bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of a ‘fast-track’ referral service for intrauterine contraception following early medical abortion: Table 1
Authors: Cameron Sharon T , Berugoda Nayani , Johnstone Anne , Glasier Anna 
Published: February 2012

BackgroundA ‘fast-track’ referral system for intrauterine contraception was established in 2007 between the medical abortion service at the Royal Infirmary of Edinburgh and the principal family planning clinic (FPC) in Edinburgh.MethodsCase note review of women fast-tracked for intrauterine contraception after medical abortion between January 2007 and June 2009. Main outcome measures were numbers of women referred, attendance rates, interval to insertion, devices chosen and known complication rates.ResultsOf the 237 women referred, 126 (53%) attended for intrauterine contraception insertion. Attenders were slightly but significantly older than non-attenders (mean ages of 30 and 27 years, respectively;p=0.003), less likely to live in an area of deprivation (p=0.045) and were significantly more likely to have attended the FPC in the past (p<0.0001). Most attenders (90%;n=113) proceeded to have an intrauterine method inserted; 57% (n=64) chose the levonorgestrel intrauterine system and 43% (n=49) chose a copper intrauterine device. The median interval to insertion was 21 (range 0–54) days. Of those women (n=55) who attended for routine follow-up 6 weeks later (49%), there were four (7.2%) cases of expulsion, two (3.6%) requests for removal and four (7.2%) cases of suspected infection.ConclusionsOnly half the women fast-tracked for intrauterine contraception actually attended and these tended to be women who were pre-existing clients of the FPC. Consideration should therefore be given to provision of immediate insertion where possible.
MRSA contaminated venepuncture tourniquets in clinical practice
Authors: Elhassan Hassan A , Dixon Teresa 
Published: February 2012

Abstract

Introduction
Meticillin-resistant Staphylococcus aureus (MRSA) hospital-acquired infection is associated with increased patient mortality. National guidelines state that shared patient equipment must be cleaned after use. The authors sought to identify MRSA contamination in a sample of non-disposable venepuncture tourniquets and audit cleaning habits between patient contacts.

Materials and methods
Fifty tourniquets were collected from junior doctors, nursing staff and wards from two district general hospitals in Essex, UK in 2007. A questionnaire was completed at the time of collection for each tourniquet. The tourniquets were cultured using standard microbiology techniques.

Findings
18/50 (36%) tourniquets were positive for S aureus and of these 6/50 (12%) were MRSA positive. 33/43 (77%) healthcare professionals using non-disposable tourniquets for venepuncture made no attempts at cleaning their tourniquets. 10/43 (23%) staff admitted to cleaning their tourniquets. The tourniquets were used for an average of 14 weeks on approximately three different patients per day. 30/50 (60%) tourniquets were visibly soiled and of these 13 were blood stained and 20/50 (40%) appeared ‘clean’. Worn tourniquets when compared with the ‘clean’ tourniquets were more likely to be contaminated with S aureus, 15/30 (50%) vs 3/20 (15%), and MRSA 5/30 (17%) vs 1/20 (5%).

Conclusion
Non-disposable venepuncture tourniquets are contaminated with MRSA and pose a risk to patients. The majority of clinical staff do not clean them between patient contacts as recommended by guidelines. The use of non-disposable venepuncture tourniquets should be abandoned. The introduction of disposable tourniquets to clinical practice should be an adjunct to current measures for MRSA prevention.
Sef Downregulation by Ras Causes MEK1/2 to Become Aberrantly Nuclear Localized Leading to Polyploidy and Neoplastic Transformation
Authors: Duhamel Stéphanie , Hébert Josée , Gaboury Louis , Bouchard Amélie , Simon Ronald , Sauter Guido , Basik Mark , Meloche Sylvain 
Published: February 2012

