bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pegfilgrastim induces elevation of serum CA 15–3 in breast carcinoma patients after receiving dose-dense adjuvant chemotherapy
Authors: Saura C. , Vilar E. , Cortes J. , Bellet M. , Ocaña A. , Gomez P. , Baselga J. 
Published: April 2020

8595 Background: CA 15–3, an epytope related with MUC-1 gene products, is a well known tumour marker to predict early recurrent disease breast cancer. MUC-1 expression can be detected in neutrophil membrane and cytoplasm. It is known that patients with breast cancer who receive adjuvant chemotherapy with G-CSF support may show CA 15–3 false positive elevations Methods: We identified by medical records 76 patients who received adjuvant sequential chemotherapy for breast cancer consisted in Doxorubicin/Ciclophosphamide for 4 cycles followed by Paclitaxel for 4 cycles every-2 (with haematopoietic support with Pegfilgrastim (Cohort A, n=29) or Filgrastim (Cohort B, n=10)) and every-3-weeks without haematopoietic support (cohort C, n=37) between October 2003 and November 2005. Mean values of CA 15–3 recorded at the first follow up (FU) visit after treatment and number of patients with levels above the cut-off value of 40 U/mL were compared between the three patients cohorts. Correlation between CA 15–3 with alkaline phosphatase (AP) levels measured at first FU and with absolute neutrophil count (ANC) mean values measured on day 14 of every cycle were performed for each cohort Results: Patients characteristics between cohorts were well balanced except for age. A statistically significantly difference in median CA 15–3 post-treatment values were observed between Cohort A and C (34.01 versus 22.3, p=0.001), but no between Cohort A and B (34.01 versus 30.53). Eight patients in Cohort A, 2 in B and 1 in C had CA 15–3 levels above 40 UI/mL (27.6% versus 20% versus 2.7%, p=0.009). CA 15–3 decreased to normal values at subsequent visits. CA 15–3, mean ANC (r= 0.272, p= 0.020), and AP (r= 0.361, p= 0.002) were found associated each other when the whole database was analyzed Conclusions: These data provide evidence that Pegfilgrastim induces elevation of CA 15–3 level in comparison with patients treated without G-CSF support. This elevation may be related to the increased neutrophil counts. Physicians should be aware of this fact during the follow up to avoid unnecessary diagnostic workup. [Table: see text]
Effect of antithrombotic prophylaxis (AP) on thrombosis-related complications and mortality in cancer patiets (pts) carrying a central venous devices (CVD)
Authors: Cimminiello C. , Isa L. , Vergani C. , Catena L. , Tomirotti M. , Visini M. , Alatri A. , De Paoli A. , Aondio G. , Verga M. 
Published: April 2020

8596 Background: Recent guidelines do recommend against antithrombotic prophylaxis in cancer pts having placed a central line to prevent catheter-related thrombosis. Methods: The present study, which was an observational and prospective one, involved 18 centres in Lombardia (Italy) to assess the management of CVD in pts affected by solid or haematological tumors to evaluate in the current practice the attitude to employ the AP and the clinical evolution as regard to the occurrence of catheter-related and systemic venous thromboses and survival. Results: 1,418 pts entered the study and were followed-up during a median period of 6 months for a total of 24,182 patients-months. Subjects receiving a continuous AP, mainly with mini-warfarin according to Levine, were 439 (31.6%): they were significantly older, with a more frequent history of Venous Thromboembolism (VTE), and with a cancer in a more advanced stage. A trend in favour of those not treated with AP was noticed as regard to catheter-related thrombosis, 3.2 % vs 1.5%, (p=0.058). The median time to the first catheter-related complication was 120 days. The frequency of systemic VTE including deep and superficial vein thromboses in sites other than the venous axis where the CVD had been placed and pulmonary embolism was significantly lower in patients not receiving AP: 1.8% vs 12.4%; OR 0.12 (95% CI: 0.07–0.22; p=.001). Mortality of pts avoiding AP was also significantly lower (23.7% vs 38%), OR 0.5 (95% CI: 0.4–0.6; p=.0001) In the multiple logistic regression analysis only advanced cancer and to be given AP were significantly associated with mortality. No major bleeding was recorded among pts assigned to receive continuous AP. Conclusions: The results of the present study do confirm the current drugs and schedules for AP are unable to prevent not only catheter-related thrombosis but also systemic VTE. Mortality does appear lower in those not treated with AP and the difference still exists after adjustment for age, history of previous VTE and to be given chemotherapy. The attitude to give a continuous AP to pts with central lines presenting with more severe disease or at increased thromboembolic risk seems to be ineffective if not dangerous. No significant financial relationships to disclose.
Statewide survey on the management of psychosocial distress by oncologists
Authors: Pirl W. F. , Muriel A. , Schapia L. , Hwang V. , Moore C. , Temel J. , Kornblith A. , Holland J. C. 
Published: April 2020

