bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacogenetics of Warfarin in a Diverse Patient Population
Authors: Mak May , Lam Carol , Pineda Sandra J. , Lou Mimi , Xu Lilia Yang , Meeks Christopher , Lin Cindy , Stone Roslynn , Rodgers Kathy , Mitani Gladys 
Published: May 2019

Introduction: Many warfarin-related genotypes have shown to impact the average daily warfarin (ADW) dose requirements; however, information in non-Caucasian populations is limited. Objectives: To identify the frequencies of 4 warfarin-related gene polymorphisms in an ethnically diverse patient population and to examine their impact with other clinical variables on ADW dose requirements. Methods: Patients were recruited from 2 anticoagulation clinics in the Los Angeles area. Blood samples were collected and genotyped for vitamin K epoxide reductase (VKORC1), CYP2C9*2, CYP2C9*3, and CYP4F2 after informed consent. Charts were reviewed to collect demographic, clinical, and warfarin dosing data. Results: A total of 291 patients were included (120 Caucasians, 127 Hispanics, and 44 Asians). In patients with wild-type genotypes for VKORC1, CYP2C9*2, CYP2C9*3, and CYP4F2, the highest warfarin requirement was found in Caucasians, lower in Hispanics, and lowest in Asians. Homozygous VKORC1 variant carriers were detected in 15%, 15%, and 79% in Caucasians, Hispanics, and Asians, respectively. Progressive lowering of ADW doses were associated with each VKORC1 variant in Caucasians and Hispanics, but the results in wild-type/ heterozygote Asians were unclear. CYP2C9 variants were associated with lower ADW doses; frequencies of CYP2C9*2 and CYP2C9*3 mutations were higher in Caucasians than in Hispanics but rare to none in Asians. The frequencies of CYP4F2 variant were similar across all ethnicities, but their impact on warfarin dose requirement were insignificant. Clinical factors such as age, body surface area, history of coronary artery disease, deep vein thrombosis or atrial fibrillation, and concomitant amiodarone or HMG-CoA reductase inhibitors had varying impact on the ADW requirements in the ethnicities studied. Conclusions: Our study demonstrated differences among 3 ethnic groups in terms of ADW dose requirements and the impact of associated clinical variables. The results suggest that a single model for all ethnicities may not provide the best performance in predicting warfarin dose requirements.
Impacts of CD40- and CD86-Silenced Antigen-Specific B Cells on the Control of Allergies
Authors: Suzuki Motohiko , Matsumoto Tamami , Toyoda Kiichi , Nakamura Yoshihisa , Murakami Shingo 
Published: May 2019

Background We previously reported that CD40-silenced B cells inhibited allergic responses and symptoms. However, more potent therapies are needed. To our knowledge, the effects of CD86-silenced B cells and synergic effects of gene silencing in B cells by 2 small interfering RNAs (siRNAs) on allergic disease control have not been reported. Objective To investigate the effects of CD86-silenced B cells and synergic effects of gene silencing in B cells on allergic responses and symptoms. Methods Mice were treated with CD40- and/or CD86-silenced B cells transfected with siRNAs and pulsed with ovalbumin (OVA). And the effects of these B cells were estimated. Results CD86-silenced OVA-pulsed B cells significantly inhibited OVA-induced allergies. Treatment with CD40-/CD86-silenced OVA-pulsed B cells led to a significantly fewer sneezes and nasal rubbing movements, as well as lower OVA-specific immunoglobulin E (IgE) levels, than that with CD40-silenced or CD86-silenced OVA-pulsed B cells alone. These inhibitory effects were observed prior to sensitization as well as after the establishment of allergic rhinitis. CD40-/CD86-silenced OVA-pulsed B cells did not inhibit keyhole limpet hemocyanin-induced allergies. CD40-/CD86-silenced OVA-pulsed B cells also significantly inhibited allergic symptoms and OVA-specific IgE level in sera compared with CD40-/CD86-silenced OVA-pulsed dendritic cells (DCs). In addition, CD19+CD40− B cells significantly increased in the nasal tissue after intravenous administration of these cells. Furthermore, CD40-/CD86-silenced B cells inhibited allergic symptoms caused by Cry j 1, a major aeroallergen of Japanese cedar pollen, and Cry j 1-specific IgE in sera. Conclusion This study showed, for the first time, that siRNA-induced CD86-silenced B cells significantly inhibited allergic responses and symptoms antigen-specifically, and that siRNA-induced CD40-/CD86-silenced antigen-specific B cells are a more useful antigen-specific therapy than CD40- or CD86-silenced B cells alone for the control of allergies. Furthermore, it was shown that CD40-/CD86-silenced B cells have stronger inhibition of IgE production and allergic symptoms than CD40-/CD86-silenced DCs.
AOSpine—Spine Trauma Classification System: The Value of Modifiers: A Narrative Review With Commentary on Evolving Descriptive Principles
Authors: Divi Srikanth N. , Schroeder Gregory D. , Oner F. Cumhur , Kandziora Frank , Schnake Klaus J. , Dvorak Marcel F. , Benneker Lorin M. , Chapman Jens R. , Vaccaro Alexander R. 
Published: May 2019

