bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the National Institute for Health and Care Excellence (NICE) guidance on medical technology uptake: analysis of the uptake of spinal cord stimulation in England 2008–2012
Authors: Vyawahare Bharati , Hallas Natalie , Brookes Morag , Taylor Rod S , Eldabe Sam 
Published: January 2014

BackgroundThe National Institute for Health and Care Excellence (NICE) Technology Appraisal Guidance on spinal cord stimulation (SCS) was published in 2008 and updated in 2012 with no change. This guidance recommends SCS as a cost-effective treatment for patients with neuropathic pain.ObjectiveTo assess the impact of NICE guidance by comparing SCS uptake in England pre-NICE (2008–2009) and post-NICE (2009–2012) guidance. We also compared the English SCS uptake rate with that of Belgium, the Netherlands, France and Germany.DesignSCS implant data for England was obtained from the Hospital Episode Statistics (HES) database and compared with other European countries where comparable data were available.ResultsThe HES data showed small increases in SCS implantation and replacement/revision procedures, and a large increase in SCS trials between 2008 and 2012. The increase in the total number of SCS procedures per million of population in England is driven primarily by revision/replacements and increased trial activity. Marked variability in SCS uptake at both health regions and primary care trust level was observed.ConclusionsDespite the positive NICE recommendation for the routine use of SCS, we found no evidence of a significant impact on SCS uptake in England. Rates of SCS implantation in England are lower than many other European countries.
The impact of pulmonary bone component embolism: an autopsy study
Authors: Dettmer Matthias S , Willi Niels , Thiesler Thore , Ochsner Peter , Cathomas Gieri 
Published: January 2014

AimsPulmonary bone marrow embolism (BME) and pulmonary bone fragment embolism (BFE) are two types of non-thrombotic pulmonary embolism (NTPE). While BME can be found consistently in autopsies, BFE is a rarely observed event. Both these conditions have bone lesions as source of embolism and are not considered to be causative for death.MethodsA retrospective autopsy study was performed and lung whole tissue slides were reviewed for the presence of pulmonary embolism. Clinicopathological data were screened for osseous lesions considered as risk factors for BME and BFE.ResultsWe reviewed 985 consecutive, unselected autopsies and identified 29 cases of BME (2.9%) and 5 cases of BFE (0.5%). Both conditions were mutually exclusive. While BME showed a significant association with costal fractures, BFE was significantly associated with osteomyelitis and previously performed femur nailing. There were between 1 and 346 bone emboli in BFE with a density ranging from 0.74 to 30.5 emboli/cm2with mean embolic diameter of 45.8±37.6 μm. In two patients, BFE contributed significantly to fatal outcome.ConclusionsBME was associated with costal fractures, while BFE was associated with orthopaedic procedures and osteomyelitis. BFE can result in patient death. Both conditions appeared exclusively, indicating that although they originate from osseous lesions their underlying pathogenesis may likely be different.
A pathologist's survey on the reporting of sessile serrated adenomas/polyps
Authors: Chetty Runjan , Bateman Adrian C , Torlakovic Emina , Wang Lai Mun , Gill Pelvender , Al-Badri Adnan , Arends Mark , Biddlestone Leigh , Burroughs Susan , Carey Frank , Cowlishaw David , Crowther Stephen , Da Costa Philip , Dada Mahomed A , d'Adhemar Charles , Dasgupta Kaushik , de Cates Chandima , Deshpande Vikram , Feakins Roger M , Foria Bineeta , Foria Vipul , Fuller Clare , Green Bryan , Greenson Joel K , Griffiths Paul , Hafezi-Bakhtiari Sara , Henry James , Jaynes Eleanor , Jeffers Michael D , Kaye Philip , Landers Robert , Lauwers Gregory Y , Loughrey Maurice , Mapstone Nicholas , Novelli Marco , Odze Robert , Poller David , Rowsell Corwyn , Sanders Scott , Sarsfield Patrick , Schofield John B , Sheahan Kieran , Shepherd Neil , Sherif Ali , Sington James , Walsh Shaun , Williams Namor , Wong Newton 
Published: January 2014

