bluuebunny/crossref_metadata_2025_split huggingface dataset:
Foley catheter-assisted six-step thrombectomy technique in the surgical management of renal cell carcinoma with Mayo level II to IV tumor thrombus
Authors: Liu Zhuo , Tang Shiying , Tian Xiaojun , Zhang Shudong , Wang Guoliang , Zhang Hongxian , Ma Lulin 
Published: March 2019

Objective To simplify Foley catheter-assisted thrombectomy to a six-step approach and determine the feasibility and results of this technique for renal cell carcinoma (RCC) with a Mayo level II to IV tumor thrombus (TT). Methods The surgical records of patients with RCC with a Mayo level II to IV TT treated in our hospital were retrospectively reviewed. Fifteen patients who underwent radical nephrectomy and thrombectomy with a Foley catheter-assisted procedure were included. Epidemiological and clinicopathological features, operation-related variables, and outcomes were evaluated. Results The TTs in all 15 patients were successfully retracted by the Foley catheter. The mean operation time was 420.1 ± 108.9 minutes. The mean intraoperative blood loss and perioperative red blood cell transfusion volumes were 1846.7 ± 1467.8 and 1288.7 ± 1060.6 mL, respectively. Five patients had perioperative complications. The median follow-up time was 9 (range, 0–34) months, and four patients died of the disease. Conclusions Simplification of Foley catheter-assisted thrombectomy to a six-step approach results in the probability of avoiding thoracotomy or cardiopulmonary bypass to a certain degree and is associated with fewer complications, less blood loss, and less perioperative red blood cell transfusion. However, experienced surgeons and multidisciplinary cooperation are still needed.
Current understanding of cortical structure and function in migraine
Authors: Tolner Else A , Chen Shih-Pin , Eikermann-Haerter Katharina 
Published: March 2019

Objective To review and discuss the literature on the role of cortical structure and function in migraine. Discussion Structural and functional findings suggest that changes in cortical morphology and function contribute to migraine susceptibility by modulating dynamic interactions across cortical and subcortical networks. The involvement of the cortex in migraine is well established for the aura phase with the underlying phenomenon of cortical spreading depolarization, while increasing evidence suggests an important role for the cortex in perception of head pain and associated sensations. As part of trigeminovascular pain and sensory processing networks, cortical dysfunction is likely to also affect initiation of attacks. Conclusion Morphological and functional changes identified across cortical regions are likely to contribute to initiation, cyclic recurrence and chronification of migraine. Future studies are needed to address underlying mechanisms, including interactions between cortical and subcortical regions and effects of internal (e.g. genetics, gender) and external (e.g. sensory inputs, stress) modifying factors, as well as possible clinical and therapeutic implications.
Only 1 in 10 Patients Told to Lose Weight Seek Help From a Health Professional: A Nationally Representative Sample
Authors: de Heer Hendrik ‘Dirk’ , Kinslow Brian , Lane Taylor , Tuckman Ron , Warren Meghan 
Published: March 2019

Purpose: Receiving weight loss advice from a health-care provider has been associated with more weight loss efforts and greater odds of achieving weight loss. However, whether patients seek help from their provider or other health professional with weight loss after receiving advice from them to lose weight is largely unknown. Design: Cross-sectional data from the 2011 to 2012 National Health and Nutrition Examination Survey (NHANES). Sample: A total of 3862 overweight/obese adults. Measures: Questionnaires asked whether participants received advice to lose weight, and whether they sought health professional’s assistance with weight management. The NHANES 2011 to 2012 was the most recent year both questions were asked. Analysis: Accounting for NHANES sampling and design, frequency distributions characterized demographics and proportions. Logistic regressions estimated odds of seeking weight loss help by demographics. Results: Of 3682 overweight/obese adults, 1908 were told they were overweight or recommended to lose weight. Of 1908 people, 68% reported weight loss efforts, but only health 10.9% sought a health professional’s help (dietician/nutritionist 4.7%, personal trainer 3.0%, doctor 2.8%). Females, people with health insurance and high health-care utilization had 1.5 to 3.5 times greater odds of seeking help; age, ethnicity, and income were not significantly associated with seeking help with weight management. Conclusion: In a nationally representative sample, only 10.9% of overweight/obese adults told to lose weight by a provider sought help from a health professional with weight loss. This underscores the opportunity for greater health professional involvement with weight management beyond giving recommendations.
Anticancer effect of metformin against 2-amino-1-methyl-6-phenylimidazo [4,5-b]pyridine-induced rat mammary carcinogenesis is through AMPK pathway and modulation of oxidative stress markers
Authors: El-Sisi AE , Sokar SS , El-Sayad ME , Moussa EA , Salim EI 
Published: March 2019

