bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Precision Medicine on Efficiencies of Novel Drug Development in Cancer
Authors: Sarvas Holly , Carlisle Benjamin , Dolter Samantha , Vinarov Esther , Kimmelman Jonathan 
Published: November 2019

Abstract
Precision medicine (PM) offers opportunities for reducing the costs, burdens, and time associated with drug development. We examined time, number of trials, indications tested, and patient burden needed to achieve first U.S. Food and Drug Administration license for all five novel anticancer PM drugs and all 10 novel non-PM drugs receiving U.S. Food and Drug Administration approval during 2010–2014. The 15 drug portfolios encompassed 242 trials: 87 for PM drugs and 155 for non-PM drugs. Embase and MEDLINE databases were searched for all prelicensure clinical trials, and data on time, patient numbers, indications tested, and total treatment-emergent grade 3–5 adverse events were measured from the first trial of each drug. We did not find patterns suggesting greater efficiencies in PM compared with non-PM. Gains in efficiency for PM drug development may be offset by challenges with recruitment.
Health Care Utilization Among Homeless Veterans in Chicago
Authors: Raad Jason H , Tarlov Elizabeth , Kho Abel N , French Dustin D 
Published: November 2019

Abstract

Introduction
The U.S. Department of Veterans Affairs (VA), the single largest health care system in the United States, provides comprehensive medical and behavioral health services to more than 9 million Veterans. The size and scope of the VA’s system of care allow health care providers, policymakers, and community stakeholders to conduct detailed analyses of health care utilization among Veterans; however, these analyses do not include health care encounters that occur outside VA. Although many Veterans obtain care in non-VA settings, understanding health care utilization among vulnerable populations of Veterans, including those who are homeless or at risk of becoming homeless, is needed to identify potential opportunities to enhance access and reduce fragmentation of care.

Materials and Methods
VA administrative data were merged with data from the Chicago HealthLNK Data Repository to identify Veterans eligible for VA services who were homeless, or at risk of becoming homeless, in the greater Chicago metropolitan area for the years 2010–2012.

Results
During the 3-year study period, about 208,554 Veterans were registered for care at two VA medical centers located in the City of Chicago and an adjacent suburb. Of those, 13,948 were identified as homeless or at risk of becoming homeless. Results suggest that 17% (n = 2,309) of Veterans in this sample received some or all of their care in the community. Much of the care these Veterans received was for chronic health conditions, substance use, and mental health disorders.

Conclusions
Veterans eligible for VA servicers who are homeless, or at risk of becoming homeless, frequently sought care in the community for a variety of chronic health conditions. Health information exchanges and partner-based registries may represent an important tool for identifying vulnerable Veteran populations while reducing duplication of care.
Estimating trajectories of meteors: an observational Monte Carlo approach – I. Theory
Authors: Vida Denis , Gural Peter S , Brown Peter G , Campbell-Brown Margaret , Wiegert Paul 
Published: November 2019

