bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Influencing the Uptake of Canadian Research Findings into the Care of Children with Arthritis: A Healthcare Provider Perspective
Authors: Rose-Davis Benjamin , Curran Janet , Wright Julia , Cellucci Tania , Duffy Ciarån M. , Tucker Lori B. , Batthish Michelle , Huber Adam M. , Lang Bianca , Levy Deborah M. , Rumsey Dax G. , Watanabe Duffy Karen N. , Stringer Elizabeth 
Published: November 2018

Objective.To determine barriers and facilitators to the uptake of findings from the Research in Arthritis in Canadian Children emphasizing Outcomes (ReACCh-Out) study into clinical care by pediatric rheumatologists (PR) and allied health professionals (AHP) caring for children with juvenile idiopathic arthritis (JIA) in Canada.Methods.PR and AHP participated in this qualitative study through telephone interviews. Interview guides were developed using the Theoretical Domains Framework and focused on the use of information from the ReACCh-Out study in the practice of counseling patients and families. A directed content analysis approach was used for coding.Results.Nineteen interviews (8 PR and 11 AHP) were completed. All PR had knowledge of the ReACCh-Out study. Three major themes were identified: (1) both groups are motivated to use information from research in clinical care; (2) volume and emotional effect of information on families are barriers; and (3) specific timepoints in care trigger providing this information. AHP had less knowledge of the ReACCh-Out study, did not feel it was their primary role to provide this information, and have a desire for more opportunity to participate in academic forums related to research.Conclusion.We have described a comprehensive overview of the barriers and facilitators perceived by healthcare providers in the translation of knowledge from JIA research into use in clinical practice. These findings provide a foundation for the development of knowledge translation strategies in the care of children with JIA and other rheumatic diseases.
Comparison of Conventional and Advanced Echocardiographic Techniques in Early Detection of Cardiotoxicity in Patients Undergoing Cancer Chemotherapy
Authors: Pradeep HN , Rupesh George , Anil Thazhath J , Geethu Krishnan , Jayakumar TG , Abdul S Khadar 
Published: November 2018

Abstract
Context: The assessment of left ventricular ejection fraction (LVEF) is the most important component in prediction and detection of cardiotoxicity in patients undergoing cancer chemotherapy. LVEF may not be sensitive enough to pick the cardiotoxicity early since drop in LVEF occurs in the last and irreversible stage. A 10%–15% early reduction in global longitudinal strain (GLS) by speckle tracking echocardiography proposed to be the earliest indicator of myocardial dysfunction. Aims: The aim of this study was to compare the early detection of cardiotoxicity (at 0 and 3 months) using drop in LVEF with two-dimensional echocardiography (2DE), three-dimensional echocardiography (3DE), and GLS techniques. Settings and Design: This was a prospective cohort study of patients attending cardiooncology clinic in a tertiary care institute. Subjects and Methods: Newly diagnosed 75 cases of cancer of various etiologies, for whom cardiotoxic chemotherapy drugs has to be used, were included from January 2016 to June 2016. Statistical Analysis Used: Data were analyzed with Pearson’s Chi-square test, mean, standard deviation, and 95% confidence interval. Results: A total of 17 (22.6%) subjects out of 75, had drop in LVEF by GLS (<−18.9%) as compared to 5 (6.6%) in 2DE and 7 (9.3%) in 3DE at 3 months with statistically significant P values (P = 0.0001). In the 17 subjects who had significant fall in GLS at 3 months, the mean GLS was −16.17 ± 1.55% with a significant reduction of 13.48% from baseline. Conclusion: Reduction in GLS preceded decrease in ejection fraction. Early detection allows modification of chemotherapeutic regimens and medical intervention preventing the irreversible cardiac damage.
Adrenocortical Carcinoma: A Rare Tumor in a 12-year-old Girl
Authors: Parelkar Sandesh V , Kulkarni Dwarkanath V , Sanghvi Beejal V , Tiwari Pooja , Mudkhedkar Kedar P , Mhaskar Satej S , Shah Rujuta Mane , Sonali S , Ilakkiya Kavimozhy 
Published: November 2018

