bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cyclooxygenase inhibition with curcumin in Helicobacter pylori infection
Authors: Santos António Mário , Lopes Teresa , Oleastro Mónica , Pereira Teresa , Alves Carolina Coimbra , Seixas Elsa , Chaves Paula , Machado Jorge , Guerreiro António Sousa 
Published: February 2018

Abstract
Background
Helicobacter pylori (H. pylori) infection increases the expression of cyclooxygenase-2 (COX-2) on the host’s gastric mucosa. The inhibition of COX-2 activity with natural products would be a major advantage. This study aims to clarify the possible effect of curcumin on COX-2 inhibition in gastric mucosa of H. pylori infected mice.

Methods
We inoculated 30 pathogen-free male C57BL/6 mice with H. pylori (SS1 Sidney strain) that were randomly divided in two different groups: infected group (IG) treated with phosphate-buffered saline (PBS) (n = 15) and infected group treated with curcumin 500 mg/kg (IG + C) (n = 15). A group of 15 non-infected mice were used as control (CG). Two weeks post-infection, both IG and CG groups received 0.5 ml of PBS, while the IG + C group received curcumin for 6, 18, and 27 weeks.

Results
The analysis by immunohistochemistry and by PCR array at 6, 18, and 27 weeks post-infection showed a significant increase on COX-2 expression on the IG mice compared to the CG mice. The group treated with curcumin (IG + C) showed a significant downregulation of COX-2 at all points of the experiment, when compared to the IG + C mice.

Conclusion
Chronic H. pylori infection induces a significant increase in COX-2 expression. Treatment with curcumin significantly decreases the COX-2 expression, and the addition of curcumin to the diet may be an interesting approach for areas of high H. pylori prevalence.
Methodology to Forecast Volume and Cost of Cancer Drugs in Low- and Middle-Income Countries
Authors: Martei Yehoda M. , Chiyapo Sebathu , Grover Surbhi , Hanna Christina , Dryden-Peterson Scott , Pusoentsi Malebogo , Shulman Lawrence N. , Tapela Neo 
Published: February 2018

Purpose In low- and middle-income countries (LMICs), frequent outages of the stock of cancer drugs undermine cancer care delivery and are potentially fatal for patients with cancer. The aim of this study is to describe a methodologic approach to forecast chemotherapy volume and estimate cost that can be readily updated and applied in most LMICs. Methods Prerequisite data for forecasting are population-based incidence data and cost estimates per unit of drug to be ordered. We used the supplementary guidelines from the WHO list of essential medicines for cancer to predict treatment plans and ordering patterns. We used de-identified aggregate data from the Botswana National Cancer Registry to estimate incident cases. The WHO Management Sciences for Health International Price Indicator was used to estimate unit costs per drug. Results Chemotherapy volume required for incident cancer cases was estimated as the product of the standardized dose required to complete a full treatment regimen per patient, with a given cancer diagnosis and stage, multiplied by the total number of incident cancer cases with the respective diagnosis. The estimated chemotherapy costs to treat the 10 most common cancers in the public health care sector of Botswana is approximately 2.3 million US dollars. An estimated 66% of the budget is allocated to costs of rituximab and trastuzumab alone, which are used by approximately 10% of the cancer population. Conclusion This method provides a reproducible approach to forecast chemotherapy volume and cost in LMICs. The chemotherapy volume and cost outputs of this methodology provide key stakeholders with valuable information that can guide budget estimation, resource allocation, and drug-price negotiations for cancer treatment. Ultimately, this will minimize drug shortages or outages and reduce potential loss of lives that result from an erratic drug supply.
Desire for Information and Preference for Participation in Treatment Decisions in Patients With Cancer Presenting to the Department of General Surgery in a Tertiary Care Hospital in India
Authors: Sankar Sushmitha Dharani , Dhanapal Baskaran , Shankar Gomathi , Krishnaraj Balamourougan , Karra Sandhya , Natesan Vignesh 
Published: February 2018

