bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification and Validation of Radiographic Enhancement for Reliable Differentiation of CD117(+) Benign Renal Oncocytoma and Chromophobe Renal Cell Carcinoma
Authors: Amin Jay , Xu Bo , Badkhshan Shervin , Creighton Terrance T. , Abbotoy Daniel , Murekeyisoni Christine , Attwood Kristopher M. , Schwaab Thomas , Hendler Craig , Petroziello Michael , Roche Charles L. , Kauffman Eric C. 
Published: May 2018

Abstract
Purpose: The diagnostic differential for CD117/KIT(+) oncocytic renal tumor biopsies is limited to benign renal oncocytoma versus chromophobe renal cell carcinoma (ChRCC); however, further differentiation is often challenging and requires surgical resection. We investigated clinical variables that might improve preoperative differentiation of CD117(+) renal oncocytoma versus ChRCC to avoid the need for benign tumor resection.
Experimental Design: A total of 124 nephrectomy patients from a single institute with 133 renal oncocytoma or ChRCC tumors were studied. Patients from 2003 to 2012 comprised a retrospective cohort to identify clinical/radiographic variables associated with renal oncocytoma versus ChRCC. Prospective validation was performed among consecutive renal oncocytoma/ChRCC tumors resected from 2013 to 2017.
Results: Tumor size and younger age were associated with ChRCC, and multifocality with renal oncocytoma; however, the most reliable variable for ChRCC versus renal oncocytoma differentiation was the tumor:cortex peak early-phase enhancement ratio (PEER) using multiphase CT. Among 54 PEER-evaluable tumors in the retrospective cohort [19 CD117(+), 13 CD117(−), 22 CD117-untested], PEER classified each correctly as renal oncocytoma (PEER &gt;0.50) or ChRCC (PEER ≤0.50), except for four misclassified CD117(−) ChRCC variants. Prospective study of PEER confirmed 100% accuracy of renal oncocytoma/ChRCC classification among 22/22 additional CD117(+) tumors. Prospective interobserver reproducibility was excellent for PEER scoring (intraclass correlation coefficient, ICC = 0.97) and perfect for renal oncocytoma/ChRCC assignment (ICC = 1.0).
Conclusions: In the largest clinical comparison of renal oncocytoma versus ChRCC to our knowledge, we identified and prospectively validated a reproducible radiographic measure that differentiates CD117(+) renal oncocytoma from ChRCC with potentially 100% accuracy. PEER may allow reliable biopsy-based diagnosis of CD117(+) renal oncocytoma, avoiding the need for diagnostic nephrectomy. Clin Cancer Res; 24(16); 3898–907. ©2018 AACR.
Outcomes and Management of Patients With Severe Pulmonary Vein Stenosis From Prior Atrial Fibrillation Ablation
Authors: Raeisi-Giglou Pejman , Wazni Oussama M. , Saliba Walid I. , Barakat Amr , Tarakji Khaldoun G. , Rickard John , Cantillon Daniel , Baranowski Bryan , Tchou Patrick J. , Bhargava Mandeep , Dresing Thomas J. , Callahan Thomas D. , Kanj Mohamed , Lindsay Bruce D. , Hussein Ayman A. 
Published: May 2018

Background:
Pulmonary vein (PV) stenosis remains a feared complication of atrial fibrillation ablation. Little is known about outcomes in patients with severe PV stenosis, especially about repeat ablations.

Methods:
In 10 368 patients undergoing atrial fibrillation ablation (2000–2015), computed tomography scans were obtained 3 to 6 months after ablation. The clinical outcomes in severe PV stenosis were determined.

RESULTS:
Severe PV stenosis was diagnosed in 52 patients (0.5%). This involved mostly the left superior PV (51% of severely stenosed veins). Percutaneous interventions were performed in 43 patients, and complications occurred in 5: 3 PV ruptures, 1 stroke, and 1 phrenic injury. Over a median follow-up of 25 months, 41 (79%) patients remained arrhythmia free. Repeat ablation was performed in 15 patients (7 from the main series and 8 from prior ablation at other institutions); of whom 10 had PV stents in place. Conduction recovery was noted in all but 2 of the stenosed or stented PVs, and areas with recovery were targeted with antral ablation. Lasso entrapment within stents occurred in 2 patients but eventually freed without complications. After redo ablation, preplanned stenting was performed in 3 patients and computed tomographic scans showed progression of concomitant stenoses in 1 patient (moderate to severe). No procedure-related deaths occurred.

