bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience of financial toxicity among gynecologic oncology patients.
Authors: Bouberhan Sara , Kennedy Alice , Buss Mary K. , Moss Laureen , Nolan Kathleen , Awtrey Christopher , Dalrymple John Lee , Garrett Leslie A. , Liu Fong W. , Hacker Michele R. , Esselen Katharine , Shea Meghan 
Published: September 2018

90 Background: “Financial toxicity” (FT) is increasingly recognized as an adverse outcome associated with cancer treatment. The degree of FT in the gynecologic oncology patient population has not been studied. This study used the comprehensive score for financial toxicity (COST) tool, a recently-validated survey, to examine FT in the gynecologic oncology population. Methods: All follow-up patients at a gynecologic oncology practice were invited to complete a cross-sectional survey including the COST (scale = 0-44) tool and a quality-of-life (QOL) survey, the EQ-5D-5L. Demographic and treatment data were gathered with additional survey questions and chart review. We dichotomized COST scores into low FT (top two tertiles) and high FT (bottom tertile); a lower COST score indicates higher FT. We assessed the correlation between COST and QOL scores using the Spearman correlation coefficient (r) and used univariable and multivariable linear regression to identify predictors of greater FT. We used log-binomial regression to calculate risk ratios (RR) and 95% confidence intervals (CI) for patient-reported financial outcomes. Results: Approximately 75% of approached patients responded; 224 were included in this analysis. The median FT score was 29.0. Greater FT was correlated with worse QOL (r = 0.43, p < 0.01). In multivariable regression, income < $50,000 (p < 0.01) and income from $50,000-$99,999 (p < 0.01) compared to income ≥$100,000; younger age (p < 0.01); and part-time employment (p = 0.01) and unemployment (p = 0.01) compared to full time employment were significant predictors of greater FT. The high FT group had an increased risk of delaying or avoiding care (RR: 4.5, 95% CI: 1.6-12.3); borrowing money or applying for financial assistance (RR: 17.0, 95% CI: 4.0-71.6); and using savings or reducing spending to meet healthcare costs (RR: 2.5; 95% CI: 1.9-3.4) relative to the low FT group. Conclusions: High FT was common in the gynecologic oncology population and was strongly associated with delays or avoidance of clinical care, requiring financial assistance, and worse QOL scores. Further study is needed to investigate FT in a broader patient population within gynecologic oncology and to identify strategies for intervention in clinical practice.
Disability burden in patients with tenosynovial giant cell tumors in the United States from employer perspective.
Authors: Lin Feng , Ionescu-Ittu Raluca , Pivneva Irina , Wynant Willy , Shi Sherry , Shohudi Mojdehi Azadeh , Wu Eric , Kwong Jackie , Abraham John A. 
Published: September 2018

92 Background: Tenosynovial giant cell tumor (TGCT) is a rare locally aggressive tumor causing pain, swelling, joint destruction, and limited mobility. This study assessed the disability burden and the associated costs in TGCT patients from an employer’s perspective. Methods: A retrospective analysis was performed using medical and disability claims from the OptumHealth database. Incident patients 18-64 years old with a diagnosis of TGCT (as identified by ICD-9: 727.02, 719.2x; ICD-10: D48.1, D21.x, M12.2) were matched 1:10 to controls without TGCT based on age, gender, index year, and follow-up duration. Patients without earning and disability data were excluded. Days of work loss due to disability claims and absenteeism associated with medical visits were compared using Poisson regression models. Costs were compared using generalized linear models. Results: A total of 1,395 eligible TGCT patients were matched with 13,950 controls without TGCT. Despite similar demographics (36% female, mean age 45-47) and only slightly higher comorbidity burden (mean Charlson Comorbidity Index (CCI): 0.3 versus 0.2), TGCT patients had increased usage of analgesic drugs (44% versus 20%) and MRI tests (37% versus 3%), prior to their diagnosis, compared with controls. During follow-up, TGCT patients were more likely to have disability claims (15.1% vs. 5.6%; p < 0.001), had more disability claim days (9.5 versus 2.0; p < 0.001), medically related absenteeism days (9.9 versus 4.3; p < 0.001), and total days of work loss (19.4 versus 6.3; p < 0.001) per person-year compared with their matched controls. After adjusting for age, gender, index year and CCI score, the average annual indirect cost per person was greater for patients with TGCT than controls ($4,653 versus $1,902; p < 0.001). Conclusions: In addition to the known problems of pain, limitation of mobility, and eventual joint destruction, TGCT patients had substantial indirect costs associated with increased work absenteeism and disability. These findings highlight the unmet need for more effective treatments to reduce not only the medical, but also the economic burden of TGCT.
Can oral chemotherapy parity laws reduce patients’ out-of-pocket (OOP) costs?
Authors: Sitlinger Andrea Phillips , Ubel Peter A. , Zhang Tian , Wong Charlene , Sachdev Rishi , Anderson David , Zafar Yousuf 
Published: September 2018

