bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis accuracy of serum glypican-3 level in patients with hepatocellular carcinoma: a systematic review with meta-analysis
Authors: Li Jian , Wang Tiezheng , Jin Boxun , Li Wenlei , Wang Zhenshun , Zhang Haitao , Song Yunjun , Li Ning 
Published: August 2018

Background: Previous studies have evaluated the diagnostic value of serum glypican-3 in patients with hepatocellular carcinoma. However, the results remain inconsistent and even controversial. Thus, the aim of the present meta-analysis was to clarify the diagnostic accuracy of serum glypican-3 for hepatocellular carcinoma. Methods: A meta-analysis including 22 studies was performed with 2325 cases and 2280 controls. Relevant studies were searched in the EMBASE, PubMed, and Web of Science databases, covering relevant papers published until November 1, 2017. The quality of the studies was assessed by revised QUADAS tools. Sensitivity, specificity, and other measures were pooled and determined to evaluate the accuracy of serum glypican-3 in the diagnosis of hepatocellular carcinoma by random-effects models. Summary receiver operating characteristic curve (sROC) analysis was performed to summarize the overall test performance. Results: The results showed that the pooled overall diagnostic sensitivity, specificity, and 95% confidence interval (CI) for serum glypican-3 in the diagnosis of hepatocellular carcinoma were 68% (56-79%) and 92% (82-96.0%), respectively. Besides, the summary diagnostic odds ratio and 95% CI for glypican-3 were 23.53 (8.57-64.63). In addition, the area under sROC and 95% CI was 0.87 (0.84-0.90). The major design deficiencies of included studies were differential verification bias, and a lack of clear exclusion and inclusion criteria. Conclusions: The results of this meta-analysis suggested that serum glypican-3 was acceptable as a moderate diagnostic marker in the diagnosis of hepatocellular carcinoma compared with healthy individuals, which could elevate the sensitivity and specificity of diagnosis. Furthermore, more well-designed studies with large sample sizes are needed to show the effectiveness of glypican-3 in the differential diagnosis of hepatocellular carcinoma.
Design of non-inferiority randomized trials using the difference in restricted mean survival times
Authors: Weir Isabelle R , Trinquart Ludovic 
Published: August 2018

Background/aims Non-inferiority trials with time-to-event outcomes are becoming increasingly common. Designing non-inferiority trials is challenging, in particular, they require very large sample sizes. We hypothesized that the difference in restricted mean survival time, an alternative to the hazard ratio, could lead to smaller required sample sizes. Methods We show how to convert a margin for the hazard ratio into a margin for the difference in restricted mean survival time and how to calculate the required sample size under a Weibull survival distribution. We systematically selected non-inferiority trials published between 2013 and 2016 in seven major journals. Based on the protocol and article of each trial, we determined the clinically relevant time horizon of interest. We reconstructed individual patient data for the primary outcome and fit a Weibull distribution to the comparator arm. We converted the margin for the hazard ratio into the margin for the difference in restricted mean survival time. We tested for non-inferiority using the difference in restricted mean survival time and hazard ratio. We determined the required sample size based on both measures, using the type I error risk and power from the original trial design. Results We included 35 trials. We found evidence of non-proportional hazards in five (14%) trials. The hazard ratio and the difference in restricted mean survival time were consistent regarding non-inferiority testing, except in one trial where the difference in restricted mean survival time led to evidence of non-inferiority while the hazard ratio did not. The median hazard ratio margin was 1.43 (Q1–Q3, 1.29–1.75). The median of the corresponding margins for the difference in restricted mean survival time was −21 days (Q1–Q3, −36 to −8) for a median time horizon of 2.0 years (Q1–Q3, 1–3 years). The required sample size according to the difference in restricted mean survival time was smaller in 71% of trials, with a median relative decrease of 8.5% (Q1–Q3, 0.4%–38.0%). Across all 35 trials, about 25,000 participants would have been spared from enrollment using the difference in restricted mean survival time compared to hazard ratio for trial design. Conclusion The margins for the hazard ratio may seem large but translate to relatively small differences in restricted mean survival time. The difference in restricted mean survival time offers meaningful interpretation and can result in considerable reductions in sample size. Restricted mean survival time-based measures should be considered more widely in the design and analysis of non-inferiority trials with time-to-event outcomes.
Early and midterm outcomes of endovascular treatment for chronic aneurysmal aortic dissection: a retrospective study
Authors: Kanaoka Yuji , Ohki Takao , Kurosawa Koji , Maeda Koji , Shukuzawa Kota , Hara Masayuki , Baba Takeshi , Takizawa Reo , Tachihara Hiromasa 
Published: August 2018