Abstract
Subcellular trafficking of key oncogenic signal pathway components is likely to be crucial for neoplastic transformation, but little is known about how such trafficking processes are spatially controlled. In this study, we show how Ras activation causes aberrant nuclear localization of phosphorylated mitogen-activated protein (MAP)/extracellular signal-regulated kinase (ERK; MEK) MEK1/2 to drive neoplastic transformation. Phosphorylated MEK1/2 was aberrantly located within the nucleus of primary colorectal tumors and human colon cancer cells, and oncogenic activation of Ras was sufficient to induce nuclear accumulation of phosphorylated MEK1/2 and ERK1/2 in intestinal epithelial cells. Enforced nuclear localization of MEK1 in epithelial cells or fibroblasts was sufficient for hyperactivation of ERK1/2, thereby driving cell proliferation, chromosomal polyploidy, and tumorigenesis. Notably, Ras-induced nuclear accumulation of activated MEK1/2 was reliant on downregulation of the spatial regulator Sef, the reexpression of which was sufficient to restore normal MEK1/2 localization and a reversal of Ras-induced proliferation and tumorigenesis. Taken together, our findings indicate that Ras-induced downregulation of Sef is an early oncogenic event that contributes to genetic instability and tumor progression by sustaining nuclear ERK1/2 signaling. Cancer Res; 72(3); 626–35. ©2012 AACR.
Reports from the 2010 Clinical and Translational Cancer Research Think Tank Meeting: Design Strategies for Personalized Therapy Trials
Authors: Berry Donald A. , Herbst Roy S. , Rubin Eric H. 
Published: February 2012

Abstract
It has long been evident that cancer is a heterogeneous disease, but only relatively recently have we come to realize the extent of this heterogeneity. No single therapy is effective for every patient with tumors having the same histology. A clinical strategy based on a single-therapy approach results in overtreatment for the majority of patients. Biomarkers can be considered as knives that dissect the disease ever more finely. The future of clinical research will be based on learning whether certain therapies are more appropriate than others for biomarker-defined subsets of patients. Therapies will eventually be tailored to narrow biomarker subsets. The ability to determine which therapies are appropriate for which patients requires information from biological science as well as empirical evidence from clinical trials. Neither is easy to achieve. Here we describe some nascent approaches for designing clinical trials that are biomarker-based and adaptive. Our focus is on adaptive trials that address many questions at once. In a way, these clinical experiments are themselves part of a much larger experiment: learning how (or whether it is possible) to design experiments that match patients in small subsets of disease with therapies that are especially effective and possibly even curative for them. Clin Cancer Res; 18(3); 638–44. ©2012 AACR.
Imaging: Strategies, Controversies, and Opportunities
Authors: Blasberg Ronald , Piwnica-Worms David 
Published: February 2012

Abstract
At a Clinical and Translational Cancer Research Think Tank meeting sponsored by the American Association for Cancer Research in 2010, one of the breakout groups focused on new technologies and imaging. The discussions emphasized new opportunities in translational imaging and its role in the future, rather than established techniques that are currently in clinical practice. New imaging methods under development are changing the approach of imaging science from a focus on the anatomic description of disease to a focus on the molecular basis of disease. Broadly referred to as molecular imaging, these new strategies directly embrace the incorporation of cell and molecular biology concepts and techniques into image generation and can involve the introduction of genes into cells with the explicit intent to image the end products of gene expression with external imaging devices. These new methods hold the promise of providing clinicians with (i) robust linkages between cell and animal models and clinical trials, (ii) in vivo biomarkers that can be measured repeatedly and sequentially over time to observe dynamic disease processes and responses to treatment, and (iii) tools for preselection and patient population enrichment in phase II and III trials to improve outcomes and better direct treatment. These strategies provide real-time pharmacodynamic parameters and can be powerful tools to monitor therapeutic effects in a spatially and tissue-specific manner, which may reduce cost during drug development, because pharmacodynamic studies in animals can inform clinical trials and accelerate the translation process. The Imaging Response Assessment Team (IRAT) program serves as an example of how imaging techniques can be incorporated into clinical trials. IRATs work to advance the role of imaging in assessment of response to therapy and to increase the application of quantitative anatomic, functional, and molecular imaging endpoints in clinical trials, and imaging strategies that will lead to individualized patient care. Clin Cancer Res; 18(3); 631–7. ©2012 AACR.
Genetically Modified Mouse Models for Biomarker Discovery and Preclinical Drug Testing
Authors: Kucherlapati Raju 
Published: February 2012

