bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic and Predictive Value of Centrally Reviewed Ki-67 Labeling Index in Postmenopausal Women With Endocrine-Responsive Breast Cancer: Results From Breast International Group Trial 1-98 Comparing Adjuvant Tamoxifen With Letrozole
Authors: Viale Giuseppe , Giobbie-Hurder Anita , Regan Meredith M. , Coates Alan S. , Mastropasqua Mauro G. , Dell'Orto Patrizia , Maiorano Eugenio , MacGrogan Gaëtan , Braye Stephen G. , Öhlschlegel Christian , Neven Patrick , Orosz Zsolt , Olszewski Wojciech P. , Knox Fiona , Thürlimann Beat , Price Karen N. , Castiglione-Gertsch Monica , Gelber Richard D. , Gusterson Barry A. , Goldhirsch Aron 
Published: November 2008

PurposeTo evaluate the prognostic and predictive value of Ki-67 labeling index (LI) in a trial comparing letrozole (Let) with tamoxifen (Tam) as adjuvant therapy in postmenopausal women with early breast cancer.Patients and MethodsBreast International Group (BIG) trial 1-98 randomly assigned 8,010 patients to four treatment arms comparing Let and Tam with sequences of each agent. Of 4,922 patients randomly assigned to receive 5 years of monotherapy with either agent, 2,685 had primary tumor material available for central pathology assessment of Ki-67 LI by immunohistochemistry and had tumors confirmed to express estrogen receptors after central review. The prognostic and predictive value of centrally measured Ki-67 LI on disease-free survival (DFS) were assessed among these patients using proportional hazards modeling, with Ki-67 LI values dichotomized at the median value of 11%.ResultsHigher values of Ki-67 LI were associated with adverse prognostic factors and with worse DFS (hazard ratio [HR; high:low] = 1.8; 95% CI, 1.4 to 2.3). The magnitude of the treatment benefit for Let versus Tam was greater among patients with high tumor Ki-67 LI (HR [Let:Tam] = 0.53; 95% CI, 0.39 to 0.72) than among patients with low tumor Ki-67 LI (HR [Let:Tam] = 0.81; 95% CI, 0.57 to 1.15; interaction P = .09).ConclusionKi-67 LI is confirmed as a prognostic factor in this study. High Ki-67 LI levels may identify a patient group that particularly benefits from initial Let adjuvant therapy.
Randomized, Phase II Study of the Thrombospondin-1-Mimetic Angiogenesis Inhibitor ABT-510 in Patients With Advanced Soft Tissue Sarcoma
Authors: Baker Laurence H. , Rowinsky Eric K. , Mendelson David , Humerickhouse Rod A. , Knight Raymond A. , Qian Jiang , Carr Robert A. , Gordon Gary B. , Demetri George D. 
Published: November 2008

Purpose Sarcomas are among the most proangiogenic malignancies in preclinical models. Phase I study results for ABT-510, which inhibits angiogenesis via a novel thrombospondin-mimetic mechanism, suggested activity in soft tissue sarcoma (STS) patients. This phase II study further evaluated the safety and efficacy of ABT-510 in advanced STS patients. Patients and Methods Patients with metastatic or unresectable STS were randomly assigned to treatment with one of two ABT-510 dose schedules (20 mg once a day [20 mg], n = 42; or 100 mg twice a day [200 mg], n = 46), which were self-administered subcutaneously in 28-day treatment periods. End points included progression-free survival (PFS), objective response rate (ORR), overall survival (OS), and safety. Results Median PFS for the 20-mg arm was 94 days, with 4- and 6-month PFS rate estimates of 42% and 24%, respectively. Median PFS for the 200-mg arm was 64 days, with 4- and 6-month PFS rate estimates of 41% and 32%, respectively. Although only one objective response was noted, stable disease was observed in 52% (20 mg) and 48% (200 mg) of patients. Median OS was 431 days (20 mg) and 295 days (200 mg). ABT-510 was well tolerated. Rare treatment-related grade 3 or 4 adverse events were one event each of hypotension, deep vein thrombosis, and hypophosphatemia. ABT-510 pharmacokinetics were dose proportional, time independent, and consistent with those in previous studies. Conclusion ABT-510 had a favorable safety profile, and the rate of disease control and OS times were encouraging. However, with low ORR and lack of dose response, the study failed to yield compelling evidence of strong single-agent activity in STS.
Risk Factors for Acute Graft-Versus-Host Disease After Human Leukocyte Antigen–Identical Sibling Transplants for Adults With Leukemia
Authors: Hahn Theresa , McCarthy Philip L. , Zhang Mei-Jie , Wang Dan , Arora Mukta , Frangoul Haydar , Gale Robert Peter , Hale Gregory A. , Horan John , Isola Luis , Maziarz Richard T. , van Rood Jon J. , Gupta Vikas , Halter Joerg , Reddy Vijay , Tiberghien Pierre , Litzow Mark , Anasetti Claudio , Pavletic Stephen , Ringdén Olle 
Published: November 2008

