bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative diffusion magnetic resonance imaging for prediction of human papillomavirus status in head and neck squamous-cell carcinoma: A systematic review and meta-analysis
Authors: Payabvash Seyedmehdi , Chan Aimee , Jabehdar Maralani Pejman , Malhotra Ajay 
Published: May 2019

Purpose Head and neck squamous-cell carcinoma (HNSCC) related to human papillomavirus (HPV) infection represents a distinct biological and prognostic subtype compared to the HPV-negative form. Prior studies suggest a correlation between the apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI) of primary tumor lesion and HPV status in HNSCC. In this meta-analysis, we compared the average ADC of primary lesion between HPV-positive and HPV-negative HNSCC. Methods A comprehensive literature search of PubMed and Embase was performed. Studies comparing the average ADC on echo-planar DWI of primary tumor lesions between HPV-positive and HPV-negative HNSCC were included. The standardized mean difference was calculated using fixed- and random-effects models. Tau-squared estimates of total heterogeneity and Higgins inconsistency index ( I2 test) were determined. Results A total of five studies, pooling data of 264 patients, were included for meta-analysis. Among these five studies, three had included oral cavity, hypopharyngeal, and/or laryngeal HNSCC in addition to oropharyngeal subsite. Primary lesions were comprised of 185 HPV-negative and 79 HPV-positive HNSCC. The meta-analysis showed lower average ADC values in HPV-positive HNSCC compared to the HPV-negative form, with a standardized mean difference of 0.961 (95% confidence interval 0.644–1.279; p < 0.0001). Since there was no significant heterogeneity in analysis ( p = 0.3852), both random- and fixed-effects models resulted in the same estimates of overall effect. Conclusions HPV-positive HNSCC primary lesions have a lower average ADC compared to the HPV-negative form, highlighting the potential application of quantitative diffusion magnetic resonance imaging as a noninvasive imaging biomarker for prediction of HPV status.
Combined effect of posttraumatic stress disorder and prescription opioid use on risk of cardiovascular disease
Authors: Scherrer Jeffrey F , Salas Joanne , Lustman Patrick , Tuerk Peter , Gebauer Sarah , Norman Sonya B , Schneider F David , Chard Kathleen M , van den Berk-Clark Carissa , Cohen Beth E , Schnurr Paula P 
Published: May 2019

Aim Prescription opioid analgesic use (OAU) is associated with increased risk of cardiovascular disease (CVD). OAU is more common in patients with than without posttraumatic stress disorder (PTSD), and PTSD is associated with higher CVD risk. We determined whether PTSD and OAU have an additive or multiplicative association with incident CVD. Methods and results Veterans Health Affairs patient medical record data from 2008 to 2015 was used to identify 2861 patients 30–70 years of age, free of cancer, CVD and OAU for 12 months before index date. We defined a four-level exposure variable: 1) no PTSD/no OAU, 2) OAU alone, 3) PTSD alone and 4) PTSD+OAU. Cox proportional hazard models estimated the association between the exposure variable and incident CVD. The mean age was 49.0 (±11.0), 85.7% were male and 58.3% were White, 34.4% had no PTSD/no OAU, 32.9% had PTSD alone, 10.6% had OAU alone, and 22.1% had PTSD+OAU. Compared with patients with no PTSD/no OAU, those with PTSD alone were not at increased risk of incident CVD (hazard ratio = 0.82; 95% confidence interval (CI): 0.63–1.17); however, OAU alone and PTSD+OAU were both significantly associated with incident CVD (hazard ratio = 1.99; 95% CI:1.36–2.92 and hazard ratio = 2.20; 95% CI: 1.61–3.02). There was no significant additive or multiplicative PTSD and OAU association with incident CVD. Conclusion OAU is associated with nearly a two-fold increased risk of CVD in patients with and without PTSD. Despite no additive or multiplicative interaction effects, the high prevalence of OAU in PTSD may represent a novel contributor to the elevated CVD burden among patients with PTSD.
Identifying causes of persistent HIV viremia in adult patients at an academic medical center
Authors: Steinbrink Julie , Imlay Hannah , Rao Krishna , Riddell James 
Published: May 2019

