bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attitudes and Other Factors Influencing End-of-Life Discussion by Physicians, Nurses, and Care Staff: A Nationwide Survey in Japan
Authors: Hamano Jun , Hanari Kyoko , Tamiya Nanako 
Published: September 2019

Context: Better understanding about the attitudes of health-care providers toward end-of-life discussion would facilitate the development of systematic strategies for improving end-of-life care. Objective: To clarify attitudes toward end-of-life discussion with patients near death and explore the factors influencing these attitudes among physicians, nurses, and care staff. Methods: This study was part of a nationwide cross-sectional anonymous survey of the public attitudes toward end-of-life medical care performed in December 2017. The participants were physicians, nurses, and care staff from randomly selected facilities, including hospitals, clinics, home-visit nursing offices, nursing homes, and long-term care facilities throughout Japan. The questionnaire was sent to 4500 physicians, 6000 nurses, and 2000 care staff. We assessed attitudes about end-of-life discussion with patients near death, identification of the proxy decision maker, and sharing documented information on end-of-life discussion with the multidisciplinary team. Results: We analyzed responses from 1012 physicians, 1824 nurses, and 749 care staff. The number of responders who considered they had adequate end-of-life discussion with patients near death was 281 (27.8%), 324 (17.8%), and 139 (18.6%), respectively. Participation in a nationwide education program and caring for at least 1 dying patient per month were factors that showed a significant association with adequate end-of-life discussion and identification of the proxy decision maker. Conclusions: The percentages of physicians, nurses, and care staff involved in adequate end-of-life discussion with patients near death were not high. Participation in a structured education program might have a positive influence on end-of-life discussion with patients.
Development of de novo psoriasis during nivolumab therapy in a patient with small cell lung cancer
Authors: C Guven Deniz , Kilickap Saadettin , Guner Gurkan , Taban Hakan , Dizdar Omer 
Published: September 2019

Introduction The immune checkpoint inhibitors recently entered to small cell lung cancer (SCLC) stage, firstly in the third and recently in the first lines of therapy. This efficacy comes at the expense of many toxicities including skin toxicity. This toxicity is usually in the form of rash and pruritis; however, rare reactions like psoriasis can also be seen. Case report Herein, we report an SCLC case who developed de novo psoriasis while treated with nivolumab as the third-line treatment for SCLC. Management and outcome The psoriatic plaques were regressed with the topical highly potent steroid therapy, and immunotherapy was continued without further complications. Discussion We think that rare adverse events like de novo psoriasis are important considering the expanding role of these agents; their timely recognition and treatment are important in the management of cancer patients.
Indocyanine Green Fluorescence Angiography Can Guide Intraoperative Localization During Parathyroid Surgery
Authors: Di Meo G. , Karampinis I. , Gerken A. , Lammert A. , Pellicani S. , Nowak K. 
Published: September 2019

Background and Aims: Intraoperative localization of pathologic parathyroid glands is of major importance for the hyperparathyroidism treatment. Based on the small size and the anatomic variability, the localization can be very challenging. The current practice is to compare preoperative ultrasonography with Technetium-99m sestamibi scintigraphy (MIBI) and plan the resection accordingly. In this study, we implemented indocyanine green angiography for the intraoperative localization of parathyroid glands. Materials and Methods: This is a retrospective analysis of 37 patients with primary, secondary, or tertiary hyperparathyroidism who were operated using indocyanine green angiography for the intraoperative localization of pathological parathyroid glands. An indocyanine green solution of 2.5 mg was were intravenously administered for parathyroid gland visualization. Different fluorescence scores were correlated with changes in postoperative parathyroid hormone levels. Results: Patients were divided into two groups depending on the presence of uniglandular or multiglandular disease. Sixty-four lesions were resected, and the final histopathologic analysis confirmed the parathyroid origin in 62 of them (96.8%). None of the patients with uniglandular disease developed postoperative hypoparathyroidism, whereas three patients in the multiglandular group developed temporary hypoparathyroidism symptoms. Indocyanine green imaging had higher sensitivity for the intraoperative detection of parathyroid glands compared with ultrasonography and MIBI ( p < 0.001). Conclusion: Indocyanine green angiography indicated high sensitivity for the intraoperative identification of pathologic parathyroid glands leading to a resection rate of 95.16%. The modality was useful, especially in cases of revisional surgery or ectopic parathyroid glands. Randomized trials have already proven the value of indocyanine green imaging in predicting postoperative hypocalcemia. Our results support the regular use of this method during parathyroid surgery.
Functional rare variants influence the clinical response to anti-TNF therapy in Crohn’s disease
Authors: Chaparro María , Aterido Adrià , Guerra Iván , Iborra Marisa , Cabriada Jose Luis , Bujanda Luis , Taxonera Carlos , García-Sánchez Valle , Marín-Jiménez Ignacio , Barreiro-de Acosta Manuel , Vera Isabel , Martín-Arranz Maria Dolores , Hernández-Breijo Borja , Mesonero Francisco , Sempere Laura , Gomollón Fernando , Hinojosa Joaquín , Bermejo Fernando , Beltrán Belén , Rodríguez-Pescador Ainhoa , Banales Jesús María , Olivares David , Aguilar-Melero Patricia , Menchén Luis , Ferreiro-Iglesias Rocío , Blazquez Gómez Isabel , Benitez García Beatriz , Guijarro Luis G , Marin Alicia C , Bernardo David , Marsal Sara , Julia Antonio , Gisbert Javier P 
Published: September 2019

