bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical behaviour of patients exposed to organic dust and diagnosed with idiopathic pulmonary fibrosis
Authors: De Sadeleer Laurens J. , Verleden Stijn E. , De Dycker Els , Yserbyt Jonas , Verschakelen Johny A. , Verbeken Eric K. , Nemery Benoit , Verleden Geert M. , Hermans Frederik , Vanaudenaerde Bart M. , Wuyts Wim A. 
Published: June 2018

AbstractBackground and objectiveAlthough idiopathic pulmonary fibrosis (IPF) patients experience a worse survival compared with chronic hypersensitivity pneumonitis (CHP), organic dust exposure is a known risk factor for both IPF and CHP.MethodsWe divided patients diagnosed with IPF, based on their exposure to moulds/birds (absent: group A; present: group B). We retrospectively compared pulmonary function and survival between groups A and B, and a separate CHP cohort (group C).ResultsA total of 293 patients were included (group A: n = 171, group B: n = 73, group C: n = 49). Demographics and baseline pulmonary function did not differ between groups A and B, but significant differences were seen between groups B and C. Median survival of group B was 84 months, which was longer than group A (43 months, P = 0.002), but lower than group C (157 months, P = 0.04), in both univariate and multivariate analyses. Antifibrotic treatment resulted in a better outcome in group A (hazard ratio (HR): 0.44) and group B (HR: 0.12) without interaction between exposure and antifibrotic use (P = 0.20). Forced vital capacity (FVC) decline was not associated with mould/bird exposure in this cohort.ConclusionGroup B patients experienced a better outcome compared with (non‐exposed) IPF patients, although worse compared with CHP patients. Antifibrotic treatment in group B resulted in a similar beneficial effect compared with group A. Further research is needed to ascertain the diagnostic designation in this exposed usual interstitial pneumonia (UIP) patient group without other CHP features.
Spontaneous gastric dilatation‐volvulus in two cats
Authors: Leary Meredith L. , Sinnott‐Stutzman Virginia 
Published: June 2018

AbstractObjectivesTo describe 2 cases of gastric dilatation‐volvulus (GDV) in cats. To describe 2 unique clinical settings in which the disease occurs in cats, and to highlight the differences between GDV in cats and dogs.Case Series SummaryTwo neutered female Persian cats were presented for evaluation of respiratory distress. Initial physical examination revealed tachypnea, dyspnea, and a markedly distended and painful abdomen in both cats. Radiographs revealed a gas‐dilated stomach and gastrointestinal (GI) tract in both cats but were only diagnostic for GDV in 1 case. Gastric dilatation‐volvulus was confirmed during exploratory laparotomy and gastropexy was performed in each case. Both cats were successfully discharged from the hospital.New and Unique Information ProvidedGastric dilatation‐volvulus in cats is a rare event and appears to occur in 2 clinical settings: in combination with traumatic diaphragmatic hernia (as previously reported) and without a history of trauma or diaphragmatic hernia, as in the 2 cases reported here. Clinicians should consider GDV in the list of differentials for cats with respiratory distress and abdominal distension, even if classic radiographic findings are not present.
Strengthening the links between mapping, planning and global engagement for disease elimination: lessons learnt from trachoma
Authors: Courtright Paul , Rotondo Lisa A , MacArthur Chad , Jones Iain , Weaver Angela , Negash Biruck Kebede , Olobio Nicholas , Binnawi Kamal , Bush Simon , Abdala Mariamo , Haddad Danny , Bonfield Astrid , Emerson Paul , Sarah Virginia , Solomon Anthony W 
Published: June 2018