Objectives: Despite many advances in medicine, not all individuals with HIV are able to achieve complete virologic suppression. This retrospective study identifies variables associated with persistent HIV viremia in an academic clinic. Methods: We studied 66 HIV-infected patients with a viral load of >200 copies/mL over 1 year, with controls matched 1:1 via a propensity score utilizing age at diagnosis, era of diagnosis, gender, and initial CD4 count. We collected data on multiple variables including medications, adherence, comorbidities, hospitalizations, and insurance status. Conditional logistic regression was used for unadjusted and adjusted analyses. Results: A total of 66 viremic cases/matched controls were included. Fewer viremic patients were on antiretroviral therapy for all 12 months (45% vs 77%; odds ratio: 0.33, p = .018) and fewer were of white race (52% vs 70%; odds ratio: 0.49, p = .053). Hospitalization (11% vs 3%; odds ratio: 10, p = .028), underinsurance (20% vs 1%; odds ratio: 5.87, p = .022), and conflicting personal beliefs about their disease (17% vs 3%; odds ratio: 5.5, p = .027) were more common in viremic patients. Psychiatric illness increased the odds of viremia in patients who had four or more visits (odds ratio: 1.63/6.64 with four/five clinic visits, respectively). Conclusion: Psychiatric illness is an important contributor to the presence of persistent viremia in HIV-infected patients and deserves further study.
Impact of Partnership Between Children’s HeartLink and IQIC Database With a Pediatric Cardiology and Cardiovascular Surgery Center in Brazil
Authors: Croti Ulisses Alexandre , Murakami Alexandre Noboru , De Marchi Carlos H. , Borim Bruna Cury , Dearani Joseph A. , Overman David , Hickey Patricia , Jenkins Kathy 
Published: May 2019

Background: Aiming at fostering local development of cardiology and cardiovascular surgery centers in developing countries, the nonprofit organization Children’s HeartLink (CHL) encourages centers to participate in the International Quality Improvement Collaborative Database for Congenital Heart Disease (IQIC). The definition of parameters and data to evaluate patient treatment provides an opportunity to improve quality of care, reducing morbidity and mortality. The objective of the study was to analyze the outcomes of the partnership between CHL and IQIC database with a single pediatric cardiology and cardiovascular surgery center for seven years providing continuous follow-up to guide actions aiming at morbidity and mortality reduction in patients with pediatric and congenital heart diseases. Methods: Data were collected from January 2011 to December 2017 independently and with external audits and included preoperative information (demographic data, nutritional status, chromosomal abnormalities), Risk Adjustment for Congenital Heart Surgery (RACHS-1) score, and postoperative information such as infections or complications within the first 30 days or until hospital discharge and/or death. Results: In the preoperative period, there was a trend toward an increase in the number of newborn patients. The postoperative period showed significant surgical procedure variations between groups for RACHS-1 risk category ( P = .003), prevalence of risk categories 2 and 3, and an increase in risk categories 4, 5, and 6, mainly in the last two years. Decreases in surgical site infection ( P = .03), bacterial sepsis, and other infections (both P < .001) were observed. At the 30-day postoperative follow-up, there was a decrease of in-hospital ( P = .16) and 30-day ( P = .14) mortality. Conclusion: The partnership between CHL and this seven-year analysis of IQIC database demonstrated structural and human flaws, whose resolution led to significant decrease in infection and reduction in mortality despite an increase in the complexity of our pediatric and congenital heart disease population.
Children’s Heart Assessment Tool for Transplantation (CHAT) Score: A Novel Risk Score Predicts Survival After Pediatric Heart Transplantation
Authors: Fraser Charles D. , Grimm Joshua C. , Zhou Xun , Lui Cecillia , Giuliano Kate , Suarez-Pierre Alejandro , Crawford Todd C. , Magruder J. Trent , Hibino Narutoshi , Vricella Luca A. 
Published: May 2019

