bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of Cause-Specific Mortality Among 2053 Survivors of Retinoblastoma, 1914–2016
Authors: Kleinerman Ruth A , Tucker Margaret A , Sigel Byron S , Abramson David H , Seddon Johanna M , Morton Lindsay M 
Published: December 2018

Abstract

Background
Previous studies of hereditary retinoblastoma survivors have reported elevated mortality, particularly for sarcomas, compared with the general population. However, cause-specific mortality patterns for long-term hereditary and nonhereditary retinoblastoma survivors are poorly understood.

Methods
Among 2053 retinoblastoma patients diagnosed during 1914–2006 at two major US treatment centers and followed to 2016, we estimated cumulative mortality, standardized mortality ratios (SMRs), and absolute excess risks (AERs) compared with the US general population.

Results
Most deaths occurred in 1129 hereditary retinoblastoma patients (n = 518 deaths, cumulative mortality 70 years after retinoblastoma = 75.8%, 95% CI = 69.0% to 82.6%; SMR = 8.5, 95% CI = 7.7 to 9.2). Of these, 267 were due to subsequent cancers (SMR = 27.4, 95% CI = 24.2 to 30.9; AER = 72.3 deaths/10 000 person-years), for which SMRs were highest 15–29 years after diagnosis (n = 69, SMR = 89.9, 95% CI = 70.0 to 113.8) but remained statistically significantly elevated at 60 and more years (n = 14, SMR = 6.7, 95% CI = 3.6 to 11.2), whereas AERs increased with time (AER<15years = 38.0; AER60+years = 327.5). Increased risk of death due to cancers of pancreas, large intestines, and kidney were noted for the first time. Overall risk of subsequent cancers was greater for those treated with radiotherapy and chemotherapy compared to radiotherapy alone, although patterns varied by organ site. For 924 patients with nonhereditary retinoblastoma, we noted a modestly increased risk of death for subsequent cancers (n = 27, SMR = 1.8, 95% CI = 1.2 to 2.6) possibly due to treatment or misclassification of hereditary status. Risks of noncancer causes of death were not elevated for hereditary or nonhereditary patients.

Conclusion
Hereditary retinoblastoma survivors died mainly from an excess risk of subsequent cancers up to six decades later, highlighting the need to develop long-term clinical management guidelines for hereditary retinoblastoma survivors treated in the past.
The influence of the dynamic state of galaxy clusters on segregation phenomena and velocity dispersion profiles
Authors: Nascimento R S , Lopes P A A , Ribeiro A L B , Costa A P , Morell D F 
Published: December 2018

Abstract
In this work we investigate the influence of the dynamic state of galaxy clusters on segregation effects and velocity dispersion profiles (VDPs) for a sample of 111 clusters extracted from SDSS-DR7. We find that 73 clusters have Gaussian (G) velocity distribution and 38 clusters have a complex or non-Gaussian (NG) velocity distribution. We also split the G and NG samples into ‘active’ and ‘passive’ galaxies, according to their specific star formation rates and stellar masses. Our results indicate a strong spatial segregation between active and passive galaxies both in G and NG systems, with passive galaxies being more central. We also found that the passive population in G systems is the only family with lower velocity dispersions for the brightest galaxies (Mr ≲ −22.75), thus presenting velocity segregation with luminosity. The similarity found between the VDPs of the galaxy populations in NG systems indicates that these sets probably share a similar mix of orbits. We also found a clear evolutionary trend for G systems, with brighter galaxies in massive clusters having flatter VDPs. The scenario emerging from this study suggests a direct relationship between segregation effects, VDPs, and the dynamic state of clusters.
Joint association of vitamins D and K status with long-term outcomes in stable kidney transplant recipients
Authors: van Ballegooijen Adriana J , Beulens Joline W J , Keyzer Charlotte A , Navis Gerjan J , Berger Stefan P , de Borst Martin H , Vervloet Marc G , Bakker Stephan J L 
Published: December 2018

