bluuebunny/crossref_metadata_2025_split huggingface dataset:
Agency Decision-Making Control and Employment Outcomes by Vocational Rehabilitation Consumers who are Blind or Visually Impaired
Authors: Steinman Bernard A. , Kwan Ngai , Boeltzig-Brown Heike , Haines Kelly , Halliday John , Foley Susan M. 
Published: January 2019

Introduction We hypothesized that consumers who are blind or visually impaired (that is, those who have low vision) who were served by state vocational rehabilitation agencies with decision-making control over administrative functions would experience better vocational rehabilitation outcomes than consumers served by vocational rehabilitation agencies with less control in these areas. Methods We merged person-level RSA-911 (fiscal year 2010) data with agency-level data collected as part of the National Survey of State Vocational Rehabilitation Agencies, which we conducted in 2011. We employed multilevel modeling, controlling for select person-level characteristics, and agency-level indicators of primary decision-making control by vocational rehabilitation agencies in six key administrative functions: human resources, infrastructure, management information systems, policies and procedures, program evaluation, and purchasing. Dependent variables were measures of “any employment” and “competitive employment” outcomes. Results We report a positive association between agency decision-making control over policies and procedures and competitive employment outcomes by consumers who were blind (odds ratio = 2.64; 95% confidence interval 1.23–5. 72). Among consumers who are visually impaired, agency decision-making control over human resources was negatively associated with any employment closures (odds ratio = 0.56; 95% confidence interval = 0.36–0.93) and competitive employment outcomes (odds ratio = 0.56; 95% confidence interval = 0.33–0.97). Discussion Results demonstrate the potential for factors related to agencies, in addition to factors related to individuals, to function as mediators of vocational rehabilitation outcomes for consumers who are blind or visually impaired. Implications for practitioners Findings highlight the importance of understanding how management control over areas such as policy and procedures have the potential to influence service delivery and subsequent employment outcomes.
Ascorbic acid improves thrombotic function of platelets during living donor liver transplantation by modulating the function of the E3 ubiquitin ligases c-Cbl and Cbl-b
Authors: Kwon Ji Hye , Kim Doyeon , Cho Hyojin , Shin Byung Seop 
Published: January 2019

Objective To investigate the effect of ascorbic acid (AA) on hemostatic function during living donor liver transplantation (LDLT). Methods Blood samples from 21 LDLT recipients were taken within 30 minutes after induction and at 120 minutes after reperfusion. Rotational thromboelastography (TEG) and western blot analysis were used to analyze for fibrinolysis and functional changes in c-Cbl and Cbl-b, respectively. TEG test samples were prepared as one of three groups: C group (0.36 mL of blood), N group (0.324 mL of blood + 0.036 mL of 0.9% normal saline), and A group (0.324 mL of blood + 0.036 mL of 200 µmol/L-AA dissolved in 0.9% normal saline). Results AA decreased fibrinolysis and increased clot rigidity at baseline and 120 minutes after reperfusion. Cbl-b expression was significantly increased at baseline and 120 minutes after reperfusion in the A group compared with the C and N groups. However, c-Cbl phosphorylation was most significantly decreased in the A group at baseline and 120 minutes after reperfusion. Conclusion AA can significantly decrease fibrinolysis and improve clot rigidity in LT recipients during LDLT, and functional changes in Cbl-b and c-Cbl might represent the underlying mechanism. AA may be considered for use during LDLT to decrease hyperfibrinolysis.
Combination of CDX2 expression and T stage improves prognostic prediction of colorectal cancer
Authors: Xu Weimin , Zhu Yilian , Shen Wei , Ding Wenjun , Wu Tingyu , Guo Yuegui , Chen Xiaobing , Zhou Mingxia , Chen Yingwei , Cui Long , Du Peng 
Published: January 2019

