bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute effects of air pollution on ischaemic stroke onset and deaths: a time-series study in Changzhou, China
Authors: Dong Huibin , Yu Yongquan , Yao Shen , Lu Yan , Chen Zhiyong , Li Guiying , Yao Yao , Yao Xingjuan , Wang Shou-Lin , Zhang Zhan 
Published: July 2018

ObjectiveTo investigate the acute effect of air pollutants on ischaemic stroke (IS) and IS-related death.SettingFive urban districts in Changzhou, China, between 9 January 2015 and 31 December 2016.ParticipantsA total of 32 840 IS cases and 4028 IS deaths were enrolled.Main outcome measuresA time-series design, generalised additive model and multivariable regression model were used to examine the percentage change (95% CI) in daily IS counts and deaths with an IQR increase in air pollutant levels for different single or multiple lag days in single-pollutant and two-pollutant models.ResultsDaily IS counts increased 0.208% (95% CI 0.036% to 0.381%) with an IQR increment in the levels of nitrogen dioxide (NO2). The estimated risk of NO2was more robust in males and in the cold season. For daily IS counts, the estimated effects of NO2and sulfur dioxide (SO2) were more significant when adjusted for particulate matter with aerodynamic diameters <2.5 µm (PM2.5) and PM10. An IQR increment in the concentration of PM10, SO2and NO2significantly increased IS deaths with 6 days of cumulative effects (0.268%, 95% CI 0.007% to 1.528%; 0.34%, 0.088% to 0.592%; and 0.263%, 0.004% to 0.522%, respectively). Young individuals (<65 years old) had a higher IS mortality risk for PM2.5, PM10, NO2and CO. For IS death, the effect estimates of SO2in the elderly, females and the cold season were more pronounced; statistical significance was also identified for SO2when adjusted for carbon monoxide (CO).ConclusionsThis study suggested that short-term exposure to ambient NO2was associated with increased IS risk. In addition, SO2was associated with increased IS onset and death.
Sensitivity and specificity of breast cancer ICD-9-CM codes in three Italian administrative healthcare databases: a diagnostic accuracy study
Authors: Abraha Iosief , Serraino Diego , Montedori Alessandro , Fusco Mario , Giovannini Gianni , Casucci Paola , Cozzolino Francesco , Orso Massimiliano , Granata Annalisa , De Giorgi Marcello , Collarile Paolo , Chiari Rita , Foglietta Jennifer , Vitale Maria Francesca , Stracci Fabrizio , Orlandi Walter , Bidoli Ettore 
Published: July 2018

ObjectivesTo assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying patients diagnosed with incident carcinoma in situ and invasive breast cancer in three Italian administrative databases.DesignA diagnostic accuracy study comparing ICD-9-CM codes for carcinoma in situ (233.0) and for invasive breast cancer (174.x) with medical chart (as a reference standard). Case definition: (1) presence of a primary nodular lesion in the breast and (2) cytological or histological documentation of cancer from a primary or metastatic site.SettingAdministrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli VeneziaGiulia (FVG) Region.ParticipantsWomen with breast carcinoma in situ (n=246) or invasive breast cancer (n=384) diagnosed (in primary position) between 2012 and 2014.Outcome measuresSensitivity and specificity for codes 233.0 and 174.x.ResultsFor invasive breast cancer the sensitivities were 98% (95% CI 93% to 99%) for Umbria, 96% (95% CI 91% to 99%) for NA and 100% (95% CI 97% to 100%) for FVG. Specificities were 90% (95% CI 82% to 95%) for Umbria, 91% (95% CI 83% to 96%) for NA and 91% (95% CI 84% to 96%) for FVG.For carcinoma in situ the sensitivities were 100% (95% CI 93% to 100%) for Umbria, 100% (95% CI 95% to 100%) for NA and 100% (95% CI 96% to 100%) for FVG. Specificities were 98% (95% CI 93% to 100%) for Umbria, 86% (95% CI 78% to 92%) for NA and 90% (95% CI 82% to 95%) for FVG.ConclusionsAdministrative healthcare databases from Umbria, NA and FVG are accurate in identifying hospitalised news cases of carcinoma of the breast. The proposed case definition is a powerful tool to perform research on large populations of newly diagnosed patients with breast cancer.
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record
Authors: Flory James H , Keating Scott Justin , Siscovick David , Mushlin Alvin I 
Published: July 2018

