bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do images influence assessment in anatomy? Exploring the effect of images on item difficulty and item discrimination
Authors: Vorstenbosch Marc A. T. M. , Klaassen Tim P. F. M. , Kooloos Jan G. M. , Bolhuis Sanneke M. , Laan Roland F. J. M. 
Published: June 2012

AbstractAnatomists often use images in assessments and examinations. This study aims to investigate the influence of different types of images on item difficulty and item discrimination in written assessments. A total of 210 of 460 students volunteered for an extra assessment in a gross anatomy course. This assessment contained 39 test items grouped in seven themes. The answer format alternated per theme and was either a labeled image or an answer list, resulting in two versions containing both images and answer lists. Subjects were randomly assigned to one version. Answer formats were compared through item scores. Both examinations had similar overall difficulty and reliability. Two cross‐sectional images resulted in greater item difficulty and item discrimination, compared to an answer list. A schematic image of fetal circulation led to decreased item difficulty and item discrimination. Three images showed variable effects. These results show that effects on assessment scores are dependent on the type of image used. Results from the two cross‐sectional images suggest an extra ability is being tested. Data from a scheme of fetal circulation suggest a cueing effect. Variable effects from other images indicate that a context‐dependent interaction takes place with the content of questions. The conclusion is that item difficulty and item discrimination can be affected when images are used instead of answer lists; thus, the use of images as a response format has potential implications for the validity of test items. Anat Sci Educ © 2012 American Association of Anatomists.
Generation of Polyfluoroaryl‐Fused H‐Pyrazolo[5,1‐a]isoquinolines through a Reaction of N′‐(2‐Alkynylbenzylidene)hydrazide with Polyfluoroarene
Authors: Zhang Ling , Xiao Qian , Ye Shengqing , Wu Jie 
Published: June 2012

AbstractPolyfluoroarene reacts with N′‐(2‐alkynylbenzylidene)hydrazide catalyzed by silver triflate in the presence of cesium carbonate, leading to polyfluoroaryl‐fused H‐pyrazolo[5,1‐a]isoquinolines in good yields.
A Point‐by‐Point Response to Recent Arguments Against the Use of Statins in Primary Prevention
Authors: Joshi Parag H. , Chaudhari Sameer , Blaha Michael J. , Jones Steven R. , Martin Seth S. , Post Wendy S. , Cannon Christopher P. , Fonarow Gregg C. , Wong Nathan D. , Amsterdam Ezra , Hirshfeld John W. , Blumenthal Roger S. 
Published: June 2012

AbstractRecently, a debate over the merits of statin therapy in primary prevention was published in the Wall Street Journal. The statin opponent claimed that statins should only be used in secondary prevention and never in any primary‐prevention patients at risk for cardiovascular events. In this evidence‐based rebuttal to those claims, we review the evidence supporting the efficacy of statin therapy in primary prevention. Cardiovascular risk is a continuum in which those at an elevated risk of events stand to benefit from early initiation of therapy. Statins should not be reserved until after a patient suffers the catastrophic consequences of atherosclerosis. Contrary to the assertions of the statin opponent, this principle has been demonstrated through reductions in heart attacks, strokes, and mortality in numerous randomized controlled primary‐prevention statin trials. Furthermore, data show that once a patient tolerates the initial treatment period, the few side effects that subsequently emerge are largely reversible. Accordingly, every major guidelines committee endorses statin use in secondary prevention and selectively in primary prevention for those with risk factors. The foundation for prevention remains increased physical activity, better dietary habits, and smoking cessation. However, prevention of heart attacks, strokes, and death from cardiovascular disease does not have to be all or none—all statin or all lifestyle. In selected at‐risk individuals, the combination of pharmacotherapy and lifestyle changes is more effective than either alone. Future investigation in prevention should focus on improving our ability to identify these at‐risk individuals.Drs Amsterdam, Blumenthal, and Wong serve on the board of directors and/or are officers of the American Society for Preventive Cardiology. Dr Wong has received research support from Merck and Bristol Myers‐Squibb and advisory board consultant fees from Merck in the past 12 months. Dr Cannon is a senior investigator in the TIMI Study Group; has received research support from Accumetrics, AstraZeneca, GlaxoSmithKline, Merck, Essentialis, and Takeda; has donated advisory board consultant fees to charity from Bristol‐Myers Squibb/Sanofi, Novartis, and Alnylam; has received honoraria for development of independent educational symposia from Pfizer and AstraZeneca; and has equity in Automedics Medical Systems. Dr Jones has received research support and advisory board consultant fees from Atherotech Diagnostics Lab and has served as a consultant for Amylin Pharmaceuticals.The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Time course, clinical pathways, and long‐term hazards risk trends of disease progression in patients with classic mycosis fungoides
Authors: Quaglino Pietro , Pimpinelli Nicola , Berti Emilio , Calzavara‐Pinton Piergiacomo , Alfonso Lombardo Giuseppe , Rupoli Serena , Alaibac Mauro , Bottoni Ugo , Carbone Angelo , Fava Paolo , Fimiani Michele , Mamusa Angela Maria , Titli Stefano , Zinzani Pier Luigi , Bernengo Maria Grazia ,   on behalf of the Gruppo Italiano Linfomi Cutanei (GILC)
Published: June 2012