Objectives: Metformin, the type 2 anti-diabetes medication, showed antitumor activity both in vivo and in vitro. This study was carried out to investigate the mechanisms behind the metformin anticancer effect against 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP)-induced mammary carcinogenesis in female Sprague-Dawley rats. Methods: Rats received 10 doses of PhIP (75 mg/kg, p.o., days 1–5 and 8–12). Then, rats were treated with metformin for 26 weeks at a dose of 2 mg/ml in drinking water. Key findings: Metformin antitumor effect was mediated by increasing the adenosine monophosphate protein kinase (AMPK) activity, liver kinase B1, and decreasing the aromatase and insulin levels compared with the PhIP-administered group. Also, this treatment resulted in a significant decrease in mammary tissue oxidative stress markers and serum lipid profile. In parallel, mammary gland tumors found in PhIP+metformin group were all histologically benign included only (hyperplasia). However, most of the mammary gland tumors found in PhIP group were histologically malignant. Conclusions: These results showed that metformin antitumor effect was mediated through AMPK pathway, reducing oxidative stress and serum lipid levels. This study supports the potential benefit of using metformin as adjuvant therapy during breast cancer treatment.
Bond–Equity Yield Ratio Market Timing in Emerging Markets
Authors: Dimic Nebojsa , Orlov Vitaly , Äijö Janne 
Published: March 2019

This article investigates the market timing ability of the bond–equity yield ratio (BEYR) from an international investor perspective. Consolidating data on emerging markets, we document no major international evidence that BEYR-based investing strategies, namely extreme values, thresholds and moving averages, provide higher risk-adjusted returns than benchmark buy-and-hold portfolios. However, we develop new augmented BEYR indicators by introducing the notion of US bonds as a safe investment relative to emerging market stocks and bonds. Dynamic strategies based on our augmented BEYR indicators produce significant gains in risk-adjusted returns compared with traditional BEYR and buy-and-hold benchmark strategies. JEL Classifications: G11, G12, G15
Do New Brooms Sweep Clean? Evidence that New CEOs Take a ‘Big Bath’ in the Banking Industry
Authors: Shen Chung-Hua , Wang Chien-An 
Published: March 2019

This study investigates whether significant changes exist in providing loan losses and loan charge-offs during turnovers of chief executive officers (CEOs). Providing loan losses is referred to as a ‘big bath in earnings’, and providing loan charge-offs is referred to as a ‘big bath in asset quality’. We classify CEO turnovers into three types, namely, forced and voluntary CEO turnovers in privately owned banks (POB), turnovers in government-owned banks (GOB) and turnovers as outcomes of mergers and acquisitions (M&As). Using findings based on the data of Taiwanese commercial banks, we demonstrate that the forcibly appointed CEOs exhibit big baths in earnings and asset quality, whereas the voluntarily appointed CEOs exhibit a big bath in earnings but not in asset quality. Compared with the CEO turnover in a POB, the appointed CEO in a GOB shows no big bath in either earnings or asset quality. Moreover, turnovers resulting from M&As do not induce big baths. JEL Classification: C23, G21, G28, M41, M48
Utilization of Palliative Care for Patients Undergoing Hematopoietic Stem Cell Transplantation During Hospitalization: A Population-Based National Study
Authors: Han Hedong , Liu Yuzhou , Qin Yuchen , Guo Wei , Ruan Yiming , Wu Cheng , Cao Yang , He Jia 
Published: March 2019

