bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonconvulsive Status Epilepticus in Acute Intracerebral Hemorrhage
Authors: Matsubara Soichiro , Sato Shoichiro , Kodama Tomohiro , Egawa Satoshi , Nakamoto Hidetoshi , Toyoda Kazunori , Kubota Yuichi 
Published: June 2018

Background and Purpose—
Patients with acute intracerebral hemorrhages (ICHs) often develop nonconvulsive status epilepticus (NCSE). We aimed to identify determinants and the prognostic significance of NCSE among patients with acute ICH.

Methods—
Consecutive patients with acute spontaneous ICH who were admitted to a comprehensive stroke center were enrolled. We diagnosed NCSE using the modified Salzburg Consensus Criteria. Factors associated with NCSE and their significance in relation to clinical outcomes were assessed using multivariate logistic regression models.

Results—
Of 228 patients (136 men; mean age, 68±14 years), 20 (8.8%) developed NCSE during their hospital stays. In logistic regression models, the adjusted odds ratios (95% confidence intervals) for NCSE were 3.5 (1.2–10.7) for craniotomy and 7.0 (2.2–31.2) for lobar involvement. The patients with NCSE had higher modified Rankin Scale scores at discharge, but NCSE was not independently associated with poor functional outcomes (modified Rankin Scale score, 4–5) or mortality after adjusting for confounders.

Conclusions—
NCSE is not a rare complication of acute ICH. Craniotomy and lobar involvement are independently associated with NCSE in patients with acute ICH.
Improved testing for vitamin B12 deficiency: correcting MMA for eGFR reduces the number of patients classified as vitamin B12 deficient
Authors: van Loon Saskia LM , Wilbik Anna M , Kaymak Uzay , van den Heuvel Edwin R , Scharnhorst Volkher , Boer Arjen-Kars 
Published: June 2018

Background Methylmalonic acid (MMA) can detect functional vitamin B12 deficiencies as it accumulates early when intracellular deficits arise. However, impaired clearance of MMA from blood due to decreased glomerular filtration rate (eGFR) also results in elevated plasma MMA concentrations. Alternative to clinical trials, a data mining approach was chosen to quantify and compensate for the effect of decreased eGFR on MMA concentration. Methods Comprehensive data on patient’s vitamin B12, eGFR and MMA concentrations were collected ( n = 2906). The relationship between vitamin B12, renal function (eGFR) and MMA was modelled using weighted multiple linear regression. The obtained model was used to estimate the influence of decreased eGFR on MMA. Clinical impact was examined by comparing the number of patients labelled vitamin B12 deficient with and without adjustment in MMA. Results Adjusting measured MMA concentrations for eGFR in the group of patients with low-normal vitamin B12 concentrations (90–300 pmol/L) showed that the use of unadjusted MMA concentrations overestimates vitamin B12 deficiency by 40%. Conclusions Through a data mining approach, the influence of eGFR on the relation between MMA and vitamin B12 can be quantified and used to correct the measured MMA concentration for decreased eGFR. Especially in the elderly, eGFR-based correction of MMA may prevent over-diagnosis of vitamin B12 deficiency and corresponding treatment.
Desorption characterization of methane and carbon dioxide in coal and its influence on outburst prediction
Authors: Liang Yunpei , Wang Fakai , Luo Yongjiang , Hu Qianting 
Published: June 2018

Coal and gas outburst is a dynamic phenomenon with violent eruptions of coal and gas from the working coal seam. It has been proved that the rapid desorption within a short period is necessary for the occurrence of an outburst. Due to limitation of the present test condition, gas desorption characterization for the first 60 s has not been researched sufficiently. In the present study, an experimental apparatus with the ability of high-frequency data collection was developed. Initial desorption characterization of methane and carbon dioxide in coal was experimentally studied. Both the initial desorption characterization of methane and carbon dioxide were experimentally studied with different equilibrium pressures. The desorbed gas pressure was measured at desorption time phase of 0–10 and 45–60 s, besides the initial amount of desorbed gas and initial diffusion velocity of coal gas were calculated to assess their risk of outburst. The results show that the gas pressure for both methane and carbon dioxide increases sharply in the initial time and then levels off, and the total amount of desorbed gas increases with the increasing desorption time. Although the amount of desorption methane is slightly larger than that of carbon dioxide at the beginning, the total amount of desorbed carbon dioxide is significantly larger than that of methane at the desorption process. Therefore, it can be concluded that the coal and carbon dioxide outburst is more dangerous than the coal and methane outburst based on the obtained experimental results.
Borderline Glenoid Bone Defect in Anterior Shoulder Instability: Latarjet Procedure Versus Bankart Repair
Authors: Jeon Yoon Sang , Jeong Ho Yeon , Lee Dong Ki , Rhee Yong Girl 
Published: June 2018