AbstractBACKGROUND:Mycosis fungoides (MF) is an indolent primary cutaneous T‐cell lymphoma. To the authors' knowledge, no data currently are available regarding the evolution over time of the risk of developing specific pathways of disease progression.METHODS:This retrospective study analyzed 1422 patients with MF who were diagnosed and followed from 1975 through 2010 in 27 Italian Study Group for Cutaneous Lymphoma centers. The primary objectives were to ascertain the time course, pathways, and hazards risk trends of cutaneous/extracutaneous disease progression; to evaluate whether different tumor‐lymph node‐metastasis‐blood (TNMB) stages have different pathways of disease progression; and to analyze differences between tumor‐stage and erythrodermic MF with regard to clinical onset, disease evolution, and prognosis. The secondary objective was to provide a further validation for the revised International Society for Cutaneous Lymphomas and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of Cancer (ISCL/EORTC) classification.RESULTS:The median follow‐up was 14.5 years; stage progression occurred in 29.7% of patients and blood involvement was the most frequent extracutaneous site of disease progression. Patients with stage IA to stage IB disease demonstrated a steady low annual incidence of disease progression to tumor‐stage (1%‐2%); patients with stage IIA disease had a higher risk within the first years (up to 9.4%). Erythroderma evolved with a significantly higher frequency from patches/plaques (13.9%/28.2%) than tumors (P= .028 andP= .013, respectively). Hazards rates of extracutaneous involvement were low (< 1%). The T‐score was found to be associated with extracutaneous involvement site, tumor‐stage disease with lymph node/visceral lesions, and erythroderma with blood involvement. TNMB classification and stage progression resulted as independent prognostic variables being detected on multivariate analysis; the type of extracutaneous involvement was found to affect survival .CONCLUSIONS:The data from the current study support the need for a stage‐tailored follow‐up, suggest that the classification of tumor‐stage disease at a stage below erythroderma could be modified, and offer a further validation for the revised TNMB classification. Cancer 2012. © 2012 American Cancer Society.
Gefitinib versus pemetrexed as second‐line treatment in patients with nonsmall cell lung cancer previously treated with platinum‐based chemotherapy (KCSG‐LU08‐01)
Authors: Sun Jong‐Mu , Lee Ki Hyeong , Kim Sang‐we , Lee Dae Ho , Min Young Joo , Yun Hwan Jung , Kim Hoon Kyo , Song Hong Suk , Kim Yeul Hong , Kim Bong‐Seog , Hwang In Gyu , Lee Keehyun , Jo Sook Jung , Lee Jae Won , Ahn Jin Seok , Park Keunchil , Ahn Myung‐Ju ,   for the Korean Cancer Study Group (KCSG)
Published: June 2012

