bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organoids Reveal That Inherent Radiosensitivity of Small and Large Intestinal Stem Cells Determines Organ Sensitivity
Authors: Martin Maria Laura , Adileh Mohammad , Hsu Kuo-Shun , Hua Guoqiang , Lee Sang Gyu , Li Christy , Fuller John D. , Rotolo Jimmy A. , Bodo Sahra , Klingler Stefan , Haimovitz-Friedman Adriana , Deasy Joseph O. , Fuks Zvi , Paty Philip B. , Kolesnick Richard N. 
Published: November 2019

Abstract

Tissue survival responses to ionizing radiation are nonlinear with dose, rather yielding tissue-specific descending curves that impede straightforward analysis of biologic effects. Apoptotic cell death often occurs at low doses, while at clinically relevant intermediate doses, double-strand break misrepair yields mitotic death that determines outcome. As researchers frequently use a single low dose for experimentation, such strategies may inaccurately depict inherent tissue responses. Cutting edge radiobiology has adopted full dose survival profiling and devised mathematical algorithms to fit curves to observed data to generate highly reproducible numerical data that accurately define clinically relevant inherent radiosensitivities. Here, we established a protocol for irradiating organoids that delivers radiation profiles simulating the organ of origin. This technique yielded highly similar dose–survival curves of small and large intestinal crypts in vivo and their cognate organoids analyzed by the single-hit multi-target (SHMT) algorithm, outcomes reflecting the inherent radiation profile of their respective Lgr5+ stem cell populations. As this technological advance is quantitative, it will be useful for accurate evaluation of intestinal (patho)physiology and drug screening.

Significance:
These findings establish standards for irradiating organoids that deliver radiation profiles that phenocopy the organ of origin.
See related commentary by Muschel et al., p. 927
Influence of Guidelines in Endovascular Therapy Decision Making in Acute Ischemic Stroke
Authors: Kashani Nima , Ospel Johanna M. , Menon Bijoy K. , Saposnik Gustavo , Almekhlafi Mohammed , Sylaja Pillai N. , Campbell Bruce C.V. , Heo Ji-Hoe , Mitchell Peter J. , Cherian Mathew , Turjman Francis , Kim Byungmoon , Fischer Urs , Wilson Alexis T. , Baxter Blaise , Rabinstein Alejandro , Yoshimura Shinichi , Hill Michael D. , Goyal Mayank 
Published: November 2019

Background and Purpose—
The American Heart Association and the American Stroke Association guidelines for early management of patients with ischemic stroke offer guidance to physicians involved in acute stroke care and clarify endovascular treatment indications. The purpose of this study was to assess concordance of physicians’ endovascular treatment decision-making with current American Heart Association and the American Stroke Association stroke treatment guidelines using a survey-approach and to explore how decision-making in the absence of guideline recommendations is approached.

Methods—
In an international cross-sectional survey (UNMASK-EVT), physicians were randomly assigned 10 of 22 case scenarios (8 constructed with level 1A and 11 with level 2B evidence for endovascular treatment and 3 scenarios without guideline coverage) and asked to declare their treatment approach (1) under their current local resources and (2) assuming there were no external constraints. The proportion of physicians offering endovascular therapy (EVT) was calculated. Subgroup analysis was performed for different specialties, geographic regions, with regard to physicians’ age, endovascular, and general stroke treatment experience.

Results—
When facing level 1A evidence, participants decided in favor of EVT in 86.8% under current local resources and in 90.6% under assumed ideal conditions, that is, 9.4% decided against EVT even under assumed ideal conditions. In case scenarios with level 2B evidence, 66.3% decided to proceed with EVT under current local resources and 69.7% under assumed ideal conditions.