Purpose Providing appropriate information to patients about their illness helps them to cope with the diagnosis. Shared decision making is a key concept in managing patients with cancer. There are no data available about the desire for information and preference for participation in treatment decisions among Indian patients with cancer. The objective of this study was to estimate the proportion of patients who have information needs and to study the patient preference for participation in treatment decisions and the factors associated with them. Methods A cross-sectional survey was conducted among patients with cancer older than 18 years. They were interviewed with a questionnaire after signing an informed consent. The association of sex, educational level, residence, diagnosis (type of cancer), Eastern Cooperative Oncology Group performance status, and treatment status with information needs and decision-making preference was analyzed using χ2 test Results Approximately 81% of patients said that they had an absolute need to know if the illness was cancer, and > 70% of patients either had an absolute need to know or would like to know about the prognosis, treatment options, and adverse effects. Regarding the decision-making preferences, 97% wanted their treating physicians to make the decision regarding their treatment, and 66% preferred to share decision making with their family. Conclusion The majority of the patients with cancer expressed a need for knowing whether they had cancer. When it comes to treatment decisions, most of them preferred a passive role, and the majority wanted to involve their families in the decision-making process. We recommend that the treating physician should elicit the patient’s preference in participating in treatment decisions and their preference about involving their family in making treatment decisions
Readmission Patterns After GI Cancer Hospitalizations: The Medical Versus Surgical Patient
Authors: Manzano Joanna-Grace M. , Yang Ming , Zhao Hui , Elting Linda S. , George Marina C. , Luo Ruili , Suarez-Almazor Maria E. 
Published: February 2018

Purpose: Readmission within 30 days has been used as a metric for quality of care received at hospitals for certain diagnoses. In the era of accountability, value-based care, and increasing cancer costs, policymakers are looking into cancer readmissions as well. It is important to describe the readmission profile of patients with cancer in the most clinically relevant approach to inform policy and health care delivery that can positively impact patient outcomes. Patients and Methods: We conducted a retrospective cohort study using linked Texas Cancer Registry and Medicare claims data. We included elderly Texas residents diagnosed with GI cancer and identified risk factors for unplanned readmission using generalized estimating equations, comparing medical with surgical cancer-related hospitalizations. Results: We analyzed 69,693 hospitalizations from 31,736 patients. The unplanned readmission rate was higher after medical hospitalizations than after surgical hospitalizations (21.6% v 13.4%, respectively). Shared risk factors for readmission after medical and surgical hospitalizations included advanced disease stage, high comorbidity index, and emergency room visit and radiation therapy within 30 days before index hospitalization. Several other associated factors and reasons for readmission were noted to be unique to medical or surgical hospitalizations alone. Conclusion: Unplanned readmissions among elderly patients with GI cancer are more common after medical hospitalizations compared with surgical hospitalizations. There are shared risk factors and unique risk factors for these hospitalizations that can inform policy, health care delivery, and interventions to reduce readmissions. Other findings underscore the importance of care coordination and comorbidity management in this patient population.
System-Level Health-Care Integration and the Costs of Cancer Care Across the Disease Continuum
Authors: Kaye Deborah R. , Min Hye Sung , Norton Edward C. , Ye Zaojun , Li Jonathan , Dupree James M. , Ellimoottil Chad , Miller David C. , Herrel Lindsey A. 
Published: February 2018

Purpose: Policy reforms in the Affordable Care Act encourage health care integration to improve quality and lower costs. We examined the association between system-level integration and longitudinal costs of cancer care. Methods: We used linked SEER-Medicare data to identify patients age 66 to 99 years diagnosed with prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian cancer from 2007 to 2012. We attributed each patient to one or more phases of care (ie, initial, continuing, and end of life) according to time from diagnosis until death or end of study interval. For each phase, we aggregated all claims with the primary cancer diagnosis and identified patients treated in an integrated delivery network (IDN), as defined by the Becker Hospital Review list of the top 100 most integrated health delivery systems. We then determined if care provided in an IDN was associated with decreased payments across cancers and for each individual cancer by phase and across phases. Results: We identified 428,300 patients diagnosed with one of 10 common cancers. Overall, there were no differences in phase-based payments between IDNs and non-IDNs. Average adjusted annual payments by phase for IDN versus non-IDNs were as follows: initial, $14,194 versus $14,421, respectively ( P = .672); continuing, $2,051 versus $2,099 ( P = .566); and end of life, $16,257 versus $16,232 ( P = .948). However, in select cancers, we observed lower payments in IDNs. For bladder cancer, payments at the end of life were lower for IDNs ($11,041 v $12,331; P = .008). Of the four cancers with the lowest 5-year survival rates (ie, pancreatic, lung, esophageal, and liver), average expenditures during the initial and continuing-care phases were lower for patients with liver cancer treated in IDNs. Conclusion: For patients with one of 10 common malignancies, treatment in an IDN generally is not associated with lower costs during any phase of cancer care.
Epileptic Encephalopathies
Authors: Hussain Shaun A. 
Published: February 2018

