bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salvage craniotomy for treatment-refractory symptomatic cerebral radiation necrosis
Authors: Shah Ashish H , Mahavadi Anil K , Morell Alexis , Eichberg Daniel G , Luther Evan , Sarkiss Christopher A , Semonche Alexa , Ivan Michael E , Komotar Ricardo J 
Published: July 2019

Abstract

Background
The incidence of symptomatic radiation necrosis (RN) has risen as radiotherapy is increasingly used to control brain tumor progression. Traditionally managed with steroids, symptomatic RN can remain refractory to medical treatment, requiring surgical intervention for control. The purpose of our study was to assess a single institution’s experience with craniotomy for steroid-refractory pure RN.

Methods
The medical records of all tumor patients who underwent craniotomies at our institution from 2011 to 2016 were retrospectively reviewed for a history of preoperative radiotherapy or radiosurgery. RN was confirmed histopathologically and patients with active tumor were excluded. Preoperative, intraoperative, and outcome information was collected. Primary outcomes measured were postoperative KPS and time to steroid freedom.

Results
Twenty-four patients with symptomatic RN were identified. Gross total resection was achieved for all patients. Patients with metastases experienced an increase in KPS (80 vs 100, P &lt; .001) and required a shortened course of dexamethasone vs patients with high-grade gliomas (3.4 vs 22.2 weeks, P = .003). RN control and neurological improvement at 13.3 months’ follow-up were 100% and 66.7%, respectively. Adrenal insufficiency after rapidly tapering dexamethasone was the only morbidity (n = 1). Overall survival was 93.3% (14/15) at 1 year.

Conclusion
In cases of treatment-refractory symptomatic RN, resection can lead to an overall improvement in postoperative health status and neurological outcomes with minimal RN recurrence. Craniotomy for surgically accessible RN can safely manage symptomatic patients, and future studies assessing the efficacy of resection vs bevacizumab may be warranted.
Expanding Hepatitis C Virus Care and Cure: National Experience Using a Clinical Pharmacist–Driven Model
Authors: Koren David E , Zuckerman Autumn , Teply Robyn , Nabulsi Nadia A , Lee Todd A , Martin Michelle T 
Published: July 2019

AbstractBackgroundThe US National Viral Hepatitis Action Plan depends on additional providers to expand hepatitis C virus (HCV) treatment capacity in order to achieve elimination goals. Clinical pharmacists manage treatment and medication within interdisciplinary teams. The study’s objective was to determine sustained virologic response (SVR) rates for clinical pharmacist–delivered HCV therapy in an open medical system.MethodsInvestigators conducted a multicenter retrospective cohort study of patients initiating direct-acting antivirals from January 1, 2014, through March 12, 2018. Data included demographics, comorbidities, treatment, and clinical outcomes. The primary outcome of SVR was determined for patients initiating (intent-to-treat) and those who completed (per-protocol) treatment. Chi-square tests were conducted to identify associations between SVR and adverse reactions, drug–drug interactions, and adherence.ResultsA total of 1253 patients initiated treatment; 95 were lost to follow-up, and 24 discontinued therapy. SVR rates were 95.1% (1079/1134) per protocol and 86.1% (1079/1253) intent to treat. The mean age (SD) was 57.4 (10.1) years, the mean body mass index (SD) was 28.7 (6.2) kg/m2, 63.9% were male, 53.7% were black, 40.3% were cirrhotic, 88.4% were genotype 1, and 81.6% were treatment-naïve. Patients missing ≥1 dose had an SVR of 74.9%; full adherence yielded 90% (P &lt; .0001).ConclusionsHCV treatment by clinical pharmacists in an open medical system resulted in high SVR rates comparable to real-world studies with specialists and nonspecialists. These findings demonstrate the success of a clinical pharmacist–delivered method for HCV treatment expansion and elimination.
Striving for State of the Art with Paradigm Interplay and Meta-Synthesis: Purpose-oriented Network Research Challenges and Good Research Practices as a Way Forward
Authors: Lemaire Robin H , Mannak Remco S , Ospina Sonia M , Groenleer Martijn 
Published: July 2019

