bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence for cannabis and cannabinoids for epilepsy: a systematic review of controlled and observational evidence
Authors: Stockings Emily , Zagic Dino , Campbell Gabrielle , Weier Megan , Hall Wayne D , Nielsen Suzanne , Herkes Geoffrey K , Farrell Michael , Degenhardt Louisa 
Published: March 2018

Review evidence for cannabinoids as adjunctive treatments for treatment-resistant epilepsy. Systematic search of Medline, Embase and PsycINFO was conducted in October 2017. Outcomes were: 50%+ seizure reduction, complete seizure freedom; improved quality of life (QoL). Tolerability/safety were assessed by study withdrawals, adverse events (AEs) and serious adverse events (SAEs). Analyses were conducted in Stata V.15.0. 36 studies were identified: 6 randomised controlled trials (RCTs), 30 observational studies. Mean age of participants was 16.1 years (range 0.5–55 years). Cannabidiol (CBD) 20 mg/kg/day was more effective than placebo at reducing seizure frequency by 50%+(relative risk (RR) 1.74, 95% CI 1.24 to 2.43, 2 RCTs, 291 patients, low Grades of Recommendation, Assessment, Development and Evaluation (GRADE) rating). The number needed to treat for one person using CBD to experience 50%+ seizure reduction was 8 (95% CI 6 to 17). CBD was more effective than placebo at achieving complete seizure freedom (RR 6.17, 95% CI 1.50 to 25.32, 3 RCTs, 306 patients, low GRADE rating), and improving QoL (RR 1.73, 95% CI 1.33 to 2.26), however increased risk of AEs (RR 1.24, 95% CI 1.13 to 1.36) and SAEs (RR 2.55, 95% CI 1.48 to 4.38). Pooled across 17 observational studies, 48.5% (95% CI 39.0% to 58.1%) of patients reported 50%+ reductions in seizures; in 14 observational studies 8.5% (95% CI 3.8% to 14.5%) were seizure-free. Twelve observational studies reported improved QoL (55.8%, 95% CI 40.5 to 70.6); 50.6% (95% CI 31.7 to 69.4) AEs and 2.2% (95% CI 0 to 7.9) SAEs. Pharmaceutical-grade CBD as adjuvant treatment in paediatric-onset drug-resistant epilepsy may reduce seizure frequency. Existing RCT evidence is mostly in paediatric samples with rare and severe epilepsy syndromes; RCTs examining other syndromes and cannabinoids are needed.PROSPERO registration numberCRD42017055412.
Is previous azithromycin treatment associated with azithromycin resistance in Neisseria gonorrhoeae? A cross-sectional study using national surveillance data in England
Authors: Clifton Soazig , Town Katy , Furegato Martina , Cole Michelle , Mohammed Hamish , Woodhall Sarah C , Kevin Dunbar J , Fifer Helen , Hughes Gwenda 
Published: March 2018

ObjectivesIt has been suggested that treatment of STIs with azithromycin may facilitate development of azithromycin resistance in Neisseria gonorrhoeae (NG) by exposing the organism to suboptimal doses. We investigated whether treatment history for non-rectal Chlamydia trachomatis (CT), non-gonococcal urethritis (NGU) or NG (proxies for azithromycin exposure) in sexual health (GUM) services was associated with susceptibility of NG to azithromycin.MethodsAzithromycin susceptibility data from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP 2013–2015, n=4606) and additional high-level azithromycin-resistant isolates (HL-AziR) identified by the Public Health England reference laboratory (2013–2016, n=54) were matched to electronic patient records in the national GUMCAD STI surveillance dataset (2012–2016). Descriptive and regression analyses were conducted to examine associations between history of previous CT/NGU/NG and subsequent susceptibility of NG to azithromycin.ResultsModal azithromycin minimum inhibitory concentration (MIC) was 0.25 mg/L (one dilution below the resistance breakpoint) in those with and without history of previous CT/NGU/NG (previous 1 month/6 months). There were no differences in MIC distribution by history of CT/NGU (P=0.98) or NG (P=0.85) in the previous 1 month/6 months or in the odds of having an elevated azithromycin MIC (>0.25 mg/L) (Adjusted OR for CT/NGU 0.97 (95% CI 0.76 to 1.25); adjusted OR for NG 0.82 (95% CI: 0.65 to 1.04)) compared with those with no CT/NGU/NG in the previous 6 months. Among patients with HL-AziR NG, 3 (4%) were treated for CT/NGU and 2 (3%) for NG in the previous 6 months, compared with 6% and 8%, respectively for all GRASP patients.ConclusionsWe found no evidence of an association between previous treatment for CT/NGU or NG in GUM services and subsequent presentation with an azithromycin-resistant strain. As many CT diagnoses occur in non-GUM settings, further research is needed to determine whether azithromycin-resistant NG is associated with azithromycin exposure in other settings and for other conditions.
Geographical variations in the use of cancer treatments are associated with survival of lung cancer patients
Authors: Møller Henrik , Coupland Victoria H , Tataru Daniela , Peake Michael D , Mellemgaard Anders , Round Thomas , Baldwin David R , Callister Matthew E J , Jakobsen Erik , Vedsted Peter , Sullivan Richard , Spicer James 
Published: March 2018

