bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy for Advanced Breast Cancer: Results of Ganglion Sentinelle et Chimiothérapie Neoadjuvante, a French Prospective Multicentric Study
Authors: Classe Jean-Marc , Bordes Virginie , Campion Loic , Mignotte Herve , Dravet François , Leveque Jean , Sagan Christine , Dupre Pierre François , Body Gilles , Giard Sylvia 
Published: December 2008

PurposeTo determine the detection rate, the false-negative rate, and the accuracy of sentinel lymph node (SLN) detection after neoadjuvant chemotherapy (NAC) for advanced breast cancer.Patients and MethodsA prospective multicentric study was initiated to evaluate the results of SLN biopsy with the combined method after NAC for advanced large operable breast cancer.ResultsFrom September 2003 to March 2007, 195 patients enrolled from 12 institutions were found suitable for evaluation. The detection rate was 90% (176 of 195 patients), and the false-negative rate was 11.5% (six of 52 patients). Patients without axillary palpable nodes (N0) before NAC had a better detection rate compared with patients with axillary suspicious nodes (N1, 94.6% v 81.5%; P = .008). The false-negative rate was not correlated with clinical nodal status before NAC (9.4% v 15%; P = .66).ConclusionThis study confirms the feasibility of SLN biopsy after NAC in the case of large operable breast cancer. The detection rate, false-negative rate, and accuracy do not differ from those obtained in the case of early breast cancer without NAC, thus demonstrating the feasibility of SLN biopsy after NAC.
Short Delay in Initiation of Radiotherapy May Not Affect Outcome of Patients With Glioblastoma: A Secondary Analysis From the Radiation Therapy Oncology Group Database
Authors: Blumenthal Deborah T. , Won Minhee , Mehta Minesh P. , Curran Walter J. , Souhami Luis , Michalski Jeff M. , Rogers C. Leland , Corn Benjamin W. 
Published: December 2008

PurposeTo analyze the Radiation Therapy Oncology Group (RTOG) database of patients with glioblastoma and appraise whether outcome was influenced by time to initiation of radiation therapy (RT).Patients and MethodsFrom 1974 through 2003, adult patients with histologically confirmed supratentorial glioblastoma were enrolled onto 16 RTOG studies. Of 3,052 enrolled patients, 197 patients (6%) were either initially rendered ineligible or had insufficient chronologic data, leaving a cohort of 2,855 patients for the present analysis. We selected four patient groups based on the interval from surgery to the start of RT: ≤ 2 weeks, 2 to 3 weeks, 3 to 4 weeks, more than 4 weeks to the protocol eligibility limit of 6 weeks. Survival times were estimated by the Kaplan-Meier method. Multivariate analysis incorporated variables of time interval, recursive partitioning analysis (RPA) class, and treatment regimen.ResultsNo decrement in survival could be identified with increasing time to initiation of RT. Among our four temporal groupings, median survival time was unexpectedly and significantly greater in the group with the longest interval (> 4 weeks) than in those with the shortest delay (≤ 2 weeks): respectively, 12.5 months versus 9.2 months (P < .0001). On multivariate analysis, with overall survival as the end point, time interval more than 4 weeks and lower RPA class were both significant predictors of improved outcome. Treatment regimen was not a significant factor.ConclusionThere is no evident reduction in survival by delaying initiation of RT within the relatively narrow constraint of 6 weeks. An unanticipated yet significantly superior outcome was identified for patients for whom RT was delayed beyond 4 weeks from surgery.
Phosphoinositide-Phospholipase C β1 Mono-Allelic Deletion Is Associated With Myelodysplastic Syndromes Evolution Into Acute Myeloid Leukemia
Authors: Follo Matilde Y. , Finelli Carlo , Clissa Cristina , Mongiorgi Sara , Bosi Costanza , Martinelli Giovanni , Baccarani Michele , Manzoli Lucia , Martelli Alberto M. , Cocco Lucio 
Published: December 2008