Abstract
The ability to grow pluripotent mouse embryonic stem cells in culture, and to introduce precise genetic modifications into those cells through gene targeting, has greatly facilitated the generation of mouse models of human disease. This technology is playing a particularly important role in cancer research. In addition to their use in elucidating the role of individual genes or combinations of 2 or more genes, the genetically engineered mouse models are being used to develop biomarkers and for preclinical drug testing. By examining plasma samples from tumor-bearing mice from mice carrying specific mutations in tumor suppressor genes and/or oncogenes, investigators can identify tumor-specific biomarkers that are overexpressed in the tumor cells. These markers are directly relevant to the corresponding human cancer. The ability to generate tumors at the correct anatomical site within the normal cellular environment is augmenting the use of xenografts in drug testing in a preclinical setting. Clin Cancer Res; 18(3); 625–30. ©2012 AACR.
Drug-Refractory Ventricular Tachycardias After Myocarditis
Authors: Russo Antonio Dello , Casella Michela , Pieroni Maurizio , Pelargonio Gemma , Bartoletti Stefano , Santangeli Pasquale , Zucchetti Martina , Innocenti Ester , Di Biase Luigi , Carbucicchio Corrado , Bellocci Fulvio , Fiorentini Cesare , Natale Andrea , Tondo Claudio 
Published: February 2012

Background—
Ventricular tachycardia (VT) is a significant therapeutic challenge in patients with myocarditis. This study aimed to assess the efficacy and safety of radiofrequency catheter ablation (RFCA) of VT in patients with myocarditis.

Methods and Results—
We enrolled 20 patients (15 men; age, 42 [28–52] years) with a history of biopsy-proven viral myocarditis and drug-refractory VT; 5 patients presented with electrical storm. The median left ventricular ejection fraction was 55% (45–60%). All patients underwent endocardial RFCA with an irrigated catheter, using contact electroanatomic mapping. Recurrence of sustained VT after endocardial RFCA was treated with additional epicardial RFCA. Endocardial RFCA was acutely successful in 14 patients (70%) while in the remaining 6 (30%) clinical VT was successfully ablated by epicardial RFCA. In 1 patient, hemodynamic instability required an intra-aortic balloon pump to complete RFCA. No major complication occurred during or after RFCA. Over a median follow-up time of 28 (11–48) months, 18 patients (90%) remained free of sustained VT; 2 patients (10%, both with baseline left ventricular ejection fraction ≤35%) died of acute heart failure unrelated to ventricular arrhythmias.

Conclusions—
In patients with myocarditis, RFCA of drug-refractory VT is feasible, safe, and effective. Epicardial RFCA should be considered as an important therapeutic option to increase success rate.
Serial Assessment of Coronary Artery Response to Paclitaxel-Eluting Stents Using Optical Coherence Tomography
Authors: Guagliumi Giulio , Bezerra Hiram G. , Sirbu Vasile , Ikejima Hideyuki , Musumeci Giuseppe , Biondi-Zoccai Giuseppe , Lortkipanidze Nikoloz , Fiocca Luigi , Capodanno Davide , Wang Wei , Tahara Satoko , Vassileva Angelina , Matiashvili Aleksandre , Valsecchi Orazio , Costa Marco A. 
Published: February 2012

Background—
The paucity of longitudinal, serial high-resolution imaging studies has limited our understanding of in vivo arterial response to drug-eluting stents. We sought to investigate the human coronary response to paclitaxel-eluting stent implantation, using serial optical coherence tomography assessments.

Methods and Results—

Thirty patients with at least 2 significant coronary lesions in different vessels were treated with a paclitaxel-eluting stent. The most severe stenosis (lesion A) was treated at the initial procedure, and the second target vessel (lesion B) was stented 3 months later. Optical coherence tomography was performed at baseline, 3-, and 9-month follow-up for lesions A and baseline and 6 months for lesions B. Prespecified end points were percent of uncovered and malapposed struts over time. In lesions A, uncovered struts were 3.77±4.94% and 3.02±4.35% at 3 versus 9 months (
P
=NS). Malapposed struts were 3.55±5.16% at post-procedure, 1.51±3.52% at 3 months, and 0.60±1.82% at 9 months (
P
<0.05, at 3 versus 9 months). Strut-level neointimal thickness was 0.19±0.09 mm and 0.20±0.11 mm (
P
=NS) over time. Newly acquired malapposition was detected in 10.4% and 3.3% of 2.5-mm segments at 3- and 9-month follow-up. In lesions B, uncovered struts were 2.91±5.47% at 6-months. Malapposed struts were 4.94±6.70% post-procedure and 1.01±3.11% at 6 months (
P
<0.01), with 0.19±0.09-mm neointimal thickness at follow-up.