IntroductionLung cancer outcomes in England are inferior to comparable countries. Patient or disease characteristics, healthcare-seeking behaviour, diagnostic pathways, and oncology service provision may contribute. We aimed to quantify associations between geographic variations in treatment and survival of patients in England.MethodsWe retrieved detailed cancer registration data to analyse the variation in survival of 176,225 lung cancer patients, diagnosed 2010-2014. We used Kaplan-Meier analysis and Cox proportional hazards regression to investigate survival in the two-year period following diagnosis.ResultsSurvival improved over the period studied. The use of active treatment varied between geographical areas, with inter-quintile ranges of 9%–17% for surgical resection, 4%–13% for radical radiotherapy, and 22%–35% for chemotherapy. At 2 years, there were 188 potentially avoidable deaths annually for surgical resection, and 373 for radical radiotherapy, if all treated proportions were the same as in the highest quintiles. At the 6 month time-point, 318 deaths per year could be postponed if chemotherapy use for all patients was as in the highest quintile. The results were robust to statistical adjustments for age, sex, socio-economic status, performance status and co-morbidity.ConclusionThe extent of use of different treatment modalities varies between geographical areas in England. These variations are not attributable to measurable patient and tumour characteristics, and more likely reflect differences in clinical management between local multi-disciplinary teams. The data suggest improvement over time, but there is potential for further survival gains if the use of active treatments in all areas could be increased towards the highest current regional rates.
Tissue Tranglutaminase Regulates Interactions between Ovarian Cancer Stem Cells and the Tumor Niche
Authors: Condello Salvatore , Sima Livia , Ivan Cristina , Cardenas Horacio , Schiltz Gary , Mishra Rama K. , Matei Daniela 
Published: March 2018

Abstract
Cancer progression and recurrence are linked to a rare population of cancer stem cells (CSC). Here, we hypothesized that interactions with the extracellular matrix drive CSC proliferation and tumor-initiating capacity and investigated the functions of scaffold protein tissue transglutaminase (TG2) in ovarian CSC. Complexes formed by TG2, fibronectin (FN), and integrin β1 were enriched in ovarian CSC and detectable in tumors. A function-inhibiting antibody against the TG2 FN-binding domain suppressed complex formation, CSC proliferation as spheroids, tumor-initiating capacity, and stemness-associated Wnt/β-catenin signaling. Disruption of the interaction between TG2 and FN also blocked spheroid formation and the response to Wnt ligands. TG2 and the Wnt receptor Frizzled 7 (Fzd7) form a complex in cancer cells and tumors, leading to Wnt pathway activation. Protein docking and peptide inhibition demonstrate that the interaction between TG2 and Fzd7 overlaps with the FN-binding domain of TG2. These results support a new function of TG2 in ovarian CSC, linked to spheroid proliferation and tumor-initiating capacity and mediated through direct interactions with Fzd7. We propose this complex as a new stem cell target.
Significance: These findings reveal a new mechanism by which ovarian CSCs interact with the tumor microenvironment, promoting cell proliferation and tumor initiation. Cancer Res; 78(11); 2990–3001. ©2018 AACR.
Telatinib Is an Effective Targeted Therapy for Pseudomyogenic Hemangioendothelioma
Authors: van IJzendoorn David G.P. , Sleijfer Stefan , Gelderblom Hans , Eskens Ferry A.L.M. , van Leenders Geert J.L.H. , Szuhai Karoly , Bovée Judith V.M.G. 
Published: March 2018