Purpose Acute graft-versus-host disease (GVHD) causes substantial morbidity and mortality after human leukocyte antigen (HLA)-identical sibling transplants. No large registry studies of acute GVHD risk factors have been reported in two decades. Risk factors may have changed in this interval as transplant-related techniques have evolved. Patients and Methods Acute GVHD risk factors were analyzed in 1,960 adults after HLA-identical sibling myeloablative transplant for acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), or chronic myeloid leukemia (CML) reported by 226 centers worldwide to the Center for International Blood and Marrow Transplant Research from 1995 to 2002. Outcome was measured as time from transplant to onset of grade 2 to 4 acute GVHD, with death without acute GVHD as a competing risk. Results Cumulative incidence of grade 2 to 4 acute GVHD was 35% (95% CI, 33% to 37%). In multivariable analyses, factors significantly associated with grade 2 to 4 acute GVHD were cyclophosphamide + total-body irradiation versus busulfan + cyclophosphamide (relative risk [RR] = 1.4; P < .0001), blood cell versus bone marrow grafts in patients age 18 to 39 years (RR = 1.43; P = .0023), recipient age 40 and older versus age 18 to 39 years receiving bone marrow grafts (RR = 1.44; P = .0005), CML versus AML/ALL (RR = 1.35; P = .0003), white/Black versus Asian/Hispanic race (RR = 1.54; P = .0003), Karnofsky performance score less than 90 versus 90 to 100 (RR = 1.27; P = .014), and recipient/donor cytomegalovirus-seronegative versus either positive (RR = 1.20; P = .04). Stratification by disease showed the same significant predictors of grade 2 to 4 acute GVHD for CML; however, KPS and cytomegalovirus serostatus were not significant predictors for AML/ALL. Conclusion This analysis confirmed several previously reported risk factors for grade 2 to 4 acute GVHD. However, several new factors were identified whereas others are no longer significant. These new data may facilitate individualized risk estimates and raise several interesting biologic questions.
Study of the multi-injection combustion process in a transparent direct injection common rail diesel engine by means of optical techniques
Authors: Mancaruso E , Merola S S , Vaglieco B M 
Published: November 2008

A combination of ultraviolet—visible optical diagnostics has been applied in the combustion chamber of a diesel engine in order to study the fuel injection, autoignition, and soot formation processes. Measurements were made in an optically accessible diesel engine equipped with a multivalve cylinder head and a common rail (CR) high-pressure injection system. Several multi-injection strategies, characteristic of new generation CR diesel engines, were tested. They consisted of two (pre + main) and three (pre + main + post) injections per cycle. Fuel injection and visible combustion were studied by imaging the natural flame luminosity, and soot formation and evolution were evaluated by means of the two-colour pyrometry method. The reactions that occur during autoignition and soot formation were investigated by chemiluminescence imaging, while the broadband ultraviolet—visible extinction and scattering spectroscopy (BUVESS) technique was used in order to measure the soot particle size and number concentration. For all the injection strategies investigated, pre injection has contributed to the reduction of the ignition delay of the main injection. Moreover, the present study showed that autoignition can be characterized to some degree by the presence of the OH radical. The effect of post injection on combustion development and soot particle diameter has also been observed and discussed.
Auditing Orthopaedic Audit
Authors: Guryel E , Acton K , Patel S 
Published: November 2008