Background: Given the shortage of donor organs in pediatric heart transplantation (HTx), pretransplant risk stratification may assist in organ allocation and recipient optimization. We sought to construct a scoring system to preoperatively stratify a patient’s risk of one-year mortality after HTx. Methods: The United Network for Organ Sharing database was queried for pediatric (<18 years) patients undergoing HTx between 2000 and 2016. The population was randomly divided in a 4:1 fashion into derivation and validation cohorts. A multivariable logistic regression model for one-year mortality was constructed within the derivation cohort. Points were then assigned to independent predictors ( P < .05) based on relative odds ratios (ORs). Risk groups were established based on easily applicable, whole-integer score cutoffs. Results: A total of 5,700 patients underwent HTx; one-year mortality was 10.7%. There was a similar distribution of variables between derivation (n = 4,560) and validation (n = 1,140) cohorts. Of the 12 covariates included in the final model, nine were allotted point values. The low-risk (score 0-9), intermediate-risk (10-20), and high-risk (>20) groups had a 5.18%, 10%, and 28% risk of one-year mortality ( P < .001), respectively. Both intermediate-risk (OR = 2.46, 95% confidence interval [95% CI]: 1.93-3.15; P < .001) and high-risk (OR = 9.24, 95% CI: 6.92-12.35; P < .001) scores were associated with an increased risk of one-year mortality when compared to the low-risk group. Conclusions: The Children’s Heart Assessment Tool for Transplantation score represents a pediatric-specific, recipient-based system to predict one-year mortality after HTx. Its use could assist providers in identification of patients at highest risk of poor outcomes and may aid in pretransplant optimization of these children.
Workforce Cost Model for Expanding Congenital and Rheumatic Heart Disease Services in Kenya
Authors: Kontchou Nelly-Ange T. , McCrary Andrew W. , Schulman Kevin A. 
Published: May 2019

Background: Cardiovascular disease is the number one global killer, with over three quarters of these deaths arising from the populations of low- and middle-income countries (LMICs). Addressing the burden of cardiovascular disease in LMICs must include medical and surgical services for these patients. In this article, we model the needs and costs to scale up the cardiac provider workforce in Kenya, which can be adapted to other LMICs based on country-specific workforce hours and workforce salaries. Methods: Using published epidemiological reports from sub-Saharan Africa, we structured the model based on the expected disease burden of congenital and rheumatic disease in a simulated 1,000-person population. Services modeled include clinic visits, echocardiograms, diagnostic cardiac catheterizations, interventional catheterizations, and heart surgery. Costs were modeled based on Kenyan public sector salaries. After scaling the model, we created a sensitivity analysis of change in service duration and salaries. Results: Based on a 1,000-person Kenyan population, we estimate that 2.5 heart surgeries will be needed every year, with a corresponding annual workforce cost of US$526. Including accompanying services of clinic visits, echocardiograms, and both diagnostic and interventional cardiac catheterizations, the total annual workforce cost is US$899. Based on estimated productive hours for public sector workforce, 196 full-time equivalent cardiac surgeons will be needed for the entire population of Kenya (2017 figure). Conclusions: We present a model for appropriate cardiovascular service staffing based on disease burden and workforce costs. This model can be scaled up as needed to plan for local capacity building.
Hepatic Vein Incorporation Into the Azygos System in Heterotaxy and Interrupted Inferior Vena Cava
Authors: Montesa Christine , Karamlou Tara , Ratnayaka Kanishka , Pophal Stephen G. , Ryan Justin , Nigro John J. 
Published: May 2019

