bluuebunny/crossref_metadata_2025_split huggingface dataset:
P105 The internet as a source of sexual health information; what do service users want?
Authors: Eddy F , Brady M 
Published: May 2012

BackgroundAccess to information is a key challenge in sexual health, with poor knowledge associated with poor outcomes. Internet interventions have been shown to improve sexual health knowledge, highlighting the potential of the web as a source of information.AimsTo assess sexual health service users' use of the Internet to obtain sexual health information, and to use the data to inform the design of a local sexual health website.Methods243 participants were recruited from a busy walk-in sexual health clinic in July and September 2011. A structured questionnaire assessed their use and rating of the Internet for various aspects of sexual health information (STIs, contraception, clinic information, homosexuality, virginity and body worries) and gauged opinion on the content of a local sexual health website.Results62% of participants were female. 44% identified as black African, black Caribbean or black British and 42% were white. 44% were aged under 25. 67% of respondents use the internet for sexual health information. It was the most popular resource for information on STIs, clinic information and homosexuality (compared to doctor/nurse, friends, family, school, TV and magazines). The next most popular choices were doctor/nurse and friends. 67% stated they would use a local sexual health website with STIs, clinic information and contraception being the topics they would most like information on. “Detailed” and “Basic” information were highlighted as important aspects of website content. Only 19% selected “original design” as being important.ConclusionsThe internet is a popular source for sexual health information. For STIs it was selected over doctors/nurses indicating the need for good online information. Both basic and detailed information were requested highlighting the importance of a range of educational resources. Originality was not as important as having a site they could trust. These findings will inform the development and content of a local website.
P113 Primary health providers' adherence to national chlamydia guidelines
Authors: Morgan J M , Mills L A , Bell A J 
Published: May 2012

AimTo re-audit district-wide management of genital chlamydia infection following implementation of NZ national chlamydia guidelines.MethodsAll healthcare settings in a single NZ health district that diagnosed 20 or more cases of chlamydia during September 2010–2011 were invited to participate and were asked to complete an audit proforma for 20 consecutive cases. Sexual Health clinic cases were excluded. Collated results were compared to findings of a similar audit of 394 cases diagnosed during 2008, which was undertaken before guideline implementation in 2009.Results19 of 22 eligible sites participated, providing data for 424 cases; of these, 302 (71.2%) were managed in General Practice, with the remainder from a range of settings including Family Planning, student health services, and A&E. 405 of 424 (95.5%) cases in 2010–2011 had documented treatment compared to 354 of 394 (89.8%) in 2008. Notifying current sexual partners was noted in 314 cases (74%), compared to 58.1% in 2008. 126 of 424 (29.7%) of cases were noted to have informed at least 50% of their sexual partners compared to 17.8% in 2008.ConclusionImproved case management and partner notification may reflect better documentation than in the initial audit but more appropriate choice of diagnostic sampling, more testing for other STIs and more appropriate dosage and duration of prescribed antibiotics supports that primary care chlamydia case management in this district has improved following local implementation of national guidelines. More work is needed to enhance documented partner management outcomes.
P116 Assessing the sexual violence services currently provided in genitourinary medicine clinics
Authors: Emerson C R , Sacks R , Foster G E 
Published: May 2012

BackgroundMany patients present to Genitourinary medicine (GUM) clinics following sexual violence (SV) occurring in circumstances including sexual assault (SA), domestic violence (DV), sex work (SW) and trafficking. BASHH has guidelines for SA but not for addressing SV in other situations. Are GUM clinics providing services for these needs?AimsTo assess services currently available in GUM for those disclosing SV.MethodsA cross sectional anonymous online survey of UK GUM clinics was performed. The survey was designed by the authors and piloted. Information was gathered on specific clinics for SV, how often they occur and which members of the multidisciplinary team are involved, and training available for SV. Links with other support services was ascertained. The data were analysed using Microsoft Excel.ResultsThe response rate was 66/178 (37%), with all regions and deaneries being represented. All responding clinics provide PEP, emergency contraception, STI screen, hepatitis prophylaxis and advice for those presenting after SA. 24% of clinics never use chain of evidence procedures. 80% have a local sexual assault referral centre (of these 87% were happy with this service). 80%, 77%, 50% and 38% have no dedicated clinic for female genital mutilation, sexual trafficking, DV and SW respectively and less than 50% have local training or procedures for these facets. 32% ask about non-consensual sex in all GUM consults, 53% ask this in special groups only. 47% routinely ask about SW.DiscussionThere is a wide variation in the SV services available at GUM clinics. Sexual assault services meet guideline recommendations for GUM but SV occurring in other contexts may not be addressed. Sexual violence is increasingly reported and GUM clinics may be the first or only location of presentation. We recommend further training and guidelines to ensure clinics are equipped to meet this need.
P118 Rape in young adolescents: risk factors for attending a sexual assault referral centre and ensuring adequate sexual health follow-up
Authors: Wilson-Brown B , Steele G , Fargie F 
Published: May 2012