Objective Prognostic prediction of colorectal cancer (CRC) remains challenging because of its heterogeneity. Aberrant expression of caudal-type homeobox transcription factor 2 (CDX2) is strongly correlated with the prognosis of CRC. Methods Tissue samples of patients with CRC who underwent surgery in Xinhua Hospital (Shanghai, China) from January 2010 to January 2013 were collected. CDX2 expression was semiquantitatively evaluated via immunohistochemistry. Results In total, 138 patients were enrolled in this study from a prospectively maintained institutional cancer database. The median follow-up duration was 57.5 months (interquartile range, 17.0–71.0 months). In the Cox proportional hazards model, low CDX2 expression combined with stage T4 CRC was significantly the worst prognostic factor for disease-free survival (hazard ratio = 7.020, 95% confidence interval = 3.922–12.564) and overall survival (hazard ratio = 5.176, 95% CI = 3.237–10.091). In the Kaplan–Meier survival analysis, patients with low CDX2 expression and stage T4 CRC showed significantly worse disease-free survival and overall survival than those with low CDX2 expression alone. Conclusion CDX2 expression combined with the T stage was more accurate for predicting the prognosis of CRC. Determining the prognosis of CRC using more than one variable is valuable in developing appropriate treatment and follow-up strategies.
Are we closing the gaps in the management of osteoporosis following fragility fractures of the femur?
Authors: Sadat-Ali Mir , AlShammari Sulliman M , Uddin Fares Z , Alani Fawaz M , Dahduli Omar S 
Published: January 2019

Objective The objective of this study was to identify deficiencies in initiating anti-osteoporotic treatment following a fragility femoral fracture. Methods All patients ≥55 years of age treated for a fragility femoral fracture between June 2012 and May 2017 were enrolled. Medications at discharge and at 90 days and 1 year of follow up were analyzed. Patients were classified into 4 groups: Group I did not receive any treatment for osteoporosis; Group II received only calcium and vitamin D3; Group III received an anabolic agent, calcium, and vitamin D3; and Group IV received bisphosphonates, calcium, and vitamin D3. Results A total of 167 patients with an average age of 65.81±12.55 years were included. There were 88 (52.7%) males and 79 (47.3%) females. At discharge, 107 patients (64.1%) were not prescribed optimal treatment for osteoporosis, and this reduced to 55 (32.9%) at the 90-day follow up. At 1 year, the number of patients receiving suboptimal treatment was further reduced to 25.74%. Conclusions Although the number of patients with fragility fractures receiving insufficient treatment was lower in the present study than in previous reports, increased efforts and coordinated treatment plans initiated by a fracture liaison service should be of high priority.
Effect of neurocentral cartilage destruction on spinal growth in immature rabbits
Authors: Wen Jie , Wang Dahui , Fang Ke , Xiao Sheng , Ma Ruixue , Liu Hong 
Published: January 2019

Objective This study was performed to observe the effect of neurocentral cartilage (NCC) destruction on spinal growth in immature rabbits. Methods The NCC of the lumbar vertebrae of 24 4-week-old female rabbits was destroyed through posterolateral and anterior approaches, and three-dimensional computed tomography examinations were performed 3 months after the procedure. Results Scoliosis was successfully induced in all rabbits of both the anterior and posterolateral approach groups. The scoliosis exceeded 10 degrees in three rabbits, which exhibited coronal scoliosis of the spine, unequal length and thickness of the bilateral pedicles, and rotation of the vertebrae. Scoliosis was not observed in the control group. Conclusions Destruction of the unilateral NCC in immature rabbits can induce structural scoliosis, similar to the pathological features of human scoliosis. The Cobb angles are similar after NCC destruction by a posterolateral approach and under direct vision via the anterior approach.
A review of R-DHAP administration in the outpatient setting and a case of the alternative regimen R-DHAX given outpatient for refractory diffuse large B-cell lymphoma
Authors: Hill Hailey , Arnall Justin , Janes Amanda , Hatley Crystal , Swift Kristen , Hargett Christy , Howell Theresa , Griffin Sarah , Larck Christopher , Park Stephen 
Published: January 2019

