bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nodules and masses are associated with malignant pleural effusion in dogs and cats but many other intrathoracic CT features are poor predictors of the effusion type
Authors: Reetz Jennifer A. , Suran Jantra N. , Zwingenberger Allison L. , Stefanovski Darko 
Published: December 2018

AbstractThoracic CT may be used in the workup of patients with pleural effusion. In humans, certain pleural features on CT aid in diagnosing an underlying cause for pleural effusion, whereas this is not well studied in veterinary medicine. This retrospective cross‐sectional analytical study assessed pleural and other intrathoracic abnormalities on CT in dogs and cats with pleural effusion and explored potential discriminatory features between effusion types. Eighty‐nine dogs and 32 cats with pleural cytology and/or histopathology were categorized into malignant pleural disease (15 dogs and 11 cats), pyothorax (34 dogs and 7 cats), chylothorax (20 dogs and 11 cats), transudative (11 dogs and 2 cats), and hemorrhagic effusion (9 dogs and 1 cat). Multivariable logistic regression analysis comparing malignancy to other effusions found that older patient age (dogs: odds ratio 1.28,P = 0.015; cats: odds ratio 1.53,P = 0.005), nodular diaphragmatic pleural thickening (dogs: odds ratio 7.64,P = 0.021; cats: odds ratio 13.67,P = 0.031), costal pleural masses (dogs: odds ratio 21.50,P = 0.018; cats: odds ratio 32.74,P = 0.019), and pulmonary masses (dogs: odds ratio 44.67,P = 0.002; cats: odds ratio 18.26,P = 0.077) were associated with malignancy. In dogs, any costal pleural abnormality (odds ratio 47.55,P = 0.002) and pulmonary masses (odds ratio 10.05,P = 0.004) were associated with malignancy/pyothorax, whereas any costal pleural abnormality (odds ratio 0.14,P = 0.006) and sternal lymphadenopathy (odds ratio 0.22,P = 0.040) were inversely associated with transudates. There were, however, many overlapping abnormalities between effusion types, so further diagnostic testing remains important for diagnosis.
Impact of a void in the equine medial femoral condyle on bone stresses and peak contact pressures in a finite element model
Authors: Frazer Lance L. , Santschi Elizabeth M. , Fischer Kenneth J. 
Published: December 2018

AbstractObjectiveTo predict bone and medial meniscal stresses and contact pressures in an equine stifle with a medial femoral condyle (MFC) intact or with a 2‐cm3 subchondral bone void, under varying degrees of internal femoral rotation (IFR).Study designFinite element model (FEM) of a cadaveric equine stifle loaded to 8000 N.MethodsThe FEM was constructed from computed tomography (CT) of the right, extended stifle of a yearling. The CT image was segmented into relevant anatomic structures and meshed into 4‐node tetrahedrons. Bone material properties were assigned according to Hounsfield units, soft tissue properties were estimated from published data, and the model was loaded to 8000 N in 155° extension.ResultsThe main stresses found in the intact MFC were in compression, with very small areas of shear and tension. Adding a 2‐cm3 MFC void increased peak compression stress by 25%, shear by 50%, and tension by 200%. An MFC void also increased tension and shear placed on the medial meniscus by 30%. Under load, IFR of 2.5° and 5° increased MFC peak stresses 8%‐21%.ConclusionA 2‐cm3 MFC void in an equine stifle FEM increased stress in the bone and meniscus. Internal femoral rotation slightly increased predicted bone stress.Clinical significanceIncreases in bone and meniscal stress predicted in an MFC with a void provide evidence to understand the persistence of voids and mechanism of damage to the medial meniscus.
The personal and social experiences of community-dwelling younger adults after stroke in Australia: a qualitative interview study
Authors: Shipley Jessica , Luker Julie , Thijs Vincent , Bernhardt Julie 
Published: December 2018