Background: The effect of low-frequency functional variation on anti-tumor necrosis factor alpha (TNF) response in Crohn’s disease (CD) patients remains unexplored. The objective of this study was to investigate the impact of functional rare variants in clinical response to anti-TNF therapy in CD. Methods: CD anti-TNF naïve patients starting anti-TNF treatment due to active disease [Crohn’s Disease Activity Index (CDAI > 150)] were included. The whole genome was sequenced using the Illumina Hiseq4000 platform. Clinical response was defined as a CDAI score <150 at week 14 of anti-TNF treatment. Low-frequency variants were annotated and classified according to their damaging potential. The whole genome of CD patients was screened to identify homozygous loss-of-function (LoF) variants. The TNF signaling pathway was tested for overabundance of damaging variants using the SKAT-O method. Functional implication of the associated rare variation was evaluated using cell-type epigenetic enrichment analyses. Results: A total of 41 consecutive CD patients were included; 3250 functional rare variants were identified (2682 damaging and 568 LoF variants). Two homozygous LoF mutations were found in HLA-B and HLA-DRB1 genes associated with lack of response and remission, respectively. Genome-wide LoF variants were enriched in epigenetic marks specific for the gastrointestinal tissue (colon, p = 4.11e–4; duodenum, p = 0.011). The burden of damaging variation in the TNF signaling pathway was associated with response to anti-TNF therapy ( p = 0.016); damaging variants were enriched in epigenetic marks from CD8+ ( p = 6.01e–4) and CD4+ ( p = 0.032) T cells. Conclusions: Functional rare variants are involved in the response to anti-TNF therapy in CD. Cell-type enrichment analysis suggests that the gut mucosa and CD8+ T cells are the main mediators of this response.
Predicting lymph node metastases with endoscopic resection in cT2N0M0 oesophageal cancer: A systematic review and meta‐analysis
Authors: Al‐Kaabi Ali , van der Post Rachel S , Huising Jonathan , Rosman Camiel , Nagtegaal Iris D , Siersema Peter D 
Published: September 2019

BackgroundDespite modern imaging modalities, staging of clinically staged T2N0M0 (cT2N0M0) oesophageal cancer is suboptimal, often leading to overtreatment. Endoscopic resection – the first‐line therapy for early localised tumours – could be used to improve staging and to attain predictors of nodal upstaging enabling more stage‐guided treatment decisions.ObjectiveA systematic literature review and a meta‐analysis were conducted to assess the prevalence and the pathological risk factors of lymph node metastases in cT2N0M0 oesophageal cancer.MethodsDatabases of PUBMED, EMBASE and Cochrane were searched for literature. The primary outcome was lymph node metastases determined after primary surgical resection.ResultsNine studies with a total of 1650 cT2N0M0 patients were included. The prevalence of lymph node metastases was 43% (95% confidence interval: 35–50%) with heterogeneity being high across studies (I 2  = 0.86, p  < 0.001). Factors potentially attainable by endoscopic resection and having a significant association with lymph node metastases were invasion depth, differentiation grade, tumour size, depth of invasion in the muscularis propria and lymphovascular invasion.ConclusionsClinical lymph node staging is inaccurate in almost half of cT2N0M0 oesophageal cancer. Endoscopic resection is a promising diagnostic modality that might even be a valid alternative to surgery in selected patients without high‐risk features, but further evidence is warranted.
Prognostic implications of 5-hydroxymethylcytosines from circulating cell-free DNA in diffuse large B-cell lymphoma
Authors: Chiu Brian C.-H. , Zhang Zhou , You Qiancheng , Zeng Chang , Stepniak Elizabeth , Bracci Paige M. , Yu Kangkang , Venkataraman Girish , Smith Sonali M. , He Chuan , Zhang Wei 
Published: September 2019

