bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and determinants of cigarette smoking relapse among US adult smokers: a longitudinal study
Authors: Alboksmaty Ahmed , Agaku Israel Terungwa , Odani Satomi , Filippidis Filippos T 
Published: November 2019

ObjectivesThis research project aims at estimating the prevalence of cigarette smoking relapse and determining its predictors among adult former smokers in the USA.SettingThis research analysed secondary data retrieved from the Tobacco Use Supplement-Current Population Survey 2010–2011 cohort in the USA.ParticipantsOut of 18 499 participants who responded to the survey in 2010 and 2011, the analysis included a total sample size of 3258 ever smokers, who were living in the USA and reported quitting smoking in 2010. The survey’s respondents who never smoked or reported current smoking in 2010 were excluded from the study sample.Primary and secondary outcome measuresSmoking relapse was defined as picking up smoking in 2011 after reporting smoking abstinence in 2010. The prevalence of relapse over the 12-month follow-up period was estimated among different subgroups. Multivariable logistic regression models were applied to determine factors associated with relapse.ResultsA total of 184 former smokers reported smoking relapse by 2011 (weighted prevalence 6.8%; 95% CI 5.7% to 8.1%). Prevalence and odds of relapse were higher among young people compared with elders. Former smokers living in smoke-free homes (SFHs) had 60% lower odds of relapse compared with those living in homes that allowed smoking inside (adjusted OR 0.40; 95% CI 0.25 to 0.64). Regarding race/ethnicity, only Hispanics showed significantly higher odds of relapse compared with Whites (non-Hispanics). Odds of relapse were higher among never married, widowed, divorced and separated individuals, compared with the married group. Continuous smoking cessation for 6 months or more significantly decreased odds of relapse.ConclusionsWider health determinants, such as race and age, but also living in SFHs showed significant associations with smoking relapse, which could inform the development of more targeted programmes to support those smokers who successfully quit, although further longitudinal studies are required to confirm our findings.
Safety and efficacy of tranexamic acid in paediatric cardiac surgery: study protocol for a double-blind randomised controlled trial
Authors: Zhang Yu , Jia Yuan , Shi Jia , Yuan Su , Wang Rong , Zhang Zhe , Wang Xu , Liu Jinping , Ran Jun , Zhao Yuchen , Hua Zhongdong , Yan Jun , Li Shoujun , Zheng Zhe , Hu Shengshou , Wang Yang , Yan Fuxia 
Published: November 2019

IntroductionAn initial retrospective study suggested that tranexamic acid (TXA) administration increased the incidence of seizures in paediatric patients undergoing cardiac surgery. However, the efficacy of TXA in paediatric cardiac surgery remains unclear owing to the small sample sizes of the studies. Therefore, this study will investigate the efficacy and safety of TXA in paediatric patients undergoing cardiac surgery. We hypothesised that TXA may increase the incidence of postoperative seizures with no effect on postoperative allogeneic transfusion in paediatric patients undergoing cardiac surgery. The pragmatic study will provide important implications for paediatric cardiac surgery.Methods and analysisThis will be a single-centre prospective, double-blind randomised controlled trial. The plan is to enrol in the study 2090 paediatric patients aged 31 days to 7 years who will be undergoing cardiac surgery with cardiopulmonary bypass (CPB). All eligible participants will be randomly assigned to either the TXA or placebo group by using a Web-based randomisation service in a 1:1 ratio. The primary safety end point will be postoperative seizures until hospital discharge, and the primary efficacy end point will be the volume of allogeneic red blood cell transfusion after termination of CPB. All patients will be followed up for 1 year postdischarge. All data will be analysed in accordance with the intention-to-treat principle.Ethics and disseminationThis study was approved by the institutional review board of Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (No 20191195). Written informed consent will be obtained from the parents/legal guardian of each patient because all participants will be <18 years of age. The results of the trial will be published in an international peer-reviewed journal.Trial registration numberChinese Clinical Trial Register (ChiCTR1900024131).
Variation in survival after out-of-hospital cardiac arrest between receiving hospitals in Japan: an observational study
Authors: Koyama Satoshi , Gibo Koichiro , Yamaguchi Yutaka , Okubo Masashi 
Published: November 2019

