bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cervical Deformity Patients Have Baseline Swallowing Dysfunction but Surgery Does Not Increase Dysphagia at 3 Months: Results From a Prospective Cohort Study
Authors: Iyer Sravisht , Kim Han Jo , Bao Hongda , Smith Justin S. , Protopsaltis Themistocles S. , Mundis Gregory M. , Passias Peter , Neuman Brian J. , Klineberg Eric O. , Lafage Virginie , Ames Christopher P. ,   The International Spine Study Group (ISSG)
Published: October 2018

Study Design: Prospective cohort study. Objectives: Most studies of dysphagia in the cervical spine have focused on a degenerative patient population; the rate of dysphagia following surgery for cervical deformity (CD) is unknown. This study aims to investigate if surgery for cervical deformity results in postoperative dysphagia. Methods: Patients with CD undergoing surgery from 2013 to 2015 were prospectively enrolled to evaluate dysphagia. Demographic, operative, and radiographic variables were analyzed. The Quality of Life in Swallowing Disorders (SWAL-QoL) was used to measure dysphagia. Paired t test, independent t tests, and bivariate Pearson correlations were performed. Results: A total of 88 CD patients, aged 61.52 ± 10.52 years, were enrolled. All patients (100%) had 3-month SWAL-QoL for analysis. The baseline preoperative SWAL-QoL was 78.35. This is roughly the same level of dysphagia as an anterior cervical discectomy patient that is 3 weeks removed from surgery. Increasing body mass index (BMI) was correlated with decreased SWAL-QoL score ( r = −0.30, P = .001). Age, gender, smoking, and Charlson Comorbidity Index (CCI) showed no significant correlations with preoperative SWAL-QoL. Patients with prior cervical surgery had a lower preoperative SWAL-QoL ( P = .04). While 11 patients had acute postoperative dysphagia, CD surgery did not result in lower SWAL-QoL at 3 months (77.26 vs 78.35, P = .53). Surgical variables, including estimated blood loss (EBL), anterior or posterior fusion levels, steroid use, preoperative traction, staged surgery, surgical approach, anterior corpectomy, posterior osteotomy, and UIV (upper instrumented vertebrae) location, showed no impact on postoperative SWAL-QoL. Correction of cervical kyphosis was not correlated to 3-month SWAL-QoL scores or the change in SWAL-QoL scores. Conclusions: While patients undergoing surgery for cervical deformity had swallowing dysfunction at baseline, we did not observe a significant decline in SWAL-QoL scores at 3 months. Patients with prior cervical surgery and higher BMI had a lower baseline SWAL-QoL. There were no surgical or radiographic variables correlated to a change in SWAL-QOL score.
The Effect of Platelet-Rich Plasma on the Zone of Stasis and Apoptosis in an Experimental Burn Model
Authors: Uraloğlu Muhammet , Ural Alper , Efe Gökhan , Yuluğ Esin , Livaoğlu Murat , Karaçal Naci 
Published: October 2018

Background: The zone of stasis that forms in acute burn is initially viable, but coagulation progresses to necrosis in the process that follows. Objective: This study investigates the effects of platelet-rich plasma (PRP) on apoptosis in the burn zone of stasis and on the viability of living tissue. Methods: Burns were established in the right ears of 20 female New Zealand rabbits using the “comb burn” model. Platelet-rich plasma was obtained from blood collected from rabbits’ ears (n = 10) and was injected subcutaneously into the zone of stasis (n = 10). The same amount of saline solution was injected into the zone of stasis of the control group rabbits (n = 10). Histological and immunohistochemical apoptosis analysis was performed to evaluate viable areas. Results: Apoptosis levels were higher in the control group than in the experimental group. The area of viable tissue in the zone of stasis was greater than in the control group. Infection-induced neutrophil infiltration was statistically significantly lower in the experimental group. Conclusion: In this animal model, apoptosis count and viable tissue area measurement and the anti-inflammatory results in the burn area confirm that PRP therapy has a statistically significant positive impact on the survival of the zone of stasis and in acute burn injury.
Rationalization, working conditions and living standards in postwar Japanese coalmining communities
Authors: Thomann Bernard 
Published: October 2018

