bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of post-colposcopy management on women's long-term worries: results from the UK population-based TOMBOLA trial
Authors: Sharp Linda , Cotton Seonaidh , Cruickshank Margaret , Gray Nicola , Smart Louise , Whynes David , Little Julian 
Published: September 2015

BackgroundEffective cervical screening reduces cancer incidence and mortality. However, these benefits may be accompanied by some harms, potentially including, adverse psychological impacts. Studies suggest women may have concerns about various specific issues, such as cervical cancer.AimTo compare worries about cervical cancer, future fertility, having sex, and general health between women managed by alternative policies at colposcopy.DesignMulticentre individually-randomised controlled trial, nested within the National Health Service Cervical Screening Programmes.SettingUK.Methods1515 women, aged 20–59 years, with low-grade cytology who attended colposcopy during February 2001–October 2002, were randomised to immediate loop excision or punch biopsies with recall for treatment if cervical intraepithelial neoplasia (CIN)2/3 was confirmed. Women completed questionnaires at recruitment and after 12, 18, 24 and 30 months. Outcomes were prevalence of worries at each time-point (point prevalence) and at any time-point during follow-up (12–30 months; cumulative prevalence). Primary analysis was by intention-to-treat (ITT); secondary per-protocol analysis compared groups according to management received among women with an abnormal transformation zone.ResultsCumulative prevalence of worries was: cervical cancer 40%; having sex 26%, future fertility 24%, and general health 60%. In ITT analyses, there were no statistically significant differences between management arms in cumulative or point prevalence of any of the worries. In per-protocol analyses, between-group differences were significant only for future fertility; cumulative prevalence was highest in women who underwent punch biopsies and treatment.ConclusionsThere is no difference in the prevalence of specific worries in women randomised to alternative post-colposcopy management policies.Clinical trial registrationISRCTN:34841617.
Trajectories of Depressive Symptoms Following Breast Cancer Diagnosis
Authors: Avis Nancy E. , Levine Beverly J. , Case L. Douglas , Naftalis Elizabeth Z. , Van Zee Kimberly J. 
Published: September 2015

Abstract
Background: This longitudinal study sought to identify groups of breast cancer survivors exhibiting distinct trajectories of depressive symptoms up to 24 months following diagnosis, and to describe characteristics associated with these trajectories.
Methods: A total of 653 women completed baseline questionnaires within 8 months of breast cancer diagnosis on patient characteristics, symptoms, and psychosocial variables. Depressive symptoms were assessed at baseline and 6, 12, and 18 months after baseline. Chart reviews provided cancer and treatment-related data. Finite mixture modeling identified trajectories of depressive symptoms measured with the Beck Depression Inventory (BDI).
Results: Six distinct trajectories were identified. Just over half of the sample had consistently very low (3.8%) or low (47.3%) BDI scores well below the traditional BDI cutoff point of 10 thought to be indicative of clinically significant depression; 29.2% had consistently borderline scores; 11.3% had initially high scores that declined over time, but remained above the cutoff point; 7.2% showed increased BDI over time; and a small but unique group (1.1%) reported chronically high scores above 25. Women in groups with lower depressive symptom levels were older, had less rigorous chemotherapy, fewer physical symptoms (fatigue and pain), and lower levels of illness intrusiveness.
Conclusions: Approximately 20% of women had levels of depressive symptoms indicative of clinical depression that were maintained 2 years postdiagnosis. Factors related to trajectory membership such as illness intrusiveness, social support, fatigue, pain, and vasomotor symptoms suggest targets for possible intervention.
Impact: Results demonstrate the heterogeneity of depressive symptoms following breast cancer and the need for continued screening posttreatment. Cancer Epidemiol Biomarkers Prev; 24(11); 1789–95. ©2015 AACR.
Differential Inequality Trends Over Time in Survival Among U.S. Children with Acute Lymphoblastic Leukemia by Race/Ethnicity, Age at Diagnosis, and Sex
Authors: Wang Linwei , Bhatia Smita , Gomez Scarlett Lin , Yasui Yutaka 
Published: September 2015