Key Points
Genome-wide 5hmC loci can be profiled in 1 to 2 ng of cfDNA from blood plasma and correlate with clinical features of DLBCL. 5hmC in cfDNA collected at the time of DLBCL diagnosis is associated with EFS and OS, independent of established prognostic factors.
Consensus recommendations for management of patients with type 2 diabetes mellitus and cardiovascular diseases
Authors: Bashier Alaaeldin , Bin Hussain Azza , Abdelgadir Elamin , Alawadi Fatheya , Sabbour Hani , Chilton Robert 
Published: September 2019

AbstractThe recent American Diabetes Association and the European Association for the Study of Diabetes guideline mentioned glycaemia management in type 2 diabetes mellitus (T2DM) patients with cardiovascular diseases (CVDs); however, it did not cover the treatment approaches for patients with T2DM having a high risk of CVD, and treatment and screening approaches for CVDs in patients with concomitant T2DM. This consensus guideline undertakes the data obtained from all the cardiovascular outcome trials (CVOTs) to propose approaches for the T2DM management in presence of CV comorbidities. For patients at high risk of CVD, metformin is the drug of choice to manage the T2DM to achieve a patient specific HbA1c target. In case of established CVD, a combination of glucagon-like peptide-1 receptor agonist with proven CV benefits is recommended along with metformin, while for chronic kidney disease or heart failure, a sodium–glucose transporter proteins-2 inhibitor with proven benefit is advised. This document also summarises various screening and investigational approaches for the major CV events with their accuracy and specificity along with the treatment guidance to assist the healthcare professionals in selecting the best management strategies for every individual. Since lifestyle modification and management plays an important role in maintaining the effectiveness of the pharmacological therapies, authors of this consensus recommendation have also briefed on the patient-centric non-pharmacological management of T2DM and CVD.
Testing cellular phone-enhanced GPS tracking technology for urban carnivores
Authors: Ishii Hiroaki , Yamazaki Koji , Noonan Michael J. , Buesching Christina D. , Newman Chris , Kaneko Yayoi 
Published: September 2019

AbstractBackgroundWe present a cellular phone-enhanced GPS tracking system (GPS mobile with CTG-001G receiver triangulation) suitable for urban carnivores, in tandem with appropriate home range analysis, as an additional tracking technology option in metropolitan settings. We conduct this proof-of-concept study working with the management of introduced invasive raccoons in Japan (and conditions implicit to this control program).ResultsEach tracking period averaged 17 days, and a tracking accuracy of < 50 m error was achieved in over 30% of the fixes. Variogram analysis demonstrates that these data were of sufficient quality to support home range analysis. Home range areas estimated from these data revealed that raccoons in urban Japan likely range over a much greater area than has previously been reported.ConclusionsAs a proof of concept, these prototype collars were successful in tracking raccoons in the difficult suburban environment, where this system (CTG) made fixes against FOMA antennae-augmented GPS and yielded data that could support home range analysis. We advocate further research and development to refine this system, with broad application as a tool to diversify wildlife tracking technology options in urbanized environments, where synanthropic and/or invasive species can cause a nuisance warranting effective management.
Neoadjuvant Modified FOLFOX6 With or Without Radiation Versus Fluorouracil Plus Radiation for Locally Advanced Rectal Cancer: Final Results of the Chinese FOWARC Trial
Authors: Deng Yanhong , Chi Pan , Lan Ping , Wang Lei , Chen Weiqing , Cui Long , Chen Daoda , Cao Jie , Wei Hongbo , Peng Xiang , Huang Zonghai , Cai Guanfu , Zhao Ren , Huang Zhongcheng , Xu Lin , Zhou Hongfeng , Wei Yisheng , Zhang Hao , Zheng Jian , Huang Yan , Zhou Zhiyang , Cai Yue , Kang Liang , Huang Meijin , Wu Xiaojian , Peng Junsheng , Ren Donglin , Wang Jianping 
Published: September 2019