Study Design: Narrative review. Objectives: To describe the current AOSpine Trauma Classification system for spinal trauma and highlight the value of patient-specific modifiers for facilitating communication and nuances in treatment. Methods: The classification for spine trauma previously developed by The AOSpine Knowledge Forum is reviewed and the importance of case modifiers in this system is discussed. Results: A successful classification system facilitates communication and agreement between physicians while also determining injury severity and provides guidance on prognosis and treatment. As each injury may be unique among different patients, the importance of considering patient-specific characteristics is highlighted in this review. In the current AOSpine Trauma Classification, the spinal column is divided into 4 regions: the upper cervical spine (C0-C2), subaxial cervical spine (C3-C7), thoracolumbar spine (T1-L5), and the sacral spine (S1-S5, including coccyx). Each region is classified according to a hierarchical system with increasing levels of injury or instability and represents the morphology of the injury, neurologic status, and clinical modifiers. Specifically, these clinical modifiers are denoted starting with M followed by a number. They describe unique conditions that may change treatment approach such as the presence of significant soft tissue damage, uncertainty about posterior tension band injury, or the presence of a critical disc herniation in a cervical bilateral facet dislocation. These characteristics are described in detail for each spinal region. Conclusions: Patient-specific modifiers in the AOSpine Trauma Classification highlight unique clinical characteristics for each injury and facilitate communication and treatment between surgeons.
The Hospital Experience Through the Patients’ Eyes
Authors: Snyder Haverly J , Fletcher Kathlyn E 
Published: May 2019

Background: Posthospital syndrome is associated with a decrease in physical and cognitive function and can contribute to overall patient decline. We can speculate on contributors to this decline (eg, poor sleep and nutrition), but other factors may also contribute. This study seeks to explain how patients experience hospitalization with particular attention on what makes the hospital stay difficult. Design: Qualitative interview study using grounded theory methodology. Setting: Single-site academic medical center. Patients: Hospitalized general medicine patients. Measurements: Interviews using a semistructured interview guide. Results: We recruited 20 general medicine inpatients from an academic medical center. Of the participants, 12 were women and the mean age was 55 years (range = 22-82 years). We found 4 major themes contributing to the hospital experience: (1) hospital environment (eg, food quality and entertainment), (2) patient factors (eg, indifference and expectations), (3) hospital personnel (eg, care team size and level of helpfulness), and (4) patient feelings (eg, level of control and feeling like an object). We discovered that these emotions arising from hospital experiences, together with the other 3 major themes, led to the patients’ perception of their hospital experience overall. We also explore the role that patient tolerance may play in the reporting of patient satisfaction. Conclusions: This article demonstrates the factors affecting how patients experience hospitalization. It provides insight into possible contributors to posthospital syndrome and offers a blueprint for specific quality improvement initiatives. Lastly, it briefly explores how patient tolerance may prove a challenge to the current system of quality reporting.
The efficacy and safety of modified FOLFIRINOX as first‐line chemotherapy for Chinese patients with metastatic pancreatic cancer
Authors: Wang Zhi‐Qiang , Zhang Fei , Deng Ting , Zhang Le , Feng Fen , Wang Feng‐Hua , Wang Wei , Wang De‐Shen , Luo Hui‐Yan , Xu Rui‐Hua , Ba Yi , Li Yu‐Hong 
Published: May 2019