ABSTRACTIt has recently been shown by Egal et al. that some types of existing meteor in-atmosphere trajectory estimation methods may be less accurate than others, particularly when applied to high-precision optical measurements. The comparative performance of trajectory solution methods has previously only been examined for a small number of cases. Besides the radiant, orbital accuracy depends on the estimation of pre-atmosphere velocities, which have both random and systematic biases. Thus, it is critical to understand the uncertainty in velocity measurement inherent to each trajectory estimation method. In this first of a series of two papers, we introduce a novel meteor trajectory estimation method that uses the observed dynamics of meteors across stations as a global optimization function and that does not require either a theoretical or an empirical flight model to solve for velocity. We also develop a 3D observational meteor trajectory simulator that uses a meteor ablation model to replicate the dynamics of meteoroid flight, as a means to validate different trajectory solvers. We both test this new method and compare it to other methods, using synthetic meteors from three major showers spanning a wide range of velocities and geometries (Draconids, Geminids, and Perseids). We determine which meteor trajectory solving algorithm performs better for all-sky, moderate field-of-view, and high-precision narrow-field optical meteor detection systems. The results are presented in the second paper in this series. Finally, we give detailed equations for estimating meteor trajectories and analytically computing meteoroid orbits, and provide the python code of the methodology as open-source software.
Thyroid Storm in the ICU: A Retrospective Multicenter Study
Authors: Bourcier Simon , Coutrot Maxime , Kimmoun Antoine , Sonneville Romain , de Montmollin Etienne , Persichini Romain , Schnell David , Charpentier Julien , Aubron Cécile , Morawiec Elise , Bigé Naïke , Nseir Saad , Terzi Nicolas , Razazi Keyvan , Azoulay Elie , Ferré Alexis , Tandjaoui-Lambiotte Yacine , Ellrodt Olivier , Hraiech Sami , Delmas Clément , Barbier François , Lautrette Alexandre , Aissaoui Nadia , Repessé Xavier , Pichereau Claire , Zerbib Yoann , Lascarrou Jean-Baptiste , Carreira Serge , Reuter Danielle , Frérou Aurélien , Peigne Vincent , Fillatre Pierre , Megarbane Bruno , Voiriot Guillaume , Combes Alain , Schmidt Matthieu 
Published: November 2019

Objectives:
Thyroid storm represents a rare but life-threatening endocrine emergency. Only rare data are available on its management and the outcome of the most severe forms requiring ICU admission. We aimed to describe the clinical manifestations, management and in-ICU and 6-month survival rates of patients with those most severe thyroid storm forms requiring ICU admission.

Design:
Retrospective, multicenter, national study over an 18-year period (2000–2017).

Setting:
Thirty-one French ICUs.

Patients:
The local medical records of patients from each participating ICU were screened using the International Classification of Diseases, 10th Revision. Inclusion criteria were “definite thyroid storm,” as defined by the Japanese Thyroid Association criteria, and at least one thyroid storm-related organ failure.

Measurements and Main Results:
Ninety-two patients were included in the study. Amiodarone-associated thyrotoxicosis and Graves’ disease represented the main thyroid storm etiologies (30 [33%] and 24 [26%] patients, respectively), while hyperthyroidism was unknown in 29 patients (32%) before ICU admission. Amiodarone use (24 patients [26%]) and antithyroid-drug discontinuation (13 patients [14%]) were the main thyroid storm-triggering factors. No triggering factor was identified for 30 patients (33%). Thirty-five patients (38%) developed cardiogenic shock within the first 48 hours after ICU admission. In-ICU and 6-month postadmission mortality rates were 17% and 22%, respectively. ICU nonsurvivors more frequently required vasopressors, extracorporeal membrane of oxygenation, renal replacement therapy, mechanical ventilation, and/or therapeutic plasmapheresis. Multivariable analyses retained Sequential Organ Failure Assessment score without cardiovascular component (odds ratio, 1.22; 95% CI, 1.03–1.46; p = 0.025) and cardiogenic shock within 48 hours post-ICU admission (odds ratio, 9.43; 1.77–50.12; p = 0.008) as being independently associated with in-ICU mortality.

Conclusions:
Thyroid storm requiring ICU admission causes high in-ICU mortality. Multiple organ failure and early cardiogenic shock seem to markedly impact the prognosis, suggesting a prompt identification and an aggressive management.
Serum Protein Changes in Pediatric Sepsis Patients Identified With an Aptamer-Based Multiplexed Proteomic Approach
Authors: Shubin Nicholas J. , Navalkar Krupa , Sampson Dayle , Yager Thomas D. , Cermelli Silvia , Seldon Therese , Sullivan Erin , Zimmerman Jerry J. , Permut Lester C. , Piliponsky Adrian M. 
Published: November 2019

Objectives:
Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response to infection, is a leading cause of death and disability among children worldwide. Identifying sepsis in pediatric patients is difficult and can lead to treatment delay. Our objective was to assess the host proteomic response to infection utilizing an aptamer-based multiplexed proteomics approach to identify novel serum protein changes that might help distinguish between pediatric sepsis and infection-negative systemic inflammation and hence can potentially improve sensitivity and specificity of the diagnosis of sepsis over current clinical criteria approaches.

