bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tropical Cyclones and Climate Change Assessment: Part I: Detection and Attribution
Authors: Knutson Thomas , Camargo Suzana J. , Chan Johnny C. L. , Emanuel Kerry , Ho Chang-Hoi , Kossin James , Mohapatra Mrutyunjay , Satoh Masaki , Sugi Masato , Walsh Kevin , Wu Liguang 
Published: May 2019

AbstractAn assessment was made of whether detectable changes in tropical cyclone (TC) activity are identifiable in observations and whether any changes can be attributed to anthropogenic climate change. Overall, historical data suggest detectable TC activity changes in some regions associated with TC track changes, while data quality and quantity issues create greater challenges for analyses based on TC intensity and frequency. A number of specific published conclusions (case studies) about possible detectable anthropogenic influence on TCs were assessed using the conventional approach of preferentially avoiding type I errors (i.e., overstating anthropogenic influence or detection). We conclude there is at least low to medium confidence that the observed poleward migration of the latitude of maximum intensity in the western North Pacific is detectable, or highly unusual compared to expected natural variability. Opinion on the author team was divided on whether any observed TC changes demonstrate discernible anthropogenic influence, or whether any other observed changes represent detectable changes. The issue was then reframed by assessing evidence for detectable anthropogenic influence while seeking to reduce the chance of type II errors (i.e., missing or understating anthropogenic influence or detection). For this purpose, we used a much weaker “balance of evidence” criterion for assessment. This leads to a number of more speculative TC detection and/or attribution statements, which we recognize have substantial potential for being false alarms (i.e., overstating anthropogenic influence or detection) but which may be useful for risk assessment. Several examples of these alternative statements, derived using this approach, are presented in the report.
Comparison of the responsiveness of the Utrecht Scale for Evaluation of Rehabilitation (USER) and the Barthel Index in stroke patients
Authors: van Meijeren-Pont Winke , Volker Gerard , Vliet Vlieland Thea , Goossens Paulien 
Published: May 2019

Objective: To compare the responsiveness of the Utrecht Scale for Evaluation of Rehabilitation (USER) to the responsiveness of the Barthel Index in stroke patients in an inpatient rehabilitation facility. Design: Observational study. Setting: Inpatient rehabilitation facility. Subjects: Consecutive stroke patients admitted for clinical rehabilitation. Interventions: Not applicable. Main measures: The USER and the Barthel Index were administered by a nurse at admission and discharge. The Effect Size and Standardized Response Mean (SRM) were calculated as measures of responsiveness. Results: From 198 (78%) of the 254 patients who were included in the study period, both admission and discharge data were available. At admission the mean score of the USER subscale Functional independence was 43.1 ( SD = 18.9) and at discharge the mean score was 59.3 ( SD = 13.8). The mean score of the Barthel Index at admission was 13.3 ( SD = 5.4) and at discharge 18.4 ( SD = 3.3). The Effect Size of the USER subscales Mobility, Self-care, Cognitive functioning, Pain, Fatigue and Mood were 0.85, 0.77, 0.48, 0.19, 0.40 and 0.28, respectively, and of the Barthel Index 0.94. The results for the SRM were in the same range. Conclusion: In inpatient rehabilitation after stroke, the USER was less responsive than the Barthel Index.
Cytokine levels and their role in the etiopathogenesis of Burning Mouth Syndrome: A systematic review
Authors: Kishore Jaimala , Shaikh Fouzia , Mirza Sana , Raffat Muhammad Arsalan , Ikram Sana , Akram Zohaib 
Published: May 2019

