bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of volume and other hospital characteristics on mortality within 30 days of acute myocardial infarction in South Korea
Authors: Han Kyu-Tae , Kim Sun Jung , Kim Woorim , Jang Sung-In , Yoo Ki-Bong , Lee Seo Yoon , Park Eun-Cheol 
Published: November 2015

ObjectiveThe mortality for acute myocardial infarction (AMI) has declined worldwide. However, improvements in care for AMI in South Korea have lagged slightly behind those in other countries. Therefore, it is important to investigate how factors such as hospital volume, structural characteristics of hospital and hospital staffing level affect 30-day mortality due to AMI in South Korea.SettingWe used health insurance claim data from 114 hospitals to analyse 30-day mortality for AMI.ParticipantsThese data consisted of 19 638 hospitalisations during 2010–2013.InterventionsNo interventions were made.Outcome measureMultilevel models were analysed to examine the association between the 30-day mortality and inpatient and hospital level variables.ResultsIn the 30 days after hospitalisation, 10.5% of patients with AMI died. Hospitalisation cases at hospitals with a higher AMI volume had generally inverse associations with 30-day mortality (1st quartile=ref; 2nd quartile=OR 0.811, 95% CI 0.658 to 0.998, 3rd quartile=OR 0.648, 95% CI 0.500 to 0.840, 4th quartile=OR 0.807, 95% CI 0.573 to 1.138). In addition, hospitals with a greater proportion of specialists were associated with better outcomes (above median=OR 0.789, 95% CI 0.663 to 0.940).ConclusionsHealth policymakers need to include volume and staffing when defining the framework for treatment of AMI in South Korean hospitals. Otherwise, they must consider increasing the proportion of specialists or regulating the hiring of emergency medicine specialists. In conclusion, they must make an effort to reduce 30-day mortality following AMI based on such considerations.
Do marginal investments made by NHS healthcare commissioners in the UK produce the outcomes they hope to achieve? Observational study
Authors: O'Cathain Alicia , Sampson Fiona , Strong Mark , Pickin Mark , Goyder Elizabeth , Dixon Simon 
Published: November 2015

ObjectiveTo investigate the effect of targeted marginal annual investments by local healthcare commissioners on the outcomes they expected to achieve with these investments.DesignControlled before and after study.Setting:152 commissioning organisations (primary care trusts) in England.MethodsNational surveys of commissioning managers in 2009 and 2010 to identify: the largest marginal investments made in four key conditions/services (diabetes, coronary heart disease, chronic pulmonary airways disease and emergency and urgent care) in 2008/2009 and 2009/2010; the outcomes commissioners expected to achieve with these investments; and the processes commissioners used to develop these investments. Collation of routinely available data on outcomes commissioners expected from these investments over the period 2007/2008 to 2010/2011.Results51% (77/152) of commissioners agreed to participate in the survey in 2009 and 60% (91/152) in 2010. Around half reported targeted marginal investments in each condition/service each year. Routine data on many of the outcomes they expected to achieve through these investments were not available. Also, commissioners expected some outcomes to be achieved beyond the time scale of our study. Therefore, only a limited number of outcomes of investments were tested. Outcomes included directly standardised emergency admission rates for the four conditions/services, and the percentage of patients with diabetes with glycated haemoglobin <7. There was no evidence that targeted marginal investments reduced emergency admission rates. There was evidence of an improvement in blood glucose management for diabetes for commissioners investing to improve diabetes care but this was compromised by a change in how the outcome was measured in different years. This investment was unlikely to be cost-effective.ConclusionsCommissioners made marginal investments in specific health conditions and services with the aim of improving a wide range of outcomes. There was little evidence of impact on the limited number of outcomes measured.
Protocol for a process-oriented qualitative evaluation of the Waltham Forest and East London Collaborative (WELC) integrated care pioneer programme using the Researcher-in-Residence model
Authors: Eyre Laura , George Bethan , Marshall Martin 
Published: November 2015