Objective: Patients undergoing hematopoietic stem cell transplantation (HSCT) have substantial physical and psychological symptoms. This study aimed to investigate the utilization of palliative care (PC) in patients undergoing HSCT during hospitalization. Methods: The 2008-2014 National Inpatient Sample was queried for eligible participants. Demographics, hospital characteristics, comorbidities, posttransplantation complications, and inpatient procedures were compared between patients with and without PC. Multivariate logistic regression was performed to identify predictors associated with PC use. Results: Among 21 458 patients undergoing HSCT during hospitalization, 278 (1.30%) received PC. The rate of PC use has significantly increased from 0.64% in 2008 to 1.95% in 2014. Patients receiving PC had more co-comorbidities, posttransplantation complications, inpatient procedures, and were more likely to carry a diagnosis of leukemia. In allogeneic HSCT, large bed size (odds ratio [OR] =2.80; 95% confidence interval [CI]: 1.17-6.70), stem cell source from cord blood (OR = 1.93; 95% CI: 1.15-3.24), and graft-versus-host disease (OR = 2.04; 95% CI: 1.36-3.06) were predictors of PC use. In a subset analysis of 783 patients who died during hospitalization, 166 (21.20%) received PC. Among the decedents, Hispanic race had lower odds of PC use (OR = 0.20; 95% CI: 0.05-0.82) in allogeneic HSCT and women had higher odds of PC (OR = 2.70; 95% CI: 1.35-5.41) in autologous HSCT. Conclusions: The rate of PC use has significantly increased among patients undergoing HSCT during hospitalization from 2008 to 2014 but still remains very low. Further investigation is warranted to verify and better understand the barriers toward PC use for HSCT patients.
Prevalence and Safety of Left-Footed Driving Following Right Foot Surgery Patients Including a Driving Simulation
Authors: McKissack Haley M. , Chodaba Yvonne E. , Bell Tyler R. , Lehtonen Eva J. , Araoye Ibukunoluwa B. , Shah Ashish B. , Stavrinos Despina , Johnson Michael D. 
Published: March 2019

Background: For many patients, returning to driving after right foot and ankle surgery is a concern, and it is not uncommon for patients to ask if driving may be performed with their left foot. A paucity of literature exists to guide physician recommendations for return to driving. The purpose of this study was to describe the driving habits of patients after right-sided foot surgery and assess the safety of left-footed driving using a driving simulator. Methods: Patients who underwent right foot or ankle operations between January 2015 and December 2015 were retrospectively identified. A survey assessing driving habits prior to surgery and during the recovery period was administered via a REDCap database through email or telephone. Additionally, simulated driving scenarios were conducted using a driving simulator in 20 volunteer subjects to compare characteristics of left- versus right-footed driving. Results: Thirty-six of 96 (37%) patients who responded to the survey reported driving with the left foot postoperatively. No trends were found associating left-footed driving prevalence and socioeconomic status. In driving simulations, patients exceeded the speed limit significantly more ( P < .001) and hit other vehicles more ( P < .026) when driving with the right foot than the left. The time to fully brake and fully release the throttle in response to vehicular hazards was significantly prolonged in left-footed driving compared with right ( P = .019 and P = .034, respectively). Conclusion: A significant proportion of right foot ankle surgery patients engaged in left-footed driving during postoperative recovery. Driving with both the right and left foot presents a risk of compromised safety. This study provides novel objective data regarding the potential risks of unipedal left-footed driving using a standard right-footed console, which indicates that driving with the left foot may prolong brake and throttle release times. Further studies are warranted for physicians to be able to appropriately advise patients about driving after foot and ankle surgery. Level of Evidence: Level IV, case series.
Cervical Cancer Protective Behavioral Patterns Among Mexican Women Living With HPV
Authors: Guerra Rodríguez Gloria Maricela , Champion Jane Dimmitt , Moreno Monsiváis María Guadalupe , Olivares Ornelas Octavio Augusto , Gil Vázquez Héctor Manuel 
Published: March 2019