AbstractA 12-year-old girl presented with intra-abdominal mass and cushingoid features. On investigation, she was diagnosed as a case of functioning adrenocortical carcinoma. Two cycles of neoadjuvant chemotherapy followed by excision of mass with right nephrectomy was performed. On 6-month follow-up, recurrence and metastasis were identified which were managed with surgery and chemotherapy.
Compliance of Cigarettes and Other Tobacco Products Act among Tobacco Vendors, Educational Institutions, and Public Places in Bengaluru City
Authors: Khargekar Naveen Chandrahas , Debnath Arpan , Khargekar Nitin Ravindra , Shetty Punith , Khargekar Vandana 
Published: November 2018

AbstractBackground: Tobacco has been the arch criminal of most head-and-neck cancers in the world. Many laws have been implemented to control this menace, but still this slow poison persists. Effectiveness of these laws has always been a matter of concern to the authorities. The present study was conducted to observe the compliance of Cigarettes and Other Tobacco Products Act (COTPA) among public places, educational institutions, and tobacco vendors in Bengaluru city. Methodology: A cross-sectional, observational study was done to assess the violations at public places, educational institutions, and tobacco vendors. Violations for Sections 4, 5, 6, and 7 of COTPA were assessed from 25 each of these places in the eight zones of Bengaluru city. The study areas were chosen by convenience sampling method, and using a questionnaire, the violations were recorded. Data were analyzed in Microsoft Excel to find out the percentage of violations. Results: The COTPA Sections 4 and 5 violation was 134 (67%) and 94 (47%), respectively. A total of 124 (62%) of the educational institutions had tobacco vendors within 100 yards, and only 30 (15%) had signboard for the prohibition of tobacco use. Around 14 tobacco vendors had beedis without proper pictorial warning with them which violated Section 7 of COTPA. Conclusion: For proper implementation of COTPA laws, we should create awareness about the laws, what amounts to violations and also the health hazards to tobacco use among general population. The law enforcing personnel should act on those who violate the law. There is a need for a sensitization workshop and advocacy for all the stakeholders.
Tyrosine Kinase Inhibitor versus Physician Choice Chemotherapy in Second-Line Epidermal Growth Factor Receptor Mutation Non-Small Cell Lung Cancer: Post hoc Analysis of Randomized Control Trial
Authors: Noronha Vanita , Pandey Avinash , Patil Vijay , Joshi Amit , Choughule Anuradha Bharat , Bhattacharjee Atanu , Kumar Rajiv , Goud Supriya , More Sucheta , Ramaswamy Anant , Karpe Ashay , Pande Nikhil , Chandrasekharan Arun , Goel Alok , Talreja Vikas , Mahajan Abhishek , Janu Amit , Purandare Nilendu , Prabhash Kumar 
Published: November 2018

Abstract
Background: There is a paucity of prospective data for patients who progressed after first-line tyrosine kinase inhibitor (TKI) or pemetrexed doublet among epidermal growth factor receptor (EGFR) mutation-positive metastatic non-small cell lung cancer (NSCLC). Aim: The aim of the study was to evaluate the outcome of second-line therapy in patients who progressed on TKI or pemetrexed doublet in EGFR mutation-positive NSCLC. Objective: The objective of the study was to calculate response rates, progression-free survival (PFS), and overall survival (OS) of patients receiving second-line therapy in EGFR mutation NSCLC. Materials and Methods: Post hoc analysis of second-line therapy among patients enrolled in randomized control trial comparing TKI versus pemetrexed doublet in EGFR mutation NSCLC. Kaplan–Meir statistics were used for PFS and OS. Impact of variables was measured with Log-rank test. Results: One hundred and eighty-seven patients who progressed on first-line therapy and received second-line agents were analyzed. Male:female: 110 (56.3%):77 (41.2%). One hundred and thirteen patients received gefitinib, while 74 received chemotherapy. Response rate (complete response + partial response) was 53% versus 24% in gefitinib versus chemotherapy group (RECIST v1.1). PFS was 7.4 months versus 4.4 months (P = 0.001), while OS was 14 months versus 9.7 months (P = 0.007), in gefitinib versus chemotherapy group, respectively. Response to TKI significantly improves PFS (10.8 months vs. 3.9 months, P = 0.001) and OS (21.4 months vs. 8.9 months, P = 0.03). Rash, pruritus, dry skin, fatigue, diarrhea, and paronychia were common toxicities of TKI. Conclusion: Second-line TKI improves outcome in EGFR mutation-positive NSCLC who progressed after first-line chemotherapy. Response to therapy, whether with TKI or chemotherapy, favorably impacts outcomes.
Undifferentiated Carcinoma of the Uterine Cervix with Evidence of Its Origin from Small-Cell Neuroendocrine Carcinoma
Authors: Muthusamy Rajeshwari K , Mehta Sangita S 
Published: November 2018