ObjectivesNon-persistence may be a significant barrier to the use of metformin. Our objective was to assess reasons for metformin non-persistence, and whether initial metformin dosing or use of extended release (ER) formulations affect persistence to metformin therapy.DesignRetrospective cohort study.SettingElectronic health record data from a network of urban academic practices.ParticipantsThe cohort was restricted to individuals receiving a metformin prescription between 2009/1/1 and 2015/9/31, under care for at least 6 months before the first prescription of metformin. The cohort was further restricted to patients with no evidence of any antihyperglycaemic agent use prior to the index date, an haemoglobin A1c measured within 1 month prior to or 1 week after the index date, at least 6 months of follow-up, and with the initial metformin prescription originating in either a general medicine or endocrinology clinic.Primary and secondary outcome measuresThe primary outcome measure was early non-persistence, as defined by the absence of further prescriptions for metformin after the first 90 days of follow-up.ResultsThe final cohort consisted of 1259 eligible individuals. The overall rate of early non-persistence was 20.3%. Initial use of ER and low starting dose metformin were associated with significantly lower rates of reported side effects and non-persistence, but after multivariable analysis, only use of low starting doses was independently associated with improved persistence (adjusted OR 0.54, 95% CI 0.37 to 0.76, for comparison of 500 mg daily dose or less to all higher doses).ConclusionsThese data support the routine prescribing of low starting doses of metformin as a tool to improve persistence. In this study setting, many providers routinely used ER metformin as an initial treatment; while this practice may have benefits, it deserves more rigorous study to assess whether increased costs are justified.
Is periprocedural sedation during acute stroke therapy associated with poorer functional outcomes?
Authors: Nichols C , Carrozzella J , Yeatts S , Tomsick T , Broderick J , Khatri P 
Published: July 2018

BackgroundTo safely perform acute intra-arterial revascularization procedures, use of sedative medications and paralytics is often necessary. During the conduct of the Interventional Management of Stroke trials (I and II), the level of sedation used periprocedurally varied. At some institutions, patients were paralyzed and intubated as part of the procedural standard of care while at other institutions no routine sedation protocol was followed. The aim of this study was to identify patient characteristics that would correlate with the need for deeper sedation and to explore whether levels of sedation relate to patient outcome.Methods75 of 81 patients in the Interventional Management of Stroke II Study were studied. Patients had anterior circulation strokes and underwent angiography and/or intervention. Four sedation categories were defined and tested for factors potentially associated with the level of sedation. Clinical outcomes were also analyzed, including successful angiographic reperfusion and the occurrence of clinical complications.ResultsOnly baseline National Institutes of Health Stroke Scale varied significantly by sedation category (p=0.01). Patients that were in the lower sedation category fared better, having a higher rate of good outcomes (p<0.01), lower death rates (p=0.02) and higher successful angiographic reperfusion rates (p=0.01). There was a significantly higher infection rate in patients receiving heavy sedation or pharmacologic paralysis (p=0.02) and a trend towards fewer groin related complications.ConclusionIn this small sample, patients not receiving sedation fared better, had higher rates of successful angiographic reperfusion and had fewer complications. Further examination of the indications for procedural sedation or paralysis and their effect on outcome is warranted.
Solitaire FR thrombectomy system: immediate results in 56 consecutive acute ischemic stroke patients
Authors: Machi Paolo , Costalat Vincent , Lobotesis Kyriakos , Lima Maldonado Igor , Vendrell Jean Francois , Riquelme Carlos , Bonafé Alain 
Published: July 2018

Background and purposePrompt recanalization of cerebral arteries in patients diagnosed with acute ischemic stroke is known to be associated with a better clinical outcome. The aim of this study was to present our initial experience regarding the efficacy and safety of the Solitaire FR as a revascularization device.Methods56 consecutive patients presenting with acute ischemic stroke underwent intra-arterial therapy using the Solitaire FR revascularization device. Immediate angiographic results and early clinical outcomes are presented.ResultsSolitaire FR was successful in achieving recanalization in 50 out of 56 patients (89%) with a final Thrombolysis in Cerebral Infarction score ≥2b. Five out of 56 patients had procedure related complications: two asymptomatic subarachnoid hemorrhages, two thromboembolic events and one symptomatic intracranial hemorrhage (PH2). Thirty patients (53.5%) demonstrated at discharge a National Institutes of Health Stroke Scale Score of ≤1 or an improvement of at least 10 points from baseline, and 26 patients (46%) had a modified Rankin Score ≤2.ConclusionsSolitaire FR is successful in achieving a high rate of arterial recanalization with a low complication rate. The Solitaire FR is a promising thrombectomy tool with a high degree of effectiveness, safety and ease of use.
North American Solitaire Stent Retriever Acute Stroke registry: post-marketing revascularization and clinical outcome results
Authors: Zaidat Osama O , Castonguay Alicia C , Gupta Rishi , Sun Chung-Huan J , Martin Coleman , Holloway William E , Mueller-Kronast Nils , English Joey D , Linfante Italo , Dabus Guilherme , Malisch Tim W , Marden Franklin A , Bozorgchami Hormozd , Xavier Andrew , Rai Ansaar T , Froehler Michael T , Badruddin Aamir , Nguyen Thanh N , Taqi M Asif , Abraham Michael G , Janardhan Vallabh , Shaltoni Hashem , Novakovic Roberta , Yoo Albert J , Abou-Chebl Alex , Chen Peng R , Britz Gavin W , Kaushal Ritesh , Nanda Ashish , Issa Mohammad A , Nogueira Raul G 
Published: July 2018

