bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fratricide of NK Cells in Daratumumab Therapy for Multiple Myeloma Overcome by Ex Vivo–Expanded Autologous NK Cells
Authors: Wang Yufeng , Zhang Yibo , Hughes Tiffany , Zhang Jianying , Caligiuri Michael A. , Benson Don M. , Yu Jianhua 
Published: April 2018

Abstract
Purpose: Daratumumab and its use in combination with other agents is becoming a new standard of care for the treatment of multiple myeloma. We mechanistically studied how daratumumab acts on natural killer (NK) cells.
Experimental Design: Quantities of NK cells in peripheral blood and/or bone marrow of patients with multiple myeloma or healthy donors were examined by flow cytometry. NK-cell apoptosis and the associated mechanism were assessed by flow cytometry and immunoblotting. Patients' NK cells were expanded in vitro using feeder cells. Combination treatment of daratumumab and expanded NK cells was performed using an MM.1S xenograft animal model.
Results: CD38−/low NK cells survived, whereas CD38+ NK cells were almost completely eliminated, in peripheral blood and bone marrow of daratumumab-treated multiple myeloma patients. NK-cell depletion occurred due to daratumumab-induced NK-cell fratricide via antibody-dependent cellular cytotoxicity. Consequently, CD38−/low NK cells were more effective for eradicating multiple myeloma cells than were CD38+ NK cells in the presence of daratumumab. Blockade of CD38 with the F(ab)2 fragments of daratumumab inhibited the antibody-mediated NK-cell fratricide. CD38−/low NK cells displayed a significantly better potential for expansion than CD38+ NK cells, and the expanded NK cells derived from the former population were more cytotoxic than those derived from the latter against multiple myeloma cells. Therefore, infusion of ex vivo–expanded autologous NK cells from daratumumab-treated patients may improve the antibody therapy.
Conclusions: We unravel a fratricide mechanism for daratumumab-mediated NK-cell depletion and provide a potential therapeutic strategy to overcome this side effect in daratumumab-treated patients with multiple myeloma. Clin Cancer Res; 24(16); 4006–17. ©2018 AACR.
National Trend in Laparoscopic Gastrectomy for Gastric Cancer: Analysis of the National Register in Chile
Authors: Norero Enrique , Funke Ricardo , Garcia Carlos , Fernandez Jose Ignacio , Lanzarini Enrique , Rodriguez Jorge , Ceroni Marco , Crovari Fernando , Pinto Gerardo , Musleh Maher , Gonzalez Paulina ,   Chilean Laparoscopic Gastrectomy Study Group. (CHILAGAS)
Published: April 2018

<b><i>Introduction:</i></b> The laparoscopic approach for the treatment of gastric cancer has many advantages. However, outside Asia there are few large case series. <b><i>Aim:</i></b> To evaluate postoperative morbidity, long-term survival, changes in indication, and the results of laparoscopic gastrectomy. <b><i>Methods:</i></b> We included all patients treated with a laparoscopic gastrectomy from 2005 to 2014. We compared results across 2 time periods: 2005–2011 and 2012–2014. Median follow-up was 39 months. <b><i>Results:</i></b> Two hundred and eleven patients underwent a laparoscopic gastrectomy (median age 64 years, 55% male patients). In 135 (64%) patients, a total gastrectomy was performed. Postoperative morbidity occurred in 29%. A significant increase in the indication of laparoscopic surgery for stages II–III (32 vs. 45%; <i>p</i> = 0.04) and higher lymph node count (27 vs. 33; <i>p</i> = 0.002) were observed between the 2 periods. The 5-year overall survival was 72%. According to the stage, the 5-year overall survival was 85, 63, and 54% for stage I, II, and III respectively (<i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> There was an acceptable rate of postoperative complications and the long-term survival was in accordance with the disease stage. There was a higher indication of laparoscopic surgery in stages II–III disease, and higher lymph node count in the latter period of this study.
Predicting 30‐Day Hospital Readmissions in Acute Myocardial Infarction: The AMI “READMITS” (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus
,
Nonmale Sex
,
Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score
Authors: Nguyen Oanh Kieu , Makam Anil N. , Clark Christopher , Zhang Song , Das Sandeep R. , Halm Ethan A. 
Published: April 2018

Background

Readmissions after hospitalization for acute myocardial infarction (
AMI
) are common. However, the few currently available
AMI
readmission risk prediction models have poor‐to‐modest predictive ability and are not readily actionable in real time. We sought to develop an actionable and accurate
AMI
readmission risk prediction model to identify high‐risk patients as early as possible during hospitalization.

