bluuebunny/crossref_metadata_2025_split huggingface dataset:
Calcified cerebral emboli: Incidence and implications
Authors: Bardon Miguel , Hanson Julian , O'Brien Bill , Naeem Adil 
Published: April 2018

AbstractIntroductionCalcified cerebral emboli are an increasingly recognized cause of ischaemic stroke, although recognition amongst general radiologists and clinicians can be limited. Recent literature suggests that calcified cerebral emboli are likely more common than originally thought. This study aims to define the prevalence of calcified cerebral emboli as the most likely aetiology within a cohort of confirmed cases of acute stroke, as well as compare and contrast these cases with cases of ‘incidental’ intracranial calcification.MethodsCases of confirmed stroke between May 2014 and May 2017 were reviewed by two readers to assess for the most likely aetiology. Cases of presumed calcified cerebral embolus were categorized in to ‘possible’ or ‘definite’. The morphology, distribution and density were analysed by two independent readers, then subsequently discussed to reach a consensus. Cases were further studied in terms of likely proximal embolic source, therapeutic interventions and clinical outcomes. A further random selection of 220 non‐contrast CT head examinations were reviewed over the same time period to assess for the presence of calcification which was favoured to be ‘intravascular’ using the same criteria.ResultsA total of 220 cases of confirmed stroke were reviewed. Thirteen of these cases were thought to be most likely secondary to calcified cerebral emboli (5.9%). Of the 13 cases, eight were considered ‘definite’ as previous premorbid imaging without calcification was available. Twelve patients had emboli within the anterior circulation and only one patient had an embolus in the posterior circulation. Moderate calcified atherosclerotic disease was noted within the aorta and carotid arteries of all patients. Of the 220 patients within the control group, three cases were thought to have intracranial calcification most likely to be intravascular without clinical sequelae or other supportive imaging findings of infarct.ConclusionPreviously thought to be a rare complication of intra‐arterial instrumentation, calcified cerebral emboli have been shown to more commonly be associated with spontaneous cerebral infarction. Whilst literature in this area remains scant, recognition and differentiation of this entity has important clinical applications regarding immediate diagnosis of stroke on non‐contrast imaging, modified treatment in the acute setting as well as in regards to recurrent event prognosis and secondary prevention.
Differential clinical presentation of Adamantiades–Behçet's disease in non‐endemic and endemic areas: retrospective data from a Middle‐European cohort study
Authors: Moosmann Thomas , Veraar Cécilia , Brunner Jürgen , Fraedrich Gustav , Frech Andreas , Horninger Wolfgang , Ratzinger Gudrun , Streif Werner , Teuchner Barbara , Willeit Johann , Zlamy Manuela , De Zordo Tobias , Schirmer Michael 
Published: April 2018

AbstractObjectivesTo assess demographical and clinical data in a Middle‐European cohort of patients with Adamantiades–Behçet's disease (ABD), together with the use of medication in adherence to international guidelines.MethodsIn a retrospective cohort study, in‐ and outpatients of an Austrian secondary and tertiary university hospital center were analyzed independent from the medical discipline involved. After ethics approval, screening for ABD‐patients in the clinical information system resulted in 1821 documents from 1997 to 2016. Patients fulfilling the International Criteria for Behçet's Disease were included, and ABD symptoms and signs together with medical interventions for immunosuppression, anticoagulation and pain management were identified by individual chart reviews and evaluated for conformity with international recommendations.ResultsA total of 76 ABD patients were identified with 39.1% Austrian and 37.0% Turkish origin. Genital aphthae and skin manifestations were more frequent, neurological, gastrointestinal and vascular manifestations less frequent in ABD patients of Turkish origin living in Austria compared to those living in Turkey (each P < 0.05). The male‐to‐female ratio averaged 0.86 (0.39 in patients with Austrian and 1.43 with Turkish backgrounds), and was 3.3 in patients with venous manifestations. Out of 174 medical interventions, 55.2% fully matched the European League Against Rheumatism recommendations of 2008, and 93.7% were considered at least as equal to the recommendations. Indications for tumor necrosis factor inhibition were in line with the 2007 Sfikakis recommendations.ConclusionsIn this Middle‐European ABD cohort clinical presentations between patients of Austrian and Turkish origin do not strongly vary, whereas Turkish patients from the non‐endemic Innsbruck cohort present differently compared to patients living in Turkey. The role of such cohort analyses will increase, from the epidemiological as well as the management perspective.
Perioperative hyperoxia and post‐operative cardiac complications in adults undergoing non‐cardiac surgery: Systematic review protocol
Authors: Petersen C. , Wetterslev J. , Meyhoff C. S. 
Published: April 2018