AimThe purpose of this survey was to ascertain reporting habits of pathologists towards sessile serrated adenomas/polyps (SSA/P).MethodsA questionnaire designed to highlight diagnostic criteria, approach and clinical implications of SSA/P was circulated electronically to 45 pathologists in the UK and North America.ResultsForty-three of 45 pathologists agreed to participate. The vast majority (88%) had a special interest in gastrointestinal (GI) pathology, had great exposure to GI polyps in general with 40% diagnosing SSA/P at least once a week if not more, abnormal architecture was thought by all participants to be histologically diagnostic, and 11% would make the diagnosis if a single diagnostic histological feature was present in one crypt only, while a further 19% would diagnose SSA/P in one crypt if more than one diagnostic feature was present. The vast majority agreed that deeper sections were useful and 88% did not feel proliferation markers were useful. More than one-third did not know whether, or did not feel that, their clinicians were aware of the implications of SSA/P.Conclusions98% of pathologists surveyed are aware that SSA/P is a precursor lesion to colorectal cancer, the majority agree on diagnostic criteria, and a significant number feel that there needs to be greater communication and awareness among pathologists and gastroenterologists about SSA/P.
Therapeutic Inhibition of Jak Activity Inhibits Progression of Gastrointestinal Tumors in Mice
Authors: Stuart Emma , Buchert Michael , Putoczki Tracy , Thiem Stefan , Farid Ryan , Elzer Joachim , Huszar Dennis , Waring Paul M. , Phesse Toby J. , Ernst Matthias 
Published: January 2014

Abstract
Aberrant activation of the latent transcription factor STAT3 and its downstream targets is a common feature of epithelial-derived human cancers, including those of the gastrointestinal tract. Mouse models of gastrointestinal malignancy implicate Stat3 as a key mediator of inflammatory-driven tumorigenesis, in which its cytokine/gp130/Janus kinase (Jak)–dependent activation provides a functional link through which the microenvironment sustains tumor promotion. Although therapeutic targeting of STAT3 is highly desirable, such molecules are not available for immediate clinical assessment. Here, we investigated whether the small-molecule Jak1/2 inhibitor AZD1480 confers therapeutic benefits in two mouse models of inflammation-associated gastrointestinal cancer, which are strictly dependent of excessive Stat3 activation. We confirm genetically that Cre-mediated, tumor cell–specific reduction of Stat3 expression arrests the growth of intestinal-type gastric tumors in gp130F/F mice. We find that systemic administration of AZD1480 readily replicates this effect, which is associated with reduced Stat3 activation and correlates with diminished tumor cell proliferation and increased apoptosis. Likewise, AZD1480 therapy also conferred a cytostatic effect on established tumors in a colitis-associated colon cancer model in wild-type mice. As predicted from our genetic observations in gp130F/F mice, the therapeutic effect of AZD1480 remains fully reversible upon cessation of compound administration. Collectively, our results provide the first evidence that pharmacologic targeting of excessively activated wild-type Jak kinases affords therapeutic suppression of inflammation-associated gastrointestinal cancers progression in vivo. Mol Cancer Ther; 13(2); 468–74. ©2014 AACR.
Nutrition and Physical Activity Cancer Prevention Guidelines, Cancer Risk, and Mortality in the Women's Health Initiative
Authors: Thomson Cynthia A. , McCullough Marjorie L. , Wertheim Betsy C. , Chlebowski Rowan T. , Martinez Maria Elena , Stefanick Marcia L. , Rohan Thomas E. , Manson JoAnn E. , Tindle Hilary A. , Ockene Judith , Vitolins Mara Z. , Wactawski-Wende Jean , Sarto Gloria E. , Lane Dorothy S. , Neuhouser Marian L. 
Published: January 2014

AbstractHealthy lifestyle behaviors are recommended to reduce cancer risk and overall mortality. Adherence to cancer-preventive health behaviors and subsequent cancer risk has not been evaluated in a diverse sample of postmenopausal women. We examined the association between the American Cancer Society (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines score and risk of incident cancer, cancer-specific mortality, and all-cause mortality in 65,838 postmenopausal women enrolled in the Women's Health Initiative Observational Study. ACS guidelines scores (0–8 points) were determined from a combined measure of diet, physical activity, body mass index (current and at age 18 years), and alcohol consumption. After a mean follow-up of 12.6 years, 8,632 incident cancers and 2,356 cancer deaths were identified. The highest ACS guidelines scores compared with the lowest were associated with a 17% lower risk of any cancer [HR, 0.83; 95% confidence interval (CI), 0.75–0.92], 22% lower risk of breast cancer (HR, 0.78; 95% CI, 0.67–0.92), 52% lower risk of colorectal cancer (HR, 0.48; 95% CI, 0.32–0.73), 27% lower risk of all-cause mortality, and 20% lower risk of cancer-specific mortality (HR, 0.80; 95% CI, 0.71–0.90). Associations with lower cancer incidence and mortality were generally strongest among Asian, black, and Hispanic women and weakest among non-Hispanic whites. Behaviors concordant with Nutrition and Physical Activity Cancer Prevention Guidelines were associated with lower risk of total, breast, and colorectal cancers and lower cancer-specific mortality in postmenopausal women. Cancer Prev Res; 7(1); 42–53. ©2014 AACR.
Low Coronary Microcirculatory Resistance Associated With Profound Hypotension During Intravenous Adenosine Infusion
Authors: Echavarría-Pinto Mauro , Gonzalo Nieves , Ibañez Borja , Petraco Ricardo , Jimenez-Quevedo Pilar , Sen Sayan , Nijjer Sukkinder , Tarkin Jason , Alfonso Fernando , Núñez-Gil Ivan J. , Bañuelos Camino , Quirós Alicia , Fernández-Ortiz Antonio , Macaya Carlos , Koo Bon-Kwon , Davies Justin , Escaned Javier 
Published: January 2014