AbstractNeuroendocrine carcinoma (NEC) of the uterine cervix is an uncommon aggressive tumor, comprises <5% of the cervical malignancies. Undifferentiated carcinoma of the cervix, described by the World Health Organization Classification of Tumors as a distinct entity, is extremely rare with no histologic evidence of differentiation. Immunohistochemistry with p63 and neuroendocrine markers helps in delineating the type as undifferentiated squamous cell carcinoma or NEC. NEC of the uterine cervix behaves biologically like any other cervical malignancy, has an association with human papillomavirus, and is similar to NEC of any possible site with early metastasis and poorer survival. We present a case of 45-year-old premenopausal female with undifferentiated carcinoma of the uterine cervix originating from small-cell NEC proven by the presence of differentiated component in the proximity of undifferentiated tumor and by the immunohistochemistry.
Lower Intestinal Langerhans Cell Histiocytosis Masquerading as Chronic Malabsorption Syndrome and Failure to Thrive in a Child: A Rare Case Presented with a Succinct Review of Recent Literature
Authors: Suryawanshi Mayur Keshav , Vig Tanush , Masih Dipti , Joseph Reny 
Published: November 2018

AbstractLangerhans cell histiocytosis (LCH) encompasses a group of disorders characterized by neoplastic proliferation of Langerhans cells causing destruction of tissue, morbidity and mortality. The authors bring forth the case of a 2-year-old child presenting with chronic diarrhea and features of chronic malabsorption that revealed lesions over the ileocolonic mucosa. Histopathological examination with immunohistochemical expression for CD1a confirmed the diagnosis of LCH. Gastrointestinal LCH is quite uncommon, and review of the published English literature revealed about 50 reported cases. The importance of diagnosing this disease is echoed by the grim survival rate of 18 months from the time of diagnosis that is seen in around 60% of cases. Owing to its rarity and unfamiliarity of practicing physicians and pathologists of this disease at this site, the authors wish to discuss the potential pitfalls and differential diagnoses.
Weekly versus Tri-weekly Cisplatin Concurrent with Radiotherapy in the Treatment of Locally Advanced Carcinoma Cervix: A Prospective Study
Authors: Sandeep Bhaskar , Sandeep Jain , Kartick Rastogi , Aseem-Rai Bhatnagar , Neeraj Sharma 
Published: November 2018

Abstract
Context: Different schedules of concurrent chemotherapy with definitive radiotherapy in locally advanced carcinoma cervix. Aims: The aim is to evaluate toxicity, compliance, and response of weekly versus tri-weekly cisplatin given concurrently with radiotherapy in locally advanced squamous cell carcinoma cervix. Subjects and Methods: One hundred and ten newly diagnosed histopathologically confirmed squamous cell carcinoma cervix patients with International Federation of Gynecologists and Oncologists stage IIB to IVA were randomly distributed among study group receiving 75 mg/m2 of cisplatin every 3 weeks for three cycles and control group receiving 40 mg/m2 of weekly cisplatin for six cycles. Results: Patients in both the arms tolerated treatment well. At the time of completion of chemoradiotherapy, 83.63% of patients of the study group and 80% of the control group had a complete response whereas 16.37% of study and 20% of the control group had a partial response, both statistically insignificant (P > 0.05). Compliance was similar in both the groups. The average time to complete radiotherapy was 54.63 days in the study group and 51.34 days in the control group. In the study group, 87.27% of patients completed all cycles of tri-weekly chemotherapy, whereas, in control group, 80% completed all 6 cycles of weekly chemotherapy. The difference was not statistically significant (P = 0.30). Toxicity in terms of vomiting, grade 3–4 leukopenia and neutropenia were more in the study group which was statistically significant (P < 0.001, P = 0.04, and P = 0.03, respectively). Conclusions: Although the 3-weekly cisplatin schedule has longer intervals and sounds convenient, the weekly cisplatin regime shows lower hematologic toxicity with similar disease response and compliance.
Utility of Magnetic Resonance Imaging Brain Epilepsy Protocol in New-Onset Seizures: How is it Different in Developing Countries?
Authors: Ponnatapura Janardhana , Vemanna Suresh , Ballal Sandeep , Singla Avisha 
Published: November 2018

Introduction:
Magnetic resonance imaging (MRI) is the current imaging tool of choice in the investigation of patients with seizures. The advent of high-resolution MRI with a dedicated seizure protocol has significantly increased the chances of identifying a cause, resulting in a positive clinical impact on the management of these patients.