BackgroundOxygen therapy is used liberally for all patients undergoing anaesthesia. Recent studies have raised concerns that it may not be without complications when arterial oxygen concentrations reach supranormal concentrations (hyperoxia). Studies of oxygen therapy have raised concerns that the risk of myocardial injury and infarction is elevated in patients with hyperoxia due to vasoconstriction and formation of reactive oxygen species. Due to lack of symptoms or silent ischaemia, post‐operative myocardial injury may be missed clinically. In some studies, perioperative hyperoxia has been linked to increased long‐term mortality, but cardiac complications are sparsely evaluated. The aim of this review is to summarize current evidence to assess the risk and benefits of perioperative hyperoxia on post‐operative cardiac complications.MethodsThis systematic review will include meta‐analyses and Trial Sequential Analyses. We will include randomized clinical trials with patients undergoing non‐cardiac surgery if the allocation separates patients into a target of either higher (above 0.60) or lower (below 0.40) inspired oxygen fraction. To minimize the risk of systematic error, we will assess the risk of bias of the included trials using the Cochrane Risk of Bias Tool. The overall quality of evidence for each outcome will be assessed with the Grading of Recommendation, Assessment, Development and Evaluation (GRADE).DiscussionThis systematic review will provide data on a severe, albeit rare, potential risk of oxygen therapy. We will do a trial sequential analysis to assess the robustness of results as well as help estimate the required patient size for future clinical trials.
Spindle cell rhabdomyosarcoma of the anterior mandible manifesting as a periapical lesion of pulpal origin: Case report
Authors: Sadhasivam Vanitha , Sherwood I. Anand , Gutmann James L. , Gururaj N. , Mahalakshmi V. , Doss Daffney M. 
Published: April 2018

AbstractA 25‐year‐old male patient presented with swelling and pain in the mandibular anterior region for the previous 6 months. He had a history of repeated traumatic episodes associated with his lower incisors. A periapical radiograph revealed a radiolucent lesion involving the apices of the lower incisors, whereas cone beam computed tomography revealed a large osteolytic lesion involving all mandibular incisors and loss of labial and lingual cortical plates. Histological, immunohistochemical and bone scan examination of the curetted tissue established a differential diagnosis of spindle cell rhabdomyosarcoma of the anterior mandible. Such rare but life‐threatening oral cancers can be correctly diagnosed and treated only through systematic analysis of clinical findings and examining the diseased tissue with histological and other diagnostic procedures.
Safety of sofosbuvir‐based regimens after liver transplantation: longitudinal assessment of renal function in the prospective ANRS CO23 CUPILT study
Authors: Anty R. , Favre G. , Coilly A. , Rossignol E. , Houssel‐Debry P. , Duvoux C. , De Ledinghen V. , Di Martino V. , Leroy V. , Radenne S. , Kamar N. , Canva V. , D'Alteroche L. , Durand F. , Dumortier J. , Lebray P. , Besch C. , Tran A. , Canivet C. M. , Botta‐Fridlund D. , Montialoux H. , Moreno C. , Conti F. , Silvain C. , Perré P. , Habersetzer F. , Abergel A. , Debette‐Gratien M. , Dharancy S. , Esnault V. L. M. , Fougerou‐Leurent C. , Cagnot C. , Diallo A. , Veislinger A. , Danjou H. , Samuel D. , Pageaux G.‐P. , Duclos‐Vallée J.‐C. ,   the ANRS CO23 CUPILT Study Group
Published: April 2018