ObjectivesPatient outcomes after out-of-hospital cardiac arrest (OHCA) varies at multilevel (geographical regions, emergency medical service agencies and receiving hospitals) in the USA. However, it remains unclear whether there is a variation in patient outcomes after OHCA between relevant units of the healthcare system such as receiving hospitals in Japan. Therefore, we aimed to quantify the variation in patient outcomes after OHCA between receiving hospitals in Japan.DesignSecondary analysis of the prospective multicentre OHCA registry.SettingThe Japan Association for Acute Medicine OHCA Registry, a prospective multicentre OHCA registry, including 73 medical institutions in Japan.Participants9303 adults (≥18 years old) with OHCA of medical origin, treated at 67 hospitals from June 2014 to December 2015.Primary and secondary outcome measuresThe primary outcome was 1-month survival after OHCA. The secondary outcome was favourable functional status at 1 month, defined as cerebral performance category scale 1 or 2. We constructed a series of multivariable hierarchical logistic regression models predicting outcomes, accounting for patient-level variables and clustering of patients within hospitals. We evaluated the adjusted 1-month survival and functional outcome for each hospital, ranked hospitals for each outcome and calculated median ORs (MORs) to quantify the between-hospital variation in outcomes.ResultsThe prevalence of 1-month survival after OHCA was 7.1% (663/9303) and that of favourable functional outcome was 3.6% (331/9303). After adjustment for patient-level factors, we observed variations in 1-month survival (range, 1.6%–13.8%; adjusted MOR 1.34; 95% CI 1.16 to 1.67) and favourable functional outcome (range, 0.7%–7.3%; adjusted MOR 1.53; 95% CI 1.10 to 2.24) between hospitals.ConclusionsWe found substantial variations in patient outcomes after OHCA within a large group of hospitals in Japan, despite adjustment for patient factors that are known to be associated with different outcomes.
Implantable cardioverter defibrillator (ICD) functionality: patient and family information for advanced decision-making
Authors: Hill Loreena Michelle , McIlfatrick Sonja , Taylor Brian , Dixon Lana , Fitzsimons Donna 
Published: November 2019

As the number of implantable cardioverter defibrillators (ICDs) implanted continues to rise, there is a growing challenge to ensure patients and family members are adequately equipped for involvement in future end-of-life decisions concerning their device.ObjectiveTo explore patients’, family members’ and professionals’ attitudes and understanding towards discussing ICD deactivation.MethodsCase study approach using qualitative interviews and framework analysis. A total of 29 qualitative interviews were undertaken, involving patients with a device, family members and healthcare professionals. Interviews were audio-recorded, transcribed verbatim and analysed using framework analysis. Data were triangulated with information obtained from the patients’ medical records (n=10).ResultsThree main themes: (1) Professionals were reluctant to engage in conversations concerning deactivation, particularly prior to implantation, believing this was in the patient’s best interest. (2) Patients and family members had limited understanding of the implanted device and its functions. It was frequently perceived as ‘life-saving’ with any negativity of the shock experience seen as acceptable. (3) All patients wanted the opportunity to discuss deactivation when death was imminent, but were indecisive whether family members should be involved. Similarly, some patients felt the decision to deactivate rested solely with the medical profession while others felt it should be a joint decision between patient, family and clinical team.ConclusionsPatients and family members require improved communication and information concerning their future treatment plan and functionality of an ICD. A proactive approach to discuss deactivation would enable shared clinical decision-making in the advanced stages of illness.
4D-CT angiography versus 3D-rotational angiography as the imaging modality for computational fluid dynamics of cerebral aneurysms
Authors: Cancelliere Nicole M , Najafi Mehdi , Brina Olivier , Bouillot Pierre , Vargas Maria I , Lovblad Karl-Olof , Krings Timo , Pereira Vitor M , Steinman David A 
Published: November 2019