Aims:
The aims of this study were to evaluate the diagnostic efficacy of standard MRI, identify whether there is an increase in the diagnostic yield with the addition of dedicated seizure protocol, and compare the diagnostic yields of MRI and electroencephalogram (EEG) individually and in combination.

Subjects and Methods:
This is a prospective study of 129 consecutive patients who presented with new-onset seizures over an 18-month period. The MRI scans performed on 1.5T were reviewed for their diagnostic yield and their association with abnormal electrical activity on EEG. Chi-square test of significance (P < 0.05) was used to test for the difference in proportion. The correlation between MRI brain and EEG was studied using McNemer test.

Results:
MRI detected potentially epileptogenic lesions in 59 patients (47%). The frequency of epileptogenic lesions was highest in patients who had focal-onset seizures (81%). The most common lesion type was infection and inflammation (28%), with neurocysticercosis being the most common, followed by mesial temporal sclerosis, ischemia, and tumor. About 37% of epileptogenic lesions were missed by standard protocol, which were detected on a dedicated seizure protocol MRI. The diagnostic yield of EEG was 31%. Abnormal MRI and EEG were concordant in 18% of patients, with EEG being normal in 37% of patients with epileptogenic lesions.

Conclusions:
MRI detects epileptogenic lesions in almost one half who presented with new-onset seizures and of these, more than third of them were detected using a “dedicated seizure protocol.” While almost 50% with seizures will have a cause identified on MRI, the sensitivity can be substantially improved by utilizing a dedicated seizure protocol.
Comparative Performances of Dipyridamole and Regadenoson to Detect Myocardial Ischemia using Cardiac Cadmium-Zinc-Telluride Single-Photon Emission Computerized Tomography
Authors: Ben Bouallègue Fayçal , Nganoa Catherine , Vigne Jonathan , Agostini Denis , Manrique Alain 
Published: November 2018

Objective:
We evaluated the relative performances of dipyridamole (Dip) and regadenoson (Reg) in a cohort of patients referred for coronary artery disease diagnosis or follow-up using myocardial perfusion imaging.

Materials and Methods:
We retrospectively included 515 consecutive patients referred for 99mTc-sestamibi myocardial perfusion single-photon emission computerized tomography (SPECT) on a cadmium-zinc-telluride (CZT) camera after pharmacologic stress. About three quarters (n = 391, 76%) received Dip. Reg was administrated to patients with chronical respiratory disease or with body mass index (BMI) over 38 kg/m2 (n = 124, 24%). Patients with an abnormal stress scan (92%) underwent a rest imaging on the same day. Qualitative interpretation of perfusion images was achieved using QPS software, and the ischemic area was assessed using the 17-segment model. In patients undergoing a stress-rest protocol, perfusion polar plots were postprocessed using automated in-house software to quantify the extension, intensity, and location of the reversible perfusion defect. Statistical comparison between groups was performed using univariate and multivariate analysis.

Results:
Qualitative analysis concluded to myocardial ischemia in 70% of the patients (69% in the Dip group, 76% in the Reg group, P = ns). In those patients, the number of involved segments (Dip 2.5 ± 1.6, Reg 2.7 ± 1.6, P = ns) and the proportion of patients with an ischemic area larger than two segments (Dip 30%, Reg 37%, P = ns) were comparable. Automated quantification of the reversible perfusion defect demonstrated similar defect extension, intensity, and severity in the two groups. Defect location was identical at the myocardial segment and vascular territory scales.

Conclusions:
Reg and Dip showed equal performances for ischemic burden characterization using myocardial CZT SPECT.
Interventions for Distal Radius Fractures: A Network Meta-analysis of Randomized Trials
Authors: Vannabouathong Christopher , Hussain Nasir , Guerra-Farfan Ernesto , Bhandari Mohit 
Published: November 2018

Introduction:
The distal radius is the second most commonly fractured bone in the elderly population. Several approaches for management exist including both surgical and nonsurgical treatments. Evidence for alternative approaches remains inconclusive and often conflicting.