ABSTRACTPURPOSE OF REVIEWThis article reviews the manifestations and treatment of the epileptic encephalopathies, which are a heterogeneous group of disorders characterized by both seizures and neurocognitive impairment.RECENT FINDINGSNext-generation (exome- and genome-based) sequencing technologies are revolutionizing the identification of single-gene causes of epileptic encephalopathy but have only had a modest impact on patient-specific treatment decisions. The treatment of most forms of epileptic encephalopathy remains a particularly challenging endeavor, with therapeutic decisions chiefly driven by the electroclinical syndrome classification. Most antiseizure drugs are ineffective in the treatment of these disorders, and treatments that are effective often entail significant risk and cost.SUMMARYThe epileptic encephalopathies continue to pose a major challenge in diagnosis and treatment, with most patients experiencing very poor outcomes, although a significant minority of patients respond to, or are even cured by, specific therapies.
Pediatric Traumatic Brain Injury and Concussion
Authors: Choe Meeryo , Barlow Karen M. 
Published: February 2018

ABSTRACTPURPOSE OF REVIEWThis article summarizes the impact and complications of mild traumatic brain injury and concussion in children and outlines the recent evidence for its assessment and early management. Useful evidence-based management strategies are provided for children who have a typical recovery following concussion as well as for those who have persistent postconcussion syndrome. Cases are used to demonstrate the commonly encountered pathologies of headache, cognitive issues, and mood disturbances following injury.RECENT FINDINGSA clinical risk score using risk factors for poor recovery (eg, female sex, adolescence, previous migraine, and a high degree of acute symptoms) can be used to help the clinician plan follow-up in the community. Prolonged periods of physical and cognitive rest should be avoided. Multidisciplinary treatment plans are often required in the management of persistent postconcussion syndrome.SUMMARYA paucity of research exists for the treatment of postconcussion syndrome. Current treatments target individual symptoms.
Transition From Pediatric to Adult Neurologic Care
Authors: Tilton Ann H. , de Gusmao Claudio Melo 
Published: February 2018

ABSTRACT

PURPOSE OF REVIEW
With advances in medical care, the number of youths surviving with medically complex conditions has been steadily increasing. Inadequate transition planning and execution can lead to gaps in care, unexpected emergency department visits, and an increase in health care costs and patient/caregiver anxiety. Many barriers that prevent adequate transition have been identified, including insufficient time or staff to provide transition services, inadequate reimbursement, resistance from patients and caregivers, and a dearth of accepting adult providers.

RECENT FINDINGS
Transition is distinct from transfer of care. Transition is a planned multistage process, while transfer refers to a point in time where responsibility of care shifts from one provider to another. Key differences exist between the pediatric and adult models of care. A successful transition should empower the patient to understand and take responsibility in managing his or her condition; foster independent functioning to the extent that is possible; integrate educational, legal, and community resources in the care plan; and identify appropriate adult health care providers at the time of transfer. Different models have been proposed to streamline the transition process, with improvement in patients' knowledge of their condition, self-efficacy, and confidence.