97 Background: Insurance plans vary coverage for infusional (IV) vs oral drugs, leading some to suggest that patients on oral drugs pay more OOP than those on IV drugs. 43 states have passed laws requiring insurers to cover oral drugs equivalently to IV drugs. Yet, there is little evidence that these “parity laws” are effective. Our aim was to estimate impact of parity laws on OOP expenses for oral vs IV drugs. Methods: We sought to determine how quickly patients on oral vs IV drugs reach their plan’s annual OOP maximum (max) as a surrogate for OOP expense. We used 2017 data from Healthcare.gov public use files to generate cost-sharing profiles for all 3,092 unique Marketplace plans. Chronic lymphocytic leukemia (CLL) and metastatic hormone sensitive prostate cancer (mHSPC) were chosen as two representative malignancies since both have accepted, first-line, IV and oral treatment options. We created guideline-concordant, first-line treatment regimens for simulated patients with CLL (oral ibrutinib vs IV bendamustine/rituximab) or mHSPC (oral abiraterone vs IV docetaxel). Drug, professional, facility, imaging, and lab claims were simulated to calculate OOP costs. The mean number of days to reach the OOP maximum for each Marketplace plan and treatment regimen were recorded. We assessed variation according to insurance coverage levels (“metal tier”: Catastrophic, Bronze, Silver, Gold, Platinum). Results: For CLL patients, 95% of plans reached OOP max in approximately one month of treatment for both oral and IV drugs (oral: mean 36 days; IV: mean 29 days). 99% of mHSPC patients reached their OOP max for oral treatment in a mean 15 days, but only 57% of plans reached OOP max for IV mHSPC treatment. Metal tier impacts time to reach OOP max (table). Conclusions: Parity laws do not lower patient costs when both IV and oral treatment options are expensive. In these cases, patients reach the OOP max rapidly. The small subset of patients most likely to benefit from parity laws are those on oral therapy for a disease where the comparable IV drug is inexpensive (eg, generic docetaxel for mHSPC). [Table: see text]
Survival gains in multiple myeloma from 2003 to 2014.
Authors: Fonseca Rafael , Jena Anupam B. , Peneva Desi , Clancy Zoe 
Published: September 2018

98 Background: Survival probabilities for patients with multiple myeloma have increased considerably over the past several decades, and a conservative estimate of 5-year survival today is approximately 50%, perhaps higher with optimal treatment. Treatment options for multiple myeloma have grown significantly beginning in 2003 with the approval of bortezomib, followed by approvals for lenalidomide and thalidomide in 2006. The second wave of novel agent approvals began in 2012 with carfilzomib, followed by pomalidomide in 2013. The aim of this study was to estimate the survival gains associated with multiple myeloma therapies after the introduction of novel therapies beginning in 2003 in the United States. Methods: We estimated survival gains for multiple myeloma patients diagnosed in the 5-year period from 2010-2014—who had access to newer therapies like lenalidomide, bortezomib, pomalidomide, and carfilzomib—compared with patients diagnosed in the 5 years prior to the approval of bortezomib (1998–2002). We used data from the Surveillance, Epidemiology, and End Results (SEER) Program cancer registry and a generalized gamma regression survival model. The sample from SEER included patients aged > 18 years who had a diagnosis of multiple myeloma between 1983 and 2014. Results: Of 88,462 patients identified in the full sample, 14,446 patients were diagnosed in 1998–2002 and 25,948 patients were diagnosed in 2010–2014. Overall survival was 51% longer ( P< 0.001) in multiple myeloma patients diagnosed in 2010–2014 than in patients diagnosed in 1998–2002. Patients diagnosed in 2010–2014 had median and mean survival of 1.32 and 2.27 years longer, respectively, than patients diagnosed in 1998–2002. Conclusions: Patients diagnosed with multiple myeloma during 2010–2014 had significant improvement in survival relative to patients diagnosed in 1998–2002. This study found continued improvement in survival in multiple myeloma patients in the most recent 5-years of survival data available, demonstrating the considerable progress made since the wave of multiple myeloma innovation began in 2003.
Optimizing the design of population-based patient-derived tumor xenograft studies to better predict clinical response
Authors: Floc'h Nicolas , Guerriero Maria Luisa , Ramos-Montoya Antonio , Davies Barry R. , Cairns Jonathan , Karp Natasha A. 
Published: September 2018