Abstract
Purpose: Pseudomyogenic hemangioendothelioma (PHE) is an extremely rare locally aggressive neoplasm with endothelial differentiation, which often presents with multiple lesions. These tumors have characteristic SERPINE1–FOSB fusions. We report a 17 years old patient with advanced unresectable PHE with a durable complete remission to the multi-tyrosine kinase inhibitor telatinib. The aim of this study was to generate an in vitro model for PHE, to study the functional consequences of SERPINE1–FOSB in endothelial cells, and its interaction with telatinib, to biologically substantiate the complete response to telatinib.
Experimental Design: As the fusion results in overexpression of a truncated form of FOSB, we overexpressed truncated FOSB in normal endothelial cells.
Results: Truncated FOSB significantly affected tumor growth in three-dimensional (3D) on matrigel with increased and sustained sprouting. Moreover, truncated FOSB acted as an active transcription factor capable to regulate its own transcription, as well as to upregulate PDGFRA and FLT1 expression (four-fold). Telatinib decreased proliferation and tumor growth in 3D and induced apoptosis. As expected, telatinib blocked VEGF signaling as phosphorylation of ERK was abolished. Interestingly, in FOSB overexpressing cells, telatinib specifically affected PDGFRA, FLT1, and FLT4 signaling and downregulated SERPINE1, thereby affecting the self-regulation of the fusion gene.
Conclusions: We provide a biological substantiation of a complete clinical remission that was seen in a patient with PHE, showing that telatinib indirectly interferes with the self-regulated expression of the fusion product. Thus, telatinib or any other currently available VEGFR1-4/PDGFRA inhibitor could be a highly specific treatment option for patients with multifocal unresectable PHE. Clin Cancer Res; 24(11); 2678–87. ©2018 AACR.
The Biopolitics of International Exchange: International Educational Exchange Programs – Facilitator or Victim in the Battle for Biopolitical Normativity?
Authors: Erbsen Heidi 
Published: March 2018

This article addresses how international educational exchange programs are increasingly used as political, and particularly bio-political, tools to promote ideologies of biological normativity. Such programs have historically been promoted by national and international institutions as means to increase participants (and therefore the sending institution’s) knowledge of the world and transfer favorable values through individuals. us and eu exchange programs with Russia in particular have been focused on achieving a ‘mutual understanding’ or promoting ‘common’ or ‘shared values’ across countries; however, a tendency of educational institutions to select like-minded individuals and countries for participation has arguably complicated rather than mended global divides. The difference in values associated with biological practices in Russia, the us, and the eu related to traditional gender roles, marriage, nuclear families, birth control, etc. have become more apparent with the spread of information and globalization.
The main argument of this work supports that attention to the promotion or cancelation of certain exchange programs can be used to better understand larger patterns in international relations and the modern system of global governance. An investigation into the founding ideologies behind programs such as flex and Fulbright (by the us) and Erasmus + (by the European Commission) and their politicization exemplifies how educational programs can become ‘battlefields’ for ideologies of biological normativity. The example of the cancelation of the flex program by the Russian Federation is used to understand key relationships between biopolitics and geopolitics, modern and post-modern, and value transfer and human capital.
Observational Constraint for Precipitation in Extratropical Cyclones: Sensitivity to Data Sources
Authors: Naud Catherine M. , Booth James F. , Lebsock Matthew , Grecu Mircea 
Published: March 2018

AbstractUsing cyclone-centered compositing and a database of extratropical-cyclone locations, the distribution of precipitation frequency and rate in oceanic extratropical cyclones is analyzed using satellite-derived datasets. The distribution of precipitation rates retrieved using two new datasets, the Global Precipitation Measurement radar–microwave radiometer combined product (GPM-CMB) and the Integrated Multisatellite Retrievals for GPM product (IMERG), is compared with CloudSat, and the differences are discussed. For reference, the composites of AMSR-E, GPCP, and two reanalyses are also examined. Cyclone-centered precipitation rates are found to be the largest with the IMERG and CloudSat datasets and lowest with GPM-CMB. A series of tests is conducted to determine the roles of swath width, swath location, sampling frequency, season, and epoch. In all cases, these effects are less than ~0.14 mm h−1 at 50-km resolution. Larger differences in the composites are related to retrieval biases, such as ground-clutter contamination in GPM-CMB and radar saturation in CloudSat. Overall the IMERG product reports precipitation more often, with larger precipitation rates at the center of the cyclones, in conditions of high precipitable water (PW). The CloudSat product tends to report more precipitation in conditions of dry or moderate PW. The GPM-CMB product tends to systematically report lower precipitation rates than the other two datasets. This intercomparison provides 1) modelers with an observational uncertainty and range (0.21–0.36 mm h−1 near the cyclone centers) when using composites of precipitation for model evaluation and 2) retrieval-algorithm developers with a categorical analysis of the sensitivity of the products to PW.
National evaluation of policies governing funding for wheelchairs and scooters in Canada
Authors: Smith Emma M. , Roberts Lynn , McColl Mary Ann , Martin Ginis Kathleen A. , Miller William C. 
Published: March 2018