IntroductionThe integration of health and social care in England is widely accepted as the answer to fragmentation, financial concerns and system inefficiencies, in the context of growing and ageing populations with increasingly complex needs. Despite an expanding body of literature, there is little evidence yet to suggest that integrated care can achieve the benefits that its advocates claim for it. Researchers have often adopted rationalist and technocratic approaches to evaluation, treating integration as an intervention rather than a process. Results have usually been of limited use to practitioners responsible for health and social care integration. There is, therefore, a need to broaden the evidence base, exploring not onlywhatworks but alsohowintegrated care can most successfully be implemented and delivered. For this reason, we are carrying out a formative evaluation of the Waltham Forest and East London Collaborative (WELC) integrated care pioneer programme. Our expectation is that this will add value to the literature by focusing on the processes by which the vision and objectives of integrated care are translated through phases of development, implementation and delivery from a central to a local perspective, and from a strategic to an operational perspective.Methods and analysisThe qualitative and process-oriented evaluation uses an innovative participative approach—the Researcher-in-Residence model. The evaluation is underpinned by a critical ontology, an interpretive epistemology and a critical discourse analysis methodology. Data will be generated using interviews, observations and documentary gathering.Ethics and disseminationEmerging findings will be interpreted and disseminated collaboratively with stakeholders, to enable the research to influence and optimise the effective implementation of integrated care across WELC. Presentations and publications will ensure that learning is shared as widely as possible. The study has received ethical approval from University College London's Research Ethics Committee and has all appropriate NHS governance clearances.
Improving the likelihood of neurology patients being examined using patient feedback
Authors: Appleton Jason Philip , Ilinca Andreea , Lindgren Arne , Puschmann Andreas , Hbahbih Majed , A. Siddiqui Khurram , de Silva Rajith , Jones Matthew , Butterworth Richard , willmot mark , Hayton Tom , Lunn Michael , Nicholl David 
Published: November 2015

AbstractWe aimed to establish whether recall of elements of the neurological examination can be improved by use of a simple patient assessment score.In a previous study we demonstrated that in-patients referred to neurology at two United Kingdom (UK) hospitals were not fully examined prior to referral; we therefore designed a larger quality improvement report with 80% power to detect a 10% increase in tendon hammer or ophthalmoscope use following an educational intervention.In-patients referred to neurology over a four month period (in hospitals in the UK (10), Jordan (1), Sweden (2), and the United Arab Emirates (1)) were asked whether they recalled being examined with a tendon hammer (T), ophthalmoscope (O), and stethoscope (S) since admission. The results were disseminated to local medical teams using various techniques (including Grand Round presentations, email, posters, discounted equipment). Data were then collected for a further four month period post-intervention.Pre-intervention and post-intervention data were available for 11 centres with 407 & 391 patients in each arm respectively. Median age of patients was 51 (range 13-100) and 49 (range 16-95) years respectively, with 44.72% and 44.76% being male in each group. 264 patients (64.86%) recalled being examined with a tendon hammer in the pre-intervention arm, which significantly improved to 298 (76.21%) (p<0.001). Only 119 patients (29.24%) recollected examination with an ophthalmoscope pre-intervention, which significantly improved to 149 (38.11%)(p=0.009). The majority of patients (321 (78.87%)) pre-intervention recalled examination with a stethoscope, which significantly improved to 330 (84.4%) to a lesser extent (p=0.045).Results indicate that most patients are not fully examined prior to neurology referral yet a simple assessment score and educational intervention can improve recall of elements of the neurological examination and thus the likelihood of patients being examined neurologically. This is the largest and - to our knowledge - only study to assess this issue. This has implications for national neurological educators.
Three-month validation of a turbuhaler electronic monitoring device: implications for asthma clinical trial use
Authors: Pilcher Janine , Shirtcliffe Philippa , Patel Mitesh , McKinstry Steve , Cripps Terrianne , Weatherall Mark , Beasley Richard 
Published: November 2015