SUMMARY
Neurologists have a key role in supporting their patients in the transition to adulthood. This article reviews basic tenets and provides tools to assist in navigating the complex transition process. These tenets are intended to improve quality of care and decrease clinician burden and remain an active area of research.
Intensive Care Unit Enhanced Recovery Pathway for Patients Undergoing Orthotopic Liver Transplants Recipients: A Prospective, Observational Study
Authors: King Adam B. , Kensinger Clark D. , Shi Yaping , Shotwell Matthew S. , Karp Seth J. , Pandharipande Pratik P. , Wright J. Kelly , Weavind Liza M. 
Published: February 2018

BACKGROUND:
Liver transplant recipients continue to have high perioperative resource utilization and prolonged length of stay despite improvements in perioperative care. Enhanced recovery pathways have been shown in other surgical populations to produce reductions in hospital resource utilization.

METHODS:
A prospective, observational study was performed to examine the effect of an enhanced recovery pathway for postoperative care after liver transplantation. Outcomes from patients undergoing liver transplantation from November 1, 2013, to October 31, 2014, managed by the pathway were compared to transplant recipients from the year before pathway implementation. Multivariable regression analysis was used to assess the association of the clinical pathway on clinical outcomes.

RESULTS:
The intervention and control groups included 141 and 106 patients, respectively. There were no demographic differences between the control and intervention group including no differences between the length of surgery and cold ischemic time. Median intensive care unit length of stay was reduced from 4.4 to 2.6 days (P < .001). The intervention group had a higher likelihood of earlier discharge (hazard ratio [95% CI], 2.01 [1.55–2.62]; P < .001), and a 69% and 65% lower odds of receiving a plasma (P < .001) or packed red blood cell (P < .001) transfusion. There was no significant effect on hospital mortality (P = .40), intensive care unit readmission rates (P = .75), or postoperative infections (urinary traction infections: P = .09; pneumonia: P = .27).

CONCLUSIONS:
An enhanced recovery pathway focused on milestone-based elements of intensive care unit management and predetermined management triggers including hemodynamic goals, fluid therapy, perioperative antibiotics, glycemic control, and standardized transfusion triggers led to reductions in intensive care unit length of stay without an increase in perioperative complications.
Power-to-Strength Ratio Influences Performance Enhancement with Contrast Training
Authors: SCHNEIKER KNUT THOMAS , FYFE JACKSON JAMES , BILLAUT FRANÇOIS , BISHOP DAVID JOHN 
Published: February 2018

ABSTRACT

Purpose
The effectiveness of contrast training (CST) for improving explosive exercise performance is modulated by various individual characteristics; however, further work is required to define these factors.

Methods
Subelite male Australian Football players (n = 22; age, 19 ± 2 yr; body mass, 80.4 ± 9.4 kg; one-repetition maximum [1-RM] half squat, 172 ± 18 kg; mean ± SD) completed two experimental trials involving two sets of squat jumps (six repetitions at 30% 1-RM) performed either alone (CTL condition) or after half squats (six repetitions at 85% 1-RM; CST condition).

Results
Squat jump peak power was similar between CTL and CST during set 1 (mean change: ±90% confidence interval, 2.8% ± 2.0%; effect size [ES]: ±90% confidence interval, 0.13 ± 0.09; P = 0.079) and set 2 (0.3% ± 1.7%; ES, 0.01 ± 0.08; P = 0.781). Peak power enhancement with CST was not related to maximal (1-RM half squat) strength (r
2 = 0.001, P = 0.884), but was negatively correlated with both baseline peak power (r
2 = 0.44, P < 0.001) and power-to-strength ratio (PSR); that is, the ratio between baseline peak power and 1-RM half squat strength (r
2 = 0.65, P < 0.001). Using a median split, analyses were performed in participants with a low PSR (LPSR group; PSR = 15.4–19.1 W·kg−1; n = 11) or high PSR (HPSR group, PSR = 19.4–24.7 W·kg−1; n = 11). Peak power was enhanced with CST for the LPSR (8.1% ± 3.9%; ES, 0.44 ± 0.21; P = 0.004) but not HPSR (−2.1% ± 1.3%; ES, −0.14 ± 0.09; P = 0.010) groups.