ObjectivesTo examine the personal and social experiences of younger adults after stroke.DesignQualitative study design involving in-depth semi-structured interviews and rigorous qualitative descriptive analysis informed by social constructionism.ParticipantsNineteen younger stroke survivors aged 18 to 55 years at the time of their first-ever stroke.SettingParticipants were recruited from urban and rural settings across Australia. Interviews took place in a clinic room of the Florey Institute of Neuroscience and Mental Health (Melbourne, Australia), over an online conference platform or by telephone.ResultsFour main themes emerged from the discourses: (1) psycho-emotional experiences after young stroke; (2) losing pre-stroke life construct and relationships; (3) recovering and adapting after young stroke; and (4) invalidated by the old-age, physical concept of stroke. While these themes ran through the narratives of all participants, data analysis also drew out interesting variation between individual experiences.ConclusionsFor many younger adults, stroke is an unexpected and devastating life event that profoundly diverts their biography and presents complex and continued challenges to fulfilling age-normative roles. While adaptation, resilience and post-traumatic growth are common, this study suggests that more bespoke support is needed for younger adults after stroke. Increasing public awareness of young stroke is also important, as is increased research attention to this problem.
Scoping review of priority setting of research topics for musculoskeletal conditions
Authors: Bourne Allison M , Johnston Renea V , Cyril Sheila , Briggs Andrew M , Clavisi Ornella , Duque Gustavo , Harris Ian A , Hill Catherine , Hiller Claire , Kamper Steven J , Latimer Jane , Lawson Andrew , Lin Chung-Wei Christine , Maher Christopher , Perriman Diana , Richards Bethan L , Smitham Peter , Taylor William John , Whittle Sam , Buchbinder Rachelle 
Published: December 2018

ObjectiveDescribe research methods used in priority-setting exercises for musculoskeletal conditions and synthesise the priorities identified.DesignScoping review.Setting and populationStudies that elicited the research priorities of patients/consumers, clinicians, researchers, policy-makers and/or funders for any musculoskeletal condition were included.Methods and analysisWe searched MEDLINE and EMBASE from inception to November 2017 and the James Lind Alliance top 10 priorities, Cochrane Priority Setting Methods Group, and Cochrane Musculoskeletal and Back Groups review priority lists. The reported methods and research topics/questions identified were extracted, and a descriptive synthesis conducted.ResultsForty-nine articles fulfilled our inclusion criteria. Methodologies and stakeholders varied widely (26 included a mix of clinicians, consumers and others, 16 included only clinicians, 6 included only consumers or patients and in 1 participants were unclear). Only two (4%) reported any explicit inclusion criteria for priorities. We identified 294 broad research priorities from 37 articles and 246 specific research questions from 17 articles, although only four (24%) of the latter listed questions in an actionable format. Research priorities for osteoarthritis were identified most often (n=7), followed by rheumatoid arthritis (n=4), osteoporosis (n=4) and back pain (n=4). Nearly half of both broad and specific research priorities were focused on treatment interventions (n=116 and 111, respectively), while few were economic (n=8, 2.7% broad and n=1, 0.4% specific), implementation (n=6, 2% broad and n=4, 1.6% specific) or health services and systems research (n=15, 5.1% broad and n=9, 3.7% specific) priorities.ConclusionsWhile many research priority-setting studies in the musculoskeletal field have been performed, methodological limitations and lack of actionable research questions limit their usefulness. Future studies should ensure they conform to good priority-setting practice to ensure that the generated priorities are of maximum value.PROSPERO registration numberCRD42017059250.
Precision-Exercise-Prescription in patients with lung cancer undergoing surgery: rationale and design of the PEP study trial
Authors: Ulrich Cornelia M , Himbert Caroline , Boucher Kenneth , Wetter David W , Hess Rachel , Kim Jaewhan , Lundberg Kelly , Ligibel Jennifer A , Barnes Christopher A , Rushton Bailee , Marcus Robin , Finlayson Samuel R G , LaStayo Paul C , Varghese Thomas K 
Published: December 2018