BackgroundTrachoma is the leading infectious cause of blindness. Until recently, reliable data on the global extent of the disease, detailed plans for elimination, and government, donor and partner engagement were all inadequate.MethodsThe trachoma community undertook a systematic, three-pronged strategy to map trachoma district by district, develop national-level trachoma elimination plans, and create a framework for governments, donors and partners to convene and coordinate in support of trachoma elimination.ResultThere has been a frame-shift in internal and external perceptions of the global trachoma programme, from being an effort working towards disease control in focussed geographical areas, to one in the process of achieving worldwide disease elimination. Multiple factors contributed to the successful implementation of mapping, planning, and cross-sectional engagement of governments, partners and donors.ConclusionsElimination of trachoma is possible if the right combination of factors is in place. Planning for success is a critical first step. Some remaining challenges must still be addressed if the elimination targets are to be successfully attained.
Immunotherapy Resistance by Inflammation-Induced Dedifferentiation
Authors: Mehta Arnav , Kim Yeon Joo , Robert Lidia , Tsoi Jennifer , Comin-Anduix Begoña , Berent-Maoz Beata , Cochran Alistair J. , Economou James S. , Tumeh Paul C. , Puig-Saus Cristina , Ribas Antoni 
Published: June 2018

Abstract
A promising arsenal of targeted and immunotherapy treatments for metastatic melanoma has emerged over the last decade. With these therapies, we now face new mechanisms of tumor-acquired resistance. We report here a patient whose metastatic melanoma underwent dedifferentiation as a resistance mechanism to adoptive T-cell transfer therapy (ACT) to the MART1 antigen, a phenomenon that had been observed only in mouse studies to date. After an initial period of tumor regression, the patient presented in relapse with tumors lacking melanocytic antigens (MART1, gp100) and expressing an inflammation-induced neural crest marker (NGFR). We demonstrate using human melanoma cell lines that this resistance phenotype can be induced in vitro by treatment with MART1 T cell receptor–expressing T cells or with TNFα, and that the phenotype is reversible with withdrawal of inflammatory stimuli. This supports the hypothesis that acquired resistance to cancer immunotherapy can be mediated by inflammation-induced cancer dedifferentiation.
Significance: We report a patient whose metastatic melanoma underwent inflammation-induced dedifferentiation as a resistance mechanism to ACT to the MART1 antigen. Our results suggest that future melanoma ACT protocols may benefit from the simultaneous targeting of multiple tumor antigens, modulating the inflammatory response, and inhibition of inflammatory dedifferentiation-inducing signals. Cancer Discov; 8(8); 935–43. ©2018 AACR.
This article is highlighted in the In This Issue feature, p. 899
Temporal Trends in the Outcomes of Dialysis Patients Admitted With Acute Ischemic Stroke
Authors: Alqahtani Fahad , Berzingi Chalak O. , Aljohani Sami , Al Hajji Mohamed , Diab Anas , Alvi Muhammad , Boobes Khaled , Alkhouli Mohamad 
Published: June 2018

Background

There is a paucity of contemporary data on the characteristics and outcomes of acute ischemic stroke (
AIS
) in patients on maintenance dialysis.

Methods and Results

We used the nationwide inpatient sample to examine contemporary trends in the incidence, management patterns, and outcomes of
AIS
in dialysis patients. A total of 930 010 patients were admitted with
AIS
between 2003 and 2014, of whom 13 642 (1.5%) were on dialysis. Overall, the incidence of
AIS
among dialysis patients decreased significantly (
P
trend
<0.001), while it remained stable in non‐dialysis patients (
P
trend
=0.78). Compared with non‐dialysis patients, those on dialysis were younger (67±13 years versus 71±15 years,
P
<0.001), and had higher prevalence of major comorbidities. Black patients constituted 35.2% of dialysis patients admitted with
AIS
compared with 16.7% of patients in the non‐dialysis group (
P
<0.001). After propensity score matching, in‐hospital mortality was higher in the dialysis group (7.6% versus 5.2%,
P
<0.001), but this mortality gap narrowed overtime (
P
trend
<0.001). Hemorrhagic conversion and gastrointestinal bleeding rates were similar, but blood transfusion was more common in the dialysis group. Rates of severe disability surrogates (tracheostomy, gastrostomy, mechanical ventilation and non‐home discharge) were also similar in both groups. However, dialysis patients had longer hospitalizations, and accrued a 25% higher total cost of acute care.