Background. Wheelchairs, scooters, and related equipment are essential for the well-being of individuals with limited mobility and impact participation, health, and quality of life. Purpose. Our objective was to identify and evaluate policies governing equipment funding for Canadian adults. We reviewed funding legislation and program documentation for adult Canadians (≥18 years of age) covered by their provincial, territorial, or federal health care plan. Documents were obtained online or through administrative staff. Policy evaluation was guided by the Disability Policy Lens from the Canadian Disability Policy Alliance. Key Issues. Coverage ranges from full funding for all individuals within the jurisdiction to programs limited by strict eligibility criteria. Each jurisdiction defines “disability” or “basic/essential need” differently, contributing to further funding disparities. Implications. Funding policies differ substantially across Canada, resulting in unequal access to equipment dependent on province or territory. We identified eligibility, funding, definitions of mobility, repair and replacement, and prescriber requirement benchmarks that represent policy targets for improved access.
College students’ experiences of hedonia and eudaimonia in their everyday activities
Authors: Atler Karen E. , Eakman Aaron M. , Orsi Rebecca 
Published: March 2018

Background. Experiences of hedonia (i.e., seeking pleasure) and eudaimonia (i.e., actualizing human potential in pursuit of meaningful goals) are central to the study of human well-being. Purpose. This study sought to examine levels of hedonia (pleasure) and eudaimonia (productivity) in a convenience sample of college (university) students’ ( n = 264) daily activities, controlling for levels of perceived stress. Method. Data were gathered using a 24-hr time-use recall diary designed to assess objective and subjective information about everyday activities. Descriptions of self-reported everyday activities were coded into 20 activity types. Findings. Activities reported high in pleasure were eating, listening to music/watching movies, and exercise. Activities reported as high in productivity were studying and working. Activities reported as high in both pleasure and productivity were reported less frequently and often had a recognizable outcome or provided social connection. Implications. Developing a greater understanding of how college students experience their daily activities could strengthen programs designed to enable students to manage stress and sustain their well-being.
Opioid Consumption Following Foot and Ankle Surgery
Authors: Merrill Haley M. , Dean Daniel M. , Mottla Jay L. , Neufeld Steven K. , Cuttica Daniel J. , Buchanan Matthew M. 
Published: March 2018

Background Orthopedic surgeons frequently prescribe pain medications during the postoperative period. The efficacy of these medications at alleviating pain after foot/ankle surgery and the quantity of medication required (and conversely, leftover) are unknown. Methods: Patients undergoing foot/ankle surgery during a 3-month period who met inclusion criteria were surveyed at their first postoperative visit. Information collected included gender, number of prescribed pills remaining, satisfaction with pain control, and willingness to surrender leftover opioids to a Drug Enforcement Administration (DEA) disposal center. Additional data, including utilization of a perioperative nerve block and type (bony versus nonbony) and anatomic region of procedure, were collected through review of the medical record. All data were analyzed in a retrospective fashion. A total of 171 patients with a mean age of 53.1 ± 15.5 years (range, 18-81 years) were included in the study. Results: The mean number of opioids taken was 27.2 ± 17.5 pills (range, 0-70). The mean number of short-acting opioids and long-acting opioids taken was 21.4 ± 14.8 and 9.2 ± 5.0 pills, respectively. Most (73.5%) patients were satisfied with their pain control. Patients who underwent ankle/hindfoot surgery took more long-acting opioids on average than others ( P = .047). There was not a significant difference in opioid usage between bony and nonbony procedures. Of those with leftover opioids, 63% were willing to surrender them to a DEA disposal center. Patients willing to surrender leftover medications had both more short-acting ( P < .001) and long-acting ( P = .015) opioids leftover than those not willing to surrender them. Conclusion: Most patients undergoing foot/ankle surgery had opioids leftover at the first postoperative visit, and most were willing to surrender them. We can adequately treat patients’ pain and decrease the number of opioid pills available in the community by decreasing the number of pills prescribed and encouraging disposal of leftovers. Level of Evidence: Level IV, retrospective case series.
Infiltration and extravasation in pediatric patients: A prevalence study in a children’s hospital
Authors: Özalp Gerçeker Gülçin , Kahraman Ayşe , Yardimci Figen , Bilsin Elif , Binay Şeyda , Çevik Özdemir Hamide Nur , Karakul Atiye , Zengin Dilek , Ardahan Sevgili Seda , Gümüş Merve , Başbakkal Zümrüt , Akpınar Selma 
Published: March 2018

