bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification and Validation of Stromal Immunotype Predict Survival and Benefit from Adjuvant Chemotherapy in Patients with Muscle-Invasive Bladder Cancer
Authors: Fu Hangcheng , Zhu Yu , Wang Yiwei , Liu Zheng , Zhang Junyu , Xie Huyang , Fu Qiang , Dai Bo , Ye Dingwei , Xu Jiejie 
Published: March 2018

Abstract
Purpose: This study aims to construct the stromal immunotype, which could improve the prediction of postsurgical survival and adjuvant platinum-based chemotherapy in muscle-invasive bladder cancer (MIBC).
Experimental Design: A total of 118 patients with MIBC from Shanghai Cancer Center, 140 patients with MIBC from Zhongshan Hospital, and 287 patients with MIBC from TCGA cohort were included in the study. Immune cell infiltration was evaluated by IHC staining or CIBERSORT method. Five immune features were selected out of 22 immune features to construct immunotypes based on the LASSO Cox regression model.
Results: Using the LASSO model, we classified patients with MIBC into stromal immunotype A subgroup (CTLhighNKhighTreglowMacrophagelowMClow) and stromal immunotype B subgroup (CTLlowNKlowTreghighMacrophagehighMChigh). Significant differences were found between immunotype A and immunotype B in the combined cohort with 5-year overall survival (OS, 76.0% vs. 44.0%; P &lt; 0.001) and 5-year disease-free survival (DFS, 62.8% vs. 48.3%; P &lt; 0.001). Stromal immunotype was revealed to be an independent prognostic indicator in multivariate analysis in all cohorts separately. Either OS or DFS was not improved by adjuvant chemotherapy (ACT) in pT2 stage patients or pT3+pT4 patients, but further analysis revealed that OS and disease-free was significantly improved by ACT in pT3+pT4 patients (P = 0.016 and P = 0.006, respectively). Finally, stromal immunotype A showed higher immune checkpoint molecules (PD-L1, PD-1, and CTLA-4) expression.
Conclusions: The stromal immunotypes could effectively predict survival and recurrence of MIBC. Furthermore, the immunotypes might be a practical predictive tool to identify pT3+pT4 patients who would benefit from ACT. Clin Cancer Res; 24(13); 3069–78. ©2018 AACR.
Effects of Gene Variants Controlling Vitamin D Metabolism and Serum Levels on Hepatic Steatosis
Authors: Jamka Małgorzata , Arslanow Anita , Bohner Annika , Krawczyk Marcin , Weber Susanne N. , Grünhage Frank , Lammert Frank , Stokes Caroline S. 
Published: March 2018

Background/Aims: Common genetic variations in vitamin D metabolism are associated with liver stiffness. Whether these genes are implicated in hepatic steatosis remains unclear. Here we aimed to analyse the association of common vitamin D pathway gene variants with liver steatosis. Methods: Liver steatosis was assessed non-invasively in 241 patients with chronic liver conditions by controlled attenuation parameter (CAP). The following polymorphisms were genotyped using TaqMan assays: group-specific component (GC) rs7041, 7-dehydrocholesterol reductase (DHCR7) rs12785878, cytochrome P450 2R1 (CYP2R1) rs10741657, ­vitamin D receptor (VDR) rs7974353. Chemiluminescence immunoassay determined serum 25-hydroxyvitamin D (25(OH) D) concentrations. Results: Vitamin D deficiency (defined by 25(OH)D concentrations <20 ng/mL) occurred in 66% of patients. Median CAP was 296 (100–400) dB/m. Patients with advanced steatosis (CAP ≥280 dB/m) had significantly (p = 0.033) lower 25(OH)D levels as compared to patients with CAP <280 dB/m. Moreover, the rare allele [T] in GC rs7041 was significantly (p = 0.018) associated with higher 25(OH)D levels in patients with CAP <280 dB/m. However, GC, DHCR7, CYP2R1, and VDR polymorphisms were not related to liver steatosis and obesity traits. Conclusions: Higher CAP values are associated with low serum 25(OH)D concentrations but not with common vitamin D pathway gene variants.
Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease
Authors: Laterza Lucrezia , Piscaglia Anna Chiara , Minordi Laura Maria , Scoleri Iolanda , Larosa Luigi , Poscia Andrea , Ingravalle Fabio , Amato Arianna , Alfieri Sergio , Armuzzi Alessandro , Cammarota Giovanni , Gasbarrini Antonio , Scaldaferri Franco 
Published: March 2018