Conclusions

Dialysis patients have 8‐folds higher incidence of
AIS
compared withnon‐dialysis patients. They also have higher risk‐adjusted in‐hospital mortality, sepsis and blood transfusion, longer hospitalizations, and higher cost. There is a need to identify preventative strategies to reduce the risk of
AIS
in the dialysis population.
The Inefficacy of Strong Ties Networks in Migration Employment Outcomes
Authors: Absuelo Ruby , Hancock Peter 
Published: June 2018

Abstract
We examined Philippine graduates’ use of social networks to obtain initial employment in the United States labour market. Our research focused on employment opportunities and found that Philippine graduates’ usage of Strong Ties networks contributed to underemployment. Reliance on Strong Ties networking decreased respondents’ broader range of US employment opportunities and further impeded their prospects of upward employment mobility. While the Philippine graduates’ Strong Ties networking provided assistance and most specifically acted as intermediaries for gaining their initial employment, this type of networking had a significant impact resulting in poor labour market outcomes and rather imperfect long-term employment opportunities. Moreover, we found that, in conjunction with the use of Strong Ties, key variables, such as low-demand degree fields, lower educational attainment, lesser proficiency in English and green card status, were also strongly associated with poor employment outcomes.
Extractive Capital, Imperialism, and the Colombian State
Authors: Sankey Kyla 
Published: June 2018

Since the turn of the century, Colombia has become increasingly dependent on mining exports to drive economic growth. While the surge in mining investments in Colombia and the problems associated with this form of economic development have received much attention from scholars and policy analysts, the common explanation is that the state has been undermined or eroded by emergent global forces. However, nation-states should be seen not as victims but as authors and enforcers of new processes of capital accumulation. The Colombian state has acted as the principal guarantor of the political and territorial conditions necessary for this form of extractive capitalism by reconstituting property and contract laws, signing free-trade agreements, reconfiguring the internal state apparatus. and expanding military forces. Desde el principio del siglo, Colombia se ha vuelto cada vez más dependiente de las exportaciones mineras para impulsar el crecimiento económico. Si bien el aumento de las inversiones mineras en Colombia y los problemas asociados con esta forma de desarrollo económico han recibido mucha atención por parte de académicos y analistas de políticas, la explicación común es que el estado ha sido socavado o erosionado por las fuerzas globales emergentes. Sin embargo, los Estados-nación deberían ser vistos no como víctimas sino como autores y ejecutores de nuevos procesos de acumulación de capital. El estado colombiano ha actuado como el principal garante de las condiciones políticas y territoriales necesarias para esta forma de capitalismo extractivo mediante la reconstitución de las leyes de propiedad y contratos, la firma de acuerdos de libre comercio, la reconfiguración del aparato estatal interno, y la expansión de fuerzas militares.
Mass Migration from Rural India: A Restudy of Kunkeri Village in Konkan, Maharashtra, 1961–1987–2017
Authors: Vartak Kalyani , Tumbe Chinmay , Bhide Amita 
Published: June 2018

This article examines a particular village—Kunkeri—in Konkan, Maharashtra, characterized by persistent mass outmigration for over five decades, by combining a field study in 2017 with detailed ethnographic and statistical baseline data collected by the Census of India in 1961 and 1987. It documents the increase in outmigration rates, catch-up in outmigration intensities by the lowest castes to those of the upper castes, diversification of household migration strategies and outmigrants’ occupations, the lessening of single-male migration strategies, the presence of a diasporic association and the growing significance of commuting and migration for education. Yet, despite mass outmigration and a general rise in the standard of living across castes, we observe strong continuity in the distribution of castes and land ownership structures within Kunkeri. These findings point to both the transformative and status-quo preserving features of persistent mass migration from rural India. JEL: O15, J61, N35
Intra-Abdominal Hypertension is a Risk Factor for Increased VAP Incidence: A Prospective Cohort Study in the ICU of a Tertiary Hospital
Authors: Papakrivou Eleni , Makris Demosthenes , Manoulakas Efstratios , Karvouniaris Marios , Zakynthinos Epaminondas 
Published: June 2018

