bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient navigation: State of the art or is it science?
Authors: Wells Kristen J. , Battaglia Tracy A. , Dudley Donald J. , Garcia Roland , Greene Amanda , Calhoun Elizabeth , Mandelblatt Jeanne S. , Paskett Electra D. , Raich Peter C. ,   the Patient Navigation Research Program
Published: September 2008

AbstractFirst implemented in 1990, patient navigation interventions are emerging today as an approach to reduce cancer disparities. However, there is lack of consensus about how patient navigation is defined, what patient navigators do, and what their qualifications should be. Little is known about the efficacy and cost‐effectiveness of patient navigation. For this review, the authors conducted a qualitative synthesis of published literature on cancer patient navigation. By using the keywords ‘navigator’ or ‘navigation’ and ‘cancer,’ 45 articles were identified in the PubMed database and from reference searches that were published or in press through October 2007. Sixteen studies provided data on the efficacy of navigation in improving timeliness and receipt of cancer screening, diagnostic follow‐up care, and treatment. Patient navigation services were defined and differentiated from other outreach services. Overall, there was evidence of some degree of efficacy for patient navigation in increasing participation in cancer screening and adherence to diagnostic follow‐up care after the detection of an abnormality. The reported increases in screening ranged from 10.8% to 17.1%, and increases in adherence to diagnostic follow‐up care ranged from 21% to 29.2% compared with control patients. There was less evidence regarding the efficacy of patient navigation in reducing either late‐stage cancer diagnosis or delays in the initiation of cancer treatment or improving outcomes during cancer survivorship. There were methodological limitations in most studies, such as a lack of control groups, small sample sizes, and contamination with other interventions. Although cancer‐related patient navigation interventions are being adopted increasingly across the United States and Canada, further research will be necessary to evaluate their efficacy and cost‐effectiveness in improving cancer care. Cancer 2008. © 2008 American Cancer Society.
Salvage stereotactic radiosurgery effectively treats recurrences from whole‐brain radiation therapy
Authors: Chao Samuel T. , Barnett Gene H. , Vogelbaum Michael A. , Angelov Lilyana , Weil Robert J. , Neyman Gennady , Reuther Alwyn M. , Suh John H. 
Published: September 2008

AbstractBACKGROUND.The purpose of the current study was to examine overall survival (OS) and time to local failure (LF) in patients who received salvage stereotactic radiosurgery (SRS) for recurrent brain metastases (BM) after initial management that included whole‐brain radiation therapy (WBRT).METHODS.The records of 1789 BM patients from August 1989 to November 2004 were reviewed. Of these, 111 underwent WBRT as part of their initial management and SRS as salvage. Patients were stratified by Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis class, primary disease, dimension of the largest metastases and number of BM at initial diagnosis, and time to first brain recurrence after WBRT. Overall survival, survival after SRS, and time to local and distant failure were analyzed.RESULTS.The median OS from the initial diagnosis of BM was 17.7 months. Median survival after salvage SRS for the entire cohort was 9.9 months. Median survival after salvage SRS was 12.3 months in patients who had their first recurrence >6 months after WBRT versus 6.8 months for those who developed disease recurrence ≤6 months after (P = .0061). Primary tumor site did not appear to affect survival after SRS. Twenty‐eight patients (25%) developed local recurrence after their first SRS with a median time of 5.2 months. A dose <22 grays and lesion size >2 cm were found to be predictive of local failure.CONCLUSIONS.In this study, patients who recurred after WBRT and were treated with salvage SRS were found to have good local control and survival after SRS. WBRT provided good initial control, as 45% of these patients failed >6 months after WBRT. Those with a longer time to failure after WBRT had significantly longer survival after SRS. Cancer 2008. © 2008 American Cancer Society.
Receipt of guideline‐recommended follow‐up in older colorectal cancer survivors
Authors: Cooper Gregory S. , Kou Tzuyung Doug , Reynolds Harry L. 
Published: September 2008