Background: Patients with heterotaxy, single ventricle and interrupted inferior vena cava are at risk of developing significant pulmonary arteriovenous malformations and cyanosis, and inequitable distribution of hepatic factor has been implicated in their development. We describe our experience with a technique for hepatic vein incorporation that reliably provides resolution of cyanosis and presumably equitable hepatic factor distribution. Methods: A retrospective review of a single-surgeon experience was conducted for patients who underwent this modified Fontan operation utilizing an extracardiac conduit from the hepatic veins to the dominant superior cavopulmonary connection. Preoperative characteristics and imaging, operative details, and postoperative course and imaging were abstracted. Results: Median age at operation was 5 years (2-10 years) and median weight was 19.6 kg (11.8-23 kg). Sixty percent (3/5) of patients had Fontan completion without cardiopulmonary bypass, and follow-up was complete at a median of 14 months (range 1-20 months). Systemic saturations increased significantly from 81% ± 1.9% preoperatively to 95% ± 3.5% postoperatively, P = .0008. Median length of stay was 10 days (range: 7-14 days). No deaths occurred. One patient required reoperation for bleeding and one was readmitted for pleural effusion. Postoperative imaging suggested distribution of hepatic factor to all lung segments with improved pulmonary arteriovenous malformation burden. Conclusions: Hepatic vein incorporation for patients with heterotaxy and interrupted inferior vena cava should optimally provide equitable pulmonary distribution of hepatic factor with resolution of cyanosis. The described technique is performed through a conventional approach, is facile, and improves cyanosis in these complex patients.
Acalabrutinib monotherapy in patients with chronic lymphocytic leukemia who are intolerant to ibrutinib
Authors: Awan Farrukh T. , Schuh Anna , Brown Jennifer R. , Furman Richard R. , Pagel John M. , Hillmen Peter , Stephens Deborah M. , Woyach Jennifer , Bibikova Elena , Charuworn Prista , Frigault Melanie M. , Hamdy Ahmed , Izumi Raquel , Linghu Bolan , Patel Priti , Wang Min Hui , Byrd John C. 
Published: May 2019

Key PointsAcalabrutinib had good tolerability in patients with relapsed or refractory CLL who were intolerant to ibrutinib. Acalabrutinib demonstrated a high response rate (81%) in patients with relapsed or refractory CLL who were intolerant to ibrutinib.
Outcomes reported on the management of COPD exacerbations: a systematic survey of randomised controlled trials
Authors: Mathioudakis Alexander G. , Moberg Mia , Janner Julie , Alonso-Coello Pablo , Vestbo Jørgen 
Published: May 2019

Randomised controlled trials (RCTs) evaluating the management of acute exacerbations of chronic obstructive pulmonary disease (COPD) report heterogeneous outcome measures, thus rendering their results incomparable, complicating their translation into clinical practice. As a first step in the development of a core outcome set that will aim to homogenise outcome measures in future RCTs, we assessed the outcomes reported in recent relevant RCTs and systematic reviews.We conducted a methodological systematic review (https://www.crd.york.ac.uk/prospero/registration number CRD42016052437) of RCTs and systematic reviews on COPD exacerbation management indexed on Medline and PubMed during the last decade. We evaluated their methodology, specifically focusing on the reported outcome measures.Based on 123 RCTs and 38 systematic reviews, we found significant variability in the outcomes reported and in their definition. Mortality, which was assessed in 82% of the included trials, was the most frequently assessed outcome, followed by the rate of treatment success or failure (63%), adverse events (59%), health status, symptoms and quality of life (59%), lung function (47%), and duration of exacerbations (42%).The significant heterogeneity in the selection and definition of outcome measures in RCTs and systematic reviews limits the interpretability and comparability of their results, and warrants the development of a core outcome set for COPD exacerbations management.
Exploring the potential benefits of digital health technology for the management of COPD: a qualitative study of patient perceptions
Authors: Slevin Patrick , Kessie Threase , Cullen John , Butler Marcus W. , Donnelly Seamas C. , Caulfield Brian 
Published: May 2019