Introduction Several regimens for treating hematologic malignancies are given inpatient due to multiple factors. Many clinicians are evaluating methods to deliver traditionally inpatient regimens in the outpatient setting to increase patient satisfaction, improve access to therapy, and reduce costs. A regimen traditionally administered inpatient, dexamethasone, cytarabine, and cisplatin (DHAP) is a common and effective salvage regimen for relapsed/refractory non-Hodgkin’s lymphoma. DHAX, which substitutes oxaliplatin for cisplatin, has been identified as a reasonable alternative to DHAP and offers the potential for tolerable administration in the outpatient setting as well. Case description A 74-year-old patient with double hit relapsed/refractory diffuse large B cell lymphoma was given rituximab, dexamethasone, high-dose cytarabine, and oxaliplatin (R-DHAX) in our outpatient clinic; however, this regimen is traditionally administered in the inpatient setting. Our main obstacle being cytarabine doses traditionally given 12 h apart. The outpatient regimen given to our patient was rituximab and oxaliplatin on day 1, cytarabine dose one late afternoon on day 2, cytarabine dose two early morning on day 3, and dexamethasone on days 1–4. Doses of oxaliplatin and cytarabine were reduced due to thrombocytopenia experienced with Cycle 1. He did not experience any increased toxicities or complications associated with the regimen moving forward. Discussion This illustrates a unique administration of R-DHAX in an infusion center that operates during typical outpatient clinic hours. Both DHAP and DHAX, with or without rituximab, administered in the outpatient setting may be options to consider in relapsed/refractory non-Hodgkin’s lymphoma.
Effect of denosumab versus zoledronic acid on calcium levels in cancer patients with bone metastasis: A retrospective cohort study
Authors: Nasser Sahar M , Sahal Arwa , Hamad Anas , Elazzazy Shereen 
Published: January 2019

Objective To identify the incidence of hypercalcemia and hypocalcemia in zoledronic acid and denosumab groups. Secondary objective was to determine the correlation between calcium supplement and calcium level control. Methods An observational retrospective cohort study was conducted by reviewing patient electronic records, laboratory results, and medication charts from 1 August 2015 to 31 July 2016. Adult cancer patients who were diagnosed with bone metastasis secondary to a solid tumor or multiple myeloma and who received either zoledronic acid or denosumab were included. Other indications for bone targeting agents were excluded. Data of bone targeting agents administration encounters were collected, evaluated, and analyzed. Results A total of 1141 encounters (for 271 patients) were included. The incidence of hypocalcemia was higher in denosumab compared to zoledronic acid group (5.5% vs. 3.1%, OR = 0.55, 95% CI [0.3–1.0]; P = 0.05). Hypercalcemia incidence was also higher in denosumab group (8.5% vs. 3.1%, OR = 2.9, 95% CI [1.68–5.03]; P < 0.0001). Breast cancer was the most common malignancy associated with hypocalcemia (27.3%) followed by ovarian cancer (25%) and multiple myeloma (22.7%). The risk of developing hypocalcemia was reduced by 16% in patients receiving calcium supplementation (RR = 0.84, 95% CI [0.55–1.20]; P = 0.39). Conclusion Denosumab use was associated with higher rates of both hypercalcemia and hypocalcemia compared to zoledronic acid. Adequate supplementation with calcium substantially reduced the risk of hypocalcemia. Our results highlight the importance of taking preventative measures upon bone targeting agents initiation and during treatment including regular monitoring of calcium levels and providing supplements accordingly.
Open Versus Endoscopic Approach for Sinonasal Melanoma: A Systematic Review and Meta-analysis
Authors: Hur Kevin , Zhang Paul , Yu Alison , Kim-Orden Natalie , Kysh Lynn , Wrobel Bozena 
Published: January 2019

Background Open resection (OR) of sinonasal mucosal melanoma (SNM) traditionally has been the gold standard for treatment. However, endoscopic resection (ER) has recently become a surgical alternative. The aim of this study was to compare survival outcomes between OR and ER of SNM. Methods A literature search encompassing PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and Google Scholar was performed. Two reviewers independently screened for original studies comparing survival outcomes between OR and ER for SNM. Data were systematically collected on study design, patient demographics, outcomes, and level of evidence. Quality assessment was performed using the Newcastle-Ottawa scale (NOS). Meta-analysis of overall survival and disease-free survival was performed using random-effects models. Results The initial search yielded 2078 abstracts, of which 9 cohort studies were included for a total of 510 patients from 6 different countries. The average quality of all included studies using the NOS was 7.7 stars. Six out of 7 studies reported no differences in the stages of SNM between patients receiving ER versus OR. Overall survival was longer in the ER group versus OR group (hazard ratio [HR]: 0.68, 95% confidence interval [CI]: 0.49–0.95). There was no significant difference in disease-free survival between groups (HR: 0.59, 95% CI: 0.28–1.25). Conclusion Based on the available literature, an endoscopic approach for SNM resection has survival outcomes that are similar or greater compared to an open approach.
How handling missing data may impact conclusions: A comparison of six different imputation methods for categorical questionnaire data
Authors: Stavseth Marianne Riksheim , Clausen Thomas , Røislien Jo 
Published: January 2019