Background: The optimal procedure for anterior shoulder instability with a borderline (15%-20%) bone defect on the anterior rim of the glenoid is still controversial. Purpose: To compare the clinical outcome and recurrence rate between the arthroscopic Bankart repair and Latarjet procedure among patients with recurrent anterior shoulder instability and a borderline glenoid bone defect. Study Design: Cohort study; Level of evidence, 3. Methods: The authors retrospectively reviewed cases of arthroscopic Bankart repair and the Latarjet procedure for recurrent anterior shoulder instability with a borderline (15%-20%) glenoid bone defect. Enrollment comprised 149 patients (Bankart group, n = 118; Latarjet group, n = 31). The mean follow-up and age at operation were 28.9 ± 7.3 months (range, 24-73 months) and 26 ± 5 years (range, 16-46 years), respectively. Results: Rowe and UCLA (University of California, Los Angeles) shoulder scores significantly improved from 42.0 ± 14.3 and 22.9 ± 3.2 preoperatively to 90.9 ± 15.4 and 32.5 ± 3.3 postoperatively in the Bankart group ( P < .001) and from 41.0 ± 17.9 and 22.3 ± 3.4 to 91.1 ± 16.1 and 32.3 ± 3.4 in the Latarjet group ( P < .001), respectively. There were no significant between-group differences in Rowe ( P = .920) or UCLA ( P = .715) scores at the final follow-up. Mean postoperative loss of motion during forward flexion, external rotation in abduction, and internal rotation to the posterior was 3.0° ± 6.2°, 11.6° ± 10.2°, and 0.6 spinal segment in the Bankart group and 3.7° ± 9.8°, 10.3° ± 12.8°, and 0.9 spinal segment in the Latarjet group, respectively. These differences were not significant. However, the loss of external rotation at the side was significantly greater in the Bankart group (13.3° ± 12.9°) than in the Latarjet group (7.3° ± 18.1°, P = .034). The overall recurrence rate was significantly higher in the Bankart group (22.9%) than in the Latarjet group (6.5%), ( P = .040). Conclusion: The Latarjet procedure and arthroscopic Bankart repair both provided satisfactory clinical outcome scores and pain relief for anterior shoulder instability with a borderline glenoid bone defect. However, the Latarjet procedure resulted in significantly lower recurrences and less external rotation limitation than the arthroscopic Bankart repair. Therefore, the Latarjet procedure could be a more reliable surgical option in anterior recurrent instability with a borderline glenoid bone defect.
Feline large-cell lymphoma following previous treatment for small-cell gastrointestinal lymphoma: incidence, clinical signs, clinicopathologic data, treatment of a secondary malignancy, response and survival
Authors: Wright Katherine Z , Hohenhaus Ann E , Verrilli Ariana M , Vaughan-Wasser Savannah 
Published: June 2018

