bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current treatments in diabetic macular oedema: systematic review and meta-analysis
Authors: Ford John Alexander , Lois Noemi , Royle Pamela , Clar Christine , Shyangdan Deepson , Waugh Norman 
Published: March 2013

ObjectivesThe aim of this systematic review is to appraise the evidence for the use of anti-VEGF drugs and steroids in diabetic macular oedema (DMO) as assessed by change in best corrected visual acuity (BCVA), central macular thickness and adverse eventsData sourceMEDLINE, EMBASE, Web of Science with Conference Proceedings and the Cochrane Library (inception to July 2012). Certain conference abstracts and drug regulatory web sites were also searched.Study eligibility criteria, participants and interventionsRandomised controlled trials were used to assess clinical effectiveness and observational trials were used for safety. Trials which assessed triamcinolone, dexamethasone, fluocinolone, bevacizumab, ranibizumab, pegaptanib or aflibercept in patients with DMO were included.Study appraisal and synthesis methodsRisk of bias was assessed using the Cochrane risk of bias tool. Study results are narratively described and, where appropriate, data were pooled using random effects meta-analysis.ResultsAnti-VEGF drugs are effective compared to both laser and placebo and seem to be more effective than steroids in improving BCVA. They have been shown to be safe in the short term but require frequent injections. Studies assessing steroids (triamcinolone, dexamethasone and fluocinolone) have reported mixed results when compared with laser or placebo. Steroids have been associated with increased incidence of cataracts and intraocular pressure rise but require fewer injections, especially when steroid implants are used.LimitationsThe quality of included studies varied considerably. Five of 14 meta-analyses had moderate or high statistical heterogeneity.Conclusions and implications of key findingsThe anti-VEGFs ranibizumab and bevacizumab have consistently shown good clinical effectiveness without major unwanted side effects. Steroid results have been mixed and are usually associated with cataract formation and intraocular pressure increase. Despite the current wider spectrum of treatments for DMO, only a small proportion of patients recover good vision (≥20/40), and thus the search for new therapies needs to continue.
Predictors of non-response in a UK-wide cohort study of children's accelerometer-determined physical activity using postal methods
Authors: Rich Carly , Cortina-Borja Mario , Dezateux Carol , Geraci Marco , Sera Francesco , Calderwood Lisa , Joshi Heather , Griffiths Lucy J 
Published: March 2013

ObjectivesTo investigate the biological, social, behavioural and environmental factors associated with non-consent, and non-return of reliable accelerometer data (≥2 days lasting ≥10 h/day), in a UK-wide postal study of children's activity.DesignNationally representative prospective cohort study.SettingChildren born across the UK, between 2000 and 2002.Participants13 681 7 to 8-year-old singleton children who were invited to wear an accelerometer on their right hip for 7 consecutive days. Consenting families were posted an Actigraph GT1M accelerometer and asked to return it by post.Primary outcome measuresStudy consent and reliable accelerometer data acquisition.ResultsConsent was obtained for 12 872 (94.5%) interviewed singletons, of whom 6497 (50.5%) returned reliable accelerometer data. Consent was less likely for children with a limiting illness or disability, children who did not have people smoking near them, children who had access to a garden, and those who lived in Northern Ireland. From those who consented, reliable accelerometer data were less likely to be acquired from children who: were boys; overweight/obese; of white, mixed or ‘other’ ethnicity; had an illness or disability limiting daily activity; whose mothers did not have a degree; who lived in rented accommodation; who exercised once a week or less; who had been breastfed; were from disadvantaged wards; had younger mothers or lone mothers; or were from households with just one, or more than three children.ConclusionsStudies need to encourage consent and reliable data return in the wide range of groups we have identified to improve response and reduce non-response bias. Additional efforts targeted at such children should increase study consent and data acquisition while also reducing non-response bias. Adjustment must be made for missing data that account for missing data as a non-random event.
On higher ground: ethical reasoning and its relationship with error disclosure
Authors: Cole Alexander Putnam , Block Lauren , Wu Albert W 
Published: March 2013

