bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of Inactivated Influenza Vaccine in Cancer Patients Receiving Immune Checkpoint Inhibitors
Authors: Chong Curtis R , Park Vivian J , Cohen Bevin , Postow Michael A , Wolchok Jedd D , Kamboj Mini 
Published: March 2019

Abstract

Background
Cancer patients are at a higher risk for developing influenza (flu)– related complications. It is unclear if the flu vaccine exacerbates immune events in patients treated with immune checkpoint inhibitors (ICIs).

Methods
We conducted an institutional review board–IRB-approved retrospective review of advanced cancer patients on ICIs who received the flu vaccine during three 3 consecutive seasons: 2014–2015, 2015–2016, and 2016–2017. The primary outcome assessed was any “new onset” immune-related adverse event (IRAE). A subset analysis of vaccinated patients newly treated with anti–programmed cell death protein 1 (PD-1) agents (nivolumab or pembrolizumab) was conducted to assess overall IRAE rates for comparison with published clinical trials.

Results
During the three 3 seasons, 370 patients met criteria for ICI and vaccination within ~ twoapproximately 2 months (65 days). The most common underlying cancers were lung (46%) and melanoma (19%); 61% of patients received an anti–PD-1 agent only. In the entire cohort, 20% experienced an IRAE (any grade); incidence of grade 3 or 4 toxicity was 8%. No grade 5 events occurred. In the subset of 170 patients newly treated with anti–PD-1 agents, the overall IRAE rate was 18% and, grade 3/4 events occurred in 7.6%. Influenza was diagnosed in 2 patients.

Conclusions
No increase in incidence or severity of IRAEs was detected in patients on ICIs who received the inactivated influenza vaccine within ~ approximately 2 months of ICI. For newly treated patients on anti–PDI-1 agents, IRAE rates were comparable to those from published clinical trials and did not vary with order of administration. Routine seasonal flu vaccination is encouraged in patients on ICIs.
Mortality and morbidity reduction after frequent premature ventricular complexes ablation in patients with left ventricular systolic dysfunction
Authors: Berruezo Antonio , Penela Diego , Jáuregui Beatriz , Soto-Iglesias David , Aguinaga Luis , Ordóñez Augusto , Fernández-Armenta Juan , Martínez Mikel , Tercedor Luis , Bisbal Felipe , Acosta Juan , Martí-Almor Julio , Aceña Marta , Anguera Ignasi , Rossi Luca , Linhart Markus , Borràs Roger , Doltra Adelina , Sánchez Paula , Ortiz-Pérez José T , Perea Rosario J , Prat-González Susana , Teres Cheryl , Bosch Xavier 
Published: March 2019

Aims
Ablation of frequent premature ventricular complexes (PVCs) improves left ventricular ejection fraction in patients with left ventricular (LV) systolic dysfunction. This study aims to evaluate the long-term hard outcomes and potential prognostic variables in this population.

Methods and results
Prospective multicentre study including 101 consecutive patients [56 ± 12 years old, 62 (61%) men] with LV systolic dysfunction and frequent PVCs who underwent PVC ablation before November 2015. The last evaluation performed was considered the long-term follow-up (LTFUP) evaluation. Mean follow-up was 34 ± 16 months (range 24–84 months). Ablation was successful in 95 (94%) patients. There was a significant reduction in the PVC burden from 21 ± 12% at baseline to 3.8 ± 6% at LTFUP, P < 0.001. Left ventricular ejection fraction improved from 32 ± 8% at baseline to 39 ± 12% at LTFUP (P < 0.001) and New York Heart Association class from 2.2 ± 0.6% to 1.3 ± 0.6% (P < 0.001). Brain natriuretic peptide levels decreased from 136 (78–321) to 68 (32–144) pg/mL (P = 0.007). Most of this improvement occurs during the first 6 months after ablation. Persistent abolition of at least 18 points of the baseline PVC burden was independently and inversely associated with the composite endpoint of cardiac mortality, cardiac transplantation, or hospitalization for heart failure during follow-up [hazard ratio 0.18 (0.05–0.66), P = 0.01].