ABSTRACT
The high attrition rate of preclinical agents entering oncology clinical trials has been associated with poor understanding of the heterogeneous patient response, arising from limitations in the preclinical pipeline with cancer models. Patient-derived tumor xenograft (PDX) models have been shown to better recapitulate the patient drug response. However, the platform of evidence generated to support clinical development in a drug discovery project typically employs a limited number of models, which may not accurately predict the response at a population level. Population PDX studies, large-scale screens of PDX models, have been proposed as a strategy to model the patient inter-tumor heterogeneity. Here, we present a freely available interactive tool that explores the design of a population PDX study and how it impacts the sensitivity and false-positive rate experienced. We discuss the reflection process needed to optimize the design for the therapeutic landscape being studied and manage the risk of false-negative and false-positive outcomes that the sponsor is willing to take. The tool has been made freely available to allow the optimal design to be determined for each drug-disease area. This will allow researchers to improve their understanding of treatment efficacy in the presence of genetic variability before taking a drug to clinic. In addition, the tool serves to refine the number of animals to be used for population-based PDX studies, ensuring researchers meet their ethical obligation when performing animal research.
Kindlin-2 interacts with a highly conserved surface of ILK to regulate focal adhesion localization and cell spreading
Authors: Kadry Yasmin A. , Huet-Calderwood Clotilde , Simon Bertrand , Calderwood David A. 
Published: September 2018

ABSTRACT
The integrin-associated adaptor proteins integrin-linked kinase (ILK) and kindlin-2 play central roles in integrin signaling and control of cell morphology. A direct ILK–kindlin-2 interaction is conserved across species and involves the F2PH subdomain of kindlin-2 and the pseudokinase domain (pKD) of ILK. However, complete understanding of the ILK–kindlin-2 interaction and its role in integrin-mediated signaling has been impeded by difficulties identifying the binding site for kindlin-2 on ILK. We used conservation-guided mapping to dissect the interaction between ILK and kindlin-2 and identified a previously unknown binding site for kindlin-2 on the C-lobe of the pKD of ILK. Mutations at this site inhibit binding to kindlin-2 while maintaining structural integrity of the pKD. Importantly, kindlin-binding-defective ILK mutants exhibit impaired focal adhesion localization and fail to fully rescue the spreading defects seen in ILK knockdown cells. Furthermore, kindlin-2 mutants with impaired ILK binding are also unable to fully support cell spreading. Thus, the interaction between ILK and kindlin-2 is critical for cell spreading and focal adhesion localization, representing a key signaling axis downstream of integrins.
This article has an associated First Person interview with the first author of the paper.
The Virtual Hospitalist: A Single‐Site Implementation Bringing Hospitalist Coverage to Critical Access Hospitals
Authors: Kuperman Ethan F. , Linson Eric L. , Klefstad Kate , Perry Evelyn , Glenn Kevin 
Published: September 2018