Purpose: The aim of this study is to determine the prevalence of infiltration and extravasation among children staying in a children’s hospital and the interventions carried out when infiltration or extravasation occurred. Methods: A prospective and descriptive research design was used in the study, conducted between September 2015 and February 2016, and determined the prevalence of infiltration and extravasation and their characteristics. The study sample consisted of 297 peripheral catheters in 173 pediatric patients. Results: Of 297 peripheral catheters, 50.8% were located on the right and 30.6% were inserted in the dorsal metacarpal vein. Infiltration and extravasation occurred in 2.9% and 2.3% of the patients, respectively. The prevalence of infiltration and extravasation was 5.5 and 4.4 per 1000 patient-days, respectively. The applied interventions after infiltration or extravasation included covering with a gauze dressing or alcohol-soaked cotton, cold application, irrigation with physiological saline, and elevation. Conclusion: The infiltration and extravasation prevalence were found to be high, but the interventions to address them were inadequate. Training and implementation strategies should be planned for pediatric nurses to prevent infiltration and extravasation.
High-resolution nerve ultrasound and magnetic resonance neurography as complementary neuroimaging tools for chronic inflammatory demyelinating polyneuropathy
Authors: Pitarokoili Kalliopi , Kronlage Moritz , Bäumer Philip , Schwarz Daniel , Gold Ralf , Bendszus Martin , Yoon Min-Suk 
Published: March 2018

Background: We present a clinical, electrophysiological, sonographical and magnetic resonance neurography (MRN) study examining the complementary role of two neuroimaging methods of the peripheral nervous system for patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Furthermore, we explore the significance of cross-sectional area (CSA) increase through correlations with MRN markers of nerve integrity. Methods: A total of 108 nerve segments on the median, ulnar, radial, tibial and fibular nerve, as well as the lumbar and cervical plexus of 18 CIDP patients were examined with high-resonance nerve ultrasound (HRUS) and MRN additionally to the nerve conduction studies. Results: We observed a fair degree of correlation of the CSA values for all nerves/nerve segments between the two methods, with a low random error in Bland–Altman analysis (bias = HRUS-CSA − MRN-CSA, −0.61 to −3.26 mm). CSA in HRUS correlated with the nerve T2-weighted (nT2) signal increase as well as with diffusion tensor imaging parameters such as fractional anisotropy, a marker of microstructural integrity. HRUS-CSA of the interscalene brachial plexus correlated significantly with the MRN-CSA and nT2 signal of the L5 and S1 roots of the lumbar plexus. Conclusions: HRUS allows for reliable CSA imaging of all peripheral nerves and the cervical plexus, and CSA correlates with markers of nerve integrity. Imaging of proximal segments as well as the estimation of nerve integrity require MRN as a complementary method.
Implementing National Institute for Health and Care Excellence smoke-free guidance in a secure facility: an evaluation of the prescribing costs in clozapine users
Authors: Noblett Stephen , Beenstock Jane , Noblett James , Ireland Joanne , Ormiston Sarah 
Published: March 2018

Aims and methodThe increased rates of smoking in people with mental illness is well documented, and establishing smoke-free mental health environments has been emphasised over recent years. This article examines the financial costs of implementing smoke free guidance and assesses the cost associated with patients who were prescribed clozapine and who committed to stopping smoking cigarettes for the duration of the study period.ResultsPatients (38) who were prescribed clozapine were included in the study. A moderate reduction in dose was noted with a moderate reduction in prescribing costs. The total increase in cost for the whole group, however, was £17 624, largely due to the use of nicotine replacement therapy and an increase in the number of clozapine assay tests.Clinical implicationsFurther studies on implementing this important policy change are needed. The positive effects must be balanced with increased financial pressure on Mental Health Trusts.Declarations of interestNone.