Conclusion
In patients with LV systolic dysfunction, ablation of frequent PVCs induces a significant improvement in functional, structural, and neurohormonal status, which persists at LTFUP. A sustained reduction in the baseline PVC burden is associated with a lower risk of cardiac mortality, cardiac transplantation, or hospitalization for heart failure during follow-up.
Does the Flemish colorectal cancer screening programme reach equity in FIT uptake?
Authors: Hoeck S , van de Veerdonk W , De Brabander I , Kellen E 
Published: March 2019

Abstract

Background
To investigate colorectal cancer (CRC) screening rates by the faecal immunochemical test (FIT) according to sociodemographic characteristics and nationality.

Methods
Men and women, aged 56–74, invited to participate in the Flemish CRC screening programme in 2013 and 2014 were included in this study. We analysed the association between CRC screening uptake and sex, age, (first and current) nationality and several proxies for socio-economic status (SES). The statistical analysis was based on descriptive analyses and logistic regression models.

Results
A total of 1 184 426 persons were included in our analysis. The overall screening uptake was 52.3%, uptake varied by sex, age, nationality and SES. Lower participation rates were associated with the youngest and oldest age categories (56–60 and 70–74) and being male. All nationalities other than Belgian or Dutch were significantly less screened. Lower uptake of screening was also associated with several proxy’s for low SES, such as having an allowance for being disabled, not being able to work, being an extended minor and having a social allowance/minimum wage. The descriptive analysis showed a 27% difference in CRC screening uptake between the (early) retired and the people entitled to a minimum wage.

Conclusions
There is a significant difference between screening uptake and demographic and socio-economic variables in the first 2 years of the population-based screening programme in Flanders. Based on the study results, implementing strategies to improve participation in those subgroups is needed.
Increasing Rates of Opioid Misuse Among Older Adults Visiting Emergency Departments
Authors: Carter Mary W , Yang Bo Kyum , Davenport Marsha , Kabel Allison 
Published: March 2019

Abstract

Objective
This study sought to investigate factors associated with opioid misuse-related emergency department (ED) visits among older adults and changes in outcomes associated with these visits, using multiple years of nationally representative data.

Methods
A retrospective analysis of the Nationwide Emergency Department Sample was conducted. Study inclusion was limited to adults aged 65 years and older. Diagnostic codes were used to identify opioid misuse disorder; sampling weights were used to adjust standard estimates of the errors. Descriptive and multivariate procedures were used to describe risk and visit outcomes.

Results
ED visits by older adults with opioid misuse identified in the ED increased sharply from 2006 to 2014, representing a nearly 220% increase over the study period. Opioid misuse was associated with an increased number of chronic conditions, greater injury risk, and higher rates of alcohol dependence and mental health diagnoses.

Conclusion
The steep increase in opioid misuse observed among older adult ED visits underscores the critical need for additional research to better understand the national scope and impact of opioid misuse on older adults, as well as to better inform policy responses to meet the needs of this particular age group.
Joint inversion of gravity with cosmic ray muon data at a well-characterized site for shallow subsurface density prediction
Authors: Cosburn Katherine , Roy Mousumi , Guardincerri Elena , Rowe Charlotte 
Published: March 2019

SUMMARYEstimating subsurface density is important for imaging various geologic structures such as volcanic edifices, reservoirs and aquifers. Muon tomography has recently been used to complement traditional gravity measurements as a powerful method for probing shallow subsurface density structure beneath volcanoes. Gravity and muon data have markedly different spatial sensitivities and, as a result, the combination is useful for imaging structures on spatial scales that are larger than the area encompassed by crossing muon trajectories. Here we explore and test a joint inversion of gravity and muon data in a study area where there is an independently characterized target anomaly: a regionally extensive, high-density layer beneath Los Alamos, New Mexico, USA. We resolve the nearly flat-lying structure using a unique experimental set-up wherein surface and subsurface gravity and muon measurements are obtained above and below the target volume. Our results show that with minimal geologic (prior) constraints, the joint inversion correctly recovers salient features of the expected density structure. The results of our study illustrate the potential of combining surface and subsurface (e.g. borehole) gravity and muon measurements to invert for shallow geologic structures.
Mendelian randomization of inorganic arsenic metabolism as a risk factor for hypertension- and diabetes-related traits among adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) cohort
Authors: Scannell Bryan Molly , Sofer Tamar , Mossavar-Rahmani Yasmin , Thyagarajan Bharat , Zeng Donglin , Daviglus Martha L , Argos Maria 
Published: March 2019