INTRODUCTION Clinical audit plays an important role in the drive to improve the quality of patient care and thus forms a cornerstone of clinical governance. Assurance that the quality of patient care has improved requires completion of the audit cycle. A considerable sum of money and time has been spent establishing audit activity in the UK. Failure to close the loop undermines the effectiveness of the audit process and wastes resources. PATIENTS AND METHODS We analysed the effectiveness of audit in trauma and orthopaedics at a local hospital by comparing audit projects completed over a 6-year period to criteria set out in the NHS National Audit and Governance report. RESULTS Of the 25 audits performed since 1999, half were presented to the relevant parties and only 20% completed the audit cycle. Only two of these were audits against national standards and 28% were not based on any standards at all. Only a third of the audits led by junior doctors resulted in implementation of their action plan compared to 75% implementation for consultant-led and 67% for nurse-led audits. CONCLUSIONS A remarkably large proportion of audits included in this analysis failed to meet accepted criteria for effective audit. Audits completed by junior doctors were found to be the least likely to complete the cycle. This may relate to the lack of continuity in modern medical training and little incentive to complete the cycle. Supervision by permanent medical staff, principally consultants, and involvement of the audit department may play the biggest role in improving implementation of change.
Dislocation Following Total Hip Replacement: The Avon Orthopaedic Centre Experience
Authors: Blom Ashley W , Rogers Mark , Taylor Adrian H , Pattison Giles , Whitehouse Sarah , Bannister Gordon C 
Published: November 2008

INTRODUCTION The aim of this study was to determine the incidence and outcome of dislocation after total hip arthroplasty at our unit. PATIENTS AND METHODS In total, 1727 primary total joint arthroplasties and 305 revision total hip arthroplasties were performed between 1993 and 1996 at our unit. We followed up 1567 (91%) of the primary hip arthroplasties and 284 (93%) of the revision hip arthroplasties at 8–11 years after surgery. Patients were traced by postal questionnaire, telephone interview or examination of case notes of the deceased. RESULTS The dislocation rates by approach were 23 out of 555 (4.1%) for the posterior approach, 0 out of 120 (0%) for the Omega approach and 30 out of 892 (3.4%) for the modified Hardinge approach. Of dislocations after primary total hip arthroplasty, 58.5% were recurrent. The mean number of dislocations per patient was 2.81. Overall, 8.1% of revision total hip arthroplasties dislocated. 70% of these became recurrent. The mean number of dislocations per patient was 2.87. The vast majority of dislocations occurred within 2 months of surgery. DISCUSSION To our knowledge, this is the largest multisurgeon audit of dislocation after total hip arthroplasty published in the UK. The follow-up of 8–11 years is longer than most comparable studies. The results of this study can be used to inform patients as to the risk and outcome of dislocation, as well as to the risk of further dislocation.
An Audit of Orthopaedic Referrals via Multi-Professional Triage Teams
Authors: Rogers BA , Kabir C , Bradley N 
Published: November 2008

INTRODUCTION Multi-Professional Triage Teams (MPTTs) were created to reduce the caseload of hospital orthopaedic clinics and this prospective study evaluated referrals made to a district general hospital orthopaedic department from a lower limb MPTT clinic. PATIENTS AND METHODS Over 9 months, 277 referrals to a lower limb hospital orthopaedic clinic were assessed. The temporal delay to hospital clinic review between patients seen at the MPTT clinic and those referred directly by their general practitioner (GP) was analysed using an ANOVA test. A qualitative assessment of diagnoses given to patients reviewed at the MPTT clinic was performed. RESULTS The 132 patients initially reviewed at the MPTT clinic and subsequently referred to a hospital consultant waited significantly longer (140 days compared to 62 days by direct GP referral; P < 0.05) to see an orthopaedic consultant. Over three-quarters of this patient cohort incorrectly identified the healthcare professional conducting their consultation at the MPTT clinic. One-third of cases (31%) had no diagnosis made and 22% were assessed as having an incorrect diagnosis. CONCLUSIONS Time delays, patient confusion regarding professional roles and diagnostic indecision are significant problems for patients referred to hospital orthopaedic clinics from MPTT clinics. This risks sub-optimal patient care and may lead to future medicolegal implications.
Pelvic Fasciae in Urology
Authors: Raychaudhuri B , Cahill D 
Published: November 2008