Purpose To evaluate the association between the presence of phosphoinositide-phospholipase C β1 (PI-PLCβ1) mono-allelic deletion with the clinical outcome of myelodysplastic syndromes (MDS) patients. Methods PI-PLCβ1, PI-PLCβ4, and PI-PLCγ1 cytogenetic investigations were performed on 80 newly diagnosed MDS patients (18 low risk, 26 intermediate 1, 18 intermediate 2, 18 high risk) comparing the results with the clinical outcome of the patients. Moreover, fluorescent in situ hybridization results were validated by real-time polymerase chain reaction (PCR). Finally, PI-PLCβ1 gene and protein expression were assessed by both real-time PCR and immunocytochemical experiments. Results Collectively, 35 (43.75%) of 80 of the MDS patients showed a specific mono-allelic deletion of PI-PLCβ1. Kaplan-Meier analysis revealed a significant association (P < .0001) between the PI-PLCβ1 mono-allelic deletion and a higher risk of evolution into acute myeloid leukemia (AML), since 23 of 35 MDS patients (65.7%) bearing the PI-PLCβ1 mono-allelic deletion evolved into AML. Even in multivariate analysis, the PI-PLCβ1 mono-allelic deletion retained a higher significance, with a P < .001, as a prognostic factor of evolution into AML (odds ratio [OR] 1.83; 95% CI, 2.26 to 17.24; P = .00045). Finally, PI-PLCβ1 deletion was related to an altered gene and protein expression. Conclusion PI-PLCβ1 mono-allelic deletion is associated with a worse clinical outcome in MDS patients, hinting at the identification of a new group at higher risk of AML evolution and representing a reliable prognostic tool. Moreover, targeting PI-PLCβ1 pathways might emerge as a new therapeutic strategy for MDS.
Radiotherapy After Segmental Resection of Breast Cancer With Favorable Prognostic Features: 12-Year Follow-Up Results of a Randomized Trial
Authors: Holli Kaija , Hietanen Päivi , Saaristo Rauni , Huhtala Heini , Hakama Matti , Joensuu Heikki 
Published: December 2008

Purpose Postoperative breast irradiation is considered standard after breast-preserving surgery for cancer. We evaluated the efficacy of radiation therapy in the prevention of local recurrence in a patient population that had small-size breast cancer with features that suggested low biologic aggressiveness. Patients and Methods Women (n = 264) older than 40 years who were treated by breast resection with ≥ 1 cm of tumor-free margin and axillary nodal dissection were randomly assigned to receive or not to receive breast irradiation (cumulative dose, 50 Gy) after surgery. The tumor was required to be ≤ 20 mm, node negative, progesterone receptor positive, well to moderately well differentiated and unifocal, and of low cell proliferation rate (ie, S phase fraction ≤ 7% or nuclear Ki-67 expression < 10%) and had to lack an extensive intraductal component. The median follow-up time was 12.1 years after random assignment. Results Sixteen (11.6%) and 34 (27.2%) cancers recurred locally in the radiotherapy and the control arms, respectively (P = .0013). Time to local recurrence was longer in the radiotherapy arm (hazard ratio [HR], 0.36; 95% CI, 0.20 to 0.65; P = .00071). Twenty-one patients assigned to radiotherapy and 26 assigned to control died during the follow-up. There were no differences in overall survival time (HR, 0.63; 95% CI, 0.35 to 1.12; P = .11), distant disease-free survival (P = .94), or breast cancer–specific survival (P = .56) between the radiation therapy and control groups. Conclusion Radiation therapy after breast resection reduces the frequency of ipsilateral breast recurrences, even among women with small-size breast cancers that have favorable histologic features and that are resected with at least a 1-cm margin. Postoperative radiotherapy did not significantly improve survival.
The Perception of Support Received from Breast Care Nurses by Depressed Patients Following a Diagnosis of Breast Cancer
Authors: Clark Louise , Holcombe Christopher , Hill Jonathan , Downey Hilary , Fisher Jean , Krespi Margorit Rita , Salmon Peter 
Published: December 2008