8601 Background: Although the NCCN has published guidelines for the management of psychosocial distress, no data exists on how oncologists manage it in clinical practice. This study surveyed oncologists in Massachusetts on their estimated rates of distress in their patients, beliefs about distress, and practice patterns. Methods: All Massachusetts oncologists belonging to ASCO were e-mailed an electronic survey up to three times. Survey completion was anonymous and a small incentive was offered for participation. Descriptive statistics and cross-tabulations were compiled. Chi-squared analyses investigated differences in rates. Results: 393 e-mail addresses were identified. 338 surveys were delivered, but the e-mail survey could be blocked by SPAM filters. Ninety-nine responses were obtained yielding a response rate of 29%. Oncologists estimated that 77% (sd=23%) of their patients experience distress, but only 33% (sd=20%) have distress that warrants treatment. Emotional problems unrelated to illness, practical problems, and coping with illness were the three most frequently encountered forms of distress. Sixty-five percent of oncologists reported that they routinely screened for psychosocial distress, but only 3% use a screening instrument. Almost all reported that they would at least consider using a brief screening instrument (93%). Lack of time was identified as the main barrier to screening, but lack of knowledge about treatment of distress was the only variable that predicted lower rates of screening (p=.03). While reported rates of referrals to mental health professionals were high, the majority (85%) reported that they directly address the psychosocial distress in their practice and almost half reported that they initiate psychotropic medications (45%). Conclusions: The majority of oncologists report that they do some screening and management of psychosocial distress in their clinical practices. Although screening appears to mainly be done through the usual clinical encounter, research has shown that this method has a poor rate of detection for psychological disorders. Despite the fact that the NCCN recommends the use of screening instruments and most oncologists report interest in using them, oncologists rarely actually use such measures. No significant financial relationships to disclose.
A randomized open-label study of darbepoetin alfa administered every 3 weeks with or without parenteral iron in anemic subjects with nonmyeloid malignancies receiving chemotherapy
Authors: Vandebroek A. , Gaede B. , Altintas S. , Smith K. , Yao B. , Schupp M. , Bastit L. 
Published: April 2020

8612 Background: Patients (pts) with cancer receiving chemotherapy often have chemotherapy-induced anemia (CIA) and reduced quality of life. Darbepoetin alfa (DA) is an erythropoiesis-stimulating agent (ESA) that can effectively treat CIA when administered once every 3 weeks (Q3W). In patients with CIA, limited data in the literature suggest that administration of intravenous (IV) iron with ESA therapy may increase clinical response. Methods: This randomized, multicenter, open-label, 16-week study evaluated the safety and efficacy of DA 500 mcg administered Q3W using the SureClick injection device in pts with CIA (Hb < 11 g/dL) who received either IV iron or standard practice for iron administration (oral iron or no iron). The dose of IV iron was 200 mcg administered either Q3W with DA Q3W or, if required, as 2 doses (200 mcg total) within a 3-week period. Pts who received ≥ 1 dose of DA and who completed the 16-week study period by October 19, 2005 are included in this interim analysis (planned sample size = 400 pts). Accrual will have finished by conference time. Randomization was stratified by tumor type and baseline (BL) Hb (< 10 or ≥ 10 g/dL). The incidence of adverse events and serious adverse events, in particular embolic/thrombotic events, was summarized. Efficacy endpoints were estimated using the crude % of pts (95% CI). Hb values within 28 days of a transfusion were not included in any efficacy analysis. Results: Of the 114 pts included in this interim analysis, 65% were women, 99% were Caucasian, the mean (SD) age was 60 years (12), and 26% had lung or gynecological tumors; study endpoints are shown in the table. Conclusions: Based on the interim results, the safety profile for pts receiving DA 500 mcg Q3W with IV iron appears to be comparable to pts receiving DA 500 mcg Q3W with oral iron or no iron. The % pts who achieved the target Hb (≥ 11 g/dL) appeared higher, and the % pts who required transfusions appeared lower, in the group receiving IV iron. [Table: see text] [Table: see text]
Three-Year Results of a Prospective Statewide Insurance Coverage Pilot for Proton Therapy: Stakeholder Collaboration Improves Patient Access to Care
Authors: Ning Matthew S. , Palmer Matthew B. , Shah Aashish K. , Chambers Laura C. , Garlock Laura B. , Melson Benjamin B. , Frank Steven J. 
Published: April 2020

