bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical, ultrasonographic, and histopathologic findings in seven horses with Descemet's membrane detachment: A case series
Authors: Slenter Inge J. M. , Hermans Hanneke , Ensink Jos M. , Willems Dorien S. , Veraa Stefanie , Grinwis Guy C. M. , Boevé Michael H. 
Published: September 2019

AbstractObjectiveTo describe ultrasonography as a diagnostic method of in vivo Descemet's membrane detachment (DMD) in horses. Animals studied: Seven horses (three Icelandic horses, two Dutch Warmblood horses, one Appaloosa, and one Welsh Pony), presenting with moderate‐to‐severe focal or diffuse corneal edema, in whom DMD was suspected on ultrasonographic examination and confirmed with histopathology, were studied.ProcedureA retrospective analysis of case records of horses with suspected DMD was performed.ResultsMedian age at presentation was 14 years (range 11‐24). Clinical signs in eyes with DMD were unilateral in all horses and included blepharospasm and epiphora (6/7), buphthalmos (5/7), moderate‐to‐severe focal or diffuse corneal edema (7/7), corneal epithelial bullae (4/7), corneal neovascularization (4/7), Haab's striae (2/7), corneal endothelial precipitates (1/7), fibrin in the anterior chamber (1/7), focal cataract (2/7), and pigment deposits on the anterior lens capsule (1/7). During transpalpebral ultrasonography, a distinct linear echogenic structure was noted in the anterior chamber, initially diverging from, and later running parallel to, the posterior lining of the cornea in all eyes studied. In all cases, the cornea was severely thickened and echogenic, consistent with edema, and DMD was suspected. In all horses, the clinical signs progressed and the affected eye was eventually enucleated. Histopathology revealed DMD (7/7), spindle cell proliferation (4/7), Descemet's membrane reformation (3/7), and inflammation of the anterior uvea (5/7). Overall incidence was 1.04%.ConclusionsUltrasonography is an adequate tool in diagnosing DMD in horses. Descemet's membrane detachment should be included in the differential diagnosis in horses with dense focal or diffuse corneal edema.
Incidence of inpatient venous thromboembolism in treated patients with rheumatoid arthritis and the association with switching biologic or targeted synthetic disease-modifying antirheumatic drugs (DMARDs) in the real-world setting
Authors: Liang Huifang , Danwada Raghava , Guo Dianlin , Curtis Jeffrey R , Kilpatrick Ryan D , Hendrickson Barbara , Islam Syed S 
Published: September 2019

ObjectivesTo assess incidence rates (IRs) of VTE in patients with rheumatoid arthritis (RA) on different DMARDs and DMARD switchers.MethodsAdults with RA on a DMARD between 2007 and 2017 were studied in a US claims database. Conventional synthetic DMARD (csDMARD) users, first biologic/targeted synthetic DMARD (b/tsDMARD) users and b/tsDMARD switchers (from a b/tsDMARD to another b/tsDMARD) were followed for inpatient VTE (pulmonary embolism (PE)/deep vein thrombosis (DVT)). Crude and adjusted IR and 95% CIs of VTE were estimated. HRs for VTE were estimated via Cox regression. VTE risk was also evaluated by number of switches between b/tsDMARDs and in patients without a VTE history.ResultsThe age and sex standardised IR (95% CI) of VTE (per 100 person-years) was 0.86 (0.70 to 1.03), 0.60 (0.52 to 0.68) and 0.58 (0.51 to 0.65) for b/tsDMARD switchers, first b/tsDMARD users and csDMARD users, respectively. After adjustment, b/tsDMARD switchers had an increased risk of VTE, compared with csDMARD users, HRadj(95% CI) being 1.36 (1.16 to 1.58), 1.36 (1.13 to 1.63) and 1.47 (1.18 to 1.83) for VTE, DVT and PE, respectively. Compared with first b/tsDMARD users, the HRadj(95% CI) for VTE was 1.35 (1.15 to 1.60) for first b/tsDMARD switchers and 1.48 (1.19 to 1.85) for second b/tsDMARD switchers.ConclusionsIn RA, b/tsDMARD switchers have a higher VTE risk compared with csDMARD users and first b/tsDMARD users. Switching b/tsDMARDs may be a proxy for higher disease severity or poorly controlled RA and an important confounder to consider in obtaining unbiased estimates of VTE risk in observational RA safety studies.
Management of Takayasu arteritis: a systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis
Authors: Águeda Ana F , Monti Sara , Luqmani Raashid Ahmed , Buttgereit Frank , Cid Maria , Dasgupta Bhaskar , Dejaco Christian , Mahr Alfred , Ponte Cristina , Salvarani Carlo , Schmidt Wolfgang , Hellmich Bernhard 
Published: September 2019