BackgroundElectronic monitoring of inhaled asthma therapy is suggested as the ‘gold standard’ for measuring patterns of medication use in clinical trials. The SmartTurbo (Adherium (NZ) Ltd, Auckland, New Zealand) is an electronic monitor for use with a turbuhaler device (AstraZeneca, UK). The aim of this study was to determine the accuracy of the SmartTurbo in recording Symbicort actuations over a 12-week period of use.MethodsTwenty SmartTurbo monitors were attached to the base of 20 Symbicort turbuhalers. Bench testing in a research facility was undertaken on days 0, 5, 6, 7, 8, 9, 14, 21, 28, 56 and 84. Patterns of ‘low-use’ (2 sets of 2 actuations on the same day) and ‘high-use’ (2 sets of 8 actuations on the same day) were performed. The date and time of actuations were recorded in a paper diary and compared with data uploaded from the SmartTurbo monitors.Results2800 actuations were performed. Monitor sensitivity was 99.9% with a lower 97.5% confidence bound of 99.6%. The positive predictive value was 99.9% with a 97.5% lower confidence bound of 99.7%. Accuracy was not affected by whether the pattern of inhaler use was low or high, or whether there was a delay in uploading the actuation data.ConclusionsThe SmartTurbo monitor is highly accurate in recording and retaining electronic data in this 12-week bench study. It can be recommended for use in clinical trial settings, in which quality control systems are incorporated into study protocols to ensure accurate data acquisition.
Rule of 5: angiographic diameters of cervicocerebral arteries in children and compatibility with adult neurointerventional devices
Authors: He Lucy , Ladner Travis R , Pruthi Sumit , Day Matthew A , Desai Aditi A , Jordan Lori C , Froehler Michael T 
Published: November 2015

Background and purposeThe safety of using adult-sized neuroendovascular devices in the smaller pediatric vasculature is not known. In this study we measure vessel diameters in the cervical and cranial circulation in children to characterize when adult-approved devices might be compatible in children.MethodsFor 54 children without vasculopathy (mean age 9.5±4.9 years (range 0.02–17.8), 20F/34M) undergoing catheter angiography, the diameters of the large vessels in the cervical and cranial circulation (10 locations, 611 total measurements) were assessed by three radiologists. Mean±SD diameter was calculated for the following age groups: 0–6 months, 1, 2, 3, 4, 5–9, 10–14, and 15–18 years. To compare with adult sizes, each vessel measurement was normalized to the respective region mean diameter in the oldest age group (15–18 years). Normalized measurements were compared with age and fitted to a segmented regression.ResultsVessel diameters increased rapidly from 0 to 5 years of age (slope=0.069/year) but changed minimally beyond that (slope=0.005/year) (R2=0.2). The regression model calculated that, at 5 years of age, vessels would be 94% of the diameter of the oldest age group (compared with 59% at birth). In addition, most vessels in children under 5, while smaller, were still potentially large enough to be compatible with many adult devices.ConclusionsThe growth curve of the cervicocerebral vasculature displays rapid growth until age 5, at which point most children's vessels are nearly adult size. By age 5, most neuroendovascular devices are size-compatible, including thrombectomy devices for stroke. Under 5 years of age, some devices might still be compatible.
Testing a geographical information system for damage and evacuation assessment during an effusive volcanic crisis
Authors: Latutrie B. , Andredakis I. , De Groeve T. , Harris A. J. L. , Langlois E. , van Wyk de Vries B. , Saubin E. , Bilotta G. , Cappello A. , Crisci G. M. , D'ambrosio D. , Del Negro C. , Favalli M. , Fujita E. , Iovine G. , Kelfoun K. , Rongo R. , Spataro W. , Tarquini S. , Coppola D. , Ganci G. , Marchese F. , Pergola N. , Tramutoli V. 
Published: November 2015

Abstract
Using two hypothetical effusive events in the Chaîne des Puys (Auvergne, France), we tested two geographical information systems (GISs) set up to allow loss assessment during an effusive crisis. The first was a local system that drew on all immediately available data for population, land use, communications, utility and building type. The second was an experimental add-on to the Global Disaster Alert and Coordination System (GDACS) global warning system maintained by the Joint Research Centre (JRC) that draws information from open-access global data. After defining lava-flow model source terms (vent location, effusion rate, lava chemistry, temperature, crystallinity and vesicularity), we ran all available lava-flow emplacement models to produce a projection for the likelihood of impact for all pixels within the GIS. Next, inundation maps and damage reports for impacted zones were produced, with those produced by both the local system and by GDACS being in good agreement. The exercise identified several shortcomings of the systems, but also indicated that the generation of a GDACS-type global response system for effusive crises that uses rapid-response model projections for lava inundation driven by real-time satellite hotspot detection – and open-access datasets – is within the current capabilities of the community.
Cosmogenic
36
Cl geochronology of late Quaternary glaciers in the Bolkar Mountains, south central Turkey
Authors: Çiner Attila , Sarıkaya Mehmet Akif 
Published: November 2015