Introduction Burning Mouth Syndrome is characterized by variable symptoms that include pain, burning and paraguesia in an otherwise healthy-appearing oral mucosa. Although the etiopathogenesis of Burning Mouth Syndrome is unknown, some studies provide evidence of subclinical inflammation leading to disrupted cytokine levels. Aim To investigate the expression of cytokines and role in the etiopathogenesis of Burning Mouth Syndrome. Methods Online databases (MEDLINE and EMBASE) were searched from November 1986 to November 2018 for case control/cross-sectional studies comparing the levels of cytokines in patients with Burning Mouth Syndrome and healthy controls. Results A total of eight studies were included in the current review. Four studies were of high and four studies were of moderate quality. Seven studies evaluated IL-6, out of which four showed comparable results, two showed higher levels and one study reported lower levels in Burning Mouth Syndrome patients compared to controls. Four studies assessed IL-2, out of which two reported comparable results whereas one study reported higher levels and one study reported lower levels in Burning Mouth Syndrome patients compared to controls. IL-10 levels were measured in three studies that reported no significant differences in the levels between Burning Mouth Syndrome and healthy controls. Discussion and conclusion The etiopathogenesis of Burning Mouth Syndrome is multifactorial. Studies have provided scientific evidence that inflammation plays a key role in Burning Mouth Syndrome pathogenesis. However, whether up-regulation or down-regulation of specific cytokines contribute to the etiopathogenesis of Burning Mouth Syndrome remains debatable. Further high-quality studies with larger sample size and assessing a wider array of cytokines are warranted in order to obtain strong conclusions.
Mathematical Model for Computer-Assisted Modification of Medication Dosing Rules
Authors: Grabel Michael Z , Vaughan Benjamin L , Dexheimer Judith W , Kirkendall Eric S 
Published: May 2019

Objective: Medication dosing in pediatrics is complex and prone to errors that may lead to patient harm. To improve computer-assisted dosing, a mathematical model and algorithm were developed to optimize clinical decision support dosing rules and reduce spurious alerts. The objective was to evaluate the feasibility of using this algorithm to adjust dosing rules. Materials and methods: Incorporating historical ordering data, a mathematical model and algorithm were developed to automatically determine optimal dosing rule parameters. The algorithm optimizes the dosing rules by balancing the number of alerts generated for a medication with a minimal length dose interval. In all, 5 candidate medications were tested. An analysis was performed to compare the number of alerts generated by the new model with the current dosing rules. Results: For the 5 medications, the algorithm generated multiple clinically relevant rule possibilities and the rules returned performed as well as current dosing rule or matched historical prescriber behavior. The rules were comparable to or better than the existing system rules in reducing the total alert burden. Discussion: The mathematical model and algorithm are an accurate and scalable solution to adjusting medication dosing rules. They can be implemented to change suboptimal rules more quickly than current manual methods and can be used to help identify and correct poor quality rules. Conclusions: Mathematical modeling using historic prescribing data can generate clinically appropriate electronic dosing rule parameters. This approach represents an automatable and scalable solution that could help reduce alert fatigue and decrease medication dosing errors.
Tumor Size and Overall Survival in Patients With Platinum-Resistant Ovarian Cancer Treated With Chemotherapy and Bevacizumab
Authors: Sostelly Alexandre , Mercier François 
Published: May 2019

Introduction: Ovarian cancer is now recognized as a constellation of distinct subtypes of neoplasia involving the ovary and related structures. As a consequence of this heterogeneity, the analysis of covariates influencing the overall survival is crucial in this disease segment. In this work, an overall survival model incorporating tumor kinetics metrics in patients with platinum-resistant ovarian cancer was developed from the randomized, open label, phase 3 AURELIA trial. Methods: Tumor size data from 361 patients randomly allocated to the bevacizumab + chemotherapy or chemotherapy study arm were collected at baseline and every 8 to 9 weeks until disease progression. Patients continued to be followed for survival after treatment discontinuation. A landmarked Cox proportional hazard survival model was developed to characterize the overall survival distribution. Results: Two sets of factors were found to be influential on survival time: those describing the type and severity of disease (Eastern Cooperative Oncology Group [ECOG], Féderation Internationale de Gynécologie et d’Obstétrique [FIGO] stages, presence of ascites) and those summarizing the key features of the tumor kinetic model (tumor shrinkage at week 8 and tumor size at treatment onset). The treatment group was not required in the final model as the drug effect was accounted for in the tumor kinetics model. Conclusions: This work has identified both ascites and tumor kinetics metrics as being the 2 most influential factors to explain variability in overall survival in patients with platinum-resistant ovarian cancer.
Antihyperglycemic Activity of Hydroalcoholic Extracts of Selective Medicinal Plants Curcuma longa, Lavandula stoechas, Aegle marmelos, and Glycyrrhiza glabra and Their Polyherbal Preparation in Alloxan-Induced Diabetic Mice
Authors: Mustafa Sodah Bint , Akram Muhammad , Muhammad Asif Hafiz , Qayyum Imran , Hashmi Asif Mehmood , Munir Naveed , Khan Fahad Said , Riaz Muhammad , Ahmad Saeed 
Published: May 2019