ObjectiveTo collect available evidence on management of large vessel vasculitis to inform the 2018 update of the EULAR management recommendations.MethodsTwo independent systematic literature reviews were performed, one on diagnosis and monitoring and the other on drugs and surgical treatments. Using a predefined PICO (population, intervention, comparator and outcome) strategy, Medline, Embase and Cochrane databases were accessed. Eligible papers were reviewed and results condensed into a summary of findings table. This paper reports the main results for Takayasu arteritis (TAK).ResultsA total of 287 articles were selected. Relevant heterogeneity precluded meta-analysis. Males appear to have more complications than females. The presence of major complications, older age, a progressive disease course and a weaker inflammatory response are associated with a more unfavourable prognosis. Evidence for details on the best disease monitoring scheme was not found. High-quality evidence to guide the treatment of TAK was not found. Glucocorticoids are widely accepted as first-line treatment. Conventional immunosuppressive drugs and tumour necrosis factor inhibitors were beneficial in case series and uncontrolled studies. Tocilizumab failed the primary endpoint (time to relapse) in a randomised controlled clinical trial; however, results still favoured tocilizumab over placebo. Vascular procedures may be required, and outcome is better when performed during inactive disease.ConclusionsEvidence to guide monitoring and treatment of patients with TAK is predominantly derived from observational studies with low level of evidence. Therefore, higher-quality studies are needed in the future.
Opioid stewardship after emergency laparoscopic general surgery
Authors: Nahanni Celina , Nadler Ashlie , Nathens Avery B 
Published: September 2019

BackgroundOpioid administration in postoperative patients has contributed to the opioid crisis by increasing the load of opioids available in the community. Implementation of evidence-based practices is key to optimizing the use of opioids for acute pain control. This study aims to characterize the administration and prescribing practices after emergency laparoscopic general surgery procedures with the goal of identifying areas for improvement.MethodsA retrospective chart review of 200 patients undergoing emergency laparoscopic appendectomies and cholecystectomies was conducted for a 2-year period at a single institution. Eligible patients were opioid-naïve adults admitted through the emergency department. Opioid administration and discharge prescriptions were converted to oral morphine equivalents (OME), and analyzed and compared with published literature and local guidelines.ResultsOpioid analgesia was provided as needed to 69% of patients in hospital with average dosing of 26.7 OME/day; comparatively, 99.5% of patients received prescriptions for opioids on discharge at an average dosing of 61.7 OME/day. The average dosing in the discharge prescriptions was not correlated with in-hospital needs (Pearson=−0.04; p=0.56); and higher narcotic doses were associated with combination opioid prescriptions compared with separate opioid prescriptions (73.8 (1.90) vs. 50.1 (1.90) OME/day; p<0.01). This difference was driven by the combination medication, Percocet.ConclusionsIn the immediate postoperative period, most patients were managed in hospital with opioid analgesia dosages that fell within guidelines. Nearly all patients were provided with prescriptions for opioids on discharge, these prescriptions both exceeded local guidelines and were not correlated with in-hospital narcotic needs or pain scores.Level of evidenceLevel 3 retrospective cohort study.
Predicting the 1p/19q Codeletion Status of Presumed Low-Grade Glioma with an Externally Validated Machine Learning Algorithm
Authors: van der Voort Sebastian R. , Incekara Fatih , Wijnenga Maarten M.J. , Kapas Georgios , Gardeniers Mayke , Schouten Joost W. , Starmans Martijn P.A. , Nandoe Tewarie Rishie , Lycklama Geert J. , French Pim J. , Dubbink Hendrikus J. , van den Bent Martin J. , Vincent Arnaud J.P.E. , Niessen Wiro J. , Klein Stefan , Smits Marion 
Published: September 2019