Purpose: Human papillomavirus (HPV) causes morbidity and mortality worldwide. Evidence-based models addressing health for women who have HPV may prevent development of cervical cancer (CC). We applied Meleis’ transition model to identify barriers and facilitators influencing CC protective behavior for women with HPV. Method: Descriptive, correlational design including nonprobabilistic sampling of women with HPV ( N = 201) in Mexico. Results: Variables linked to CC protective behavior (cervical cytology, stable partner, condom use, communication) included awareness of HPV/CC as well as attitude toward diagnosis and cytological control of HPV (λ = 890, F[196.00] = 6.057, p = .001). Acceptance of HPV diagnosis related to HPV carrier attitude, stigma, age, education, and length of HPV diagnosis ( R2 = .155 , F[5, 195] = 8.34, p < .05). Knowledge of HPV, attitude toward HPV diagnosis/cytological control, and age had direct effects on self-efficacy for CC protective behavior ( R2 = .239, F[7, 193] = 9.95, p < .05). Coping with HPV diagnosis, self-efficacy for CC protective behavior, and age were also associated with CC protective behavior ( R2 = 14.6, F[3.7] = 12.39, p = .001). Conclusions: Identification of factors inhibiting or facilitating transition among women who have HPV decrease progression to CC by increasing CC protective behaviors.
Motivational Interviewing and Home Visits to Improve Health Behaviors and Reduce Childhood Obesity: A Pilot Study
Authors: Early Gayle J. , Cheffer Natalie D. 
Published: March 2019

Introduction: Childhood obesity prevalence is highest among low-income, Hispanic, and Black children. The purpose of this study was to examine the feasibility of using motivational interviewing (MI) with home visits and the 5-2-1-0 Let’s Go! program to improve health behaviors in children. Desirable health behaviors include daily consuming five servings of fruits or vegetables, limiting recreational screen time to 2 hours, exercising for 1 hour, and avoiding sugar-sweetened beverages. Method: Of 68 predominantly Hispanic/Latino participants from three clinic sites, 35 completed the study. One site provided usual care (UC). MI was conducted by a nurse practitioner, reinforced with home or clinic visits. Survey and biometric data were obtained three times over 6 months. Analyses included mean difference of behaviors, and matched pairs t test of initial and final visit behaviors. Results: Health behavior trends improved in both the MI and UC groups; however, more improvement was evident in the MI group. Home visits were appreciated but challenging as the social context of immigration law in 2017 had an unanticipated effect on the study. Conclusions: MI and clinician reinforcement of healthy behaviors may be beneficial for children and families. Home visits cannot be recommended in the undocumented immigrant population at this time.
Radiomics: a novel feature extraction method for brain neuron degeneration disease using 18F-FDG PET imaging and its implementation for Alzheimer’s disease and mild cognitive impairment
Authors: Li Yupeng , Jiang Jiehui , Lu Jiaying , Jiang Juanjuan , Zhang Huiwei , Zuo Chuantao 
Published: March 2019