Conclusions:
The incidence of severe PV stenosis is low but remains associated with significant morbidity. In patients with recurrent arrhythmia, conduction recovery at the stenosed or stented veins is common. Care must be taken to ablate antrally to avoid stenosis progression. In patients with prior PV stents, we suggest to avoid using Lasso.
Genetic Study of White Matter Integrity in UK Biobank (N=8448) and the Overlap With Stroke, Depression, and Dementia
Authors: Rutten-Jacobs Loes C.A. , Tozer Daniel J. , Duering Marco , Malik Rainer , Dichgans Martin , Markus Hugh S. , Traylor Matthew 
Published: May 2018

Background and Purpose—
Structural integrity of the white matter is a marker of cerebral small vessel disease, which is the major cause of vascular dementia and a quarter of all strokes. Genetic studies provide a way to obtain novel insights in the disease mechanism underlying cerebral small vessel disease. The aim was to identify common variants associated with microstructural integrity of the white matter and to elucidate the relationships of white matter structural integrity with stroke, major depressive disorder, and Alzheimer disease.

Methods—
This genome-wide association analysis included 8448 individuals from UK Biobank—a population-based cohort study that recruited individuals from across the United Kingdom between 2006 and 2010, aged 40 to 69 years. Microstructural integrity was measured as fractional anisotropy- (FA) and mean diffusivity (MD)-derived parameters on diffusion tensor images. White matter hyperintensity volumes (WMHV) were assessed on T2-weighted fluid-attenuated inversion recovery images.

Results—

We identified 1 novel locus at genome-wide significance (
VCAN
[versican]: rs13164785;
P
=3.7×10
−18
for MD and rs67827860;
P
=1.3×10
−14
for FA). LD score regression showed a significant genome-wide correlation between FA, MD, and WMHV (FA-WMHV rG 0.39 [SE, 0.15]; MD-WMHV rG 0.56 [SE, 0.19]). In polygenic risk score analysis, FA, MD, and WMHV were significantly associated with lacunar stroke, MD with major depressive disorder, and WMHV with Alzheimer disease.

Conclusions—

Genetic variants within the
VCAN
gene may play a role in the mechanisms underlying microstructural integrity of the white matter in the brain measured as FA and MD. Mechanisms underlying white matter alterations are shared with cerebrovascular disease, and inherited differences in white matter microstructure impact on Alzheimer disease and major depressive disorder.
Synergistic Effects of Enriched Environment and Task-Specific Reach Training on Poststroke Recovery of Motor Function
Authors: Jeffers Matthew Strider , Corbett Dale 
Published: May 2018

Background and Purpose—
Reach training in concert with environmental enrichment provides functional benefits after experimental stroke in rats. The present study extended these findings by assessing whether intensive task-specific reach training or enrichment initiated alone would provide similar functional benefit. Additionally, we investigated whether the 70% recovery rule, or a combined model of initial poststroke impairment, cortical infarct volume, and rehabilitation intensity, could predict recovery in the single-pellet task, as previously found for the Montoya staircase.

Methods—
Rats were trained on single-pellet reaching before middle cerebral artery occlusion via intracerebral injection of ET-1 (endothelin-1). There were 4 experimental groups: stroke+enrichment, stroke+reaching, stroke+enrichment+reaching, and sham+enrichment+reaching. Reaching rehabilitation utilized a modified Whishaw box that encouraged impaired forelimb reaching for 6 hours per day, 5 days per week, for 4 weeks. All treatment paradigms began 7 days after ischemia with weekly assessment on the single-pellet task during rehabilitation and again 4 weeks after rehabilitation concluded.

