bluuebunny/crossref_metadata_2025_split huggingface dataset:
A phase III randomised clinical trial of perioperative therapy (neoadjuvant chemotherapy versus chemoradiotherapy) in locally advanced gallbladder cancers (POLCAGB): study protocol
Authors: Engineer Reena , Patkar Shraddha , Lewis Shirley Christabel , Sharma Ashutosh Das , Shetty Nitin , Ostwal Vikas , Ramaswamy Anant , Chopra Supriya , Agrawal Archi , Patil Prachi , Mehta Shaesta , Goel Mahesh 
Published: June 2019

IntroductionNeoadjuvant chemotherapy (NACT) is considered the current standard for locally advanced gallbladder cancer (GBC). There is no consensus on the optimal neoadjuvant approach. A pilot study from our institution has shown improved overall survival (OS) and progression-free survival (PFS) with neoadjuvant chemoradiation (NACRT). The present randomised phase III trial is designed to compare NACRT with NACT alone and will test the superiority of chemoradiation in terms of tumour downstaging and improvement in OS.Methods and analysisPatients with biopsy-proven locally advanced GBC (T3–4) with predefined clinical–radiological features will be randomised to the gemcitabine-based chemotherapy-alone arm or the chemoradiation arm. Patients with resectable disease or with distant metastases will be excluded. The primary end point of the study is to compare OS between the two arms. The secondary end point was to compare PFS, R0 resection rates, acute and late toxicity, postoperative complications and quality of life between the two study arms. The trial is designed to detect an improvement in median OS by 5.5 months in the study arm (11 months in the control group, HR of 0.7) with 80.0% power at a 0.05 significance level. The resultant sample size to achieve this aim is 314 (157 in each arm) over a duration of 5 years with a 10% attrition rate.Ethics and disseminationThe institutional ethics committee has approved this trial and will be routinely monitoring the trial at frequent intervals. The results of the study will be disseminated via peer-reviewed scientific journals, conference presentations and submission to regulatory authorities.RegistrationThe trial is registered with Clinical Trials Registry India (CTRI/2016/08/007199) and ClinicalTrials.gov (NCT02867865). This trial aims to assess the superiority of NACRT over NACT in locally advanced GBCs in terms of improvement in OS. The results of this study will define the optimal neoadjuvant approach in locally advanced GBC.Trial registration numberNCT02867865; Pre-results.
Effect of the phenotype of the M1-middle cerebral artery occlusion on the recanalization rates in the ASTER trial
Authors: Consoli Arturo , Zhu François , Bourcier Romain , Dargazanli Cyril , Marnat Gaultier , Duhamel Alain , Blanc Raphaël , Saleme Suzana , Costalat V , Desal Hubert , Bracard Serge , Labreuche Julien , Kyheng Maeva , Puccinelli Francesco , Mosimann Pascal J , Gory Benjamin , Piotin Michel , Lapergue Bertrand 
Published: June 2019

IntroductionAn adequate recanalization grade is an independent predictor of a good clinical outcome in patients with acute ischemic stroke. It can be obtained with stent retrievers (SR) and contact aspiration (CA). The aim of this ancillary study of the ASTER trial was to investigate the effect of the regular and irregular phenotype of the M1-middle cerebral artery (M1-MCA) segment occlusion on the procedural and clinical outcomes in the ASTER trial population.MethodsThe predetermined occlusion phenotype assessment was performed by the core laboratory of the ASTER trial and patients with M1-MCA occlusion were included in this study. Clinical and procedural outcomes were analyzed according to the technique used and to the occlusion phenotype.Results188 patients were included in the analysis (95 received SR, 93 CA as first-line treatment). The occlusion phenotypes were graded as irregular in 52.7% of cases (n=99, 95% CI 45.5% to 59.8%). In patients with an irregular occlusion phenotype, complete or adequate recanalization at the end of the first-line strategy was more often achieved with SR than CA (TICI 3: SR 44.1% vs CA 22.5%, OR 0.35, 95% CI 0.14 to 0.89, p=0.027), with a shorter procedure time, a lower number of passes (>2 passes: SR 32.2% vs CA 57.5%, OR 3.31, 95% CI 1.36 to 8.03, p=0.009), and higher rates of favorable clinical outcome (SR 55.2% vs CA 31.6%, OR 0.40, 95% CI 0.16 to 0.97, p=0.042).ConclusionIrregular M1-MCA occlusion phenotypes treated with SR as first-line approach were associated with better procedural and clinical outcomes in the ASTER trial population
Impact of adding and removing warning label messages from cigarette packages on adult smokers’ awareness about the health harms of smoking: findings from the ITC Canada Survey
Authors: Green Annika C , Driezen Pete , Noar Seth M , Hammond David , Fong Geoffrey T 
Published: June 2019