Methods and Results

We used electronic health record data from consecutive
AMI
hospitalizations from 6 hospitals in north Texas from 2009 to 2010 to derive and validate models predicting all‐cause nonelective 30‐day readmissions, using stepwise backward selection and 5‐fold cross‐validation. Of 826 patients hospitalized with
AMI
, 13% had a 30‐day readmission. The first‐day
AMI
model (the
AMI
“
READMITS
” score) included 7 predictors: renal function, elevated brain natriuretic peptide, age, diabetes mellitus, nonmale sex, intervention with timely percutaneous coronary intervention, and low systolic blood pressure, had an optimism‐corrected C‐statistic of 0.73 (95% confidence interval, 0.71–0.74) and was well calibrated. The full‐stay
AMI
model, which included 3 additional predictors (use of intravenous diuretics, anemia on discharge, and discharge to postacute care), had an optimism‐corrected C‐statistic of 0.75 (95% confidence interval, 0.74–0.76) with minimally improved net reclassification and calibration. Both
AMI
models outperformed corresponding multicondition readmission models.

Conclusions

The parsimonious
AMI READMITS
score enables early prospective identification of high‐risk
AMI
patients for targeted readmissions reduction interventions within the first 24 hours of hospitalization. A full‐stay
AMI
readmission model only modestly outperformed the
AMI READMITS
score in terms of discrimination, but surprisingly did
not
meaningfully improve reclassification.
Steering Control in a Low-Cost Driving Simulator: A Case for the Role of Virtual Vehicle Cab
Authors: Mecheri Sami , Lobjois Régis 
Published: April 2018

Objective: The aim of this study was to investigate steering control in a low-cost driving simulator with and without a virtual vehicle cab. Background: In low-cost simulators, the lack of a vehicle cab denies driver access to vehicle width, which could affect steering control, insofar as locomotor adjustments are known to be based on action-scaled visual judgments of the environment. Method: Two experiments were conducted in which steering control with and without a virtual vehicle cab was investigated in a within-subject design, using cornering and straight-lane-keeping tasks. Results: Driving around curves without vehicle cab information made drivers deviate more from the lane center toward the inner edge in right (virtual cab = 4 ± 19 cm; no cab = 42 ± 28 cm; at the apex of the curve, p < .001) but not in left curves. More lateral deviation from the lane center toward the edge line was also found in driving without the virtual cab on straight roads (virtual cab = 21 ± 28 cm; no cab = 36 ± 27 cm; p < .001), whereas driving stability and presence ratings were not affected. In both experiments, the greater lateral deviation in the no-cab condition led to significantly more time driving off the lane. Conclusion: The findings strongly suggest that without cab information, participants underestimate the distance to the right edge of the car (in contrast to the left edge) and thus vehicle width. This produces considerable differences in the steering trajectory. Application: Providing a virtual vehicle cab must be encouraged for more effectively capturing drivers’ steering control in low-cost simulators.
Immediate Use of Uncuffed Tracheostomy after Free Flap Reconstruction of the Head and Neck
Authors: Patel Priyesh N. , Valmadrid Al C. , Hong Daniel Y. , Francis David O. , Sim Michael W. , Rohde Sarah L. 
Published: April 2018

ObjectiveTo determine if immediate postoperative uncuffed tracheostomy placement following oral cavity or oropharyngeal head and neck free flap reconstruction is associated with shorter hospital length of stay and higher inpatient decannulation rates without an increase in respiratory complications, as compared with immediate placement of cuffed tracheostomy.Study DesignRetrospective cohort.SettingTertiary referral center.Subjects and MethodsPatients were included if they underwent free flap reconstruction for oral cavity or oropharyngeal squamous cell carcinoma and had an intraoperative tracheostomy placed between 2005 and 2016. In 2012, head and neck surgeons changed from routine placement of cuffed to uncuffed tracheostomy tubes immediately after free flap reconstruction. This study compares length of hospital stay, inpatient decannulation rates, and respiratory complications between patients who had cuffed and uncuffed tracheostomies. Analysis of variance and chi‐square test were used to examine continuous and categorical variables, respectively. Multivariable regression analyses were performed to determine whether cuff status was independently associated with primary outcomes of length of hospital stay, decannulation, and respiratory complications.ResultsOf 752 patients who underwent free flap reconstruction, 493 patients met inclusion criteria (cuffed, n = 366; uncuffed, n = 127). Patient variables (ie, age, sex, body mass index, prior chemoradiation) and tumor characteristics (ie, location, stage) did not differ significantly between groups. Adjusted analysis showed that an uncuffed tracheostomy (vs a cuffed tracheostomy) was associated with shorter length of stay (7.7 vs 9.7 days, P <. 001) and did not increase the rate of respiratory complications.ConclusionImmediate placement of a uncuffed tracheostomy after oral cavity or oropharyngeal free flap reconstruction is associated with shorter hospital stays without an increase in respiratory complications.
Differential Diagnosis of Sinonasal Lymphoma and Squamous Cell Carcinoma on CT, MRI, and PET/CT
Authors: Kim Seok‐Hyun , Mun Sue‐Jean , Kim Hak‐Jin , Kim Seon Lin , Kim Sung‐Dong , Cho Kyu‐Sup 
Published: April 2018