Engaging chronic obstructive pulmonary disease (COPD) patients to actively participate in self-management has proven difficult. Digital health technology (DHT) promises to facilitate a patient-centred care model for the management of COPD by empowering patients to self-manage effectively. However, digital health studies in COPD have yet to demonstrate significant patient outcomes, suggesting that this research has still to adequately address the needs of patients in the intervention development process. The current study explored COPD patients' perceptions of the potential benefits of DHT in the self-management and treatment of their disease.A sample of convenience was chosen and participants (n=30) were recruited from two Dublin university hospitals and each underwent a qualitative semi-structured interview. Thematic analysis of the data was completed using NVivo 12 software.Six themes were identified: symptom management, anxiety management, interaction with physician, care management, personalising care and preventative intervention.In our findings, patients reported a willingness to take a more active role in self-management using DHT. They perceived DHT potentially enhancing their self-management by improving self-efficacy and engagement and by supporting healthcare professionals to practise preventative care provision. The findings can be used to inform patient-centred COPD digital interventions for researchers and clinicians who wish to develop study aims that align with the needs and preferences of patients.
The IllustrisTNG simulations: public data release
Authors: Nelson Dylan , Springel Volker , Pillepich Annalisa , Rodriguez-Gomez Vicente , Torrey Paul , Genel Shy , Vogelsberger Mark , Pakmor Ruediger , Marinacci Federico , Weinberger Rainer , Kelley Luke , Lovell Mark , Diemer Benedikt , Hernquist Lars 
Published: May 2019

AbstractWe present the full public release of all data from the TNG100 and TNG300 simulations of the IllustrisTNG project. IllustrisTNG is a suite of large volume, cosmological, gravo-magnetohydrodynamical simulations run with the moving-mesh code Arepo. TNG includes a comprehensive model for galaxy formation physics, and each TNG simulation self-consistently solves for the coupled evolution of dark matter, cosmic gas, luminous stars, and supermassive black holes from early time to the present day, $z=0$
z
=
0
. Each of the flagship runs—TNG50, TNG100, and TNG300—are accompanied by halo/subhalo catalogs, merger trees, lower-resolution and dark-matter only counterparts, all available with 100 snapshots. We discuss scientific and numerical cautions and caveats relevant when using TNG.The data volume now directly accessible online is ∼750 TB, including 1200 full volume snapshots and ∼80,000 high time-resolution subbox snapshots. This will increase to ∼1.1 PB with the future release of TNG50. Data access and analysis examples are available in IDL, Python, and Matlab. We describe improvements and new functionality in the web-based API, including on-demand visualization and analysis of galaxies and halos, exploratory plotting of scaling relations and other relationships between galactic and halo properties, and a new JupyterLab interface. This provides an online, browser-based, near-native data analysis platform enabling user computation with local access to TNG data, alleviating the need to download large datasets.
Eighteen-year trajectories of depressive symptoms in mothers with a lifetime eating disorder: findings from the ALSPAC cohort
Authors: Chua Yu Wei , Lewis Gemma , Easter Abigail , Lewis Glyn , Solmi Francesca 
Published: May 2019

BackgroundTwo longitudinal studies have shown that depressive symptoms in women with eating disorders might improve in the antenatal and early postnatal periods. No study has followed up women beyond 8 months postnatal.AimsTo investigate long-term trajectories of depressive symptoms in mothers with lifetime self-reported eating disorders.MethodUsing data from the Avon Longitudinal Study of Parents and Children and multilevel growth curves we modelled trajectories of depressive symptoms from the 18th week of pregnancy to 18 years postnatal in women with lifetime self-reported anorexia nervosa, bulimia nervosa or both anorexia and bulimia nervosa. As sensitivity analyses we also investigated these trajectories using quintiles of a continuous measure of body image in pregnancy.ResultsOf the 9276 women in our main sample, 126 (1.4%) reported a lifetime diagnosis of anorexia nervosa, 153 (1.6%) of bulimia nervosa and 60 (0.6%) of both anorexia and bulimia nervosa. Women with lifetime eating disorders had greater depressive symptoms scores than women with no eating disorders, before and after adjustment for confounders (anorexia nervosa: 2.10, 95% CI 1.36–2.83; bulimia nervosa: 2.28, 95% CI: 1.61–2.94, both anorexia and bulimia nervosa: 2.86, 95% CI 1.81–3.90). We also observed a dose–response association between greater body image and eating concerns in pregnancy and more severe trajectories of depressive symptoms, even after adjusting for lifetime eating disorders which also remained independently associated with greater depressive symptoms.ConclusionsWomen with eating disorders experience persistently greater depressive symptoms across the life-course. More training for practitioners and midwives on how to recognise eating disorders in pregnancy could help to identify depressive symptoms and reduce the long-term burden of disease resulting from this comorbidity.