AbstractBACKGROUND:Gefitinib was compared with pemetrexed as second‐line therapy in a clinically selected population previously treated with platinum‐based chemotherapy.METHODS:A phase 3 trial of gefitinib (250 mg/day) versus pemetrexed (500 mg/m2 on day 1, every 3 weeks) was conducted in patients who had never smoked and who had advanced pulmonary adenocarcinoma treated with 1 previous platinum‐based regimen. The primary endpoint was progression‐free survival (PFS).RESULTS:A total of 135 patients were analyzed. The gefitinib group had significantly longer PFS compared with the pemetrexed group, with a median PFS time of 9.0 versus 3.0 months (P = .0006). The objective response rates were 58.8% and 22.4% for gefitinib and pemetrexed, respectively (P < .001). However, there was no statistically significant difference in overall survival between the 2 groups (22.2 vs 18.9 months; P = .37). The difference of PFS was increased in a subgroup analysis of 33 patients with activating epidermal growth factor receptor mutation (15.7 vs 2.9 months; hazard ratio, 0.3; 95% confidence interval, 0.13‐0.72; P = .005), with numerical superiority of gefitinib in the 38 patients testing negative for epidermal growth factor receptor mutation (5.9 vs 2.7 months; P = .099). Both regimens were well tolerated. There were no significantly different changes in quality of life between the 2 groups, except that symptom scores for dyspnea and diarrhea favored the gefitinib and pemetrexed arms, respectively.CONCLUSIONS:Gefitinib showed superior efficacy to pemetrexed as second‐line therapy in Korean never‐smokers with pulmonary adenocarcinoma. Cancer 2012. © 2012 American Cancer Society.
How feasible is implementation of distress screening by cancer clinicians in routine clinical care?
Authors: Mitchell Alex J. , Lord Karen , Slattery Jo , Grainger Lorraine , Symonds Paul 
Published: June 2012

AbstractBACKGROUND:There is considerable uncertainty regarding the acceptability of routine distress screening.METHODS:In an unfunded implementation study, the authors asked 50 clinicians (chemotherapy nurses and treatment radiographers/radiation technologists) to implement a screening program for distress as part of routine care and to record their feedback after each clinical encounter. In total, 379 patients were screened using a simple paper‐and‐pencil versions of distress thermometer and the emotion thermometer (ET).RESULTS:Across all screening applications, clinicians believed that screening was useful during 43% of assessments and was not useful during 35.9% of assessments, and they were unsure or neutral in 21.1% of assessments. The application of the screening program assisted staff in changing their clinical opinion after 41.9% of assessments, and clinicians believed that the screening program helped with communication in >50% of assessments. However, 37.5% believed that screening was impractical for routine use, and more chemotherapy nurses than radiographers rated the screening program as “not useful.” On multivariate analysis, 3 variables were associated with high staff satisfaction with screening, namely, receipt of prior training, talking with the patient about psychosocial issues, and improved detection of psychological problems. A favorable perception of screening also was linked to a change in clinical opinion.CONCLUSIONS:Opinions of cancer clinicians regarding routine distress screening were mixed: Approximately 33% considered screening not useful/impractical, whereas >50%n believed promoted good communication and/or helped with recognition. Clinicians who were more positive about screening gained greater benefits from screening in terms of communication and recognition. Cancer 2012. © 2012 American Cancer Society.
The effect of aging and cancer on the symptom experience and physical function of elderly breast cancer survivors
Authors: Bellury Lanell , Pett Marjorie A. , Ellington Lee , Beck Susan L. , Clark Jane C. , Stein Kevin D. 
Published: June 2012

AbstractBACKGROUND:The majority of cancer survivors are aged ≥65 years, yet, historically, cancer research has focused infrequently on older patients. The objective of this study was to examine predictors of physical function within a framework that integrates the gerontologic and oncologic needs of older cancer survivors.METHODS:Path analysis tested 759 women who were breast cancer survivors aged ≥70 years from the American Cancer Society Study of Cancer Survivors II to examine the cancer, aging, and personal characteristics that had an impact on symptoms and physical functioning.RESULTS:High levels of symptom bother (β = −.42) and comorbidities (β = −.21) were strongly associated with lower physical function. Comorbidity and social support (β = .21) indirectly influenced symptom bother through emotional status (β = −.35). The model demonstrated good fit with the data (chi‐square statistic, 50.6; adjusted chi‐square statistic, 2.8; P < .001; goodness‐of‐fit index, .98; root mean square error of approximation, .049 [confidence interval, .03‐.05]).CONCLUSIONS:The current findings supported prior research indicating that the majority of older survivors of breast cancer are doing well, but there is a subset of survivors that requires ongoing attention to symptoms, comorbidities, emotional health, and social support to thrive after cancer treatment. Cancer 2012. © 2012 American Cancer Society.
Two phase 2 trials of the novel Akt inhibitor perifosine in patients with advanced renal cell carcinoma after progression on vascular endothelial growth factor‐targeted therapy
Authors: Cho Daniel C. , Hutson Thomas E. , Samlowski Wolfram , Sportelli Peter , Somer Brad , Richards Paul , Sosman Jeffrey A. , Puzanov Igor , Michaelson M. Dror , Flaherty Keith T. , Figlin Robert A. , Vogelzang Nicholas J. 
Published: June 2012