Background: Diabetes mellitus is a metabolic disorder associated with relative or absolute insulin deficiency or resistance, characterized by hyperglycemia. Modern prescriptions such as pioglitazone have better therapeutic potential, but its side effects and financial burden for developing countries have motivated the researchers to find alternative natural drugs to compete hyperglycemia in patients with diabetes. The present study was conducted to explore the therapeutic potential of selected medicinal plants for the treatment of diabetes as an alternative to allopathic medicines. Method: In present study, hydroalcoholic extracts of Curcuma longa, Lavandula stoechas, Aegle marmelos, and Glycyrrhiza glabra and their polyherbal preparation (PHP) as compound drug were investigated for their antihyperglycemic potential in alloxan-induced diabetic mice. The study subjects (mice) were divided into different groups as normal control, diabetic control, pioglitazone treated (standard drug), test groups (plant extract treated 50, 100, and 150 mg/kg body weight), and PHP-treated group. Blood glucose concentration of all the study animals was determined by Glucose strip test. Qualitative phytochemical analysis of all the plant extracts was also performed following standard methods. Result: It was investigated that treatment of alloxan-induced diabetic mice with hydroalcoholic extracts of studied medicinal plants showed significant ( P < .05) effects on fasting blood glucose levels (from baseline to normal range) in a manner comparable to that of the reference drug, pioglitazone (1 mg/kg body weight intraperitoneal). The tested plant extracts significantly ( P < .05) reduced the glucose concentration in blood of diabetes-induced mice in a dose-dependent manner. Conclusion: It could be concluded that studied medicinal plants have antihyperglycemic activity. The study findings favor the use of traditional herbal medicinal practices for the management of diabetes that might due to the presence of bioactive phytoconstituents in plants. However, larger studies are required to identify, isolate, and characterize the bioactive phytoconstituents responsible for antihyperglycemic activity of studied medicinal plants.
Trends in recruitment of women and reporting of sex differences in large-scale published randomized controlled trials in stroke
Authors: Carcel Cheryl , Woodward Mark , Balicki Grace , Koroneos Georgia Louise , Sousa Diana Aguiar de , Cordonnier Charlotte , Lukaszyk Caroline , Thompson Kelly , Wang Xia , Davies Leo , Bassi Meenakshi , Anderson Craig S , Peters Sanne AE , Sandset Else Charlotte 
Published: May 2019

Background Understanding of sex differences, especially in terms of the influence of sex on therapeutic interventions, can lead to improved treatment and management for all. Aim We examined temporal and regional trends in female participation and the reporting of sex differences in stroke randomized controlled trials. Methods Randomized controlled trials from 1990 to 2018 were identified from ClinicalTrials.gov, using keywords “stroke” and “cerebrovascular accidents.” Studies were selected if they enrolled ≥100 participants, included both sexes and were published trials (identified using PubMed, Google Scholar, and Scopus). Results Of 1700 stroke randomized controlled trials identified, 277 were published and eligible for analysis. Overall, these randomized controlled trials enrolled only 40% females, and in the past 10 years, this percentage barely changed, peaking at 41% in 2008–2009 and 2012–2013. North American randomized controlled trials recruited the most women, at 43%, and Asia the lowest, at 40%. Among the 277 randomized controlled trials, 101 (36%) reported results according to sex, of which 91 (33%) were pre-specified analyses. The increasing trend in the number of studies reporting sex-differentiated results from 2008 to 2018 merely paralleled the increase in the number of papers published during the same time period. North American randomized controlled trials most often reported sex-specific results (42%), and Australia and Europe least often (31%). Conclusion Little progress has been made in the inclusion of females and the reporting of sex in stroke randomized controlled trials. This highlights the need for key stakeholders, such as funders and journal editors, to provide clear guidance and effective implementation strategies to researchers in the scientific reporting of sex.
Efficacy of Short-Term Systemic Corticosteroid Therapy in Chronic Rhinosinusitis With Nasal Polyps: A Meta-Analysis of Randomized Controlled Trials and Systematic Review
Authors: Zhang Yunyun , Wang Chengshuo , Huang Yanran , Lou Hongfei , Zhang Luo 
Published: May 2019