Design:
Retrospective, observational cohort study.

Setting:
PICU and cardiac ICU, Seattle Children’s Hospital, Seattle, WA.

Patients:
A cohort of 40 children with clinically overt sepsis and 30 children immediately postcardiopulmonary bypass surgery (infection-negative systemic inflammation control subjects) was recruited. Children with sepsis had a confirmed or suspected infection, two or more systemic inflammatory response syndrome criteria, and at least cardiovascular and/or pulmonary organ dysfunction.

Interventions:
None.

Measurements and Main Results:
Serum samples from 35 of the sepsis and 28 of the bypass surgery subjects were available for screening with an aptamer-based proteomic platform that measures 1,305 proteins to search for large-scale serum protein expression pattern changes in sepsis. A total of 111 proteins were significantly differentially expressed between the sepsis and control groups, using the linear models for microarray data (linear modeling) and Boruta (decision trees) R packages, with 55 being previously identified in sepsis patients. Weighted gene correlation network analysis helped identify 76 proteins that correlated highly with clinical sepsis traits, 27 of which had not been previously reported in sepsis.

Conclusions:
The serum protein changes identified with the aptamer-based multiplexed proteomics approach used in this study can be useful to distinguish between sepsis and noninfectious systemic inflammation.
The Physician's Guide to Platelet-Rich Plasma in Dermatologic Surgery Part I: Definitions, Mechanisms of Action, and Technical Specifications
Authors: Hausauer Amelia K. , Humphrey Shannon 
Published: November 2019

BACKGROUND
Platelet-rich plasma (PRP) is an increasingly popular treatment modality for various dermatologic conditions, but there are limitations in both the published literature and clinician knowledge.

OBJECTIVE
To create a high-yield, in-depth analysis of PRP in procedural dermatology by reviewing available data on its role in hair restoration, soft-tissue remodeling, resurfacing, and rejuvenation; identifying practice gaps and controversies; and making suggestions for future research that will establish dermatologists as pioneers of regenerative medicine.

MATERIALS AND METHODS
A 2-part systematic review and expert analysis of publications before October 2018.

RESULTS AND CONCLUSION
Most studies on PRP report favorable outcomes with the strongest level of evidence existing for androgenetic alopecia followed by postprocedure wound healing, scar revision, striae, rejuvenation, and dermal filling. There is a dearth of large randomized controlled trials, considerable heterogeneity in the variables studied, and lack of specificity in the preparatory protocols, which may influence clinical outcomes. Future investigations should use consistent nomenclature, find ideal solution parameters for each cutaneous indication, determine significant outcome metrics, and follow double-blinded, randomized, controlled methodologies. Addressing these deficiencies will take sound scientific inquiry but ultimately has the potential to benefit the authors' specialty greatly.
Diagnostic Validity of Cardiopulmonary Exercise Testing for Screening Pulmonary Hypertension in Patients With Chronic Obstructive Pulmonary Disease
Authors: Kader Mohamed Nabhan , Moiz Jamal Ali , Bhati Pooja , Ali Mir Shad , Talwar Deepak 
Published: November 2019

Purpose:
To determine diagnostic validity of cardiopulmonary exercise testing (CPX) parameters for detecting pulmonary hypertension (PH) in patients with chronic obstructive pulmonary disease (COPD) and to investigate association between CPX parameters and indices of PH.

Methods:
This cross-sectional study enrolled 48 moderate to very severe COPD patients in whom PH was confirmed by echocardiography. Symptom-limited CPX was performed using an incremental exercise protocol. Relevant CPX parameters were derived and were tested for their diagnostic ability for diagnosing PH. Logistic regression was applied to examine the effect of various clinical covariates on the diagnostic ability of exercise test variables for detecting PH.