BackgroundLimited post-marketing data exist on the use of the Solitaire FR device in clinical practice. The North American Solitaire Stent Retriever Acute Stroke (NASA) registry aimed to assess the real world performance of the Solitaire FR device in contrast with the results from the SWIFT (Solitaire with the Intention for Thrombectomy) and TREVO 2 (Trevo versus Merci retrievers for thrombectomy revascularization of large vessel occlusions in acute ischemic stroke) trials.MethodsThe investigator initiated NASA registry recruited North American sites to submit retrospective angiographic and clinical outcome data on consecutive acute ischemic stroke (AIS) patients treated with the Solitaire FR between March 2012 and February 2013. The primary outcome was a Thrombolysis in Myocardial Ischemia (TIMI) score of ≥2 or a Treatment in Cerebral Infarction (TICI) score of ≥2a. Secondary outcomes were 90 day modified Rankin Scale (mRS) score, mortality, and symptomatic intracranial hemorrhage.Results354 patients underwent treatment for AIS using the Solitaire FR device in 24 centers. Mean time from onset to groin puncture was 363.4±239 min, mean fluoroscopy time was 32.9±25.7 min, and mean procedure time was 100.9±57.8 min.Recanalization outcome:TIMI ≥2 rate of 83.3% (315/354) and TICI ≥2a rate of 87.5% (310/354) compared with the operator reported TIMI ≥2 rate of 83% in SWIFT and TICI ≥2a rate of 85% in TREVO 2.Clinical outcome:42% (132/315) of NASA patients demonstrated a 90 day mRS ≤2 compared with 37% (SWIFT) and 40% (TREVO 2). 90 day mortality was 30.2% (95/315) versus 17.2% (SWIFT) and 29% (TREVO 2).ConclusionsThe NASA registry demonstrated that the Solitaire FR device performance in clinical practice is comparable with the SWIFT and TREVO 2 trial results.
Individualised tobacco affordability in the UK 2002–2014: findings from the International Tobacco Control Policy Evaluation Project
Authors: Partos Timea R , Branston J Robert , Hiscock Rosemary , Gilmore Anna B , McNeill Ann 
Published: July 2018

ObjectiveThe existing measures of tobacco affordability (smokers' purchasing power for tobacco) use national estimates of income and average cigarette prices, and exclude roll-your-own (RYO) tobacco. This study developed an individualised measure of tobacco affordability using smokers' own incomes and factory-made (FM) or RYO tobacco purchase prices, and explored how it was impacted by taxation changes, individual characteristics and purchase patterns.DesignCross-sectional survey data collated from 10 waves of a longitudinal cohort study.Data sourcesAdult smokers (n=4062) from the International Tobacco Control Policy Evaluation Project United Kingdom (UK), surveyed between 2002 and 2014, providing 8943 observations over 10 surveys.AnalysisAffordability was calculated as the percentage of annual income remaining with the individuals after their annual tobacco expenditure. Multilevel linear regression models were used with affordability as the outcome using time, sex, age, geographical region, ethnicity, education, nicotine dependence and tobacco purchase source as the predictor variables.ResultsAffordability of FM cigarettes decreased significantly from 91.5% (±95% CI: 91.0% to 91.9%) in 2002 to 87.8% (87.0% to 88.5%) in 2014; and RYO from 96.3% (95.7% to 96.9%) in 2006 to 93.7% (93.0% to 94.4%) in 2014. Affordability was significantly lower for FM than RYO. Year-on-year decreases were not statistically significant. Tobacco was more affordable for males, those with higher education, less dependent smokers and those purchasing from non-store (potentially illicit) or non-UK sources.ConclusionsAn individualised measure of tobacco affordability provided useful insights on the impact of tobacco taxes, social inequalities and purchase patterns in the UK. Although tobacco became less affordable, the annual rate of decline was low, suggesting annual tax rises were not large enough.
Nilotinib as Coadjuvant Treatment with Doxorubicin in Patients with Sarcomas: A Phase I Trial of the Spanish Group for Research on Sarcoma
Authors: Alemany Regina , Moura David S. , Redondo Andres , Martinez-Trufero Javier , Calabuig Silvia , Saus Carlos , Obrador-Hevia Antonia , Ramos Rafael , Villar Victor H. , Valverde Claudia , Vaz Maria Angeles , Medina Javier , Felipe-Abrio Irene , Hindi Nadia , Taron Miguel , Martin-Broto Javier 
Published: July 2018