Background Corticosteroids are considered the most effective medication to control chronic rhinosinusitis with nasal polyps (CRSwNP); however, the studies of systemic corticosteroids in this field are relatively few and meta-analyses are lacking. Objective We aimed to systematically review the efficacy and safety of systemic corticosteroids for patients with CRSwNP via meta-analysis. Methods Data were extracted from relevant and appropriate randomized controlled trials (RCTs) of systemic corticosteroids for patients with CRSwNP from PubMed, MEDLINE, Ovid, Embase, the Cochrane Central Register of Controlled Trials, and Google Scholar. Efficacy was assessed based on clinical outcomes, while safety was assessed based on adverse events (AEs). Results A total of 337 relevant publications were identified, of which 7 RCTs including 414 participants were included in the meta-analysis. Compared to placebos or nonsteroid treatments, systemic corticosteroids significantly improved nasal obstruction scores standardized mean difference (SMD −2.81; 95% confidence interval [CI], −4.68 to −0.95; P = .003), reduced the nasal polyp size (SMD −4.76; 95% CI, −6.99 to −2.52; P < .0001), and improved peak nasal inspiratory flow (PNIF) (SMD 42.39; 95% CI, 28.95 to 55.84; P < .00001). The high-dose (more than or equal to 50 mg/day prednisone) and low-dose subgroups (less than 50 mg/day prednisone) experienced similar benefits. However, insomnia and gastrointestinal disturbances were noted more frequently in patients treated with high doses of prednisone. Other AEs were infrequent and were not significantly different between the subgroups. Conclusion Systemic corticosteroids provide significant improvements in nasal symptoms and PNIF as well as a reduction in nasal polyp size for patients with CRSwNP. Prednisone doses less than 50 mg/day were recommended when the efficacy of oral corticosteroids in CRSwNP was balanced against potential adverse effects.
Therapeutic levetiracetam monitoring during pregnancy: “mind the gap”
Authors: Berlin Maya , Barchel Dana , Gandelman-Marton Revital , Brandriss Nurit , Blatt Ilan , Ziv-Baran Tomer , Neufeld Miri Y. , Dinavitser Natalie , Kohn Elkana , Shaniv Dotan , De-Haan Tal , Ofek Fanny , Koren Gideon , Stepensky David , Berkovitch Matitiahu 
Published: May 2019

Background: Epilepsy is one of the most common chronic neurological conditions and its treatment during pregnancy is challenging. Levetiracetam (LEV) is an antiepileptic medication frequently used during pregnancy. Only a few small studies have been published on LEV monitoring during pregnancy, demonstrating decreased serum LEV levels during the first and second trimester; however, the most significant decrease was observed during the third trimester of pregnancy. In this study we aimed to evaluate LEV pharmacokinetics during different stages of pregnancy. Methods: We followed up and monitored serum levels of pregnant women treated with LEV for epilepsy. Results: Fifty-nine women with 66 pregnancies during the study period were included. The lowest raw LEV serum concentrations were observed during the first trimester. Compared with the pre-pregnancy period, raw serum concentration was lower by 5.76 mg/L [95% confidence interval (CI) (2.78, 8.75), p = 0.039] during the first trimester. Comparing the decrease in the first trimester with either the second or the third, no significant changes were observed ( p = 0.945, p = 0.866). Compared with pre-pregnancy measurements, apparent clearance was increased by 71.08 L/day [95%CI (16.34, 125.83), p = 0.011] during the first trimester. About 30% of LEV serum levels during pregnancy were below the laboratory quoted reference range. Conclusions: Raw LEV serum levels tend to decrease during pregnancy, mainly during the first trimester contrary to previous reports. Monitoring of LEV serum levels is essential upon planning pregnancy and thereafter if pre-pregnancy LEV levels are to be maintained. However, more studies are needed to assess the correlation with clinical outcome.
Hypertensive disorders of pregnancy and cardiometabolic outcomes in childhood: A systematic review
Authors: Jansen Maria AC , Pluymen Linda PM , Dalmeijer Geertje W , Groenhof T Katrien J , Uiterwaal Cuno SPM , Smit Henriëtte A , van Rossem Lenie 
Published: May 2019