BackgroundThere is broad consensus that disclosure of harmful medical errors is vital to improve safety and is ethically required. Although most physicians-in-training are taught ethics, there have been no empirical studies on whether ethical reasoning is related to disclosure. We examined whether scores on a test of ethical reasoning were associated with greater willingness to disclose errors.MethodsWe conducted a cross-sectional survey of house officers in internal medicine at Johns Hopkins Hospital. Ethical reasoning was assessed using the Defining Issues Test, V.2 (DIT-2). Higher DIT-2 scores are associated with more sophisticated ethical reasoning, and scores tend to improve after formal ethical training. Respondents were then given a medical error scenario with multiple scripted disclosure options. Ethical reasoning scores were compared for different levels of disclosure.ResultsA total of 29 out of 127 medicine residents completed the survey (response rate=22.8%). The 41% of residents who would explicitly tell a patient that, ‘an error happened’ had significantly higher DIT-2 scores than those who would not (51.1 vs 31.6, p<0.01).Higher DIT-2 scores were found in the 62% of residents who would give the most detail about the error (44.8 vs 31.2, p=0.04) and in the 71% of residents who would take personal responsibility (43.5 vs 27.9, p=0.03).ConclusionsEthical reasoning scores were associated with acknowledging an error, providing more detailed explanations and taking personal responsibility. The low response rate may limit generalisability. Nevertheless, taken together with prior studies showing that ethical reasoning can be taught and measured, our findings suggest that ethical training may help to improve disclosure of medical errors.
Predictive factors for longer length of stay in an emergency department: a prospective multicentre study evaluating the impact of age, patient's clinical acuity and complexity, and care pathways
Authors: Casalino Enrique , Wargon Mathias , Peroziello Anne , Choquet Christophe , Leroy Christophe , Beaune Sebastien , Pereira Laurent , Bernard Julien , Buzzi Jean-Claude 
Published: March 2013

BackgroundIt has been reported that emergency department length of stay (ED-LOS) for older patients is longer than average. Our objective was to determine the effect of age, patient's clinical acuity and complexity, and care pathways on ED-LOS and ED plus observation unit (EDOU) LOS (EDOU-LOS).MethodsThis was a prospective, multicentre, observational study including all patients attending in 2011. Age groups were: I, <50; II, ≥50–64; III, ≥65–74; IV, ≥75–84; V, ≥85 years. Univariate and multivariate analyses were performed.ResultsOf 125 478 attendances, 20 845(16.6%) were of patients aged ≥65 years. Multivariate analysis found significant predictors for ED-LOS (C-statistics 0.79, p<0.0000001) to be: arrival mode (ambulance, OR 1.13 (95% CI 1.08 to 1.18)); acuity level (level 4, OR 1.24 (95% CI 1.21 to 1.28); level 1–3, OR 1.54 (95% CI 1.5 to 1.59)); haematological examinations (OR 3.34 (95% CI 3.15 to 3.56)); intravenous treatment (OR 1.58 (95% CI 1.47 to 1.69)); monitoring of vital signs (OR 1.89 (95% CI 1.69 to 2.10)); x-ray examinations (OR 1.53 (95% CI 1.45 to 1.61)); CT/MRI/ultrasound (OR 2.60 (95% CI 2.39 to 2.82)); and specialist advice (OR 1.39 (95% CI 1.30 to 1.48)). For EDOU-LOS (C-statistics 0.81, p<0.0000001) we found: age group (II, OR 1.19 (95% CI 1.16 to 1.22); III, OR 1.42 (95% CI 1.38 to 1.46); IV, OR 1.69 (95% CI 1.65 to 1.74); V, 2.01 (95% CI 1.96 to 2.07)); acuity level (level 4, OR 1.31 (95% CI 1.27 to 1.35); level 1–3, OR 1.71 (95% CI 1.66 to 1.77)); haematological examinations (OR 7.81 (95% CI 7.23 to 8.43)); intravenous treatment (OR 1.95 (95% CI 1.8 to 2.12)); x-ray examinations (OR 1.95 (95% CI 1.85 to 2.06)); CT/MRI/ultrasound (OR 6.74 (95% CI 5.98 to 7.6)); specialist advice (OR 2.24 (95% CI 2.07 to 2.42)); admission to a medical or surgical ward (OR 0.61 (95% CI 0.54 to 0.68)); and transfer (OR 1.79 (95% CI 1.54 to 2.07)).ConclusionsWhereas ED-LOS and EDOU-LOS seem to be directly related to patients’ acuity and complexity, notably the need for diagnostic and therapeutic interventions, only EDOU-LOS was significantly associated with age and proposed care pathways. We propose that EDOU-LOS measurement should be made in EDs with an OU.
Frequent expression of follicular dendritic cell markers in Hodgkin lymphoma and anaplastic large cell lymphoma
Authors: Kim Soo Hee , Choe Ji-young , Jeon Yoonkyong , Huh Jooryung , Jung Hye Ra , Choi Yoo-Duk , Kim Hyun-Jung , Cha Hee Jeong , Park Weon Seo , Kim Ji Eun 
Published: March 2013