INTRODUCTION Due to their specialist training, breast care nurses (BCNs) should be able to detect emotional distress and offer support to breast cancer patients. However, patients who are most distressed after diagnosis generally experience least support from care staff. To test whether BCNs overcome this potential barrier, we compared the support experienced by depressed and non-depressed patients from their BCNs and the other main professionals involved in their care: surgeons and ward nurses. PATIENTS AND METHODS Women with primary breast cancer (n = 355) 2–4 days after mastectomy or wide local excision, self-reported perceived professional support and current depression. Analysis of variance compared support ratings of depressed and non-depressed patients across staff types. RESULTS There was evidence of depression in 31 (9%) patients. Depressed patients recorded less surgeon and ward nurse support than those who were not depressed but the support received by patients from the BCN was high, whether or not patients were depressed. CONCLUSIONS BCNs were able to provide as much support to depressed patients as to non-depressed patients, whereas depressed patients felt less supported by surgeons and ward nurses than did non-depressed patients. Future research should examine the basis of BCNs' ability to overcome barriers to support in depressed patients. Our findings confirm the importance of maintaining the special role of the BCN.
A Simple Prophylaxis Regimen for MRSA: Its Impact on the Incidence of Infection in Patients Undergoing Liver Resection
Authors: Al-Mukhtar Ahmed , Wong Vincent KH , Malik Hassan Z , Abu-Hilal Mohammed , Denton Miles , Wilcox Mark , Lodge J Peter A , Toogood Giles J , Prasad K Rajendra 
Published: December 2008

INTRODUCTION Methicillin-resistant Staphylococcus aureus (MRSA) infection has increased at an alarming rate in the recent past and has major cost implications. The aim of this study is to assess the impact of a policy of pre-operative MRSA prophylaxis on the incidence of MRSA infection in patients undergoing liver resection. PATIENTS AND METHODS A total of 585 patients underwent hepatectomy in a tertiary referral centre between January 2000 and September 2005. In September 2003, a policy of MRSA prophylaxis (nasal mupirocin and triclosan wash for 5 days) was introduced within this unit. Demographic, pathological and outcome data were compared between the pre- and post-MRSA prophylaxis cohorts. RESULTS The prevalence of MRSA infection prior to initiating the prophylaxis protocol was 29 patients (8.3%) and this fell to 9 patients (3.8%; P= 0.029). Furthermore, patients who had MRSA-related infection had a higher incidence of additional complications compared to the rest of the cohort (P= 0.001). Total cost savings incurred as a result of this protocol over the past 2 years has been approximated at £28,893. CONCLUSIONS Introduction of a simple MRSA prophylaxis policy has had a significant reduction on the incidence MRSA-related infection within our patient population, leading to reduced morbidity and cost saving to the UK National Health Service.
Community-Based Orthopaedic Follow-Up. Is it What Doctors and Patients Want?
Authors: Harle Daniel , Ilyas Shazad , Darrah Clare , Tucker Keith , Donell Simon 
Published: December 2008

INTRODUCTION The objective of this study was to investigate how patients, general practitioners (GPs) and orthopaedic trainees, feel about the proposed governmental changes to reduce orthopaedic out-patient clinics by having GPs and specialist nurses follow-up postoperative orthopaedic patients in the community. SUBJECTS AND METHODS The design was a cross-sectional questionnaire study including a teaching hospital and general practitioners in the Norfolk primary care trust. Participants were 73 orthopaedic postoperative patients who attended out-patients over a 1-week period in July 2007 who all responded. Of 250 GPs, 239 responded. Of 38 orthopaedic trainees at the level of senior house officer (post MRCS) and specialist registrar (Eastern Deanery Rotation and Pott Rotation), 30 responded RESULTS Of the 73 patients, 56 (77%) felt the surgeon was best suited to manage them postoperatively. Of these, 47 felt that it was very important that the surgical team saw them postoperatively. Also, 53 felt that their GP did not have sufficient knowledge and experience to deal with their current orthopaedic problem adequately. Only 12 GPs of 239 (5%) felt very confident assessing postoperative patients. Inadequate resources available to diagnose and treat postoperative complications was noted by 74% as the reason for not performing follow-up in primary care, and only 18% felt they should follow-up postoperative patients. All trainees felt that following up their own postoperative patients was important to their training. Conclusions Most patients, GPs, and orthopaedic trainees had serious doubts about the proposed governmental changes to reduce orthopaedic out-patient clinics by having GPs and specialist nurses follow-up postoperative orthopaedic patients in the community.
Anterior Shoulder Dislocation
Authors: Cutts Steven , Prempeh Mark , Drew Steven 
Published: December 2008