Conclusions—
There is potential for improving thinking around the decision to offer endovascular treatment, since physicians did not offer EVT even under assumed ideal conditions in 9.4% despite facing level 1A evidence. A majority of physicians would offer EVT even for level 2B evidence cases.
A Composite Analysis of Snowfall Modes from Four Winter Seasons in Marquette, Michigan
Authors: Pettersen Claire , Kulie Mark S. , Bliven Larry F. , Merrelli Aronne J. , Petersen Walter A. , Wagner Timothy J. , Wolff David B. , Wood Norman B. 
Published: November 2019

AbstractPresented are four winter seasons of data from an enhanced precipitation instrument suite based at the National Weather Service (NWS) Office in Marquette (MQT), Michigan (250–500 cm of annual snow accumulation). In 2014 the site was augmented with a Micro Rain Radar (MRR) and a Precipitation Imaging Package (PIP). MRR observations are utilized to partition large-scale synoptically driven (deep) and surface-forced (shallow) snow events. Coincident PIP and NWS MQT meteorological surface observations illustrate different characteristics with respect to snow event category. Shallow snow events are often extremely shallow, with MRR-indicated precipitation heights of less than 1500 m above ground level. Large vertical reflectivity gradients indicate efficient particle growth, and increased boundary layer turbulence inferred from observations of spectral width implies increased aggregation in shallow snow events. Shallow snow events occur 2 times as often as deep events; however, both categories contribute approximately equally to estimated annual accumulation. PIP measurements reveal distinct regime-dependent snow microphysical differences, with shallow snow events having broader particle size distributions and comparatively fewer small particles and deep snow events having narrower particle size distributions and comparatively more small particles. In addition, coincident surface meteorological measurements indicate that most shallow snow events are associated with surface winds originating from the northwest (over Lake Superior), cold temperatures, and relatively high surface pressures, which are characteristics that are consistent with cold-air outbreaks. Deep snow events have meteorologically distinct conditions that are accordant with midlatitude cyclones and frontal structures, with mostly southwest surface winds, warmer temperatures approaching freezing, and lower surface pressures.
Prevalence of Pediatric Dizziness and Imbalance in the United States
Authors: Brodsky Jacob R. , Lipson Sophie , Bhattacharyya Neil 
Published: November 2019

ObjectivesUnderstand the prevalence of vestibular symptoms in US children.Study DesignCross‐sectional analysisSetting2016 National Health Interview Survey.Subjects and MethodsResponses from the 2016 National Health Interview Survey for children ages 3 to 17 years were examined to determine the prevalence of vestibular symptoms and provider‐assigned diagnoses.ResultsDizziness or imbalance was reported in 3.5 (95% confidence interval, 3.1‐3.9) million patients (5.6%) with a mean age of 11.5 years. Dizziness was reported in 1.2 million patients (2.0%) with a mean age of 12.7 years and balance impairment in 2.3 million patients (3.7%) with a mean age of 10.6 years. Prevalence of dizziness and imbalance did not vary by sex (P =. 6, P =. 2). Evaluation by a health professional was reported for 42% of patients with dizziness and 43% of patients with imbalance, with diagnoses reported in 45% and 48% of patients with dizziness and imbalance, respectively. The most common diagnoses reported for dizziness were depression or child psychiatric disorder (12%), side effects from medications (11%), head/neck injury or concussion (8.4%), and developmental motor coordination disorder (8.3%). The most common diagnoses reported for imbalance were blurred vision with head motion, “bouncing” or rapid eye movements (9.1%), depression or child psychiatric disorder (6.2%), head/neck injury or concussion (6.1%), and side effects from medications (5.9%).ConclusionThe national prevalence of childhood vestibular symptoms is more common than previously thought. Reported diagnoses varied greatly from the literature, suggesting a need for increased awareness of causes of vestibular symptoms in children.
Postoperative Recurrence of Instability After Arthroscopic Bankart Repair for Shoulders With Primary Instability Compared With Recurrent Instability: Influence of Bipolar Bone Defect Size
Authors: Nakagawa Shigeto , Hirose Takehito , Uchida Ryohei , Tanaka Makoto , Mae Tatsuo 
Published: November 2019