Background: Ventilator-associated pneumonia (VAP) might be increased in cases with intra-abdominal hypertension (IAH). However, despite animal experimentation and physiological studies on humans in favor of this hypothesis, there is no definitive clinical data that IAH is associated with VAP. We therefore aimed to study whether IAH is a risk factor for increased incidence of VAP in critical care patients. This 1-center prospective observational cohort study was conducted in the intensive care unit of the University Hospital of Larissa, Greece, during 2013 to 2015. Consecutive patients were recruited if they presented risk factors for IAH at admission and were evaluated systematically for IAH and VAP for a 28-day period. Results: Forty-five (36.6%) of 123 patients presented IAH and 45 (36.6%) presented VAP; 24 patients presented VAP following IAH. Cox regression analysis showed that VAP was independently associated with IAH (1.06 [1.01-1.11]; P = .053), while there was an indication for an independent association between VAP and abdominal surgery (1.62 [0.87-3.03]; P = .11] and chronic obstructive pulmonary disease (1.79 [0.96-3.37]; P = .06). Conclusions: Intra-abdominal hypertension is an independent risk factor for increased VAP incidence in critically ill patients who present risk factors for IAH at admission to the ICU.
Is Muscle MELD a More Promising Predictor for Mortality After Living Donor Liver Transplantation?
Authors: Badawy Amr , Kaido Toshimi , Hamaguchi Yuhei , Anazawa Takayuki , Yagi Shintaro , Fukumitsu Ken , Kamo Naoko , Okajima Hideaki , Uemoto Shinji 
Published: June 2018

Background: To improve the outcome of living donor liver transplantation (LDLT), a scoring system that could predict accurately the patient and graft survival posttransplant is necessary. The aim of this study is to evaluate our previously proposed Muscle-model for end-stage liver disease (M-MELD) score and to compare it with the other available scores to find the best system that correlates with postoperative outcome after liver transplant. Methods: We retrospectively reviewed the data of 199 patients who underwent LDLT from January 2010 to July 2016 and calculated the preoperative MELD, MELD Na, the product of donor age and MELD (D-MELD), M-MELD, integrated MELD, and the balance of risk (BAR) score in all patients. The area under the receiver operating characteristics curves (AUCs) of each score was computed and compared at 3-, 6-months, and 1-year after LDLT. Results: The M-MELD, D-MELD, and integrated MELD had a good discriminative performance in predicting 3-month mortality after LDLT with AUCs > 0.7, while the M-MELD was the only score that showed a good discriminative performance in predicting 6-month and 1-year mortality after LDLT with AUCs > 0.7. Conclusion: Muscle-MELD score is a simple and useful predictor of patient survival after LDLT which showed a better predictive performance than other available scores.
Risk factors for poor outcome in community-onset Clostridium difficile infection
Authors: Lee Eunyoung , Song Kyoung-Ho , Bae Ji Yun , Yoon Doran , Hwang Joo-Hee , Choe Pyoeng Gyun , Park Wan Beom , Bang Ji Hwan , Kim Eu Suk , Park Sang Won , Kim Nam Joong , Oh Myoung-don , Kim Hong Bin 
Published: June 2018

Abstract
Background
A substantial portion of Clostridium difficile infection (CDI) cases occur in communities, and community-onset CDI (CO-CDI) can lead to serious complications including mortality. This study aimed to identify the risk factors for a poor outcome in CO-CDI.

Methods
We performed a retrospective review of all inpatients with CDI, in a 1300-bed tertiary-care hospital in Korea, from 2008 through 2015. CO-CDI was defined as CDI occurring within 48 h of admission. Poor outcome was defined as follows: 1) all-cause 30-day mortality, 2) in-hospital mortality, or 3) surgery due to CDI.

Results
Of a total 1256 CDIs occurring over 8 years, 152 (12.1%) cases were classified as CO-CDI and 23 (15.1%) had a poor outcome, including 22 (14.5%) cases of mortality and 2 (1.3%) cases of surgery. Patients with a poor outcome had a higher mean age than those without a poor outcome (75.8 vs. 69.6 years, p = 0.03). The proportion of men and prior proton pump inhibitor (PPI) use were significantly higher in the poor outcome group (65.2% vs. 41.9%, p = 0.04; 39.1% vs. 17.6%, p = 0.02, respectively). Multivariate binary logistic model showed that PPI use and anemia (hemoglobin < 10 g/dL) at presentation were significantly associated with a poor outcome (adjusted odds ratio [aOR], 3.76; 95% confidence interval [95CI], 1.26–11.21, aOR, 4.67; 95CI, 1.52–14.34, respectively).