INTRODUCTION Anterior dislocation of the shoulder is commonly seen in accident and emergency (A&E) and trauma clinics. In this article, we review the existing literature on the injury and the recent trends in management. MATERIALS AND METHODS We have discussed this condition with our colleagues and performed a Medline search (‘anterior shoulder dislocation’) of the relevant papers. We also describe key historical publications and recent developments regarding immobilisation of the joint. RESULTS Management decisions regarding this condition continue to vary between units, especially for recurrent and posterior dislocation. This paper lays some emphasis on the choice of analgesic agent when attempting shoulder reduction in the A&E setting. A summary of the data from our own department has provided a graphical representation of the classical age and sex distribution for this condition. CONCLUSIONS Shoulder dislocation is a common injury. Delays in diagnosis remain the single biggest obstacle to optimum results in this group of patients. A significant proportion will require eventual surgery and up to a third of these patients will go on to develop long-term shoulder arthritis. Even patients who have experienced a single episode of dislocation may go on to develop long-term sequelae.
The Incidence and Reporting Rates of Needle-Stick Injury Amongst UK Surgeons
Authors: Thomas WJC , Murray JRD 
Published: December 2008

INTRODUCTION Needle-stick injuries are common. Such accidents are associated with a small, but significant, risk to our career, health, families and not least our patients. National guidelines steer institution-specific strategies to provide a consistent and safe method of dealing with such incidents. Surgeon-specific guidelines are not currently available. We have observed that hospital sharps policy is often considered cumbersome to the surgeon, resulting in on-the-spot decision making with potential long-term implications. By their essence, these decisions are inconsistent, not reproducible and, thus, we believe them to be unsafe. The under-reporting to occupational health departments is well documented. Current surgical practice has the potential to expose the surgeon to unnecessary risk. The aims of this study were to establish the true incidence of contaminations caused by needle-stick injury in our hospital and to assess how well current protocols are really implemented. SUBJECTS AND METHODS We identified all surgeons of consultant, non-career staff grade (NCSG) and registrar grade working in a large 687-bed district general hospital serving a population of 550,000, in the UK. We designed a retrospective, anonymous 30-second survey. Surgeons' awareness and opinion of local policy was sought in a free-text section. RESULTS Of the 98 surgeons in the hospital, 77% responded to the questionnaire and 44% anonymously admitted to having a needle-stick injury. Only 3 of the 33 (9%) who sustained an needle-stick injury said that they followed the agreed local policy. Twenty-three surgeons (70%) performed first aid type procedures such as informing scrub nurse, changing needle and gloves. Seven surgeons (21%) simply ignored the incident and continued. Forty-three surgeons commented on the policy's nature with only 9 who regarded it as ‘user friendly’. CONCLUSIONS Needle-stick injury is still a common problem, particularly in the surgical cohort and remains significantly under-reported. The disparity between hospital sharps policy and actual surgical practice is considered and an explanation for the difference sought. Without this awareness of ‘real-life’ surgical practice, the occupational health figures for sharps injury will always tell a rosy story under-estimating a real problem. We strongly advocate universal precautions in the operating theatre. However, we acknowledge that sharps injuries will occur. We should remain vigilant and act upon contaminations without surgical bravado but with mater-of-fact professionalism. This includes regular review of policy and, particularly, promotion of surgical awareness.
Using Polyalkylene Glycol Quenchants to Effectively Control Distortion and Residual Stresses in Heat Treated Aluminum Alloys
Authors: Croucher Tom 
Published: December 2008