AbstractBackgroundHypertension and diabetes have been associated with inefficient arsenic metabolism, primarily through studies undertaken in populations exposed through drinking water. Recently, rice has been recognized as a source of arsenic exposure, but it remains unclear whether populations with high rice consumption but no known water exposure are at risk for the health problems associated with inefficient arsenic metabolism.MethodsThe relationships between arsenic metabolism efficiency (% inorganic arsenic, % monomethylarsenate and % dimethylarsinate in urine) and three hypertension- and seven diabetes-related traits were estimated among 12 609 participants of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). A two-sample Mendelian randomization approach incorporated genotype-arsenic metabolism relationships from literature, and genotype-trait relationships from HCHS/SOL, with a mixed-effect linear model. Analyses were stratified by rice consumption and smoking.ResultsAmong never smokers with high rice consumption, each percentage point increase in was associated with increases of 1.96 mmHg systolic blood pressure (P = 0.034) and 1.85 mmHg inorganic arsenic diastolic blood pressure (P = 0.003). Monomethylarsenate was associated with increased systolic (1.64 mmHg/percentage point increase; P = 0.021) and diastolic (1.33 mmHg/percentage point increase; P = 0.005) blood pressure. Dimethylarsinate, a marker of efficient metabolism, was associated with lower systolic (−0.92 mmHg/percentage point increase; P = 0.025) and diastolic (-0.79 mmHg/percentage point increase; P = 0.004) blood pressure. Among low rice consumers and ever smokers, the results were consistent with no association. Evidence for a relationship with diabetes was equivocal.ConclusionsLess efficient arsenic metabolism was associated with increased blood pressure among never smokers with high rice consumption, suggesting that arsenic exposure through rice may contribute to high blood pressure in the Hispanic/Latino community.
Solar cycle variation in radar meteor rates
Authors: Campbell-Brown M D 
Published: March 2019

ABSTRACT
16 yr of meteor radar data from the Canadian Meteor Orbit Radar (CMOR) were used to investigate the link between observed meteor rates and both solar and geomagnetic activity. Meteor rates were corrected for transmitter power and receiver noise, and seasonal effects were removed. A strong negative correlation is seen between solar activity, as measured with the 10.7 cm flux, and observed meteor rates. This lends support to the idea that heating in the atmosphere at times of elevated solar activity changes the scale height and therefore the length and maximum brightness of meteors; a larger scale height near solar maximum leads to longer, fainter meteors and therefore lower rates. A weaker negative correlation was observed with geomagnetic activity as measured with the K index; this correlation was still present when solar activity effects were removed. Meteor activity at solar maximum is as much as 30 per cent lower than at solar minimum, strictly due to observing biases; geomagnetic activity usually affects meteor rates by less than 10 per cent.
The role of charitable funding in university research
Authors: Kundu Oishee , Matthews Nicholas E 
Published: March 2019

AbstractThere has been a diversification in the sources of university research funding in recent decades. While substantial research efforts have explored and discussed the implications of this diversification, with the exception of biomedical research the role of charities has typically been neglected, despite their importance in funding university research. This article explores the significance of charitable funding in academic research through the sponsorship of doctoral students. We demonstrate a sponsor classification strategy which classifies PhD theses by sponsor type with high accuracy and coverage. We find that: 1. charities play a significant role in funding doctoral students particularly within medical research, 2. charities are prominent in the wider network of research sponsors, and 3. they exhibit distinct preferences in terms of the subjects they fund. The dataset generated through this study provides an instrumental resource to initiate greater discussion on the role of this important source of research funding.
Linguistic Fractionalization and Health Information in Sub-Saharan Africa
Authors: Gomes Joseph Flavian 
Published: March 2019

Abstract
This paper explores the relationship between linguistic diversity and the stock of health information in society. Information is measured using individual-level knowledge about the oral rehydration product for treating children with diarrhea. Exploiting an individual woman-level dataset from the Demographic and Health Surveys for 14 sub-Saharan African countries combined with a novel high-resolution dataset on the spatial distribution of linguistic groups at a 1 km × 1 km level, this study shows that linguistic diversity has an inverted U-shaped relationship with the stock of information in society.
XVIII Bibliography, Textual Criticism, and Reference Works
Authors: Baker William 
Published: March 2019