AimsAlthough the tumour cells of Hodgkin lymphoma (HL) are derived from mature B-cells, the lineage infidelity of Hodgkin/Reed–Sternberg cells (HRSs) often causes diagnostic problems. Recently introduced HRS markers are also positive for follicular dendritic cells (FDCs). We investigated the expression of several FDC markers in HL and anaplastic large cell lymphoma (ALCL) and evaluated their diagnostic efficacy.MethodsEighty-five cases of HL and 52 cases of ALCL were included in this study. Immunohistochemistry was performed for glioma-associated homologue (GLI) 3, class III β-tubulin (TUBB3), fascin, clusterin, γ-synuclein, podoplanin, syntenin, CD21, CD35 and EGFR.ResultsHRSs were diffusely positive for GLI3, fascin and TUBB3; the mean positivity rates per case were 94% for GLI3, 82% for fascin, 69% for TUBB3, 17% for clusterin, 17% for γ-synuclein and 14% for syntenin. Podoplanin, CD21, CD35 and EGFR were almost negative. However, the frequency of marker expression was not associated with the histologic subtype or the presence of Epstein–Barr virus (EBV). ALCL showed a similar pattern to HL, but the overall frequency of positivity was lower than that observed in HL. The mean positivity rates were 56% for GLI3, 62% for fascin, 58% for TUBB3 and 21% for clusterin. The other markers were nearly negative. Anaplastic large cell lymphoma kinase positivity did not affect the expression rates.ConclusionsThis study confirmed the frequent expression of FDC markers in HL and ALCL. Especially, GLI3, fascin and TUBB3 are the most sensitive markers. Further studies are required to evaluate the association between FDCs, HRSs and ALCL cells.
Trichomonas vaginalisinfection among women receiving gynaecological care at an Alabama HIV Clinic
Authors: Muzny Christina A , Rivers Charles A , Austin Erika L , Schwebke Jane R 
Published: March 2013

ObjectiveTrichomoniasis vaginalisis a risk factor for the acquisition and transmission of HIV. The objective of this study was to determine the prevalence ofT vaginalis(using culture) among HIV-infected women receiving gynaecological care at an university HIV clinic in Alabama in addition to predictors of infection.MethodsElectronic medical record review of women presenting to the clinic for gynaecological care during 2006–2012 was performed. Demographic and sexual history data was abstracted in addition to absolute CD4 cell count, HIV-1 viral load and sexually transmitted infection (STI) (includingT vaginalis) testing results. Analysis was conducted using Stata V.12.ResultsT vaginaliswas prevalent in 17.4% (83/478) of HIV-infected women; other STIs were less prevalent. Among these women, 384 presented for routine STI screening, of which 12% (46/384) wereT vaginalis-infected. Younger age, African-American race, lifetime history of tobacco and drug abuse, lack of HIV therapy, HIV-1 viral load >400 copies/ml, and report of seeking gynaecological care for reasons other than routine STI screening (ie, having symptoms) were significant predictors ofT vaginalisin univariate analysis. Age, African American race, and report of seeking gynaecological care for reasons other than routine STI screening remained associated withT vaginalisin multivariable analysis.ConclusionsT vaginalisremains highly prevalent among HIV-infected women, a proportion of which may be asymptomatic. If left undiagnosed and untreated, these women may be more likely to transmit HIV. Increased emphasis on screening for high risk sexual behaviours, testing forT vaginalis, and risk reduction counselling is necessary for all HIV-infected women.
Constraining the uncertainties of volcano thermal anomaly monitoring using a Kalman filter technique
Authors: Zakšek Klemen , Shirzaei Manoochehr , Hort Matthias 
Published: March 2013

