bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex-Based Disparities in Venous Thromboembolism Sociodemographics and Outcomes: A National Inpatient Sample (NIS)-Based Analysis
Authors: Marshall Ariela L. , Bartley Adam C , Ashrani Aneel A. , Gonsalves Wilson I , Kapoor Prashant , Hashmi Shahrukh K. , Siddiqui Mustaqeem A. , Durani Urshila , Go Ronald S. 
Published: November 2019

Abstract
Background: Venous thromboembolism (VTE) contributes to significant morbidity, mortality, and socioeconomic burden. Though male sex is a known risk factor for recurrent VTE, there is a paucity of literature regarding sex-based sociodemographic differences as well as differences in VTE outcomes including hospital length of stay and mortality rates.
Methods: We conducted a retrospective analysis from the National Inpatient Sample (NIS) database from 2012-2013. Inclusion criteria were age 18 years and older and primary discharge diagnosis of VTE Sociodemographic features and medical comorbidities were analyzed, as were hospital length of stay and in-hospital mortality rates.
Results: 107,896 patients in the NIS, representing a national estimate of 539,480 patients hospitalized for VTE between 2012 and 2013, met inclusion criteria. 53% were female and 47% were male. Mean age was 63 years and on average women were older than men (65 years versus 62 years, p<0.001). There were significant differences between men and women with respect to race, primary insurance payor, and VTE location as well as medical comorbidities (Table 1). Median overall length of stay (LOS) was 4 days and in-hospital mortality rates were 2.1%. Female sex was associated with a small but significantly longer hospital LOS (RR 1.04, CI 1.03-1.05, p<0.001) which was also seen in subgroup analyses of lower extremity DVT (RR 1.05, CI 1.03-1.06, p<0.001) and pulmonary embolism (RR 1.03, CI 1.02-1.05, p<0.001) but not upper extremity (RR 1.04, CI 0.96-1.12, p=0.36). There were no significant sex-based differences in in-hospital mortality (2.2% in women versus 2.1% in men, p=0.15). In a multivariate model correcting for sociodemographic differences and medical comorbidities, there were no significant differences between women and men with respect to hospital LOS or in-hospital mortality (Table 2).
Conclusion: We used data from the NIS to study a large number of patients hospitalized for VTE, and identified several sex-based disparities in sociodemographic factors and location of VTE. However, in a multivariable analysis correcting for these factors, sex was not associated with significant differences in hospital LOS or inpatient mortality rates.

Disclosures
Kapoor: Celgene: Research Funding; Takeda: Research Funding; Amgen: Research Funding.
Aiming to Reduce Admissions and Also Re-Admissions in Pediatric Sickle Cell Disease: A Single Institutional Experience with Six Interventions
Authors: Onimoe Grace I. , Carlson Aimee , Frazier Rebecca , Bartley Rebecca , Feldman Erin 
Published: November 2019

Abstract
BACKGROUND AND OBJECTIVES
Sickle Cell disease is an inherited blood disorder of the hemoglobin beta-globin protein in the red blood cells which results in significant risk for hospitalization. Since over 100,000 people in the USA have Sickle Cell Disease and recurrent hospitalizations occur; this constitutes a significant disease burden that are not only costly, but also contribute to loss of income, learned helplessness, additional immense morbidities and psychosocial stressors.
Readmission within 30 days after hospitalization for sickle cell crises was developed at the National Association of Children's Hospitals (NACHRI) as a measurable benchmark to improve hospital quality. The NACHRI, multi state study of sickle cell disease care utilization found an overall readmission rate of 33.4% with lower rates in children (12.8% in children age1-9 and 23.4% for patients ages 10-17).
At our institution, we implemented several interventions to reduce the readmission rate for sickle cell pain crises and will share results and insights.
INTERVENTIONS
The following interventions were employed: a) services of a sickle cell coordinator to co-ordinate clinic visits and patient care b) provide additional standardized teaching on sickle cell care via direct interactions with caregivers, provision of educational materials and organization of a sickle cell awareness conference c) verbal discussions to improve understanding and compliance with a written sickle cell action plan, d) obtaining more frequent parental approval for hydroxyurea therapy, e) increasing tracking immunization rates (influenza), and f) 24hr/72hr discharge telephone call.
The sickle cell team comprising of physicians, nurse practitioners, care coordinator, nurses and social worker actively participated in implementing these steps, and majority of the interventions took place in the outpatient setting.
RESULTS
We reviewed sickle cell admissions and readmissions in 2014 and 2015 in patient's age 0-26 years. Mean age of patients was16.8year (N= 14 Standard deviation = 8.04).
Pre-intervention in 2014 there were 91 admissions with 14/91 re-admissions (15.4%). After beginning implementation of interventions in 2015 there were not only 59% fewer admissions (63), but also 58% fewer readmissions (6 re admit/63 discharges = 9.5%). Thus our interventions affected both admission rate and readmission rates.
CONCLUSION
Sickle cell admissions and subsequent readmissions continue to be a major challenge in successful management of young people with sickle cell disease. Our interventions may help abate some of the hospitalizations and re-admissions as shown by an approximately 40% reduction rate. Although there is undoubtedly much room for additional progress in this area, we have made a good start towards improving our sickle cell population's health.