Background: The aim of this study was to evaluate endovascular treatment for enlarged Stanford type B chronic aneurysmal aortic dissection (CAAD). The conventional treatment for CAAD is open repair; however, the operative mortality is high in extensive prosthetic graft replacements. Methods: A retrospective single-center study was conducted on 74 consecutive patients who underwent endovascular treatment for CAAD in the past 8.5 years. In the partial exclusion (PE) group, entry sites in close proximity to the maximum diameter of CAAD were closed using a stent graft and reentry sites were left without closure. In the complete exclusion (CE) group, we attempted to close all entry and reentry sites. Results: A total of 43 patients (PE group) and 31 patients (CE group) were included with mean ages of 59 and 63 years, respectively. Operative mortalities of 2.3% and 0% were observed in the PE and CE groups, respectively. Complete tear closure was successful in 17 of 31 patients (54.8%) in the CE group. In the PE group, complete thrombosis of the false lumen was achieved in only one case (2.3%). Freedom rates from reentry closure were 90.2%, 86.9%, and 78.2% at 1, 3, and 5 years, respectively. The diameter of the true lumen/aorta changed from 16.9/62.9 mm to 30.2/53.6 mm and from 13.7/55.1 mm to 25.8/51.0 mm in the aortic arch and descending thoracic aorta, respectively. The freedom rates from secondary intervention in successful and unsuccessful CE cases were 92.9% and 69.1%, respectively, at 1 year and 92.9% and 53.7%, respectively, at 3 years. Conclusion: Endovascular treatment for CAAD had favorable early and midterm outcomes.
Inflammatory bowel disease and cardiovascular disease incidence and mortality: A meta-analysis
Authors: Sun Hong-Hao , Tian Feng 
Published: August 2018

Background The risk of cardiovascular disease occurrence and death in inflammatory bowel disease patients is still unclear. Design Meta-analysis. Methods Pertinent studies were identified by searching articles in PubMed and Web of Knowledge to December 2017 and reviewing the reference lists of the retrieved articles. We used the fixed-effect model to pool the study-specific estimates when there was no indication of heterogeneity; otherwise, the random-effect model was used. Results A total of 27 articles was included, of which 11 studies reported the risk of cardiovascular disease incidence and 16 studies reported the risk of cardiovascular disease death. The pooled relative risks were 1.25 (95% confidence interval (CI): 1.08, 1.44), 1.17 (95% CI: 1.07, 1.27) and 1.12 (95% CI: 1.05, 1.21) for cerebrovascular disease, coronary heart disease and myocardial infarction, respectively. In particular, the pooled relative risk was much higher in females. The pooled standardized mortality ratios were 1.01 (95% CI: 0.90, 1.14) for Crohn's disease patients and 0.93 (95% CI: 0.86, 1.01) for ulcerative colitis patients with low heterogeneity across studies. No publication bias was detected. Conclusions There was a positive association between inflammatory bowel disease and higher risk of cardiovascular disease incidence, particularly in females. Such an association was not observed for cardiovascular disease mortality.
Primary Ankle Arthrodesis vs ORIF for Severely Comminuted Pilon Fractures
Authors: Beckwitt Colin H. , Monaco Spencer J. , Gruen Gary S. 
Published: August 2018

