bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum potassium and clinical outcomes in heart failure patients: results of risk calculations in 21 334 patients in the UK
Authors: Linde Cecilia , Qin Lei , Bakhai Ameet , Furuland Hans , Evans Marc , Ayoubkhani Daniel , Palaka Eirini , Bennett Hayley , McEwan Phil 
Published: January 2019

AbstractAimsAt present, the clinical burden of hypokalaemia and hyperkalaemia among European heart failure patients, and relationships between serum potassium and adverse clinical outcomes in this population, is not well characterized. The aim of this study was to investigate associations between mortality, major adverse cardiac events, and renin–angiotensin–aldosterone system inhibitor (RAASi) discontinuation across serum potassium levels, in a UK cohort of incident heart failure patients.Methods and resultsThis was a retrospective observational cohort study of newly diagnosed heart failure patients listed in the Clinical Practice Research Datalink, with a first record of heart failure (index date) between 2006 and 2015. Hypokalaemia and hyperkalaemia episodes were defined as the number of serum potassium measurements exceeding each threshold (<3.5, ≥5.0, ≥5.5, and ≥6.0 mmol/L), without such a measurement in the preceding 7 days. Risk equations developed using Poisson generalized estimating equations were utilized to estimate adjusted incident rate ratios (IRRs) relating serum potassium and clinical outcomes (death, major adverse cardiac event, and RAASi discontinuation). Among 21,334 eligible heart failure patients, 1969 (9.2%), 7648 (35.9%), 2725 (12.8%), and 763 (3.6%) experienced episodes of serum potassium <3.5, ≥5.0, ≥5.5, and ≥6.0 mmol/L, respectively. The adjusted IRRs for mortality exhibited a U‐shaped association pattern with serum potassium. Relative to the reference category (4.5 to <5.0 mmol/L), adjusted IRRs for mortality were estimated as 1.98 (95% confidence interval: 1.69–2.33), 1.23 (1.12–1.36), 1.35 (1.14–1.60), and 3.02 (2.28–4.02), for patients with serum potassium <3.5, ≥5.0 to <5.5, ≥5.5 to <6.0, and ≥6.0 mmol/L, respectively. The adjusted IRRs for major adverse cardiac events demonstrated a non‐statistically significant relationship with serum potassium. Discontinuation of RAASi therapy exhibited a J‐shaped trend in association with serum potassium. Compared with the reference category (4.5 to <5.0 mmol/L), adjusted IRRs were estimated as 1.07 (0.89–1.28) in patients with serum potassium <3.5 mmol/L, increasing to 1.32 (1.14–1.53) and 2.19 (1.63–2.95) among those with serum potassium ≥5.5 to <6.0 and ≥6.0 mmol/L, respectively.ConclusionsIn UK patients with new onset heart failure, both hypokalaemia and hyperkalaemia were associated with increased mortality risk, and hyperkalaemia was associated with increased likelihood of RAASi discontinuation. Our results demonstrate the potential importance of serum potassium monitoring for heart failure outcomes and management.
Effect of treatment modality on chronic opioid use in patients with T1/T2 oropharyngeal cancer
Authors: Bollig Craig A. , Jorgensen Jeffrey B. 
Published: January 2019

AbstractBackgroundThe effect of treatment modality on long‐term opioid dependence in patients with oropharyngeal cancer has not been reported.MethodsA retrospective cohort of 122 patients with T1/T2 oropharyngeal cancer undergoing treatment was generated. Risk factors associated with chronic opioid use were investigated by univariate and multivariate analyses.ResultsThe prevalence of chronic opioid use was 45.9%. On multivariate analysis, primary nonsurgical treatment (odds ratio [OR] 4.5, 95% confidence interval [CI]: 1.7‐11.4), pretreatment opioid use (OR 14.9, 95% CI: 3.5‐62.5), psychiatric disorder (OR 4.3, 95% CI: 1.03‐18.5), alcohol use (OR 2.6, 95% CI: 1.03‐6.5), and younger age (OR 1.1, 95% CI: 1.02‐1.11) were significantly associated with chronic opioid use.ConclusionPrimary nonsurgical treatment, younger age, pretreatment opioid use, alcohol use, and psychiatric disorder were independently associated with an increased risk of chronic opioid use. Preventative strategies should be especially focused toward these patients to reduce their risk of long‐term opioid use.
Clinical management and outcomes of lacrimal sac squamous cell carcinoma
Authors: Song Xinmao , Wang Shengzi , Wang Jie , Wang Weifang , Wang Shuyi , Yang Gang , Li Ji , Zhu Yi , Chen Fu , Zhu Wenjia 
Published: January 2019