PURPOSE: Proton therapy is increasingly prescribed, given its potential to improve outcomes; however, prior authorization remains a barrier to access and is associated with frequent denials and treatment delays. We sought to determine whether appropriate access to proton therapy could ensure timely care without overuse or increased costs. METHODS: Our large academic cancer center collaborated with a statewide self-funded employer (n = 186,000 enrollees) on an insurance coverage pilot, incorporating a value-based analysis and ensuring preauthorization for appropriate indications. Coverage was ensured for prospective trials and five evidence-supported anatomic sites. Enrollment initiated in 2016 and continued for 3 years. Primary end points were use, authorization time, and cost of care, with case-matched comparison of total charges at 1 month pretreatment through 6 months posttreatment. RESULTS: Thirty-two patients were approved over 3 years, with only 22 actually receiving proton therapy, versus a predicted use by 120 patients ( P < .01). Median follow-up was 20.1 months, and average authorization time decreased from 17 days to < 1 day ( P < .01), significantly enhancing patient access. During this time, 25 patients who met pilot eligibility were instead treated with photons; and 17 patients with > 6 months of follow-up were case matched by treatment site to 17 patients receiving proton therapy, with no significant differences in sex, age, performance status, stage, histology, indication, prescribed fractions, or chemotherapy. Total medical costs (including radiation therapy [RT] and non-RT charges) for patients treated with PBT were lower than expected (a cost increase initially was expected), with no significant difference in total average charges ( P = .82), in the context of overall ancillary care use. CONCLUSION: This coverage pilot demonstrated that appropriate access to proton therapy does not necessitate overuse or significantly increase comprehensive medical costs. Objective evidence-based coverage polices ensure appropriate patient selection. Stakeholder collaboration can streamline patient access while reducing administrative burden.
A comprehensive study of phospholipid fatty acid rearrangements in metabolic syndrome: correlations with organ dysfunction
Authors: Bacle Amélie , Kadri Linette , Khoury Spiro , Ferru-Clément Romain , Faivre Jean-François , Cognard Christian , Bescond Jocelyn , Krzesiak Amandine , Contzler Hugo , Delpech Nathalie , Colas Jenny , Vandebrouck Clarisse , Sébille Stéphane , Ferreira Thierry 
Published: April 2020

ABSTRACT
The balance within phospholipids (PLs) between saturated fatty acids and monounsaturated or polyunsaturated fatty acids is known to regulate the biophysical properties of cellular membranes. As a consequence, in many cell types, perturbing this balance alters crucial cellular processes, such as vesicular budding and the trafficking/function of membrane-anchored proteins. The worldwide spread of the Western diet, which is highly enriched in saturated fats, has been clearly correlated with the emergence of a complex syndrome known as metabolic syndrome (MetS). MetS is defined as a cluster of risk factors for cardiovascular diseases, type 2 diabetes and hepatic steatosis; however, no clear correlations have been established between diet-induced fatty acid redistribution within cellular PLs and the severity/chronology of the symptoms associated with MetS or the function of the targeted organs. To address this issue, in this study we analyzed PL remodeling in rats exposed to a high-fat/high-fructose diet (HFHF) over a 15-week period. PL remodeling was analyzed in several organs, including known MetS targets. We show that fatty acids from the diet can redistribute within PLs in a very selective manner, with phosphatidylcholine being the preferred sink for this redistribution. Moreover, in the HFHF rat model, most organs are protected from this redistribution, at least during the early onset of MetS, at the expense of the liver and skeletal muscles. Interestingly, such a redistribution correlates with clear-cut alterations in the function of these organs.
This article has an associated First Person interview with the first author of the paper.
Effect of differences in pixel size on image characteristics of digital intraoral radiographic systems: a physical and visual evaluation
Authors: Kuramoto Taku , Takarabe Shinya , Okamura Kazutoshi , Shiotsuki Kenshi , Shibayama Yusuke , Tsuru Hiroki , Akamine Hiroshi , Tatsumi Masato , Kato Toyoyuki , Morishita Junji , Yoshiura Kazunori 
Published: April 2020