<b><i>Aim:</i></b> To evaluate if a single and/or combined (clinical, endoscopic and radiological) assessment could predict clinical outcomes in Crohn’s disease (CD). <b><i>Methods:</i></b> We prospectively evaluated 57 CD cases who underwent both a colonoscopy and a CT-enterography (CTE). Harvey-Bradshaw Index (HBi), SES-CD (and/or Rutgeerts score) and the radiological disease activity were defined to stratify patients according to clinical, endoscopic and radiological disease activity respectively. Hospitalizations, surgery, therapeutic changes and deaths were evaluated up to 36 months (time 1) for 53 patients. <b><i>Results:</i></b> CTE and endoscopy agreed in stratifying disease activity in 47% of cases (k = –0.05; <i>p</i> = 0.694), CTE and HBi in 35% (k = 0.09; <i>p</i> = 0.08), endoscopy and HBi in 39% (k = 0.13; <i>p</i> = 0.03). Taken together, CTE, endoscopy and HBi agreed only in 18% of cases (k = 0.01; <i>p</i> = 0.41). Among the 11 cases with mucosal healing, only 3 (27%) showed transmural healing. Patients with endoscopic activity needed significantly more changes of therapy compared to patients with endoscopic remission (<i>p</i> = 0.02). Patients with higher transmural or clinical activity at baseline required significantly more hospitalizations (<i>p</i> &#x3c; 0.01). Hospitalization rate decreases with an increase in the number of parameters indicating remissions at baseline (<i>p</i> = 0.04). <b><i>Conclusions:</i></b> Clinical, endoscopic and radiological assessments offer complementary information and could predict different mid-term outcomes in CD.
Real-World Scenario Improvements in Serum Phosphorus Levels and Pill Burden in Peritoneal Dialysis Patients Treated with Sucroferric Oxyhydroxide
Authors: Kalantar-Zadeh Kamyar , Parameswaran Vidhya , Ficociello Linda H. , Anderson Ludmila , Ofsthun Norma J. , Kwoh Christopher , Mullon Claudy , Kossmann Robert J. , Coyne Daniel W. 
Published: March 2018

<b><i>Background:</i></b> A database analysis was conducted to assess the effectiveness of sucroferric oxyhydroxide (SO) on lowering serum phosphorus and phosphate binder (PB) pill burden among adult peritoneal dialysis (PD) patients prescribed SO as part of routine care. <b><i>Methods:</i></b> Adult PD patients (<i>n</i> = 258) prescribed SO through a renal pharmacy service were analyzed. Baseline was 3 months before SO prescription. SO-treated follow-up was for 6 months or until either a new PB was prescribed, SO was not refilled, PD modality changed, or patient was discharged. In-range serum phosphorus was defined as ≤5.5 mg/dL. <b><i>Results:</i></b> At baseline, mean serum phosphorus was 6.59 mg/dL with 10 prescribed PB pills/day. The proportion of patients achieving in-range serum phosphorus increased by 72% from baseline to month 6. Prescribed PB pills/day decreased by 57% (10 at baseline to 4.3 at SO follow-up, <i>p</i> &#x3c; 0.0001). The mean length of SO follow-up was 5.1 months; SO follow-up ended for 38, 27, and 50 patients at months 4, 5, and 6, respectively, due to no further PB fills, and for 10, 11, and 4 patients at months 4, 5, and 6, respectively, due to another PB prescribed. In patients with baseline serum phosphorus &#x3e;5.5 mg/dL who achieved in-range serum phosphorus during SO follow-up for ≥1 quarter, a notable improvement in serum phosphorus (6.54 to 5.10 mg/dL, <i>p</i> &#x3c; 0.0001) was observed, and there was a 53% reduction in PB pill burden (9.9 to 4.7, <i>p</i> &#x3c; 0.0001). <b><i>Conclusion:</i></b> Among PD patients prescribed SO as part of routine care, improvements in serum phosphorus control and &#x3e;50% reduction in PB pills/day were observed.
Long-Term Outcomes of Childhood Left Ventricular Noncompaction Cardiomyopathy
Authors: Shi William Y. , Moreno-Betancur Margarita , Nugent Alan W. , Cheung Michael , Colan Steven , Turner Christian , Sholler Gary F. , Robertson Terry , Justo Robert , Bullock Andrew , King Ingrid , Davis Andrew M. , Daubeney Piers E.F. , Weintraub Robert G. 
Published: March 2018

Background:
Long-term outcomes for childhood left ventricular noncompaction (LVNC) are uncertain. We examined late outcomes for children with LVNC enrolled in a national population-based study.