Objectives Lymphoma is a common and clinically important malignancy in cats. Development of a second malignancy has been reported previously in 7–14% of cats with small-cell gastrointestinal (GI) lymphoma. The aim of our study was to describe the incidence, clinical signs, clinicopathologic data, response to therapy and outcomes in cats diagnosed with large-cell lymphoma following treatment for small-cell GI lymphoma. Methods Medical records from a single referral specialty hospital were reviewed for all cats with lymphoma diagnosed between 2008 and 2017. The cases with a diagnosis of small-cell GI lymphoma followed by a diagnosis of any large-cell lymphoma and complete outcome data were selected for further review. Results Seven hundred and forty cats with a diagnosis of lymphoma were identified. Twelve cats (12/121) treated for small-cell GI lymphoma followed by a diagnosis of any anatomic form of large cell lymphoma were identified. Nine cats met the study inclusion criteria and were used in analyses. Mean event-free survival time from small-cell GI lymphoma diagnosis until diagnosis of large-cell lymphoma was 543 days, with a median survival time of 615 days. Mean event-free survival time from large-cell lymphoma to death was 55 days, with a median survival time of 24.5 days. Hematocrit, albumin and total protein were significantly decreased when cats developed large-cell lymphoma compared with their values at the time of small-cell lymphoma diagnosis. Conclusions and relevance Large-cell lymphoma occurred in 9.9% (12/121) of cats treated for small-cell GI lymphoma. Feline practitioners should include large-cell lymphoma on their list of differential diagnoses in cats diagnosed with small-cell GI lymphoma developing weight loss, anemia, hypoalbuminemia and hypoproteinemia.
Diabetes mellitus and abdominal aortic aneurysms: A review of the mechanisms underlying the negative relationship
Authors: Dattani Nikesh , Sayers Robert D , Bown Matthew J 
Published: June 2018

Introduction:Diabetes mellitus appears to be negatively associated with abdominal aortic aneurysm; however, the mechanisms underlying this relationship remain poorly understood. The aim of this article is to provide a comprehensive review of the currently understood biological pathways underlying this relationship.Methods:A review of the literature (‘diabetes’ OR ‘hyperglycaemia’ AND ‘aneurysm’) was performed and relevant studies grouped into biological pathways.Results:This review identified a number of biological pathways through which diabetes mellitus may limit the presence, growth and rupture of abdominal aortic aneurysms. These include those influencing extracellular matrix volume, extracellular matrix glycation, the formation of advanced glycation end-products, inflammation, oxidative stress and intraluminal thrombus biology. In addition, there is an increasing evidence to suggest that the medications used to treat diabetes can also limit the development and progression of abdominal aortic aneurysms.Conclusion:The negative association between diabetes and abdominal aortic aneurysm is robust. Future studies should attempt to target the pathways identified in this review to develop novel therapeutic agents aimed at slowing or even halting aneurysm progression.
Holmium laser versus thulium laser enucleation of the prostate: a matched-pair analysis from two centers
Authors: Pirola Giacomo Maria , Saredi Giovanni , Codas Duarte Ricardo , Bernard Lorraine , Pacchetti Andrea , Berti Lorenzo , Martorana Eugenio , Carcano Giulio , Badet Lionel , Fassi-Fehri Hakim 
Published: June 2018

Background: The aim of our study was to compare perioperative and functional outcomes of two different prostatic laser enucleation techniques performed in two high-volume centers: 100 W holmium laser enucleation of the prostate (HoLEP) (Lyon, France) and 110 W thulium laser enucleation of the prostate (ThuLEP) (Varese, Italy). Materials and Methods: A nonrandomized, observational, retrospective and matched-pair analysis was performed on two homogeneous groups of 117 patients that underwent prostate laser enucleation in the HoLEP or ThuLEP centers between January 2015 and April 2017, following the classical ‘three lobes’ enucleation technique. The American Society of Anesthesiologists (ASA) score and prostate volume were the main parameters considered for matching the patients between the two groups. Patients on anticoagulant therapy, with documented detrusor hypoactivity or hyperactivity or with the finding of concurrent prostate cancer were excluded from the study. Follow up was assessed at 3, 6 and 12 months after surgery. Results: Median enucleation and morcellation time was 75.5 and 11.5 min, respectively, in the HoLEP group versus 70.5 and 12 min, respectively, in the ThuLEP group ( p = 0.001 and 0.49, respectively). Enucleated adenoma weight was comparable (44 g versus 45.6 g, p = 0.60). Energy index (3884.63 versus 4137.35 J/g, p = 0.30) and enucleation index (0.57 versus 0.6 g/min, p = 0.81) were similar in the two groups. Catheterization time was comparable (1 versus 1 day; p = 0.14). The International Prostate Symptom Score and Quality of Life score significantly decreased, as well as maximal urinary flow rate. Median prostate-specific antigen (PSA) drop 1 year after surgery was 2.1 ng/ml in the HoLEP group (−52.83%) versus 1.75 ng/ml in the ThuLEP group (−47.85%) ( p = 0.013). Conclusion: Both HoLEP (100 W) and ThuLEP (110 W) relieve lower urinary tract symptoms in a comparable way with high efficacy and safety, with negligible clinical differences.
Clevidipine as a therapeutic and cost-effective alternative to sodium nitroprusside in patients with acute aortic syndromes
Authors: Alviar Carlos L , Gutierrez Alejandra , Cho Leslie , Krishnaswamy Amar , Saleh Amr , Lincoff Michael A , Roselli Eric , Militello Michael , Menon Venu 
Published: June 2018