BackgroundWe are an urban sexual assault referral centre (SARC) also covering a large rural area. We see men and women over the age of 13 who have been sexually assaulted in the last 7 days. In 2011 we saw 53 attendences from adolescents between 13 and 15 years (13% of all SARC attendences).Aims(1) To review the profile of young victims of rape and sexual assault. (2) Retrospectively review the sexual and emotional health follow-up received by this client group post sexual assault. Method 2 data sets were reviewed. The SARC database were used to identify all clients attending in 2011 aged between 13 and 15 and to collect information including demographics/details of the assault/particular vulnerabilities including alcohol use and whether looked after and accommodated (LAAC) or known to social work. The National Sexual Health electronic patient record (NASH) was then used to review whether these clients attended for any sexual/emotional health follow from their local sexual health services to which they are routinely referred post assault. (A few clients requested referral to their GP.)Results32/53 (60%)of clients had been drinking alcohol prior to the assault. 14/53 (26%) of clients were LAAC and a further 12/53 (23%) were known to social work. 5/53 clients had previously attended the SARC and were attending after a second sexual assault and all five clients were LAAC. 36/53 (67%) had specialist sexual health input post assault with five clients due to attend in the next few weeks. Four clients were referred to their GP. Eight clients failed to attend any follow-up and social work were informed.ConclusionA significant proportion of young adolescents attending our SARC have one or more markers for vulnerability. Health services need to be aware of the increased risk of sexual violence for these clients. Successful follow-up is possible with close liaison between health and social care workers.
P120 Correlation of patient completed triage tools with patient symptoms in an integrated sexual health service
Authors: Bhaduri S , Gosling C 
Published: May 2012

BackgroundTriage tools (TT) were introduced in an integrated sexual health service to enable patients to be streamed to the most appropriate healthcare professional. The tool used is a patient completed questionnaire to ascertain reasons for attendance and any presenting symptoms.AimTo determine whether the TT is a good indicator of patient symptoms and predictor of the skill mix required for the service.MethodA retrospective analysis of case notes reviewed gender, reported symptoms stated on TT and whether these symptoms correlated with the history taken from the patient.Results360 notes were analysed (178 females, 182 males), 125/178 (70%) of females were symptomatic according to TT. In 17/178 (9%) the correlation between TT and history taking was deficient. In 8/17 of these cases, issues related to contraception or referral for termination of pregnancy. 53/178 (30%) were asymptomatic according to TT. In 13/53 cases, symptoms were later disclosed on history taking (dyspareunia, vulval discomfort, disclosure of assault or contraception issues). In males, 82/182 (45%) were symptomatic and 7/182 (4%) of cases demonstrated a correlation deficit (eg, disclosure of assault). 100/182 (54%) of cases were asymptomatic on TT of which 24/100 were not on history taking.ConclusionIn 61/360 (17%) of patients the correlation of symptoms was incomplete on history taking compared to the TT. This indicates that although the tool remains a useful guide to patient presentation, clinics require a broad skill mix, including those with experience in dealing all aspects of integrated sexual health.
P123 Non-medical prescribing by nurse practitioners in a walk-in sexual health clinic
Authors: Black A , Roberts C , Smith A 
Published: May 2012