Disclosures
No relevant conflicts of interest to declare.
Limited Benefit of Additional Contrast-Enhanced CT to End-of- Treatment PET-CT Evaluation in Patients with Follicular Lymphoma
Authors: Paone Gaetano , Raditchkova-Sarnelli Mariana , Stathis Anastasios , Giovanella Luca , Zucca Emanuele , Ceriani Luca 
Published: November 2019

Abstract
BACKGROUND: Follicular lymphoma (FL) is generally characterized by a moderate metabolic activity (FDG-avidity) in nodal and extra-nodal sites and by the frequent detection of residual disease in post-treatment PET scans. Since median age at diagnosis is over 60 years, in many FL patients several conditions that affect the elderly often occur in combination with the tumor, thus complicating and limiting the use of conventional imaging for lymphoma staging and response assessment. For this reason, the choice of the imaging technique should take into account clinical needs (preservation of renal function, reduction of diagnostic radiation exposure) as well as the necessity to constrain health care costs.
OBJECTIVE: The aim of the study was to investigate if there is any advantage in the use of contrast-enhanced CT (ceCT) vs. unenhanced low-dose CT (ldCT) in routine protocols for end-of-therapy PET/CT evaluation of patients with FL.
METHODS: Thirty FL patients who underwent end-of-therapy PET/CT protocol with ldCT and ceCT were analyzed retrospectively. Two different observers evaluated PET/ldCT and PET/ceCT in a blinded manner. Number and sites of nodal or extra-nodal disease were compared, using PET/ceCT as gold standard in order to evaluate if the type of CT could result in changes of the DS and therapeutic strategy.
RESULTS: In 26 of 30 patients (87%; 95% confidence interval, 73%-98%), PET/ldCT showed the same number and sites of lesions highlighted by PET/ceCT. The inter-observer concordance and overall concordance between imaging procedures were excellent with a very high Cohen's kappa (respectively 0.82 and 0.83). 97% of lesions (103/107) were found by PET/ldCT and in 4 of 30 patients (13%) PET/ceCT provided additional nodal lesions in the mesenteric and iliac regions (3 mesenteric nodes and 1 iliac node; <1%). In these 4 patients, DS and consequently the therapeutic strategy were not changed after additional ceCT findings. PET/ldCT accuracy, sensibility, specificity, positive predictive value and negative predictive value and NPV were respectively 87%, 83%, 100%,100% and 60%.
CONCLUSION: Our results indicate that the clinical impact of PET/ceCT in assessing end-therapy evaluation in FL is limited. The PET/ldCT could be suggested as primary imaging modality of choice, thus limiting the acquisition of PET/ceCT images only for doubtful cases of residual disease in mesenteric area (represented solely by 13 % in our series). This diagnostic approach would be less expensive, minimize diagnostic radiation exposure, and preserve renal function.