AbstractBackgroundTo investigate the management and outcomes of patients with lacrimal sac squamous cell carcinoma (SCC).MethodsThis retrospective study examined 69 lacrimal sac SCC cases treated at our hospital between 1992 and 2017. The potential risk factors for prognosis, a new staging method, treatment outcomes, and complications were investigated.ResultsThe 5‐year overall survival (OS) and progression‐free survival (PFS) were 87.6 ± 4.8% and 76.3 ± 6.4%, respectively. Positive lymph node was associated with worse OS and PFS. We divided lacrimal sac SCC into four clinical stages, with significant differences in OS (P = .026) and PFS (P = .042) among each stage. Definitive radiotherapy was equivalent to surgery plus radiotherapy in 26.1% (18/69) of cases, and the incidence of complications was not higher.ConclusionsLymph node status was a key factor in determining outcomes. Our staging method could effectively classify tumor stage and predict prognosis, which can contribute to optimizing treatment regimes. Radiotherapy played an important role in treatment.
Genetic counselor workflow study: The times are they a‐changin’?
Authors: Attard Courtney A. , Carmany Erin P. , Trepanier Angela M. 
Published: January 2019

AbstractGenetic services have historically been time and labor intensive. Little information is known about the proportion of time genetic counselors (GCs) spend face‐to‐face with patients in comparison to the time spent on patient‐related activities (PRA). We aimed to perform a real‐time workflow study of GCs representing multiple clinics and specialties. We developed an electronic collection tool formatted in 15‐min increments for real‐time documentation of how the GC spent his/her time throughout the workday for one full week, based on a defined task list. Participants were Michigan GCs recruited via email solicitation. Sixteen of an estimated 70 patient‐facing GCs (23%) representing prenatal, cancer, adult, and pediatric genetics took part by completing a demographic survey and the workflow study. The GCs reported spending approximately 20% of their time face‐to‐face with patients, 64% on PRA including case preparation, follow‐up, and administrative tasks, and 16% on tasks unrelated to direct patient care. They saw a mean of 10 patients/week with a mean session length of 47 min. Approximately 3 hr of PRA were performed for the 0.78 hr (47 min) of face‐to‐face time with a patient. The most time‐consuming task in the PRA category was letter writing. Identifying strategies to reduce the amount of time spent on PRA could increase the amount of available time GCs have to spend on providing face‐to‐face services and subsequently, the number of patients seen. Such efforts are critical to help meet the growing demand for genetic counseling services.
Fast optimization of sparse antenna array using numerical Green's function and genetic algorithm
Authors: Raji Mordecai F. , Zhao Huapeng , Monday Happy N. 
Published: January 2019

AbstractA single‐element antenna is unfit for application in most wireless systems and an alternative is an array of antenna. The desire to reduce weight and cost of antenna arrays gave rise to sparse arrays. The design of a sparse antenna array requires an optimization process, which is time‐consuming for large arrays. In order to accelerate the optimization process, a method combining the numerical Green's function (NGF) and genetic algorithm (GA) is presented in this paper. In the proposed method, binary coding is applied to describe the status of antenna elements, and GA optimization is performed to sparsify the array subject to constraint on the peak side lobe level (PSLL). The PSLL is calculated efficiently by the NGF. Simulation results are presented to illustrate the advantage of the proposed method. It is shown that the proposed method significantly reduces the optimization time.
Improvement and optimization of an autonomous photovoltaic pumping system
Authors: Ksentini Abdelhamid , Azzag El Bahi 
Published: January 2019

AbstractThe climate in Algeria can be considered semiarid in most areas. The water demand is expected to increase because of population growth in the coming years. Water supply is always a great concern for the populations in the landlocked regions. Pumping water using the solar photovoltaic energy is a well‐suited solution where the traditional electricity grid is absent. Indeed, the majority of these regions are very sunny, and water is available in underground aquifers. Our system consists on a photovoltaic generator (PVG), a direct current (DC)‐DC converters, a multilevel inverter with five levels, and an asynchronous motor coupled to a centrifugal pump. The objective of this process is to ensure the operation at maximum power of the PVG system under various conditions by the maximum power point tracking (MPPT) method based on fuzzy logic control (FLC). The modeling and simulation of this system were carried out and based on our experimental work in the site meteorological database of city Adrar in Algeria. This system avoids the use of a motor pump (diesel) and eliminates costs and operating constraints in an environment friendly manner according to the COP21 recommendation.
Unique abdominal twiddler syndrome
Authors: Higuchi Satoshi , Shoda Morio , Satomi Natsuko , Iwanami Yuji , Yagishita Daigo , Ejima Koichiro , Hagiwara Nobuhisa 
Published: January 2019