Background: In shoulders with traumatic anterior instability, a bipolar bone defect has recently been recognized as an important indicator of the prognosis. Purpose: To investigate the influence of bipolar bone defects on postoperative recurrence after arthroscopic Bankart repair performed at primary instability. Study Design: Cohort study; Level of evidence, 3. Methods: The study group consisted of 45 patients (45 shoulders) who underwent arthroscopic Bankart repair at primary instability before recurrence and were followed for at least 2 years. The control group consisted of 95 patients (95 shoulders) with recurrent instability who underwent Bankart repair and were followed for at least 2 years. Glenoid defects and Hill-Sachs lesions were classified into 5 size categories on 3-dimensional computed tomography and were allocated scores ranging from 0 for no defect to 4 for the largest defect. The shoulders were classified according to the total score for both lesions (0-8 points). The postoperative recurrence rate was investigated for each score of bipolar bone defects and was compared between patients with primary instability and patients with recurrent instability. The same analysis was performed for the age at operation (<20 years, 20-29 years, or ≥30 years) and for the presence of an off-track Hill-Sachs lesion. Results: Bipolar bone defects were smaller in shoulders with primary instability (mean ± SD defect score, 1.4 ± 1.5 points) than in those with recurrent instability (3.6 ± 1.9 points) and were larger in older patients than in younger patients at the time of primary instability. The postoperative recurrence rate was low (6.7%) in shoulders with primary instability regardless of the size of the bipolar bone defect and the patient’s age, whereas the postoperative recurrence rate was high (23.2%) in shoulders with recurrent instability, especially among patients younger than 20 years with bipolar bone defects of 2 points or greater. An off-track Hill-Sachs lesion was found in only 1 patient in the oldest age group (2.2%) at primary instability, but it was found in 19 patients (20%) at recurrent instability, including 14 patients younger than 30 years. Among patients with an off-track lesion, the postoperative recurrence rate was significantly higher in patients younger than 20 years with recurrent instability (recurrence rates: <20 years, 71.4%; 20-29 years, 14.3%; ≥30 years, 0%). Conclusion: The recurrence rate was consistently low in patients with primary instability and was significantly influenced by bipolar bone defect size and patient age in patients with recurrent instability.
Risk Factors Associated With a Noncontact Anterior Cruciate Ligament Injury to the Contralateral Knee After Unilateral Anterior Cruciate Ligament Injury in High School and College Female Athletes: A Prospective Study
Authors: Davey Annabelle P. , Vacek Pamela M. , Caldwell Ryan A. , Slauterbeck James R. , Gardner-Morse Mack G. , Tourville Timothy W. , Beynnon Bruce D. 
Published: November 2019

Background: The incidence of contralateral anterior cruciate ligament (CACL) injuries after recovery from a first-time anterior cruciate ligament (ACL) disruption is high in women; however, little is known about the risk factors associated with this trauma. Hypothesis: Patient characteristics, strength, anatomic alignment, and neuromuscular characteristics of the contralateral uninjured leg at the time of the first ACL trauma are associated with risk of subsequent CACL injury, and these risk factors are distinct from those for a first-time ACL injury. Study Design: Case-control study; Level of evidence, 3. Methods: Sixty-one women who suffered a first-time noncontact ACL injury while participating in high school or college sports and underwent measurement of potential risk factors on their contralateral limb soon after the initial ACL injury and before reconstruction were followed until either a CACL injury or an ACL graft injury occurred, or until the last date of contact. Results: Follow-up information was available for 55 (90.0%) of the 61 athletes and 11 (20.0%) suffered a CACL injury. Younger age, decreased participation in sport before the first ACL disruption, decreased anterior stiffness of the contralateral knee, and increased hip anteversion were associated with increases in the risk of suffering a CACL injury. Conclusion: A portion of CACL injury risk factors were modifiable (time spent participating in sport and increasing anterior knee stiffness with bracing), while others were nonmodifiable (younger age and increased hip anteversion). The relationship between younger age at the time of an initial ACL injury and increased risk of subsequent CACL trauma may be explained by younger athletes having more years available to be exposed to at-risk activities compared with older athletes. A decrease of anterior stiffness of the knee is linked to decreased material properties and width of the ACL, and this may explain why some women are predisposed to bilateral ACL trauma while others only suffer the index injury. The risk factors for CACL injury are unique to women who suffer bilateral ACL trauma compared with those who suffer unilateral ACL trauma. This information is important for the identification of athletes who may benefit from risk reduction interventions.
Survival Impact and Clinical Predictors of Acute Gastrointestinal Bleeding in Patients With Bloodstream Infection
Authors: Huang Amy Huaishiuan , Liu Ye , Hsien Yenh-Chen , Hsu Tzu-Chun , Yen Debra , Hsu Wan-Ting , Lin Hsin-Yang , Chen Shyr-Chyr , Lee Chien-Chang ,   NTUH Health Data Science Research Group
Published: November 2019