AbstractWith the growing amount and increasing heterogeneity of research on purpose-oriented networks (PONs) in the public sector, it is imperative to find a way to synthesize this research. Drawing on the varied research perspectives on PONs, we advance the idea of paradigm interplay and meta-synthesis as aspirations for the field and argue this is especially key if we want the study of PONs to inform practice. However, we recognize several challenges in the current state of the PON research that prevent the field from making strides in paradigm interplay and meta-synthesis. We discuss six challenges which we consider the most critical: different labels, differences across research foci, variation in measurement, the nestedness of networks, the dynamism of networks, and variation in the network context. We suggest six good research practices that could contribute to overcoming the challenges now so as to make integration of the research field more of a possibility in the future.
Investor Information Acquisition and Money Market Fund Risk Rebalancing during the 2011–2012 Eurozone Crisis*
Authors: Gallagher Emily A , Schmidt Lawrence D W , Timmermann Allan , Wermers Russ 
Published: July 2019

Abstract
We study investor redemptions and portfolio rebalancing decisions of prime money market mutual funds (MMFs) during the Eurozone crisis. We find that sophisticated investors selectively acquire information about MMFs’ risk exposures to Europe, which leads managers to withdraw funding from information-sensitive European issuers. That is, MMF managers, particularly those serving the most sophisticated investors, selectively adjust their portfolio risk exposures to avoid information-sensitive European risks, while maintaining or increasing risk exposures to other regions. This mechanism helps to explain the occurrence of selective “dry-ups” in debt markets where delegation is common and returns to information production are usually low. (JEL G01, G21, G23)
Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Effects of Conditioned Pain Modulation on the Nociceptive Flexion Reflex in Healthy People
Authors: Dhondt Evy , Van Oosterwijck Sophie , Coppieters Iris , Danneels Lieven , Van Oosterwijck Jessica 
Published: July 2019

Objectives:
The nociceptive flexion reflex (NFR) is a spinal reflex induced by painful stimuli resulting in a withdrawal response. Research has shown that the NFR is inhibited through endogenous pain inhibitory mechanisms, which can be assessed by conditioned pain modulation (CPM) paradigms. Although accumulating research suggests that the NFR can be affected by CPM, no clear overview of the current evidence exists. Therefore, the present review aimed at providing such a synthesis of the literature. In addition, the influence of personal factors on the CPM of the NFR was investigated.

Materials and Methods:
A systematic review was performed and reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Five electronic databases were searched to identify relevant articles. Retrieved articles were screened on eligibility using predefined inclusion criteria. Risk of bias was investigated according to the modified Newcastle-Ottawa Scale. Levels of evidence and strength of conclusion were assigned following the guidelines of the Dutch Institute for Healthcare Improvement.

Results:
Forty articles were included. There is some evidence that CPM produced by thermal or mechanical stimuli induces inhibitory effects on the NFR. However, inconclusive evidence exists with regard to the effect of electrical conditioning stimuli. While several personal factors do not affect CPM of the NFR, increased cognitive interference is associated with reduced NFR inhibition.

Discussion:
The present review demonstrates that certain types of nociceptive conditioning stimuli have the potential to depress, at the spinal level, nociceptive stimuli elicited from distant body regions. Although CPM of the NFR seems to be robust to the influence of several personal factors, it can be affected by cognitive influences.
Outcomes of Neonates With Complex Medical Needs
Authors: Kieran Emily , Sara Rahnuma , Claydon Jennifer , Hait Valoria , de Salaberry Julie , Osiovich Horacio , Shivananda Sandesh 
Published: July 2019

Background:
Children with complex medical needs (CMN) are high healthcare resource utilizers, have varying underlying diagnoses, and experience repeated hospitalizations. Outcomes on neonatal intensive care (NICU) patients with CMN are unknown.

Purpose:
The primary aim is to describe the clinical profile, resource use, prevalence, and both in-hospital and postdischarge outcomes of neonates with CMN. The secondary aim is to assess the feasibility of sustaining the use of the neonatal complex care team (NCCT).

Methods:
A retrospective cohort study was conducted after implementing a new model of care for neonates with CMN in the NICU. All neonates born between January 2013 and December 2016 and who met the criteria for CMN and were cared for by the NCCT were included.

Results:
One hundred forty-seven neonates with a mean (standard deviation) gestational age of 34 (5) weeks were included. The major underlying diagnoses were genetic/chromosomal abnormalities (48%), extreme prematurity (26%), neurological abnormality (12%), and congenital anomalies (11%). Interventions received included mechanical ventilation (69%), parenteral nutrition (68%), and technology dependency at discharge (91%). Mortality was 3% before discharge and 17% after discharge. Postdischarge hospital attendances included emergency department visits (44%) and inpatient admissions (58%), which involved pediatric intensive care unit admissions (26%).