SummaryBackgroundIn liver transplant recipients with hepatitis C virus recurrence, there is concern about renal safety of sofosbuvir‐based regimens. Changes in serum creatinine or in the estimated glomerular filtration rate (eGFR) under treatment are used to look for possible renal toxicity. However, serum creatinine and eGFR are highly variable.AimTo analyse renal function trajectory with numerous assays of serum creatinine over a long period of time.MethodsIn a multicentre cohort of 139 patients, the eGFR was obtained from serum creatinine using the Chronic Kidney Disease–Epidemiology Collaboration (CKD‐EPI) equation. Slopes of eGFR were defined as a change in eGFR during a period divided by time. Pre‐treatment, on‐treatment and post‐treatment periods were 9 months, 3‐9 months and 4.5 months. Interactions between eGFR slopes and the pre‐treatment eGFR, use of ribavirin or mycophenolate mofetil, and stage of fibrosis were addressed. On‐treatment eGFR slopes were separated in tertiles. Pre‐ and post‐treatment eGFR slopes were compared globally and according to tertiles.ResultsThe post‐treatment eGFR slope was significantly better than pre‐treatment eGFR slope (+0.18 (IQR −0.76 to +1.32) vs −0.11 (IQR −1.01 to +0.73) mL/min/1.73 m2/month, P = 0.03) independently of the pre‐treatment eGFR (P = 0.99), ribavirin administration (P = 0.26), mycophenolate mofetil administration (P = 0.51) and stage of fibrosis (F3 and F4 vs lower stages, P = 0.18; F4 vs lower stages, P = 0.08; F4 Child‐Pugh B and C vs lower stages, P = 0.38). Tertiles of on‐treatment eGFR slopes were −1.71 (IQR −2.54 to −1.48), −0.78 (IQR −1.03 to −0.36) and +0.75 (IQR +0.28 to +1.47) mL/min/1.73 m2/month. Pre‐ and post‐treatment eGFR slopes were not significantly different according to tertiles (respectively, P = 0.34, 0.08, 0.73).ConclusionThe eGFR varies during treatment and gives a confusing picture of the renal safety of sofosbuvir‐based regimens. In contrast, longitudinal assessment of the eGFR shows a rising trajectory over longer time, meaning that these therapies are safe for the kidneys in our cohort of liver transplant recipients.
High body mass index is associated with increased risk of treatment failure and surgery in biologic‐treated patients with ulcerative colitis
Authors: Kurnool S. , Nguyen N. H. , Proudfoot J. , Dulai P. S. , Boland B. S. , Vande Casteele N. , Evans E. , Grunvald E. L. , Zarrinpar A. , Sandborn W. J. , Singh S. 
Published: April 2018

SummaryBackgroundThough pharmacokinetic studies suggest accelerated biologic drug clearance with increasing body weight, evidence of obesity's impact on clinical outcomes in biologic‐treated patients with ulcerative colitis (UC) is inconsistent.AimTo evaluate the impact of obesity on real world response to biological therapy in patients with UC.MethodsIn a single‐centre retrospective cohort study between 2011‐2016 of biologic‐treated patients with UC, we evaluated treatment response by baseline body mass index (BMI). Primary outcome was treatment failure (composite outcome of IBD‐related surgery/hospitalisation or treatment modification including dose escalation, treatment discontinuation or addition of corticosteroids); secondary outcomes were risk of IBD‐related surgery/hospitalisation and endoscopic remission. We conducted multivariate Cox proportional hazard analyses to evaluate the independent impact of BMI on clinical outcomes. Stratified analysis by weight‐based regimens (infliximab) or fixed‐dose regimens (adalimumab, golimumab, vedolizumab, certolizumab pegol) was performed.ResultsWe included 160 biologic‐treated UC patients (50% males, 55% on infliximab) with median (IQR) age 36 y (26‐52) and BMI 24.3 kg/m2 (21.4‐28.7). On multivariate analysis, each 1 kg/m2 increase in BMI was associated with 4% increase in the risk of treatment failure (adjusted hazard ratio [aHR], 1.04 [95% CI, 1.00‐1.08]) and 8% increase in the risk of surgery/hospitalisation (aHR, 1.08 [1.02‐1.14]). The effect on treatment failure was seen in patients on weight‐based dosing regimens or fixed‐dose therapies.ConclusionBMI is independently associated with increased risk of treatment failure in biologic‐treated patients with UC, independent of dosing regimen.
Use of Non‐Vitamin K Antagonist Oral Anticoagulants 2008–2016: A Danish Nationwide Cohort Study
Authors: Haastrup Simone Bonde , Hellfritzsch Maja , Rasmussen Lotte , Pottegård Anton , Grove Erik Lerkevang 
Published: April 2018