Background and purposeComputational fluid dynamics (CFD) can provide valuable information regarding intracranial hemodynamics. Patient-specific models can be segmented from various imaging modalities, which may influence the geometric output and thus hemodynamic results. This study aims to compare CFD results from aneurysm models segmented from three-dimensional rotational angiography (3D-RA) versus novel four-dimensional CT angiography (4D-CTA).MethodsFourteen patients with 16 cerebral aneurysms underwent novel 4D-CTA followed by 3D-RA. Endoluminal geometries were segmented from each modality using an identical workflow, blinded to the other modality, to produce 28 'original' models. Each was then minimally edited a second time to match length of branches, producing 28 additional 'matched' models. CFD simulations were performed using estimated flow rates for 'original' models (representing real-world experience) and patient-specific flow rates from 4D-CTA for 'matched' models (to control for influence of modality alone).ResultsOverall, geometric and hemodynamic results were consistent between models segmented from 3D-RA and 4D-CTA, with correlations improving after matching to control for operator-introduced variability. Despite smaller 4D-CTA parent artery diameters (3.49±0.97 mm vs 3.78±0.92 mm for 3D-RA; p=0.005) and sac volumes (157 (37–750 mm3) vs 173 (53–770 mm3) for 3D-RA; p=0.0002), sac averages of time-averaged wall shear stress (TAWSS), oscillatory shear (OSI), and high frequency fluctuations (measured by spectral power index, SPI) were well correlated between 3D-RA and 4D-CTA 'matched' control models (TAWSS, R2=0.91; OSI, R2=0.79; SPI, R2=0.90).ConclusionsOur study shows that CFD performed using 4D-CTA models produces reliable geometric and hemodynamic information in the intracranial circulation. 4D-CTA may be considered as a follow-up imaging tool for hemodynamic assessment of cerebral aneurysms.
Reciprocal and Autonomous Glucocorticoid and Androgen Receptor Activation in Salivary Duct Carcinoma
Authors: Mitani Yoshitsugu , Lin Sue-Hwa , Pytynia Kristen B. , Ferrarotto Renata , El-Naggar Adel K. 
Published: November 2019

Abstract

Purpose:
To determine the expression of glucocorticoid receptor (GR) and androgen receptor (AR) in salivary duct carcinoma (SDC) and to analyze the role of these proteins in the development and management of this disease entity.

Experimental Design:
We performed a phenotypic assessment of GR and AR localization and expression, and determined their association with clinicopathologic factors in 67 primary SDCs. In vitro functional and response analysis of SDC cell lines was also performed.

Results:
Of the 67 primary tumors, 12 (18%) overexpressed GR protein, 30 (45%) had constitutive expression, and 25 (37%) had complete loss of expression. Reciprocal GR and AR expression was found in 32 (48%) tumors, concurrent constitutive GR and AR expression in 23 (34%), and simultaneous loss of both receptors and high GR with AR expressions were found in 12 (18%). GR overexpression was significantly associated with worse clinical outcomes. In vitro ligand-independent AR activation was observed in both male- and female-derived cell lines. GR antagonist treatment resulted in decreased cell proliferation and survival in GR-overexpressing cells, irrespective of AR status. Reciprocal GR- and AR-knockdown experiments revealed an independent interaction.

Conclusions:
Our study, for the first time, demonstrates differential GR and AR expressions, autonomous GR and AR activation, and ligand-independent AR expression and activation in SDC cells. The findings provide critical information on the roles of GR and AR steroid receptors in SDC tumorigenesis and development of biomarkers to guide targeted steroid receptor therapy trials in patients with these tumors.
Baseline Characteristics, Treatment Patterns, and Outcomes in Patients with HER2-Positive Metastatic Breast Cancer by Hormone Receptor Status from SystHERs
Authors: Cobleigh Melody , Yardley Denise A. , Brufsky Adam M. , Rugo Hope S. , Swain Sandra M. , Kaufman Peter A. , Tripathy Debu , Hurvitz Sara A. , O'Shaughnessy Joyce , Mason Ginny , Antao Vincent , Li Haocheng , Chu Laura , Jahanzeb Mohammad 
Published: November 2019

Abstract

Purpose:
We report treatments and outcomes in a contemporary patient population with HER2-positive metastatic breast cancer (MBC) by hormone receptor (HR) status from the Systemic Therapies for HER2-positive Metastatic Breast Cancer Study (SystHERs).

Experimental Design:
SystHERs (NCT01615068) was an observational, prospective registry study of U.S.-based patients with newly diagnosed HER2-positive MBC. Endpoints included treatment patterns and clinical outcomes.

Results:
Of 977 eligible patients (enrolled from 2012 to 2016), 70.1% (n = 685) had HR-positive and 29.9% (n = 292) had HR-negative disease. Overall, 59.1% (405/685) of patients with HR-positive disease received any first-line endocrine therapy (with or without HER2-targeted therapy or chemotherapy); 34.9% (239/685) received HER2-targeted therapy + chemotherapy + sequential endocrine therapy. Patients with HR-positive versus HR-negative disease had longer median overall survival (OS; 53.0 vs 43.4 months; hazard ratio, 0.70; 95% confidence interval, 0.56–0.87). Compared with patients with high HR-positive staining (10%–100%, n = 550), those with low HR-positive staining (1%–9%, n = 60) received endocrine therapy less commonly (64.2% vs 33.3%) and had shorter median OS (53.8 vs 40.1 months). Similar median OS (43.4 vs 40.1 months) was observed in patients with HR-negative versus low HR-positive tumors (1%–9%).