AbstractBACKGROUND:The clinical activity of allosteric inhibitors of mammalian target of rapamycin (mTOR) inhibitors in renal cell carcinoma (RCC) may be limited by upstream activation of phosphatidylinositol 3 (PI3)‐kinase/Akt resulting from mTOR1 inhibition. On the basis of this rationale, 2 independent phase 2 trials (Perifosine 228 and 231) were conducted to assess the efficacy and safety of the novel Akt inhibitor perifosine in patients with advanced RCC who had failed on previous vascular endothelial growth factor (VEGF)‐targeted therapy.METHODS:In the Perifosine 228 trial, 24 patients with advanced RCC received oral perifosine (100 mg daily). Perifosine 231 enrolled 2 groups that received daily oral perifosine (100 mg daily): Group A comprised 32 patients who had received no prior mTOR inhibitor, and Group B comprised 18 patients who had received 1 prior mTOR inhibitor.RESULTS:In the Perifosine 228 trial, 1 patient achieved a partial response (objective response rate, 4%; 95% confidence interval, 0.7%‐20%), and 11 patients (46%) had stable disease as their best response. The median progression‐free survival was 14.2 weeks (95% confidence interval, 7.7‐21.6 weeks). In the Perifosine 231 trial, 5 patients achieved a partial response (objective response rate, 10%; 95% confidence interval, 4.5%‐22.2%) and 16 patients (32%) had stable disease as their best response. The median progression‐free survival was 14 weeks (95% confidence interval, 12.9, 20.7 weeks). Overall, perifosine was well tolerated, and there were very few grade 3 and 4 events. The most common toxicities included nausea, diarrhea, musculoskeletal pain, and fatigue.CONCLUSIONS:Although perifosine demonstrated activity in patients with advanced RCC after failure on VEGF‐targeted therapy, its activity was not superior to currently available second‐line agents. Nonetheless, perifosine may be worthy of further study in RCC in combination with other currently available therapies. Cancer 2012. © 2012 American Cancer Society.
A longitudinal study of pain variability and its correlates in ambulatory patients with advanced stage cancer
Authors: Zhu Junya , Davis Roger B. , Stuver Sherri O. , Berry Donna L. , Block Susan , Weeks Jane C. , Weingart Saul N. 
Published: June 2012

AbstractBACKGROUND:Although pain is common among patients with advanced cancer, little is known about longitudinal variability in pain intensity. For this report, the authors examined variability in pain intensity over 24 months among ambulatory patients with advanced stage cancers, associations between patient characteristics and within‐patient pain variability, and the relation of pain variability to overall survival.METHODS:The sample comprised 949 patients with solid tumors who received care and reported pain scores in at least 3 different months within 24 months of their initial stage IV diagnosis during the period from 2004 to 2006. Pain intensity was measured using a scale ranging from 0 (no pain) to 10 (worst pain). Pain variability was defined as the standard deviation of the maximum monthly pain scores and was dichotomized at the 50th percentile into high and low variability groups.RESULTS:Considerable between‐patient differences in pain variability (range, 0‐5.77) were observed. Nonwhites, patients with a stage IV cancer diagnosed within the previous 3 months, and those with moderate or severe pain at baseline were more likely to experience high pain variability. Although patients with head and neck cancer generally had the highest pain variability, the intensity of their pain typically decreased over the disease course. High pain variability with worsening pain trajectory was associated with increased risk of death.CONCLUSIONS:Longitudinally, pain intensity was highly variable among patients with stage IV cancer. Minority patients, newly diagnosed patients, patients with head and neck cancer, and patients with moderate or severe pain at baseline were at higher risk of large fluctuations in pain intensity. Cancer 2012. © 2012 American Cancer Society.
A multi‐institution experience comparing the clinical and physiologic differences between upper extremity and lower extremity melphalan‐based isolated limb infusion
Authors: Beasley Georgia M. , Sharma Ketan , Wong Joyce , Miller Mike , Turley Ryan S. , Lidsky Michael , Masoud Melanie , Dewhirst Mark W. , Mosca Paul J. , Zager Jonathan S. , Tyler Douglas S. 
Published: June 2012