AbstractWe aimed to provide detailed utilization data on the total use of non‐vitamin K antagonist oral anticoagulants (NOACs) since their introduction in 2008. Using the nationwide Danish National Prescription Registry, we identified all individuals filling prescriptions for NOACs 2008–2016. We reported the development in incident and prevalent users and explored baseline characteristics and treatment persistence according to treatment indication. A total of 126,691 NOAC users were identified within the Danish population of 5.7 million inhabitants. The annual incidence and prevalence increased rapidly reaching 10 and 17 per 1000 individuals in 2016. Patients received NOACs due to atrial fibrillation (AF) (43%), venous thromboembolism (VTE) prophylaxis after arthroplastic surgery (17%), VTE (12%) and no registered indication (28%). The most frequently used NOAC was rivaroxaban (n = 52,431), followed by dabigatran (n = 47,067), apixaban (n = 27,116) and edoxaban (n = 77). The proportion of AF and VTE patients initiating low‐dose NOACs were between 23% and 50%. Patients treated with NOAC for VTE primarily received rivaroxaban. We observed a trend towards increased use of apixaban and rivaroxaban at the expense of dabigatran. Treatment persistence was highly dependent on treatment indication. Persistence to NOAC after 3 years was only 62% in AF compared to 28% for VTE. We documented an accelerating increase in the use of all four NOACs in the first 8 years after introduction. We have identified areas requiring further attention, including reasons for missing indications, potential inappropriate dosing and low long‐term persistence with NOACs in patients with AF.
MILFM: Multiple Index Latent Factor Model Based on High-Dimensional Features
Authors: Yang Hojin , Zhu Hongtu , Ibrahim Joseph G. 
Published: April 2018

SummaryThe aim of this article is to develop a multiple-index latent factor modeling (MILFM) framework to build an accurate prediction model for clinical outcomes based on a massive number of features. We develop a three-stage estimation procedure to build the prediction model. MILFM uses an independent screening method to select a set of informative features, which may have a complex nonlinear relationship with the outcome variables. Moreover, we develop a latent factor model to project all informative predictors onto a small number of local subspaces, which lead to a few key features that capture reliable and informative covariate information. Finally, we fit the regularized empirical estimate to those key features in order to accurately predict clinical outcomes. We systematically investigate the theoretical properties of MILFM, such as risk bounds and selection consistency. Our simulation results and real data analysis show that MILFM outperforms many state-of-the-art methods in terms of prediction accuracy.
Pseudo and Conditional Score Approach to Joint Analysis of Current Count and Current Status Data
Authors: Wen Chi-Chung , Chen Yi-Hau 
Published: April 2018

Summary
We develop a joint analysis approach for recurrent and nonrecurrent event processes subject to case I interval censorship, which are also known in literature as current count and current status data, respectively. We use a shared frailty to link the recurrent and nonrecurrent event processes, while leaving the distribution of the frailty fully unspecified. Conditional on the frailty, the recurrent event is assumed to follow a nonhomogeneous Poisson process, and the mean function of the recurrent event and the survival function of the nonrecurrent event are assumed to follow some general form of semiparametric transformation models. Estimation of the models is based on the pseudo-likelihood and the conditional score techniques. The resulting estimators for the regression parameters and the unspecified baseline functions are shown to be consistent with rates of square and cubic roots of the sample size, respectively. Asymptotic normality with closed-form asymptotic variance is derived for the estimator of the regression parameters. We apply the proposed method to a fracture-osteoporosis survey data to identify risk factors jointly for fracture and osteoporosis in elders, while accounting for association between the two events within a subject.
On the Analysis of Discrete Time Competing Risks Data
Authors: Lee Minjung , Feuer Eric J. , Fine Jason P. 
Published: April 2018

Summary
Regression methodology has been well developed for competing risks data with continuous event times, both for the cause-specific hazard and cumulative incidence functions. However, in many applications, including those from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute, the event times may be observed discretely. Naive application of continuous time regression methods to such data is not appropriate. We propose maximum likelihood inferences for estimation of model parameters for the discrete time cause-specific hazard functions, develop predictions for the associated cumulative incidence functions, and derive consistent variance estimators for the predicted cumulative incidence functions. The methods are readily implemented using standard software for generalized estimating equations, where models for different causes may be fitted separately. For the SEER data, it may be desirable to model different event types on different time scales and the methods are generalized to accommodate such scenarios, extending earlier work on continuous time data. Simulation studies demonstrate that the methods perform well in realistic set-ups. The methodology is illustrated with stage III colon cancer data from SEER.
Perceived peer and school norm effects on youth antisocial and prosocial behaviours through intergroup contact in Northern Ireland
Authors: McKeown Shelley , Taylor Laura K. 
Published: April 2018