IntroductionLung cancer is a significant burden on societies worldwide, and the most common cause of death in patients with cancer overall. Exercise intervention studies in patients with lung cancer have consistently shown benefits with respect to physical and emotional functioning. However, to date, exercise training has not been consistently implemented into clinical practice given that interventions have been costly and not aligned with clinical care.Methods/designThe Precision-Exercise-Prescription (PEP) study is a prospective randomised controlled trial comparing the effectiveness and feasibility of a personalised intervention exercise programme among patients with lung cancer undergoing surgery. Two-hundred patients who are diagnosed with stage primary or secondary lung cancer and are eligible to undergo surgical treatment at Huntsman Cancer Institute comprise the target population. Patients are randomised to either the (1) outpatient precision-exercise intervention group or (2) delayed intervention group. The intervention approach uses Motivation and Problem Solving, a hybrid behavioural treatment based on motivational interviewing and practical problem solving. The dosage of the exercise intervention is personalised based on the individual’s Activity Measure for Post-Acute-Care outpatient basic mobility score, and incorporates four exercise modes: mobility, callisthenics, aerobic and resistance. Exercise is implemented by physical therapists at study visits from presurgery until 6 months postsurgery. The primary endpoint is the level of physical function assessed by 6 min walk distance at 2 months postsurgery. Secondary outcomes include patient-reported outcomes (eg, quality of life, fatigue and self-efficacy) and other clinical outcomes, including length of stay, complications, readmission, pulmonary function and treatment-related costs up to 6 months postsurgery.Ethics/disseminationThe PEP study will test the clinical effectiveness and feasibility of a personalised exercise intervention in patients with lung cancer undergoing surgery. Outcomes of this clinical trial will be presented at national and international conferences and symposia and will be published in international, peer-reviewed journals. Ethics approval was obtained at the University of Utah (IRB 00104671).Trial registration numberNCT03306992.
Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis
Authors: Kvaslerud Anette Borger , Hussain Amjad Iqbal , Auensen Andreas , Ueland Thor , Michelsen Annika E , Pettersen Kjell Ingar , Aukrust Pål , Mørkrid Lars , Gullestad Lars , Broch Kaspar 
Published: December 2018

ObjectiveThe aim of this study was to evaluate the prevalence and prognostic implication of iron deficiency (ID) and anaemia in patients with severe aortic stenosis (AS).MethodsIn an observational study of consecutive patients referred for aortic valve replacement (AVR), we assessed a wide range of biomarkers of iron status, including the definition of ID commonly applied in patients with chronic heart failure (ferritin <100 µg/L or ferritin 100–299 µg/L with a transferrin saturation <20%). The endpoints were short-term (one-year) and long-term (median 4.7 years, IQR: 3.8–5.5) mortality and major adverse cardiovascular events (MACE) within the first year after inclusion.Results464 patients were included in this substudy. 91 patients (20%) received conservative treatment and 373 patients (80%) received AVR. ID was detected in 246 patients (53%). 94 patients (20%) had anaemia. Patients with ID had an overall worse clinical profile than patients without ID. During follow-up, 129 patients (28%) died. Neither ID as defined above, soluble transferrin receptor nor hepcidin were associated with short-term or long-term mortality or MACE independent on treatment allocation. Anaemia was associated with one-year mortality in conservatively treated patients.ConclusionsID and anaemia are prevalent in patients with severe AS. In our cohort, ID did not provide independent prognostic information on top of conventional risk factors. More studies are required to determine how to correctly diagnose ID in patients with AS.Trial registration numberNCT01794832.
Performance of the Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis in a geographically distant National Register-based cohort: an external validation
Authors: Ljung Lotta , Ueda Peter , Liao Katherine P , Greenberg Jeffrey D , Etzel Carol J , Solomon Daniel H , Askling Johan 
Published: December 2018

BackgroundCardiovascular (CV) risk stratification for patients with rheumatoid arthritis (RA) should facilitate evidence-based management. Prior work has derived an internally validated a CV risk score, the Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis (ERS-RA), using US data. The aim of this study was to perform an external validation among unselected patients with RA from Europe.MethodsThree large, partially overlapping, cohorts of patients with RA from the Swedish Rheumatology Quality register were identified for external validation, two with information on smoking and two with close to 10 years of median follow-up. The 10 -year rate of first CV events was assessed using the Kaplan-Meier method. The performance of ERS-RA was assessed using C-index and comparisons of observed versus predicted risks.ResultsThe C-index for ERS-RA varied across the three RA cohorts, from 0.75 to 0.78. Predicted risks corresponded well to observed risks among individuals with ≤10 % observed 10- year CV risk, but underestimated risk in individuals with a higher observed risk. In the absence of data on smoking, ERS-RA underestimated the CV risk by 3.3%, whereas in the cohorts including data on smoking, the calibration was within 1% (0.06% and 0.7%). In the clinically relevant risk intervals (<5%, 5.0%–<7.5%, 7.5%–<10%), ERS-RA performed well.ConclusionsIn an unselected Swedish population with RA, ERS-RA performed well, although the 10-year CV risk was underestimated in high-risk groups and in the absence of data on smoking. ERS-RA could be considered as a risk stratification tool for targeted preventive interventions in clinical rheumatology practice.
Review of Modern Data Science
Authors: Miller Allan M. 
Published: December 2018