AbstractBackgroundHypertensive disorders of pregnancy (HDPs) are among the leading causes of maternal and perinatal morbidity and mortality worldwide and have been suggested to increase long-term cardiovascular disease risk in the offspring.ObjectiveThe objective of this study was to investigate whether HDPs are associated with cardiometabolic markers in childhood.Search strategyPubMed, The Cochrane Library and reference lists of included studies up to January 2019.Selection criteriaStudies comparing cardiometabolic markers in 2–18-year-old children of mothers with HDP in utero, to children of mothers without HDP.Data collection and analysisSixteen studies reported in 25 publications were included in this systematic review, of which three were considered as having high risk of bias. Thus 13 studies were included in the evidence synthesis: respectively two and eight reported pregnancy induced hypertension and preeclampsia, and three studies reported on both HDPs.Main resultsMost studies (n = 4/5) found a higher blood pressure in children exposed to pregnancy induced hypertension. Most studies (n = 7/10) found no statistically significantly higher blood pressure in children exposed to preeclampsia. No association was found between exposure to HDP and levels of cholesterol, triglycerides or glucose (n = 5/5). No studies investigated an association with (carotid) intima-media thickness, glycated haemoglobin or diabetes mellitus type 2.ConclusionsMost studies showed that exposure to pregnancy induced hypertension is associated with a higher offspring blood pressure. There is no convincing evidence for an association between exposure to preeclampsia and blood pressure in childhood. Based on current evidence, exposure to HDP is not associated with blood levels of cholesterol, triglycerides and glucose in childhood.
Deep infiltrating endometriosis: Interest of the robotic approach for a fledgling team
Authors: Poujois Julie , Mézan De Malartic Cécile , Callec Ronan , Bresler Laurent , Hubert Nicolas , Judlin Philippe , Morel Oliver 
Published: May 2019

Introduction: Mini-invasive surgery of deep endometriosis is challenging. Surgical difficulties related to the technical limitations of classical laparoscopic approach might be overcome with the use of robotic assistance. The aim of this study was to evaluate the safety and feasibility of robotic surgery for deep infiltrating endometriosis in the learning phase of our team. Methods: The 20 first cases of robotic-assisted laparoscopies for endometriosis were included over a 2-year period. Baseline characteristics of patients and surgical data were reviewed. Surgical outcomes and follow-up information of the patients were analyzed. Results: Twenty women were included. The mean age was 31.9 years (range: 25–44) and mean body mass index was 23 kg/m2 (range: 16–35). Ten patients had rectovaginal or uterosacral location only (50%) and nine women had deep infiltrating endometriosis with digestive or urinary tract lesions (45%). In addition to the gynecologic surgeon, urologic or visceral surgeons were required in 10 cases, and there were 3 cases where the three specialties were needed. The mean operative time was 183.9 min (range: 85–398) and no difference was observed between the first five cases and the last five cases. There was one laparoconversion, and only two urologic postoperative complications occurred. Conclusion: Thanks to the use of robotic surgical assistance and a multidisciplinary approach, and despite the start of the team for deep endometriosis care, no learning curve effect was observed regarding surgical procedures’ success, safety, or duration. The use of robotic assistance might improve the quality of care for women facing deep endometriosis.
Amikacin exposure and susceptibility of macrolide-resistantMycobacterium abscessus
Authors: Daniel-Wayman Shelby , Shallom Shamira , Azeem Nabila , Olivier Kenneth N. , Zelazny Adrian M. , Prevots D. Rebecca 
Published: May 2019

Mycobacterium abscessusis associated with antibiotic resistance and poor treatment outcomes. We described within-patient changes inM. abscessusresistance to clarithromycin and amikacin.Patients with amikacin exposure and a >50-month interval betweenM. abscessusisolates were identified. Antimicrobial susceptibility testing was performed on the first and last isolates by broth microdilution, and genetic markers of resistance were identified.16 patients were identified with a median amikacin exposure of 2.3 years (range 0.6–8.6 years). 15 patients also received macrolides (median 7.2 years, range 1.3–10.7 years). All initial isolates were resistant to clarithromycin (minimum inhibitory concentration (MIC) ≥8 µg·mL−1). Two patients had later susceptible isolates, which were of a different subspecies (M. abscessussubsp.massiliense) than the initial isolates (M. abscessussubsp.abscessus). All initial isolates were susceptible or intermediately resistant to amikacin, and only one patient had a resistant final isolate (MIC >64 µg·mL−1), accompanied by an A→G mutation at position 1408 of the 16S ribosomal RNA. Forced expiratory volume in 1 s decreased significantly over the study period, while smear quantity and the proportions of patients with elevated C-reactive protein or cavitary lesions all increased significantly.Despite prolonged, mostly inhaled amikacin exposure, development of amikacin resistance was uncommon in this patient population; however, disease progression continued.