AbstractAfter 1945, unionization, the introduction of a new wage system, a huge effort by experts to understand the social and biological lives of miners and their families, the introduction of a new form of solidarity, and closer monitoring of the health of mining community members contributed, along with the development of the welfare state, to the formation of a more stable community around the mines and a more secure life for a new generation of miners recruited en masse just after the war to replace Korean and Chinese forced labor. Yet there is also more to the story than the narrative of a social compromise driven by rationalization and productivity policies that generated an inexorable, universal Fordist virtuous circle leading the working class to security. A close look at the social history of postwar mining communities highlights the divide between the growing stabilization of miners’ lives with the advance of the welfare state and the increasing physical and economic risks they faced with the advance of the industry’s rationalization policies driven by the decline of Japanese coal.
Application of a new hybrid particle swarm optimization-mixed kernels function-based support vector machine model for reservoir porosity prediction: A case study in Jacksonburg-Stringtown oil field, West Virginia, USA
Authors: Zhong Zhi , Carr Timothy R. 
Published: October 2018

Porosity is a fundamental property that characterizes the storage capability of fluid and gas-bearing formations in a reservoir. An accurate porosity value can be measured from core samples in the laboratory; however, core analysis is expensive and time consuming. Well-log data can be used to calculate porosity, but the availability of log suites is often limited in mature fields. Therefore, robust porosity prediction requires integration of core-measured porosity with available well-log suites to control for changes in lithology and fluid content. A support vector machine (SVM) model with mixed kernel function (MKF) is used to construct the relationship between limited conventional well-log suites and sparse core data. Porosity is the desired output, and two conventional well-log responses (gamma ray [GR] and bulk density) and three well-log-derived parameters (the slope of GR, the slope of density, and [Formula: see text]) are input parameters. A global stochastic searching algorithm, particle swarm optimization (PSO), is applied to improve the efficiency of locating the appropriate values of five control parameters in MKF-SVM model. The results of SVM with different traditional kernel functions were compared, and the MKF-SVM model provided an improvement over the traditional SVM model. To confirm the advantage of the hybrid PSO-MKF-SVM model, the results from three models: (1) radial basis function (RBF)-based least-squares SVM, (2) multilayer perceptron artificial neural network (ANN), and (3) RBF ANN, are compared with the result of the hybrid PSO-MKF-SVM model. The results indicate that the hybrid PSO-MKF-SVM model improves porosity prediction with the highest correlation coefficient ([Formula: see text] of 0.9560), the highest coefficient of determination ([Formula: see text] of 0.9140), the lowest root-mean-square error (1.6505), average absolute error value (1.4050), and maximum absolute error (2.717).
Risk Factors for Transformation to Higher-Grade Lymphoma and Its Impact on Survival in a Large Cohort of Patients With Marginal Zone Lymphoma From a Single Institution
Authors: Alderuccio Juan Pablo , Zhao Wei , Desai Amrita , Gallastegui Nicolas , Ramdial Jeremy , Kimble Erik , de la Fuente Macarena I. , Rosenblatt Joseph D. , Chapman Jennifer R. , Vega Francisco , Reis Isildinha M. , Lossos Izidore S. 
Published: October 2018

Purpose Given the paucity of data on higher-grade transformation (HGT) to aggressive lymphoma in patients with marginal zone lymphoma (MZL), we report on a large cohort of patients, identify risk factors, and determine HGT impact on overall survival (OS). Methods We analyzed 453 patients with biopsy-proven MZL seen at our institution between 1995 and 2016. Kaplan-Meier, Cox proportional hazards regression, and competing risk methods were used in analyses of time-to-event outcomes. Results Thirty-four patients (7.5%) had biopsy-proven HGT to diffuse large B-cell lymphoma, including seven (21%) diagnosed at the time of initial MZL diagnosis. Among 27 incident patients, median time to HGT was 29 months (range, 1.3 to 135 months). Higher risk of HGT was observed in those with nodal/splenic MZL (subdistribution hazard ratio [SHR], 2.60; P = .023). On multivariable competing risk analysis, elevated lactate dehydrogenase (SHR, 2.71), more than four nodal sites (SHR, 2.97), and failure to achieve complete remission (CR) after initial treatment (SHR, 3.76) conveyed significantly higher risk for HGT ( P < .02). International Prognostic Index (IPI), Follicular Lymphoma IPI, and Mucosa-Associated Lymphoid Tissue Lymphoma IPI were only significant predictors of HGT univariably. Patients with HGT had shorter OS (5-year rate, 65% v 86%; P < .001). Patients who presented with HGT within 12 months since MZL diagnosis had shorter OS than those with HGT at MZL diagnosis combined with those with HGT more than 12 months later (4-year rate, 43% v 81%, P < .001). Non-CR and higher scores of IPI, Follicular Lymphoma IPI, and Mucosa-Associated Lymphoid Tissue Lymphoma IPI were the main significant predictors for shorter progression-free survival and OS. Conclusion Failure to achieve CR after initial treatment, elevated lactate dehydrogenase, and more than four nodal sites at the time of MZL diagnosis are the main predictors of increased risk of HGT. Patients with HGT have shorter OS.
Resource-Stratified Diagnostics in India: Current Practices and Aspirations for a National Standard
Authors: Bhattacharya Manisha 
Published: October 2018