AbstractBACKGROUNDAfter curative resection for colorectal cancer, routine follow‐up with office visits, carcinoembryonic antigen (CEA), and colonoscopy is recommended. The actual adherence to these guidelines as well as the potential overuse of testing in routine practice has not been well studied.METHODSThe authors identified 9426 eligible patients aged ≥66 years in a linked tumor registry‐claims database who were diagnosed with adenocarcinoma of the colon or rectum from 2000 to 2001. Patients were observed to 3 years after diagnosis. Receipt of ≥2 office visits per year, ≥2 CEA tests per year (years 1 and 2), and ≥1 colonoscopy within 3 years constituted guideline fulfillment.RESULTSGuidelines for office visits, colonoscopy, and CEA testing were met in 92.3%, 73.6%, and 46.7% of patients, respectively. In addition, receipt of 2 nonrecommended procedures, abdominal/pelvic computed tomography scans and positron emission tomography scans, was documented in 47.7% and 6.8%, respectively. Overall, 60.2% received testing below recommended levels, 17.1% at recommended frequency, and 22.7% above guideline recommendations. In a multivariate analysis, factors associated with meeting guidelines included younger age group, white race, regional stage cancers, and poorly differentiated tumors. Considerable geographic variation in meeting guidelines was also observed.CONCLUSIONSMany older colorectal cancer survivors in this population‐based cohort underwent testing below a minimum frequency specified by clinical practice guidelines, especially with regard to CEA. Further studies should ascertain the reasons for poor compliance and the effect on patient outcome. Cancer 2008. © 2008 American Cancer Society.
Patient‐physician disagreement regarding performance status is associated with worse survivorship in patients with advanced cancer
Authors: Schnadig Ian D. , Fromme Erik K. , Loprinzi Charles L. , Sloan Jeff A. , Mori Motomi , Li Hong , Beer Tomasz M. 
Published: September 2008

AbstractBACKGROUND.Physician‐reported performance status (PS) is an important prognostic factor and frequently influences treatment decisions. To the authors' knowledge, the extent, prognostic importance, and predictors of disagreements in PS assessment between physicians and patients have not been adequately examined.METHODS.Using North Central Cancer Treatment Group (NCCTG) clinical trial data from 1987 through 1990, the authors compared PS (Eastern Cooperative Oncology Group [ECOG] and Karnofsky [KPS]) and nutrition scores reported by physicians and patients individually. Differences were analyzed using a Student t test for paired data and degree of disagreement by kappa statistic. The effect of disagreement on overall survival was determined by the Kaplan‐Meier method and Cox regression analysis. Predictors of disagreement were identified by logistic regression.RESULTS.In all, 1636 patients with advanced lung and colorectal cancer had a median survival of 9.8 months (95% confidence interval [95% CI], 9.4‐10.4 months). Percent disagreement between patients and physicians regarding KPS, ECOG PS, and nutrition score were 67.1%, 56.6%, and 58.0%, respectively. Physicians were more likely to rate patients better than individual patients were to rate themselves: ECOG (mean 0.91 vs 1.30; P < .0001), KPS (mean 83.3 vs 81.7; P < .0001), and nutrition score (mean 1.6 vs 2.1; P < .0001). Disagreement between patients and their physicians was associated with increased risk of death: KPS (hazards ratio [HR] of 1.16; 95% CI, 1.04‐1.30 [P = .008]) and nutrition scores (HR of 1.44; 95% CI, 1.29‐1.61 [P < .0001]) after adjustment for covariates. Patient sociodemographic factors that predict disagreement were identified.CONCLUSIONS.Physicians and patients frequently disagree regarding PS and nutritional status. Disagreement is associated with an increased risk of death in patients with advanced malignancies. These findings illustrate the limitations of physician‐only assessed PS. Cancer 2008. © 2008 American Cancer Society.
A phase 2 trial of whole‐brain radiotherapy combined with intravenous chemotherapy in patients with brain metastases from breast cancer
Authors: Cassier Philippe A. , Ray‐Coquard Isabelle , Sunyach Marie‐Pierre , Lancry Laurence , Guastalla Jean‐Paul , Ferlay Céline , Gomez Frédéric , Curé Hervé , Lortholary Alain , Claude Line , Blay Jean‐Yves , Bachelot Thomas 
Published: September 2008