Disclosures
No relevant conflicts of interest to declare.
Validation and Reliability Study for the Korean Version of the Haemophilia Activity List
Authors: Yoon Hwi-Joong , Kim Ji Yoon , Yoo Ki Young , Choi Eun Jin , Kim Soon Ki , Park Sang Gyu , Lee Kun Soo 
Published: November 2019

Abstract
Background: There has been increasing interest in the patients perspective on the outcome of the treatment. The Haemophilia Activity List (HAL) has been developed as a disease-specific questionnaire for haemophilia patients and is a validated self-report measure of function developed according to WHO International Classification of Functioning, Disability and Health. In this study, we performed a cross-cultural adaptation and linguistic validation of the HAL questionnaire to assess the health-related quality of life in Korean hemophilia patients in the future.
Methods: To validate HAL in Korean, the English versions of HAL were translated into Korean using the forward-backward translation method and merged into a final Korean version. Validation was performed against the Korean version of the questionnaires EQ-5D-5L (EQ-5D) as general tool and Routine Assessment of Patient Index Data (RAPID3) as similar disease-specific tool. All processes were done with permission of the developer and according to WHO guidelines.
Results: One hundred patients with severe and moderate forms of haemophilia A and B from Korea Hemophlia Foundation were invited to participate in the study. Spearmans rank correlation test was used for validation and internal consistency of the HAL was calculated with Cronbach alpha.
Eighty-seven patients (87%) (18-62 years old) answered the questionnaires.
The internal consistency of the Korean version of HAL was high, with Cronbachs alpha being 0.80-0.95.
Upper extremity function had the highest consistency and leisure activities and sport had the lowest. The correlation was good between the HAL overall score and EQ-5D overall (r=0.78), EQ-5D usual activity (r=0.79), and RAPID3 physical function (r=0.82).
Conclusion: The Korean version of HAL has reliability from internal consistency and intraclass correlation by test-retest analysis. The Korean version of HAL has validity which correlated with EQ-5D as general tool and RAPID3 as similar disease-specific tool. This questionnaire of Korean version can be useful as a hemophilia disease-specific instrument for evaluation of the health-related quality of life in Korean patients.

Disclosures
No relevant conflicts of interest to declare.
Regional Intra-Arterial Steroid Treatment in 113 Patients with Steroid Resistant or Dependent Graft-Versus-Host Disease
Authors: Shapira Michael Y , Vipul Sheth , Klimov Alexander , Griesaro Sigal , Tsirigotis Panagiotis , Avni Batia Ronit , Or Reuven , Bloom Allan 
Published: November 2019

Abstract
Introduction : Graft-versus-host disease (GVHD) is a major complication of allogeneic bone marrow transplantation (BMT), resulting in death in the majority of steroid-resistant patients.
In the past 15 years, we revolutionized the use of interventional radiology procedures in the field of stem cell transplantation. This study was aimed to assess the efficacy of regional intra-arterial steroid (IAS) treatment in the largest published cohort of patients with resistant/dependent hepatic and/or gastrointestinal (GI) GVHD. In total, 113 patients with steroid resistant or dependent grade 3-4 hepatic (n = 21), gastrointestinal (GI) (n = 62) GVHD or both (n = 30) were given intra-arterial treatment.
Patients and methods: Patients with liver GVHD received IAS in hepatic artery and patients with gastrointestinal GVHD received IAS in the superior and inferior mesenteric as well as the internal iliac arteries. Patients with pronounced upper GI symptoms also received IAS to the gastroduodenal artery. In total 148 procedures were carried out (range 1-3 per patient).
Results : Partial responses were observed in 33 out of 51 (65%) patients with hepatic GVHD, out of which (55%) had complete response. Median time to complete response was 45 days (range - 5 to 300 days).
For GI GVHD complete responses were observed in 69 out of 92 (75%) and partial responses were observed in 76 out of 92 (83%). The median time to complete response was 20 days (range - 3 to 200 days ).
As this is the largest published cohort of regional IAS therapy for GVHD, multivariate and univariate analysis was done in order to identify the patients with highest chance of response.
Conclusions : Regional treatment of severe GVHD with IAS treatment is effective and safe. GI treatment is more effective than intrahepatic treatment. Early administration of isolated intra-arterial therapy in high-risk patients may further improve the outcome and reduce untoward effects of prolonged systemic immunosuppressive treatment.
Figure 1. Figure 1. Figure 2. Figure 2.