BackgroundNon-medical prescribing legislation in the UK provides suitably qualified nurses with prescribing powers comparable with doctors. This facilitates autonomous practice and allows independent completion of care episodes. There is however limited evidence regarding the application and safety of nurse prescribing.AimInvestigate the application of non-medical prescribing in sexual health.MethodsA cross-sectional study explored non-medical prescribing in a London based GUM department between 1 January 2010 and 30 June 2010. A retrospective review of randomly selected clinical notes was performed. This included 382 nurse prescriber led and 255 non-prescriber led GUM consultations. Prescribing frequency; range of medications and diagnoses; independent episode completion and prescribing safety were investigated.ResultsMedication was dispensed in 52.9% (n=337) of consultations in the 637 combined episodes. A total of 427 diagnoses were identified that required 34 different medicinal products and 452 treatments to be dispensed in total by nurse practitioners. The management of sexual contacts accounted for 22.1% (n=60) of treatments. A statistical difference in independent practice existed between practitioners (χ2test p<0.001), with prescribers 15.52 times (CI 9.41 to 25.59) more likely to independently complete episodes of care. Safe appropriate prescribing was identified in 99.1% (n=210) of cases. On two occasions a lack of documentation of concurrent medication or allergies made it difficult to assess safety. There were no serious errors in prescribing practice found.ConclusionsIn our GUM clinic widespread use of prescribing skills was demonstrated. Nurses with prescribing skills were able to work more independently. Non-medical prescribing has been applied safely in accordance with clear treatment guidelines.
Precambrian sedimentary basins of India: an appraisal of their petroleum potential
Authors: Ojha Prem Shanker 
Published: May 2012

Abstract
The Indian Proterozoic Super Basins were part of the Northern Rim of Gondwanaland prior to its break-up along six major radial fractures. The Proterozoic rocks of these basins are extensively exposed in the northern as well as the southern parts of the Indian Peninsula. Based on recently conducted geochemical and seismic surveys within these basins, followed by well drilling in the Son Valley, Ganga Valley, and the Bikaner–Nagaur basin, it is concluded that hydrocarbons have been generated within these basins and conditions conducive to hydrocarbon accumulation exist within them. The discovery of gas within Son Valley has indicated the existence of an active Mesoproterozoic petroleum system that is likely to have continued up to Infracambrian times. Based on the correlation of Indian Proterozoic Super Basins with their analogous Chinese and Australian basins, it appears that elements of a similar petroleum system exist within these basins, together with the possibility of an active Ordovician–Silurian petroleum system within the northernmost Ganga Valley Vindhyans, where sedimentation continued up to the lower Devonian. Modelling and empirical data show that the Chambal Valley, as well as the probably trap-concealed Vindhyans, underwent intense wrenching during Neoproterozoic times, accompanied by good entrapment conditions. Even the peninsular SW Cuddapah Superbasin also appears worth exploring as an element of the Meso–Neoproterozoic petroleum system.
Perturbation of Rb, p53, and Brca1 or Brca2 Cooperate in Inducing Metastatic Serous Epithelial Ovarian Cancer
Authors: Szabova Ludmila , Yin Chaoying , Bupp Sujata , Guerin Theresa M. , Schlomer Jerome J. , Householder Deborah B. , Baran Maureen L. , Yi Ming , Song Yurong , Sun Wenping , McDunn Jonathan E. , Martin Philip L. , Van Dyke Terry , Difilippantonio Simone 
Published: May 2012

Abstract
The majority of human high-grade serous epithelial ovarian cancer (SEOC) is characterized by frequent mutations in p53 and alterations in the RB and FOXM1 pathways. A subset of human SEOC harbors a combination of germline and somatic mutations as well as epigenetic dysfunction for BRCA1/2. Using Cre-conditional alleles and intrabursal induction by Cre-expressing adenovirus in genetically engineered mice, we analyzed the roles of pathway perturbations in epithelial ovarian cancer initiation and progression. Inactivation of RB-mediated tumor suppression induced surface epithelial proliferation with progression to stage I carcinoma. Additional biallelic inactivation and/or missense p53 mutation in the presence or absence of Brca1/2 caused progression to stage IV disease. As in human SEOC, mice developed peritoneal carcinomatosis, ascites, and distant metastases. Unbiased gene expression and metabolomic profiling confirmed that Rb, p53, and Brca1/2-triple mutant tumors aligned with human SEOC, and not with other intraperitoneal cancers. Together, our findings provide a novel resource for evaluating disease etiology and biomarkers, therapeutic evaluation, and improved imaging strategies in epithelial ovarian cancer. Cancer Res; 72(16); 4141–53. ©2012 AACR.
Integrative Genomic Analysis Implicates Gain ofPIK3CAat 3q26 andMYCat 8q24 in Chronic Lymphocytic Leukemia
Authors: Brown Jennifer R. , Hanna Megan , Tesar Bethany , Werner Lillian , Pochet Nathalie , Asara John M. , Wang Yaoyu E. , dal Cin Paola , Fernandes Stacey M. , Thompson Christina , MacConaill Laura , Wu Catherine J. , Van de Peer Yves , Correll Mick , Regev Aviv , Neuberg Donna , Freedman Arnold S. 
Published: May 2012