AbstractTwiddler syndrome is an uncommon complication that occurs by twisting of the generator and may cause torsion, dislodgement, and injury of the leads. We report a rare case of a twiddler syndrome associated with an abdominal permanent pacemaker. Abdominal twiddler syndrome may possess a unique mechanism, which may not be seen in chest twiddler syndrome.
Two‐step stem cell therapy improves bone regeneration compared to concentrated bone marrow therapy
Authors: Bolte Julia , Vater Corina , Culla Anna Carla , Ahlfeld Tilman , Nowotny Jörg , Kasten Philip , Disch Alexander C. , Goodman Stuart B. , Gelinsky Michael , Stiehler Maik , Zwingenberger Stefan 
Published: January 2019

ABSTRACTAdult stem cells are a promising tool to positively influence bone regeneration. Concentrated bone marrow therapy entails isolating osteoprogenitor cells during surgery with, however, only low cells yield. Two step stem cell therapy requires an additional harvesting procedure but generates high numbers of progenitor cells that facilitate osteogenic pre‐differentiation. To further improve bone regeneration, stem cell therapy can be combined with growth factors from platelet rich plasma (PRP) or its lysate (PL) to potentially fostering vascularization. The aim of this study was to investigate the effects of bone marrow concentrate (BMC), osteogenic pre‐differentiation of mesenchymal stromal cells (MSCs), and PL on bone regeneration and vascularization. Bone marrow from four different healthy human donors was used for either generation of BMC or for isolation of MSCs. Seventy‐two mice were randomized to six groups (Control, PL, BMC, BMC + PL, pre‐differentiated MSCs, pre‐differentiated MSCs + PL). The influence of PL, BMC, and pre‐differentiated MSCs was investigated systematically in a 2 mm femoral bone defect model. After a 6‐week follow‐up, the pre‐differentiated MSCs + PL group showed the highest bone volume, highest grade of histological defect healing and highest number of bridged defects with measurable biomechanical stiffness. Using expanded and osteogenically pre‐differentiated MSCs for treatment of a critical‐size bone defect was favorable with regards to bone regeneration compared to treatment with cells from BMC. The addition of PL alone had no significant influence; therefore the role of PL for bone regeneration remains unclear. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1318–1328, 2019.
Effect of pH and mobile phase additives on the chromatographic behaviour of an amide‐embedded stationary phase: Cyanocobalamin and its diaminemonochloro‐platinum(II) conjugate as a case study
Authors: Ventura Giovanni , Calvano Cosima Damiana , Losito Ilario , Bianco Giuliana , Pascale Raffaella , Palmisano Francesco , Cataldi Tommaso R.I. 
Published: January 2019

AbstractSeveral mobile phase additives (i.e., organic acids and their ammonium salts) were used to modulate the chromatographic retention of cyanocobalamin and its cis‐diaminemonochloroplatinum(II) conjugate, depending on the specific nature of the stationary phase. Regardless of the mobile phase additive, the positively charged cyanocobalamin‐cis‐diaminemonochloroplatinum(II) conjugate was systematically less retained than cyanocobalamin on a conventional octadecyl‐silica column. In contrast, the amide‐embedded C18 column exhibited a progressive increase in the conjugate retention time upon changing the mobile phase additive from organic (acetic, formic and trifluoroacetic) acids to ammonium salts, ultimately leading to an inversion of the elution order. This change of retention was interpreted by invoking the interplay between hydrophobic interactions, hydrogen bonding between the conjugate and the polar amide groups and the ion‐pairing ability of the lyophilic counterions, whereby the acetate anion was found to be the most suitable to control the solute retention.
Optimal sequencing of chemoradiotherapy for locally advanced laryngeal cancer
Authors: Shah Nishant K. , Qureshi Muhammad M. , Dyer Michael A. , Patel Sagar A. , Kim Kristine , Everett Peter C. , Grillone Gregory A. , Jalisi Scharukh M. , Truong Minh Tam 
Published: January 2019