Results—
Rats exposed to the combination of enrichment and reaching showed the greatest improvement in pellet retrieval and comparable performance to shams after 3 weeks of treatment, whereas those groups that received a monotherapy remained significantly impaired at all time points. Initial impairment alone did not significantly predict recovery in single-pellet as the 70% rule would suggest; however, a combined model of cortical infarct volume and rehabilitation intensity predicted change in pellet retrieval on the single-pellet task with the same accuracy as previously shown with the staircase, demonstrating the generalizability of this model across reaching tasks.

Conclusions—
Task-specific reach training and environmental enrichment have synergistic effects in rats that persist long after rehabilitation ends, and this recovery is predicted by infarct volume and rehabilitation intensity.
A new species of Nagumoea (Bacillariophyta) from Antarctica, and a further consideration of the systematic position of the genus
Authors: VAN DE VIJVER BART , KOCIOLEK J. PATRICK 
Published: May 2018

Nagumoea livingstonensis sp. nov., a new diatom species is described from a coastal pool on the Maritime Antarctic Livingston Island, South Shetland Islands, based on light and scanning electron microscopy observations. A morphological comparison is made with the two other known Nagumoea taxa. The new species can be separated by the clear hyaline line between the valve face and mantle areolae, differences in the structure of its a scalariform valvocopula and broader fibulae. The taxonomic position of the genus Nagumoea is discussed. A placement within the Rhopalodiales is doubtful based on the absence of clover-shaped areolae coverings in Nagumoea making the order of Bacillariales a more probable position.
Leucovorin, Fluorouracil, and Oxaliplatin (FOLFOX 4) Regimen for Colorectal Cancer
Authors: Waddell J. Aubrey , Russell Martin , Solimando Dominic A. 
Published: May 2018

The increasing complexity of cancer chemotherapy heightens the requirement that pharmacists be familiar with these highly toxic agents. This column will review various issues related to preparation, dispensing, and administration of cancer chemotherapy. It will also serve as a review of various agents, both commercially available and investigational, used to treat malignant diseases. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the US Department of the Army or the Department of Defense.
Hospital Reimbursement for Adult Patients with Severe Sepsis Treated with Drotrecogin Alfa (Activated)
Authors: Smith Brian S. , Schroeder Walter S. , Tataronis Gary R. 
Published: May 2018

Purpose Patients with severe sepsis are critically ill and use a high level of health care resources. The high resource utilization and lack of a specific diagnosis related group may lead to a significant loss in revenue for health care organizations secondary to inadequate reimbursement. The primary objective of this study is to quantify the difference in total cost and reimbursement in patients with severe sepsis treated with drotrecogin alfa (activated) (DAA) at our institution. Methods All patients between December 2001 and December 2003 diagnosed with severe sepsis and treated with DAA were evaluated. Demographic data, primary payer, diagnosis related group, hospital length of stay, length of medical/surgical stay, length of Intensive Care Unit stay, days on mechanical ventilation, total costs, and total reimbursement were determined by chart review and our institution's information systems. Results Data from a total of 71 patients were included. The total treatment cost was $6,294,590, and the total reimbursement received was $4,295,950. This represents a loss of $1,998,640 or $28,150 per patient. The primary factor contributing to this loss was Intensive Care Unit length of stay (P = 0.011). Conclusion Management of patients with severe sepsis is costly and strains hospital resources. The current reimbursement system does not allow for appropriate compensation. Therefore, in addition to efforts directed toward improved treatment strategies for severe sepsis, health care practitioners must target interventions to reduce hospital length of stay and maximize reimbursement.
Hydromorphone Hydrochloride Extended-Release Capsules (C-II)
Authors: Cada Dennis J. , Levien Terri , Baker Danial E. 
Published: May 2018

Each month, subscribers to The Formulary Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late Phase III trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and CD ROM forms and are available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The January 2005 monograph topics are natalizumab, solifenacin succinate, vincristine sulfate liposomes injection, sodium tetradecyl sulfate injection, and testosterone transdermal. The DUE is on natalizumab.
Identifying positive deviants in healthcare quality and safety: a mixed methods study
Authors: O’Hara Jane K , Grasic Katja , Gutacker Nils , Street Andrew , Foy Robbie , Thompson Carl , Wright John , Lawton Rebecca 
Published: May 2018