PURPOSE In the multicenter, open-label, phase III FOWARC trial, modified infusional fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) plus radiotherapy resulted in a higher pathologic complete response rate than fluorouracil plus radiotherapy in Chinese patients with locally advanced rectal cancer. Here, we report the final results. METHODS Adults ages 18 to 75 years with stage II/III rectal cancer were randomly assigned (1:1:1) to five cycles of infusional fluorouracil (leucovorin 400 mg/m2, fluorouracil 400 mg/m2, and fluorouracil 2.4 g/m2 over 48 hours) plus radiotherapy (46.0 to 50.4 Gy delivered in 23 to 25 fractions during cycles 2 to 4) followed by surgery and seven cycles of infusional fluorouracil, the same treatment plus intravenous oxaliplatin 85 mg/m2 on day 1 of each cycle (mFOLFOX6), or four to six cycles of mFOLFOX6 followed by surgery and six to eight cycles of mFOLFOX6. The primary end point was 3-year disease-free survival (DFS). RESULTS In total, 495 patients were randomly assigned to treatment. After a median follow-up of 45.2 months, DFS events were reported in 46, 39, and 46 patients in the fluorouracil plus radiotherapy, mFOLFOX6 plus radiotherapy, and mFOLFOX6 arms. In each arm, the probability of 3-year DFS was 72.9%, 77.2%, and 73.5% ( P = .709 by the log-rank test), the 3-year probability of local recurrence after R0/1 resection was 8.0%, 7.0%, and 8.3% ( P = .873 by the log-rank test), and the 3-year overall survival rate was 91.3%, 89.1%, and 90.7% ( P = .971 by log-rank test), respectively. CONCLUSION mFOLFOX6, with or without radiation, did not significantly improve 3-year DFS versus fluorouracil with radiation in patients with locally advanced rectal cancer. No significant difference in outcomes was found between mFOLFOX6 without radiotherapy and fluorouracil with radiotherapy, which requires additional investigation of the role of radiotherapy in these regimens.
Prospective Comparison of Preoperative Predictive Performance Between 3 Leading Frailty Instruments
Authors: McIsaac Daniel I. , Harris Emma P. , Hladkowicz Emily , Moloo Husein , Lalu Manoj M. , Bryson Gregory L. , Huang Allen , Joanisse John , Hamilton Gavin M. , Forster Alan J. , van Walraven Carl 
Published: September 2019

BACKGROUND:
Guidelines recommend routine preoperative frailty assessment for older people. However, the degree to which frailty instruments improve predictive accuracy when added to traditional risk factors is poorly described. Our objective was to measure the accuracy gained in predicting outcomes important to older patients when adding the Clinical Frailty Scale (CFS), Fried Phenotype (FP), or Frailty Index (FI) to traditional risk factors.

METHODS:
This was an analysis of a multicenter prospective cohort of elective noncardiac surgery patients ≥65 years of age. Each frailty instrument was prospectively collected. The added predictive performance of each frailty instrument beyond the baseline model (age, sex, American Society of Anesthesiologists’ score, procedural risk) was estimated using likelihood ratio test, discrimination, calibration, explained variance, and reclassification. Outcomes analyzed included death or new disability, prolonged length of stay (LoS, >75th percentile), and adverse discharge (death or non-home discharge).

RESULTS:
We included 645 participants (mean age, 74 [standard deviation, 6]); 72 (11.2%) participants died or experienced a new disability, 164 (25.4%) had prolonged LoS, and 60 (9.2%) had adverse discharge. Compared to the baseline model predicting death or new disability (area under the curve [AUC], 0.67; R
2, 0.08, good calibration), prolonged LoS (AUC, 0.73; R
2, 0.18, good calibration), and adverse discharge (AUC, 0.78; R
2, 0.16, poor calibration), the CFS improved fit per the likelihood ratio test (P < .02 for death or new disability, <.001 for LoS, <.001 for discharge), discrimination (AUC = 0.71 for death or new disability, 0.76 for LoS, 0.82 for discharge), calibration (good for death or new disability, LoS, and discharge), explained variance (R
2 = 0.11 for death or new disability, 0.22 for LoS, 0.25 for discharge), and reclassification (appropriate directional reclassification) for all outcomes. The FP improved discrimination and R
2 for all outcomes, but to a lesser degree than the CFS. The FI improved discrimination for death or new disability and R
2 for all outcomes, but to a lesser degree than the CFS and the FP. These results were consistent in internal validation.