ObjectiveTo determine the optimal sequencing of chemoradiotherapy for locally advanced laryngeal cancer. The hypothesis was that concurrent chemoradiotherapy (CCRT) would be associated with improved overall survival (OS) compared to induction chemotherapy followed by radiotherapy (RT)/surgery (IC).MethodsThe National Cancer Database identified 8,154 patients with American Joint Commission on Cancer stage III/IV (excluding T1) laryngeal cancer between 2004 and 2013 treated with one of the established organ preservation techniques: CCRT or IC. The association between OS and total radiation dose (< 66 gray [Gy] or ≥ 66 Gy) was analyzed using the Kaplan‐Meier method, as was the association between OS and timing of IC (21–42, 43–100, or 101–120 days before RT). Hazard ratios (HR) adjusted for patient and clinical characteristics were computed using Cox regression modeling.ResultsThe median follow‐up was 32.7 months. The estimated 5‐year OS for CCRT and IC was 49.9% and 50.6%, respectively (P = 0.653). On multivariate analysis, no difference was observed between the two regimens (IC, adjusted HR 0.96, 95% confidence interval [CI] 0.88–1.04, P = 0.268). Radiation dose ≥66 Gy had improved OS overall in CCRT group but not in IC patients. When comparing CCRT and IC in patients receiving ≥66 Gy, there was no difference in OS (adjusted HR 0.97, 95% CI 0.89–1.06, P = 0.552). Patients starting chemotherapy 21 to 42 or 101 to 120 days prior to RT had inferior OS compared to patients starting between 43 to 100 days.ConclusionFor locally advanced laryngeal cancer, there is no difference in OS between CCRT and IC. Factors associated with survival included radiation dose and timing of induction chemotherapy before RT.Level of Evidence3bLaryngoscope, 129:2313–2320, 2019
Three‐dimensional endoscopy: The future of nasoendoscopic training
Authors: Bickerton Robert , Nassimizadeh Abdul‐Karim , Ahmed Shahzada 
Published: January 2019

Objectives/HypothesisThree‐dimensional (3D) endoscopy is an emerging tool in surgery that provides real‐time depth perception. Its benefits have been investigated in surgical training, but the current literature lacks significant objective outcome data. We aimed to objectively compare the efficacy of two‐dimensional (2D) versus 3D high‐definition endoscopes in novice users.Study DesignProspective, randomized crossover study.MethodsNinety‐two novice medical students who used both 2D and 3D endoscopes to complete two validated tasks in a box trainer participated in the study. Time taken and error rates were measured, and subjective data were collected.ResultsWilcoxon tests showed 3D technology was significantly faster than 2D (78 vs. 95 seconds, P = .004), and errors per task were significantly lower (3 vs. 5, P < .001). Sixty‐nine percent of participants preferred the 3D endoscope.Conclusions3D high‐definition endoscopy could be instrumental in training the next generation of endoscopic surgeons. Further research is required in a clinical setting.Level of Evidence2bLaryngoscope, 129:1280–1285, 2019
A comprehensive study of immunology repertoires in both preoperative stage and postoperative stage in patients with colorectal cancer
Authors: Liu Xicheng , Cui Yuanyuan , Zhang Yaoxian , Liu Zhanli , Zhang Qiuli , Wu Wenyan , Zheng Zihao , Li Shien , Zhang Zhongjun , Li Yali 
Published: January 2019

AbstractBackgroundColorectal cancer (CRC) is the 3rd most common cancer type in the world. The correlation between immune repertoire and prognosis of CRC has been well studied in the last decades. The diversity and stability of the immune cells can be measured by hypervariable complementarity‐determining region 3 (CDR3) segments of the T‐cell receptor (TCR).MethodsIn this study, we collected five healthy controls and 19 CRC patients’ peripheral blood mononuclear cells (PBMCs) in three stages, namely 1 day preoperative, 3 days’ postoperative, and 7 days’ postoperative, respectively. Simultaneously, we have also done the comparative analysis of these two different anesthesia methods, namely TIVA and CEGA. Sequencing of the TCR segments has been performed by multiplex PCR and high‐throughput next‐generation sequencing. We also analyzed the distribution of CDR3 length, highly expansion clones (HECs), TRBV, and TRBJ gene usage.ResultsOur result showed a significant difference between TCR CDR3 length distribution and HEC distribution between CRC patients and healthy controls. We also found that TRBV11‐2, TRBV12‐1, TRBV16, TRBV3‐2, TRBV4‐2, TRBV4‐3, TRBV5‐4, TRBV6‐8, TRBV7‐8, TRBV7‐9 and RBV11‐2, TRBV12‐1, TRBV16, TRBV3‐2, TRBV4‐2, TRBV4‐3, TRBV5‐4, TRBV6‐8, TRBV7‐8, and TRBV7‐9 usages are different between CRC patients and healthy controls.ConclusionIn conclusion, CRC patients were presented with different immune repertoire in comparison with healthy controls. In this study, significant difference in TRBV and TRBJ gene usage in between case and control group could provide some potential biomarker for the diagnosis and the treatment of the patients with CRC.
Multicenter CT phantoms public dataset for radiomics reproducibility tests
Authors: Kalendralis Petros , Traverso Alberto , Shi Zhenwei , Zhovannik Ivan , Monshouwer René , Starmans Martijn P. A. , Klein Stefan , Pfaehler Elisabeth , Boellaard Ronald , Dekker Andre , Wee Leonard 
Published: January 2019