Methods:
The National Australian Childhood Cardiomyopathy Study includes all children in Australia with primary cardiomyopathy diagnosed before 10 years of age between 1987 and 1996. Outcomes for subjects with LVNC with a dilated phenotype (LVNC-D) were compared with outcomes for those with dilated cardiomyopathy. Propensity-score analysis was used for risk factor adjustment.

Results:

There were 29 subjects with LVNC (9.2% of all cardiomyopathy subjects), with a mean annual incidence of newly diagnosed cases of 0.11 per 100 000 at-risk individuals. Congestive heart failure was the initial symptom in 24 of 29 subjects (83%), and 27 (93%) had LVNC-D. The median age at diagnosis was 0.3 (interquartile interval, 0.08–1.3) years. The median duration of follow-up was 6.8 (interquartile interval, 0.7–24.0) years for all subjects and 24.7 (interquartile interval, 23.3 – 27.7) years for surviving subjects. Freedom from death or transplantation was 48% (95% confidence interval [CI], 30–65) at 10 years after diagnosis and 45% (95% CI, 27–63) at 15 years. In competing-risk analysis, 21% of subjects with LVNC were alive with normal left ventricular systolic function, and 31% were alive with abnormal function at 15 years. Propensity-score matching between subjects with LVNC-D and those with dilated cardiomyopathy suggested a lower freedom from death/transplantation at 15 years after diagnosis in the subjects with LVNC-D (LVNC-D, 46% [95% CI, 26–66] versus dilated cardiomyopathy, 70% [95% CI, 42–97];
P
=0.08). Using propensity-score inverse probability of treatment–weighted Cox regression, we found evidence that LVNC-D was associated with a greater risk of death or transplantation (hazard ratio, 2.3; 95% CI, 1.4–3.8;
P
=0.0012).

Conclusions:
Symptomatic children with LVNC usually present in early infancy with a predominant dilated phenotype. Long-term outcomes are worse than for matched children with dilated cardiomyopathy.
The eu-Energy Security and Geopolitical Economy
Authors: Amineh Mehdi P. , Crijns-Graus Wina H. J. 
Published: March 2018

Abstract
Although energy supply security is an important long-term goal of the eu, member states are in control over external supplies and their domestic energy mix, and an overarching institutional structure is lacking. In this paper, we focus on the availability of oil and gas and the risks of supply disruptions for the eu. The last two decades have been marked by a decrease in fossil fuel production and increasing import dependence. Proven oil and gas reserves in the eu are very limited. Especially in the case of oil the outlook of both global and own eu reserves looks bleak. At the same time, global trends show an increasing demand for energy in the coming decades, concentrated mainly in developing countries, specifically in China. The Persian Gulf area and the Caspian Sea region hold some of the world’s largest oil and gas reserves, and these will make them increasingly significant in global markets. These factors create a setting for the eu of demand- and supply-induced and structural scarcity. The persistence of Arab patrimonial rentier states and societies are a domestic and geopolitical source of instability. These states’ Sovereign Wealth Funds are used by ruling elites to divert assets from socioeconomic development towards individual profit. Emerging Asian economies involved in the me and the cea, especially China, will influence the regions’ future geopolitical and geo-economic reality. China relies on resources for domestic development and the resource-rich Middle Eastern countries have long been a destination from which to acquire them.
Driver Vigilance in Automated Vehicles: Hazard Detection Failures Are a Matter of Time
Authors: Greenlee Eric T. , DeLucia Patricia R. , Newton David C. 
Published: March 2018

Objective: The primary aim of the current study was to determine whether monitoring the roadway for hazards during automated driving results in a vigilance decrement. Background: Although automated vehicles are relatively novel, the nature of human-automation interaction within them has the classic hallmarks of a vigilance task. Drivers must maintain attention for prolonged periods of time to detect and respond to rare and unpredictable events, for example, roadway hazards that automation may be ill equipped to detect. Given the similarity with traditional vigilance tasks, we predicted that drivers of a simulated automated vehicle would demonstrate a vigilance decrement in hazard detection performance. Method: Participants “drove” a simulated automated vehicle for 40 minutes. During that time, their task was to monitor the roadway for roadway hazards. Results: As predicted, hazard detection rate declined precipitously, and reaction times slowed as the drive progressed. Further, subjective ratings of workload and task-related stress indicated that sustained monitoring is demanding and distressing and it is a challenge to maintain task engagement. Conclusion: Monitoring the roadway for potential hazards during automated driving results in workload, stress, and performance decrements similar to those observed in traditional vigilance tasks. Application: To the degree that vigilance is required of automated vehicle drivers, performance errors and associated safety risks are likely to occur as a function of time on task. Vigilance should be a focal safety concern in the development of vehicle automation.
Improving Measurement Efficiency of the Inner EAR Scale with Item Response Theory
Authors: Jessen Annika , Ho Andrew D. , Corrales C. Eduardo , Yueh Bevan , Shin Jennifer J. 
Published: March 2018