AbstractBackgroundOxaliplatin, irinotecan, 5‐fluorouracil, and l‐leucovorin (FOLFIRINOX) has become one of the first‐line treatment options for advanced pancreatic cancer (PC). However, the relatively high rate of grade 3 or 4 adverse events associated with the standard dosage of FOLFIRINOX limits its widespread use in clinical practice. In this study, we were to evaluate the efficacy and safety of a modified FOLFIRINOX regimen as a first‐line chemotherapy for Chinese patients with metastatic PC.MethodsPatients with histologically confirmed primary metastatic pancreatic adenocarcinoma with an Eastern Cooperative Oncology Group (ECOG) performance status score of 0–2 were recruited to receive the modified FOLFIRINOX regimen (intravenous infusion of oxaliplatin, 65 mg/m2; irinotecan, 150 mg/m2; l‐leucovorin, 200 mg/m2; and 5‐fluorouracil, 2400 mg/m2, repeated every 2 weeks). The treatment was continued for 12 cycles unless the patient had progressive disease (PD), stable disease (SD) with symptom deterioration, unacceptable adverse events, or requested to terminate the treatment prematurely. The primary endpoint was objective response rate (ORR).ResultsSixty‐five patients were enrolled from July 2012 to April 2017 in three institutions, and they all received at least one cycle of chemotherapy, with a median of 8 cycles (range 1–12 cycles). No complete response was observed. Twenty‐one (32.3%) patients had partial responses, and 27 (41.5%) had SD. The ORR and disease control rate of the study cohort was 32.3% and 73.8%. The estimated median overall survival and progression‐free survival were 11.60 (95% confidence interval [CI] 8.76–14.44) and 5.77 (95% CI 5.00–6.54) months. Major grade 3 or 4 adverse events included neutropenia (12.3%) and diarrhea (6.2%). No treatment‐related death was observed.ConclusionsModified FOLFIRINOX was well‐tolerated and might be a promising option as first‐line therapy for Chinese patients with metastatic PC.Trial registration ClinicalTrials.gov, NCT02028806. Registered 7 January 2014, https://clinicaltrials.gov/ct2/show/NCT02028806
Local Consolidative Therapy Vs. Maintenance Therapy or Observation for Patients With Oligometastatic Non–Small-Cell Lung Cancer: Long-Term Results of a Multi-Institutional, Phase II, Randomized Study
Authors: Gomez Daniel R. , Tang Chad , Zhang Jianjun , Blumenschein George R. , Hernandez Mike , Lee J. Jack , Ye Rong , Palma David A. , Louie Alexander V. , Camidge D. Ross , Doebele Robert C. , Skoulidis Ferdinandos , Gaspar Laurie E. , Welsh James W. , Gibbons Don L. , Karam Jose A. , Kavanagh Brian D. , Tsao Anne S. , Sepesi Boris , Swisher Stephen G. , Heymach John V. 
Published: May 2019

PURPOSE Our previously published findings reported that local consolidative therapy (LCT) with radiotherapy or surgery improved progression-free survival (PFS) and delayed new disease in patients with oligometastatic non–small-cell lung cancer (NSCLC) that did not progress after front-line systemic therapy. Herein, we present the longer-term overall survival (OS) results accompanied by additional secondary end points. PATIENTS AND METHODS This multicenter, randomized, phase II trial enrolled patients with stage IV NSCLC, three or fewer metastases, and no progression at 3 or more months after front-line systemic therapy. Patients were randomly assigned (1:1) to maintenance therapy or observation (MT/O) or to LCT to all active disease sites. The primary end point was PFS; secondary end points were OS, toxicity, and the appearance of new lesions. All analyses were two sided, and P values less than .10 were deemed significant. RESULTS The Data Safety and Monitoring Board recommended early trial closure after 49 patients were randomly assigned because of a significant PFS benefit in the LCT arm. With an updated median follow-up time of 38.8 months (range, 28.3 to 61.4 months), the PFS benefit was durable (median, 14.2 months [95% CI, 7.4 to 23.1 months] with LCT v 4.4 months [95% CI, 2.2 to 8.3 months] with MT/O; P = .022). We also found an OS benefit in the LCT arm (median, 41.2 months [95% CI, 18.9 months to not reached] with LCT v 17.0 months [95% CI, 10.1 to 39.8 months] with MT/O; P = .017). No additional grade 3 or greater toxicities were observed. Survival after progression was longer in the LCT group (37.6 months with LCT v 9.4 months with MT/O; P = .034). Of the 20 patients who experienced progression in the MT/O arm, nine received LCT to all lesions after progression, and the median OS was 17 months (95% CI, 7.8 months to not reached). CONCLUSION In patients with oligometastatic NSCLC that did not progress after front-line systemic therapy, LCT prolonged PFS and OS relative to MT/O.
Improved clinical outcomes in pressure ulcer prevention using the SEM scanner
Authors: Smith Glenn 
Published: May 2019