Objective Solutions to quality and safety problems exist within healthcare organisations, but to maximise the learning from these positive deviants, we first need to identify them. This study explores using routinely collected, publicly available data in England to identify positively deviant services in one region of the country. Design A mixed methods study undertaken July 2014 to February 2015, employing expert discussion, consensus and statistical modelling to identify indicators of quality and safety, establish a set of criteria to inform decisions about which indicators were robust and useful measures, and whether these could be used to identify positive deviants. Setting Yorkshire and Humber, England. Participants None - analysis based on routinely collected, administrative English hospital data. Main outcome measures We identified 49 indicators of quality and safety from acute care settings across eight data sources. Twenty-six indicators did not allow comparison of quality at the sub-hospital level. Of the 23 remaining indicators, 12 met all criteria and were possible candidates for identifying positive deviants. Results Four indicators (readmission and patient reported outcomes for hip and knee surgery) offered indicators of the same service. These were selected by an expert group as the basis for statistical modelling, which supported identification of one service in Yorkshire and Humber showing a 50% positive deviation from the national average. Conclusion Relatively few indicators of quality and safety relate to a service level, making meaningful comparisons and local improvement based on the measures difficult. It was possible, however, to identify a set of indicators that provided robust measurement of the quality and safety of services providing hip and knee surgery.
Fatty Infiltration Is a Prognostic Marker of Muscle Function After Rotator Cuff Tear
Authors: Valencia Ana P. , Lai Jim K. , Iyer Shama R. , Mistretta Katherine L. , Spangenburg Espen E. , Davis Derik L. , Lovering Richard M. , Gilotra Mohit N. 
Published: May 2018

Background: Massive rotator cuff tears (RCTs) begin as primary tendon injuries and cause a myriad of changes in the muscle, including atrophy, fatty infiltration (FI), and fibrosis. However, it is unclear which changes are most closely associated with muscle function. Purpose: To determine if FI of the supraspinatus muscle after acute RCT relates to short-term changes in muscle function. Study Design: Controlled laboratory study. Methods: Unilateral RCTs were induced in female rabbits via tenotomy of the supraspinatus and infraspinatus. Maximal isometric force and rate of fatigue were measured in the supraspinatus in vivo at 6 and 12 weeks after tenotomy. Computed tomography scanning was performed, followed by histologic analysis of myofiber size, FI, and fibrosis. Results: Tenotomy resulted in supraspinatus weakness, reduced myofiber size, FI, and fibrosis, but no differences were evident between 6 and 12 weeks after tenotomy except for increased collagen content at 12 weeks. FI was a predictor of supraspinatus weakness and was strongly correlated to force, even after accounting for muscle cross-sectional area. While muscle atrophy accounted for the loss in force in tenotomized muscles with minimal FI, it did not account for the greater loss in force in tenotomized muscles with the most FI. Collagen content was not strongly correlated with maximal isometric force, even when normalized to muscle size. Conclusion: After RCT, muscle atrophy results in the loss of contractile force from the supraspinatus, but exacerbated weakness is observed with increased FI. Therefore, the level of FI can help predict contractile function of torn rotator cuff muscles. Clinical Relevance: Markers to predict contractile function of RCTs will help determine the appropriate treatment to improve functional recovery after RCTs.
A Standardized Protocol for the Prospective Follow-Up of Cleft Lip and Palate Patients
Authors: Salimi Negar , Jolanta Aleksejūnienė , Edwin Yen , Angelina Loo 
Published: May 2018