Background: The treatment for highly comminuted pilon fractures remains controversial. The goal of this retrospective cohort study was to compare functional outcomes of primary arthrodesis of the tibiotalar joint (fusion) and open reduction internal fixation (ORIF). Methods: Patients who underwent primary ORIF or fusion for pilon fractures at our institution since 2000 were identified by Current Procedural Terminology ( CPT) code. Inclusion criteria for the ORIF cohort were patients with an AO/Orthopaedic Trauma Association type C3 pilon fracture. Additional inclusion criteria for the fusion cohort were patients whose fractures were deemed non-reconstructable by the treating surgeon. Outcome assessment was determined by the Foot and Ankle Outcome Score (FAOS) and Short Form 36-item health survey (SF-36), time to radiographic union or fusion, and wound-healing complications at a minimum of 2 years after their surgery. Results: Nineteen ORIF and 16 fusion patients completed the study’s outcome assessments. A higher rate of nonunion was observed in patients treated by primary ORIF than primary fusion (5/19 vs 1/16). Posttraumatic arthritis was observed in 11 of 19 primary ORIF patients. Primary fusion patients exhibited increased symptoms, pain, and physical role limits but were equivalent to primary ORIF patients on all other functional metrics examined. Conclusions: Primary ankle arthrodesis achieves a lower rate of nonunion and comparable functional outcomes to ORIF in patients with severely comminuted pilon fractures. The higher rate of nonunion observed in the primary ORIF group suggests that primary fusion should be considered an effective procedure for severe injuries to decrease the need for further operative intervention. Level of Evidence: Therapeutic Level III, retrospective cohort.
Circulating eosinophil levels do not predict severe exacerbations in COPD: a retrospective study
Authors: Adir Yochai , Hakrush Omar , Shteinberg Michal , Schneer Sonia , Agusti Alvar 
Published: August 2018

Whether the level of circulating eosinophils in chronic obstructive pulmonary disease (COPD) patients can predict the risk of exacerbations of COPD (ECOPD) or response to treatment is debated. Here, we evaluate the prevalence of elevated eosinophils in COPD patients and its relationship with severe ECOPD requiring hospitalisation.We retrospectively reviewed the charts of COPD patients hospitalised in our centre between January 1, 2005 and November 30, 2015 because of ECOPD or other reasons (controls). In a second analysis, the ECOPD patients were divided into two subgroups based on having ECOPD in the next year after the index event or not. Circulating eosinophils, both during clinical stability and hospitalisation, as well as clinical and functional data and the relation to recurrent exacerbations were analysed.We studied 992 COPD patients (318 ECOPD patients and 674 controls). Among ECOPD patients, 121 had one or more ECOPD during the year after the index event. The prevalence of eosinophils ≥2% was 72% in ECOPD patients and 71% in controls (p=0.93). Among ECOPD patients, eosinophil levels ≥2%, ≥4% or ≥300 cells·μL−1, either when clinically stable or during hospitalisation, did not show a significant association with the rate of recurrent severe exacerbations. The severity of airflow limitation was associated with recurrent exacerbations, but inhaled corticosteroid treatment was not.The majority of COPD patients have circulating eosinophils >2% and a significant association with the risk of severe ECOPD or response to inhaled corticosteroids was not demonstrated.
Determinants and outcomes of change in physical activity in COPD
Authors: Kantorowski Ana , Wan Emily S. , Homsy Diana , Kadri Reema , Richardson Caroline R. , Moy Marilyn L. 
Published: August 2018

Determinants of change in physical activity and outcomes of physical activity promotion are unclear. In this secondary analysis of a randomised controlled trial of a physical activity intervention, we assess predictors of change in physical activity and the effects of increasing physical activity on chronic obstructive pulmonary disease (COPD) measures.Physical activity was promoted in 94 subjects with COPD using the Omron HJ-720ITC pedometer alone or the pedometer plus a website that provides goal setting, feedback, motivational and educational messages, and social support for 3 months. We assessed forced expiratory volume in 1 s (FEV1), 6-min walk test (6MWT) distance, depression, social support and markers of systemic inflammation (C-reactive protein (CRP) and interleukin (IL)-6). Data from both groups were combined and subjects categorised as responders (increased steps per day) or nonresponders (decreased steps per day). Linear regression models explored predictors of change in physical activity and assessed the effect of response on changes in COPD measures.The cohort of responders (n=62) and nonresponders (n=32) had mean FEV11.89±0.64 L (63±22% predicted). Baseline steps per day, diagnosis of depression, social support, oxygen use and season significantly predicted change in daily step count. Responders had increases in physical activity (2038 steps per day), FEV1(308 mL) and 6MWT distance (43.6 m), and decreases in CRP (7.84 mg·L−1) and IL-6 (2.73 ng·mL−1) compared with nonresponders (p<0.0001–0.009).History of depression, social support, oxygen use and season predict change in physical activity, and should be routinely assessed in exercise counselling. Increases in physical activity are associated with improvements in lung function, exercise capacity and systemic inflammation.
Feeding-Induced Cortisol Response in Newborn Infants
Authors: Kinoshita Masahiro , Iwata Sachiko , Okamura Hisayoshi , Tsuda Kennosuke , Saikusa Mamoru , Harada Eimei , Yamashita Yushiro , Saitoh Shinji , Iwata Osuke 
Published: August 2018