Objective:An in-practice evaluation of an sub-epidermal moisture (SEM) scanner, to detect non-visible pressure damage, allowing appropriate, targeted pressure ulcer (PU) prevention interventions.Method:The evaluation included patients on a single medical-surgical ward over a period of two months.Results:The evaluation included 35 patients. The outcomes of the evaluation suggest that the SEM scanner provided objective evidence that both the interventions being employed and the increase in repositioning and assessment prevented further incipient skin damage.Conclusion:We conclude that the early detection of non-visible tissue injury using the SEM scanner as an adjunct to the usual PU risk assessment strategies can reduce PU incidence, leading to improved patient outcomes and released productivity.
Comparação entre diferentes métodos de interpolação zonal para estimativa populacional: estudo de caso das áreas urbanas do Distrito Federal
Authors: De Castro Kássia Batista , Roig Henrique Llacer , Neumann Marina Rolim Bilich 
Published: May 2019

Os dados acerca das características da população, normalmente divulgados pelo censo, são de suma importância, pois subsidiam inúmeros estudos sociais, econômicos e ambientais. Estes dados são agregados de maneira arbitrária, considerando a informação homogênea em um determinado espaço. Uma alternativa para contornar esse problema e gerar informação com qualidade espacial mais precisa é a utilização do mapeamento dasimétrico. O mapa dasimétrico utiliza dados auxiliares para refinar a representação da distribuição espacial da variável analisada. No decorrer das últimas décadas essa se tornou uma técnica bastante utilizada e diversos trabalhos foram realizados com diferentes abordagens metodológicas. Dessa forma, este trabalho tem como objetivo avaliar o desempenho de três diferentes abordagens do mapeamento dasimétrico para a estimativa da população urbana do Distrito Federal. Para tanto, utilizou-se os modelos dasimétricos por ponderação de área (MD1), utilizando densidade relativa subjetiva (MD2) e o método dasimétrico inteligente (MDI) com a densidade relativa amostrada pelo método do centroide (MD3). Para a geração dos mapas foram utilizados dados do censo com o valor populacional em nível de subdistrito. O mapa de uso e cobertura utilizado possui resolução de 1m e foi modificado a partir do mapeamento de tipos de estruturas urbanas (UST) do DF, o qual classifica a área urbana em relação a sua homogeneidade considerando aspectos de funcionalidade, material de cobertura e características físicas. Para a avaliação dos métodos gerados utilizou-se métodos estatísticos e gráficos, utilizando como comparação a informação da população em nível de setores censitários. De acordo com as análises aplicadas o modelo que demonstrou o melhor desempenho foi o MD3, sendo esta técnica aplicada para o nível de informação de setores censitários como mapa final de estimativa da distribuição espacial da população urbana do DF.
Influência da Forma das Encostas na Suscetibilidade à Erosão na Bacia Hidrográfica do Rio Claro (Santa Rita do Passa Quatro, SP)
Authors: Basilio Thamiris Cristina Costa , Fujimoto Jaqueline Tomiê , Lopes Thiago , Asciutti Gustavo Augusto Mendonça , Lorandi Reinaldo , De Lollo José Augusto 
Published: May 2019

A erosão é conhecida como um fenômeno que gera graves consequências ao ambiente, se tornou uma preocupação global e foco de muitos estudos que buscam prevenir ou controlar seus efeitos. A bacia hidrográfica do Rio Claro, situada na região nordeste do estado de São Paulo é constituída predominantemente de materiais inconsolidados de textura arenosa e compreende uma área de 251,91km². Este trabalho investigou, na escala 1:50.000, a influência das formas das encostas na suscetibilidade à erosão acelerada dessa bacia, a partir de dois métodos análise: Processo Analítico Hierárquico (AHP) e o Método da Soma Ponderada (Weighted Sum - WS). Com base em um banco de dados ambientais pré-existente, foram gerados mapas e cartas intermediários e temáticos. Os resultados mostram alta concentração de registros de erosões ativas de grande porte nas áreas com declividades entre 2% e 10%, compreendendo 1.55 km² relevo composto por colinas médias côncavas e convexas, e presença de materiais inconsolidados derivados das Formações Quaternárias e Terciárias. Tais processos se concentram em áreas classificadas como baixa e muito baixa suscetibilidade a erosão, segundo as duas técnicas utilizadas. Além da influência da textura arenosa e baixa compacidade dos solos, a concentração dos processos erosivos é controlada principalmente pela forma das encostas. Em termos percentuais, ocorrem mais processos erosivos nas áreas de colinas de perfil divergente côncavo, enquanto as maiores densidades de processos erosivos se localizam em áreas de colinas divergentes convexas e, secundariamente, nas colinas divergentes retilíneas.
Orientalische Handschriften der Wissenschaftlichen Stadtbibliothek Mainz erschlossen
Authors: Ottermann Annelen 
Published: May 2019