AbstractPurpose: The disease course of chronic lymphocytic leukemia (CLL) varies significantly within cytogenetic groups. We hypothesized that high-resolution genomic analysis of CLL would identify additional recurrent abnormalities associated with short time-to-first therapy (TTFT).Experimental Design: We undertook high-resolution genomic analysis of 161 prospectively enrolled CLLs using Affymetrix 6.0 SNP arrays, and integrated analysis of this data set with gene expression profiles.Results: Copy number analysis (CNA) of nonprogressive CLL reveals a stable genotype, with a median of only 1 somatic CNA per sample. Progressive CLL with 13q deletion was associated with additional somatic CNAs, and a greater number of CNAs was predictive of TTFT. We identified other recurrent CNAs associated with short TTFT: 8q24 amplification focused on the cancer susceptibility locus near MYC in 3.7%; 3q26 amplifications focused on PIK3CA in 5.6%; and 8p deletions in 5% of patients. Sequencing of MYC further identified somatic mutations in two CLLs. We determined which catalytic subunits of phosphoinositide 3-kinase (PI3K) were in active complex with the p85 regulatory subunit and showed enrichment for the α subunit in three CLLs carrying PIK3CA amplification.Conclusions: Our findings implicate amplifications of 3q26 focused on PIK3CA and 8q24 focused on MYC in CLL. Clin Cancer Res; 18(14); 3791–802. ©2012 AACR.
Elevation of c-FLIP in Castrate-Resistant Prostate Cancer Antagonizes Therapeutic Response to Androgen Receptor–Targeted Therapy
Authors: McCourt Clare , Maxwell Pamela , Mazzucchelli Roberta , Montironi Rodolfo , Scarpelli Marina , Salto-Tellez Manuel , O'Sullivan Joe M. , Longley Daniel B. , Waugh David J.J. 
Published: May 2012

Abstract
Purpose: To characterize the importance of cellular Fas-associated death domain (FADD)–like interleukin 1β-converting enzyme (FLICE) inhibitory protein (c-FLIP), a key regulator of caspase-8 (FLICE)–promoted apoptosis, in modulating the response of prostate cancer cells to androgen receptor (AR)–targeted therapy.
Experimental Design: c-FLIP expression was characterized by immunohistochemical analysis of prostatectomy tissue. The functional importance of c-FLIP to survival and modulating response to bicalutamide was studied by molecular and pharmacologic interventions.
Results: c-FLIP expression was increased in high-grade prostatic intraepithelial neoplasia and prostate cancer tissue relative to normal prostate epithelium (P &lt; 0.001). Maximal c-FLIP expression was detected in castrate-resistant prostate cancer (CRPC; P &lt; 0.001). In vitro, silencing of c-FLIP induced spontaneous apoptosis and increased 22Rv1 and LNCaP cell sensitivity to bicalutamide, determined by flow cytometry, PARP cleavage, and caspase activity assays. The histone deacetylase inhibitors (HDACi), droxinostat and SAHA, also downregulated c-FLIP expression, induced caspase-8- and caspase-3/7–mediated apoptosis, and increased apoptosis in bicalutamide-treated cells. Conversely, the elevated expression of c-FLIP detected in the CRPC cell line VCaP underpinned their insensitivity to bicalutamide and SAHA in vitro. However, knockdown of c-FLIP induced spontaneous apoptosis in VCaP cells, indicating its relevance to cell survival and therapeutic resistance.
Conclusion: c-FLIP reduces the efficacy of AR-targeted therapy and maintains the viability of prostate cancer cells. A combination of HDACi with androgen deprivation therapy may be effective in early-stage disease, using c-FLIP expression as a predictive biomarker of sensitivity. Direct targeting of c-FLIP, however, may be relevant to enhance the response of existing and novel therapeutics in CRPC. Clin Cancer Res; 18(14); 3822–33. ©2012 AACR.
Alpha-Melanocyte–Stimulating Hormone Suppresses Oxidative Stress through a p53-Mediated Signaling Pathway in Human Melanocytes
Authors: Kadekaro Ana Luisa , Chen Juping , Yang Jennifer , Chen Shuna , Jameson Joshua , Swope Viki B. , Cheng Tan , Kadakia Madhavi , Abdel-Malek Zalfa 
Published: May 2012