Purpose As international health systems set goals to improve and expand access to cancer care services, the global health community has applied evidence-based principles to develop resource-stratified pathways for cancer detection, diagnosis, and treatment. The Breast Health Global Initiative (BHGI) defines four detailed sets of infrastructure at the levels of basic, limited, enhanced, and maximal. Operationalizing these pathways to improve and expand breast cancer care requires an assessment of current resource availability and use, as well as an understanding of how clinical stakeholders value and prioritize various modalities. This study adapted the BHGI framework for breast cancer diagnostics to characterize the natural state of health system capabilities in India. This work aims to contribute to the validation of the resource stratification schema while collecting implicit practitioner impressions of an aspirational resource level, as would be codified by a national standard. Methods We interviewed oncologists at public and private hospitals in six urban areas throughout India with a multisection survey tool about the effects of cancer care infrastructure on patient care. In this section, respondents filled out a grid representation of 30 BHGI 2.5 diagnostic modalities divided into clinical tools, imaging and laboratory tests, and pathology. Respondents indicated whether they currently used each modality, and whether they would recommend that this should be included in a national standard of breast cancer care for India. Results At least three fourths of respondents indicated that they personally use 21 of the diagnostic modalities (n = 52), but only recommended 15 modalities for the national standard (n = 50). The top 11 modalities currently used included six basic, three limited, and two enhanced, whereas the top 11 modalities recommended for the national standard included four basic, one limited, three enhanced, and three maximal. Conclusion Diagnostic modalities consistently used by urban oncologists are not fully congruent with the group’s collective vision for a national standard of care, nor do the oncologists recommend a consistently more basic or limited national approach compared with urban practice. These heterogeneous results indicate that expanding breast cancer care in India will likely require dynamic recalibration of goal resource level definitions across the nodes of each regional referral network. AUTHOR’S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs for the author.
New Horizons for Breast Cancer Care: Patient Navigation in a Low- and Middle-Income Country
Authors: Jaganathan Maheswari , Siu-Hoong Stephanie Teh , Zi-Yi Yeoh , Rajaram Nadia , Zainal Nur Hidayati , Hwang Teo Soo , Abdul Wahab Mohamed Yusof 
Published: October 2018

Purpose We established a patient navigation program in a secondary hospital in Malaysia. Here, we report on its impact on diagnostic and treatment timeliness for patients in the first 2 years of its implementation (n = 135 in 2015 and n = 155 in 2016) and compare these patients’ timeliness outcomes with those of patients who were diagnosed in 2014 (n = 147). Methods A dedicated navigation team provided education, supportive care, and practical help in overcoming individual barriers. Demographic, clinical, and timeliness data were collected and analyzed using Kruskal-Wallis and Fisher’s exact tests. Results Navigated patients were more likely to meet national service targets for mammography (95% in 2015 and 96% in 2016 v 74% in 2014; P < .001), biopsy (92% in 2015 and 94% in 2016 v 77% in 2014; P < .001), and communication of news (80% in 2015 and 82% in 2016 v 58% in 2014; P < .001). There was a modest impact on primary surgery (58% in 2015 and 65% in 2016 v 52% in 2014; P = .077) and neoadjuvant chemotherapy (42% in 2015 and 54% in 2016 v 56% in 2014; P = .284). We observed improvements in surgery timeliness among patients with early-stage disease but not in late-stage patients’ surgery and neoadjuvant timeliness. Barriers typically associated with late-stage disease at presentation, such as health literacy, residential distance from the hospital, and financial barriers, were not associated with delayed treatment initiation. Of interest, patients who delayed treatment initiation were less likely to have dependents younger than age 17 years (29% v 63%; P = .033). Conclusion Our results demonstrate that a navigation program is feasible and sustainable in a state-run hospital in a low-resource community. Whereas the program improved overall diagnostic timeliness, opportunities to improve outcomes in patients with late-stage disease may lie in diversifying navigation solutions. This includes addressing challenges that are specific to late-stage presenters and harnessing efforts at the primary care and community level to downstage breast cancer burden in Malaysia. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Teo Soo Hwang Speakers’ Bureau: AstraZeneca Research Funding: AstraZeneca Patents, Royalties, Other Intellectual Property: Cancer Research Malaysia Travel, Accommodations, Expenses: AstraZeneca
Access to Human Epidermal Growth Factor Receptor 2–Targeted Therapy at a Tertiary Care Center in India: An Evolution
Authors: Nair Nita S. , Gupta Sudeep , Ghosh Jaya , Desai Sangeeta , Parmar Vani , Shet Tanuja , Badwe Rajendra A. 
Published: October 2018