Modern Data Science with R (MDSR) is one of the first textbooks to provide a comprehensive introduction to data science for students at the undergraduate level (it is also suitable for graduate students and professionals in other fields). The authors follow the approach taken by Garrett Grolemund and Hadley Wickham in their book, R for Data Science7, and David Robinson in Teach the Tidyverse to Beginners, which emphasizes the teaching of data visualization and the tidyverse (using dplyr and chained pipes) before covering base R, along with using real-world data and modern data science methods.
The textbook includes end of chapter exercises (an instructor's solution manual is available), and a series of lab activities is also under development. The result is an excellent textbook that provides a solid foundation in data science for students and professionals alike.
Edsger W. Dijkstra
Authors: Alpern Bowen 
Published: December 2018

It would be understatement to say that news of this year's Dijkstra award came to me as a surprise. In fact, it put me into a rather profound funk, occasioning unsought re ection on my arguably misspent adulthood. It has been some time since I have done signi cant scienti c research. So, I am quite humbled to be here.
I did not really know Dijkstra, but I certainly knew of him. With Fred and David Gries on the faculty, his in uence on the Computer Science Department at Cornell was substantial when I was a graduate student. (I trust it still is.)
AKT/mTORC2 Inhibition Activates FOXO1 Function in CLL Cells Reducing B-Cell Receptor-Mediated Survival
Authors: Cosimo Emilio , Tarafdar Anuradha , Moles Michael W. , Holroyd Ailsa K. , Malik Natasha , Catherwood Mark A. , Hay Jodie , Dunn Karen M. , Macdonald Alan M. , Guichard Sylvie M. , O'Rourke Declan , Leach Michael T. , Sansom Owen J. , Cosulich Sabina C. , McCaig Alison M. , Michie Alison M. 
Published: December 2018

AbstractPurpose:To determine whether inhibition of mTOR kinase-mediated signaling represents a valid therapeutic approach for chronic lymphocytic leukemia (CLL).Experimental Design:Stratification of mTOR activity was carried out in patients with primary CLL samples and an aggressive CLL-like mouse model. The potency of dual mTOR inhibitor AZD8055 to induce apoptosis in primary CLL cells was assessed in the presence/absence of B-cell receptor (BCR) ligation. Furthermore, we addressed the molecular and functional impact of dual mTOR inhibition in combination with BTK inhibitor ibrutinib.Results:Differential regulation of basal mTORC1 activity was observed in poor prognostic CLL samples, with elevated p4EBP1T37/46 and decreased p70S6 kinase activity, suggesting that dual mTORC1/2 inhibitors may exhibit improved response in poor prognostic CLL compared with rapalogs. AZD8055 treatment of primary CLL cells significantly reduced CLL survival in vitro compared with rapamycin, preferentially targeting poor prognostic subsets and overcoming BCR-mediated survival advantages. Furthermore, AZD8055, and clinical analog AZD2014, significantly reduced CLL tumor load in mice. AKT substrate FOXO1, while overexpressed in CLL cells of poor prognostic patients in LN biopsies, peripheral CLL cells, and mouse-derived CLL-like cells, appeared to be inactive. AZD8055 treatment partially reversed FOXO1 inactivation downstream of BCR crosslinking, significantly inhibiting FOXO1T24 phosphorylation in an mTORC2-AKT–dependent manner, to promote FOXO1 nuclear localization, activity, and FOXO1-mediated gene regulation. FOXO1 activity was further significantly enhanced on combining AZD8055 with ibrutinib.Conclusions:Our studies demonstrate that dual mTOR inhibitors show promise as future CLL therapies, particularly in combination with ibrutinib.
Impact of Breast Cancer Subtypes on Prognosis of Women with Operable Invasive Breast Cancer: A Population-based Study Using SEER Database
Authors: Hwang Ki-Tae , Kim Jongjin , Jung Jiwoong , Chang Ji Hyun , Chai Young Jun , Oh So Won , Oh Sohee , Kim Young A. , Park Sung Bae , Hwang Kyu Ri 
Published: December 2018

Abstract

Purpose:
To determine the prognostic roles of breast cancer subtypes in females with operable invasive breast cancer.
Experimental Design: Data of 321,958 patients from Surveillance, Epidemiology, and End Results (SEER) database were analyzed. Breast cancer subtypes were classified into four categories according to the status of hormone receptor (HRc) and HER2: HRc(+)/HER2(−), HRc(+)/HER2(+), HRc(−)/HER2(+), and HRc(−)/HER2(−).