ObjectiveThe purpose of this study was to analyze computed tomography (CT) and magnetic resonance (MR) images and to evaluate the maximum standardized uptake value (SUV max) of positron emission tomography (PET)/CT parameters between sinonasal non‐Hodgkin's lymphoma (NHL) and squamous cell carcinoma (SCC), knowing the imaging features that distinguish sinonasal NHL from SCC.Study DesignCase series with chart review.SettingUniversity tertiary care facility.Subjects and MethodsWe analyzed the features on CT, MR imaging, and PET/CT of 78 patients diagnosed with sinonasal NHL or SCC histopathologically. The CT (n = 34), MRI (n = 25), and PET/CT (n = 33) images of 39 patients with sinonasal NHL and the CT (n = 38), MR (n = 28), and PET/CT (n = 31) images of 39 patients with SCC were evaluated. The sinonasal NHL was diagnosed as natural killer/T‐cell lymphoma (n = 28) and diffuse large B‐cell lymphoma (n = 11).ResultsPatients with sinonasal NHL had a larger tumor volume and higher tumor homogeneity than patients with SCC on T2‐weighted and postcontrast MR images. Most of the sinonasal NHL and SCC showed a high degree of enhancement. The apparent diffusion coefficient (ADC) values and adjacent bone destruction were significantly lower in sinonasal NHL than in SCC. However, cervical lymphadenopathy, Waldeyer's ring involvement, and PET/CT SUV max showed no significant differences between sinonasal NHL and SCC.ConclusionCT and MR images of sinonasal masses showing a bulky lesion, marked homogeneity, and low ADC values without adjacent bone destruction are more suggestive of sinonasal NHL than SCC.
Synthesis, characterization and application of composite derived from rice husk ash with aluminium oxide for sorption of uranium
Authors: Youssef W. M. , Hagag M. S. , Ali A. H. 
Published: April 2018

A composite of rice husk (RH), caustic soda and aluminium oxide was synthesized at 500°C. The activated carbon and amorphous silica dispersed over the aluminium oxide selectively adsorbed uranium in the presence of other elements. At equilibrium time 1 h, phase ratio S/L (0.1 g/10 ml), pH = 5 and uranium initial concentration 120.6 mg/l uranium adsorption efficiency was 96.35%. The uranium stripping efficiency from the load RHA–alumina composite fulfilled 99.9% at 1 h equilibrium time, a phase ratio (S/A) of 0.05 g/10 ml and 0.5 mol/l HNO3. The scanning electron microscopy photos revealed that the rice husk ash (RHA)–alumina composite has vacant or regular cavities before the adsorption, and the cavities are fully occupied by uranium after adsorption. The Fourier transform infrared spectroscopy shows a more broadening of the band υ = 3526 and 3462 cm−1 which was ascribed to the uranium adsorption. The composite adsorbed 93.75% of uranium from a waste sample. The uranium adsorption exhibited a Langmuir isotherm.
Is there a role for postoperative physiotherapy in degenerative cervical myelopathy? A systematic review
Authors: Badran Abdul , Davies Benjamin M , Bailey Heidi-Marie , Kalsi-Ryan Sukhvinder , Kotter Mark RN 
Published: April 2018