Background—
Intravenous adenosine infusion produces coronary and systemic vasodilatation, generally leading to systemic hypotension. However, adenosine-induced hypotension during stable hyperemia is heterogeneous, and its relevance to coronary stenoses assessment with fractional flow reserve (FFR) remains largely unknown.

Methods and Results—

FFR, coronary flow reserve, and index of microcirculatory resistance were measured in 93 stenosed arteries (79 patients). Clinical and intracoronary measurements were analyzed among tertiles of the percentage degree of adenosine-induced hypotension, defined as follows: %ΔP
a
=–[100–(hyperemic aortic pressure×100/baseline aortic pressure)]. Overall, %ΔP
a
was –13.6±12.0%. Body mass index was associated with %ΔP
a
(
r
=0.258;
P
=0.025) and obesity, an independent predictor of profound adenosine-induced hypotension (tertile 3 of %ΔP
a
; odds ratio, 3.95 [95% confidence interval, 1.48–10.54];
P
=0.006). %ΔP
a
was associated with index of microcirculatory resistance (ρ=0.311;
P
=0.002), coronary flow reserve (
r
=–0.246;
P
=0.017), and marginally with FFR (
r
=0.203;
P
=0.051). However, index of microcirculatory resistance (β=0.003;
P
<0.001) and not %ΔP
a
(β=–0.001;
P
=0.564) was a predictor of FFR. Compared with tertiles 1 and 2 of %ΔP
a
(n=62 [66.6%]), stenoses assessed during profound adenosine-induced hypotension (n=31 [33.3%]) had lower index of microcirculatory resistance (12.4 [8.6–22.7] versus 20 [15.8–35.5];
P
=0.001) and FFR values (0.77±0.13 versus 0.83±0.12;
P
=0.021), as well as a nonsignificant increase in coronary flow reserve (2.5±1.1 versus 2.2±0.87;
P
=0.170).

Conclusions—
The modification of systemic blood pressure during intravenous adenosine infusion is related to hyperemic microcirculatory resistance in the heart. Profound adenosine-induced hypotension is associated with obesity, lower coronary microcirculatory resistance, and lower FFR values.
Circulating Inflammatory Markers Are Associated With Magnetic Resonance Imaging-Visible Perivascular Spaces But Not Directly With White Matter Hyperintensities
Authors: Aribisala Benjamin S. , Wiseman Stewart , Morris Zoe , Valdés-Hernández Maria C. , Royle Natalie A. , Maniega Susana M. , Gow Alan J. , Corley Janie , Bastin Mark E. , Starr John , Deary Ian J. , Wardlaw Joanna M. 
Published: January 2014

Background and Purpose—
White matter hyperintensities (WMH) and perivascular spaces (PVS) are features of small vessel disease, found jointly on MRI of older people. Inflammation is a prominent pathological feature of small vessel disease. We examined the association between inflammation, PVS, and WMH in the Lothian Birth Cohort 1936 (N=634).

Methods—

We measured plasma fibrinogen, C-reactive protein, and interleukin-6 and rated PVS in 3 brain regions. We measured WMH volumetrically and visually using the Fazekas scale. We derived latent variables for
PVS, WMH
, and
Inflammation
from measured PVS, WMH, and inflammation markers and modelled associations using structural equation modelling.

Results—

After accounting for age, sex, stroke, and vascular risk factors,
PVS
were significantly associated with
WMH
(β=0.47;
P
<0.0001);
Inflammation
was weakly but significantly associated with
PVS
(β=0.12;
P
=0.048), but not with
WMH
(β=0.02;
P
=NS).