AbstractThis chapter has five sections: 1: Periodicals; 2. Editions; 3. Bibliography and Associated Books and Articles; 4. Histories and Companions; 5. Shakespeare, History of Libraries, Collections, and Miscellaneous including Reference Materials. These sections are not inviolable. With some exceptions this review of the year’s work published in 2017 in the areas of bibliography, textual criticism, and reference materials is alphabetically arranged. Within the alphabetical arrangement by author there are some exceptions where publications are grouped under the respective authors rather than under editors of, for instance, the correspondence. There is also included in this chapter work that has been missed in some of the other chapters in this volume. Readers should be aware that coverage is largely limited to those items that have been received by the contributor, who would like to thank James E. May, James Fergusson, Patrick Scott, and Jan Webster for their assistance.
Epidemiology of Cervical Injuries in NCAA Football Players
Authors: Chung Andrew S. , Makovicka Justin L. , Hassebrock Jeffrey D. , Patel Karan A. , Tummala Sailesh V. , Deckey David G. , Hydrick Thomas C. , Rubel Nicolas C. , Chhabra Anikar 
Published: March 2019

Study Design.
Descriptive epidemiology study.

Objective.
The purpose of this study was to describe the epidemiology of cervical spine injuries in collegiate football players.

Summary of Background Data.
The incidence and etiology of cervical spine injuries in National Collegiate Athletic Association (NCAA) football players has not been well defined in recent years.

Methods.
The incidence and characteristics of cervical spine injuries were identified utilizing the NCAA-ISP database. Rates of injury were calculated as the number of injuries divided by the total number of athlete-exposures (AEs). AEs were defined as any student participation in one NCAA-sanctioned practice or competition.

Results.
An estimated 7496 cervical spine injuries were identified. Of these, 85.6% were categorized as new injuries. These occurred at a rate of 2.91 per 10000 AEs. Stingers were most common (1.87 per 10000 AEs) followed by cervical strains (0.80 per 10000 AEs). Injuries were nine times more likely to occur during competition when compared with practice settings. When compared with the regular season, the relative risks of sustaining a cervical spine injury during the preseason and postseason were 0.69 (95% CI 0.52–0.90) and 0.39 (95% CI 0.16–0.94), respectively. The rate of cervical spine injuries was highest in Division I athletes. Direct contact-related injuries were most common, representing 90.8% of all injuries sustained. Injuries were most common in linebackers (20.3%) followed secondarily by defensive linemen (18.2%). Most players returned to play within 24 hours of the initial injury (64.4%), while only 2.8% remained out of play for > 21 days.

Conclusion.
Fortunately, the rate of significant and disabling cervical spine injuries appears to be low in the NCAA football athlete. The promotion of safer tackling techniques, appropriate modification of protective gear, and preventive rehabilitation in these aforementioned settings is of continued value.

Level of Evidence: 4
Dropped Head Syndrome
Authors: Drain Joseph P. , Virk Sohrab S. , Jain Nikhil , Yu Elizabeth 
Published: March 2019

Study design:
This study was a systematic review.

Objectives:
To reveal demographic factors, etiologies, response to treatment, and to propose a novel treatment algorithm for dropped head syndrome (DHS).

Summary of background data:
DHS is a rare condition defined by weakness of the cervical paraspinal muscles resulting in passively correctable flexion of the cervical spine. Patients present with neck pain, difficulty eating, and impaired horizontal gaze. Because of the rarity of DHS, a paucity of information exists with regard to demographics, etiology, and relative superiority of medical and surgical treatment.

Materials and Methods:
We conducted a systematic literature review by searching PubMed for “dropped head syndrome,” “chin on chest,” “isolated neck extensor myopathy” (INEM), and “camptocephalia.” Inclusion criteria were English-language articles that applied a specific treatment regimen with outcome data. A binomial logistic regression analysis was then performed to determine which covariates (age, sex, and treatments) were predictive of a positive response to treatment.