AbstractBackgroundKidney transplant recipients (KTRs) experience substantial survival benefit compared with dialysis patients. However, their mortality and graft failure risk remain high. KTRs are often low in micronutrient status, including vitamins D and K. We investigated the association of both vitamins D and K status, and vitamin D treatment with all-cause mortality and death-censored graft failure.MethodsWe studied 461 KTRs from a single-centre study at median 6.1 years after transplantation. At baseline, vitamins D and K concentrations were measured by 25-hydroxyvitamin D [25(OH)D] and dephosphorylated uncarboxylated matrix gla protein (dp-ucMGP) and patients were categorized into: 25(OH)D &lt;50/≥50 nmol/L and median dp-ucMGP &lt;1057/≥1057 pmol/L.ResultsMean age was 52 ± 12 years, and 122 KTRs (26%) had low vitamins D and K status. During median 9.8 years follow-up, 128 patients (28%) died and 48 (10%) developed death-censored graft failure. Low vitamins D and K status was associated with 2.33 (1.26–4.30) [hazard ratio (95% confidence interval)] increased mortality risk and 3.25 (1.17–9.08) increased graft failure risk compared with KTR with 25(OH)D ≥50 nmol/L and dp-ucMGP &lt;1057 pmol/L. Dp-ucMGP was strongly associated with mortality (per 500 pmol/L increase): 1.41 (1.08–1.41) for vitamin D treatment versus no treatment 1.07 (0.97–1.18), and graft failure 1.71 (1.17–2.49) for vitamin D treatment versus 1.19 (1.05–1.36) no treatment, P-interaction &lt;0.07 for vitamin D treatment (n = 44).ConclusionsCombined vitamins D and K deficiency are highly prevalent and are associated with increased mortality and graft failure risk compared with high vitamins D and K status. Low vitamin K status was strongly associated with an increased risk of premature mortality and graft failure for patients treated with vitamin D versus no vitamin D treatment.
OCCUPATIONAL EYE LENS DOSE ESTIMATED USING WHOLE-BODY DOSEMETER IN INTERVENTIONAL CARDIOLOGY AND RADIOLOGY: A MONTE CARLO STUDY
Authors: Božović Predrag , Ciraj-Bjelac Olivera , Petrović Jelena Stanković 
Published: December 2018

Abstract
Medical personnel performing interventional procedures in cardiology and radiology is considered to be a professional group exposed to high doses of ionizing radiation. Reduction of the eye lens dose limit made its assessment in the interventional procedures one of the most challenging topics. The objective of this work is to assess eye lens doses based on the whole-body doses using methods of computational dosimetry. Assessment included different C-arm orientations (PA, LAO and RAO), tube voltages (80 –110 kV) and efficiency of different combinations of protective equipment used in interventional procedures. Center position at the height of the thyroid gives best estimate of eye lens dose, with spreads of 11% (13%), 13% (17%) and 14% (13%) for the left (right) eye lens. The conversion factors of 1.03 (0.83), 1.28 (1.06) and 1.36 (1.06) to convert whole body to eye lens dose were derived for positions of first operator, nurse and radiographer, respectively. The eye lens dose reduction factors for different combinations of applied protective equipment are 178, 5 and 6, respectively.
The Impact of Individual Mentored Career Development (K) Awards on the Research Trajectories of Early-Career Scientists
Authors: Nikaj Silda , Lund P. Kay 
Published: December 2018

Purpose
This analysis examined the role of a National Institutes of Health (NIH) individual Mentored Career Development Award (K01, K08, K23) on launching and sustaining independent research careers for early-career scientists, and investigated the effects of these awards during and after the doubling of the NIH budget.

Method
The authors used grants data from the NIH covering the period 1990 through 2016, and compared success in receipt of R01 equivalent awards (R01 Eq.) and Research Project Grants (RPGs) for K awardees and K applicants who did not receive funding. The analysis combined regression discontinuity design with coarsened exact matching, and regression.

Results
Overall, receipt of K award was associated with a 24.1% increase in likelihood of first independent NIH award (P < .01), and a larger number of R01 Eq. and RPG awards. After accounting for first major independent awards, K awards were uncorrelated with receiving second major independent research awards. Comparing different funding periods, K01 awards were predictive of subsequent R01 Eq. and RPG awards after but not during the NIH doubling, K08 awards were predictive only during the NIH doubling, and K23 awards were predictive during both periods.

Conclusions
Receipt of Mentored Career Development Awards was linked to increased likelihood that early-career scientists successfully transitioned to an independent research career. These findings indicate that extending funding to additional K award applicants with meritorious scores could significantly strengthen the pipeline of biomedical researchers. In addition, enhancing K awards may be relevant to sustaining research careers for clinician scientists.
Anatomic Considerations in the Lateral Transpsoas Interbody Fusion
Authors: Mai Harry T. , Schneider Andrew D. , Alvarez Andrew P. , Hashmi Sohaib Z. , Smith Justin T. , Freshman Ryan D. , Mitchell Sean M. , Qin Charles D. , Hsu Wellington K. 
Published: December 2018

Study Design:
This is a retrospective case series.