Abstract

Purpose:
Patients with 1p/19q codeleted low-grade glioma (LGG) have longer overall survival and better treatment response than patients with 1p/19q intact tumors. Therefore, it is relevant to know the 1p/19q status. To investigate whether the 1p/19q status can be assessed prior to tumor resection, we developed a machine learning algorithm to predict the 1p/19q status of presumed LGG based on preoperative MRI.

Experimental Design:
Preoperative brain MR images from 284 patients who had undergone biopsy or resection of presumed LGG were used to train a support vector machine algorithm. The algorithm was trained on the basis of features extracted from post-contrast T1-weighted and T2-weighted MR images and on patients' age and sex. The performance of the algorithm compared with tissue diagnosis was assessed on an external validation dataset of MR images from 129 patients with LGG from The Cancer Imaging Archive (TCIA). Four clinical experts also predicted the 1p/19q status of the TCIA MR images.

Results:
The algorithm achieved an AUC of 0.72 in the external validation dataset. The algorithm had a higher predictive performance than the average of the neurosurgeons (AUC 0.52) but lower than that of the neuroradiologists (AUC of 0.81). There was a wide variability between clinical experts (AUC 0.45–0.83).

Conclusions:
Our results suggest that our algorithm can noninvasively predict the 1p/19q status of presumed LGG with a performance that on average outperformed the oncological neurosurgeons. Evaluation on an independent dataset indicates that our algorithm is robust and generalizable.
Role of KEAP1/NFE2L2 Mutations in the Chemotherapeutic Response of Patients with Non–Small Cell Lung Cancer
Authors: Jeong Youngtae , Hellyer Jessica A. , Stehr Henning , Hoang Ngoc T. , Niu Xiaomin , Das Millie , Padda Sukhmani K. , Ramchandran Kavitha , Neal Joel W. , Wakelee Heather , Diehn Maximilian 
Published: September 2019

Abstract

Purpose:
Activation of NFE2L2 has been linked to chemoresistance in cell line models. Recently, somatic mutations that activate NFE2L2, including mutations in NFE2L2, KEAP1, or CUL3, have been found to be associated with poor outcomes in patients with non–small cell lung cancer (NSCLC). However, the impact of these mutations on chemoresistance remains incompletely explored.

Experimental Design:
We investigated the effect of Keap1 deletion on chemoresistance in cell lines from Trp53-based mouse models of lung squamous cell carcinoma (LSCC) and lung adenocarcinoma (LUAD). Separately, we identified 51 patients with stage IV NSCLC with KEAP1, NFE2L2, or CUL3 mutations and a matched cohort of 52 wild-type patients. Time to treatment failure after first-line platinum doublet chemotherapy and overall survival was compared between the two groups.

Results:
Deletion of Keap1 in Trp53-null murine LUAD and LSCC resulted in increased clonogenic survival upon treatment with diverse cytotoxic chemotherapies. In patients with NSCLC, median time to treatment failure (TTF) after first-line chemotherapy for the KEAP1/NFE2L2/CUL3-mutant cohort was 2.8 months compared with 8.3 months in the control group (P &lt; 0.0001). Median overall survival (OS) was 11.2 months in the KEAP1/NFE2L2/CUL3-mutant group and 36.8 months in the control group (P = 0.006).