Conclusion
The PSR appears to influence the effectiveness of CST, with performance enhancement more likely in those with a lower PSR.
Aerobic Training Improves Quality of Life in Women with Polycystic Ovary Syndrome
Authors: COSTA EDUARDO CALDAS , DE SÁ JOCELINE CÁSSIA FEREZINI , STEPTO NIGEL KEITH , COSTA INGRID BEZERRA BARBOSA , FARIAS-JUNIOR LUIZ FERNANDO , MOREIRA SIMONE DA NÓBREGA TOMAZ , SOARES ELVIRA MARIA MAFALDO , LEMOS TELMA MARIA ARAÚJO MOURA , BROWNE RODRIGO ALBERTO VIEIRA , AZEVEDO GEORGE DANTAS 
Published: February 2018

ABSTRACT

Purpose
To investigate the effects of a supervised aerobic exercise training intervention on health-related quality of life (HRQL), cardiorespiratory fitness, cardiometabolic profile, and affective response in overweight/obese women with polycystic ovary syndrome (PCOS).

Methods
Twenty-seven overweight/obese inactive women with PCOS (body mass index, ≥ 25 kg·m−2; age 18 to 34 yr) were allocated into an exercise group (n = 14) and a control group (n = 13). Progressive aerobic exercise training was performed three times per week (~150 min·wk−1) over 16 wk. Cardiorespiratory fitness, HRQL, and cardiometabolic profile were evaluated before and after the intervention. Affective response (i.e., feeling of pleasure/displeasure) was evaluated during the exercise sessions.

Results
The exercise group improved 21% ± 12% of cardiorespiratory fitness (P < 0.001) and HRQL in the following domains: physical functioning, general health, and mental health (P < 0.05). Moreover, the exercise group decreased body mass index, waist circumference, systolic and diastolic blood pressure, and total cholesterol level (P < 0.05). The affective response varied from “good” to “fairly good” (i.e., positive affective response) in an exercise intensity-dependent manner during the exercise training sessions.

Conclusions
Progressive aerobic exercise training improved HRQL, cardiorespiratory fitness, and cardiometabolic profile of overweight/obese women with PCOS. Moreover, the participants reported the exercise training sessions as pleasant over the intervention. These results reinforce the importance of supervised exercise training as a therapeutic approach for overweight/obese women with PCOS.
Image-guided biopsy of small (≤4 cm) renal masses: the effect of size and anatomical location on biopsy success rate and complications
Authors: Seager Matthew J , Patel Uday , Anderson Christopher J , Gonsalves Michael 
Published: February 2018

Objective:
To study the influence of tumour diameter and anatomy on the success and complication rates of small renal mass (SRM, ≤4 cm) core biopsy.

Methods:
Retrospective analysis of SRMs that underwent ultrasound or CT-guided biopsy. Diagnostic and complication rates were compared according to tumour size (subcategorised as axial diameter ≤2 cm, &gt;2 to– ≤3 cm, &gt;3–≤4 cm) and anatomical disposition (exophytic/endophytic, centrality, polar location and anterior/posterior).

Results:
94 patients (54 male; age range 21.8–84.3 years) with 95 SRMs underwent biopsy. The first biopsy was diagnostic in 81/95 (85.3%). Seven patients underwent repeat biopsy (6/7 diagnostic), to give an overall diagnostic rate of 91.5%. The primary diagnostic rates in the ≤2, &gt;2–≤3 , &gt;3–≤4 cm groups were 21/25 (84%); 38/44 (86.4%) and 22/26 (84.6%) respectively and were similar (p = 1.00). Anterior and upper pole SRMs were more likely to fail initial biopsy (odds ratio 13.8, p &lt; 0.01; and odds ratio 4.35, p = 0.04) respectively, but other anatomical factors were not relevant. Complications occurred in 14% (all conservatively managed perinephric haematomas; Clavien-Dindo Grade 1) and size or location were not relevant.

Conclusion:
Image-guided biopsy of SRMs has a high diagnostic rate irrespective of tumour size. Anterior and upper pole location had lower diagnostic rates. Biopsy should be considered for all patients with SRMs, if the result will impact on management and we list specific scenarios where an SRM biopsy may be helpful.

Advances in knowledge:
SRM size does not affect the likelihood of a diagnostic biopsy.