CONCLUSIONS:
Frailty instruments provide meaningful increases in accuracy when predicting postoperative outcomes for older people. Compared to the FP and FI, the CFS appears to improve all measures of predictive performance to the greatest extent and across outcomes. Combined with previous research demonstrating that the CFS is easy to use and requires less time than the FP, clinicians should consider its use in preoperative practice.
Convergent evolution of super black plumage near bright color in 15 bird families
Authors: McCoy Dakota E. , Prum Richard O. 
Published: September 2019

ABSTRACT
We examined extremely low-reflectance, velvety black plumage patches in 32 bird species from 15 families and five orders and compared them with 22 closely related control species with normal black plumage. We used scanning electron microscopy to investigate microscopic feather anatomy, and applied spectrophotometry and hyperspectral imaging to measure plumage reflectance. Super black plumages are significantly darker and have more broadband low reflectance than normal black plumages, and they have evolved convergently in 15 avian families. Super black feather barbules quantitatively differ in microstructure from normal black feathers. Microstructural variation is significantly correlated with reflectance: tightly packed, strap-shaped barbules have lower reflectance. We assigned these super black feathers to five heuristic classes of microstructure, each of which has evolved multiple times independently. All classes have minimal exposed horizontal surface area and 3D micrometer-scale cavities greater in width and depth than wavelengths of light. In many species, barbule morphology varied between the super black exposed tip of a feather and its (i) concealed base or (ii) iridescently colored spot. We propose that super black plumages reduce reflectance, and flatten reflectance spectra, through multiple light scattering between the vertically oriented surfaces of microscale cavities, contributing to near-complete absorption of light by melanin. All super black plumage patches identified occur adjacent to brilliant colored patches. Super black plumage lacks all white specular reflections (reference points used to calibrate color perception), thus exaggerating the perceived brightness of nearby colors. We hypothesize that this sensory bias is an unavoidable by-product of color correction in variable light environments.
Η «βυζαντινή φατρία των χυδαϊστών». Επισκοπώντας τα αντικοραϊκά δημοσιεύματα του 1811
Authors: Φραγκίσκος Εμμ. Ν. 
Published: September 2019

A «CLIQUE BYZANTINE DES ADEPTES DU DÉMOTICISME». Une revue des publications anticoraïques de l'an 1811 En 1811 ont vu le jour deux publications opposées à la théorie de Coray qui concernait la correction de la langue néogrecque : le Rêve, publié sans signature dans l’édition des Lyriques d’Athanase Christopoulos à Vienne et une seconde signée par l’initial N. et inserée dans les pages de Loghios Hermès en forme de lettre-réponse à l’article d’Alexandre Vassileiou, publié aussi dans ce magazine littéraire, par lequel le négociant savant de Vienne défendait les idées linguistiques de son ami Coray. Les auteurs des deux textes, écrits sous l’influence de la tradition populaire de la langue des D. Catartzi et D. Philippides, employaient d’arguments théoriques identiques, en faveur de la langue vulgaire, et de l’autre côté ils habitaient dans le même lieu, à savoir à Constantinople. Quand ces publications furent parvenues aux mains de Coray, le Grec savant commentera dans sa correspondance seulement la seconde, en considérant que D. Philippides fût son auteur. Mais l’anonyme de Loghios Hermès, comme le professeur Walter Puchner a indiqué autrefois, était Iacovakis Rizos Neroulos, l’auteur des Korakistika, et cette identification est confirmée dans l’article présent par beaucoup d’autres documents. Le fait que, d’après les informations d’Ath. Christopoulos à Ath. Psalidas, cette satire, qui serait publiée l’année 1813, circulait déjà en 1811 en forme manuscrite dans les cercles des savants de Constantinople et les amusait fort, nous fait réfléchir que cet événement était la source de la réaction de Coray quand le mois de décembre de la même année il parlait dans ses lettres des clabaudages des législateurs byzantins de la langue ou de la clique byzantine des adeptes du démoticisme. Évidemment, il aurait reçu lui-même d’informations semblables par son ami Al. Vassileiou transmises de la part de ses frères, aussi négociants savants, qui demeuraient à Constantinople. Donc, puisque tous les trois textes anticoraϊques, le Rêve, texte en forme théâtrale, où on rencontre pour la première fois le terme «korakistika», la lettre anonyme du Loghios Hermès, et la comédie Korakistika, sonts liés de plusieurs points entre eux, on ne peut pas écarter la probabilité qu’ils provenaient du même auteur, à savoir de I. R. Neroulos. En tout cas, face aux atteintes qu’il recevait par ses adversaires, Coray refusait le rôle du législateur de la langue (les seuls législateurs n’étaient que les écrivains et les poètes classiques, pas l’usage commun), il était saisi de doutes sur l’application générale de sa doctrine linguistique en désapprouvant en même temps les confrontations sur ce sujet.Emm. N. Franghiskos