BACKGROUNDOn‐site hospitalist care can improve patient care, but it is economically infeasible for small critical access hospitals (CAHs). A telemedicine “virtual hospitalist” may expand CAH capabilities at a fractional cost of an on‐site provider.OBJECTIVETo evaluate the impact of a virtual hospitalist on transfers from a CAH to outside hospitals.DESIGN, SETTING, AND PARTICIPANTSA six‐month pilot program providing “virtual hospitalist” coverage to patients at a CAH in rural Iowa.MEASUREMENTSThe primary outcome was the rate of outside transfers from the CAH Emergency Department (ED). The secondary outcomes included transfer from either the ED or the inpatient wards, daily census, length of stay, transfers after admission, virtual hospitalist time commitment, and patient and staff satisfaction. The preceding 24‐week baseline was compared with 24 weeks after implementation, excluding a two‐week transition period.RESULTSAt baseline, there were 947 ED visits and 176 combined inpatient and observation encounters, compared to 930 and 176 after implementation, respectively. Outside transfers from the ED decreased from 16.6% to 10.5% (157/947 to 98/930, P < .001), and transfers at any time decreased from 17.3% to 11.9% (164/947 to 111/930, P < .001). Daily census, length of stay, and transfers after admission were unchanged. Time commitment for a virtual hospitalist was 35 minutes per patient per day. The intervention was well received by the CAH staff and patients.CONCLUSIONSThe virtual hospitalist model increased the percentage of ED patients who could safely receive their care locally. A single virtual hospitalist may be able to cover multiple CAHs simultaneously.
Paediatric orthopaedics through paintings
Authors: Camurcu Y. , Sofu H. , Ucpunar H. , Duman S. , Cobden A. 
Published: September 2018

Purpose Some famous artistic representations created throughout the centuries can reveal a hidden or mysterious diagnosis of some diseases and these paintings have always drawn the attention of physicians interested in art. Artistic illustration of a child with a malformation or disability can reflect the characteristic appearance of a disease and its historic perspective. Some articles have revealed the definite diagnosis of a child with achondroplasia through portraits of dwarfs and some studies have discussed the secret diagnosis of a crippled child with Pes Equinovarus or poliomyelitis. In this study, we aim to introduce some paintings that reveal musculoskeletal diseases related to paediatric orthopaedics. Methods Paintings painted since the Renaissance were reviewed and collected via web searches. Artistic paintings depicting children with suspected paediatric orthopaedic diseases were analyzed in this study. Results Paintings in which artists have depicted children with achondroplasia, poliomyelitis and clubfoot were found. Conclusion The investigation of a drawing depicting a disabled child may encourage an orthopaedic surgeon to introduce an analytical approach using visual cues. These paintings may also enhance the observational skills of paediatric orthopaedic surgeons, give information about the historical process of a disease and demonstrate the impact of the disease at the time the painting was painted.
Review Essay
Authors: Edelheim Johan R. 
Published: September 2018

Abstract
Innovation in Hospitality Education: Anticipating the Educational Needs of a Changing Profession, Jeroen A. Oskam, Daphne M. Dekker and Karoline Wiegerink (eds) (2018) Cham: Springer, 232 pp., ISBN: 9783319613789, h/bk, £99.99
Embodying Islam: The political, social and spiritual use of the body in performative practice
Authors: Bridgeman Lauren 
Published: September 2018

Abstract
Attitudes towards the performing body in Islam are complex and varied. The highly codified ritual prayer salat is central to daily life, while dancing is oft regarded as an immoral and frivolous activity. Sufi Muslims embrace movement-based practices as part of a spiritual experience and receive harsh criticism from other Islamic denominations. Yet, many people enjoy dancing, at celebrations, for example, and those living in conservative countries put themselves at extreme risk to do so. This article explores this paradox by analysing the political, social and spiritual use of the body in Islam through three embodied practices: dance, salat and Sufi worship. How does belief affect Muslims’ experiential and everyday modes of being? How does it manifest in performative aspects of both culture and religion? What are the politics of performance in Islam? This research reveals how history, culture and Islamic ideology intersect to form dynamic and multifarious interpretations of the body and its boundaries.
Arterial infusion of rapamycin in the treatment of rabbit hepatocellular carcinoma to improve the effect of TACE
Authors: Wu Tao , Yao Yihui , Sun Ruimin , Wang Huili , Yin Xiaoxiang , Zhang Junna , Zhou Qing , Huangfu Chaoshen 
Published: September 2018