Implications for Practice:
Neonates with CMN have multiple comorbidities, high resource needs, significant postdischarge mortality, and rehospitalization rates. These cohorts of NICU patients can be identified early during their NICU course and serve as targets for implementing innovative care models to meet their unique needs.

Implications for Research:
Future studies should explore the feasibility of implementing innovative care models and their potential impact on patient outcomes and cost-effectiveness.
Porphyromonas gingivalis and rheumatoid arthritis
Authors: Perricone Carlo , Ceccarelli Fulvia , Matteo Saccucci , Di Carlo Gabriele , Bogdanos Dimitrios P. , Lucchetti Ramona , Pilloni Andrea , Valesini Guido , Polimeni Antonella , Conti Fabrizio 
Published: July 2019

Purpose of review
To explore the pathogenic association between periodontal disease and rheumatoid arthritis focusing on the role of Porphyromonas gingivalis.

Recent findings
In the last decades our knowledge about the pathogenesis of rheumatoid arthritis substantially changed. Several evidences demonstrated that the initial production of autoantibodies is not localized in the joint, rather in other immunological-active sites. A central role seems to be played by periodontal disease, in particular because of the ability of P. gingivalis to induce citrullination, the posttranslational modification leading to the production of anticitrullinated protein/peptide antibodies, the most sensitive and specific rheumatoid arthritis biomarker.

Summary
The pathogenic role of P. gingivalis has been demonstrated in mouse models in which arthritis was either triggered or worsened in infected animals. P. gingivalis showed its detrimental role not only by inducing citrullination but also by means of other key mechanisms including induction of NETosis, osteoclastogenesis, and Th17 proinflammatory response leading to bone damage and systemic inflammation.
A Case of Adjacent, Clonally Distinct Borderline Melanocytic Tumors on the Arm
Authors: Schuler Andrew , Smith Mallory , Zahn Joseph , Wang Min , Noh Iris , Chan May P. , Andea Aleodor A. , Harms Paul W. 
Published: July 2019

Abstract:
Atypical Spitz tumor (AST) is a melanocytic proliferation that shares histopathologic features of Spitz nevus and spitzoid melanoma. Distinction of AST from spitzoid melanoma is critical because the majority of ASTs will follow an indolent course. Array-based comparative genomic hybridization (aCGH) has been suggested as a potential tool for evaluating malignant potential in spitzoid tumors. We present a case of a 52-year-old woman with an AST in which aCGH was crucial in guiding correct diagnosis and management. The patient first presented with a flesh-colored papule on her arm that was changing color. Biopsy revealed a dermal nevoid melanocytic tumor of indeterminate histopathology, favored to be a severely atypical nevus. The tumor was excised. One year later, another flesh-colored papule proximal to the excision site of the first tumor was biopsied and showed a predominantly dermal atypical spitzoid melanocytic proliferation with a differential diagnosis of AST versus spitzoid melanoma. Recurrent or metastatic melanoma was also a concern given proximity to the previous excision site. Molecular analysis of both lesions by aCGH revealed distinct molecular signatures, supporting the 2 tumors to be clonally unrelated. Furthermore, the new tumor displayed limited evidence of genomic instability, supporting classification as an AST with predicted indolent behavior. This case highlights the utility of aCGH in evaluating borderline melanocytic lesions, including assessment of malignant potential in ASTs, and clonality analysis to assist in exclusion of metastatic disease.
Intravascular Colonization of Kaposi Sarcoma: Expanding the Spectrum of Specific Infiltrates of B-Cell Chronic Lymphocytic Leukemia
Authors: Saggini Andrea , Del Poeta Giovanni , Santinelli Enrico , Bianchi Luca , Caposiena Caro Raffaele D. , Orlandi Augusto 
Published: July 2019