Abstract
Epidermal melanocytes are skin cells specialized in melanin production. Activation of the melanocortin 1 receptor (MC1R) on melanocytes by α-melanocyte–stimulating hormone (α-MSH) induces synthesis of the brown/black pigment eumelanin that confers photoprotection from solar UV radiation (UVR). Contrary to keratinocytes, melanocytes are slow proliferating cells that persist in the skin for decades, in an environment with high levels of UVR-induced reactive oxygen species (ROS). We previously reported that in addition to its role in pigmentation, α-MSH also reduces oxidative stress and enhances the repair of DNA photoproducts in melanocytes, independent of melanin synthesis. Given the significance of ROS in carcinogenesis, here we investigated the mechanisms by which α-MSH exerts antioxidant effects in melanocytes. We show that activation of the MC1R by α-MSH contributes to phosphorylation of p53 on serine 15, a known requirement for stabilization and activation of p53, a major sensor of DNA damage. This effect is mediated by the cAMP/PKA pathway and by the activation of phosphoinositide 3-kinase (PI3K) ATR and DNA protein kinase (DNA-PK). α-MSH increases the levels of 8-oxoguanine DNA glycosylase (OGG1) and apurinic apyrimidinic endonuclease 1 (APE-1/Ref-1), enzymes essential for base excision repair. Nutlin-3, an HDM2 inhibitor, mimicked the effects of α-MSH resulting in reduced phosphorylation of H2AX (γ-H2AX), a marker of DNA damage. Conversely, the p53 inhibitor pifithrin-α or silencing of p53 abolished the effects of α-MSH and augmented oxidative stress. These results show that p53 is an important target of the downstream MC1R signaling that reduces oxidative stress and possibly malignant transformation of melanocytes. Mol Cancer Res; 10(6); 778–86. ©2012 AACR.
Relationship Between Chest Compression Rates and Outcomes From Cardiac Arrest
Authors: Idris Ahamed H. , Guffey Danielle , Aufderheide Tom P. , Brown Siobhan , Morrison Laurie J. , Nichols Patrick , Powell Judy , Daya Mohamud , Bigham Blair L. , Atkins Dianne L. , Berg Robert , Davis Dan , Stiell Ian , Sopko George , Nichol Graham 
Published: May 2012

Background—
Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions per minute. Animal and human studies have reported that blood flow is greatest with chest compression rates near 120/min, but few have reported rates used during out-of-hospital (OOH) cardiopulmonary resuscitation or the relationship between rate and outcome. The purpose of this study was to describe chest compression rates used by emergency medical services providers to resuscitate patients with OOH cardiac arrest and to determine the relationship between chest compression rate and outcome.

Methods and Results—

Included were patients aged ≥20 years with OOH cardiac arrest treated by emergency medical services providers participating in the Resuscitation Outcomes Consortium. Data were abstracted from monitor-defibrillator recordings during cardiopulmonary resuscitation. Multiple logistic regression analysis assessed the association between chest compression rate and outcome. From December 2005 to May 2007, 3098 patients with OOH cardiac arrest were included in this study. Mean age was 67±16 years, and 8.6% survived to hospital discharge. Mean compression rate was 112±19/min. A curvilinear association between chest compression rate and return of spontaneous circulation was found in cubic spline models after multivariable adjustment (
P
=0.012). Return of spontaneous circulation rates peaked at a compression rate of ≈125/min and then declined. Chest compression rate was not significantly associated with survival to hospital discharge in multivariable categorical or cubic spline models.

Conclusions—
Chest compression rate was associated with return of spontaneous circulation but not with survival to hospital discharge in OOH cardiac arrest.