Objective: To review peer-reviewed literature relating to postoperative physiotherapy for degenerative cervical myelopathy (DCM), to determine efficacy in improving clinical outcome and recovery. Data sources: MEDLINE, EMBASE, CENTRAL, PEDro, ISRCTN registry, WHO ICTRP and Clinicaltrials.gov . References and citations of relevant articles were searched. Methods: A systematic search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42016039511) from the origins of the databases till 15 February 2018. Included were all studies investigating physiotherapy as an intervention after surgical treatment of DCM to determine effect on clinical outcome and recovery. Study quality was determined using the Grades of Recommendation, Assessment, Development and Evaluation guidelines. Results: In all, 300 records were identified through tailored systematic searches, after removing duplicates. After screening, only one investigated postoperative rehabilitation using physiotherapy for DCM; however, this was retrospective with no controls. This study suggested that rehabilitation including physiotherapy improved postoperative recovery. There are currently two registered trials investigating the use of postoperative physiotherapy for DCM. Conclusions: The literature provides insufficient evidence to make any evidence-based recommendations regarding postoperative physiotherapy use in DCM.
Histopathologic Interobserver Agreement on the Diagnosis of Melanocytic Skin Lesions with Equivocal Dermoscopic Features: A Pilot Study
Authors: Ferrara Gerardo , Argenziano Giuseppe , Soyer H. Peter , D'Argenio Paolo , Carli Paolo , Cerroni Lorenzo , Chimenti Sergio , De Giorgi Vincenzo , Delfino Mario , De Rosa Gaetano , Shabrawi-Caelen Laila El , Ferrari Angela , Massi Daniela , Mazzocchetti Giampiero , Peris Ketty , Piccolo Domenico , Santucci Marco , Scalvenzi Massimiliano , Staibano Stefania 
Published: April 2018

Aims and background Dermoscopy (dermatoscopy, skin surface microscopy, epiluminescence microscopy) has been increasingly employed in recent years for the preoperative detection of cutaneous melanoma, and dermatoscopic features of pigmented skin lesions have been previously defined using histopathology (HP) as the “key to the code”. The aim of the present study was to evaluate the interobserver agreement on the HP diagnosis in a series of epiluminescence microscopy equivocal melanocytic skin lesions. Study design Ten melanocytic skin lesions were selected on the basis of diagnostic disagreement of at least 2 out of 9 epiluminescence microscopy observers. The histologic specimens from the 10 lesions were examined by 9 HP observers. The agreement of the HP diagnoses was calculated by means of Fleiss' k statistics. Results The overall HP agreement was less than excellent (k = 0.5). When considering the prevailing epiluminescence microscopic and HP diagnoses, 2 cases were shown to be epiluminescence microscopy false-negative melanomas. Virtually no agreement was found among epiluminescence microscopy observers in 4 cases (40%) or among HP observers in 3 cases (30%). However, only one pigmented skin lesion remained un-classifiable on epiluminescence microscopy as well as HP. Conclusions When at least 2 epiluminescence microscopy experts disagree in the evaluation of a given melanocytic skin lesion, even HP consultations may give equivocal results. The need to establish more reliable epiluminescence microscopic and HP criteria by performing an improved and meticulous clinicopathologic correlation, e.g. by using telecommunication via Internet, is emphasized.
Weekly Paclitaxel in Metastatic Breast Cancer Patients: A Phase II Study
Authors: Gori Stefania , Mosconi Anna Maria , Basurto Carlo , Cherubini Roberta , De Angelis Verena , Tonato Maurizio , Colozza Mariantonietta 
Published: April 2018

Aims and background Paclitaxel, a microtubule inhibitor, is one of the most active drugs in metastatic breast cancer. A weekly schedule, at a median dose-intensity of 91 mg/m2, is effective and has less side effects than a 3-week schedule. In this phase II study, we evaluated the toxicity and the activity of weekly 1 hr paclitaxel infusions in metastatic breast cancer patients. Study design Between February 1999 and February 2001, 26 patients with metastatic breast cancer were treated with weekly paclitaxel (60–90 mg/m2/1 hour iv infusion/weekly). The treatment was planned to continue until disease progression or prohibitive toxicity; in patients with responsive or stable disease, paclitaxel was stopped after 6 months of therapy. Results At a median follow-up of 18.7 months (range, 6.8–30.8), all patients are assessable for response and toxicity. We obtained 8 partial responses (30.8%), 8 stable disease (30.8%) and 10 disease progression (38.4.%). The overall response was 30.8% (95% CI, 13.1–48.5). The median duration of response was 7.6 months (range, 1.8–12.4); median time to progression was 4.86 months (range, 1.4–12.4); median overall survival was 9.9 months (range, 1.7–29.2+). Treatment was well tolerated. Hematological toxicity was mild and only one patient developed grade 3 anemia. Two patients experienced grade 3 cardiovascular toxicity; both had received anthracycline-based regimens. Conclusions In our experience, weekly administration of paclitaxel shows a substantial degree of activity even in pretreated metastatic breast cancer patients. The toxicity profile is favorable.
Analysis of the Evolution in the Management of Endometrial Cancer in Italy: A CTF Study
Authors: Zola Paolo , Jacomuzzi Maria Elena , Mazzola Simona , Fuso Luca , Ferrero Annamaria , Landoni Fabio , Gadducci Angiolo , Sartori Enrico , Maggino Tiziano 
Published: April 2018

