retrospective study
Authors: Altarriba-Bartes Albert , Drobnic Franchek , Til Lluís , Malliaropoulos Nikolaos , Montoro José Bruno , Irurtia Alfredo 
Published: February 2014

ObjectiveTaekwondo injuries differ according to the characteristics of the athletes and the competition. This analytical cross-sectional retrospective cohort study aimed to describe reported taekwondo injuries and to determine the prevalence, characteristics and possible risk factors for injuries sustained by athletes of the Spanish national team. In addition, we compared each identified risk factor—age, weight category, annual quarter, injury timing and competition difficulty level—with its relation to injury location and type.SettingsInjury occurrences in taekwondo athletes of the Spanish national team during two Olympic periods at the High Performance Centre in Barcelona were analysed.Participants48 taekwondo athletes (22 male, 26 female; age range 15–31 years) were studied; 1678 injury episodes occurred. Inclusion criteria were: (1) having trained with the national taekwondo group for a minimum of one sports season; (2) being a member of the Spanish national team.ResultsIndependently of sex or Olympic period, the anatomical sites with most injury episodes were knee (21.3%), foot (17.0%), ankle (12.2%), thigh (11.4%) and lower leg (8.8%). Contusions (29.3%) and cartilage (17.6%) and joint (15.7%) injuries were the prevalent types of injury. Chronological age, weight category and annual quarter can be considered risk factors for sustaining injuries in male and female elite taekwondists according to their location and type (p≤0.001).ConclusionsThis study provides epidemiological information that will help to inform future injury surveillance studies and the development of prevention strategies and recommendations to reduce the number of injuries in taekwondo competition.
Major bleeding after percutaneous coronary intervention and risk of subsequent mortality: a systematic review and meta-analysis
Authors: Kwok Chun Shing , Rao Sunil V , Myint Phyo K , Keavney Bernard , Nolan James , Ludman Peter F , Belder Mark A de , Loke Yoon K , Mamas Mamas A 
Published: February 2014

ObjectivesTo examine the relationship between periprocedural bleeding complications and major adverse cardiovascular events (MACEs) and mortality outcomes following percutaneous coronary intervention (PCI) and study differences in the prognostic impact of different bleeding definitions.MethodsWe conducted a systematic review and meta-analysis of PCI studies that evaluated periprocedural bleeding complications and their impact on MACEs and mortality outcomes. A systematic search of MEDLINE and EMBASE was conducted to identify relevant studies. Data from relevant studies were extracted and random effects meta-analysis was used to estimate the risk of adverse outcomes with periprocedural bleeding. Statistical heterogeneity was assessed by considering the I2statistic.Results42 relevant studies were identified including 533 333 patients. Meta-analysis demonstrated that periprocedural major bleeding complications was independently associated with increased risk of mortality (OR 3.31 (2.86 to 3.82), I2=80%) and MACEs (OR 3.89 (3.26 to 4.64), I2=42%). A differential impact of major bleeding as defined by different bleeding definitions on mortality outcomes was observed, in which the REPLACE-2 (OR 6.69, 95% CI 2.26 to 19.81), STEEPLE (OR 6.59, 95% CI 3.89 to 11.16) and BARC (OR 5.40, 95% CI 1.74 to 16.74) had the worst prognostic impacts while HORIZONS-AMI (OR 1.51, 95% CI 1.11 to 2.05) had the least impact on mortality outcomes.ConclusionsMajor bleeding after PCI is independently associated with a threefold increase in mortality and MACEs outcomes. Different contemporary bleeding definitions have differential impacts on mortality outcomes, with 1.5–6.7-fold increases in mortality observed depending on the definition of major bleeding used.
T Lymphocytes Restrain Spontaneous Metastases in Permanent Dormancy
Authors: Romero Irene , Garrido Cristina , Algarra Ignacio , Collado Antonia , Garrido Federico , Garcia-Lora Angel M. 
Published: February 2014