Objectives(1) To assess the 11‐item Inner Effectiveness of Auditory Rehabilitation (Inner EAR) instrument with item response theory (IRT). (2) To determine whether the underlying latent ability could also be accurately represented by a subset of the items for use in high‐volume clinical scenarios. (3) To determine whether the Inner EAR instrument correlates with pure tone thresholds and word recognition scores.DesignIRT evaluation of prospective cohort data.SettingTertiary care academic ambulatory otolaryngology clinic.Subjects and MethodsModern psychometric methods, including factor analysis and IRT, were used to assess unidimensionality and item properties. Regression methods were used to assess prediction of word recognition and pure tone audiometry scores.ResultsThe Inner EAR scale is unidimensional, and items varied in their location and information. Information parameter estimates ranged from 1.63 to 4.52, with higher values indicating more useful items. The IRT model provided a basis for identifying 2 sets of items with relatively lower information parameters. Item information functions demonstrated which items added insubstantial value over and above other items and were removed in stages, creating a 8‐ and 3‐item Inner EAR scale for more efficient assessment. The 8‐item version accurately reflected the underlying construct. All versions correlated moderately with word recognition scores and pure tone averages.ConclusionThe 11‐, 8‐, and 3‐item versions of the Inner EAR scale have strong psychometric properties, and there is correlational validity evidence for the observed scores. Modern psychometric methods can help streamline care delivery by maximizing relevant information per item administered.
Attitudes of radiation oncologists to percutaneous endoscopic gastrostomy in patients with head and neck cancer and eating difficulties: A survey in China
Authors: Fan Lingli , Li Jie , Xiang Miao , Yuan Li , Zhang Yu , Feng Gang , Du Xiaobo 
Published: March 2018

Objective To investigate the attitudes of radiation oncologists towards using percutaneous endoscopic gastrostomy (PEG) to solve nutritional problems in patients with head and neck cancer (HNC) undergoing radiotherapy. Methods A self-reported questionnaire was developed and used to assess the willingness of radiation oncologists from 26 hospitals throughout several provinces in China to use the nutritional method. Results Of the 433 radiation oncologists who were contacted and returned questionnaires, 361 were completed correctly and used in the study (83.4% completion rate). Years of working and degree of understanding PEG were significantly related to the willingness of oncologists to use PEG in patients with HNC. Radiation oncologists who were willing to accept PEG training were more willing to use PEG. Main reasons for unwillingness to use PEG were poor understanding of the operation or cost and fear of side effects causing medical disputes. Conclusions The findings of the survey suggest that attitudes of radiation oncologists in China towards using PEG in patients with HNC requiring nutritional support may be improved by providing accessible training in the technique.
The Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS): Normative Data
Authors: Fabricant Peter D. , Suryavanshi Joash R. , Calcei Jacob G. , Marx Robert G. , Widmann Roger F. , Green Daniel W. 
Published: March 2018

Background: Recent data have shown an increase in youth sports participation at younger ages, which may be linked to greater musculoskeletal injury risk. The Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS) is a validated 8-item instrument designed to quantify the activity of children between 10 and 18 years old. Normative data on pediatric and adolescent activity level are unknown. Purpose: To establish normative activity-level data for American youth and to determine if there is a natural decrease in activity level during adolescence. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A cross-sectional investigation was performed among 2002 US children and adolescents equally split by sex and age and representing census-weighted distributions of state of residency, race/ethnicity, and health insurance status. Respondents completed the HSS Pedi-FABS, as well as survey questions on demographics and sports participation. Normative data were reported with descriptive statistics. Linear regression analysis was performed to determine if there was an effect of age on activity level during adolescence. Results: A total of 2002 respondents completed the survey; the mean age of the respondents at the time of survey completion was 14.0 ± 2.6 years. Mean weekly amount of reported physical activity was 9.3 ± 8.4 hours. HSS Pedi-FABS scores were normally distributed with a mean of 15.4 ± 8.5 points (out of 30 possible points). There was a modest but statistically significant decrease in HSS Pedi-FABS activity scores with increasing age ( r = −0.175, P < .001), corresponding to a linear decrease in activity scores by 27% on average from age 10 to 18 years. Conclusion: The current study provides baseline normative data for activity level in a census-weighted representative population sample of 2002 American youth through the use of a validated activity score (HSS Pedi-FABS). There was a modest but statistically significant decrease in activity scores with increasing age. These results will aid future research by providing normative, representative population-level activity data and will help to quantify the natural rate of decreased activity during adolescence.
Comparison of two intramuscular sedation protocols on sedation, recovery and ease of venipuncture for cats undergoing blood donation
Authors: Reader Rebecca C , Barton Bruce A , Abelson Amanda L 
Published: March 2018