Objective In 1994 we mailed questionnaires to referral centers in Italy in order to evaluate the different opinions concerning aspects of endometrial cancer treatment, which is still controversial. The data processing showed a significant nonhomogeneity in disease management and prompted the Italian Society of Gynecologic Oncology to define guidelines for endometrial cancer adjuvant treatment. In 2001, we mailed again the same questionnaire to the same referral Centers in Italy. The aim of the second enquiry was the evaluation of changes in endometrial cancer management and the effective impact of the guidelines published. Methods The enquiry used the same questionnaires mailed in 1994; actually, we mailed those questionnaires to the same referral centers in Italy twice: in December 2000 and March 2001. The results of both the enquiries were collected in a relational data base, and the statistical evaluations were calculated using SPSS-statistics (Window ver. 8). Results Endometrial cancer treatment consists in abdominal hysterectomy and bilateral salpingo-oophorectomy. The unique relevant difference as to 1994 consists in the systemic performing of peritoneal cytology in endometrial cancer staging. Unlike the previous enquiry, adjuvant radiotherapy is not systematically performed in disease at stage Ic because of the substantial absence of confirmed data demonstrating a real benefit in terms of survival rate. The comparison between the two enquiries shows a significant change in medical planning and diversification attitude according to patient age and menopausal state. The disease management changes in patients over 75 years old, mainly with respect to surgery and primary therapy. Conclusions We noted a resistance of many centers to accept some trends actually widespread in the literature but not yet performed in practical clinical.
Paclitaxel and Carboplatin in Neo-Adjuvant and Concomitant Chemoradiotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma
Authors: Fornari Gianni , Artusio Elisa , Mairone Lorenza , Airoldi Mario , Bongioannini Guido , Amasio Enrica , Rosmino Claudia , Gabriele Pietro 
Published: April 2018

Aim and background To evaluate feasibility of neoadjuvant chemotherapy (NA-CT) followed by CT + radiotherapy (RT) in locally advanced or unresectable head and neck squamous cell carcinoma (HNSCC). Methods 22 HNSCC patients were enrolled (18 males, 4 females; median age, 59.5 years; median ECOG PS, 1). Sites of disease: oral cavity, 18.2%; oropharynx, 40.9%; hypopharynx, 18.2%; larynx, 4.6%, multiple sites, 18.2%. T (tumor) category: T2, 13.6%; T3, 31.8%;T4, 54.5%. N (nodes) category: N0, 9.1%; N1, 18.1%; N2, 40.9%; N3, 31.8%. Stage: III, 4.6%; IVA, 63.6%; IVB, 31.8%. Induction carboplatin (AUC = 6) and paclitaxel (200 mg/m2) × 3 cycles (q21 days) were given. Responders received definitive radiotherapy with concurrent carboplatin (35 mg/m2/day from days 1 to 5 in weeks 1, 3, 5 and 7) and paclitaxel (50 mg/m2 on days 10, 24 and 38). Patients with node involvement were suggested to undergo postradiotherapy neck dissection. Results NA-CT. 97% of planned chemotherapy cycles were administered. Prevalent toxicity was hematologic: 50% G4 neutropenia and 31.8% G3, one neutropenic fever. All patients had alopecia. Complete responses in T and N were 4 (18.2%) and 3 (15%), respectively. Partial responses were 13 (59%) and 9 (45%). There was 1 progressive disease. CT + RT. 79.9% of planned cycles of CT were administered. In 19 patients (86.4%) more than 50% of planned cycles of CT were completed. Median dose of RT was 70.2 Gy on T/N+ and 54 Gy on N0. Limiting toxicity was mucositis in 77.3%, followed by neutropenia (59.1% G3–G4). Median weight loss was 4.9%. 18.2% of patients required hospitalization. Complete responses in T and N were 15 (68.1%) and 8 (40%), respectively. Partial responses were 5 (22.7%) and 7 (35%). Conclusions The preliminary results of this study are encouraging, despite the toxicity. Adequate follow-up is required to evaluate efficacy in terms of local-regional control and overall survival.