IntroductionAdding messages to cigarette health warning labels (HWLs) about the harms of smoking increases awareness of these health facts, but little is known about the impact of removing messages. This is the first study to directly investigate the impact of addingandremoving messages from cigarette HWLs on smokers’ awareness of harms.MethodsData were drawn from nine waves of the International Tobacco Control (ITC) Canada Survey, a national representative cohort of adult smokers (n=5863) conducted nearly annually between 2002 and 2013–2014. Two analytical approaches were conducted: generalised estimating equation (GEE) regression models estimated adjusted percentages of correct smoking-related health statements at each wave and segmented regression analyses modelled temporal trends in awareness before and after the revisions by measuring the difference in slopes.ResultsAdding messages to HWLs significantly increased awareness that smoking causes blindness (OR=3.36 (95% CI 2.71 to 4.18); p<0.001; estimated increase of 1.01 million smokers in Canada) and bladder cancer (OR=2.14 (95% CI 1.71 to 2.66), p<0.001; estimated increase of 1.09 million smokers). Adding the warning that nicotine causes addiction did not significantly impact smokers’ awareness. Removing messages was shown to decrease awareness that cigarette smoke contains carbon monoxide (OR=0.53 (95% CI 0.41 to 0.70), p<0.001; estimated decrease of 342 000 smokers) and smoking causes impotence (p=0.007 for the difference in slopes; estimated decrease of 354 000 smokers).ConclusionsAdding messages to HWLs increases smokers’ awareness of health facts, but removing messages decreases awareness. These findings demonstrate the importance of carefully considering the implications of adding and especially removing messages from HWLs and the importance of regularly revising warnings.
Dietary sodium, potassium, and blood pressure in normotensive pregnant women: the National Health and Nutrition Examination Survey
Authors: Lane-Cordova Abbi D. , Schneider Lara R. , Tucker William C. , Cook James W. , Wilcox Sara , Liu Jihong 
Published: June 2019

Dietary sodium, potassium, and sodium-to-potassium ratio are linearly associated with blood pressure in nonpregnant adults. Earlier investigations suggested null or inverse associations of blood pressure and sodium during normotensive pregnancy; findings have not been confirmed in race/ethnically diverse women or while accounting for potassium. Our purpose was to evaluate associations of blood pressure with sodium and potassium and sodium-to-potassium ratio in race/ethnically diverse normotensive pregnant women. We used cross-sectional blood pressure and dietary data from 984 women in multiple cycles of the National Health and Nutrition Examination Survey (mean age = 27.6 ± 0.2 years). We tested for differences in blood pressure across quartiles of sodium intake using Kruskal–Wallis tests and linear regression to evaluate associations of sodium, potassium, and the sodium-to-potassium ratio with systolic (SBP) and diastolic (DBP) blood pressures. We adjusted for potential confounding variables: age, race/ethnicity, education, marital status, body mass index, smoking, and month of pregnancy. SBP and DBP were similar across quartiles of sodium intake: quartile 1 (lowest sodium intake): 107/59; quartile 2: 106/59; quartile 3: 108/60; quartile 4 (highest sodium intake): 108/58 mm Hg, p > 0.60 for all. Sodium (β = 0.16, 95% confidence interval (CI): –0.20 to 0.52) and potassium (β = 0.18, 95% CI: –0.24 to 0.60) and the sodium-to-potassium ratio (β = –0.54, 95% CI: –1.55 to 0.47) were not associated with SBP or DBP. Results were similar in stratified analyses. Novelty Blood pressure was similar among quartiles of sodium or potassium intake, even in analyses stratified by race/ethnicity and trimester of pregnancy. There was no association of sodium or potassium with blood pressure. Blood pressure may be insensitive to dietary sodium and potassium during normotensive pregnancy.
Prognostic Score and Cytogenetic Risk Classification for Chronic Lymphocytic Leukemia Patients: Center for International Blood and Marrow Transplant Research Report
Authors: Kim Haesook T. , Ahn Kwang Woo , Hu Zhen-Huan , Davids Matthew S. , Volpe Virginia O. , Antin Joseph H. , Sorror Mohamed L. , Shadman Mazyar , Press Oliver , Pidala Joseph , Hogan William , Negrin Robert , Devine Steven , Uberti Joseph , Agura Edward , Nash Richard , Mehta Jayesh , McGuirk Joseph , Forman Stephen , Langston Amelia , Giralt Sergio A. , Perales Miguel-Angel , Battiwalla Minoo , Hale Gregory A. , Gale Robert Peter , Marks David I. , Hamadani Mehdi , Ganguly Sid , Bacher Ulrike , Lazarus Hillard , Reshef Ran , Hildebrandt Gerhard C. , Inamoto Yoshihiro , Cahn Jean-Yves , Solh Melhem , Kharfan-Dabaja Mohamed A. , Ghosh Nilanjan , Saad Ayman , Aljurf Mahmoud , Schouten Harry C. , Hill Brian T. , Pawarode Attaphol , Kindwall-Keller Tamila , Saba Nakhle , Copelan Edward A. , Nathan Sunita , Beitinjaneh Amer , Savani Bipin N. , Cerny Jan , Grunwald Michael R. , Yared Jean , Wirk Baldeep M. , Nishihori Taiga , Chhabra Saurabh , Olsson Richard F. , Bashey Asad , Gergis Usama , Popat Uday , Sobecks Ronald , Alyea Edwin , Saber Wael , Brown Jennifer R. 
Published: June 2019