AbstractBACKGROUND:Although studies of melphalan‐based isolated limb infusion (ILI) combine data from upper extremity (UE) treatments with those from lower extremity (LE) treatments, differences between the 2 may be clinically important.METHODS:Candidates for UE ILI (n = 51) and LE ILI (n = 192) were identified from prospective databases at 2 institutions. The Response Evaluation Criteria in Solid Tumors and Wieberdink toxicity scale were used as appropriate.RESULTS:The following patients had indications for UE ILI: melanoma, 36 of 47 patients (77%); sarcoma, 5 of 47 patients (11%); Merkel cell sarcoma, 3 of 47 patients (6%), and squamous cell carcinoma, 3 of 47 patients (6%). The patients who underwent UE ILI, as expected, had lower limb volumes (mean, 2.5 L vs 8.6 L; P < .001) and lower mean melphalan doses (20.7 mg vs 49.5 mg; P < .001). On perfusate blood gas analysis, the mean base excess at 30 minutes (−13.9 vs −9.1; P < .001) and the mean pH at 30 minutes (7.06 vs 7.15; P < .001) were lower for UE procedures than for LE procedures, although the mean ischemic time was longer in LE procedures (67.2 minutes) than in UE procedures (61.6 minutes; P = .03). The rate of regional toxicity grade ≥3 for UE ILI was 7% compared with 24% (P = .005) for LE ILI. There was no difference in the complete response rate for melanoma UE procedures (28%; 95% confidence interval, 16%‐44%) compared with LE ILI procedures (32%; 95% confidence interval, 25%‐39%).CONCLUSIONS:ILI for UE disease was associated with similar complete response rates but lower toxicity than ILI for LE disease and with different physiologic sequelae despite comparable methods. The UE appears relatively resistant to toxic effects of melphalan‐based ILI as currently performed, which suggests a potential for further optimization of drug dosing for UE ILI. Cancer 2012. © 2012 American Cancer Society.
An immunohistochemical signature comprising PTEN, MYC, and Ki67 predicts progression in prostate cancer patients receiving adjuvant docetaxel after prostatectomy
Authors: Antonarakis Emmanuel S. , Keizman Daniel , Zhang Zhe , Gurel Bora , Lotan Tamara L. , Hicks Jessica L. , Fedor Helen L. , Carducci Michael A. , De Marzo Angelo M. , Eisenberger Mario A. 
Published: June 2012

AbstractBACKGROUND:Loss of the tumor suppressor PTEN is common in prostate cancer and may have prognostic significance. The authors examined PTEN and additional protein markers in primary tumors from patients with high‐risk, localized prostate cancer who received adjuvant docetaxel in a prospective multicenter trial (TAX2501).METHODS:Fifty‐six of 77 patients enrolled in TAX2501 had primary prostatectomy specimens available for immunohistochemical analysis of PTEN, MYC, ERG, tumor protein p53 (p53), antigen KI‐67 (Ki67), and phosphorylated forms of Akt, mammalian target of rapamycin (mTOR), and S6 ribosomal protein. Protocol‐defined progression included a prostate‐specific antigen (PSA) level ≥0.4 ng/mL, radiologic/clinical recurrence, or death. Univariate and multivariable proportional hazards regression analyses were used to investigate the influence of PTEN status (and other protein markers) on progression‐free survival (PFS).RESULTS:In this exploratory, post hoc analysis, PTEN protein loss (vs presence) was observed in 61% of patients and was associated with lower preoperative PSA levels, higher clinical stage, lower Ki67 expression, the presence of p53, and the presence of ERG. In univariate analysis, the factors associated with PFS included Gleason sum, seminal vesicle invasion, PTEN status, MYC expression, and Ki67 expression. In multivariable analysis, only 3 variables emerged as independent prognostic factors for PFS: PTEN status (P = .035), MYC expression (P = .001), and Ki67 expression (P < .001). A prognostic model was constructed that incorporated clinical covariates as well as information on PTEN, MYC, and Ki67.CONCLUSIONS:The current results indicated that PTEN status, MYC expression, and Ki67 expression in primary tumor samples may predict PFS more accurately than clinical factors alone in men with high‐risk prostate cancer who receive adjuvant docetaxel after prostatectomy. If validated, these hypothesis‐generating findings may have prognostic and therapeutic implications and may aid clinical trial design. Cancer 2012. © 2012 American Cancer Society.