AbstractTumor dormancy is a clinical phenomenon related to immune equilibrium during cancer immunoediting. The mechanisms involved in dormant metastases are poorly understood due to the lack of preclinical models. Here, we present a nontransgenic mouse model in which spontaneous metastases remain in permanent immunomediated dormancy with no additional antitumor treatment. After the injection of a GR9-B11 mouse fibrosarcoma clone into syngeneic BALB/c mice, all animals remained free of spontaneous metastases at the experimental endpoints (3–8 months) but also as long as 24 months after tumor cell injection. Strikingly, when tumor-bearing mice were immunodepleted of T lymphocytes or asialo GM1-positive cells, the restraint on dormant disseminated metastatic cells was relieved and lung metastases progressed. Immunostimulation was documented at both local and systemic levels, with results supporting the evidence that the immune system was able to restrain spontaneous metastases in permanent dormancy. Notably, the GR9-B11 tumor clone did not express MHC class I molecules on the cell surface, yet all metastases in immunodepleted mice were MHC class I–positive. This model system may be valuable for more in-depth analyses of metastatic dormancy, offering new opportunities for immunotherapeutic management of metastatic disease. Cancer Res; 74(7); 1958–68. ©2014 AACR.
A Small-Molecule c-Rel Inhibitor Reduces Alloactivation of T Cells without Compromising Antitumor Activity
Authors: Shono Yusuke , Tuckett Andrea Z. , Ouk Samedy , Liou Hsiou-Chi , Altan-Bonnet Grégoire , Tsai Jennifer J. , Oyler Jennifer E. , Smith Odette M. , West Mallory L. , Singer Natalie V. , Doubrovina Ekaterina , Pankov Dmitry , Undhad Chandresh V. , Murphy George F. , Lezcano Cecilia , Liu Chen , O'Reilly Richard J. , van den Brink Marcel R.M. , Zakrzewski Johannes L. 
Published: February 2014

AbstractPreventing unfavorable GVHD without inducing broad suppression of the immune system presents a major challenge of allogeneic hematopoietic stem cell transplantation (allo-HSCT). We developed a novel strategy to ameliorate GVHD while preserving graft-versus-tumor (GVT) activity by small molecule–based inhibition of the NF-κB family member c-Rel. Underlying mechanisms included reduced alloactivation, defective gut homing, and impaired negative feedback on interleukin (IL)-2 production, resulting in optimal IL-2 levels, which, in the absence of competition by effector T cells, translated into expansion of regulatory T cells. c-Rel activity was dispensable for antigen-specific T-cell receptor (TCR) activation, allowing c-Rel–deficient T cells to display normal GVT activity. In addition, inhibition of c-Rel activity reduced alloactivation without compromising antigen-specific cytotoxicity of human T cells. Finally, we were able to demonstrate the feasibility and efficacy of systemic c-Rel inhibitor administration. Our findings validate c-Rel as a promising target for immunomodulatory therapy and demonstrate the feasibility and efficacy of pharmaceutical inhibition of c-Rel activity.Significance: Chemical inhibition of c-Rel diminishes alloactivation while preserving antigen-specific TCR activation, revealing the redundancy of c-Rel in T cell–mediated antitumor activity of both mouse and human T cells. Our study provides a highly innovative immunomodulatory approach that has true potential for drug development and clinical application with broad therapeutic implications, including allo-tolerance induction after allo-HSCT, as well as antitumor therapies. Cancer Discov; 4(5); 578–91. ©2014 AACR.This article is highlighted in the In This Issue feature, p. 495
T-Cell–Mediated Inflammatory Activity in the Stellate Ganglia of Patients With Ion-Channel Disease and Severe Ventricular Arrhythmias
Authors: Rizzo Stefania , Basso Cristina , Troost Dirk , Aronica Eleonora , Frigo Anna Chiara , Driessen Antoine H.G. , Thiene Gaetano , Wilde Arthur A.M. , van der Wal Allard C. 
Published: February 2014

Background—
Long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT) are electric diseases characterized by catecholamine-induced ventricular arrhythmias. Unbalanced autonomic innervation of the heart may trigger arrhythmic events and stellectomy is a treatment option for patients who are resistant to pharmacological drugs. We analyzed left stellectomy specimens of LQTS and CPVT patients for signs of inflammatory activity.

Methods and Results—

Stellate ganglia were retrieved from 12 consecutive patients (8F; 4 mol/L; mean age, 23.4±17 years) with either LQTS (n=8) or CPVT (n=4) and serious arrhythmias. Control stellate ganglia were obtained from 10 accidently deceased patients (6F; 4 mol/L; mean age, 35±17.6 years). Sections were immunostained with antibodies against T cells (CD3, CD4, CD8, CD20, Granzyme B), CD68 (macrophages), and HLA-DR (human leukocyte antigen-DR) antigens (activation marker). Immunopositive cells were quantified as cells/mm
2
. Polymerase chain reaction (PCR) and reverse transcription PCR were performed to screen for herpes virus DNA. Stellate ganglia of all 12 LQTS/CPVT patients revealed mild but distinct inflammatory infiltrates composed of T lymphocytes and macrophages, which were diffusely spread, but also clustered in small foci opposed to ganglion cells, interpreted as T-cell–mediated ganglionitis. Morphometric analysis showed that CD3+ and CD8+ T cells/mm
2
were significantly higher in the ganglia of LQTS/CPVT cases than in healthy controls (
P
=0.0018 and
P
=0.0009, respectively). Molecular analyses were negative for neurotropic viruses.

Conclusions—
T-cell–mediated cytotoxicity toward ganglion cells may boost adrenergic activity as to trigger or enhance electric instability in LQTS/CPVT patients who are already genetically predisposed to arrhythmias.