AbstractBACKGROUNDA study was conducted to determine the efficacy, tolerability, and safety of concurrent cisplatin and vinorelbine chemotherapy and radiotherapy in patients with previously untreated brain metastases from breast cancer.METHODSTwenty‐five patients with untreated brain metastases from breast cancer were treated with cisplatin (at a dose of 20 mg/m2/day, Days 1‐5) and vinorelbine (6‐mg/m2 bolus on Day 1 and 6 mg/m2/day continuous infusion on Days 1‐5) chemotherapy combined with concurrent 30‐gray fractionated external‐beam radiotherapy. Chemotherapy was given at 3‐week intervals for a total of 4 cycles. Primary endpoint was the rate of radiologic response of brain metastases.RESULTSComplete response in the brain was observed in 3 patients, and partial response was noted in 16 patients, yielding a 76% response rate in the brain. The overall systemic response rate was 44%. Progression‐free and overall survival were 3.7 months and 6.5 months, respectively. Overall toxicity was acceptable; nonhematologic grade 3‐4 events were noted in 5 (20%) patients, and there were no toxic deaths.CONCLUSIONSConcurrent chemoradiation with cisplatin and vinorelbine for brain metastases from breast cancer appears to be active and well tolerated. Cancer 2008. © 2008 American Cancer Society.
Management of brain metastases from ovarian and endometrial carcinoma with stereotactic radiosurgery
Authors: Monaco Edward , Kondziolka Douglas , Mongia Sanjay , Niranjan Ajay , Flickinger John C. , Lunsford L. Dade 
Published: September 2008

AbstractBACKGROUNDMetastases to the brain from ovarian and endometrial carcinoma are uncommon and to the authors' knowledge consensus regarding optimal management is lacking. Stereotactic radiosurgery (SRS) has proven useful for the treatment of many benign and malignant brain tumors. In the current study, the authors evaluated outcomes after SRS in patients with ovarian and endometrial carcinoma.METHODSTwenty‐seven patients with brain metastases underwent gamma–knife SRS. Six patients had endometrial carcinoma, whereas 21 patients had ovarian carcinoma. Eighteen patients also received whole–brain radiotherapy. A total of 68 tumors were treated with gamma–knife SRS.RESULTSAt the time of last follow–up, 1 patient was still alive and 26 had died. The median survival was 7 months after the initial diagnosis of brain metastasis and 5 months after SRS. The 1‐year survival rate after radiosurgery was 15% and that from the diagnosis of brain metastases was 22%. On final imaging, all tumors were controlled without further growth. Two patients (7.4%) developed new or progressive neurologic deficits after SRS.CONCLUSIONSSRS is an acceptable choice for the treatment of brain metastases resulting from ovarian and endometrial carcinoma, and provides local tumor control with limited morbidity. Careful patient selection is warranted in the setting of patients with uncontrolled systemic disease in whom a limited survival benefit is expected. Cancer 2008. © 2008 American Cancer Society.
Performance status and sensitivity to first‐line chemotherapy are significant prognostic factors in patients with recurrent small cell lung cancer receiving second‐line chemotherapy
Authors: Kim Young Hak , Goto Koichi , Yoh Kiyotaka , Niho Seiji , Ohmatsu Hironobu , Kubota Kaoru , Saijo Nagahiro , Nishiwaki Yutaka 
Published: September 2008

AbstractBACKGROUNDTo the authors' knowledge, the prognostic factors in recurrent small cell lung cancer (SCLC) patients treated with second‐line chemotherapy have not yet been clearly identified to date.METHODSBetween July 1992 and December 2003, 232 of 515 patients who were diagnosed to have SCLC at the National Cancer Center Hospital East were administered second‐line chemotherapy for recurrent disease. The authors retrospectively analyzed the relation between clinical factors evaluated at the time of recurrence and the response to second‐line chemotherapy or survival in these patients.RESULTSThe results of univariate analyses revealed that response was significantly associated with the performance status (PS) alone, whereas survival was significantly associated with the PS, disease extent, and sensitivity to first‐line chemotherapy. Multivariate analysis identified PS (P < .0001) and sensitivity to first‐line chemotherapy (P = .0024) as the independent prognostic factors for survival. When the patients were grouped according to these 2 significant prognostic factors, the survival of patients with a PS of 0 to 1 was significantly better than that of the patients with a PS of 2 to 4 both among cases that were sensitive and those that were refractory to first‐line chemotherapy. Although the survival of sensitive recurrent cases was significantly better than that of the refractory recurrent cases among the patients with a PS of 0 to 1 patients, no survival difference was observed between the sensitive and refractory recurrent cases in the patients with a PS of 2 to 4.CONCLUSIONSBoth PS and sensitivity to initial chemotherapy were found to be significant prognostic factors for survival in recurrent SCLC patients treated with second‐line chemotherapy. These 2 factors should therefore be used as stratification factors in future clinical trials. Cancer 2008. © 2008 American Cancer Society.
A synthesis and a practical approach to complex systems
Authors: Brodu Nicolas 
Published: September 2008