Abstract
Polyalkylene glycol quenchants (also commonly called “glycol” quenchants throughout the industry) were introduced into the aluminum heat treating industry in the mid 1960s and immediately became the most important tool for reducing quenching distortion in sheet metal alloys. Later, the feasibility and benefit of glycol quenching thicker products, such as castings and forgings (which were normally quenched in hot or boiling water), was proven. Specifications were changed to permit glycol quenching of forgings and castings. However, because of a lack of understanding of the technology, the original benefits achieved in sheet metal distortion control and optimum distortion and residual stress control of thicker products has diminished. Currently, there is a significant lack of understanding regarding glycol quenching and, as a result, the full benefit of this technology is not currently being utilized. Distortion of sheet metal products and precision forgings has increased, resulting in increased check and straightening costs and higher residual stresses being imparted to parts. The realization of the benefits of glycols being able to reduce residual stress and ultimately machining costs is waning due to the reluctance of many engineers to recognize and understand the benefits of expanding the limits of the technology to achieve results not heretofore achievable. It is the purpose of this paper to review the basic concepts regarding glycol quenching of high strength aluminum alloys and to present recommendations for optimum control of distortion and residual stresses using the products. Specific illustrations showing that the proper use of glycol quenchants can provide the producer significant savings by (1) reducing quenching distortion and (2) minimizing residual stresses (which significantly improve machining practices and reduce the generation of scrap) are provided.
A Synthesis of the World Literature of Ice Hockey Injuries: Epidemiologic Principles and Future Directions
Authors: Stuart M. J. , Dajani K. A. , Crawford B. J. , Gill M. L. , Link A. A. , Smith A. M. 
Published: December 2008

Abstract
Ice hockey is a fast-paced, aggressive sport whose participants are subject to relatively high rates of injury. Although there is a growing emphasis on the epidemiology of ice hockey research and its application towards reducing injuries, the literature has never been organized into an accessible database. Ice hockey is played in North America, Europe, Scandinavia, the U.K., and several other non-English speaking countries, yet injury reports not written in English are often ignored in review articles. The purpose of this project was to synthesize the existing world literature on ice hockey injuries into a framework of epidemiologic criteria, accessible in an organized, retrievable library. An extensive search of the following databases was done: MEDLINE, BIOSIS, EMBASE, NTIS, CURRENT CONTENTS, DISSERTATION ABSTRACTS, SPORT DISCUS, CINAHL, and WEB OF SCIENCE. Key words used were “ice hockey” and “injuries,” and the search range was 1966 to July 2007. Endnote X (Thompson Corp., Stamford, CT) was used for reference compilation. Eight hundred sixty seven documents were catalogued, from 27 countries in 8 languages. Documents were first categorized by type, including injury (226), equipment (45), case reports (94), review articles (294), editorials (39), or as focusing on the physiological, psychological, or medical aspects of ice hockey (169). Documents were then subdivided by study type and whether they were prospective (117) or retrospective (109). Further subdivisions beyond these levels were based on the inclusion of certain critical epidemiological criteria, including exposure time, a clear definition of “injury,” and the level of play, among others. This comprehensive database should make future ice hockey research more efficient, as well as promote sound epidemiology and a more global perspective.
Experimental and Numerical Determination of Mixed Mode Crack Extension Angle
Authors: Merah Nesar , Albinmousa Jafar 
Published: December 2008

Abstract
Crack initiation angles for mixed mode fracture are measured and predicted using photoelastic and finite element techniques. Different crack inclination angles (0°, 10°, 20°, 30°, and 40°) are considered. The Schroedl and Smith method is used for estimating pure opening mode I stress intensity factor. On the other hand, the Sanford and Dally method is used to estimate stress intensity factors in mixed mode (I and II). The Smith and Smith method for estimating mixed mode SIF is also examined. In addition, the ANSYS finite element code is employed to estimate the pure and mixed mode SIF numerically. The estimated values of the SIF from both finite element analysis and photoelasticity are incorporated into six criteria for crack initiation angle prediction. The applicability of the crack initiation criteria such as maximum tangential stress (MTS), minimum strain energy density (S), maximum dilatational strain (T), maximum triaxial stress (M), modified MTS (MMTS), (R) criterion, and fringe symmetry axis method (FSAM) are investigated. An experimental setup is used to measure the initiation angles at different crack inclinations. The measured crack initiation angles are used to validate the predicted values. The results showed that the initiation angles estimated by different criteria using SIFs determined experimentally and numerically compared well with the measured ones, especially at higher inclination angles.