Abstract
Background: It is unclear how inequalities in survival among children with acute lymphoblastic leukemia (ALL) have changed over time in different race/ethnicity groups.
Methods: Children diagnosed with a first primary malignant ALL at ages 0 to 19 years in 1975–2010 in the nine Surveillance, Epidemiology, and End Results cancer registries were included. Cumulative ALL mortalities were compared, and multivariable Cox regression analyses were applied to estimate ALL mortality HRs associated with race/ethnicity, age at diagnosis, and sex, adjusting for each other, within each diagnosis period (1975–1983, 1984–1991, 1992–1999, and 2000–2010).
Results: Compared with non-Hispanic-whites (NH-whites), the HR in non-Hispanic-blacks (NH-blacks) dropped to 1.21 [95% confidence interval (CI), 0.74–1.96] in 2000–2010 from the largest inequality in 1984–1991 (HR, 2.09; 95% CI, 1.57–2.79); the HR in Hispanics increased, however, from 1.28 (95% CI, 0.98–1.66) in 1975–1983 to 1.95 (95% CI, 1.48–2.58) in 2000–2010. Asian/Pacific Islanders (API) and American Indian/Alaska Natives (AIAN) had HRs of 1.39 (95% CI, 0.92–2.11) and 2.31 (95% CI, 1.13–4.74), respectively, in 2000–2010 with nonstatistically significant increases over time. In 2000–2010, compared with NH-white counterparts, NH-blacks and APIs diagnosed at 1–9 years, Hispanics diagnosed at 1–9 and 10–19 years, and AIANs diagnosed at 10–19 years all had about twice the ALL mortality hazard rates; inequality was observed among API boys (HR, 1.61; 95% CI, 1.00–2.60) but not API girls.
Conclusions: Survival inequalities changed differently across subgroups of children with ALL.
Impact: Underlying causes of the differential trends need to be examined, such that targeted interventions can be developed to reduce inequalities. Cancer Epidemiol Biomarkers Prev; 24(11); 1781–8. ©2015 AACR.
Releasing the Brake on Oncolytic Viral Therapy
Authors: Slaney Clare Y. , Darcy Phillip K. 
Published: September 2015

Abstract
Oncolytic virus that selectively targets and eradicates tumor cells and immune checkpoint blockade that unleashes host antitumor immune responses show synergistic effects against cancer. This combination holds great promise for future treatment of a broad range of cancers in patients. Clin Cancer Res; 21(24); 5417–9. ©2015 AACR.
See related article by Rojas et al., p. 5543
On the Prospects for Observing Spray-Mediated Air–Sea Transfer in Wind–Water Tunnels
Authors: Andreas Edgar L , Mahrt Larry 
Published: September 2015

Abstract
Nature is wild, unconstrained, and often dangerous. In particular, studying air–sea interaction in winds typical of tropical cyclones can place researchers, their instruments, and even their research platforms in jeopardy. As an alternative, laboratory wind–water tunnels can probe 10-m equivalent winds of hurricane strength under conditions that are well constrained and place no personnel or equipment at risk. Wind–water tunnels, however, cannot simulate all aspects of air–sea interaction in high winds. The authors use here the comprehensive data from the Air–Sea Interaction Salt Water Tank (ASIST) wind–water tunnel at the University of Miami that Jeong, Haus, and Donelan published in this journal to demonstrate how spray-mediated processes are different over the open ocean and in wind tunnels. A key result is that, at all high-wind speeds, the ASIST tunnel was able to quantify the so-called interfacial air–sea enthalpy flux—the flux controlled by molecular processes right at the air–water interface. This flux cannot be measured in high winds over the open ocean because the ubiquitous spray-mediated enthalpy transfer confounds the measurements. The resulting parameterization for this interfacial flux has implications for modeling air–sea heat fluxes from moderate winds to winds of hurricane strength.
A Summary of Recent National-Scale Lightning Fatality Studies
Authors: Holle Ronald L. 
Published: September 2015