Conclusions:
Keap1 deletion confers chemoresistance in murine lung cancer cells. Patients with metastatic NSCLC with mutations in KEAP1, NFE2L2, or CUL3 have shorter TTF and OS after first-line platinum doublet chemotherapy compared with matched controls. Novel approaches for improving outcomes in this subset of patients with NSCLC are therefore needed.
Therapeutic Drug Monitoring to Guide Clinical Decision Making in Inflammatory Bowel Disease Patients with Loss of Response to Anti-TNF: A Delphi Technique-Based Consensus
Authors: Greuter Thomas , Maillard Michel H. , Juillerat Pascal , Michetti Pierre , Seibold Frank , Mottet Christian , Zahnd Nadine , Sauter Bernhard , Schoepfer Alain M. , Rogler Gerhard , Vavricka Stephan R. ,   on behalf of the Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology
Published: September 2019

Background: Loss of response is frequently encountered in patients with inflammatory bowel disease (IBD) treated with antitumor necrosis factor (TNF) agents. Therapeutic drug monitoring (TDM) and antidrug antibody measurement are increasingly used in this setting. Methods: To establish a consensus on the use of TDM in the context of loss of response to anti-TNFs, we performed a vote using a Delphi-style process followed by an expert panel discussion among 8 IBD specialists practicing in Switzerland, Europe. Statements were rated on an even Likert-scale ranging from 1 (strong disagreement) to 4 (strong agreement), based on expert opinion and the available literature. Results: The experts agreed on the following statements: (i) loss of response is associated with inadequate drug levels in both Crohn’s disease and ulcerative colitis; (ii) best timepoint for measuring drug levels is prior to the next application (= trough levels) with different thresholds for anti-TNF agents (infliximab 5 μg/mL, adalimumab 8 μg/mL, certolizumab pegol 10 μg/mL); (iii) antidrug antibodies are predictive for loss of response; and (iv) antidrug-antibody titers and drug trough levels are key determinants in the treatment algorithm. Data about non-anti-TNF biologics were considered too limited to propose recommendations. Conclusion: A Delphi-style consensus among 8 IBD experts shows that TDM and measurement of antidrug-antibody titers are useful in the context of loss of response to anti-TNF. Optimal cutoff levels depend on the type of anti-TNF. These values are critical in the decision making process. More studies are needed to address the value of such measurements for non-anti-TNF biologics.
Successful Negotiation of Anticipated and Unanticipated Obstacles in Young and Older Adults: Not All Is as Expected
Authors: Eyal Shlomit , Kurz Ilan , Mirelman Anat , Maidan Inbal , Giladi Nir , Hausdorff Jeffrey M. 
Published: September 2019