Abstract

Context
Understanding the biological rhythms and stress response in sick newborns is important to minimize the negative effects of intensive care. Salivary cortisol has been used as a noninvasive surrogate marker of adrenal function; however, understanding of its control variables is insufficient.

Objective
To investigate the presence of feeding-induced cortisol response and its control variables in newborns.

Design, Setting, and Patients
Fifty-three newborn infants, who were between 30 and 40 weeks’ corrected age and were on 3-hourly regular oral/enteral feeding, were recruited between January 2013 and June 2014.

Main Outcome Measure
Saliva samples were collected before and 1 hour after regular feeding. Dependence of cortisol levels (adjusted for postnatal age) and their feeding-related elevation on clinical variables was assessed by using generalized estimating equations.

Results
Higher cortisol levels were associated with corrected age ≥37 weeks and saliva samples collected after feeding (both P &lt; 0.001). Oral feeding was associated with a greater feeding-induced cortisol response compared with exclusive enteral feeding (P = 0.034), whereas a prolonged feeding duration (≥30 minutes) was associated with a reduced cortisol response compared with brief feeding (&lt;30 minutes) (P &lt; 0.001). Gestational age, corrected age, antenatal/postnatal glucocorticoids, type of milk, and daily feeding volume had no effect on cortisol response.

Conclusions
Feeding-induced cortisol response was observed in newborns. The cortisol response was more prominent following oral feeding and was reduced with prolonged feeding. Future studies may investigate whether feeding-induced cortisol response plays a role in the acquisition of adrenal ultradian and diurnal rhythms.
The Migraine Postdrome
Authors: Bose Pyari , Karsan Nazia , Goadsby Peter J. 
Published: August 2018

ABSTRACT

PURPOSE OF REVIEW
The migraine postdrome is the least studied and least understood phase of migraine. This article covers the salient features of the migraine postdrome and provides insight into the history, clinical symptoms, and future implications of this phase of migraine.

RECENT FINDINGS
Prospective electronic diary studies have shown that patients are left disabled with various nonheadache symptoms in the migraine postdrome, and 81% of patients report at least one nonheadache symptom in the postdrome. Hence, it is important to understand this phase better and ensure that more effective treatments become available in the future to lessen the morbidity associated with this phase. Functional imaging shows widespread reduction in brain-blood flow in the postdrome, which explains the multitudes of symptoms experienced by patients.

SUMMARY
The disability related to migraine is not exclusive to the headache phase but extends into the postdrome phase and is associated with several nonheadache symptoms that prolong the symptoms experienced by patients with migraine. Further research into the postdrome is crucial to improve our overall understanding of migraine mechanisms. This knowledge may also help to treat the concurrent nonheadache symptoms better in the future. Novel neuroimaging techniques provide a valuable noninvasive tool to push the frontiers in the understanding of migraine pathophysiology. These methods may help shed further light onto the possible links between key brain structures and networks that could be implicated in the pathophysiology of the various migraine phases.
It’s the economy, stupid! When economics and politics override health policy goals – the case of tax reliefs to build private hospitals in Ireland in the early 2000s
Authors: Burke Sara A. , Brugha Ruairi , Thomas Stephen 
Published: August 2018