Abstract
There is a major difference in population-weighted lightning fatality rates between the lower fatality rates in developed countries and the higher fatality rates in developing countries. The large decrease in annual rates of population-weighted lightning fatalities in the United States is described over the last century. A similar large reduction in lightning fatality rates has occurred during recent years in Australia, Canada, Japan, and western Europe, where there has also been a change from a mainly rural agricultural society to a primarily urban society. An important accompanying aspect of the lower casualty rates has been the widespread availability of lightning-safe large buildings and fully enclosed metal-topped vehicles, as well as much greater awareness of the lightning threat, better medical treatment, and availability of real-time lightning information. However, lightning exposure for many people in lesser-developed countries is similar to that of a century ago in developed countries. The number of people living in these areas may be increasing in number, so the number of people killed by lightning may be increasing globally due to these socioeconomic factors. It can be difficult to locate national lightning fatality data because of their mainly obscure publication sources. The present paper synthesizes lightning fatality data from 23 published national-scale studies during periods ending in 1979 and later, and maps these fatality rates per million by continent.
Predictors of psychiatric readmission among patients with bipolar disorder at an academic safety-net hospital
Authors: Hamilton Jane E , Passos Ives C , de Azevedo Cardoso Taiane , Jansen Karen , Allen Melissa , Begley Charles E , Soares Jair C , Kapczinski Flavio 
Published: September 2015

Objective: Even with treatment, approximately one-third of patients with bipolar disorder relapse into depression or mania within 1 year. Unfavorable clinical outcomes for patients with bipolar disorder include increased rates of psychiatric hospitalization and functional impairment. However, only a few studies have examined predictors of psychiatric hospital readmission in a sample of patients with bipolar disorder. The purpose of this study was to examine predictors of psychiatric readmission within 30 days, 90 days and 1 year of discharge among patients with bipolar disorder using a conceptual model adapted from Andersen’s Behavioral Model of Health Service Use. Methods: In this retrospective study, univariate and multivariate logistic regression analyses were conducted in a sample of 2443 adult patients with bipolar disorder who were consecutively admitted to a public psychiatric hospital in the United States from 1 January to 31 December 2013. Results: In the multivariate models, several enabling and need factors were significantly associated with an increased risk of readmission across all time periods examined, including being uninsured, having ⩾3 psychiatric hospitalizations and having a lower Global Assessment of Functioning score. Additional factors associated with psychiatric readmission within 30 and 90 days of discharge included patient homelessness. Patient race/ethnicity, bipolar disorder type or a current manic episode did not significantly predict readmission across all time periods examined; however, patients who were male were more likely to readmit within 1 year. The 30-day and 1-year multivariate models showed the best model fit. Conclusion: Our study found enabling and need factors to be the strongest predictors of psychiatric readmission, suggesting that the prevention of psychiatric readmission for patients with bipolar disorder at safety-net hospitals may be best achieved by developing and implementing innovative transitional care initiatives that address the issues of multiple psychiatric hospitalizations, housing instability, insurance coverage and functional impairment.
Barriers and (im)mobility in Rio de Janeiro
Authors: Motte-Baumvol Benjamin , Bonin Olivier , David Nassi Carlos , Belton-Chevallier Leslie 
Published: September 2015

In Rio de Janeiro, immobility or the share of people with no journeys on any given day is very high (46%). Immobility has a marked geographical dimension in what is a segregated city. But income has only limited explanatory power. The population structure, with high proportions of people who are not in the labour force and who are unemployed, accounts for the high levels of immobility in the poor districts. Although population structure effects prevail, spatial factors such as the severance effect also account for differences between districts. Indeed, Rio de Janeiro features many different types of barriers that affect immobility in several districts and for several population groups. These barriers may be physical or symbolic and perceptive. This study proposes therefore to identify the scope of those barriers as they affect immobility. Our findings from the latest household travel survey available for the metropolitan area of Rio de Janeiro (2003) illustrate the effects of the two types of barrier, physical or symbolic and perceptive, on immobility that more specifically mark out certain categories of individuals such as housewives, the elderly, the unemployed or poor workers. Conversely, the wealthier active population seems to be little affected by the two types of barriers under study. Lastly, our results show that social fragmentation does not lead to greater immobility of favela populations in the heart of rich districts, but on the contrary to increased mobility, especially for the working age population in employment or looking for employment.
Demographic Profile of the Internet-Using Population of India
Authors: Varshney Bharti , Kumar Prashant , Sapre Vivek , Varshney Sanjeev 
Published: September 2015