Conclusions—
Circulating inflammatory markers are weakly associated with MR-visible PVS, but not directly with WMH. Longitudinal studies should examine whether visible PVS predate WMH progression and whether inflammation modulators can prevent small vessel disease.
Role of Cumulus Congestus in Tropical Cyclone Formation in a High-Resolution Numerical Model Simulation
Authors: Wang Zhuo 
Published: January 2014

AbstractThe role of cumulus congestus (shallow and congestus convection) in tropical cyclone (TC) formation is examined in a high-resolution simulation of Tropical Cyclone Fay (2008). It is found that cumulus congestus plays a dominant role in moistening the lower to middle troposphere and spinning up the near-surface circulation prior to genesis, while deep convection plays a key role in moistening the upper troposphere and intensifying the cyclonic circulation over a deep layer. The transition from the tropical wave stage to the TC stage is marked by a substantial increase in net condensation and potential vorticity generation by deep convection in the inner wave pouch region.This study suggests that TC formation can be regarded as a two-stage process. The first stage is a gradual process of moisture preconditioning and low-level spinup, in which cumulus congestus plays a dominant role. The second stage commences with the rapid development of deep convection in the inner pouch region after the air column is moistened sufficiently, whereupon the concentrated convective heating near the pouch center strengthens the transverse circulation and leads to the amplification of the cyclonic circulation over a deep layer. The rapid development of deep convection can be explained by the power-law increase of precipitation rate with column water vapor (CWV) above a critical value. The high CWV near the pouch center thus plays an important role in convective organization. It is also shown that cumulus congestus can effectively drive the low-level convergence and provides a direct and simple pathway for the development of the TC protovortex near the surface.
MRI Information for Commonly Used Otologic Implants: Review and Update
Authors: Azadarmaki Roya , Tubbs Rhonda , Chen Douglas A. , Shellock Frank G. 
Published: January 2014

ObjectiveTo review information on magnetic resonance imaging (MRI) issues for commonly used otologic implants.Data SourcesManufacturing companies, National Library of Medicine's online database, and an additional online database (www.MRIsafety.com).Review MethodsA literature review of the National Library of Medicine's online database with focus on MRI issues for otologic implants was performed. The MRI information on implants provided by manufacturers was reviewed.ResultsBaha and Ponto Pro osseointegrated implants’ abutment and fixture and the implanted magnet of the Sophono Alpha 1 and 2 abutment‐free systems are approved for 3‐Tesla magnetic resonance (MR) systems. The external processors of these devices are MR Unsafe. Of the implants tested, middle ear ossicular prostheses, including stapes prostheses, except for the 1987 McGee prosthesis, are MR Conditional for 1.5‐Tesla (and many are approved for 3‐Tesla) MR systems. Cochlear implants with removable magnets are approved for patients undergoing MRI at 1.5 Tesla after magnet removal. The MED‐EL PULSAR, SONATA, CONCERT, and CONCERT PIN cochlear implants can be used in patients undergoing MRI at 1.5 Tesla with application of a protective bandage. The MED‐EL COMBI 40+ can be used in 0.2‐Tesla MR systems. Implants made from nonmagnetic and nonconducting materials are MR Safe.ConclusionKnowledge of MRI guidelines for commonly used otologic implants is important. Guidelines on MRI issues approved by the US Food and Drug Administration are not always the same compared with other parts of the world.Implications for PracticeThis monograph provides a current reference for physicians on MRI issues for commonly used otologic implants.
Timing of endoscopy in gastrointestinal bleeding
Authors: Sonnenberg Amnon 
Published: January 2014

BackgroundIn gastrointestinal bleeding, a physician often has to make a decision between two possible choices. Endoscopic management of the bleeding could be initiated immediately, or it could be delayed until the patient has become haemodynamically stable or the conditions for a successful endoscopy have otherwise improved.ObjectiveThe present article serves to present such situations and highlights their characteristic features.MethodsThe choice between immediate and delayed endoscopy is analysed in terms of a decision tree, comparing the expected results of the two management alternatives. The decision tree is applied to three different clinical scenarios associated with gastrointestinal bleeding, where performing endoscopy later rather than sooner represents the preferred management option.ResultsThe work up of chronic iron‐deficient anaemia in patients with serious cardiac problems should be deferred until resolution of their reduced cardiovascular status. It is also recommended that, even in acute bleeding, endoscopy is deferred until the patient has become haemodynamically stable. Lastly, for nonemergency treatment of oesophageal varices bleeding, a long rather than short interval between consecutive banding sessions appears more beneficial.ConclusionsThe results illustrate how to use threshold analysis as a simple bedside tool to solve seemingly complex decisions associated with management of gastrointestinal bleeding.
A Complete Extracorporeal Circulation-Free Approach to Patients With Functionally Univentricular Hearts Provides Superior Early Outcomes
Authors: Talwar Sachin , Muthukkumaran Subramanian , Choudhary Shiv Kumar , Makhija Neeti , Sreenivas Vishnubhatla , Saxena Anita , Juneja Rajnish , Kothari Shyam Sunder , Airan Balram 
Published: January 2014