Results:
Of the 48 patients, 29 were diagnosed with PH and 19 were negative for PH based on echocardiographic testing. CPX measures including peak oxygen uptake (% predicted

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2peak,

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2peak [mL/min],

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2/kg), oxygen pulse (

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2/HR % predicted,

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2/HR mL/beat), and peak minute ventilation (

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e
peak [L/m]) were inversely correlated with mean pulmonary arterial pressure (mPAP). Peak

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2/HR and

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2peak were found to be significant predictors of PH in univariate analysis.

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2peak (%),

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2/HR (mL/beat), and desaturation (%) were identified as independent predictors of PH adjusted for age, forced expiratory volume in 1 sec (%), and forced vital capacity (L).

Conclusion:
The present study validates the use of CPX parameters such as

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2peak and

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2/HR as a diagnostic tool for correctly identifying PH in COPD patients. Therefore, CPX may be used as an adjunct to echocardiographic measurement of PH where there is unavailability of equipment and expertise.
Pedometer Feedback Interventions Increase Daily Physical Activity in Phase III Cardiac Rehabilitation Participants
Authors: Ozemek Cemal , Strath Scott J. , Riggin Katrina , Harber Matthew P. , Imboden Mary T. , Kaminsky Leonard A. 
Published: November 2019

Purpose:
To determine the effects of individually tailored interventions designed to increase physical activity (PA) in cardiac patients.

Methods:
A total of 99 (77 men and 22 women, 61.5 ± 10.7 yr) patients entering a phase III cardiac rehabilitation program completed a 12-wk PA intervention. Patients were randomized to usual care (UC, time-based recommendation), pedometer feedback (PF), newsletter-based motivational messaging (MM), or PF + MM. Both PF groups were given a goal of increasing steps/d by 10% of individual baseline value each week. If the goal for the week was not reached, the same goal was used for the next week. Physical activity was assessed for 7 d before beginning and after completing the program. The change in steps/d, moderate to vigorous intensity PA minutes, and sedentary time were compared among intervention groups.

Results:
Average change in steps/d was found to be significantly greater (P < .01) in the PF (2957 ± 3185) and the PF + MM (3150 ± 3007) compared with UC (264 ± 2065) and MM (718 ± 2415) groups. No group experienced changes in moderate to vigorous intensity PA time and only the PF intervention group decreased sedentary time (baseline 470.2 ± 77.1 to postintervention 447.8 ± 74.9 min/d, P = .01).

Conclusion:
The findings from this study demonstrate that using PF was superior to the usual time–based PA recommendations and to newsletter-based MM in patients starting a phase III CR program. Cardiac rehabilitation programs are encouraged to implement PA feedback with individualized PA goals in order to support the increase in PA.
Design and Outcomes of a Novel Keratoprosthesis: Addressing Unmet Needs in End-Stage Cicatricial Corneal Blindness
Authors: Bakshi Shaunak K. , Graney John , Paschalis Eleftherios I. , Agarwal Shweta , Basu Sayan , Iyer Geetha , Liu Christopher , Srinivasan Bhaskar , Chodosh James 
Published: November 2019

Purpose:
The most commonly applied prosthetic devices for corneal blindness in the setting of severe cicatricial keratoconjunctivitis are the Boston keratoprosthesis type II and the modified osteo-odonto-keratoprosthesis, with these requiring either normal eyelid skin or a healthy cuspid tooth, respectively. For patients with neither attribute, we developed a new keratoprosthesis device combining positive aspects of both Boston keratoprosthesis type II and modified osteo-odonto-keratoprosthesis, which we have named the “Lux.”

Methods:
Short-term postoperative outcomes for the Lux keratoprosthesis, best-corrected visual acuity (BCVA), device retention, and complications, were examined in a retrospective case series of 9 eyes of 9 patients implanted at 4 centers.