The study seeks to investigate the Internet usage habits among the online population in India. It intends to confirm if respondents differed on the basis of demographic variables such as age, gender, occupation and city/town tier. Based on primary research, the present study examines the differential effects of demographic variables on various online activities, their usage frequency and duration. The study proposes a possible segmentation of Internet users and a classification of Internet activities. K-mean cluster analysis and one-way analysis of variance (ANOVA) have been used to capture the same. The results suggest that activity-wise usage and duration of Internet usage vary with age, occupation and city/town tier of the respondents, but not much with gender. The factor analysis suggested grouping the dependent usage and activity variables into five major factors. The article would be helpful for the Internet service providers in segmenting the Internet users and enhancing the scholars’ understanding of effect of given demographic variables on Internet usage.
Spiritual history taking in palliative home care: A cluster randomized controlled trial
Authors: Vermandere Mieke , Warmenhoven Franca , Van Severen Evie , De Lepeleire Jan , Aertgeerts Bert 
Published: September 2015

Background: Many health-care providers experience barriers to addressing spiritual needs, such as not having the right vocabulary. The ars moriendi model might be a feasible tool for spiritual history taking in palliative care. Aim: To investigate the effect of a structured spiritual history taking on the spiritual well-being of palliative patients in home care. Design: Cluster randomized controlled trial, conducted between February and October 2013. Patients and methods: Registered nurses and general practitioners approached eligible patients with an incurable, life-threatening disease for study participation. Health-care providers allocated to the intervention arm of the study took a spiritual history on the basis of the ars moriendi model. Health-care providers in the control arm provided care as usual. Patient-reported outcomes on spiritual well-being, quality of life, pain, and patient–provider trust were assessed at two points in time. Results: A total of 245 health-care providers participated in the study (204 nurses and 41 physicians). In all, 49 patient–provider dyads completed the entire study protocol. The median age of the patients was 75 years (range: 41–95 years), and 55% of the patients were female. There were no significant differences at any point in time in the scores on spiritual well-being, quality of life, pain, or patient–provider trust between the intervention and the control group. Conclusion: This cluster randomized controlled trial showed no demonstrable effect of spiritual history taking on patient scores for spiritual well-being, quality of life, health-care relationship trust, or pain. Further research is needed to develop instruments that accurately assess the effectiveness of spiritual interventions in palliative care populations.
Flat detector C-arm CT-guidance system in performing percutaneous transthoracic needle biopsy of small (≤3 cm) pulmonary lesions
Authors: Jiao De-chao , Li Zong-ming , Yuan Hui-feng , Zhang Quan-hui , Ren Jian-Zhuang , Zhou Peng-li , Wu Gang , Han Xin-wei 
Published: September 2015

Background Nowadays, flat detector (FD) equipped angiographic C-arm computed tomography (CACT) systems can be used to acquire CT-like cross-sectional images directly within the interventional suite. The CACT systems offer real time visualization of transthoracic needle biopsy (TNB) procedure and more flexibility in the orientation of the detector system around the patient compared to traditional CT systems. Purpose To evaluate the value of a flat detector C-arm CT-guidance system in performing percutaneous transthoracic needle biopsy (PTNB) for small (≤3 cm) pulmonary lesions in clinical practice. Material and Methods A total of 60 patients with solid lung lesions were retrospectively enrolled to undergo PTNB procedures. The mean diameter of lesions was 2.3 ± 0.6 cm (range, 0.6–3 cm). The needle path was carefully planned and calculated on the C-arm CT system, which acquired three-dimensional CT-like cross-sectional images. The PTNB procedures were performed under needle guidance with fluoroscopic feedbacks. Results Histopathologic tissue was successfully obtained from 59 patients with a puncture success rate of 98.3% (59/60). The diagnostic accuracy rate was found to be 91.5% (54/59). There were only two cases of pneumothorax (3.3%) requiring therapy. The rates of pneumothorax and hemoptysis were low (15.0% [9/60] and 8.3% [5/60], respectively). The overall procedural time was in the range of 12–18 min, resulting in a mean exposure dose of 224.4 ± 4.8 mGy. Conclusion Our study shows that C-arm CT-based needle guidance enables reliable and efficient needle positioning and progression by providing real-time intraoperative guidance for small (≤3 cm) pulmonary lesions in clinical practice.
Variation of bilateral transverse ligament tubercles with age and gender in a large series of subjects on multidetector computed tomography
Authors: Ban Yongguang , Luan Qinhua , Liu Kai , Wang Ximing , Sun Bo , Zhao Bin , Chhabra Avneesh 
Published: September 2015