Objectives: To analyse the policy process that led to changes to the Finance Acts in 2001 and 2002 that gave tax-reliefs to build private hospitals in Ireland. Methods: Qualitative research methods of documentary analysis and in-depth semi-structured interviews with elites involved in the policy processes, were used and examined through a conceptual framework devised for this research. Results: This research found a highly politicised and personalised policy making process where policy entrepreneurs, namely private sector interests, had significant impact on the policy process. Effective private sector lobbying encouraged the Minister of Finance to introduce the tax-reliefs for building private hospitals despite advice against this policy measure from his own officials, officials in the Department of Health and the health minister. The Finance Acts in 2001 and 2002 introduced tax-reliefs for building private hospitals, without any public or political scrutiny or consensus. Conclusion: The changes to the Finance Acts to give tax-reliefs to build private hospitals in 2001 and private for-profit hospitals 2002 is an example of a closed, personalised policy making process. It is an example of a politically imposed policy by the finance minister, where economic policy goals overrode health policy goals. The documentary analysis and elite interviews examined through a conceptual framework enabled an in-depth analysis of this specific policy making process. These methods and the framework may be useful to other policy making analyses.
The Effect of Long Term Service at Elevated Temperatures on Microstructure Degradation of Austenitic Reformer Tubes
Authors: Łabanowski J. , Jurkowski M. , Landowski M. 
Published: August 2018

Abstract
The paper analyses the relationship between an increase of the inner diameter of tubes made of Manaurite XM cast steel and transformations occurring in their microstructure due to long-lasting operation in methane reformer. Examinations included metallographic analysis with light microscope (LM), scanning electron microscope (SEM) and microanalysis of the chemical composition of precipitates (EDX). It was indicated that there is a relationship between the microstructure degradation ratio, morphology of the precipitates and an increase of the inner diameter of the tubes.
Effect of Glass-Fabrics and High-Melting Powder Fillers on Thermal Protective Properties of Thermosetting Laminates
Authors: Kucharczyk W. , Żurowski W. , Gumiński R. , Przybyłek P. , Komorek A. 
Published: August 2018

Abstract
The present work investigates the ablative and thermal properties of phenol formaldehyde glass-fabrics laminates filled with mixtures of corundum Al2O3 and carbon C powders. The laminates specimens of dimensions 10x25x35 mm were treated with hot combustion gases having a temperature of more than 2800ºC. The carbonization of the thermosetting matrix was observed. Statistical methods for planning experiments were used, and the effect of components on the average rate of ablation, the maximum back side temperature of specimen and the average mass waste under intensive heat flow after 30 s of treatment with hot combustion gases was established. The best thermal protective properties were exhibited by the laminate containing 30% matrix, 25% fibre glass-fabric reinforcement, 9% corundum, and 36% carbon powder.
Design of a 1D phase-mask translational scanner for large-size spatially coherent grating printing
Authors: Parriaux Olivier , Jourlin Yves 
Published: August 2018

Abstract
Controlled translational displacement between a large-surface photosensitive planar substrate and a wide and short 1D grating phase-mask enables the printing of large-width, spatially highly coherent gratings of principally unlimited length, using a limited number of opto-mechanical control parameters. The phase-mask is illuminated by a temporally modulated exposure light sheet controlled by a displacement sensor. The proposed method is compared with existing techniques, and its functional elements and their combination are analyzed.
New Drugs - From Necessity to Delivery
Authors: Kedzierska Ewa , Dabkowska Lila , Krzanowski Tomasz , Gibula Ewa , Orzelska-Gorka Jolanta , Wujec Monika 
Published: August 2018

Abstract
How to get a new drug to market? How much time does it take to go from the idea to implementation? In this study we followed the path drugs take from synthesis to introduction to the market. In doing so, articles in the PubMed and the Google Scholar database have been analyzed using the keywords: drug development, drug design, lead compound, preclinical trials, clinical trials. The available literature was subjectively selected due to its usefulness in the topic. Based on the obtained articles, we presented the stages that a would-be drug takes on the way from the idea to marketing. Herein, it is underlined that the process of creating new drugs is long, extremely labor-intensive, and involves many restrictions in the context of the use of animals, as well as humans