bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk stratification model for post-stroke pneumonia in patients with acute ischemic stroke
Authors: Kuo Ya-Wen , Huang Yen-Chu , Lee Meng , Lee Tsong-Hai , Lee Jiann-Der 
Published: November 2019

Background: Post-stroke pneumonia (PSP) has been implicated in the morbidity, mortality, and increased medical costs after acute ischemic stroke. Aim: The aim of this study was to develop a prediction model for PSP in patients with acute ischemic stroke. Methods: A retrospective, case-control, secondary analysis study was conducted using data for 10,034 patients with ischemic stroke who presented to the hospital within 24 hours of onset of stroke symptoms. The predictive factors for PSP were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 546 patients (5.4%) had PSP. Multivariate logistic regression revealed that age, atrial fibrillation, smoking habit, body temperature at admission, pulse rate at admission, National Institute of Health Stroke Scale (NIHSS) score upon admission, white blood cell count, and blood urea nitrogen level were major predictive factors of PSP. CART analysis identified NIHSS score at admission, pulse rate at admission, and percentage of lymphocyte as important factors for PSP to stratify the patients into subgroups. The subgroup of patients with an NIHSS score >14 at admission and pulse rate >111 beats per minute at admission and those with an NIHSS score >14, pulse rate ⩽111 beats per minute at admission, and percentage of lymphocyte ⩽9.2% had a relatively high risk of PSP (39.6% and 35.5%, respectively). Conclusions: In this study, CART analysis has a similar predictive value of PSP as compared with a logistic regression model. In addition, decision rules generated by CART can easily be interpreted and applied in clinical practice.
Structural brain network fingerprints of focal dystonia
Authors: Chirumamilla Venkata C. , Dresel Christian , Koirala Nabin , Gonzalez-Escamilla Gabriel , Deuschl Günther , Zeuner Kirsten E. , Muthuraman Muthuraman , Groppa Sergiu 
Published: November 2019

Background: Focal dystonias are severe and disabling movement disorders of a still unclear origin. The structural brain networks associated with focal dystonia have not been well characterized. Here, we investigated structural brain network fingerprints in patients with blepharospasm (BSP) compared with those with hemifacial spasm (HFS), and healthy controls (HC). The patients were also examined following treatment with botulinum neurotoxin (BoNT). Methods: This study included matched groups of 13 BSP patients, 13 HFS patients, and 13 HC. We measured patients using structural-magnetic resonance imaging (MRI) at baseline and after one month BoNT treatment, at time points of maximal and minimal clinical symptom representation, and HC at baseline. Group regional cross-correlation matrices calculated based on grey matter volume were included in graph-based network analysis. We used these to quantify global network measures of segregation and integration, and also looked at local connectivity properties of different brain regions. Results: The networks in patients with BSP were more segregated than in patients with HFS and HC ( p < 0.001). BSP patients had increased connectivity in frontal and temporal cortices, including sensorimotor cortex, and reduced connectivity in the cerebellum, relative to both HFS patients and HC ( p < 0.05). Compared with HC, HFS patients showed increased connectivity in temporal and parietal cortices and a decreased connectivity in the frontal cortex ( p < 0.05). In BSP patients, the connectivity of the frontal cortex diminished after BoNT treatment ( p < 0.05). In contrast, HFS patients showed increased connectivity in the temporal cortex and reduced connectivity in cerebellum after BoNT treatment ( p < 0.05). Conclusions: Our results show that BSP patients display alterations in both segregation and integration in the brain at the network level. The regional differences identified in the sensorimotor cortex and cerebellum of these patients may play a role in the pathophysiology of focal dystonia. Moreover, symptomatic reduction of hyperkinesia by BoNT treatment was associated with different brain network fingerprints in both BSP and HFS patients.
Metastasis pattern and prognosis of male breast cancer patients in US: a population-based study from SEER database
Authors: Xie Jun , Ying Yao-Yu , Xu Bin , Li Yan , Zhang Xian , Li Chong 
Published: November 2019