AbstractThis document is both a synthesis of current notions about complex systems and a practical approach description. A disambiguation is proposed and exposes possible reasons for controversies related to causation and emergence. Theoretical considerations about simulations are presented. A justification is then given for the development of practical tools and techniques for the investigation of complex systems. A methodology for the usage of these tools is finally suggested, illustrated by application examples. © 2008 Wiley Periodicals, Inc. Complexity, 2009.
Immunocytochemical study of urine cytological preparations from secondary prostatic adenocarcinoma involving the urinary bladder
Authors: Mai Kien T. , Ahmed Itrat , Robertson Susan J. , Belanger Eric C. , Veinot John P. , Islam Shahid 
Published: September 2008

AbstractInvolvement of the urinary bladder by prostatic adenocarcinoma (PCA) occasionally occurs. In this study, we analyzed urine cytological findings in patients with secondary involvement of the urinary bladder by PCA with the help of the immunocytochemistry. The cases were divided into two groups: (1) prospective study group: three cases; and (2) retrospective study group: 12 cases which were retrieved from our cytopathological files. The urine cytology specimens (cytospins) from all cases were submitted for prostatic specific antigen (PSA) immunocytochemistry. Additional immunostaining for high‐molecular‐weight cytokeratin (HMWCK) was performed if PSA immunoreactivity was negative. All cytospin smears showed atypical cells characterized by large, round and uniform nuclei with prominent nucleoli and dense cytoplasm. They were present as single cells or in cell groups simulating urothelial carcinoma. The diagnosis of PCA was made if the atypical cells were either immunoreactive for PSA or nonreactive for HMWCK. The urothelial cells were PSA− and HMWCK+. The immunostaining supported the PCA diagnosis in all three cases from the prospective group and two cases in the retrospective group. The remaining 10 cases in the retrospective group were diagnosed as negative: 3, atypia: 5 urothelial carcinoma: 2. The positive diagnosis for PCA was based on the PSA immunoreactivity or nonreactivity to HMWCK and the cytological atypia. In conclusions, immunostaining for PSA and HMWCK performed on cytospins of urine specimens from patients with a prior history of high‐grade and/or stage of PCA is helpful to make a positive diagnosis of secondary bladder involvement from PCA. Diagn. Cytopathol. 2008;36:715–720. © 2008 Wiley‐Liss, Inc.
Restoring satisfactory status in ThinPrep Pap test specimens with too few squamous cells and containing microscopic red blood cells
Authors: Pang Yijun , Smola Brian , Pu Robert T. , Michael Claire W. 
Published: September 2008

AbstractTreatment of specimens that contain excessive blood can effectively reduce the unsatisfactory rate; however, a considerable number of unsatisfactory specimens remain. We evaluated the effectiveness of reprocessing unsatisfactory specimens that had too few squamous cells and contained microscopic red blood cells (TFSQRBC).Out of the 688 unsatisfactory specimens at microscopic screening, 197 (28.63%) were TFSQRBC that were reprocessed by treatment of glacial acetic acid (GAA). Red blood cells were observed clogging the pores in the filter of the ThinPrep device. After reprocessing, 129 (68.48%) yielded a satisfactory diagnosis, which accounted for a reduction of the unsatisfactory rate by 18.25%. In the restored satisfactory specimens, abnormal diagnoses of 1 high‐grade squamous intraepithelial lesion (HSIL) (0.78%), 3 atypical glandular cells (AGC) (2.33%), and 13 atypical squamous cells of undetermined significance (ASCUS) (10.08%) were made. The abnormal diagnoses in this group of patients were significantly higher than that in the general population screened.Reprocessing unsatisfactory ThinPrep® (TP) specimens of TFSQRBC can reduce the unsatisfactory rate of the TP Pap test significantly and is a cost‐effective measure. The initially unsatisfactory specimens are more likely to represent cases with an abnormal diagnosis, which also justifies the effort of reprocessing this group of specimens. Adjustment of the pore size on the ThinPrep filter device may reduce the interference of red blood cells. Diagn. Cytopathol. 2008;36:696–700. © 2008 Wiley‐Liss, Inc.
On‐line dynamic security assessment to mitigate the risk of blackout in the Italian power system
Authors: Cirio Diego , Lucarella Dario , Massucco Stefano 
Published: September 2008