Zusammenfassung
Die sieben orientalischen Handschriften der Mainzer Wissenschaftlichen Stadtbibliothek wurden 2017/18 an der Arbeitsstelle Jena „Arabische Handschriften“ des Projekts „Katalogisierung der Orientalischen Handschriften in Deutschland“ der Göttinger Akademie der Wissenschaften erschlossen. Die Datenbank KOHD ist seit Jahresbeginn online.
Area Deprivation and its Impact on Population Health: Conceptual Aspects, Measurement and Evidence from Germany
Authors: Karmann Alexander , Weinhold Ines , Wende Danny 
Published: May 2019

Abstract
Empirical evidence demonstrates associations between socioeconomic or environmental area deprivation and public health. To measure such structural effects, deprivation indices have been developed in the UK initially. Meanwhile their application is increasingly discussed in Germany, however with little attempts to adapt the concept to national conditions. In this paper, we develop a model of area deprivation differentiating between material, social and ecological deprivation effects. We apply structural equation modelling to endogenously estimate the latent deprivation dimensions as well as their relative impact on the health outcome, accounting for potential measurement errors and controlling for health care infrastructure. We use data at the level of German municipal associations (n=4,491) for the years 2013 and 2016, if available. We find that differences in material (βmaterial=−0.168, p<0.001) and social deprivation (βsocial=−0.249, p<0.001) as well as ecological damage (βecological=−0.077, p<0.001) explain part of the health differences in Germany. The social dimension is paramount in a health context. Moreover, deprivation dimensions cancel out each other and combining them in one overall index blurs the diverse picture of area deprivation in Germany. The small area analysis illustrates, that different strategies in environmental-, education- or health policy are necessary to reduce deprivation in different regions.
Halfway there: the transition from 1968 to 2068 in tourism and hospitality
Authors: Webster Craig 
Published: May 2019

Summary

Objectives
The intention of this paper is to discuss the changes that have taken place in the past fifty years and the changes that we expect in the next fifty years. We will look into the political and economic changes in the global economy and see what some of the trends that are predictable will lead to (population decreases in developed countries and difficulties funding pension schemes in developed countries…). We will also investigate some of the major issues with which humanity will have to deal with in the next fifty years for which the end is less predictable (energy depletion, resource depletion, economic integration…). We will discuss the changes that have gone on and the changes that we can expect, explaining how the tourism and hospitality industries have responded and will have to respond to the major and impactful changes that will come.

Methodology
The methodology is an investigation of the economic and political trends of the past fifty years and a discussion of the probable continuation of some of the trends and probability of major shifts in the next fifty years.

Main Results and Contributions
In 1968, the world was different from now and the tourism industry has undergone a transformation as a response to major social, political, and economic changes. Fifty years on, we have transitioned from the world of the Cold War and are well into the digital age with a globalized political economy. Here, we take the time to discuss the ways that the great political, economic, and social transformations of the last 50 years have impacted upon the social practice of tourism. We will look at the trends and their trajectory to make an assessment of how tourism will have to adjust to the new world of tourism in the next 50 years. Key in this discussion are some social changes, such as demographic changes in wealthy countries, petroleum dependency, the shift in production to Asia, the trajectory of the fiat currency system, and the increasing use of robotic technologies and artificial intelligence, among other things. We end a discussion with a discussion of how the travel and tourism industries will have to adjust to the new political, economic, and social realities of 2068.

Limitations
The chief limitation is that there are many salient variables to investigate in terms of coming to terms with critical changes of the past and the critical ones that will be drivers to the future.

Conclusions
There will be many changes in the next fifty years that we can expect such as increasing stress on the pension systems in developed countries, negative population growths in the developed countries, the increasingly critical roles of robots and artificial intelligence in service industries and resource/energy depletion. The major geopolitical reorientation of the world towards Asia is also a key variable to consider, as well as whether the long-term trend towards economic liberalization and globalization of the world economy will continue.