Abstract

We present the first quantitative late Quaternary cosmogenic
36
Cl glacial geochronology from the Bolkar Mountains of south central Turkey. Thirty samples were collected from three glaciated valleys. The geomorphological investigations indicate that the palaeoglaciers deposited their moraines between 3200 and 2200 m above sea level on the north- and south-facing valleys. We recognize four glacial periods, with the oldest one dating back to about 46.0±7.0 ka in the northern Karagöl Valley. Later, glaciers reached their maximum positions (∼5.5 km from cirque to snout) by 18.9±3.3 ka (during the local Last Glacial Maximum; LGM) in the Karagöl Valley. Late-glacial moraines were dated to between 15.2±1.6 and 12.6±2.3 ka in both northern Alagöl and southern Elmalı Valleys, respectively. The final deglaciation in the mountain commenced in the early Holocene (9.0±0.9 ka in the Karagöl Valley; 8.5±1.8 ka in the Elmalı Valley). A contemporaneous outwash plain dates to 8.4±1.0 ka at the outlet of the Alagöl Valley. Our results agree well with the glacial chronologies obtained from other Turkish and Mediterranean mountains.

Supplementary material:
Google Earth sample locations of this article are available at
http://www.geolsoc.org.uk/SUP18877
A GWAS Meta-analysis and Replication Study Identifies a Novel Locus withinCLPTM1L/TERTAssociated with Nasopharyngeal Carcinoma in Individuals of Chinese Ancestry
Authors: Bei Jin-Xin , Su Wen-Hui , Ng Ching-Ching , Yu Kai , Chin Yoon-Ming , Lou Pei-Jen , Hsu Wan-Lun , McKay James D. , Chen Chien-Jen , Chang Yu-Sun , Chen Li-Zhen , Chen Ming-Yuan , Cui Qian , Feng Fu-Tuo , Feng Qi-Shen , Guo Yun-Miao , Jia Wei-Hua , Khoo Alan Soo-Beng , Liu Wen-Sheng , Mo Hao-Yuan , Pua Kin-Choo , Teo Soo-Hwang , Tse Ka-Po , Xia Yun-Fei , Zhang Hongxin , Zhou Gang-Qiao , Liu Jian-Jun , Zeng Yi-Xin , Hildesheim Allan 
Published: November 2015

AbstractBackground: Genetic loci within the major histocompatibility complex (MHC) have been associated with nasopharyngeal carcinoma (NPC), an Epstein-Barr virus (EBV)-associated cancer, in several GWAS. Results outside this region have varied.Methods: We conducted a meta-analysis of four NPC GWAS among Chinese individuals (2,152 cases; 3,740 controls). Forty-three noteworthy findings outside the MHC region were identified and targeted for replication in a pooled analysis of four independent case–control studies across three regions in Asia (4,716 cases; 5,379 controls). A meta-analysis that combined results from the initial GWA and replication studies was performed.Results: In the combined meta-analysis, rs31489, located within the CLPTM1L/TERT region on chromosome 5p15.33, was strongly associated with NPC (OR = 0.81; P value 6.3 × 10−13). Our results also provide support for associations reported from published NPC GWAS—rs6774494 (P = 1.5 × 10−12; located in the MECOM gene region), rs9510787 (P = 5.0 × 10−10; located in the TNFRSF19 gene region), and rs1412829/rs4977756/rs1063192 (P = 2.8 × 10−8, P = 7.0 × 10−7, and P = 8.4 × 10−7, respectively; located in the CDKN2A/B gene region).Conclusions: We have identified a novel association between genetic variation in the CLPTM1L/TERT region and NPC. Supporting our finding, rs31489 and other SNPs in this region have been reported to be associated with multiple cancer sites, candidate-based studies have reported associations between polymorphisms in this region and NPC, the TERT gene has been shown to be important for telomere maintenance and has been reported to be overexpressed in NPC, and an EBV protein expressed in NPC (LMP1) has been reported to modulate TERT expression/telomerase activity.Impact: Our finding suggests that factors involved in telomere length maintenance are involved in NPC pathogenesis. Cancer Epidemiol Biomarkers Prev; 25(1); 188–92. ©2015 AACR.
Body Mass Index at Diagnosis and Breast Cancer Survival Prognosis in Clinical Trial Populations from NRG Oncology/NSABP B-30, B-31, B-34, and B-38
Authors: Cecchini Reena S. , Swain Sandra M. , Costantino Joseph P. , Rastogi Priya , Jeong Jong-Hyeon , Anderson Stewart J. , Tang Gong , Geyer Charles E. , Lembersky Barry C. , Romond Edward H. , Paterson Alexander H.G. , Wolmark Norman 
Published: November 2015