Abstract

Purpose:
To develop a prognostic model and cytogenetic risk classification for previously treated patients with chronic lymphocytic leukemia (CLL) undergoing reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT).

Experimental Design:
We performed a retrospective analysis of outcomes of 606 patients with CLL who underwent RIC allogeneic HCT between 2008 and 2014 reported to the Center for International Blood and Marrow Transplant Research.

Results:
On the basis of multivariable models, disease status, comorbidity index, lymphocyte count, and white blood cell count at HCT were selected for the development of prognostic model. Using the prognostic score, we stratified patients into low-, intermediate-, high-, and very-high-risk [4-year progression-free survival (PFS) 58%, 42%, 33%, and 25%, respectively, P &lt; 0.0001; 4-year overall survival (OS) 70%, 57%, 54%, and 38%, respectively, P &lt; 0.0001]. We also evaluated karyotypic abnormalities together with del(17p) and found that del(17p) or ≥5 abnormalities showed inferior PFS. Using a multivariable model, we classified cytogenetic risk into low, intermediate, and high (P &lt; 0.0001). When the prognostic score and cytogenetic risk were combined, patients with low prognostic score and low cytogenetic risk had prolonged PFS (61% at 4 years) and OS (75% at 4 years).

Conclusions:
In this large cohort of patients with previously treated CLL who underwent RIC HCT, we developed a robust prognostic scoring system of HCT outcomes and a novel cytogenetic-based risk stratification system. These prognostic models can be used for counseling patients, comparing data across studies, and providing a benchmark for future interventions. For future study, we will further validate these models for patients receiving targeted therapies prior to HCT.
Epigenetic Modification of Enhancer of Zeste Homolog 2 Modulates the Activation of Dendritic Cells in Allergen Immunotherapy
Authors: Li Hang , Wen Yihui , Wu Shulian , Chen Dehua , Luo Xi , Xu Rui , Ma Renqiang , Wen Weiping 
Published: June 2019

<b><i>Background:</i></b> Allergen immunotherapy (AIT) is the only etiological and potentially curative therapy for allergic rhinitis (AR). <b><i>Objectives:</i></b> We sought to investigate the role of epigenetic regulator enhancer of zeste homolog 2 (EZH2) in the activation of dendritic cells (DCs) in AIT. <b><i>Method:</i></b> In this study, EZH2 expression in circulating myeloid DCs (mDCs) and plasmacytoid DCs (pDCs) were evaluated using flow cytometry. Clinical information from 56 AR patients receiving AIT was collected, including 30 subjects with subcutaneous immunotherapy (SCIT) and 26 subjects with sublingual immunotherapy (SLIT). In vitro, the effect of EZH2 inhibitor, 3 Deazaneplanocin A (DZNep), on the phenotypic and functional activation of monocyte-derived DCs (moDCs) was evaluated. <b><i>Results:</i></b> EZH2 expression in circulating mDCs and pDCs were both negatively correlated to treatment time of AIT (<i>r</i> = –0.39, <i>p</i> = 0.003 and <i>r</i> = –0.47, <i>p</i> = 0.0002, respectively). Furthermore, there was a higher correlation between EZH2 expression and AIT treatment time in the SCIT group compared to that of the SLIT group in mDCs (<i>r</i> = –0.42, <i>p</i> = 0.02 vs. <i>r</i> = –0.23, <i>p</i> = 0.26)and pDCs (<i>r</i> = –0.52, <i>p</i> = 0.003 vs. <i>r</i> = –0.33, <i>p</i> = 0.10). In vitro, the co-stimulatory molecules on moDCs, such as CD80, CD86, and CD83, were significantly inhibited by DZNep in a dose-dependent manner. The ­DC-driven T-cell proliferation was suppressed by DZNep (MD = 22.88, 95% CI 7.809–37.96, <i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> Our study shows that EZH2, which is required in the activation of DCs, mediates the epigenetic modification in AIT and stresses the importance of patient adherence during AIT.
Refining the World Health Organization Definition
Authors: Tseng Zian H. , Salazar James W. , Olgin Jeffrey E. , Ursell Philip C. , Kim Anthony S. , Bedigian Annie , Probert Joanne , Hart Amy P. , Moffatt Ellen , Vittinghoff Eric 
Published: June 2019