Abstract:
B-cell chronic lymphocytic leukemia (CLL), a low-grade malignancy consisting of CD5(+), CD23(+), and CD43(+) small B lymphocytes, is the most frequent leukemia in the western world. Patients with CLL may exhibit skin changes characterized by histopathologic evidence of infiltration by atypical B lymphocytes, also known as “specific cutaneous infiltrates of CLL”; in addition, CLL is known to be associated with an increased risk of second cancers, including Kaposi sarcoma (KS). The combination of KS and CLL within the same cutaneous biopsy specimen has only rarely been described. We report a peculiar case of KS occurring in a patient with CLL, in which histopathological evaluation of KS lesions revealed prominent accumulation of CLL lymphocytes within neoplastic vascular spaces. We believe that our findings represent a novel example of intravascular colonization of vascular neoplasms by neoplastic lymphoid cells, further expanding the evergrowing spectrum of specific cutaneous infiltrates of CLL.
Official International Association for Therapeutic Drug Monitoring and Clinical Toxicology Guideline: Development and Validation of Dried Blood Spot–Based Methods for Therapeutic Drug Monitoring
Authors: Capiau Sara , Veenhof Herman , Koster Remco A. , Bergqvist Yngve , Boettcher Michael , Halmingh Otto , Keevil Brian G. , Koch Birgit C.P. , Linden Rafael , Pistos Constantinos , Stolk Leo M. , Touw Daan J. , Stove Christophe P. , Alffenaar Jan-Willem C. 
Published: July 2019

Abstract:
Dried blood spot (DBS) analysis has been introduced more and more into clinical practice to facilitate Therapeutic Drug Monitoring (TDM). To assure the quality of bioanalytical methods, the design, development and validation needs to fit the intended use. Current validation requirements, described in guidelines for traditional matrices (blood, plasma, serum), do not cover all necessary aspects of method development, analytical- and clinical validation of DBS assays for TDM. Therefore, this guideline provides parameters required for the validation of quantitative determination of small molecule drugs in DBS using chromatographic methods, and to provide advice on how these can be assessed. In addition, guidance is given on the application of validated methods in a routine context. First, considerations for the method development stage are described covering sample collection procedure, type of filter paper and punch size, sample volume, drying and storage, internal standard incorporation, type of blood used, sample preparation and prevalidation. Second, common parameters regarding analytical validation are described in context of DBS analysis with the addition of DBS-specific parameters, such as volume-, volcano- and hematocrit effects. Third, clinical validation studies are described, including number of clinical samples and patients, comparison of DBS with venous blood, statistical methods and interpretation, spot quality, sampling procedure, duplicates, outliers, automated analysis methods and quality control programs. Lastly, cross-validation is discussed, covering changes made to existing sampling- and analysis methods. This guideline of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology on the development, validation and evaluation of DBS-based methods for the purpose of TDM aims to contribute to high-quality micro sampling methods used in clinical practice.
Tacrolimus Levels in the Prophylaxis of Acute Graft-Versus-Host Disease in the Chinese Early After Hematopoietic Stem Cell Transplantation
Authors: Tian Ji-Xin , Zhang Ping , Miao Wen-Juan , Wang Xiao-Dan , Liu Xue-Ou , Liao Ying-Xi , Li Shan , Yan Hai-Hong 
Published: July 2019

Background:
Tacrolimus has been widely accepted as the backbone of acute graft-versus-host disease (aGVHD) prophylaxis in allogeneic hematopoietic stem cell transplantation (alloHSCT). The present work evaluated whether tacrolimus concentrations early after transplant correlate with the incidence of aGVHD in Chinese alloHSCT recipients.

Methods:
One hundred four Chinese alloHSCT recipients were included in this retrospective study. All patients received standard prophylaxis with tacrolimus and short-term methotrexate. Blood samples were taken at steady-state for those on i.v. tacrolimus (Cv) or predose (C0) and 2 hours after the last oral dose (C2).

Results:
In the first 8 weeks after alloHSCT, significant variability in Cv, C0, and C2 of Chinese patients was observed. It was found that higher tacrolimus C0 and C2 values tended to be associated with a reduced risk of aGVHD, although this was a nonsignificant trend due to the small sample size involved. Receiver operating characteristic curve analysis indicated that Cv levels of ≥16.52 ng/mL, C0 levels of ≥5.56 ng/mL, and C2 levels of ≥7.83 ng/mL minimized the incidence of treatment failure during weeks 3–4 with intravenous administration and weeks 5–6 with oral administration. There was no statistically significant association of the patient liver and kidney function with the blood concentration of tacrolimus in the desired range of 5–20 ng/mL.