INTRODUCTION Despite the vast literature on pelvic fascia, there is confusion over the periprostatic structures and their nomenclature, including their orientation, the neurovascular bundles and the existence of the prostatic ‘capsule’. In this review, we seek to clarify some of these issues. MATERIALS AND METHODS Review of published medical literature relating to the anatomy of the pelvic fascia including a Pubmed search using the terms – pelvic fascia, Denonvilliers' fascia, prostate capsule, neurovascular bundle of Walsh, pubo-prostatic ligament and the detrusor apron. CONCLUSIONS The findings of the study were as follows: The ‘capsule’ of the prostate does not exist. Rather, the fibromuscular band surrounding the prostate forms an integral part of the gland. The prostate is surrounded by fascial structures – anteriorly/anterolaterally by the prostatic fascia and posteriorly by the Denonvilliers' fascia. Laterally, the prostatic fascia merges with the endopelvic fascia. The posterior longitudinal fascia of the detrusor comprises a ‘posterior layer’ of the detrusor apron, extending from the bladder neck to the prostate base. The neurovascular structures tend to be located posterolaterally, but may not always form a bundle. A significant proportion of fibres may lie away from the main nerve structures, along the lateral/posterior aspects of the prostate.
The Effect of Operating Time on Surgeons' Muscular Fatigue
Authors: Slack PS , Coulson CJ , Ma X , Webster K , Proops DW 
Published: November 2008

INTRODUCTION A study was completed to determine if operating has an effect on a surgeon's muscular fatigue. SUBJECTS AND METHODS Six head and neck surgery consultants, two ENT registrars, 20 normal controls from two tertiary referral centres in the West Midlands participated in the study. Electromyography (EMG) measurements were taken throughout a day of operating and fatigue indices were compared to controls performing desk work. RESULTS The percentage changes in mean frequency of muscular contractions were examined; there was no significant difference in fatigue levels between consultants and registrars. Operating led to an increase in fatigue in all subjects, compared to no increase in controls performing desk work. It was also found that the brachioradialis muscle is used more than the mid-deltoid muscle and, hence, fatigues at a faster rate. CONCLUSIONS Surgeons should be aware that their muscular fatigue levels will increase as an operation progresses; therefore, if possible, more complex parts of the operation should be performed as early as possible, or, in the case of a very long operation, a change in surgeon may be necessary.
Using an extended theory of planned behaviour to inform interventions aimed at increasing breastfeeding uptake in primiparas experiencing material deprivation
Authors: McMillan Brian , Conner Mark , Green Josephine , Dyson Lisa , Renfrew Mary , Woolridge Mike 
Published: November 2008

Objectives The theory of planned behaviour (TPB) was employed to investigate infant feeding intentions and subsequent behaviour in women from selected areas of economic hardship in the UK. Underlying beliefs were examined in order to inform future interventions aimed at increasing breastfeeding uptake among women living in such areas, which is associated with low rates of breastfeeding.Design Midwives recruited women from areas meeting study criteria. TPB measures were obtained from 303 primiparas via postal questionnaires completed during pregnancy, and feeding method was subsequently obtained from 286 of these women.Results A model containing age, education, deprivation, attitude, subjective norm (SN), and perceived behavioural control (PBC) predicted intention to breastfeed (R2=.44) and intention to formula feed (R2=.45). A model controlling for age, education and deprivation predicted ever having breastfed (86.1% correctly classified) and ever having formula fed (77.1% correctly classified). MANCOVAs differentiated those who intended to breastfeed and subsequently did (inclined actors), those who intended to breastfeed but did not (inclined abstainers), and those who did not intend to breastfeed and did not (disinclined abstainers). Differentiating outcome beliefs, normative beliefs, and control beliefs are presented.Conclusions The TPB provided a useful framework with which to examine the factors underlying breastfeeding intentions and behaviour amongst primiparas. A grouping system based on the congruence between intentions and subsequent behaviour revealed important differences between beliefs of the three groups. Further research might usefully test the effectiveness of interventions targeting the beliefs identified here in increasing breastfeeding uptake and duration.
What predicts post‐traumatic stress following spinal cord injury/
Authors: Hatcher Mal B. , Whitaker Chris , Karl Anke 
Published: November 2008