Background:
Conventional definitions of sudden cardiac death (SCD) presume cardiac cause. We studied the World Health Organization–defined SCDs autopsied in the POST SCD study (Postmortem Systematic Investigation of SCD) to determine whether premortem characteristics could identify autopsy-defined sudden arrhythmic death (SAD) among presumed SCDs.

Methods:
Between January 2, 2011, and January 4, 2016, we prospectively identified all 615 World Health Organization–defined SCDs (144 witnessed) 18 to 90 years in San Francisco County for medical record review and autopsy via medical examiner surveillance. Autopsy-defined SADs had no extracardiac or acute heart failure cause of death. We used 2 nested sets of premortem predictors—an emergency medical system set and a comprehensive set adding medical record data—to develop Least Absolute Selection and Shrinkage Operator models of SAD among witnessed and unwitnessed cohorts.

Results:
Of 615 presumed SCDs, 348 (57%) were autopsy-defined SAD. For witnessed cases, the emergency medical system model (area under the receiver operator curve 0.75 [0.67–0.82]) included presenting rhythm of ventricular tachycardia/fibrillation and pulseless electrical activity, while the comprehensive (area under the receiver operator curve 0.78 [0.70–0.84]) added depression. If only ventricular tachycardia/fibrillation witnessed cases (n=48) were classified as SAD, sensitivity was 0.46 (0.36–0.57), and specificity was 0.90 (0.79–0.97). For unwitnessed cases, the emergency medical system model (area under the receiver operator curve 0.68 [0.64–0.73]) included black race, male sex, age, and time since last seen normal, while the comprehensive (area under the receiver operator curve 0.75 [0.71–0.79]) added use of β-blockers, antidepressants, QT-prolonging drugs, opiates, illicit drugs, and dyslipidemia. If only unwitnessed cases <1 hour (n=59) were classified as SAD, sensitivity was 0.18 (0.13–0.22) and specificity was 0.95 (0.90–0.97).

Conclusions:
Our models identify premortem characteristics that can better specify autopsy-defined SAD among presumed SCDs and suggest the World Health Organization definition can be improved by restricting witnessed SCDs to ventricular tachycardia/fibrillation or nonpulseless electrical activity rhythms and unwitnessed cases to <1 hour since last normal, at the cost of sensitivity.
In-Orbit Performance of the Constellation of CYGNSS Hurricane Satellites
Authors: Ruf Christopher , Asharaf Shakeel , Balasubramaniam Rajeswari , Gleason Scott , Lang Timothy , McKague Darren , Twigg Dorina , Waliser Duane 
Published: June 2019

AbstractThe NASA Cyclone Global Navigation Satellite System (CYGNSS) constellation of eight satellites was successfully launched into low Earth orbit on 15 December 2016. Each satellite carries a radar receiver that measures GPS signals scattered from the surface. Wind speed over the ocean is determined from distortions in the signal caused by wind-driven surface roughness. GPS operates at a sufficiently low frequency to allow for propagation through all precipitation, including the extreme rain rates present in the eyewall of tropical cyclones. The spacing and orbit of the satellites were chosen to optimize frequent sampling of tropical cyclones. In this study, we characterize the CYGNSS ocean surface wind speed measurements by their uncertainty, dynamic range, sensitivity to precipitation, spatial resolution, spatial and temporal sampling, and data latency. The current status of each of these properties is examined and potential future improvements are discussed. In addition, examples are given of current science investigations that make use of the data.
Regional Arctic Amplification by a Fast Atmospheric Response to Anthropogenic Sulfate Aerosol Forcing in China
Authors: Kim Minjoong J. , Yeh Sang-Wook , Park Rokjin J. , Son Seok-Woo , Moon Byung-Kwon , Kim Byung-Gon , Kim Jae-Jin , Kim Sang-Woo 
Published: June 2019