<b><i>Background:</i></b> Tripping over an obstacle is one of the most common causes of falls among older adults; however, the impact of obstacle parameters and subject characteristics are not well described. <b><i>Objectives:</i></b> To evaluate age-associated changes in the ability to negotiate obstacles and the role of obstacle parameters (e.g., anticipated vs. unanticipated, height, and available response time [ART]), and subject characteristics. <b><i>Methods:</i></b> Twenty healthy older adults (77.7 ± 3.4 years; 50% women) and 20 healthy young adults (29.3 ± 3.8 years; 50% women) underwent cognitive, gait, and balance testing before negotiating a computer-controlled obstacle course. The primary outcome measure was the ability to successfully negotiate the obstacles (without touching them). <b><i>Results:</i></b> The success rate for all subjects was higher when the obstacle was anticipated (99.0 ± 2.8%) than when unanticipated (66.0 ± 20.2%; <i>p</i> &#x3c; 0.001). The obstacle height had a significant effect on the success rate (<i>p</i> = 0.022); the success rate was lower when the obstacle height was lower. No significant interaction between group and obstacle height was observed (<i>p</i> = 0.096). ART had no significant effect on the success rate (<i>p</i> = 0.294) in both of the groups (ART × group, <i>p</i> = 0.136). However, a significant interaction between group, obstacle height, and ART was found (<i>p</i> = 0.013), reflecting a lower success rate in the older adults when the obstacles were low and unanticipated. In general, older adults demonstrated a trend towards a lower success rate in all types of obstacles compared to the young adults (<i>p</i> = 0.057). Among the older adults, the success rate in the anticipated obstacle condition was correlated with stride length (ρ = 0.600, <i>p</i> = 0.005), step time coefficient of variation (ρ = –0.635, <i>p</i> = 0.003), and gait speed (rho = 0.530, <i>p</i> = 0.016). Montreal Cognitive Assessment scores tended to be related to the difference in the success rate between the anticipated and unanticipated conditions.<b><i> Conclusions:</i></b> These findings support the idea that motor and, to some degree, cognitive functions are needed to successfully negotiate obstacles, and provide new insights into the ability of older adults to successfully negotiate obstacles. Furthermore, the present results suggest that when it comes to the physical properties of obstacles, not all is as expected, and low obstacles may impose a greater danger to tripping than obstacles that have a higher height.
The Effects of Listening to Music on Anxiety, Pain, and Satisfaction during Urodynamic Study: A Randomized Controlled Trial
Authors: Diri Mehmet Akif , Çetinkaya Funda , Gül Murat 
Published: September 2019

<b><i>Introduction:</i></b> To assess the influence of music therapy on perceived anxiety and pain during outpatient urodynamic study (UDS) in a prospective, randomized fashion. <b><i>Methods:</i></b> Between January and December 2018, a total of 70 patients were randomized to either have music therapy (study) or not have (control) in a 1:1 ratio. To the study group, Sufi music was delivered at low tempo. All participants performed the State-Trait Anxiety Inventory evaluation after the procedure and assessed their degree of pain, satisfaction, and willingness to undergo an additional or repeat procedure using the Visual Analog Scale. <b><i>Results:</i></b> Patient demographic and baseline characteristics were found to be similar between the 2 groups. Though music did not significantly alleviate pain (4.6 ± 1.2 vs. 4.4 ± 1.7; <i>p</i> = 0.76) and anxiety (47.7 ± 7.75 vs. 46.4 ± 6.5; <i>p</i> = 0.36), it had a positive impact on the patient’s willingness to repeat UDS (3.4 ± 1.4 vs. 6.1 ± 1.3; <i>p</i> = 0.005) and provided overall satisfaction (4.6 ± 0.61 vs. 7.2 ± 1.33; <i>p</i> = 0.004). <b><i>Conclusions:</i></b> Music is a practical, harmless, and inexpensive non-pharmacological option that can be adopted during medical and surgical procedures, although according to this present study, listening to music during UDS had no effect on pain and anxiety levels.
Correlation between Automated Bone Scan Index Change after Cabazitaxel and Survival among Men with Castration-Resistant Prostate Cancer
Authors: Miyoshi Yasuhide , Sakamoto Shinichi , Kawahara Takashi , Uemura Koichi , Yokomizo Yumiko , Uemura Hiroji 
Published: September 2019