Objectives The aim of this study was to compare the quality of sedation and recovery, and ease of venipuncture following sedation for feline blood donation using two intramuscular (IM) sedation protocols: alfaxalone/butorphanol (AB) and dexmedetomidine/butorphanol (DB). Methods This was an experimental randomized, blinded, crossover study. Ten client-owned healthy cats were recruited to participate in the study. Cats were sedated with AB (alfaxalone 2 mg/kg and butorphanol 0.2 mg/kg) for one donation and DB (dexmedetomidine 10 μg/kg and butorphanol 0.2 mg/kg) for another. Reaction to injection, quality of sedation and quality of recovery were assessed by a blinded observer. Time to lateral recumbency, number of venipuncture attempts, time required for blood collection and time to return to sternal recumbency were recorded. Cats were monitored for evidence of gastrointestinal distress. Each donation consisted of a maximum of 53 ml whole blood drawn over 3–22 mins. Donors received 100 ml subcutaneous lactated Ringer’s solution in recovery. Owners, unaware of sedation protocol, were asked to complete a questionnaire evaluating their cat’s behavior following sedation. Results IM injections were well tolerated by both treatment groups. There was no significant difference between treatment groups in sedation scores for posture ( P = 0.30) or behavior ( P = 0.06). Cats sedated with DB had significantly higher muscle relaxation scores ( P = 0.03) compared with AB. There was no significant difference between treatment groups in time to lateral recumbency ( P = 0.12), number of venipuncture attempts ( P = 0.91) and time for blood draw ( P = 0.29). There was no difference in quality of recoveries between treatment groups based on simple descriptive scores ( P = 0.18) and owner evaluation 24 h following sedation. One cat vomited following administration of DB. Conclusions and relevance Alfaxalone is a suitable alternative to dexmedetomidine when combined with butorphanol and used as part of an IM sedation protocol for cats undergoing blood donation.
Evaluation of orally administered telmisartan for the reduction of indirect systolic arterial blood pressure in awake, clinically normal cats
Authors: Coleman Amanda E , Brown Scott A , Stark Marcus , Bryson Lawrence , Zimmerman Alicia , Zimmering Tanja , Traas Anne M 
Published: March 2018

Objectives The aim of this study was to compare the effects of multiple once- or twice-daily oral dosage rates of the angiotensin II, type-1 receptor blocker, telmisartan (TEL), or placebo (PLA) on indirect systolic arterial blood pressure (SBP) in awake, clinically normal cats. Methods Utilizing an incomplete crossover design and following a 14 day acclimation period, 28 healthy laboratory cats were randomized to undergo treatment with three of the following 14 day treatment protocols, each separated by a 1 week washout period: oral PLA q24h, oral TEL at a dosage of 1, 1.5, 2 or 3 mg/kg q24h, or oral TEL at a dosage of 1 or 1.5 mg/kg q12h. Using the Doppler ultrasound method, indirect SBP was measured daily during each treatment period, and daily during the first 5 days of each washout period, approximately 3 h after administration of the morning treatment. Results Each treatment protocol was administered to a total of 12 cats. A statistically significant effect of treatment period was identified for the entire study; therefore, only data from the first treatment period (four cats per treatment group) were used for further analysis. Compared with PLA, during the first treatment period, SBP values were significantly lower in cats treated with TEL at all tested dosages by the second week of treatment. SBP remained significantly lower than in PLA-treated animals for 2 days following administration of the last dose in all TEL treatment groups. No clinical signs of hypotension were noted in any group. Conclusions and relevance These results suggest that treatment with TEL at a total daily dose of 1–3 mg/kg – administered as a single dose, or split into two equal doses administered 12 h apart – results in a significant, relatively long-lasting reduction of SBP in clinically normal cats. TEL appears to be well tolerated by normal cats at the dosages tested.