Background The transverse ligament tubercles play an important role in maintaining the stability of upper cervical spine, but the variation of these tubercles with aging has not been studied systematically. Purpose To evaluate the variation of the height of the transverse ligament tubercles with respect to age and gender, and assess side-to-side differences on multidetector computed tomography (MDCT). Material and Methods A consecutive series of 291 Chinese patients undergoing a head or neck MDCT were divided into eight age groups. The bony anatomy of the atlas was displayed symmetrically by aligning the axial plane and the mean height of bilateral transverse ligament tubercles was measured. The height was correlated with age and gender and side-to-side differences were analyzed. Finally, the inter-observer performance was assessed. Results No transverse ligament tubercles were seen in 51 cases (17.5%, 51/291) and unilateral transverse ligament tubercles were seen in two cases (0.7%, 2/291). Bilateral transverse ligament tubercles were observed in 238 cases (81.8%, 238/291). The average height of the left and right tubercles were 2.68 ± 1.58 mm and 2.68 ± 1.54 mm, respectively, with no significant side-to-side differences (t = 0.061, P > 0.05). The height was also similar in both genders (left: t = 0.497, P > 0.05, right: t = 0.730, P > 0.05). The height increased linearly with age (left: r = 0.513, P < 0.05, right: r = 0.516, P < 0.05). The inter-observer reliability was excellent. Conclusion The height of the transverse ligament tubercles on MDCT linearly increases with increasing age with no significant differences among the genders or the side measured.
Efficacy of early intravenous bolus oxycodone or fentanyl in emergence from general anaesthesia and postoperative analgesia following laparoscopic cholecystectomy: A randomized trial
Authors: Choi Yoon-Ji , Park Sang-Wook , Kwon Hyun-Jung , Choi Jae-Moon , Lee Yu-Mi 
Published: September 2015

Objectives To compare prospectively the efficacy of early intravenous bolus of oxycodone or fentanyl in providing analgesia at emergence from general anaesthesia following laparoscopic cholecystectomy. Methods Patients were randomly assigned to receive either 0.08 mg/kg oxycodone (Group O) or 1 µg/kg fentanyl (Group F), 20 min before the end of surgery. Postoperative pain was evaluated using a visual analogue scale (VAS). The time to first postoperative analgesic dose, requirement for analgesia and side-effects were assessed in the postanaesthesia care unit (PACU). Results The VAS scores at 0 min and 30 min and requirement for analgesia were significantly lower in Group O ( n = 28) than in Group F ( n = 26). The time to first analgesia dose was significantly longer in Group O than Group F. There were no significant between-group differences in the incidence of side-effects. Conclusions Oxycodone relieves immediate postoperative pain significantly better than fentanyl, and is not associated with an increase in side-effects in patients undergoing laparoscopic cholecystectomy.
Vertigo/dizziness in pediatric emergency department: Five years’ experience
Authors: Raucci Umberto , Vanacore Nicola , Paolino Maria Chiara , Silenzi Romina , Mariani Rosanna , Urbano Antonella , Reale Antonino , Villa Maria Pia , Parisi Pasquale 
Published: September 2015

Background Vertigo/Dizziness in childhood is not a rare cause of visits to the emergency department (ED). We analyzed a selected group with vertigo/dizziness to identify signs and symptoms that may help to guide the diagnostic approach and management. Methods A total of 616 children admitted for vertigo to the ED over a five-year period were retrospectively reviewed. Their medical history, clinical characteristics, laboratory and neuroimaging tests, final diagnoses and management were analyzed. Results Migraine and syncope were the most frequent causes. Two patients were affected by life-threatening cardiac syncope, while structural life-threatening central nervous system diseases were found in 15 patients, none of whom presented with vertigo as an isolated clinical finding. Conclusions Most cases of vertigo/dizziness in childhood that consist mainly of migraine and syncope are of benign origin. The prompt identification of neurological or cardiological signs or symptoms associated with vertigo in children is mandatory to rule out life-threatening conditions.