Conclusions
Clinicians should not only be aware of the possibility of CDI in the community setting but also pay more attention to PPI-using elderly patients with anemia in consideration of a poor outcome.
Have 100 years of talking therapies taught psychiatrists how to communicate?
Authors: Wilson Jon 
Published: June 2018

SUMMARYFormal communication skills training is the norm at UK medical schools, and evidence is mounting that it is effective in a number of domains, including patient satisfaction and shared decision-making, leading to improved treatment adherence. However, applying these models in mental health settings is challenging, despite the fact that positive therapeutic relationships and an ability to actively manage consultations are the cornerstone of psychiatric practice. Communication skills training is still too often regarded as better suited to physical health consultations than more complex psychiatric interviews. Here, it is considered why this might be, with reference to the one eligible randomised controlled trial identified in this systematic literature review.DECLARATION OF INTERESTJ.W. has previously worked with Professor Papageorgiou at the University of East Anglia and has authored chapters in books that she has co-edited.
Does evidence support the high expectations placed in precision medicine? A bibliographic review
Authors: Cortés Jordi , González José Antonio , Medina María Nuncia , Vogler Markus , Vilaró Marta , Elmore Matt , Senn Stephen John , Campbell Michael , Cobo Erik 
Published: June 2018

Background: Precision medicine is the Holy Grail of interventions that are tailored to a patient’s individual characteristics. However, conventional clinical trials are designed to find differences with the implicit assumption that the effect is the same in all patients within the eligibility criteria. If this were the case, then there would be no grounds for treating different patients differently. One consequence of the assumption is that the variance in the outcome variable would be the same in treated and control arms. We reviewed the literature to see if this were the case and so to see how often precision medicine would not be useful. Methods: We reviewed parallel trials with quantitative outcomes published in 2004, 2007, 2010 and 2013. We collected baseline and final standard deviations of the main outcome. We assessed homoscedasticity by comparing the variance of the primary endpoint between arms through the outcome variance ratio (treated to control group). Results: The review provided 208 articles with enough information to conduct the analysis. One out of seven studies (n = 30, 14.4%) had statistically different variances between groups, leading a non-constant-effect. The adjusted point estimate of the mean outcome variance ratio (treated to control group) is 0.89 (95% CI 0.81 to 0.97). Conclusions: We found that the outcome variance was more often smaller in the intervention group, suggesting that treated patients may end up pertaining more often to reference or “normality” values and thus would not require further precision medicine. However, this result may also be compatible with a reduced effect in some patients, which would require studying whether the effect merits enduring the side effects as well as the economic costs. We have shown that the comparison of variances is a useful but not definitive tool to asses if the design assumption of a constant effect holds.
shinySISPA: A web tool for defining sample groups using gene sets from multiple-omics data
Authors: Dwivedi Bhakti , Kowalski Jeanne 
Published: June 2018

As opposed to genome-wide testing of several hundreds of thousands of genes on very few samples, gene panels target as few as tens of genes and enable the simultaneous testing of many samples. For example, some cancer gene panels test for 50 genes that can affect tumor growth and potentially identify treatment options directed against the genetic mutation. The increasing popularity of gene panel testing has spurred the technological development of panels that test for diverse data types such as expression and mutation. Once samples are tested, there is the desire to examine clinical associations based on the panel and for this purpose, one would like to identify, among the samples tested, which show support for a molecular profile (e.g., presence of mutation with increased expression) versus those samples that do not among the genes tested. With user-specified molecular profile of interest, and gene panel data matrices (e.g., gene expression, variants, etc.) that define the profile, shinySISPA (Sample Integrated Set Profile Analysis) is a web-based shiny tool to define two sample groups with and without profile support based on our previously published method from which clinical associations may be readily examined. The shinySISPA can be accessed from http://shinygispa.winship.emory.edu/shinySISPA/.