Objectives: To quantify and validate the effect of pixel size on a digital intraoral radiographic system according to International Electrotechnical Commission standards through physical and visual evaluations. Methods: The digital intraoral radiographic system used was the photostimulable phosphor imaging plate and scanner system. The system had three image capture modes: high-speed (HS), high-resolution (HR), and super high-resolution (SHR) with different pixels. The physical characteristics of the system were evaluated using presampled modulation transfer function (MTF) and the normalized noise power spectrum (NNPS). An aluminum (Al) step phantom with different depths of holes was used to acquire images under various exposure conditions. The average number of perceptible holes from all steps was plotted against each exposure dose. The results were compared to analyze the effects of pixel size on image quality of intraoral radiographs. Results: The MTF was slightly higher with SHR than with HR and HS. The NNPS with SHR showed about a 40% decrease in magnitude compared to HS. The total number of perceptible holes in the Al step phantom was higher with SHR than with HS and HR in all exposure conditions. Conclusions: The MTF and NNPS obtained with different pixel size could be quantified by physical evaluation, and the differences were visually validated with Al step phantom. The SHR mode has the potential to decrease the radiation dose without compromising the image quality.
Warning Against Recurring Risks: An Information Design Approach
Authors: Alizamir Saed , de Véricourt Francis , Wang Shouqiang 
Published: April 2020

The World Health Organization seeks effective ways to alert its member states about global pandemics. Motivated by this challenge, we study a public agency’s problem of designing warning policies to mitigate potential disasters that occur with advance notice. The agency privately receives early information about recurring harmful events and issues warnings to induce an uninformed stakeholder to take preemptive actions. The agency’s decision to issue a warning critically depends on its reputation, which we define as the stakeholder’s belief regarding the accuracy of the agency’s information. The agency faces then a trade-off between eliciting a proper response today and maintaining its reputation to elicit responses to future events. We formulate this problem as a dynamic Bayesian persuasion game, which we solve in closed form. We find that the agency sometimes strategically misrepresents its advance information about a current threat to cultivate its future reputation. When its reputation is sufficiently low, the agency downplays the risk and actually downplays more as its reputation improves. By contrast, when its reputation is high, the agency sometimes exaggerates the threat and exaggerates more as its reputation deteriorates. Only when its reputation is moderate does the agency send warning messages that fully disclose its private information. Our study suggests a plausible and novel rationale for some of the false alarms or omissions observed in practice. We further test the robustness of our findings to imperfect advance information, disasters without advance notice, and heterogeneous receivers. This paper was accepted by Manel Baucells, decision analysis.
Orthodontic pain
Authors: Grewal Sukhraj , Harris Lydia MJ , Ponduri Sirisha , Naish Hywel , Ellis Pamela , Sandy Jonathan R , Ireland Anthony J 
Published: April 2020

Pain is a common side-effect of orthodontic treatment. The aetiology of orthodontic pain, pain pathways and pain management will be described. CPD/Clinical Relevance: An understanding of the cause and subsequent management of orthodontic pain is essential for any orthodontist in order to improve patient co-operation and satisfaction with treatment.
Orthodontic bonding to atypical tooth surfaces
Authors: Prado Naomi , Caldwell Susi , Ashley Martin 
Published: April 2020

Orthodontic bonding techniques continue to evolve with the ever-changing population. With the demand for orthodontic treatment increasing, the specialty is regularly presented with restored dentitions, anterior crowns, bleached teeth, as well as those presenting with developmental conditions, such as fluorosis and amelogenesis imperfecta. Reduced orthodontic bond strength can lead to failure of the appliance and in turn lead to prolonged treatment times and patient dissatisfaction. This article aims to summarize the recommended methods for bonding and give an updated review of optimizing techniques. CPD/Clinical Relevance: Adequate bracket bond strength is an essential part of orthodontic treatment, to prevent breakages and reduce treatment time and risk factors.
Predictors of length of stay following shoulder arthroplasty in a high-volume UK centre
Authors: Dacombe P , Harries L , McCann P , Crowther M , Packham I , Sarangi P , Whitehouse MR 
Published: April 2020