Purpose In a previous retrospective audit from our institution, access to human epidermal growth factor receptor 2 (HER2) –targeted therapy (H2T) in patients registered and treated in 2008 was reported, wherein only 38 (8.61%) of 441 patients received some form of H2T. Three developments occurred in subsequent years that potentially affected access to H2T at our institution—that is, a patient access program supported by the innovator pharmaceutical company, a generous philanthropic donor, and the use of biosimilars. Methods To evaluate the cumulative impact of these developments on access to trastuzumab, we reviewed access to H2T in a recent cohort of patients with breast cancer registered in at our institution. Results In 2016, 4,717 new patients with breast cancer were registered at our institution. Among these patients, HER2 3+ expression by immunohistochemistry or fluorescent in situ hybridization (FISH) was reported in 828 patients (22.77%). Assuming the same 33.22% amplification rate in the 343 patients who did not undergo FISH testing, there were potentially 114 more patients with HER2-amplified tumors. Thus, the final number of HER2-overexpressing/-amplified tumors is estimated to be 942 in 2016 (729 HER2 immunohistochemistry 3+, 99 known FISH amplified, and 114 estimated FISH amplified). Of these 942 patients, 13 were not deemed suitable for H2T and 94 did not follow-up for additional treatment at our institution. The remaining 835 patients were eligible to receive H2T and were analyzed for access to this treatment. Overall, 444 (53.2%) of these 835 patients received trastuzumab for durations that ranged from 12 weeks to 12 months in the (neo)adjuvant setting or other durations in the metastatic setting. This is in contrast to the previously reported 8.61% use of H2T in the cohort of patients registered in 2008. Conclusion We suggest that other institutions, especially public hospitals that treat underprivileged patients, make concerted efforts to increase access to potentially curative treatments, such as trastuzumab, using targeted programs and philanthropic support, and consider using a shorter duration of 12 weeks of trastuzumab to improve patient outcomes. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.
Two-Phased Strategy for Improvement of Breast Cancer Care in Bangladesh
Authors: Sarker Masuma , Masum Nazmul Hoque 
Published: October 2018

Purpose Bangladesh has a low incidence of breast cancer; however, the incidence is rising rapidly and the mortality rate is significantly higher, which is complicated by limited resources. Hence, a screening and treatment strategy will not be the same as those of high-income countries. Methods We did a literature review, resource evaluation, and finally propose a resource-stratified two-phased implementation strategy to improve breast cancer care in Bangladesh. Results There is a lack of qualitative and quantitative epidemiologic data. According to limited available data, breast cancer demography is different, as almost all patients present in advanced stage and most are premenopausal women. We have identified the three most important factors that affect breast cancer management: social, cultural, and religious barriers to early detection; few treatment facilities, which are concentrated mainly in the capital; and a lack of female health care providers while seeking treatment. We propose a two-phased approach. A female-orientated primary health care system has been successful in Bangladesh in achieving many health goals. In the first phase, we propose involving a female health assistant of the primary health care system to increase awareness, early detection (clinical downstaging), and effective referral of patients with breast cancer. This program can be integrated into existing perinatal care, as a majority of patients with breast cancer are of reproductive age. At the same time, we will modify tertiary health care (THC) to establish a model one-stop breast cancer facility and we propose a single day of a week when female health care providers will be available to provide care. THC providers will conduct outreach programs at the district level. In addition, a population-based epidemiologic study and cancer registry should be started immediately. In the second phase, we aim to establish an effective breast cancer care facility at the secondary health care level, as this is accessible by a large portion of the population. We propose establishing a one-stop breast cancer facility in every district that will be inspired by the THC model clinic. Adequate resources should be allocated to achieve this goal. Conclusion This strategy could be a model for other resource-limited developing countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.