Background:
Sodium nitroprusside is the preferred agent for the treatment of high blood pressure during acute aortic syndrome if blood pressure remains elevated after heart rate control with beta-blockers. The increasing cost of sodium nitroprusside in the USA led us to assess the efficacy and safety of intravenous clevidipine, a calcium channel blocker with quick onset of action, short half-life and significantly lower costs than sodium nitroprusside, in patients presenting with acute aortic syndrome.

Methods:
We performed a retrospective chart review of consecutive patients admitted to the Cleveland Clinic Cardiac Intensive Care Unit from 2013–2016 with a diagnosis of acute aortic syndrome. Patients who received intravenous sodium nitroprusside were compared with those receiving intravenous clevidipine. The primary outcome was a significant difference in blood pressure at one, three and six hours. Secondary outcomes included time to achieving blood pressure target and in hospital mortality with rates of hypotension and bradycardia as safety endpoints.

Results:
A total of 85 patients with suspected acute aortic pathology received clevidipine and 50 received sodium nitroprusside. Clinical and demographic characteristics were similar in both groups, except for a higher incidence of abdominal aortic aneurysm in the clevidipine group and for a trend towards higher use of labetalol in the clevidipine group. There were no significant differences in blood pressure or heart rate at one, three and six hours after starting either infusion. The rates of hypotension, bradycardia and in-hospital mortality did not differ. Time to achieve blood pressure control were also similar between groups.

Conclusion:
Intravenous clevidipine appears to be a safe and effective alternative to sodium nitroprusside for the management of high blood pressure during acute aortic dissection. In the USA, clevidipine could represent a cost effective therapy providing similar outcomes than sodium nitroprusside.
Extracellular galectins as controllers of cytokines in hematological cancer
Authors: Gordon-Alonso Monica , Bruger Annika M. , van der Bruggen Pierre 
Published: June 2018

AbstractGalectins and cytokines are both secreted proteins whose levels are prognosis factors for several cancers. Extracellular galectins bind to the glycans decorating glycoproteins and are overproduced in most cancers. Accumulative evidence shows that galectins regulate cytokines during cancer progression. Although galectins alter cytokine function by binding to the glycans decorating cytokines or their receptors, cytokines could also regulate galectin expression and function. This review revises these complex interactions and their clinical impact, particularly in hematological cancers.
Utilization of initial chemotherapy for newly diagnosed acute myeloid leukemia in the United States
Authors: Bhatt Vijaya Raj , Shostrom Valerie , Gundabolu Krishna , Armitage James O. 
Published: June 2018

Key Points
An analysis of 61 775 adults with AML diagnosed between 2003 and 2011 demonstrated that 25% did not receive any chemotherapy. Factors such as facility type, patients’ race, income, and insurance status were associated with the rates of use of chemotherapy.
Applied Informatics Decision Support Tool for Mortality Predictions in Patients With Cancer
Authors: Bertsimas Dimitris , Dunn Jack , Pawlowski Colin , Silberholz John , Weinstein Alexander , Zhuo Ying Daisy , Chen Eddy , Elfiky Aymen A. 
Published: June 2018