Objectives. Spinal cord injury (SCI) is a severe, traumatic event and recently research into the role of post‐traumatic stress disorder (PTSD) subsequent to the injury has become of increasing interest. This study has been conducted in order to investigate potential risk factors for the development of post‐traumatic stress disorder symptoms in those with SCI.Design. This cross‐sectional study used multiple regression analysis to look for associations between post‐traumatic stress symptom severity, SCI‐related factors and previously identified risk factors for PTSD such as dysfunctional cognitions, demographic factors and personality predispositions (neuroticism, alexithymia).Method. A total of 102 participants with SCI completed measures of post‐traumatic stress severity, acceptance of injury, post‐traumatic cognitions, social support, neuroticism and alexithymia. In addition, information about type, level and cause of the SCI was assessed.Results. High levels of post‐traumatic stress symptoms were found. Potential risk factors for the development of PTSD were negative cognitions of self and neuroticism. Variables that added to the variance explained by the models included time since injury and difficulty identifying feelings. Acceptance of injury was mediated by negative cognitions of the self and neuroticism.Conclusions. The study highlights the need for services to be aware of the psychological difficulties experienced by this client group. An important finding is that the acceptance of the injury is mediated by negative cognitions of the self which need to be identified as potential risk factors in order to prevent the development of post‐traumatic symptoms in this population.
Does Magical Thinking Improve Across Treatment For Obsessive–Compulsive Disorder?
Authors: Einstein Danielle A. , Menzies Ross G. 
Published: November 2008

AbstractThe present study investigated whether MI is a mechanism for change in the treatment of obsessive–compulsive disorder (OCD). The Magical Ideation scale (MI), the Obsessive–Compulsive Inventory — Short Version (OCI-SV) and the Padua Inventory were completed by 34 obsessive–compulsive patients pre- and post cognitive–behavioural treatment. Treatment did not target magical styles of thinking. Significant improvements on all three measures of obsessive–compulsive symptoms were demonstrated by t tests over the course of treatment. Improvement in magical thinking was also shown to be significant in t test results. In support of the hypothesis, correlations between MI improvement and improvement on the obsessive–compulsive symptom scales were significant (at a level of .05) suggesting that there is an association between improvement in magical thinking and improvement in obsessive–compulsive symptoms. Notably, a significant negative correlation was obtained between prescores on MI and change scores on the OCD measures. This suggests that high levels of MI are associated with high levels of treatment intractability. High MI appears to be a poor prognostic factor in OCD.
Thought–Action Fusion: Is it Present in Schizophrenia?
Authors: Kabakcı Elif , Demir Başaran , Demirel Hilal , Şevik Ali Emre 
Published: November 2008

AbstractThought–action fusion (TAF) refers to the belief that thoughts and actions are linked. While ‘Moral’ TAF refers to the belief that unacceptable thoughts are morally equivalent to overt actions, ‘Likelihood’ TAF is the belief that certain thoughts can increase the probability of some events (related to self or others) to occur. The objective of this study was to compare the schizophrenic patients with nonclinical controls in terms of TAF Likelihood and TAF Moral after controlling for the effects of obsessive compulsive and depressive symptoms, magical ideation and schizotypy. The sample was composed of patients hospitalised for schizophrenia (n = 45) and nonclinical control subjects (n = 41). Thought–Action Fusion Scale, Maudsley Obsessive–Compulsive Inventory, Magical Ideation Scale, Schizotypal Personality Characteristics Subscale and Beck Depression Inventory were administered. Results revealed that after controlling the effects of obsessive–compulsive and depressive symptoms, magical ideation and schizotypy, patients still had higher scores on TAF Likelihood Others but not on Self. Patients also had a tendency to get higher scores on TAF Moral. It is concluded that the study shows the presence of TAF Likelihood Others in schizophrenia even after controlling for the effects of magical ideation, depressive and OCD symptoms and schizotypal characteristics.
Critical Factors of Social Physique Anxiety: Exercising and Body Image Satisfaction
Authors: Atalay Ayşe Altan , Gençöz Tülin 
Published: November 2008

AbstractThis study aimed to examine the critical roles of exercising and body image satisfaction on social physique anxiety (SPA) among female university students. For this aim, 118 female university students, 58 of whom exercised regularly, participated in the study. The Social Physique Anxiety Scale, Eating Attitudes Test, and Liebowitz Social Anxiety Scale were administered to the participants; their dieting habits were also investigated. Results revealed that approximately half of the participants used at least one unhealthy weight control method in the past 6 months. An analysis of covariance indicated that, after controlling for the effects of abnormal eating behavior, participants who were dissatisfied with their body image and did not participate in a regular exercise activity experienced higher social physique anxiety. However, such a tendency was not found for social anxiety. Thus, these characteristics seem to be specific to social physique anxiety. It was concluded that individuals who have negative view of their appearance were more prone to experience SPA, and they might be avoiding exercise for self presentational purposes. Findings were discussed in the light of literature.