Results:
Seven of 9 (77.8%) eyes had cicatricial corneal blindness due to autoimmune disease and 2 (22.2%) from severe burns. Preoperative BCVA was ≤hand motions in all patients. Three (33.3%) had previously received at least 1 keratoprosthesis in the affected eye, and 4 (44.4%) had previously undergone ≥1 therapeutic keratoplasty. One patient had 19 previous eye surgeries. The mean duration of postoperative follow-up was 18.7 months (range 7–28 months). BCVA of ≥20/200 was achieved in all 9 patients, with 2 (22.2%) reaching 20/20 at the last examination, and all 9 (100%) of the devices were retained. One recipient developed a retinal detachment 2 months after implantation. Two (22.2%) patients required placement of a glaucoma drainage device.

Conclusions:
The Lux keratoprosthesis was developed for patients with severe cicatricial keratoconjunctivitis who were otherwise not candidates for existing keratoprosthesis designs. Short-term outcomes after implantation of the Lux keratoprosthesis were encouraging.
Complexities of HIV Disclosure in Patients Newly Entering HIV Care: A Qualitative Analysis
Authors: Chapman Lambert Crystal , Tarver Will L. , Musoke Pamela L. , Stringer Kristi L. , Whitfield Samantha , Turan Bulent , Modi Riddhi , Mugavero Michael J. , Fredericksen Rob J. , Weiser Sheri , Johnson Mallory O. , Turan Janet M. 
Published: November 2019

Abstract
The role of HIV disclosure and its influence on engagement in HIV care after initial linkage to care is not well understood. We conducted 28 in-depth interviews with patients newly entering HIV care. Gaining access to social support was a key reason that many patients disclosed their HIV status. For some, HIV disclosure improved support networks related to engagement in care at the time of care entry, in the form of appointment reminders, emotional support, and confidence to disclose more widely. However, some participants cited anticipated stigma as a barrier to disclosure, as they feared rejection or further disclosure without their permission. Early access to social support and skill building related to stigma reduction and coping can be useful resources to help patients manage HIV, as they initiate care. In addition, incorporating support for smart disclosure decisions into interventions may improve access to social support, ultimately improving engagement in care.
Follow-Up of the Libby, Montana Screening Cohort
Authors: Larson Theodore C. , Williamson Laura , Antao Vinicius C. 
Published: November 2019

Objective:
To evaluate mortality patterns among participants in a community-based screening program for asbestos-related disease.

Methods:
We calculated standardized mortality ratios (SMRs) and stratified results by exposure group (three occupational exposure groups, household contacts and residents without occupational asbestos exposure) and by radiographic abnormality presence.

Results:
All-cause mortality (15.8%; 1,429/8,043) was statistically lower than expected. Asbestosis was statistically elevated in all exposure groups. Lung cancer was moderately associated with vermiculite miner/miller employment. Mesothelioma was elevated in that same exposure group and among residents. Systemic autoimmune disease mortality was also elevated. Radiographic parenchymal abnormalities were associated with lung cancer mortality.

Conclusion:
In addition to asbestos-related mortality in occupational exposure groups, this initial follow-up of this cohort also shows elevated mortality for some asbestos-related causes in non-occupational exposure groups.
Nerve Function Impairment After Acute Vibration Exposure
Authors: Löfgren Anton , Vihlborg Per , Fornander Louise , Bryngelsson Ing-Liss , Graff Pål 
Published: November 2019

Objective:
This study was to investigate the acute effects of hand-arm vibrations on the nerve functions of the hands, and the impact of the grip force applied to the vibrating tool during exposure.

Methods:
Grip strength and perception of vibration, touch, and temperature were evaluated using quantitative sensory testing (QST) before and after vibration exposure in 21 occupationally unexposed individuals. The procedure was performed twice, with a higher grip force being applied during exposure on the second occasion.

Results:
Vibration perception was significantly impaired after both exposures. Grip strength, perception of touch, and temperature were only significantly affected after the high grip force exposure.

Conclusions:
Exposure to hand-arm vibrations has acute effects on hand nerve function that are sensitive to the grip force applied during exposure.