Objective: We compared the early outcomes of patients undergoing extracardiac total cavopulmonary connection (TCPC) with or without cardiopulmonary bypass (CPB). Methods: Between February 2012 and February 2013, 27 patients undergoing TCPC without CPB (off-pump group) were compared with matched 27 patients undergoing TCPC on CPB (on-pump group). Outcome parameters studied were inotropic score, time to extubation, intensive care unit (ICU) stay, first 12 hours mediastinal drainage in ICU, average pleural drainage, time to removal of chest tubes, total hospital stay, and saturation at discharge. Results: There was one early death in each group. No patient required conversion from off CPB to CPB. The inotropic score (6.1 ± 5.91 vs 10.1 ± 6.80, P = .03), time to extubation (8.7 ± 6.95 vs 10.31 ± 8.69 hours, P = .03), first 12 hours mediastinal drainage in ICU (611.9 ± 341.4 vs 922.2 ± 145.6 mL, P = .03), and ICU stay (1.6 ± 0.58 vs 2.9 ± 1.37 days, P = .001) were significantly less in the off-pump group when compared to the on-pump group, and saturation at discharge (99.7 ± 0.60 vs 98.6 ± 2.13, P = .026) was higher in the off-pump group. However, the average daily pleural drainage (125 ± 61.72 vs 150 ± 103.4 mL, P = .7), time to removal of chest tubes (12.69 ± 7.1 vs 15.44 ± 19.26 days, P = .45), and the total hospital stay (14.23 ± 7.4 vs 18.89 ± 19.9 days, P = .22) were no different. There were substantial savings in costs in patients undergoing off-pump TCPC ( P = .016). Conclusions: The TCPC without CPB is easy to perform, is cost-effective, and is associated with superior early postoperative outcomes as compared to TCPC on CPB. With appropriate modifications, this operation can be performed in almost all morphological subsets of patients who do not need an associated intracardiac procedure.
Germ-line JAK2 mutations in the kinase domain are responsible for hereditary thrombocytosis and are resistant to JAK2 and HSP90 inhibitors
Authors: Marty Caroline , Saint-Martin Cécile , Pecquet Christian , Grosjean Sarah , Saliba Joseph , Mouton Céline , Leroy Emilie , Harutyunyan Ashot S. , Abgrall Jean-François , Favier Rémi , Toussaint Aurélie , Solary Eric , Kralovics Robert , Constantinescu Stefan N. , Najman Albert , Vainchenker William , Plo Isabelle , Bellanné-Chantelot Christine 
Published: January 2014

Key Points
New germ-line mutations of JAK2 in the kinase domain were identified. Specificity for MPL and resistance to JAK2 and HSP90 inhibitors was determined.
A recurrent 11q aberration pattern characterizes a subset of MYC-negative high-grade B-cell lymphomas resembling Burkitt lymphoma
Authors: Salaverria Itziar , Martin-Guerrero Idoia , Wagener Rabea , Kreuz Markus , Kohler Christian W. , Richter Julia , Pienkowska-Grela Barbara , Adam Patrick , Burkhardt Birgit , Claviez Alexander , Damm-Welk Christine , Drexler Hans G. , Hummel Michael , Jaffe Elaine S. , Küppers Ralf , Lefebvre Christine , Lisfeld Jasmin , Löffler Markus , Macleod Roderick A. F. , Nagel Inga , Oschlies Ilske , Rosolowski Maciej , Russell Robert B. , Rymkiewicz Grzegorz , Schindler Detlev , Schlesner Matthias , Scholtysik René , Schwaenen Carsten , Spang Rainer , Szczepanowski Monika , Trümper Lorenz , Vater Inga , Wessendorf Swen , Klapper Wolfram , Siebert Reiner 
Published: January 2014

Key Points
A subset of lymphomas with gene expression and pathological characteristics of Burkitt lymphomas but absence of MYC translocation does exist. These lymphomas carry chr 11q proximal gains and telomeric losses, suggesting co-deregulation of oncogenes and tumor suppressor genes.