Conclusions:
Despite evidence that first-line HER2-targeted therapy, chemotherapy, and sequential endocrine therapy improves survival in patients with HR-positive, HER2-positive disease, only 34.9% of patients in this real-world setting received such treatment. Patients with low tumor HR positivity (1%–9%) had lower endocrine therapy use and worse survival than those with high tumor HR positivity (10%–100%).
Analysis of Released Circulating Tumor Cells During Surgery for Non-Small Cell Lung Cancer
Authors: Tamminga Menno , de Wit Sanne , van de Wauwer Caroline , van den Bos Hilda , Swennenhuis Joost F. , Klinkenberg Theo J. , Hiltermann T. Jeroen N. , Andree Kiki C. , Spierings Diana C.J. , Lansdorp Peter M. , van den Berg Anke , Timens Wim , Terstappen Leon W.M.M. , Groen Harry J.M. 
Published: November 2019

Abstract

Purpose:
Tumor cells from patients with lung cancer are expelled from the primary tumor into the blood, but difficult to detect in the peripheral circulation. We studied the release of circulating tumor cells (CTCs) during surgery to test the hypothesis that CTC counts are influenced by hemodynamic changes (caused by surgical approach) and manipulation.

Experimental Design:
Patients undergoing video-assisted thoracic surgery (VATS) or open surgery for (suspected) primary lung cancer were included. Blood samples were taken before surgery (T0) from the radial artery (RA), from both the RA and pulmonary vein (PV) when the PV was located (T1) and when either the pulmonary artery (T2 open) or the PV (T2 VATS) was dissected. The CTCs were enumerated using the CellSearch system. Single-cell whole-genome sequencing was performed on isolated CTCs for aneuploidy.

Results:
CTCs were detected in 58 of 138 samples (42%) of 31 patients. CTCs were more often detected in the PV (70%) compared with the RA (22%, P &lt; 0.01) and in higher counts (P &lt; 0.01). After surgery, the RA but not the PV showed less often CTCs (P = 0.02). Type of surgery did not influence CTC release. Only six of 496 isolated CTCs showed aneuploidy, despite matched primary tumor tissue being aneuploid. Euploid so-called CTCs had a different morphology than aneuploid.

Conclusions:
CTCs defined by CellSearch were identified more often and in higher numbers in the PV compared with the RA, suggesting central clearance. The majority of cells in the PV were normal epithelial cells and outnumbered CTCs. Release of CTCs was not influenced by surgical approach.
Targeting CMTM6 Suppresses Stem Cell–Like Properties and Enhances Antitumor Immunity in Head and Neck Squamous Cell Carcinoma
Authors: Chen Lei , Yang Qi-Chao , Li Yi-Cun , Yang Lei-Lei , Liu Jian-Feng , Li Hao , Xiao Yao , Bu Lin-Lin , Zhang Wen-Feng , Sun Zhi-Jun 
Published: November 2019

AbstractCMTM6, a regulator of PD-L1 expression, also modulates tumor immunity. Little is known about the function of CMTM6 and its mechanism of action in head and neck squamous cell carcinoma (HNSCC). In this study, we found by IHC analysis that CMTM6 overexpression predicted a poor prognosis for patients with HNSCC. We discovered that CMTM6 expression was correlated with increased activity through the Wnt/β-catenin signaling pathway, which is essential for tumorigenesis, maintenance of cancer stem cells (CSC), and the epithelial-to-mesenchymal transition (EMT) characteristic of multiple cancers. We used short hairpin RNA to eliminate expression of CMTM6, which led, in HNSCC cells, to reduced expression of nuclear β-catenin as well as inhibition of stem cell–like properties, TGFβ-induced EMT, and cell proliferation. Consistent with these results, we identified a significant positive correlation between expression of CMTM6 and EMT- and CSC-related genes in The Cancer Genome Atlas (TCGA). We found positive correlations for both RNA and protein between expression of CMTM6 and immune checkpoint components. CMTM6 silencing–induced PD-L1 downregulation delayed SCC7 tumor growth and increased CD8+ and CD4+ T-cell infiltration. The proportions of PD-1+, TIM-3+, VISTA+, LAG-3+, and B7-H3+ exhausted T cells were decreased significantly in the CMTM6 knockdown group. CMTM6 thus regulates stemness, EMT, and T-cell dysfunction and may be a promising therapeutic target in the treatment of HNSCC.
Avoidance of Vagal Response During Circumferential Pulmonary Vein Isolation
Authors: Hu Feng , Zheng Lihui , Liu Shangyu , Shen Lishui , Liang Erpeng , Ding Ligang , Wu Lingmin , Chen Gang , Fan Xiaohan , Yao Yan 
Published: November 2019