Background: The aims of this study were to analyze the metastasis pattern and prognosis of male breast cancer (MBC) and compare it with female breast cancer (FBC), and to determine the independent factors affecting the prognosis of MBC patients. Methods: Metastatic MBC diagnosed in the Surveillance, Epidemiology and End results (SEER) database from 2010 to 2015 were selected. Chi-squared test was used to compare clinicopathological characteristics. Survival differences were compared by Kaplan–Meier analysis. Cox proportional hazard model was used to determine the prognostic factors affecting overall survival. Results: A total of 2754 MBC patients were identified, of which 196 had distant metastasis. Compared with nonmetastatic MBC, metastatic MBC patients had a higher proportion of <60 years old and grade III–IV, and were more likely to receive chemotherapy and radiotherapy, while the proportion of surgery, central portion of the breast, and Her2–/HR+ was lower. Compared with metastatic FBC, metastatic MBC patients had a higher proportion of ⩾60 years old, central portion of the breast, surgery, simultaneous bone and lung metastasis, while the proportion of Her2+/HR–, triple negative, liver metastasis only, and simultaneous bone and liver metastasis was lower. MBC patients with lung alone, bone alone, and simultaneous lung and bone metastasis had a higher hazard ratio (2.41; 3.06; 2.52; p < 0.0001) compared with nonmetastatic patients. Conclusions: Compared with nonmetastatic MBC patients, metastatic MBC patients had unique clinicopathological features, and were also different from metastatic FBC patients. However, there was no difference in prognosis between metastatic MBC and FBC patients. Distant metastasis was an independent risk factor for the prognosis of MBC patients.
Return to Work After Autologous Chondrocyte Implantation of the Knee in Patients with Workers Compensation Insurance
Authors: Lane John G. 
Published: November 2019

Objective This retrospective analysis aimed to evaluate patient and defect characteristics on return to work after autologous chondrocyte implantation (ACI) for all patients with workers compensation insurance in our clinic. Methods Retrospective analysis of medical records of patients with workers compensation treated with ACI in our clinic over 10 years (August 2004 to November 2014). Data were collected on demographics, lesion size and location, number of defects, duration of symptoms, and outcomes. Results A total of 28 patients with 30 ACI procedures were included in this analysis. Patients had a mean age of 40.0 years, were mostly male, and tended to be overweight (mean body mass index = 31.5 kg/m2). Most patients were employed in occupations with high physical demand (85.7%) compared with lower physical demand jobs (14.3%). The mean number of lesions per knee = 1.73. Overall, the mean total surface area of the defect was large (12.6 cm2), with large mean individual lesion size of 7.39 cm2. All 28 patients returned to work in some capacity, with a total of 22 (79%) returning to full work, and 6 (21%) returning to modified work. There were no significant differences in the comparison of patients who returned to full versus modified work, in mean age, body mass index, high versus low physical demand occupation, or lesion characteristics (size, chronicity, or location). Conclusions Our results demonstrate that in a challenging workers compensation cohort, in patients with multiple large defects, treatment with ACI allows a high percentage of patients to return to their normal vigorous work activities within 9 months to 1 year following cartilage restoration. This study is a level IV retrospective case series.
Multiple Erythroid Isoforms of Human Long-Chain acyl-CoA Synthetases Are Produced by a Switch of the Fatty Acid Gate-Domains.
Authors: Soupene Eric , Kuypers Frans A. 
Published: November 2019