Results:
Proportions of HRc(+)/HER2(−), HRc(+)/HER2(+), HRc(−)/HER2(+), HRc(−)/HER2(−), and unknown subtype were 70.3%, 9.4%, 3.9%, 10.4%, and 6.0%, respectively. HRc(+)/HER2(−) showed the highest 5-year breast cancer–specific survival (BCSS) rate (95.5%), followed by HRc(+)/HER2(+) (94.1%), HRc(−)/HER2(+) (89.3%), and HRc(−)/HER2(−) (83.1%). HRc(+)/HER2(−) and HRc(+)/HER2(+) showed higher 5-year overall survival (OS) rates (88.4% and 88.2%, respectively) than HRc(−)/HER2(+) and HRc(−)/HER2(−) (83.9% and 76.5%, respectively). HRc(−)/HER2(−) showed the worst BCSS irrespective of race, age, or stage. Although proportions of HRc(−)/HER2(−) in the subgroup with negative event regarding BCSS and OS were 10.4% and 10.2%, respectively, they were 34.2% and 22.7%, respectively, in the subgroup with positive event. Subtype was a significant factor in both univariable and multivariable analyses regarding both BCSS and OS (all P &lt; 0.001).

Conclusions:
Breast cancer subtype was a significant independent prognostic factor regarding both BCSS and OS in multivariable analyses. HRc(+) subtypes showed better prognosis compared with HRc(−) subtypes regarding both BCSS and OS. HRc(−)/HER2(+) showed better prognosis than HRc(−)/HER2(−) but worse prognosis than HRc(+) subtypes regarding both BCSS and OS. The triple-negative subtype showed the worst BCSS compared with the other subtypes irrespective of race, age, or stage.
Profiling Hospital Performance Based on Mortality After Transcatheter Aortic Valve Replacement in Ontario, Canada
Authors: Elbaz-Greener Gabby , Qiu Feng , Masih Shannon , Fang Jiming , Austin Peter C. , Cantor Warren J. , Dvir Danny , Asgar Anita W. , Webb John G. , Ko Dennis T. , Wijeysundera Harindra C. 
Published: December 2018

Background:
Public reporting of hospital-level outcomes is increasingly common as a means to target quality improvement strategies to ensure the delivery of optimal care. Despite the rapid dissemination of transcatheter aortic valve replacement (TAVR), there is a paucity of reliable case-mix adjustment models for hospital profiling in TAVR. Our objective was to develop and evaluate different models for calculating risk-standardized all-cause mortality rates (RSMRs) post-TAVR.

Methods and Results:
In this population-based study in Ontario, Canada, we identified all patients who underwent a TAVR procedure between April 1, 2012, and March 31, 2016. For each hospital, we calculated 30-day and 1-year RSMR, using 2-level hierarchical logistic regression models that accounted for patient-specific demographic and clinical characteristics, as well as the clustering of patients within the same hospital using a hospital-specific random effects. We classified each hospital into one of 3 groups: performing worse than expected, better than expected, or performing as expected, based on whether the 95% CI of the RSMR was above, below, or included the provincial average mortality rate, respectively. Our cohort consisted of 2129 TAVR procedures performed at 10 hospitals. The observed mortality was 7.0% at 30 days and 16.4% at 1 year, with a range of 4% to 10% and 8% to 22%, respectively, across hospitals. We developed case-mix adjustment models using 28 clinically relevant variables. Using 30-day and 1-year RSMR to profile each hospital, we found that all hospitals performed as expected, with 95% CI that included the provincial average.

Conclusions:
We found no significant interhospital variation in RSMR among hospitals, suggesting that quality improvement efforts should be directed at aspects other than the variation in observed mortality.