Background:
Circumferential pulmonary vein isolation (CPVI) often cause unavoidable vagal reflexes during procedure due to the coincidental modification of ganglionated plexus which are located on pulmonary vein (PV) antrum. The right anterior ganglionated plexi (RAGP) which located at superoanterior area of right superior PV antrum is an essential station to regulate the cardiac autonomic nerve activities and is easily coincidentally ablated during CPVI. The aim of this study is to assess the effect of RAGP ablation on vagal response (VR) during CPVI.

Methods:
A total of 80 patients with paroxysmal atrial fibrillation who underwent the first time CPVI were prospectively enrolled and randomly assigned to 2 groups: group A (n=40), CPVI started with right PVs at RAGP site; group B (n=40): CPVI started with left PVs first, and the last ablation site is RAGP. Electrophysiological parameters include basal cycle length, A-H interval, H-V interval, sinus node recovery time, and atrioventricular node Wenckebach point were recorded before and after CPVI procedure.

Results:

During CPVI, the positive VR were only observed on 1 patient in group A and 25 patients in group B (
P
<0.001). A total of 21 patients with positive VR in group B needed for temporary ventricular pacing during procedure, while the only patient with positive VR in group A did not need for temporary ventricular pacing (
P
<0.001). Compared with baseline, basal cycle length, sinus node recovery time, and atrioventricular node Wenckebach point were decreased significantly after CPVI procedure in both groups (all
P
<0.05) and without differences between 2 groups.

Conclusions:
Circumferential PV isolation initiated from RAGP could effectively inhibit VR occurrence and significantly increase heart rate during procedure.
Effects of Crushed Ticagrelor Versus Eptifibatide Bolus Plus Clopidogrel in Troponin‐Negative Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention: A Randomized Clinical Trial
Authors: Marian Moazez J. , Abu Daya Hussein , Chatterjee Arka , Al Solaiman Firas , Sasse Mark F. , Fonbah William S. , Workman Raymond W. , Johnson Brittany E. , Carlson Sarah E. , Brott Brigitta C. , Prabhu Sumanth D. , Leesar Massoud A. 
Published: November 2019

Background

After a loading dose of ticagrelor, the rate of high on‐treatment platelet reactivity remains elevated, which increases periprocedural myocardial infarction and injury. This indicates that faster platelet inhibition with crushed ticagrelor (
CTIC
) or eptifibatide is needed to reduce high on‐treatment platelet reactivity. The efficacy of
CTIC
versus eptifibatide bolus plus clopidogrel is unknown.

Methods and Results

A total of 100 P2Y
12
naïve, troponin‐negative patients with acute coronary syndrome were randomized to
CTIC
(180 mg) versus eptifibatide bolus (180 μg/kg×2 intravenous boluses) plus clopidogrel (600 mg) at the time of percutaneous coronary intervention. High on‐treatment platelet reactivity was markedly higher with
CTIC
versus eptifibatide bolus plus clopidogrel (42% versus 0%;
P
<0.001) at 30 minutes and persisted up to 2 hours (12% versus 0%;
P
=0.01, respectively). Platelet aggregation by adenosine diphosphate dropped faster from baseline with eptifibatide bolus plus clopidogrel versus
CTIC
(0.5 versus 2 hours, respectively) and was higher with
CTIC
versus eptifibatide bolus plus clopidogrel at 0.5, 2, and 4 hours after loading dose (53±12% versus 1.3±2%; 35±11% versus 0.34±1.0%; and 23±9% versus 3.5±2%, respectively;
P
<0.001). Eptifibatide bolus plus clopidogrel, but not
CTIC
, significantly inhibited platelet aggregation induced by thrombin‐receptor activating peptide. Periprocedural myocardial infarction and injury was higher with
CTIC
versus eptifibatide bolus plus clopidogrel (48% versus 28%, respectively;
P
=0.035). Post–percutaneous coronary intervention hemoglobin levels were not different between groups.

Conclusions

Eptifibatide bolus plus clopidogrel led to faster and more potent platelet inhibition than
CTIC
and reduced periprocedural myocardial infarction and injury in troponin‐negative acute coronary syndrome patients undergoing percutaneous coronary intervention, with no significant hemoglobin drop after percutaneous coronary intervention.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
02925923.