Objectives: Missing data is a recurrent issue in many fields of medical research, particularly in questionnaires. The aim of this article is to describe and compare six conceptually different multiple imputation methods, alongside the commonly used complete case analysis, and to explore whether the choice of methodology for handling missing data might impact clinical conclusions drawn from a regression model when data are categorical. Methods: In addition to the commonly used complete case analysis, we tested the following six imputation methods: multiple imputation using expectation–maximization with bootstrapping, multiple imputation using multiple correspondence analysis, multiple imputation using latent class analysis, multiple hot deck imputation and multivariate imputation by chained equations with two different model specifications: logistic regression and random forests. The methods are tested on real data from a questionnaire-based study in the Norwegian opioid maintenance treatment programme. Results: All methods performed relatively well when the sample size was large (n = 1000). For a smaller sample size (n = 200), the regression estimates depend heavily on the level of missing. When the amount of missing was ⩾20%, in particular, complete case analysis, hot deck and random forests had biased estimates with too low coverage. Multiple imputation using multiple correspondence analysis had the best performance all over. Conclusion: The choice of missing handling methodology has a significant impact on the clinical interpretation of the accompanying statistical analyses. With missing data, the choice of whether to impute or not, and choice of imputation method, can influence clinical conclusion drawn from a regression model and should therefore be given sufficient consideration.
Exploratory analysis of comparative clinical trials used for marketing approval in patients with type 2 diabetes in Japan
Authors: Kaneko Reina , Ono Shunsuke 
Published: January 2019

Background/objectives: The results of phase 2 and 3 clinical trials, which justify decisions regarding marketing approval for new drugs, are used for comparison of drugs in the post-marketing phase. A number of meta-analyses of approved antidiabetics have been performed, but the heterogeneity of trials has not been fully examined. The aim of this study was to explore factors that may influence baseline HbA1c in trial samples and treatment outcomes (i.e. HbA1c reductions and effect sizes), with the goal of providing unbiased and fair retrospective comparisons between different antidiabetics. Method: We conducted three meta-regression analyses using 78 randomized or non-randomized comparative phase 2 or 3 trials of 24 approved antidiabetics in Japan, conducted from 1987 to 2012. Results: Baseline HbA1c of each arm was higher in phase 2 trials, trials with a greater number of subjects, trials with a lower proportion of male subjects, trials of combination therapy, or trials with longer subject disease duration. Entry criteria were different among drug classes and caused variations in baseline HbA1c. HbA1c reductions were larger in non-randomized trials, trials with a shorter treatment period, or trials with a lower proportion of male subjects. Effect sizes were larger in phase 2 trials, or trials of combination therapy. Larger effect sizes were observed in drugs with later market entry for alpha-glucosidase inhibitors and glinides. Conclusion: Baseline HbA1c, an important characteristic of subjects enrolled in trials of antidiabetics, differed significantly across trials. Differences in features of study subjects were caused by explicit stipulations in eligibility criteria of HbA1c and also by other conditions (e.g. trial design, regulatory guidance, treatment guideline) and/or interventions of investigators and pharmaceutical companies that were specific to drugs and trials. Healthcare professionals should carefully consider these heterogeneities in trials used for marketing approval review when making a retrospective comparison to select the best treatment option for patients.
Optical diagnosis of colorectal polyps with Blue Light Imaging using a new international classification
Authors: Subramaniam Sharmila , Hayee Bu , Aepli Patrick , Schoon Erik , Stefanovic Milan , Kandiah Kesavan , Thayalasekaran Sreedhari , Alkandari Asma , Bassett Paul , Coron Emmanuel , Pech Oliver , Hassan Cesare , Neumann Helmut , Bisschops Raf , Repici Alessandro , Bhandari Pradeep 
Published: January 2019