Purpose With rapidly evolving treatment options in cancer, the complexity in the clinical decision-making process for oncologists represents a growing challenge magnified by oncologists’ disposition of intuition-based assessment of treatment risks and overall mortality. Given the unmet need for accurate prognostication with meaningful clinical rationale, we developed a highly interpretable prediction tool to identify patients with high mortality risk before the start of treatment regimens. Methods We obtained electronic health record data between 2004 and 2014 from a large national cancer center and extracted 401 predictors, including demographics, diagnosis, gene mutations, treatment history, comorbidities, resource utilization, vital signs, and laboratory test results. We built an actionable tool using novel developments in modern machine learning to predict 60-, 90- and 180-day mortality from the start of an anticancer regimen. The model was validated in unseen data against benchmark models. Results We identified 23,983 patients who initiated 46,646 anticancer treatment lines, with a median survival of 514 days. Our proposed prediction models achieved significantly higher estimation quality in unseen data (area under the curve, 0.83 to 0.86) compared with benchmark models. We identified key predictors of mortality, such as change in weight and albumin levels. The results are presented in an interactive and interpretable tool ( www.oncomortality.com ). Conclusion Our fully transparent prediction model was able to distinguish with high precision between highest- and lowest-risk patients. Given the rich data available in electronic health records and advances in machine learning methods, this tool can have significant implications for value-based shared decision making at the point of care and personalized goals-of-care management to catalyze practice reforms.
TAILORx: Phase III trial of chemoendocrine therapy versus endocrine therapy alone in hormone receptor-positive, HER2-negative, node-negative breast cancer and an intermediate prognosis 21-gene recurrence score.
Authors: Sparano Joseph A. , Gray Robert James , Wood William C. , Makower Della F. , Lively Tracy G. , Saphner Thomas James , Keane Maccon M. , Gomez Henry Leonidas , Reddy Pavan S. , Goggins Timothy F , Mayer Ingrid A. , Toppmeyer Deborah , Brufsky Adam , Goetz Matthew P. , Hayes Daniel F. , Dees Elizabeth Claire , Pritchard Kathleen I. , Geyer Charles E. , Olson John A. , Sledge George W. 
Published: June 2018

LBA1 Background: In hormone receptor (HR)-positive, HER2-negative, axillary node (AN)-negative breast cancer, the 21-gene expression assay (Oncotype DX Recurrence Score [RS]) is prognostic for distant recurrence, prognostic for low recurrence with endocrine therapy alone if low (0-10), and predictive of chemotherapy benefit if high (26 or higher). We performed a prospective, randomized trial of endocrine therapy (ET) versus chemoendocrine therapy (CET) in women with a mid-range RS of 11-25. Methods: Eligibility criteria included women 18-75 years of age with HR-positive, HER2-negative, axillary node (AN)-negative breast cancer and tumors 1.1-5.0 cm in size (or 0.6-1.0 cm and int/high grade) and agreed to have chemotherapy assigned or randomized based on the RS. Women with a mid-range RS (11-25) were randomized to receive ET or CET. The primary endpoint was invasive disease-free survival (iDFS), and the trial was designed to show non-inferiority for ET alone by not rejecting equality (hazard ratio [HR] margin up to 1.322 for omission of chemotherapy, 1-sided type I error rate 10%, type II error rate 5%). The target sample size was adjusted to compensate for non-adherence to randomized treatment, and the protocol-specified final analysis was triggered after 835 iDFS events. Results: Of the 10,253 eligible women enrolled between 4/7/06-10/6/10, 6711 (65.5%) had a RS of 11-25 and adequate information. There were 836 iDFS events at final analysis with a median followup of 90 months. ET was non-inferior to CET for iDFS (HR 1.08, 95% confidence intervals [CI] 0.94, 1.24, p=0.26) in the intention-to-treat (ITT) population. ET was also non-inferior for distant recurrence-free interval (DRFI; HR 1.03, p=0.80), recurrence-free interval (RFI; HR 1.12, p=0.28), and overall survival (OS; HR 0.97, p=0.80). Nine year rates were similar for iDFS (83.3% vs. 84.3%), DRFI (94.5% vs. 95.0%), RFI (92.2% vs. 92.9%), and OS (93.9% vs. 93.8%). Recurrence accounted for 338 (41.6%) the first iDFS event, of which 199 (23.8%) were distant recurrences. Treatment interaction tests were significant for age (iDFS p=0.03; RFI p= 0.02), but not menopause, tumor size, grade, or RS (continuous or RS 11-15, 16-20, 21-25). Conclusions: In women with HR-positive, HER2-negative, AN-negative breast cancer and a RS of 11-25, adjuvant ET was not inferior to CET in the ITT analysis. (Funded by NCI, BCRF, and Komen Foundation.) Clinical trial information: NCT00310180.