Methods:
Electronic database searches were conducted to identify randomized trials that (1) enrolled adults with a distal radius fracture; (2) compared external fixation, intramedullary nailing, K-wires, plaster casting (PC), or plate fixation (PF) to one of the other treatments listed; and (3) reported on a functional outcome that categorized patients as “excellent” and “good” or reported fracture healing complication (loss of reduction, malunion, delayed union, nonunion, and refracture). Data were synthesized using a Bayesian network meta-analysis. Odds ratios (ORs) with 95% credible intervals (CrIs) using a random-effects model were calculated.

Results:
Thirty-eight trials were included. Total sample sizes ranged from 30 to 461 patients. Although no differences were noted between treatments at 3 months, PF was ranked the highest for improving functional outcomes at 6 and 12 months, and it demonstrated a statistically significant difference compared with PC at 12 months (OR = 4.27; 95% CrI, 1.07 to 15.12). For reduction in fracture healing complications, PF was ranked the highest again, showing significantly more favorable results relative to the four other interventions: OR = 0.25 (95% CrI, 0.07 to 0.86) versus external fixation, OR = 0.09 (95% CrI, 0.02 to 0.36) versus K-wire, OR = 0.01 (95% CrI, 0.00 to 0.03) versus PC, and OR = 0.00 (95% CrI, 0.00 to 0.35) versus intramedullary nailing.

Conclusions:
A network meta-analysis of randomized trials revealed that open reduction and internal fixation with a plate offers the best results for adult patients with a distal radius fracture, in terms of early and sustained functional recovery and a reduction in fracture healing complications. Determining whether one approach to PF or plate design is superior requires further study.
2018/27 Citizen’s rights after Brexit: no preliminary questions to the ECJ (NL)
Authors: Vos Jan-Pieter 
Published: November 2018

2018/27 Citizen’s rights after Brexit: no preliminary questions to the ECJ (NL)
The Amsterdam Court of First Instance had contemplated asking certain preliminary questions to the ECJ about the EU rights of UK citizens residing outside the UK (see EELC 2018/18), but the Court of Appeal has now refused this, considering the underlying claims to be too vague.
Variation Simulation and Diagnosis Model of Compliant Block Assembly Considering Welding Deformation
Authors: Lee Junghyun , Choi Wooyoung , Kang Minseok , Chung Hyun 
Published: November 2018

This article proposes a variation simulation and diagnosis model for ship block assembly processes considering the effects of welding distortion. The welding process and the deformation pattern affecting the final shape of a block assembly are diagnosed. Prior studies on welding distortion mainly focused on mitigation methodologies. In this research, welding distortion is regarded as the main cause of geometric variation in parts. In addition, how geometric variations are accumulated throughout multiple assembly processes is mathematically modeled. The variation simulation model is based on a state space equation, where variations of previous stages are propagated to the current stage. The diagnosis model predicts the quantitative effect of each variation source on the final assembly's geometrical variation, based on a normal equation and designated component analysis. The proposed model is simulated with FEM (Dassault Systèmes Americas Corp., Waltham, MA) and MATLAB (Mathworks (https://www.mathworks.com/), Massachusetts, United States) replicating a realistic block assembly process for validation. The model can effectively simulate the propagation of welding distortion and quantitatively diagnose variation patterns and welding processes.

1. Introduction
Analysis, management, and variation diagnostics are some of the important aspects of the production process. These have been mainly studied in mass production processes such as in the automobile industry. Mantripragada and Whitney (1999) and Whitney (2004) proposed a tolerance analysis method for the multistage rigid body assembly using a state space equation. Huang et al. (2006a, 2007) proposed a ship block tolerance model for the single and multiple stage variation propagation of a rigid body model. Liu and Hu (1995,1997) proposed a compliant assembly model using FEM, called the method of influence coefficients (MIC). Govik et al. (2012) proved MIC using an FEM simulation. Variation propagation in a multiple stage process while considering a compliant assembly has been proposed by Camelio et al. (2003, 2002a). Variation propagation models considering the location of data such as in key control characteristics, key product characteristics, and a local coordinate system of parts were proposed by Qu et al. (2016).