Results:
A total of 129 patients were described in 74 studies. Mean age was 63.6 and 63% were female. More than two-thirds of all patients fell into just 4 diagnostic categories (isolated neck extensor myopathy, 31.8%; Parkinson’s, 20.2%; myasthenia gravis, 12.4%; amyotrophic lateral sclerosis, 7.0%). Overall positive response to treatment was 64.3%; primary medical treatment (73.5%), immune suppression (78.9%), and a combination of both (87.5%). Surgery was 93.8% successful. A treatment algorithm focused on appropriate diagnosis, initial medical management, with surgical evaluation only after failure of medical treatment was proposed.

Conclusions:
Treatment for DHS starts with accurate diagnosis of the underlying etiology and is often associated with neuromuscular disease. A treatment algorithm for appropriate management of these patients was proposed. A trial of medical management and/or immunomodulators is warranted. Failing nonoperative management, surgery is predictive of a positive outcome.

Level of Evidence:
Level V.
The Implications of Pouch Physiology
Authors: Church James 
Published: March 2019

INTRODUCTION:
Patients undergoing an IPAA experience a completely different physiology of defecation than when they had a rectum. The new “normal” is poorly appreciated and incompletely understood, and the lack of understanding has implications for pouch function. This technical note lays out the physiology of defecation with an ileal pouch and its implications for patients and surgeons.

TECHNIQUE:
An intestinal pouch acts as a reservoir because the united antegrade and retrograde peristaltic loops produce no evacuatory pressure. Defecation occurs by gravity. Efficient defecation results in fewer stools, but inefficient defecation may cause stool frequency, incontinence, obstruction, constipation, and pouch inflammation. The technical aspects of pouch construction that impact emptying include a long efferent limb of an S-pouch, any degree of twist in the pouch body, afferent limb syndrome, and anal stenosis.

RESULTS:
Constructing a pouch with no twists and with an open anus, maintaining liquid stool, and encouraging unhurried defecation can improve pouch function.

CONCLUSIONS:
Understanding pouch physiology is important in optimizing pouch function and maintaining patient expectations.
Randomized Clinical Trial: A Normocaloric Low-Fiber Diet the Day Before Colonoscopy Is the Most Effective Approach to Bowel Preparation in Colorectal Cancer Screening Colonoscopy
Authors: Alvarez-Gonzalez Marco A. , Pantaleon Miguel A. , Flores-Le Roux Juana A. , Zaffalon Diana , Amorós Jaume , Bessa Xavier , Seoane Agustin , Pedro-Botet Juan 
Published: March 2019

BACKGROUND:
Clinical guidelines recommend either a clear-liquid diet or a low-fiber diet for colonoscopy preparation. Participants in a screening program are usually motivated healthy individuals in which a good tolerability is important to improve adherence to potential surveillance colonoscopies.

OBJECTIVE:
Our aim was to assess whether or not a normocaloric low-fiber diet followed the day before a screening colonoscopy compromises the efficacy of bowel cleansing and may improve the tolerability of bowel preparation.

DESIGN:
This is a randomized, endoscopist-blinded, noninferiority clinical trial.

SETTINGS:
The study was conducted at a tertiary care center.

PATIENTS:
A total of 276 consecutive participants of the Barcelona colorectal cancer screening program were included.

INTERVENTION:
Participants were randomly assigned to a clear-liquid diet or a normocaloric low-fiber diet the day before the colonoscopy. Both groups received 4 L of polyethylene glycol in a split-dose regimen.

MAIN OUTCOME MEASURES:
Primary outcome was the adequate bowel preparation rate measured with the Boston bowel preparation scale. Secondary outcomes included tolerability, fluid-intake perception, hunger, side effects, and acceptability.

RESULTS:
Participants in both groups were similar in baseline characteristics. Adequate bowel preparation was achieved in 89.1% vs 95.7% in clear-liquid diet and low-fiber diet groups, showing not only noninferiority, but also superiority (p = 0.04). Low-fiber diet participants reported less fluid-intake perception (p = 0.04) and less hunger (p = 0.006), with no differences in bloating or nausea.

LIMITATIONS:
The single-center design of the study could limit the external validity of the results. The present findings may not be comparable to other clinical settings.

CONCLUSION:
A normocaloric low-fiber diet the day before a screening colonoscopy achieved better results than a clear-liquid diet in terms of adequate colon preparation. Moreover, it also improved the perception of hunger and excessive fluid intake. Registered at clinicaltrials.gov: NCT02401802. See Video Abstract at http://links.lww.com/DCR/A829.