Abstract

The activity status of a volcano can be evaluated from the remotely measured radiant power (
RP
). The measured
RP
contains noise due to reasons such as atmospheric effects and instrument characteristics. Here we first show how to estimate the uncertainty of each single
RP
measurement. To additionally reduce the temporal noise of the
RP
time series we apply a Kalman filter. The Kalman filter is able to recursively analyse an unevenly sampled time series. To validate our filtering scheme, we applied it to an eruption of Etna in 2002, as well as to the eruption of Nyamuragira in 2010. In the case of the Etna eruption, the denoised time series agrees well with
in situ
observations of a waxing and waning flow. For the case of Nyamuragira, the enhanced time series of
RP
shows more fluctuation probably due to cloud coverage. Thus, we propose a multiple instrument approach that increases the temporal resolution of the
RP
time series and reduces the associated noise.
Siah: A Promising Anticancer Target
Authors: Wong Christina S.F. , Möller Andreas 
Published: March 2013

Abstract
Siah ubiquitin ligases play important roles in a number of signaling pathways involved in the progression and spread of cancer in cell-based models, but their role in tumor progression remains controversial. Siah proteins have been described to be both oncogenic and tumor suppressive in a variety of patient cohort studies and animal cancer models. This review collates the current knowledge of Siah in cancer progression and identifies potential methods of translation of these findings into the clinic. Furthermore, key experiments needed to close the gaps in our understanding of the role Siah proteins play in tumor progression are suggested. Cancer Res; 73(8); 2400–6. ©2013 AACR.
Potentially Prognostic miRNAs in HPV-Associated Oropharyngeal Carcinoma
Authors: Hui Angela B.Y. , Lin Alice , Xu Wei , Waldron Levi , Perez-Ordonez Bayardo , Weinreb Ilan , Shi Wei , Bruce Jeff , Huang Shao Hui , O'Sullivan Brian , Waldron John , Gullane Patrick , Irish Jonathan C. , Chan Kelvin , Liu Fei-Fei 
Published: March 2013

AbstractPurpose: Deregulation of miRNAs is associated with almost all human malignancies. Human papillomavirus (HPV)-associated oropharyngeal carcinoma (OPC) has a significantly more favorable outcome compared with HPV-negative OPCs; however, the underlying mechanisms are not well understood. Hence, the objectives of this study were to determine whether miRNA expression differed as a function of HPV status and to assess whether such miRNAs provide prognostic value beyond HPV status.Methods: Global miRNA profilings were conducted on 88 formalin-fixed and paraffin-embedded (FFPE) OPC biopsies (p16-positive: 56; p16-negative: 32), wherein the expression levels of 365 miRNAs plus 3 endogenous controls were simultaneously measured using quantitative real-time (qRT)-PCR. Seven FFPE specimens of histologically normal tonsils were used as controls.Results: Overall, 224 miRNAs were expressed in more than 80% of the investigated samples, with 128 (57%) being significantly differentially expressed between tumor versus normal tissues (P &lt; 0.05). Upregulated miR-20b, miR-9, and miR-9* were significantly associated with HPV/p16-status. Three miRNA sets were significantly associated with overall survival (miR-107, miR-151, miR-492; P = 0.0002), disease-free survival (miR-20b, miR-107, miR-151, miR-182, miR-361; P = 0.0001), and distant metastasis (miR-151, miR-152, miR-324-5p, miR-361, miR492; P = 0.0087), which retained significance even after adjusting for p16 status. The associated biologic functions of these miRNAs include immune surveillance, treatment resistance, invasion, and metastasis.Conclusion: We have identified several miRNAs, which associate with HPV status in OPC; furthermore, three candidate prognostic sets of miRNAs seem to correlate with clinical outcome, independent of p16 status. Furthermore, evaluations will offer biologic insights into the mechanisms underlying the differences between HPV-positive versus HPV-negative OPC. Clin Cancer Res; 19(8); 2154–62. ©2013 AACR.
Molecular Dissection of Microsatellite Instable Colorectal Cancer
Authors: Vilar Eduardo , Tabernero Josep 
Published: March 2013

AbstractColorectal cancer was one of the first solid tumors to be classified on the basis of molecular profiling. Microsatellite instability has allowed researchers to distinguish a specific subtype of colorectal cancer that has a clearly identified molecular origin (mismatch repair deficiency), arises on a hereditary and sporadic basis, is linked to a clear clinicopathologic profile, and has prognostic implications. Inconclusive predictive data along with a paucity of targeted drug development have prevented this molecular classification system from being implemented in the clinical setting. New high-throughput genomic data have validated it, thus stressing the fact that it is ready to be applied clinically.Significance: Application of a molecular classification of colorectal cancer in the clinical arena is an unmet promise. Recent results of large-scale genomic analyses have provided confirmation and further insights into the molecular biology of already known colorectal cancer subgroups. The quintessential example is the microsatellite instability subgroup, which has been well characterized during the past 2 decades. Future drug development and clinical research initiatives in colorectal oncology should consider these and other known cancer subgroups and start targeting these selected patient populations. Cancer Discov; 3(5); 502–11. ©2012 AACR.
A Nuclear Rapture: The Apocalyptic Art of Kenny Scharf
Authors: Phillips Natalie E. 
Published: March 2013