AbstractThis paper provides a comprehensive survey of the major initiatives and research projects recently carried out by the Italian system operator, Cesi Ricerca, and Universities on power system monitoring, defense, and security assessment. The technological and methodological features of an advanced wide area measurement system (WAMS) are described and the main aspects of an adaptive system for event‐based automatic load shedding are presented. Then preventive and corrective security assessment, with particular emphasis to dynamic security assessment—DSA, is introduced. Results from an EU project, where the Italian power system served as a test site for on‐line experimentation, are reported. Considering the need for very fast assessment by stability indices, a complementary approach to the above “conventional” DSA, currently under way, is described in further detail. The methodology relies on a correlation model relating significant power system measurements with local loadability margins. Results of some tests on the Italian power system are presented and discussed. Copyright © 2008 John Wiley & Sons, Ltd.
The effects of PRGF on bone regeneration and on titanium implant osseointegration in goats: A histologic and histomorphometric study
Authors: Anitua Eduardo , Orive Gorka , Pla Rafael , Roman Pedro , Serrano Victoriano , Andía Isabel 
Published: September 2008

AbstractThe effect of local application of scaffold‐like preparation rich in growth factors (PRGF) on bone regeneration in artificial defects and the potential effect of humidifying titanium dental implants with liquid PRGF on their osseointegration were investigated. The PRGF formulations were obtained from venous blood of three goats and applied either as a 3D fibrin scaffold (scaffold‐like PRGF) in the regeneration of artificial defects or as liquid PRGF via humidifying the implants before their insertion. Initially, 12 defects were filled with scaffold‐like PRGF and another 12 were used as controls. The histological analysis at 8 weeks revealed mature bone trabeculae when PRGF was used, whereas the control samples showed mainly connective tissue with incipient signs of bone formation. For the second set of experiments, 26 implants (13 humidified with liquid PRGF) were placed in the tibiae of goats. Histological and histomorphometric results demonstrated that application of liquid PRGF increased the percentage of bone‐implant contact in 84.7%. The whole surface of the PRGF‐treated implants was covered by newly formed bone, whereas only the upper half was surrounded in control implants. In summary, PRGF can accelerate bone regeneration in artificial defects and improve the osseointegration of titanium dental implants. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res, 2009
In vitro biodegradation of designed tubular scaffolds of electrospun protein/polyglyconate blend fibers
Authors: Zhang Xing , Thomas Vinoy , Vohra Yogesh K. 
Published: September 2008

AbstractElectrospun polyglyconate (Maxon®) and its blends with proteins such as gelatin and elastin, with a spatially designed layer structure, were prepared as potential scaffolds for vascular tissue engineering. In vitro biodegradation of the electrospun tubular protein/Maxon scaffolds in phosphate buffered saline (pH = 7.3) was studied for the first time. The biodegradation is manifested by uptake of the PBS medium by the hydrophilic proteins and also by the mass loss due to the removal of degraded fragments and uncrosslinked proteins from the matrices. The effect of degradation on the structure–property relations was evaluated by IR, XRD, and DSC analyses of the aged scaffolds. The degradation of amorphous phase of Maxon in the early stages of aging has resulted in an increase in the crystallinity of the polymer. SEM analysis indicated a significant change in nanofiber morphology and fiber‐breaking. The mass loss and fiber breaking have negatively impacted the mechanical properties and the effect was maximum at 15–20 days of aging. The scaffold containing low molecular weight buffer soluble elastin revealed relatively better degradation properties compared to that containing high molecular weight buffer insoluble elastin. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2009