Abstract
Purpose: Nilotinib plus doxorubicin showed to be synergistic regarding apoptosis in several sarcoma cell lines. A phase I/II trial was thus designed to explore the feasibility of nilotinib as coadjuvant of doxorubicin by inhibiting MRP-1/P-gp efflux activity. The phase I part of the study is presented here.
Patients and Methods: Nilotinib 400 mg/12 hours was administered in fixed dose from day 1 to 6, and doxorubicin on day 5 of each cycle. Three dose escalation levels for doxorubicin at 60, 65, and 75 mg/m2 were planned. Cycles were repeated every 3 weeks for a total of 4 cycles. Eligible subtypes were retroperitoneal liposarcoma, leiomyosarcoma, and unresectable/metastatic high-grade chondrosarcoma.
Results: Thirteen patients were enrolled: 7 chondrosarcoma, 4 liposarcoma, and 2 leiomyosarcoma. In 46 cycles administered, the most relevant grade 3/4 adverse effects per patient were neutropenia 54%, febrile neutropenia 15%, and asthenia 8%. No cardiac toxicity was observed. Only one dose-limiting toxicity (febrile neutropenia) was reported in the third dose level. With regard to efficacy, 1 partial response (1 liposarcoma), 9 stable diseases (5 chondrosarcoma, 2 liposarcoma, 1 leiomyosarcoma), and 3 progressive diseases (2 chondrosarcoma and 1 leiomyosarcoma) were present. ABCB1 and ABCC1 RNA expression levels decreased by 58.47-fold and 1.47-fold, respectively, on day 5 of the cycle.
Conclusions: Combination of MRP-1/P-gp inhibitor, nilotinib, as coadjuvant with doxorubicin is feasible; it appears not to add substantial toxicity compared with doxorubicin alone. Pharmacodynamic study supports this concept. The recommended dose for the phase II part for doxorubicin was 75 mg/m2. Clin Cancer Res; 24(21); 5239–49. ©2018 AACR.
KIM-1 as a Blood-Based Marker for Early Detection of Kidney Cancer: A Prospective Nested Case–Control Study
Authors: Scelo Ghislaine , Muller David C. , Riboli Elio , Johansson Mattias , Cross Amanda J. , Vineis Paolo , Tsilidis Konstantinos K. , Brennan Paul , Boeing Heiner , Peeters Petra H.M. , Vermeulen Roel C.H. , Overvad Kim , Bueno-de-Mesquita H. Bas , Severi Gianluca , Perduca Vittorio , Kvaskoff Marina , Trichopoulou Antonia , La Vecchia Carlo , Karakatsani Anna , Palli Domenico , Sieri Sabina , Panico Salvatore , Weiderpass Elisabete , Sandanger Torkjel M. , Nøst Therese H. , Agudo Antonio , Quirós J. Ramón , Rodríguez-Barranco Miguel , Chirlaque Maria-Dolores , Key Timothy J. , Khanna Prateek , Bonventre Joseph V. , Sabbisetti Venkata S. , Bhatt Rupal S. 
Published: July 2018