Abstract
In mammals, long-chain acyl-CoA synthetases (ACSL) are necessary for fatty acid degradation, phospholipid remodeling, and production of long acyl-CoA esters that regulate various physiological processes. These enzymes play a crucial role in plasma membrane phospholipid turnover in erythrocytes, maintaining the complex phospholipid molecular species composition essential for proper membrane function. The mechanism by which this highly dynamic turnover together with an ever-changing plasma fatty acid pool maintains phospholipid composition is poorly understood. We have previously cloned Acyl-CoA Synthetase Long-chain member 6 (ACSL6), the isoform responsible for activation of long-chain fatty acids in erythrocytes. Two additional transcript variants of this protein were subsequently isolated from brain and testis. We report the expression of four different variants of ACLS6 in reticulocytes, one as we originally reported, two of which are novel, one as was identified in brain cells. PCR amplifications using primers for the predicted variable regions were performed from cDNAs of CD34 positive erythroid progenitors, K562 cells, fetal blood cells, reticulocytes and placenta. ACSL variants were expressed in E. coli host BL21DE3 cells using the pET28a vector, and detected by His tag immuno detection. Sequence alignments were generated using sequences retrieved from RefSeq and GenBank databases on the NCBI site. Exon and intron definition for ACSL members were obtained using evidence viewer and model maker available at the map viewer page of each gene.
We identified four different spliced variants of ACSL6 in erythroid cells based on a mutually exclusive exon pair. Each exon of this pair encodes a slightly different short motif that contains the fatty acid Gate domain, a conserved structural domain found in all vertebrate and invertebrate ACSL homologs. The motif differs in the presence of either the aromatic residue phenylalanine (Phe) or tyrosine (Tyr), and seems to play a role in substrate specificity. One of the new forms contained an exon not found in any other ACSL isoforms. Erythroid precursors also express the closely related ACSL1, and we characterized two additional isoforms of this protein, similar to ACSL6. When analyzed on denaturing SDS polyacrylamide gel both ACSL1 and 6 appeared to exist as a dimer. Based on our results, we propose the generation of two different Gate-domains by alternative splicing of the two exons in these proteins. One represents a switch of the Phe to the Tyr Gate-domain motif, the other resulted of the exclusion of both. Swapping of this motif appears to be common to all mammalian homologs of ACSL1 and 6. We conclude that the Phe to a Tyr substitution in the Gate-domain, or its removal, together with the formation of homo or heterodimers will allow ACSL6 the structural diversity to define substrate specificity that maintains the complex plasma membrane phospholipid molecular species composition in erythrocytes.
Variance in Outcomes by Physician Providers for Patients with Non-Hodgkin’s Lymphoma.
Authors: Dillman Robert O. , McClure Stephanie E. 
Published: November 2019

Abstract
We previously documented an improvement in survival for patients diagnosed with non-Hodgkin’s lymphoma at our institution during the years 1998–2003 compared to those diagnosed during 1990–1997. [Blood2005;106:242b] Because patients were being treated by several community-based practitioners, we examined the variance in lymphoma-specific survival by physician provider. The Hoag Cancer Registry data base was used to identify patients with a diagnosis of lymphoma. Observed and relative 5-year survival rates were calculated using a computer software program designed specifically for this purpose (Electronic Registry Systems, Inc., Cincinnati, OH). Relative survival was used to estimate lymphoma specific survival. The 802 patients from all practitioners had a median age of 64 years and a relative 5-year survival of 66% and observed 5-year survival of 54%. Data was reviewed for the 6 individual physicians who had managed at least 40 lymphoma patients during 1990–2003 (range 48–189), who accounted for 77% of all lymphoma patients. The observed and relative 5-year survival by these practitioners were: A 62% & 78%, B 67% & 77%, C 54% & 69%, D 51% & 65%, E 58% & 64%, and F 45% & 54%. Patient populations were dissimilar: practitioners D & E had the highest numbers of patients, B & F had the youngest patients, A & C the oldest, A the highest proportion with indolent lymphoma, and B the highest proportion with stage I disease. Combining data for physicians ABC (highest survival rates) (n=215) vs DEF (n=404) revealed a superior survival rate for ABC (p=.020), and a difference by whether systemic chemotherapy was initiated at the time of initial diagnosis (p=.016), as opposed to no therapy or local therapy only. This study demonstrated a 24 percentage point difference in relative 5-year survival rates among practitioners. There were differences in prognostic variables for specific populations of patients managed by individual physicians, but such differences were not seen for ABC vs DEF. Collectively, the three physicians whose patients had the best survival were more likely to use systemic therapy within four months of initial diagnosis rather than local therapy or no treatment. It is important to understand the impact of prognostic variables and physician-specific treatment differences on the variance of outcomes among different practitioners.
Castleman’s Disease: Four Extraordinary Presantations and Review of Literature.
Authors: Kupesiz Gokben Yildirim , Akkaya Bahar , Kupesiz O. Alphan , Karpuzoglu Gulten 
Published: November 2019