Conclusions—
Optical coherence tomography imaging suggested the first 3 months to be the period with most biological activity after paclitaxel-eluting stent implantation, when the proliferative reaction mainly occurs and malapposition resolves. A less active, yet continuous, dynamic arterial response, with resolution and development of malapposition, occurs through 9 months post-treatment.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00704145.
Coronary Microcirculatory Resistance Is Independent of Epicardial Stenosis
Authors: Yong Andy S.C. , Ho Michael , Shah Maulik G. , Ng Martin K.C. , Fearon William F. 
Published: February 2012

Background—
Recent studies show that coronary microcirculatory impairment is an independent predictor of poor outcomes in patients with cardiovascular disease. However, controversy exists over whether microcirculatory resistance, a measure of coronary microcirculatory status, is dependent on epicardial stenosis severity. Previous studies demonstrating that microcirculatory resistance is dependent on epicardial stenosis severity have not accounted for collateral flow in their measurement of microcirculatory resistance. We investigated whether the index of microcirculatory resistance is independent of epicardial stenosis by comparing the index of microcirculatory resistance (IMR) levels in patients before and after percutaneous coronary intervention (PCI).

Methods and Results—

Consecutive patients undergoing elective PCI of the left anterior descending artery were recruited. Patients who developed periprocedural myocardial infarction were excluded. A pressure-temperature sensor wire was used to measure the apparent IMR (IMR
app
), which does not adjust for collateral flow, and the true IMR (IMR
true
), which incorporates wedge pressure measurement to account for collateral flow, before and after PCI. In 43 patients, there was no difference between pre- and post-PCI IMR
true
(mean difference=0.8±11.7,
P
=0.675). IMR
app
was higher pre-PCI compared with post-PCI (mean difference=10.0±14.5,
P
<0.001). IMR
app
was higher than IMR
true
(mean difference=9.3±14.2,
P
<0.001), and the difference between the IMR
app
and IMR
true
became greater with decreasing fractional flow reserve and increasing coronary wedge pressure. Pre-PCI fractional flow reserve correlated modestly with IMR
app
(
r
=−0.33,
P
=0.03), but not IMR
true
(
r
=0.26,
P
=0.10).

Conclusions—
Coronary microcirculatory resistance is independent of functional epicardial stenosis severity when collateral flow is taken into account.
A Multiscale Analysis of the Extreme Weather Events over Western Russia and Northern Pakistan during July 2010
Authors: Galarneau Thomas J. , Hamill Thomas M. , Dole Randall M. , Perlwitz Judith 
Published: February 2012

AbstractThis manuscript presents a detailed multiscale analysis—using observations, model analyses, and ensemble forecasts—of the extreme heat wave over Russia and historic floods over Pakistan during late July 2010, with an emphasis on the floods over northern Pakistan. The results show that recirculation of air and dynamically driven subsidence occurring with the intensification of the blocking anticyclone in late July 2010 were key factors for producing the exceptionally warm temperatures over western Russia. Downstream energy dispersion from the blocking region led to trough deepening northwest of Pakistan and ridge building over the Tibetan Plateau, thereby providing the linkage between the Russian heat wave and Pakistan flood events on the large scale, in agreement with previous studies.The extratropical downstream energy dispersion and enhanced convective outflow on the large scale associated with the active phase of the Madden–Julian oscillation facilitated the formation of an intense upper-level jet northwest of Pakistan. During this same period an intense southeasterly, low-level, barrier jet–like feature formed over northern Pakistan in conjunction with a westward-moving monsoon depression. This low-level jet and deep easterly flow on the equatorward flank of an anomalous anticyclone over the Tibetan Plateau further enhanced the transport of deep tropical moisture into Pakistan and produced a sustained upslope flow and an extended period of active convection, thereby providing an important contribution leading to the exceptional rainfall amounts. The deep easterly flow and intense low-level jet were features that were absent during previous convective episodes over northern Pakistan in 2010, and hence, were likely key factors in the increased severity of the late July event.
Systematic Evaluation of the Upper Airway in the Adult Population of São Paulo, Brazil
Authors: Stefanini Renato , Tufik Sergio , Soares Maria Claudia Mattos , Haddad Fernanda Louise Martinho , Bittencourt Lia Rita Azeredo , Santos‐Silva Rogerio , Gregorio Luis Carlos 
Published: February 2012