Purpose: The impact of gastrointestinal bleeding (GIB) on outcomes of patients with bloodstream infection (BSI) has not been studied. We aim to evaluate the risk factors and survival impact of GIB on the outcome of BSI. Materials and Methods: This study was conducted prospectively at National Taiwan University Hospital Yunlin Branch between January 1, 2015, and December 31, 2016. Patients aged ≥18 years for who BSI was confirmed by blood cultures were enrolled and followed for 90 days. Risk factors of GIB were identified by univariable and multivariable logistic regression models. The survival impact of GIB on BSI was evaluated with the Cox proportional hazards model with inverse probability of treatment weighting. Results: Of the 1034 patients with BSI, 79 (7.64%) developed acute GIB. We identified 5 independent predictors of GIB. Patients with BSI complicated with GIB had an increased 90-day mortality compared to patients without GIB (hazard ratio 1.74, 95% confidence interval: 1.14, 2.65). Conclusions: Gastrointestinal bleeding had an adverse impact on the short-term survival in patients with BSI. The clinical predictors may help identify patients who may benefit from active prevention and treatment of GIB.
A simple method to identify undiagnosed drug-induced liver injury (DILI) and its application in oncology pharmacy practice
Authors: Wen Haini , Ge Maojun , Yao Di , Liu Li 
Published: November 2019

Aims To establish a simple method to identify chemotherapy-induced liver injury among oncological patients. To evaluate current clinical approach to elevated laboratory liver test results. Methods A total of 289 patients admitted to oncology department who had systemic chemotherapy episodes for cancer treatment from 1 January 2017 to 31 December 2017 were identified. With aid of healthcare information system, Hy's law was applied to laboratory liver test results to identify potential hepatocellular drug-induced liver injury cases. Medical record review was carried out among identified patients to exclude liver dysfunction of alternative causes. Current clinical approach to elevated laboratory liver tests was evaluated through medical record review. Results Of 289 patients who were treated by systemic chemotherapies, there were 123 patients with elevated laboratory liver tests, among which 8 patients were suspected as potential Hy's law cases. After medical record review, there were two patients determined with chemotherapy-associated liver injury, caused by 5-fluorouracil, leucovorin, irinotecan, and S-1 plus paclitaxel separately. Of eight potential Hy's law cases, seven (87.5%) patients were prescribed with ≥2 kinds of liver protectants and remained treated with traditional Chinese medicine for decoction. Conclusions A reliable and simple method to identify undiagnosed drug-induced liver injury was successfully established. An annual incidence of 0.69% of chemotherapy-associated liver injury in oncology department of the setting was found.
Predicting disability progression in multiple sclerosis: Insights from advanced statistical modeling
Authors: Pellegrini Fabio , Copetti Massimiliano , Sormani Maria Pia , Bovis Francesca , de Moor Carl , Debray Thomas PA , Kieseier Bernd C 
Published: November 2019

Background: There is an unmet need for precise methods estimating disease prognosis in multiple sclerosis (MS). Objective: Using advanced statistical modeling, we assessed the prognostic value of various clinical measures for disability progression. Methods: Advanced models to assess baseline prognostic factors for disability progression over 2 years were applied to a pooled sample of patients from placebo arms in four different phase III clinical trials. least absolute shrinkage and selection operator (LASSO) and ridge regression, elastic nets, support vector machines, and unconditional and conditional random forests were applied to model time to clinical disability progression confirmed at 24 weeks. Sensitivity analyses for different definitions of a combined endpoint were carried out, and bootstrap was used to assess prediction model performance. Results: A total of 1582 patients were included, of which 434 (27.4%) had disability progression in a combined endpoint over 2 years. Overall model discrimination performance was relatively poor (all C-indices ⩽ 0.65) across all models and across different definitions of progression. Conclusion: Inconsistency of prognostic factor importance ranking confirmed the relatively poor prediction ability of baseline factors in modeling disease progression in MS. Our findings underline the importance to explore alternative predictors as well as alternative definitions of commonly used endpoints.
Five-Year Two-Center Retrospective Comparison of Central Laboratory Glucose to GEM 4000 and ABL 800 Blood Glucose: Demonstrating the (In)adequacy of Blood Gas Glucose
Authors: Cembrowski George , Jung Joanna , Mei Junyi , Xu Eric , Curic Tihomir , Gibney RT Noel , Jacka Michael , Sadrzadeh Hossein 
Published: November 2019