Abstract
Castleman’s disease is a rare disorder of the lymphoid tissue with three possible histological variants--the hyalin-vascular type, with a good prognosis, the plasma-cellular type and the mixed type; the latter two are both more aggressive than the hyalin-vascular type. Two clinical types of this disease have already been described: the localized or unifocal type and the multicentric or multifocal type. Localized and multicentric Castleman’s disease may be different clinical disorders with overlapping histologic features. Localized disease generally presented with a single enlarged lymph node or widening of the mediastinum, whereas multicentric disease is a systemic lymphoproliferative disorder characterized by lymphadenopathy, hepatosplenomegaly, constitutional symptoms, anemia, hypoalbuminemia, and hypergammaglobulinemia. Unlike the localized type, for which surgical excision is curative regardless of the histologic type, multicentric disease often necessitates aggressive systemic therapy and portends a poorer outcome. The aetiology of Castleman’s disease remains unclear. Here, we report four cases of Castleman’s disease, with extraordinary presentations. Tumors from retroperitoneum, mesenterium, bladder vicinity and nasopharenx locations were included. All of patients were taken to the surgery with different pre operative diagnosis. There were 1 female and 3 males; ages ranged from 16–62 years old; sizes ranged from 4– 9 cm (mean 5.5 cm). All patients presented with localized disease. One of the patients had previous NHL and lung cancer history. None of the patients demonstrated systemic involvement or signs of the POEMS syndrome. Hystopathologically 3 of the cases were classified as hyalin-vascular type and 1 of the cases were classified as plasma-cellular type. None of the patients had recurrences. Castleman ‘s disease is an uncommon cause of lymphadenopathy, and must be considered after all other causes have been eliminated. We also add the overview of the literature of the cases with extraordinary presentations.
Efficacy of 90Y-Ibritumomab Tiuxetan in Marginal-Zone Lymphoma (MZL).
Authors: Vanazzi Anna , Ferrucci Pier Francesco , Grana Chiara , Pruneri Giancarlo , Crosta Cristiano , Pinto Antonello , Chinol Marco , Paganelli Giovanni , Martinelli Giovanni 
Published: November 2019

Abstract
Radio-immunotherapy (RIT) is an effective approach for patients with relapse-refractory NHL. RIT targets radiation to the tumor bulk while limiting exposure of normal tissues. Toxicity is prevalently hematologic, but transient and reversible. 90Y-Ibritumomab Tiuxetan in particular has demonstrated activity in follicular (FL) and Diffuse Large B-Cell (DLBC) NHL, but data are still lacking in MZL. 90Y-Ibritumomab Tiuxetan could offer an alternative option to those pts who relapse or do not respond to conventional treatment. We report efficacy results of a pilot study of 90Y-Ibritumomab Tiuxetan delivered at conventional activity (0,4 mCi/kg) in MZL patients. From May 2004 to July 2007, 15 patients were enrolled. Median age was 57 ys (range 36–83 ys); 9 female and 6 male. Six out of 15 pts had Helicobacter Pylori-negative gastric MALT (mucosa-associated lymphoid tissue) NHL. The remaining 9 pts had non gastric extranodal MZL. At time of treatment 6/15 pts had limited disease (stage I/II), 9/15 disseminated disease (stage III/IV; Ann-Arbor Staging System); bone marrow biopsy showed disease localization in 3/15 pts. Median number of previous therapies received was 2 (0–4): all pts except one had received prior CT, 7 prior Rituximab, 3 prior RT. Toxicities were primarily haematological, as expected, and reversible. Response evaluation was performed two months after 90Y-Ibritumomab Tiuxetan administration by upper gastrointestinal endoscopy with multiple biopsy and endoscopic ultrasonography in gastric NHL and by CT scan in the remaining pts. Ten out of 15 patients are now evaluable for response: 6 CR, 1 uCR, 3 SD. Response are durable: 5 CRs have been maintained for CR at 33, 26, 22, 15 and 14 months, respectively.
CONCLUSIONS: 90Y-Ibritumomab Tiuxetan seems to be very active in pts with MZL resistant or refractory to conventional systemic treatment. Its mechanism of action mimics conventional RT already known as valid option in MZL with localized disease. If these preliminary results are confirmed in larger number of patients, one single administration of 90Y-Ibritumomab Tiuxetan delivered at conventional activity (0,4 mCi/kg) could be considered a possible alternative option in the treatment of such indolent disease.
Methotrexate and/or Rituximab in a New Nude Rat Central Nervous System Lymphoma Model: Efficacy, Toxicity and Magnetic Resonance Imaging.
Authors: Jahnke Kristoph , Muldoon Leslie L. , Varallyay Csanad G. , Lewin Seth J. , Brown Robert D. , Kraemer Dale F. , Soussain Carole , Neuwelt Edward A. 
Published: November 2019