Objective:
Define the anatomic variations and the risk factors for such within the operative corridor of the transpsoas lateral interbody fusion.

Summary of Background Data:
The lateral interbody fusion approach has recently been associated with devastating complications such as injury to the lumbosacral plexus, surrounding vasculature, and bowel. A more comprehensive understanding of anatomic structures in relation to this approach using preoperative imaging would help surgeons identify high-risk patients potentially minimizing these complications.

Materials and Methods:
Age-sex distributed, naive lumbar spine magnetic resonance imagings (n=180) were used to identify the corridor for the lateral lumbar interbody approach using axial images. Bilateral measurements were taken from L1–S1 to determine the locations of critical vascular, intraperitoneal, and muscular structures. In addition, a subcohort of scoliosis patients (n=39) with a Cobb angle >10 degrees were identified and compared.

Results:
Right-sided vascular anatomy was significantly more variant than left (9.9% vs. 5.7%; P=0.001). There were 9 instances of “at-risk” vasculature on the right side compared with 0 on the left (P=0.004). Age increased vascular anatomy variance bilaterally, particularly in the more caudal levels (P≤0.001). A “rising-psoas sign” was observed in 26.1% of patients. Bowel was identified within the corridor in 30.5% of patients and correlated positively with body mass index (P<0.001). Scoliosis increased variant anatomy of left-sided vasculature at L2–3/L3–4. Nearly all variant anatomy in this group was found on the convex side of the curvature (94.2%).

Conclusions:
Given the risks and complications associated with this approach, careful planning must be taken with an understanding of vulnerable anatomic structures. Our analysis suggests that approaching the intervertebral space from the patient’s left may reduce the risk of encountering critical vascular structures. Similarly, in the setting of scoliosis, an approach toward the concave side may have a more predictable course for surrounding anatomy.

Level of Evidence:
Level 3—study.
Impact of Altered Airway Pressure on Intracranial Pressure, Perfusion, and Oxygenation: A Narrative Review
Authors: Chen Han , Menon David K. , Kavanagh Brian P. 
Published: December 2018

Objectives:
A narrative review of the pathophysiology linking altered airway pressure and intracranial pressure and cerebral oxygenation.

Data Sources:
Online search of PubMed and manual review of articles (laboratory and patient studies) of the altered airway pressure on intracranial pressure, cerebral perfusion, or cerebral oxygenation.

Study Selection:
Randomized trials, observational and physiologic studies.

Data Extraction:
Our group determined by consensus which resources would best inform this review.

Data Synthesis:
In the normal brain, positive-pressure ventilation does not significantly alter intracranial pressure, cerebral oxygenation, or perfusion. In injured brains, the impact of airway pressure on intracranial pressure is variable and determined by several factors; a cerebral venous Starling resistor explains much of the variability. Negative-pressure ventilation can improve cerebral perfusion and oxygenation and reduce intracranial pressure in experimental models, but data are limited, and mechanisms and clinical benefit remain uncertain.

Conclusions:
The effects of airway pressure and ventilation on cerebral perfusion and oxygenation are increasingly understood, especially in the setting of brain injury. In the face of competing mechanisms and priorities, multimodal monitoring and individualized titration will increasingly be required to optimize care.
Heterogeneity and Variability in Pressure Autoregulation of Organ Blood Flow: Lessons Learned Over 100+ Years
Authors: Meng Lingzhong , Wang Yingwei , Zhang Lina , McDonagh David L. 
Published: December 2018

Objectives:
Pressure autoregulation is an organ’s intrinsic ability to maintain blood flow despite changes in perfusion pressure. The purpose of this review is to discuss autoregulation’s heterogeneity among different organs and variability under different conditions, a very clinically relevant topic.

Data Sources:
Systematic search of Ovid MEDLINE; nonsystematic search of PubMed, Google Scholar, and reference lists.

Study Selection:
Animal or human studies investigating the potency or variation of pressure autoregulation of any organs or the association between autoregulation and outcomes.