Abstract
The art of Kenny Scharf is paradoxical in nature. He combines carefree cartoon worlds with distinctly religious apocalyptic images of terrifying nuclear holocaust. The odd juxtapositions Scharf creates between the horrific and the benign are the artist’s means of coping with his own apocalyptic anxiety, as well as a critique of the self-destructive behavior of American society in the 1980s. At the time, Ronald Reagan’s strong doomsday rhetoric and his emphasis on the Arms Race collided with the AIDS Crisis, creating a specific 1980s brand of the apocalyptic. Scharf responds to this widespread, heightened anxiety by using the cartoon (and a cartoon-based religion of his own invention) as a purposefully ludicrous anesthetic to numb his apocalyptic fears.
So Much Law so Little Protection! A Case Study of the Protection of the Narwhal
Authors: Fitzmaurice Malgosia 
Published: March 2013

Abstract
This essay investigates the effectiveness of various international instruments at global, regional, bilateral and European levels and national legislation in relation to the protection of the narwhal. Narwhal is listed on almost all the most important conventions protecting biodiversity as endangered species, as well as the CITES. However, due to various gaps in the law and in some instances disagreements between States parties to conventions how to interpret their jurisdictional scope (e.g. the International Whaling Convention), narwhal are not sufficiently protected and its numbers are dwindling towards extinction. However, there is no a simple answer to this state of affairs as there are a multitude of factors, ecological, sociological and political which play a role in the management of narwhal stocks. The best way forward is basing the future cooperation regarding this issue at the regional or bilateral levels, as the directly involved and interested stakeholders will find the most acceptable solution, which will take into account all the above-mentioned factors.
Protecting Polar Wilderness: Just a Western Philosophical Idea or a Useful Concept for Regulating Human Activities in the Polar Regions?
Authors: Bastmeijer Kees 
Published: March 2013

Abstract
This article focuses on the question to what extent wilderness protection receives attention in the international governance systems for the Polar Regions (Arctic Council and Antarctic Treaty System). First, on the basis of a definition of the term ‘wilderness’, the role of law in protecting wilderness is discussed. Next, attention is focused on wilderness protection in the Arctic and Antarctic. It is concluded that the international governance systems pay very little attention to the preservation of the Polar Regions as the last relatively untouched wildernesses on earth. The applicability of various multilateral environmental agreements (particularly the Arctic) is not very helpful in this respect as wilderness protection does not receive substantial attention in these legal instruments either. In view of the broad acknowledgement of the wilderness values of the Polar Regions and the fast increase of commercial activities in these regions, the author urges stakeholders involved in the Arctic Council and the Antarctic Treaty System to open the debate on relevant questions: What are wilderness values in the context of the Polar Regions and when would these values be affected? For the Arctic, how could wilderness protection be integrated in the efforts regarding sustainable development to ensure the right balance between wilderness protection and the protection of indigenous peoples rights? The questions are certainly complex; however, excluding these questions from the international governance debate with the argument that the concept is too vague, subjective or sensitive will most certainly result in a continuing loss of untouched nature, both in the Arctic and Antarctic.
Terrestrial Area Management in Polar Regions: Applying the Eco-System-Based Approach to the Coalface of Climate Change
Authors: Jeffery Michael I. 
Published: March 2013

Abstract
This paper will outline the challenges for the protection of biodiversity and wilderness in the polar regions that are becoming increasingly evident from impacts attributed to climate change, globalisation and energy resource development. Although all of these impacts have significant adverse environmental consequences for fragile marine eco-systems, the terrestrial areas in these regions are also in danger of experiencing irreversible damage unless immediate attention is given to address the situation through a concerted and focused effort on the part of the several nations claiming sovereignty over these disputed areas. In particular, the paper will use the plight of the polar bear, that has just recently been designated as a ‘threatened’ specie under the US Endangered Species Act, as a case study of how terrestrial area management in polar regions must adapt to a rapidly changing set of parameters.