Background: Alzheimer’s disease (AD) is the most common form of progressive and irreversible dementia, and accurate diagnosis of AD at its prodromal stage is clinically important. Currently, computer-aided diagnosis of AD and mild cognitive impairment (MCI) using 18F-fluorodeoxy-glucose positron emission tomography (18F-FDG PET) imaging is usually based on low-level imaging features or deep learning methods, which have difficulties in achieving sufficient classification accuracy or lack clinical significance. This research therefore aimed to implement a new feature extraction method known as radiomics, to improve the classification accuracy and discover high-order features that can reveal pathological information. Methods: In this study, 18F-FDG PET and clinical assessments were collected in a cohort of 422 individuals [including 130 with AD, 130 with MCI, and 162 healthy controls (HCs)] from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and 44 individuals (including 22 with AD, and 22 HCs) from Huashan Hospital, Shanghai, China. First, we performed a group comparison using a two-sample Student’s t test to determine the regions of interest (ROIs) based on 30 AD patients and 30 HCs from ADNI cohorts. Second, based on two time scans of 32 HCs from ADNI cohorts, we used Cronbach’s alpha coefficient for radiomic feature stability analyses. Pearson’s correlation coefficients were regarded as a feature selection criterion, to select effective features associated with the clinical cognitive scale [clinical dementia rating scale in its sum of boxes (CDRSB); Alzheimer’s disease assessment scale (ADAS)] with 500-times cross-validation. Finally, a support vector machine (SVM) was used to test the ability of the radiomic features to classify HCs, MCI and AD patients. Results: As a result, we identified brain regions which were mainly distributed in the temporal, occipital and frontal areas as ROIs. A total of 168 radiomic features of AD were stable (alpha > 0.8). The classification experiment led to maximal accuracies of 91.5%, 83.1% and 85.9% for classifying AD versus HC, MCI versus HCs and AD versus MCI. Conclusion: The research in this paper proved that the novel approach based on high-order radiomic features extracted from 18F-FDG PET brain images that can be used for AD and MCI computer-aided diagnosis.
FAI SURGERY IN THE ADOLESCENT POPULATION: MILD DEFORMITIES AND LACK OF SPORTS PARTICIPATION ARE ASSOCIATED WITH AN INCREASED RISK OF TREATMENT FAILURE
Authors: Nepple Jeffrey J. , Yen Yi-Meng , Zaltz Ira , Podeszwa David , Sink Ernest L. , Kim Young-jo , Sucato Dan , Group Anchor , Clohisy John 
Published: March 2019

Background: Femoroacetabular impingement (FAI) is as prevalent in adolescents as in adults, yet few studies have analyzed treatment outcomes in the adolescent population. The purpose of this study was to determine the clinical outcomes of FAI surgery in adolescent patients and to identify predictors of treatment failure. Methods: A cohort of 126 adolescent patients (<18 years) undergoing surgery for symptomatic FAI were prospectively assessed among a larger multicenter cohort. The adolescent subgroup included 74 (58.7%) males and 52 (41.3%) females, had a mean age of 16.1 years (range 11.3-18.0), and a mean follow-up of 3.7 years. Mild cam FAI was defined by an alpha angle less than 55 degrees. Clinical outcomes were analyzed with the mHHS, HOOS (5 domains), and UCLA activity score. Failure was defined as revision surgery or clinical failure (failure to reach MCID (minimally clinically important difference) or PASS (patient acceptable symptoms state) for modified Harris Hip score. Statistical analysis was performed to identify factors significantly associated with failure. Results: There was clinically important improvement in all PROs (mHHS, all HOOS domains) for the overall cohort and 81% of patients met criteria for a successful outcome. The failure rate (revision surgery or clinical failure) of the overall cohort was 19%, including revision surgery in 8.7%. Female patients were significantly more likely than male patients to be classified as a failure (25.7% vs. 9.1%, p=0.017, OR 2.6), in part because of a lower preoperative mHHS (59.1 vs. 67.0, p<0.001). Mild cam FAI (alpha less than 55 degrees) was present in 31.5% of cases including 39.1% of females and 14.5% of males. Maximal alpha angle was significantly inversely associated with the failure rate (37.5% for alpha<55, 19.2% for alpha 55-63, and 6.8% for alpha>63, p<0.005). Non-athletes were at a significantly greater risk of failure compared to athletes (26.5% vs. 10.3%, p=0.043, OR 2.3). Multivariable logistic regression identified mild cam FAI and lack of participation in sports as predictive of failure (p=0.005 and p=0.04), while gender was no longer significantly associated with failure after controlling for other variables. Conclusions: Adolescent patients undergoing surgical treatment of FAI demonstrate significant improvement at early followup. However, mild cam FAI deformities (which are common in adolescent female patients) and lack of participation in sports are independently associated with higher rates of treatment failure. These factors associated with treatment failure should be considered in surgical treatment decision-making and patient counseling.