Conclusions:
Tacrolimus therapeutic drug monitoring improved treatment outcomes of Chinese alloHSCT recipients. Cv measurements during weeks 3–4 and C0 or C2 measurements during weeks 5–6 better predicted aGVHD (I–IV) than the concentrations measured at other time points during the first 6 weeks after alloHSCT.
Association of the ESR1 polymorphism with menopause and MLXIPL genetic variant influence serum uric acid levels in Slovak midlife women
Authors: Vorobeľová Lenka , Danková Zuzana , Candráková-Čerňanová Veronika , Falbová Darina , Cvíčelová Marta , Beňuš Radoslav , Siváková Daniela 
Published: July 2019

Abstract

Objective:
This study examines associations between the ESR1 (XbaI, PvuII) and the MLXIPL (rs3812316) gene polymorphisms, and uric acid (UA) levels in Slovak midlife women, subdivided according to their menopause status.

Methods:
We assessed a total of 362 women from 38 to 65 years of age. Women were recruited from different localities in the western and middle parts of Slovakia. Participants were interviewed during their medical examination at local health centers. They were investigated with respect to a variety of aspects such as medical, anthropometrical, and lifestyle. Participants provided a blood sample for biochemical analyses and DNA genotyping. The MLXIPL gene (rs3812316 SNP variant) and ESR1 gene (PvuII and XbaI) genotypes were then detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Data were analyzed using general linear models and multiple linear regression analyses to adjust for risk factors elevating the UA level such as fat mass (FM), triglycerides (TGs) and creatinine.

Results:
A positive association between MLXIPL and UA level was observed in the total sample of women after control for confounding covariates, including FM, TGs, and creatinine (P = 0.027). Women with the CC genotype had higher UA levels than the G-allele carriers (261.5 μmol/L ± 68.3 vs 241.1 μmol/L ± 55.1 P = 0.013). A statistically significant association was noticed between postmenopause status and the ESR1 XbaI genotype and their effect on UA (P = 0.028). The Bonferroni pairwise comparison determined that the G-allele carriers in the postmenopausal period had higher estimated UA marginal mean (269.7 μmol/L) than the AA-allele postmenopausal women (236.5 μmol/L) (P = 0.012). The estimated UA marginal mean showed a significant increasing trend according to the MS in G allele carriers (248.5 μmol/L in pre/peri-menopausal vs 269.7 μmol/L in postmenopausal, P = 0.009). In contrast, a decreasing trend was observed in AA carriers (250.6 μmol/L in pre/perimenopausal women vs 236.5 μmol/L in postmenopausal). However, this trend was not statistically significant (P = 0.288).

Conclusions:
This cross-sectional study suggests that MLXIPL (rs3812316) polymorphism is associated with higher serum UA levels and that the ESR1 (XbaI) polymorphism is associated with UA levels only in the postmenopausal cohort.
Disparities in Receipt of Bariatric Surgery in Canada
Authors: Zhang Joyce C. , Tomlinson George , Wnuk Susan , Sockalingam Sanjeev , Cram Peter 
Published: July 2019

Background:
Patients with lower socioeconomic status (SES) in the United States have reduced access to many health services including bariatric surgery. It is unclear whether disparities in bariatric surgery exist in countries with government-sponsored universal health benefits. The authors used data from a large regional Canadian bariatric surgery referral center to examine the relationship between SES and receipt of bariatric surgery.

Methods:
The Toronto Western Hospital bariatric surgery registry was used to identify all adults referred for bariatric surgery assessment from 2010 to 2017. The authors compared demographics, SES measures, and clinical measures among patients who did not and did undergo bariatric surgery (Roux-en-Y or sleeve gastrectomy). Multiple logistic regression was used to examine differences in receipt of bariatric surgery according to patient demographic characteristics and SES factors.

Results:
Among 2417 patients included in the study, 646 (26.7%) did not receive surgery and 1771 patients (73.2%) did. Patients who did not undergo surgery were more likely to be male individual (29.1% vs. 19.3%; P<0.001), black (12.1% vs. 8.3%; P=0.005), South Asian/Middle Eastern (8.2% vs. 4.5%; P<0.001), and less likely to be white (68.9% vs. 76.7%; P<0.001). In multiple logistic regression, factors associated with not receiving surgery were male sex, Black and South Asian/Middle Eastern ethnicity, being single, lack of employment, and history of psychiatric illness.

Conclusions:
Among patients referred for bariatric surgery, those who were male individuals, nonwhite, single, and unemployed were less likely to undergo surgery. Our results suggest that even with equal insurance, there are disparities in receipt of bariatric surgery.