Objective: To develop a standardized all-encompassing protocol for the assessment of cleft lip and palate patients with clinical and research implications. Method: Electronic database searches were conducted and 13 major cleft centers worldwide were contacted in order to prepare for the development of the protocol. In preparation, the available evidence was reviewed and potential fistula-related risk determinants from 4 different domains were identified. Results: No standardized protocol for the assessment of cleft patients could be found in any of the electronic database searches that were conducted. Interviews with representatives from several major centers revealed that the majority of centers do not have a standardized comprehensive strategy for the reporting and follow-up of cleft lip and palate patients. The protocol was developed and consisted of the following domains of determinants: (1) the sociodemographic domain, (2) the cleft defect domain, (3) the surgery domain, and (4) the fistula domain. Conclusion: The proposed protocol has the potential to enhance the quality of patient care by ensuring that multiple patient-related aspects are consistently reported. It may also facilitate future multicenter research, which could contribute to the reduction of fistula occurrence in cleft lip and palate patients.
Adherence to topical glaucoma medications and associated factors in Gondar University Hospital Tertiary Eye Care Center, northwest Ethiopia
Authors: Anbesse Dereje Hayilu , Yibekal Betelhem Temesgen , Assefa Natnael Lakachew 
Published: May 2018

Purpose: The purpose of the study was to determine proportion of adherence to topical glaucoma medications and associated factors among glaucoma patients in Gondar University Hospital Tertiary Eye Care and Training Center, northwest Ethiopia. Methods: This cross-sectional design study was conducted on 360 participants from April–May 2017. Structured questionnaire was completed and adherence was assessed by patients’ self-report survey. The data were analyzed by SPSS version 20. Multivariate logistic regression was used to identify the determinant factors. The significance was considered at p value less than 0.05. Result: More than half, 221 (61.4%) (95% confidence interval: 56.1–66.7), of the study participants were found to adhere well to glaucoma medications. Male sex (adjusted odds ratio = 1.86 (95% confidence interval: 1.13–3.06)), urban residence (adjusted odds ratio = 2.33 (95% confidence interval: 1.46–3.72)), normal visual acuity (adjusted odds ratio = 2.23 (95% confidence interval: 1.13–4.42)), low visual acuity (adjusted odds ratio = 1.74 (95% confidence interval: 1.05–2.88)), and self-sponsor for medications (adjusted odds ratio = 0.21 (95% confidence interval: 0.12–0.38)) were significantly associated with good adherence Conclusion: The level of medication adherence to topical glaucoma medications is not good enough as compared to other studies done in Ethiopia. Male sex, urban residence, normal, and low visual acuity were positive predictors, whereas self-sponsored for medications was negative predictors for good adherence to glaucoma medications.
Nostalgia as a psychological resource for people with dementia: A systematic review and meta-analysis of evidence of effectiveness from experimental studies
Authors: Umar Ismail Sanda , Cheston Richard , Christopher Gary , Meyrick Jane 
Published: May 2018

Objective This review systematically examines evidence relating to the effect of nostalgia on psychological well-being through a meta-analysis of measures of social connectedness, self-esteem, meaning in life, self-continuity, optimism and positive and negative affect. Rationale: If nostalgia is to be used as a clinical intervention to boost well-being in dementia by reducing threat, then it is important to assess its therapeutic potential. Results Searches carried out in July 2014 and updated in February 2018 identified 47 eligible experimental studies comparing nostalgic reminiscence and non-nostalgic reminiscence to be included in the meta-analysis. Nostalgic reminiscence had moderate effects on positive affect (0.51 (0.37, 0.65), p= 0.001), social connectedness (0.72 (0.57, 0.87), p= 0.001), self-esteem (0.50 (0.30, 0.70), p= 0.001), meaning in life (0.77 (0.47, 1.08), p= 0.001) and optimism (0.38 (0.28, 0.47), p= 0.001) and a large effect on self-continuity (0.81 (0.55, 1.07), p= 0.001). There was, however, no difference between the effect of nostalgic reminiscence and non-nostalgic reminiscence for negative affect (−0.06 (−0.20, 0.09), p= 0.443). Conclusion This systematic review and meta-analysis provides an overview of the evidence base for nostalgia. This is an important stage in developing nostalgia as a clinical intervention for people with dementia which might be achieved, for instance, by adapting current reminiscence and life review techniques. This meta-analysis will therefore also serve as a valuable reference point for the continued exploration of nostalgia as an intervention.