Data Extraction:
Two authors screened the identified studies independently then collectively agreed upon articles to be used as the basis for this review.

Data Synthesis:
Study details, including subjects, organ investigated, methods of blood pressure intervention and blood flow measurement, and values of the lower limit, upper limit, and plateau were examined. Comparative canine studies were used to demonstrate the heterogeneity of pressure autoregulation among different organs and validate the proposed scale for organ categorization by autoregulatory capacity. Autoregulatory variability is discussed per organ. The association between cerebral autoregulation and outcome is summarized.

Conclusions:
The organs with robust autoregulation are the brain, spinal cord, heart, and kidney. Skeletal muscle has moderate autoregulation. Nearly all splanchnic organs including the stomach, small intestine, colon, liver, and pancreas possess weak autoregulation. Autoregulation can be readily affected by a variety of clinically relevant factors. Organs with weak or weakened autoregulation are at a greater risk of suboptimal perfusion when blood pressure fluctuates. Cerebral autoregulation and outcomes are closely related. These lessons learned over 100+ years are instructive in clinical care.
Low Serum Trough Concentrations and High Vancomycin Minimum Inhibitory Concentration in Methicillin-Sensitive Staphylococcus aureus From Hemodialysis Patients in Brazil
Authors: Vitória Michel Penedo da , Alvarenga Cristiane Gomes de Sousa , Vasconcellos Filho Lauro Monteiro , Birro Jéssica de Cássia Teixeira , Barbosa Maralisi Coutinho , Ferreira Mariana Abou Mourad , Schuenck Ricardo Pinto , Nunes Ana Paula Ferreira , Santos Kênia Valéria dos 
Published: December 2018

Background:
The empiric antimicrobial therapy for bacteremia of long-term hemodialysis (HD) outpatients is currently based on the combination of vancomycin and gentamicin because of the high frequency of isolated Staphylococcus species. The vancomycin trough level range from 15 to 20 mcg/mL is expected for therapeutic success against methicillin-resistant Staphylococcus aureus with vancomycin minimum inhibitory concentration (MIC) ≥1.0 mcg/mL. Despite the availability of clinical practice guidelines for vancomycin therapeutic drug monitoring, these target serum concentrations are not reached in many patients.

Methods:
In this study, the authors investigated the vancomycin trough levels in 20 HD patients with S. aureus bacteremia and the antimicrobial susceptibility pattern of 45 S. aureus strains isolated from 45 HD patients. The vancomycin serum concentration was determined by chemiluminescent assay. The MIC was determined by broth microdilution method.

Results:
None of the HD patients included in this study had vancomycin trough concentrations within the therapeutic range. Also, the vancomycin MIC for most methicillin-sensitive S. aureus isolated from bacteremia was ≥1.0 mcg/mL.

Conclusions:
The therapeutic range of vancomycin was not achieved, and vancomycin MIC was surprisingly high in methicillin-sensitive S. aureus.
Evaluation of clinical meaningfulness of estrogen plus progesterone oral capsule (TX-001HR) on moderate to severe vasomotor symptoms
Authors: Constantine Ginger D. , Revicki Dennis A. , Kagan Risa , Simon James A. , Graham Shelli , Bernick Brian , Mirkin Sebastian 
Published: December 2018

Abstract

Objective:
The aim of this study was to determine the clinical meaningfulness of TX-001HR in reducing moderate to severe vasomotor symptoms (VMS) in menopausal women with a uterus.

Methods:
In the REPLENISH study (NCT01942668), women with moderate to severe hot flushes (≥7/d or ≥50/wk) were enrolled in a VMS substudy and randomized to four doses of daily TX-001HR (17β-estradiol/progesterone) or placebo. Participants assessed improvement of their VMS by the Clinical Global Impression and the Menopause-Specific Quality of Life (MENQOL) questionnaire, which were used to define clinical responders, clinically important differences (CIDs) or minimal CID (MCID) in VMS frequency. Response thresholds were determined by nonparametric discriminant analyses utilizing bootstrapping methods.