In adolescence, youth spend a high proportion of their time with their peers and in school; it is hardly surprising therefore that perceptions of peer and school norms have a strong influence on their attitudes and behaviours. These norms, however, do not always influence youth in the same way. Building on past research, the present study examines the role of peer norms and school norms in influencing the quantity and quality of intergroup contact, as well as the impact of such contact on positive and negative intergroup behaviours. Youth (aged 14–16) living in Northern Ireland (N = 466, evenly split by religion and gender) were recruited through their school as part of a two‐wave study and completed a series of survey measures including intergroup contact (quality and quantity), norms (peer and school), and participation in sectarian antisocial behaviour and outgroup prosocial behaviour. Mediation analysis was conducted in Mplus. Controlling for wave 1 responses on contact and behavioural outcomes, findings demonstrate that more positive peer norms are associated with less participation in antisocial behaviour and more participation in prosocial outgroup behaviours through increased and better quality intergroup contact. Positive school norms were also associated with increased prosocial behaviour, but only though better quality contact. Findings demonstrate the relative importance of peer norms compared to school norms for this age group. The results have implications for school‐based interventions that aim to improve intergroup relations and highlight the importance of peer networks to promote more positive outgroup behaviours in divided societies such as Northern Ireland.
A high‐resolution sea‐level proxy dated using quartz OSL from the Holocene Skagen Odde spit system, Denmark
Authors: Clemmensen Lars B. , Hougaard Iben W. , Murray Andrew S. , Pedersen Simone S. 
Published: April 2018

The contact between wave‐influenced foreshore and aeolian‐influenced backshore sediments (BA boundary) in raised spit deposits (Skagen Odde) is here used as a proxy for palaeo‐sea level over the past 7600 years. The elevation of the BA boundary was measured at 57 sample sites along the northwestern coast of the spit, and the age of these sites determined by optically stimulated luminescence (OSL) dating of quartz grains. The elevation of the BA boundary with age gives past variation in relative sea level; relative sea level rose between c. 7600 and c. 6250 years ago, when it reached a peak value around 12.5 m above present mean sea level (apmsl), followed by a slow sea‐level fall until c. 4600 years ago before it dropped rapidly to reach 2 m apmsl c. 2000 years ago. From the new data it is tentatively deduced that the land uplift rate declined from about 3 mm a−1 6000 years ago to about 1.5 mm a−1 2000 years ago (low estimate), or alternatively from 5 mm a−1 5000 years ago to 1.5 mm a−1 2000 years ago (extreme estimate). These data indicate that the long‐term average rate of vertical land movement during the past 5000 years was around 1.8 mm a−1 (low estimate) or around 2.5 mm a−1 (extreme estimate). These values seem reasonable compared with a modern value of about 1.6 to 1.7 mm a−1. The lack of an independent data set illustrating the isostatic uplift history with time, however, precludes the construction of a well‐constrained eustatic sea‐level curve.
From humans to hydra: patterns of cancer across the tree of life
Authors: Albuquerque Thales A. F. , Drummond do Val Luisa , Doherty Aoife , de Magalhães João Pedro 
Published: April 2018

ABSTRACTCancer is a disease of multicellularity; it originates when cells become dysregulated due to mutations and grow out of control, invading other tissues and provoking discomfort, disability, and eventually death. Human life expectancy has greatly increased in the last two centuries, and consequently so has the incidence of cancer. However, how cancer patterns in humans compare to those of other species remains largely unknown. In this review, we search for clues about cancer and its evolutionary underpinnings across the tree of life. We discuss data from a wide range of species, drawing comparisons with humans when adequate, and interpret our findings from an evolutionary perspective. We conclude that certain cancers are uniquely common in humans, such as lung, prostate, and testicular cancer; while others are common across many species. Lymphomas appear in almost every animal analysed, including in young animals, which may be related to pathogens imposing selection on the immune system. Cancers unique to humans may be due to our modern environment or may be evolutionary accidents: random events in the evolution of our species. Finally, we find that cancer‐resistant animals such as whales and mole‐rats have evolved cellular mechanisms that help them avoid neoplasia, and we argue that there are multiple natural routes to cancer resistance.