Disclosures
No relevant conflicts of interest to declare.
IN VITRO STUDY OF BONE MARROW
Authors: PLUM CLAUS MUNK 
Published: November 2019

Abstract
Two types of apparatus are described for the culture of bone marrow in vitro. The first, a macro method, is suited to the study of large amounts of bone marrow. The second, a micro method, allows observations of the development of individual cells.
Studies of erythropoiesis by these technics has allowed insight into production of erythrocytes. These data will be reported in a subsequent article.
NORMAL BONE MARROW AS OBTAINED BY STERNAL PUNCTURE
Authors: VAUGHAN STUART L. , BROCKMYRE FRANCES 
Published: November 2019

Abstract
A study of aspirated sternal bone marrow of 50 normal human adult volunteer subjects has been presented. Samples of exactly 3 cc. each were collected in a uniform manner. The technic of performing total nucleated cell counts, differential counts, reticulocyte counts, and megakaryocyte counts has been described and the results given. These results have been subjected to statistical analysis and compared with those of other workers.
HEMOGRAMS AND MYELOGRAMS OF HEALTHY FEMALE MICE OF C-57 BROWN AND CFW STRAINS
Authors: ENDICOTT K. M. , GUMP HAZEL 
Published: November 2019

Abstract
The hemogram and myelogram of healthy female mice 2 months old of two strains, C-57 brown and CFW albino, are presented. The average cellularity of marrow has been determined and the marrow differential has been corrected with this figure to establish a normal index of the total quantity of each type of cell. The average weight of the body and of the submaxillary lymph nodes, thymus, spleen, and kidney are presented.
A METHOD FOR THE SEPARATION OF LEUKOCYTES FROM WHOLE BLOOD BY FLOTATION ON SERUM ALBUMIN
Authors: VALLEE BERT L. , HUGHES WALTER L. , GIBSON JOHN G. 
Published: November 2019

Abstract
A technic for the separation of leukocytes from whole blood, utilizing the known difference in density of leukocytes and erythrocytes, is described. Complete separation is effected by means of solutions of serum albumin adjusted to the correct physicochemical properties.
THE PREPARATION OF MORPHOLOGICALLY INTACT LEUKOCYTES FROM PERIPHERAL BLOOD BY MEANS OF GRAMICIDIN AND LYSOLECITHIN
Authors: SINGER THOMAS P. , SILBERBACH INGELORE , SCHWARTZ SAMUEL 
Published: November 2019

Abstract
A method involving the combined use of gramicidin and lysolecithin is described for the rapid and apparently quantitative isolation of morphologically intact leukocytes from circulating blood. The mixture of these two compounds gives rapid and complete lysis of erythrocytes. The use of either gramicidin or of lysolecithin alone in sufficient amount to completely lyse the red cells results in morphological damage to the leukocytes. For some as yet unknown reason, however, the combined use of these two agents in a definite ratio results in cancellation of this leukocyte damaging effect. The cells thus prepared appear to be consistently more intact morphologically than any yet prepared in this laboratory.
Airway G-CSF identifies neutrophilic inflammation and contributes to asthma progression
Authors: Kim Young-Min , Kim Hyekang , Lee Seungwon , Kim Sora , Lee Jong-Uk , Choi Youngwoo , Park Han Wook , You Gihoon , Kang Hansol , Lee Seyoung , Park Jong-Sook , Park Yunji , Park Hae-Sim , Park Choon-Sik , Lee Seung-Woo 
Published: November 2019

Stratification of asthmatic patients based on relevant biomarkers enables the prediction of responsiveness against immune-targeted therapies in patients with asthma. Individualised therapy in patients with eosinophilic asthma has yielded improved clinical outcomes; similar approaches in patients with neutrophilic asthma have yet to be developed. We determined whether colony-stimulating factors (CSFs) in the airway reflect the inflammatory phenotypes of asthma and contribute to disease progression of neutrophilic asthma.We analysed three different mouse models of asthma and assessed cytokine profiles in sputum from human patients with asthma stratified according to inflammatory phenotype. In addition, we evaluated the therapeutic efficacy of various cytokine blockades in a mouse model of neutrophilic asthma.Among the CSFs, airway granulocyte CSF (G-CSF) contributes to airway neutrophilia by promoting neutrophil development in bone marrow and thereby distinguishes neutrophilic inflammation from eosinophilic inflammation in mouse models of asthma. G-CSF is produced by concurrent stimulation of the lung epithelium with interleukin (IL)-17A and tumour necrosis factor (TNF)-α; therefore, dual blockade of upstream stimuli using monoclonal antibodies or genetic deficiency of the cytokines in IL-17A×TNF-α double-knockout mice reduced the serum level of G-CSF, leading to alleviation of neutrophilic inflammation in the airway. In humans, the sputum level of G-CSF can be used to stratify patients with asthma with neutrophil-dominated inflammation.Our results indicated that myelopoiesis-promoting G-CSF and cytokines as the upstream inducing factors are potential diagnostic and therapeutic targets in patients with neutrophilic asthma.
Preservation of renal function in cardiac surgery patients with low cardiac output syndrome: levosimendan vs beta agonists
Authors: Guerrero Orriach Jose Luis , Navarro Arce I. , Hernandez Rodriguez P. , Raigón Ponferrada A. , Malo Manso A. , Ramirez Aliaga M. , Ramirez Fernandez A. , Escalona Belmonte J. J. , Bellido Estevez I. , Gomez Luque A. , Barrera Serrano R. , Toledo Medina C. S. , Rubio Navarro M. , Cruz Mañas J. 
Published: November 2019