Purpose: To evaluate the glucose assays of two blood gas analyzers (BGAs) in intensive care unit (ICU) patients by comparing ICU BGA glucoses to central laboratory (CL) glucoses of almost simultaneously drawn specimens. Methods: Data repositories provided five years of ICU BGA glucoses and contemporaneously drawn CL glucoses from a Calgary, Alberta ICU equipped with IL GEM 4000 and CL Roche Cobas 8000-C702, and an Edmonton, Alberta ICU equipped with Radiometer ABL 800 and CL Beckman-Coulter DxC. Blood glucose analyzer and CL glucose differences were evaluated if they were both drawn either within ±15 or ±5 minutes. Glucose differences were assessed graphically and quantitatively with simple run charts and the surveillance error grid (SEG) and quantitatively with the 2016 Food and Drug Administration guidance document, with ISO 15197 and SEG statistical summaries. As the GEM glucose exhibits diurnal variation, CL-arterial blood gas (ABG) differences were evaluated according to time of day. Results: Compared to the GEM glucoses measured between 0200 and 0800, the run charts of (GEM-CL) glucose demonstrate significant outliers between 0800 and 0200 which are identified as moderate to severe clinical outliers by SEG analysis ( P < .002 and P < .0005 for 5- and 15-minute intervals). Over the entire 24-hour period, the rates of moderate to severe glucose clinical outliers are 3.5/1000 (GEM) and 0.6/1000 glucoses (ABL), respectively, using the 15-minute interval ( P < .0001). Discussion: The GEM ABG glucose is associated with a higher frequency of moderate to severe glucose clinical outliers, especially between 0800 and 0200, increased CL testing and higher average patient glucoses.
Evaluation of radiologic diagnostic criteria and treatment options in skeletal muscle hydatid cysts
Authors: Oğur Hasan U , Kapukaya Rana , Külahçı Özgür , Yılmaz Cengiz , Yüce Kemal , Tuhanioğlu Ümit 
Published: November 2019

Aim: To investigate the diagnosis and treatment methods of soft tissue involvement of hydatid cysts (HCs). Materials and Methods: Eleven patients who were diagnosed as having HC with muscular tissue (soft tissue) involvement between 2010 and 2016 were evaluated retrospectively. Seven patients had typical HC magnetic resonance imaging (MRI) and four patients had cysts with an unusual appearance. We evaluated how to diagnose the cysts using imaging methods, their characteristic radiologic images, and treatment alternatives against the disease. The patients were treated with antihelminthic chemotherapy preoperatively and postoperatively. Results: Of the 11 patients who underwent treatment, 7 were diagnosed using MRI and 4 were diagnosed with histopathologic examinations. The mean follow-up period was 16 (range, 6–24) months, and the mean age was 39.4 (range, 24–56) years. In seven patients, multivesicular appearance with specific MRI findings, T2-hypointense rim appearance, double-rim sign, membrane dissociation, and appearance of daughter cysts were identified as diagnostic criteria. Two patients underwent ultrasound assisted percutaneous aspiration–injection–reaspiration (PAIR) treatment. Seven patients underwent total pericystectomy, and two patients underwent subtotal pericystectomy with serum saline injection into the cyst. Two patients showed signs of mild anaphylaxis, one during the diagnosis and one during treatment. Conclusion: There may be difficulties in the diagnosis and treatment of HCs of the musculoskeletal system. It should be known that there are alternative methods in the treatment (cyst excision and PAIR treatment). Clinical, serologic, and radiologic findings should be used in the diagnosis. To avoid complications during the histopathologic diagnosis, MRI should be examined in detail. It is thought that atypical cysts can be diagnosed (double-layer appearance and peripheral rim sign) in addition to typical cysts (detached membrane and multivesicular appearance), and diagnosis and treatment can be planned without anaphylactic complications.