AbstractBackgroundHepatocellular carcinoma is one of the leading causes of cancer-related death. Hepatic transcatheter arterial chemo-embolization (TACE) is commonly used clinically for advanced hepatocellular carcinoma treatment.AIMThe aim of this study was to evaluate whether arterial infusion of rapamycin can improve the effect of TACE in treatment of rabbit hepatocellular carcinoma.Material and MethodsEighteen healthy New Zealand white rabbits weighing 2.6 ± 0.3 kg were used in a standardised hepatocellular carcinoma model and randomly divided into three groups of 6 rabbits. Group A: the rabbits were treated with rapamycin and TACE by administering arterial perfusion of 2 mg/kg rapamycin + 1 mg/kg epirubicin, 0.2 mg/kg mitomycin, and lipiodol emulsion embolization. Group B: rapamycin was reduced to 1 mg/kg. And for Group C, the rabbits received only TACE treatment. 14 days post operation, CT scan and digital subtraction angiography (DSA) was performed to examine TACE efficacy. The rabbits were killed by air embolism and the expression of HIF-1a, VEGF, iNOS, and CD34 were measured in an immunohistochemical assay of thetumor tissue.ResultsHIF-1a, VEGF and iNOS protein expression in Group A was significantly lower than that of Group B and Group C (P<0.05). The tumor MVD in group C was significantly higher than that of group A and group B (P<0.05); and the tumor MVD of group B was significantly higher than group A (P<0.05).ConclusionArterial infusion of rapamycin combined with TACE can improve treatment efficacy by decreasing HIF-1a, VEGF, iNOS and CD34 expression.
SSR Markers Suitable for Marker Assisted Selection in Sunflower for Downy Mildew Resistance
Authors: Şahin Ezgi Çabuk , Kalenderoğlu Aral , Aydın Yıldız , Evci Göksel , Uncuoğlu Ahu Altınkut 
Published: September 2018

AbstractThe effectiveness of Pl genes is known to be resistant to downy mildew (DM) disease affected by fungus Plasmopara halstedii in sunflower. In this study phenotypic analysis was performed using inoculation tests and genotypic analysis were carried out with three DM resistance genes Plarg, Pl13 and Pl8. A total of 69 simple sequence repeat markers and 241 F2 individuals derived from a cross of RHA-419 (R) x P6LC (S), RHA-419 (R) x CL (S), RHA-419 (R) x OL (S), RHA419 (R) x 9758R (S), HA-R5 (R) x P6LC (S) and HA89 (R) x P6LC (S) parental lines were used to identify resistant hybrids in sunflower. Results of SSR analysis using markers linked with downy mildew resistance genes (Plarg, Pl8 and Pl13) and downy mildew inoculation tests were evaluated together and ORS716 (for Plarg and Pl13), HA4011 (for Pl8) markers showed positive correlation with their phenotypic results. These results suggest that these markers are associated with DM resistance and they can be used successfully in marker-assisted selection for sunflower breeding programs specific for downy mildew resistance.
Improved Adaptive Neuro-Fuzzy Inference System Using Gray Wolf Optimization: A Case Study in Predicting Biochar Yield
Authors: Ewees Ahmed A. , Elaziz Mohamed Abd 
Published: September 2018

Abstract
This paper presents an alternative method for predicting biochar yields from biomass thermochemical processes. As biochar is considered a renewable and sustainable energy source, it has received more attention. Several methods have been presented to predict biochar, such as neural network (NN) and least square support vector machine (LS-SVM). However, each of them has its own drawbacks, such as getting stuck in a local optimum, which occurs in NN, and lack of uncertainty and time complexity, as in LS-SVM. Therefore, this paper avoids this limitation by using a hybrid method between the adaptive neuro-fuzzy inference system (ANFIS) and gray wolf optimization (GWO) algorithm. The proposed method is called ANFIS-GWO, which consists of two stages. In the first stage, GWO is used to learn the parameters of ANFIS using the training set. Meanwhile, in the second stage, the testing set is used to evaluate the performance of the proposed ANFIS-GWO method. Three experiments were performed to assess the performance of the proposed method. The first experiment used a set of UCI (University of California, Irvine) benchmark datasets to evaluate the effectiveness of ANFIS-GWO. The aim of the second experiment was to evaluate the performance of the proposed ANFIS-GWO method to predict biochar yield from manure pyrolysis. The third experiment aimed to estimate the values of input parameters of pyrolysis that maximize biochar production. The obtained results were compared to those of other methods, such as ANFIS using gradient descent, practical swarm optimization, genetic algorithm, whale optimization algorithm, sine-cosine algorithm, and LS-SVM. The results of the ANFIS-GWO method were >35% of the standard ANFIS and also better than those of other methods.