ObjectivesTo study the prevalence of otorhinolaryngologic symptoms and findings of physical examination of the upper airway (UA) of a representative sample of the adult population of São Paulo, Brazil, and the association between these findings.Study DesignCross‐sectional survey.SettingPopulation sample.MethodsA total of 1101 randomly selected volunteers representing the adult population of São Paulo according to sex, age, and socioeconomic class were included in this study. Otorhinolaryngological evaluation included investigation of nasal complaints, physical examination of the UA, and a facial inspection.ResultsA total of 993 volunteers (53.9% women), with a mean age of 41.8 ± 0.89 years, underwent otorhinolaryngologic examination. The most prevalent symptoms were the following: symptoms suggestive of rhinitis (44.9%), snoring (42.8%), mouth breathing (39.3%), and nasal obstruction (33.3%). In physical examination, the most common findings were a web palate (redundant posterior pillar; 62.9%), septum deviation (56.9%), and inferior turbinate hypertrophy (37.7%). Significant associations were found between nasal obstruction and septum deviations, inferior turbinate hypertrophy, high‐arched palate, and class II dental occlusion; between symptoms of rhinitis and inferior turbinate hypertrophy; and between snoring and obstructive deviated septum, modified Mallampatti grades III and IV, increased neck circumference, and age greater than or equal to 50 years.ConclusionsThe prevalence of otorhinolaryngologic symptoms and alterations in physical examination of the UA were high in the adult population of São Paulo, Brazil. The snoring and nasal symptoms were significantly associated with findings from UA physical examination and inspection of the facial skeleton.
Minimally Invasive Osteotomy for Symptomatic Bunionette Deformity Is Not Advisable for Severe Deformities
Authors: Waizy Hazibullah , Olender Gavin , Mansouri Farhad , Floerkemeier Thilo , Stukenborg-Colsman Christina 
Published: February 2012

Bunionette, or tailor’s bunion, is a painful protrusion on the plantar and/or lateral aspect of the fifth metatarsal head. Until recently, there have been very good results reported in literature when minimally invasive therapy is used to treat this deformity. In this study, the authors critically review the outcome of patients operated by the minimal invasive technique. A total of 31 feet were retrospectively reviewed with a mean follow-up of 52 months (range 14-106 months). The results were related to the preoperative severity of the bunionette deformity. The mean intermetatarsal angle IV/V was reduced from 12° to 7.5° postoperatively. The American Orthopaedic Foot and Ankle Society score showed good and excellent values (80-100 points) at follow-up in 16 (12 type I, 4 type III) feet. Fourteen (2 type I, 5 type II, 7 type III) feet were rated as satisfactory (60-80 points) and one (type III) foot with fair (56 points). Nine patients (5 type II and 4 type III) indicated that they would not undergo the operative procedure again. Our results show inclusive evidence that minimal invasive osteotomies have a good clinical outcome in the treatment of high-grade deformities. The best future option is to consider the classification of the deformity before a minimally invasive operation is to take place. Levels of Evidence: Prognostic, Level IV, Case series
Minimally Invasive Flexor Hallucis Longus Transfer in Management of Acute Achilles Tendon Rupture Associated With Tendinosis
Authors: Lui Tun Hing 
Published: February 2012

Chronic tendinopathy is characterized by pain in the tendon, generally at the start and completion of exercise. However, tendinosis may lead to decreased blood flow, increased stiffness of the tendon and reduced tensile strength, and predispose to rupture. Operative treatment is indicated to restore the function of the Achilles tendon and alleviate the prerupture heel cord pain. A case of acute Achilles tendon rupture with extensive tendinosis that was successfully treated with minimally invasive flexor hallucis longus transfer is reported. Levels of Evidence: Therapeutic, Level IV