AbstractIt is known that an increase of water vapor over the Arctic is one of most plausible causes driving Arctic amplification. However, debate continues with regard to the explanation of the underlying mechanisms driving the increase of moisture over the Arctic region in the observations. Here, we used the Community Atmosphere Model with prescribed sea surface temperature along with reanalysis datasets to examine the role of fast atmospheric responses to the increase of anthropogenic sulfate aerosol concentrations in China. We found that it plays an additive role in moisture transport from the midlatitudes, resulting in warming of the Arctic region, especially around the Barents–Kara Seas. Specifically, sulfate aerosol forcing in China reduces the meridional temperature gradient and leads to the increase of moisture transport into the Arctic by altering atmospheric circulation. The resulting increase of moisture then leads to surface warming through the enhancement of the downwelling longwave radiation. This implies that Arctic warming around the Barents–Kara Seas has been accelerated, at least in part, by a fast atmospheric response to anthropogenic sulfate aerosol emissions in China in the recent past.
Equatorial Windows and Barriers for Stationary Rossby Wave Propagation
Authors: Li Yanjie , Feng Jin , Li Jianping , Hu Aixue 
Published: June 2019

Abstract
Rossby waves can cross the equator and connect the Northern Hemisphere (NH) and Southern Hemisphere (SH), or be blocked in the vicinity of the equator. This work explores the windows and barriers for the cross-equatorial waves (CEWs) by the wave ray ensemble method. The eastern Pacific and Atlantic regions are identified as common windows in both boreal winter and summer, while the Africa–Indian Ocean section exists as a window only in boreal summer. The western–central Pacific is found to be a barrier section. These results are consistent with correlation analysis of reanalysis data. Moreover, the dependence on the wavenumber of CEWs is investigated, revealing that they are restricted to long waves with zonal wavenumbers less than 6 and that their wavenumber vectors exhibit a northwest–southeast (southwest–northeast) tilt when they cross the equator from the NH to SH (from the SH to NH). This long-wave dominance of CEWs results from the spectral-selective filtering mechanism, which suggests that long waves have narrower equatorial barriers than short waves. Finally, the main wave duct associated with each window is obtained by the global passing CEW density distribution. The results indicate that the main CEW ducts roughly follow a great circle–like pathway, except for the Africa–Indian Ocean window in boreal summer, which may be modulated by the cross-equatorial monsoonal flow.
Service availability and capacity in rural mental health in Australia: Analysing gaps using an Integrated Mental Health Atlas
Authors: van Spijker Bregje A , Salinas-Perez Jose A , Mendoza John , Bell Tanya , Bagheri Nasser , Furst Mary Anne , Reynolds Julia , Rock Daniel , Harvey Andrew , Rosen Alan , Salvador-Carulla Luis 
Published: June 2019

Objective: Access to services and workforce shortages are major challenges in rural areas worldwide. In order to improve access to mental health care, it is imperative to understand what services are available, what their capacity is and where existing funds might be spent to increase availability and accessibility. The aim of this study is to investigate mental health service provision in a selection of rural and remote areas across Australia by analysing service availability, placement capacity and diversity. Method: This research studies the health regions of Western New South Wales and Country Western Australia and their nine health areas. Service provision was analysed using the DESDE-LTC system for long-term care service description and classification that allows international comparison. Rates per 100,000 inhabitants were calculated to compare the care availability and placement capacity for children and adolescents, adults and older adults. Results: The lowest diversity was found in northern Western Australia. Overall, Western New South Wales had a higher availability of non-acute outpatient services for adults, but hardly any acute outpatient services. In Country Western Australia, substantially fewer non-acute outpatient services were found, while acute services were much more common. Acute inpatient care services were more common in Western New South Wales, while sub-acute inpatient services and non-acute day care services were only found in Western New South Wales. Conclusion: The number and span of services in the two regions showed discrepancies both within and between regions, raising issues on the equity of access to mental health care in Australia. The standard description of the local pattern of rural mental health care and its comparison across jurisdictions is critical for evidence-informed policy planning and resource allocation.