Introduction Shoulder arthroplasty rates are increasing in the UK. No data have been published from a UK centre on predictors of length of inpatient stay following shoulder arthroplasty. This study analyses the length of inpatient stay following shoulder arthroplasty in a high-volume UK centre and identifies predictors of prolonged inpatient stay. Materials and methods All shoulder arthroplasty cases performed between 2012 and 2018 were identified. A review of case notes and electronic patient records was completed to identify demographic data, Charlson comorbidity score, length of inpatient stay and factors associated with length of stay. Multiple linear regression analysis was conducted to determine which factors were independently associated with length of inpatient stay. Results A total of 640 shoulder arthroplasty cases were performed in 566 patients. Median length of stay was two days. Length of stay was predicted by age, sex, chronic kidney disease, congestive cardiac failure, previous myocardial infarction, intraoperative complication and postoperative transfusion. Discussion Increasing age, female sex, chronic kidney disease, congestive cardiac failure, previous myocardial infarction, intraoperative complication and transfusion were independent predictors of increased length of stay. Strategies to reduce perioperative complication and transfusion, and to optimise renal and cardiac comorbidities may reduce overall length of stay for shoulder arthroplasty patients.
PERNIKAHAN SEBAGAI SANKSI KHALWAT: Studi Kasus Desa Bedulang, Bandar Pusaka, Aceh Tamiang
Authors: Rizki Wahyu Fahrul 
Published: April 2020

This article addesses the issue on the implementation of forced marriage as a sanction of seclusion (khalwat) practiced in Batu Bedulang Aceh Tamiang. Based on empirical research, this paper argued that there are some reasons behind the practice and religious and social reasons are two important factors. Avoiding fornication is a religious doctrine underlying the practice. Feeling ashamed of the whole family members if one of them is doing seclusion is another reason of the implementation of the sanction. Based on these reasons, the implementation of forced marriage as a sanction of seclusion exsists, eventhough the groom and bride candidates are still under permissible marriage age.Penelitian ini berangkat dari ketertarikan peneliti terhadap kawin paksa sebagai sanksi khalwat yang ada di Desa Batu Bedulang. Dengan memanfaatkan data empiris dari hasil wawancara dengan pemangku adat dan tokoh agama, tulisan ini menunjukkan bahwa praktek turun temurun tentang pernikahan sebagai sanksi khalwat yang dipraktekkan di Desa Batu Bedulang disebabkan oleh beberapa faktor. Faktor agama dan moral dan sosial merupakan dua sebab penting adanya praktek tersebut. Melekatnya doktrin menghindari perzinaan adalah faktor agama yang dijadikan alasan diterapkannya sanksi ini. Sedangkan alasan moral sosial adalah adanya rasa malu pada keluarga jika salah satu anggota keluarganya melakukan khalwat, lebih lagi jika yang melakukan perempuan. Dengan alasan seperti ini, maka pernikahan sebagai sanksi khalwat tetap diterapkan meskipun usia calon mempelai masih di bawah usia perkawinan.
Individualized metabolomics: opportunities and challenges
Authors: Misra Biswapriya 
Published: April 2020

Abstract
The goal of advancing science in health care is to provide high quality treatment and therapeutic opportunities to patients in need. This is especially true in precision medicine, wherein the ultimate goal is to link disease phenotypes to targeted treatments and novel therapeutics at the scale of an individual. With the advent of -omics technologies, such as genomics, proteomics, microbiome, among others, the metabolome is of wider and immediate interest for its important role in metabolic regulation. The metabolome, of course, comes with its own questions regarding technological challenges. In this opinion article, I attempt to interrogate some of the main challenges associated with individualized metabolomics, and available opportunities in the context of its clinical application. Some questions this article addresses and attempts to find answers for are: Can a personal metabolome (n = 1) be inexpensive, affordable and informative enough (i.e. provide predictive yet validated biomarkers) to represent the entirety of a population? How can a personal metabolome complement advances in other -omics areas and the use of monitoring devices, which occupy our personal space?