Abstract
Purpose: Renal cell carcinoma (RCC) has the potential for cure with surgery when diagnosed at an early stage. Kidney injury molecule-1 (KIM-1) has been shown to be elevated in the plasma of RCC patients. We aimed to test whether plasma KIM-1 could represent a means of detecting RCC prior to clinical diagnosis.
Experimental Design: KIM-1 concentrations were measured in prediagnostic plasma from 190 RCC cases and 190 controls nested within a population-based prospective cohort study. Cases had entered the cohort up to 5 years before diagnosis, and controls were matched on cases for date of birth, date at blood donation, sex, and country. We applied conditional logistic regression and flexible parametric survival models to evaluate the association between plasma KIM-1 concentrations and RCC risk and survival.
Results: The incidence rate ratio (IRR) of RCC for a doubling in KIM-1 concentration was 1.71 [95% confidence interval (CI), 1.44–2.03, P = 4.1 × 10−23], corresponding to an IRR of 63.3 (95% CI, 16.2–246.9) comparing the 80th to the 20th percentiles of the KIM-1 distribution in this sample. Compared with a risk model including known risk factors of RCC (age, sex, country, body mass index, and tobacco smoking status), a risk model additionally including KIM-1 substantially improved discrimination between cases and controls (area under the receiver-operating characteristic curve of 0.8 compared with 0.7). High plasma KIM-1 concentrations were also associated with poorer survival (P = 0.0053).
Conclusions: Plasma KIM-1 concentrations could predict RCC incidence up to 5 years prior to diagnosis and were associated with poorer survival. Clin Cancer Res; 24(22); 5594–601. ©2018 AACR.
Comparison of Surgical Site Infections in Ankle Fracture Surgery With or Without the Use of Postoperative Antibiotics
Authors: Lachman James Robert , Elkrief Justin I. , Pipitone Paul S. , Haydel Christopher L. 
Published: July 2018

Background: Surgeon preference has been replaced by an approach using evidence-based medicine in clinical decision making. The use of postoperative antibiosis in ankle fracture surgery is more common for inpatients but variable for outpatient surgery. Some surgeons prefer to prescribe 24 hours of oral antibiotics, whereas others give no antibiotics at all postoperatively. In this study, inpatients receiving 24 hours of intravenous antibiotics were compared to those patients receiving 24 hours of oral antibiotics and those receiving no postoperative antibiotics. Methods: A total of 1442 patients with ankle fractures requiring operative fixation were retrospectively reviewed in this multicenter study. Demographic data including age, sex, and body mass index were collected. Clinical data including diabetes status, smoking status, hepatitis C virus (HCV) or human immunodeficiency virus (HIV) status, infection requiring additional antibiotics, and infection requiring return to operating room (RTOR) were compared across the groups. Results: No differences in incidence of cellulitis or return to OR for infection were demonstrated between the 3 groups. No differences were noted among the groups for any risk factors for infection including body mass index, previous infection, smoking status, HCV/HIV status, or diabetes. The rates of cellulitis ( P = .402), infection requiring additional antibiotics ( P = .563), and infection requiring return to the operating room ( P = .878) showed no difference between the groups. Conclusion: The use of antibiotics postoperatively did not decrease the incidence of surgical site infection. The findings in this study suggest that the routine use of postoperative antibiotics after ankle fracture surgery is not beneficial. Level of Evidence: Level III, retrospective comparative study.
The Significance of Thallium-201-Chloride SPECT Myocardial Perfusion Imaging in the Management of Patients With Stable Chronic Coronary Artery Disease
Authors: Jurić Ivan , Fazlibegović Emir , Pravdić Danijel , Starčević Boris , Punda Ante , Huić Dražen , Hadžiomerović Mustafa , Rozić Damir , Martinac Marko , Markota Darko , Vasilj Mirjana , Vasilj Ivan , Saxena Anshul 
Published: July 2018

Background: Patients with stable coronary artery disease (CAD) can be evaluated for myocardial viability by examining reverse redistribution of Thallium-201 (201TI) through cardiac scintigraphy. There is limited knowledge about association of a reverse redistribution with favorable cardiac outcomes. In this study, we hypothesized that higher left ventricular ejection fraction (LVEF), lower myocardial necrosis, fewer ischemic events, and less angina will be associated with reverse redistribution of 201TI imaging. Methods: Adult patients with stable CAD included in this study underwent exercise-redistribution Thallium single-photon emission computed tomography (SPECT) and were followed for one year. LVEF and regional wall motion abnormalities were evaluated with echocardiography, exercise duration by bicycle testing, and myocardial ischemia and viability by Thallium SPECT. Results: We studied 159 patients (87 men, 72 women, median age 60 years, range: 38-84) with well-developed collaterals. Those with reverse redistribution on SPECT (n = 61, 38.3%) had significantly better exercise tolerance (⩾85%; P < .001). Subjects with reverse redistribution had better LVEF ( P < .001), wall motion parameters ( P < .001), a lower degree of myocardial necrosis ( P < .05), less angina during follow-up ( P = .02), and fewer ischemic events whether treated with OMT or PCI ( P < .001). Conclusions: Reverse redistribution of 201Tl on scintigraphic images is a predictor of myocardial viability. Evidence from our study suggests that optimally treated chronic CAD patients with reverse redistribution may have lower likelihood of future adverse cardiovascular events and better prognosis.