Abstract
Background
Some studies have been performed to assess the effects of levosimendan on cardiac function when administered to cardiac surgery patients with low cardiac output syndrome (LCOS) in the immediate postoperative period. Levosimendan is an inotropic agent for the treatment of low cardiac output syndrome that seems to have a protective effect on renal function.

Methods
It is a quasi-experimental study. A total of 100 patients with LCOS received either beta-agonists or levosimendan. We assessed the incidence of postoperative kidney failure in cardiac surgery patients. In patients who had kidney failure at diagnosis of LCOS, we examined whether differences existed in the evolution of kidney failure based on the treatment administered for LCOS. The parameters measured included haemodynamics, oxygen supply, and renal function as assessed by the AKI scale. ANOVA, Student’s t-test and Wilcoxon or Friedman tests were used.

Results
Up to 30% of cardiac surgery patients had kidney failure at diagnosis of LCOS. Kidney failure at discharge from the ICU was more frequent in patients who received beta-agonist drugs as compared to those who received levosimendan (p < 0.05).

Conclusion
The incidence of kidney failure decreased with the postoperative administration of levosimendan to cardiac surgery patients with LCOS, as compared to beta-agonists.

Trial registration
Current Controlled Trials ISRCTN 46058317. Date of registration: 7/10/2019.
Retrospectively registered.
Combined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort study
Authors: Chen Chen , Liu Yingchun , Cao Zhaojin , Yin Zhaoxue , Zhao Feng , Lv Yuebin , Liu Zuyun , Mao Chen , Song Shixun , Liu Ling , Qu Yingli , Ji Saisai , Duan Jun , Wang Jiaonan , Kraus Virginia Byers , Zeng Yi , Shi Xiaoming 
Published: November 2019

Abstract
Background
Inflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), and cognitive impairment (CI) are associated with mortality; CRP is related to the deterioration of CI. However, it is still unknown whether these two indices predict mortality independent of each other. Furthermore, their joint effect on all-cause mortality has not been well established, especially in oldest-old adults.

Methods
Based on data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we included 1447 oldest-old adults (mean age 84.7 years and 58.7% were female, weighted) with information on hs-CRP (stratified by a cutoff value of 3.0 mg/L) and cognition (quantified by Mini-Mental Status Examination (MMSE) scored according to the personal educational level) at baseline. Mortality was assessed in followed 2014 and 2017 waves. Cox proportional hazards regression models were used, with adjustment for hs-CRP and cognition (mutually controlled) and several traditional mortality risk factors.

Results
During a median follow-up period of 32.8 months (Q1-Q3, 9.7–59.0 months), 826 participants died. Hs-CRP [HR > 3.0 mg/L vs ≤ 3.0 mg/L: 1.64 (95% CI, 1.17, 2.30)] and cognition [HR CI vs normal: 2.30 (95% CI, 1.64, 3.21)] each was independent predictor of all-cause mortality, even after accounting for each other and other covariates. Monotonic and positive associations were observed in combined analyses, in which the highest mortality risk was obtained in elders with both high hs-CRP> 3.0 mg/L and CI [HR: 3.56 (95% CI, 2.35, 5.38)].The combined effects were stronger in male and younger oldest-old (aged 80–89 years).

Conclusion
High hs-CRP and CI, both individually and jointly, were associated with increased all-cause mortality risks in Chinese oldest-old. Intervention strategies for preventing inflammation and maintaining adequate cognitive function may be more important in male and younger oldest-old for reducing mortality risk.