Abstract
The aim of this study was to determine the efficacy and toxicity of methotrexate (MTX) and/or rituximab treatment in a novel central nervous system (CNS) lymphoma model, using either intravenous (IV) or intraarterial (IA) drug administration in conjunction with osmotic blood-brain barrier disruption (BBBD). Female athymic nude rats (rnu/rnu) were inoculated with human MC116 B-cell lymphoma cells in the caudate putamen. On the day of treatment and first magnetic resonance imaging (MRI) (day 16–20), rats were randomized into 7 groups:
control group with saline IV (n = 15) or IA/BBBD (n = 7); rituximab 375 mg/m2 IV (n = 6) or IA/BBBD (n = 3); MTX 1000 mg/m2 IV (n = 6) or IA/BBBD (n = 6); and rituximab 375 mg/m2 IV + MTX 1000 mg/m2 IV (n = 6).
A second MRI scan was done 1 week after treatment. Study end points included tumor response on MRI (defined as ≤75% tumor volume on post-treatment MRI), toxicity, and tumor volumes on histology. In the IV groups, the percent change in tumor volume on T2/FLAIR images in the control versus rituximab group was statistically significant (p = 0.0051). In the IA/BBBD groups, there was a statistically significant difference between control and rituximab (p = 0.0167) for absolute and percent changes in tumor volumes on both T2/FLAIR and T1 with gadolinium sequences. For T1 with gadolinium, the difference between control and MTX was also significant for both absolute change (p = 0.0066) and percent change (p = 0.0043). Response rates in the IV groups differed significantly between controls and rituximab (p = 0.0017 on T2/FLAIR and p = 0.0049 on T1 with gadolinium). A good correlation between tumor volumes (in log mm3) on histology and fluid-attenuated inversion recovery (FLAIR)/T2 (R2 = 0.83) or contrast-enhanced T1 weighted images (R2 = 0.73) for tumors located in the caudate putamen was observed. Results of complete blood counts at sacrifice did not differ significantly between the groups. The MC116 CNS lymphoma model is valuable for preclinical testing of efficacy and toxicity of various treatment regimens. Rituximab and MTX were particularly effective in this model, regardless of the route of administration.
Congenital Hypothyroidism Following Maternal Exposure throughout Pregnancy to Imatinib.
Authors: Leeksma Onno C. , van Mil Edgar A. 
Published: November 2019

Abstract
Imatinib mesylate has revolutionized treatment of Chronic Myeloid Leukemia. Yet for women of child bearing age problems may arise during pregnancy. While continuation of the drug is in the interest of maternal health, the safety of this approach for the fetus has been questioned. Therapy is therefore usually immediately interrupted on recognition of pregnancy. Only three successful pregnancies have been reported to date in which imatinib was continued. A 34-year-old woman of Chinese descent in complete cytogenetic and major molecular remission (i.e. 3-log reduction of BCR-ABL transcripts) of her CML in chronic phase on 400mg imatinib daily continued treatment during conception and throughout pregnancy. After an uneventful full term pregnancy she gave birth to an apparently healthy son. The mother retained her major molecular remission. Routine screening for congenital hypothyroidism of her child however repeatedly revealed an elevated TSH, rising from 11 mU/l at the age of 1 week to15 mU/l at 4 weeks, associated with a relatively low free T4 of 24.8 and 17.4 pmol/l respectively. Thyroglobulin and thyroxine binding globulin concentrations were normal for age. The mother was euthyroid and had no detectable anti-thyroid antibodies. A mild primary hypothyroidism was suspected. An ultrasound showed no developmental defect of his thyroid gland and a 123I scan with a perchlorate discharge test ruled out an intra-thyroidal iodide organification defect. There was no family history of congenital hypothyroidism. The child was put on levothyroxine and is currently doing well. Hypothyroidism has been noticed as a potential side effect of imatinib therapy in thyroidectomized patients receiving levothyroxine and has been ascribed to enhanced non-deiodination clearance of T4 (de Groot et al Clin Pharmacol Ther2005;78:433–8). An induction of uridine diphosphate-glucuronosyl transferases by imatinib was hypothesized as mechanism for an altered levothyroxine metabolism in these patients. Congenital hypothyroidism has to the best of our knowledge not been reported as a potential consequence of imatinib therapy.