Results:
In the modified intent-to-treat VMS substudy population (n = 726), statistically significantly more Clinical Global Impression–based clinical responders were observed with TX-001HR than placebo for MCID (weekly reduction of ≥25 moderate to severe VMS: 82-88% vs 69%; all, P < 0.05) and CID (weekly reduction of ≥39 VMS: 68%-73% vs 52%; all, P < 0.05) at week 12. Week 4 results were similar. For Menopause Quality of Life–based analysis, significantly more clinical responders were observed with TX-001HR than placebo for MCID (weekly reduction of ≥34 VMS: 74%-81% vs 55%; all, P < 0.01) and CID (weekly reduction of ≥44 VMS: 61%-69% vs 42%; all, P < 0.01) at week 12.

Conclusions:
TX-001HR provided clinically meaningful improvements (as measured by 2 different methods), in addition to statistically significant reductions, in menopausal VMS frequency. TX-001HR may provide a new option, as a single oral capsule of estradiol and progesterone (identical to the hormones naturally occurring in women) for the treatment of moderate to severe VMS in menopausal women with a uterus.
The relationship between serum fibroblast growth factor 23, Klotho, and lumbar spine bone mineral density in northern Chinese postmenopausal women
Authors: Han Wen , Bai Xiao-juan , Han Lu-lu , Sun Xue-feng , Chen Xiang-mei 
Published: December 2018

Abstract

Objectives:
Changes in serum protein levels of fibroblast growth factor 23 (FGF23) and Klotho resulting from bone metabolism are still controversial. The purpose of this study was to observe the relationship between FGF23 and Klotho serum proteins and lumbar spine bone mineral density (LBMD) in northern Chinese postmenopausal women.

Methods:
This was a community-based cross-sectional study carried out in Shenyang, a northern Chinese city. The study included 355 postmenopausal women with an average age of 62.92 ± 8.78 years. FGF23 and Klotho serum proteins were measured using a sandwich enzyme immunoassay. LBMD was examined using dual-energy X-ray absorptiometry. Pearson's correlation and regression analyses were performed to investigate the associations among them.

Results:
The LgKlotho was positively correlated with LBMD (r = 0.105). There was a linear relationship between LgKlotho serum levels and LBMD (P = 0.007) after adjusting for BMI, and the relationship still existed after adjustments for many confounding variables (P = 0.045), including age, BMI, systolic blood pressure, diastolic blood pressure, total protein, total bilirubin, high-density lipoprotein cholesterol, fasting blood glucose, serum calcium, estimated glomerular filtration rate, serum uric acid, estradiol, cigarette smoking, alcohol consumption, milk intake, calcium and vitamin D supplements, physical exercise, and fracture history in postmenopausal women. FGF23 serum levels were, however, not significantly associated with LBMD.

Conclusions:
Klotho was positively correlated with LBMD, and there was a linear relationship between Klotho serum protein levels and LBMD; however, the levels of serum Klotho were not independently associated with reduced LBMD in northern Chinese postmenopausal women. Moreover, serum FGF23 levels were not significantly related to LBMD in this sample population.
Scleral Ischemia in Acute Ocular Chemical Injury: Long-Term Impact on Rehabilitation With Limbal Stem Cell Therapy
Authors: Gupta Nidhi , Singh Aastha , Mathur Umang 
Published: December 2018

Purpose:
This study describes the impact of scleral ischemia on globe survival in cases of acute chemical injury and the outcome of limbal stem cell transplant in these eyes.

Methods:
This is a single-center, retrospective case study that reviews outcomes in all patients with acute chemical injury of grades IV and above who presented within 6 weeks from injury. The period of the study is between May 2012 and May 2017. Eyes presenting without scleral ischemia underwent amniotic membrane transplantation (group A), whereas eyes presenting with scleral ischemia underwent tenonplasty with amniotic membrane transplantation (group B). Simple limbal epithelial transplantation (SLET) was performed at 6 months in all consenting patients from both these groups. The primary outcome was defined as globe preservation at 3 months, whereas the secondary outcome was defined as SLET success at 1 year.

Results:
Twenty-three eyes of the 23 patients were included in our study. Of the 13 eyes in group B, 2 eyes developed phthisis and 2 eyes developed hypotony. None of the 10 eyes in group A developed hypotony or phthisis. The eyes that developed into hypotony and phthisis had presented with more extensive scleral ischemia (>180 degrees). In group B, 5 of 7 patients failed SLET. This was high compared with group A in which 2 of 8 patients failed SLET.

Conclusions:
The presence and extent of scleral ischemia are important prognostic factors when assessing recovery in eyes with acute chemical injury. The authors recommend that it be added as a poor prognostic indicator in the existing classifications of acute chemical injury.