<b><i>Background:</i></b> Automated bone scan index (aBSI) change (ΔBSI) after treatment and survival in men with prostate cancer remains unclear. We evaluated the correlation between ΔBSI after cabazitaxel and overall survival (OS) in men with bone metastatic castration-resistant prostate cancer (CRPC). <b><i>Methods:</i></b> We retrospectively enrolled 32 men with bone metastatic CRPC who had received cabazitaxel. The correlation between ΔBSI from baseline to 16 weeks after starting cabazitaxel and OS was analyzed by multivariate analysis. <b><i>Results:</i></b> Median age and time to CRPC were 70.7 years and 9.5 months, respectively. The median cycles of docetaxel before cabazitaxel were eight. Ten (31.2%) patients had visceral metastases at baseline. Median baseline prostate-specific antigen (PSA) was 123.0 ng/mL. The median aBSIs at baseline and 16 weeks after cabazitaxel were 3.2 and 4.4%, respectively. Improvements in aBSI and PSA after 16 weeks of cabazitaxel occurred in 7 (21.9%) and 12 patients (37.5%), respectively. There were no correlations between ΔBSI and OS (<i>p</i> = 0.55), but PSA change was significantly correlated with OS (<i>p</i> = 0.03) by multivariate analysis. <b><i>Conclusions:</i></b> This study demonstrated that ΔBSI from baseline to16 weeks after starting cabazitaxel was not correlated with OS among men with bone metastatic CRPC. Further prospective studies may be warranted to confirm the limited utility of aBSI in this setting.
A new species of Odontothrips (Thysanoptera, Thripidae) from Fars province, Iran
Authors: HAKIMARA MAHSA , MINAEI KAMBIZ 
Published: September 2019

Mound and Palmer (1981) included the following eight genera in Megalurothrips genus-group: Ceratothrips, Ceratothripoides, Craspedothrips, Lefroyothrips, Megalurothrips, Odontothripiella, Odontothrips, and Projectothrips. However, a series of shared morphological characters, as well as their shared host-plant association with members of the plant family Fabaceae, indicates that Megalurothrips, Odontothrips, and Odontothripiella are particularly closely related (Xie et al. 2010). The species of these three genera all have a pair of dorso-apical setae on the first antennal segment, a character state that distinguishes them from most Thripinae (Zhang et al. 2018). Of these, Odontothrips is the most species-rich genus with 34 species distributed in the Palaearctic (ThripsWiki 2019). In Iran only 5 species (O. confusus, O. iranensis, O. loti, O. meliloti, O. phlomidinus) have been recorded (Minaei 2017). Despite more than 60 years since O. phlomidinus was described from Iran, this species remains known only from the type series (Priesner 1954). In this paper, a new species of the genus is described from southern Iran that seems to be close to O. phlomidinus. Moreover, a provisional key is provided, based on females, for six species recorded from Iran. Authority names are available on the web (ThripsWiki 2019).
Does Insurance Status Impact Delivery of Care with Upper Airway Stimulation for OSA?
Authors: Patel Jena , Topf Michael C. , Huntley Colin , Boon Maurits 
Published: September 2019

Objective: To understand differences in patient demographics, insurance-related treatment delays, and average waiting times for Medicare and private insurance patients undergoing upper airway stimulation (UAS) for treatment of obstructive sleep apnea (OSA). Methods: Retrospective chart review of all Medicare and private insurance patients undergoing upper airway stimulation (UAS) from 2015 to 2018 at a single academic center. Primary outcomes were insurance-related procedure cancellation rate and time from drug induced sleep endoscopy (DISE) and UAS treatment recommendation to UAS surgery in Medicare versus private insurance patients. Results: In our cohort 207 underwent DISE and were recommended treatment with UAS. Forty-four patients with Medicare and 30 patients with private insurance underwent UAS procedure. Patients with Medicare undergoing UAS were older (67.4 ± 11.1 years) than patients with private insurance (54.9 ± 8.1 years). Medicare patients had a shorter mean wait time of 121.9 ± 75.8 days (range, 15-331 days) from the time of UAS treatment recommendation to UAS surgery when compared to patients with private insurance (201.3 ± 102.2 days; range, 33-477 days). Three patients with Medicare (6.4%) and 8 patients with private insurance (21.1%) were ultimately denied UAS. Conclusion: Medicare patients undergoing UAS have shorter waiting periods, fewer insurance-related treatment delays and may experience fewer procedure cancellations when compared to patients with private insurance. The investigational status of UAS by private insurance companies delays care for patients with OSA. Level of Evidence: 4