PurposeThe aim of this paper is to describe a public, open‐access, computed tomography (CT) phantom image set acquired at three centers and collected especially for radiomics reproducibility research. The dataset is useful to test radiomic features reproducibility with respect to various parameters, such as acquisition settings, scanners, and reconstruction algorithms.Acquisition and validation methodsThree phantoms were scanned in three independent institutions. Images of the following phantoms were acquired: Catphan 700 and COPDGene Phantom II (Phantom Laboratory, Greenwich, NY, USA), and the Triple modality 3D Abdominal Phantom (CIRS, Norfolk, VA, USA). Data were collected at three Dutch medical centers: MAASTRO Clinic (Maastricht, NL), Radboud University Medical Center (Nijmegen, NL), and University Medical Center Groningen (Groningen, NL) with scanners from two different manufacturers Siemens Healthcare and Philips Healthcare. The following acquisition parameter were varied in the phantom scans: slice thickness, reconstruction kernels, and tube current.Data format and usage notesWe made the dataset publically available on the Dutch instance of “Extensible Neuroimaging Archive Toolkit‐XNAT” (https://xnat.bmia.nl). The dataset is freely available and reusable with attribution (Creative Commons 3.0 license).Potential applicationsOur goal was to provide a findable, open‐access, annotated, and reusable CT phantom dataset for radiomics reproducibility studies. Reproducibility testing and harmonization are fundamental requirements for wide generalizability of radiomics‐based clinical prediction models. It is highly desirable to include only reproducible features into models, to be more assured of external validity across hitherto unseen contexts. In this view, phantom data from different centers represent a valuable source of information to exclude CT radiomic features that may already be unstable with respect to simplified structures and tightly controlled scan settings. The intended extension of our shared dataset is to include other modalities and phantoms with more realistic lesion simulations.
Pharmacologically pertinent period of effect (PPPE)
Authors: Suissa Melanie , LeLorier Jacques 
Published: January 2019

AbstractBackgroundThe period of time during which a patient is exposed to a drug does not necessarily correspond to the period during which the drug produces the adverse effect under consideration. We propose the term Pharmacologically pertinent period of effect (PPPE) to address this time window. We explored the PPPE in light of the rofecoxib saga.MethodsWe identified the observational database studies of rofecoxib at doses 25 and 50 mg daily and thromboembolic events. We also obtained the Kaplan‐Meier curves of Vioxx Gastrointestinal Outcomes Research trial (VIGOR) and Adenomatous Polyp Prevention on Vioxx (APPROVE) trials.ResultsWe found seven observational studies with nine analyses. All the studies only looked at current exposure. At the dose of 25 mg, only three of nine analyses were barely statistically significant. At the dose of 50 mg, the risk ratios were much higher. The visual inspection of the Kaplan‐Meier curves shows that in the APPROVE trial (25 mg), the placebo and rofecoxib curves start separating to become statistically significantly different only after 36 months. In contrast the VIGOR (50 mg), curves start separating very early and the divergence increases after 8 months.DiscussionThe 50 mg observational studies, looking at current exposure, correctively identified the almost immediate increase in risk evident in the VIGOR Kaplan‐Meier curves. The absence of an immediate increase in risk shown by the APPROVE trial was also correctively identified by most observational 25 mg studies. To our knowledge no observational study was done on the long‐term cardiac toxicity of the 25‐mg dose. It would thus appear that the two doses of rofecoxib have different PPPEs.