Abstract
Background: Body mass index (BMI) has been associated with breast cancer outcomes. However, few studies used clinical trial settings where treatments and outcomes are consistently evaluated and documented. There are also limited data assessing how patient/disease characteristics and treatment may alter the BMI–breast cancer association.
Methods: We evaluated 15,538 breast cancer participants from four NSABP protocols. B-34 studied early-stage breast cancer patients (N = 3,311); B-30 and B-38 included node-positive breast cancer patients (N = 5,265 and 4,860); and B-31 studied node-positive and HER2-positive breast cancer patients (N = 2,102). We used Cox proportional hazards regression to calculate adjusted hazards ratios (HR) for risk of death and recurrence, and conducted separate analyses by estrogen receptor (ER) status and treatment group.
Results: In B-30, increased BMI was significantly related to survival. Compared with BMI &lt; 25, HRs were 1.04 for BMI 25 to 29.9 and 1.18 for BMI ≥ 30 (P = 0.02). Separate analyses indicated the significant relationship was only in ER-positive disease (P = 0.002) and the subgroup treated with doxorubicin/cyclophosphamide (P = 0.005). There were no significant trends across BMI for the other three trials. Similar results were found for recurrence. Increased BMI was significantly related to recurrence in B-30 (P = 0.03); and the significant relationship was only in ER-positive breast cancers (P = 0.001). Recurrence was also significant among ER-positive disease in B-38 (P = 0.03).
Conclusions: In our investigation, we did not find a consistent relationship between BMI at diagnosis and breast cancer recurrence or death.
Impact: This work demonstrates that the heterogeneity of breast cancer between different breast cancer populations and the different therapies used to treat them may modify any association that exists between BMI and breast cancer outcome. Cancer Epidemiol Biomarkers Prev; 25(1); 51–59. ©2015 AACR.
Methylated B3GAT2 and ZNF793 Are Potential Detection Biomarkers for Barrett's Esophagus
Authors: Yu Ming , O'Leary Rachele M. , Kaz Andrew M. , Morris Shelli M. , Carter Kelly T. , Chak Amitabh , Chandar Apoorva , Willis Joseph E. , Moinova Helen R. , Markowitz Sanford D. , Brenner Dean E. , Anandabapasathy Sharmila , Westerhoff Maria , Wong Chao-Jen , Shaheen Nicholas J. , Chen Yanwen , Barnholtz-Sloan Jill S. , Grady William M. 
Published: November 2015

Abstract
Background: Barrett's esophagus (BE) is a preneoplastic condition in which normal esophageal squamous epithelium (SQ) is replaced by specialized intestinal metaplasia. It is the presumed precursor for esophageal adenocarcinoma (EAC) as well as the strongest risk factor for this cancer. Unfortunately, many patients with BE go undiagnosed under the current BE screening guidelines. The development of noninvasive and accurate BE detection assays could potentially identify many of these undiagnosed BE patients.
Methods: DNA methylation is a common epigenetic alteration in BE. Therefore, we conducted a genome-wide methylation screen to identify potential BE biomarkers. Samples from SQ (N = 12), stomach (N = 28), and BE (N = 29) were analyzed and methylation levels at over 485,000 CpG sites were compared. Pyrosequencing assays were used to validate the results and MethyLight assays were developed to detect the methylated alleles in endoscopic brushings.
Results: We discovered two genes, B3GAT2 and ZNF793, that are aberrantly methylated in BE. Clinical validation studies confirmed B3GAT2 and ZNF793 methylation levels were significantly higher in BE samples (median = 32.5% and 33.1%, respectively) than in control tissues (median = 2.29% and 2.52%, respectively; P &lt; 0.0001 for both genes). Furthermore, gene-specific MethyLight assays could accurately detect BE (P &lt; 0.0001 for both) in endoscopic brushing samples.
Conclusion: B3GAT2 and ZNF793 are hypermethylated in BE, and the methylation status of these genes can be used to detect BE in tissue samples.
Impact: These findings support the development of methylated B3GAT2 and ZNF793 as biomarkers for noninvasive assays for the detection of BE. Cancer Epidemiol Biomarkers Prev; 24(12); 1890–7. ©2015 AACR.