BackgroundBlue Light Imaging (BLI) is a new imaging technology that enhances mucosal surface and vessel patterns. A specific BLI classification was recently developed to enable better characterisation of colorectal polyps (BLI Adenoma Serrated International Classification (BASIC)). The aim of this study was to validate the diagnostic performance of BASIC in predicting polyp histology in experienced and trainee endoscopists.MethodsFive experienced and five trainee endoscopists evaluated high‐definition white light (HDWL) and BLI images from 45 small polyps to assess baseline accuracy, sensitivity, specificity, and positive and negative predictive values (NPVs) of polyp histology. Each endoscopist was trained with the BLI classification before repeating the exercise. Results were compared pre‐ and post‐training.ResultsThe overall pre‐training accuracy improved from 87% to 94%. The sensitivity and NPV of adenoma diagnosis also improved significantly from 79% to 96% and 81% to 95% with BASIC training. This improvement was noted in both groups. The interobserver level of agreement was very good (K = 0.90) in the experienced cohort and good (K = 0.66) in the trainee group post‐training.ConclusionsBLI is a useful tool for optical diagnosis, and the use of BASIC with adequate training can significantly improve the accuracy, sensitivity and NPV of adenoma diagnosis.
Canadian Nephrologist Views Regarding Stroke and Systemic Embolism Prevention in Dialysis Patients With Nonvalvular Atrial Fibrillation: A Survey
Authors: Collister David , Healey Jeff S. , Conen David , Brimble K. Scott , Rigatto Claudio , Harel Ziv , Sood Manish M. , Walsh Michael 
Published: January 2019

Background: Nonvalvular atrial fibrillation (NVAF) is an independent risk factor for ischemic stroke and is common in chronic kidney disease (CKD) and dialysis patients. The use of oral anticoagulation to prevent stroke and systemic embolism in the setting of kidney disease is controversial. Novel alternatives to vitamin K antagonists include left atrial appendage occlusion devices (LAAOD) and apixaban. Objective: We sought to elicit Canadian nephrologist views regarding stroke and systemic embolism prevention therapies in CKD and dialysis patients with NVAF. Design: Survey. Setting: Online via https://www.surveymonkey.com . Participants: Canadian Society of Nephrology members actively treating adult dialysis patients with NVAF. Measurements: Management questions were asked with response options consisting of a Likert scale ranging from 1 to 8 (with 1 being definitely would not and 8 being definitely would). Methods: We randomly allocated each respondent to 2 of 4 cases that varied by stroke and bleeding risks (using varying CHADS2 and HASBLED scores, respectively). Results: There were 91 responses (36.3% response rate) from mostly university (83.5%) and also community with university affiliation (12.1%) and community (4.4%) nephrologists. Warfarin was more likely to be recommended in individuals at high stroke risk and low bleeding risk (mean = 5.47, 95% confidence interval = 4.87-6.07) and less likely to be recommended in individuals at moderate stroke risk and high bleeding risk (mean = 2.89, 95% confidence interval = 2.37-3.41). The likelihood of recommending LAAOD did not vary by stroke or bleeding risks (means ranging from 3.92-4.90). Apixaban was not likely to be recommended in any case (means ranging from 2.60-3.50). However, nephrologists felt there was equipoise regarding anticoagulation strategies allowing participation in appropriate randomized controlled trials (RCTs). Limitations: The survey only involved nephrologists and only 4 cases with dichotomized risk categories were presented instead of complete range of stroke and bleeding risk combinations. As with any survey, there was the potential for responder bias and treatment decisions are not anchored directly to patient management. Conclusions: Nephrologists caring for patients with kidney disease appear willing to include patients in clinical trials examining alternatives to warfarin for stroke and systemic embolism prevention for NVAF in the setting of kidney disease.
Fluorescent labeling of CRISPR/Cas9 RNP for gene knockout in HSPCs and iPSCs reveals an essential role for GADD45b in stress response
Authors: Nasri Masoud , Mir Perihan , Dannenmann Benjamin , Amend Diana , Skroblyn Tessa , Xu Yun , Schulze-Osthoff Klaus , Klimiankou Maksim , Welte Karl , Skokowa Julia 
Published: January 2019

Abstract
CRISPR/Cas9-mediated gene editing of stem cells and primary cell types has several limitations for clinical applications. The direct delivery of ribonucleoprotein (RNP) complexes consisting of Cas9 nuclease and guide RNA (gRNA) has improved DNA- and virus-free gene modifications, but it does not enable the essential enrichment of the gene-edited cells. Here, we established a protocol for the fluorescent labeling and delivery of CRISPR/Cas9–gRNA RNP in primary human hematopoietic stem and progenitor cells (HSPCs) and induced pluripotent stem cells (iPSCs). As a proof of principle for genes with low-abundance transcripts and context-dependent inducible expression, we successfully deleted growth arrest and DNA-damage-inducible β (GADD45B). We found that GADD45B is indispensable for DNA damage protection and survival in stem cells. Thus, we describe an easy and efficient protocol of DNA-free gene editing of hard-to-target transcripts and enrichment of gene-modified cells that are generally difficult to transfect.